When Creative Problem Solving Strategy Meets Web-Based Cooperative Learning Environment in Accounting Education

ERIC Educational Resources Information Center

Cheng, Kai Wen

2011-01-01

Background: Facing highly competitive and changing environment, cultivating citizens with problem-solving attitudes is one critical vision of education. In brief, the importance of education is to cultivate students with practical abilities. Realizing the advantages of web-based cooperative learning (web-based CL) and creative problem solving…

An investigation of new inhibitors to mitigate rebar corrosion in concrete.

DOT National Transportation Integrated Search

1996-01-01

Rebar corrosion in concrete is the most costly and performance-limiting problem facing the nation's infrastructure. One of the most practical and economical approaches to this problem is to use corrosion inhibitors in a quality concrete mix for new c...

In search of evidence-based plastic surgery: the problems faced by the specialty.

PubMed

Offer, G J; Perks, A G

2000-07-01

Recently, there has been significant interest both from government and medical practitioners in the discipline of evidence-based medicine. In this article we discuss the problems faced by the plastic surgeon when trying to ensure that practice is evidence-based and highlight some of the reasons behind these difficulties. With the rapid growth of the Internet we also outline its use to access high quality information for the plastic surgeon. Copyright 2000 The British Association of Plastic Surgeons.

Responsive Teaching, Informal Learning and Cultural Tools in Year Nine Ensemble Practice: A Lost Opportunity

ERIC Educational Resources Information Center

Wallerstedt, Cecilia; Pramling, Niklas

2016-01-01

In the present study we investigate what problems adolescents in year-nine compulsory school face when trying to learn to play a song together, how they take on these, and how their teacher responds to these problems. The studied practice, where students are to form a band and learn to play a song together in music class, is an example of…

Task Design for L2 Oral Practice in Audioblogs

ERIC Educational Resources Information Center

Appel, Christine; Borges, Federico

2012-01-01

The development of oral skills poses a challenge in language teaching whether this takes place face-to-face, through distance education or in blended learning contexts. Two main problems arise: first of all students don't have enough opportunity to use their target language orally, and secondly, students oral performance is mostly unrecorded and…

Teaching the Content Subjects to Indochinese Students.

ERIC Educational Resources Information Center

Thuy, Vuong G.

Indochinese children entering American schools face many problems in learning the content area subjects. The problems include the tremendous linguistic barrier, differences in American and Indochinese educational practices, values, expectations, and patterns of thinking, and misplacement in American schools based on the age of Indochinese…

Feasibility of an online and a face-to-face version of a self-management program for young adults with a rheumatic disease: experiences of young adults and peer leaders

PubMed Central

2014-01-01

Background Based on the self-efficacy theory, an online and a face-to-face self-management programs ‘Challenge your Arthritis’ for young adults with a rheumatic disease have recently been developed. These two courses are led by young peer leaders. The objective of this study was to test the feasibility of the online and face-to-face self-management program. Methods Feasibility was evaluated on items of perceived usefulness, perceived ease of use, user-acceptance, and adherence to both programs in young adults and peer leaders. Additional analyses of interactions on the e-Health applications, discussion board and chat board, were conducted. Results Twenty-two young adults with a diagnosed rheumatic disease participated in the study: 12 young adults followed the online program and 10 followed the face-to-face program. Both programs appeared to be feasible, especially in dealing with problems in daily life, and the participants indicated the time investment as ‘worthwhile’. In using the online program, no technical problems occurred. Participants found the program easy to use, user friendly, and liked the ‘look and feel’ of the program. Conclusions Both the online and the face-to-face versions of a self-management program. ‘Challenge your arthritis’ were found to be feasible and well appreciated by young adults with a rheumatic disease. Because these programs are likely to be a practical aid to health practices, a randomized controlled study to investigate the effects on patient outcomes is planned. PMID:24666817

Feasibility of an online and a face-to-face version of a self-management program for young adults with a rheumatic disease: experiences of young adults and peer leaders.

PubMed

Ammerlaan, Judy; van Os-Medendorp, Harmieke; Scholtus, Lieske; de Vos, André; Zwier, Matthijs; Bijlsma, Hans; Kruize, Aike A

2014-03-25

Based on the self-efficacy theory, an online and a face-to-face self-management programs 'Challenge your Arthritis' for young adults with a rheumatic disease have recently been developed. These two courses are led by young peer leaders. The objective of this study was to test the feasibility of the online and face-to-face self-management program. Feasibility was evaluated on items of perceived usefulness, perceived ease of use, user-acceptance, and adherence to both programs in young adults and peer leaders. Additional analyses of interactions on the e-Health applications, discussion board and chat board, were conducted. Twenty-two young adults with a diagnosed rheumatic disease participated in the study: 12 young adults followed the online program and 10 followed the face-to-face program. Both programs appeared to be feasible, especially in dealing with problems in daily life, and the participants indicated the time investment as 'worthwhile'. In using the online program, no technical problems occurred. Participants found the program easy to use, user friendly, and liked the 'look and feel' of the program. Both the online and the face-to-face versions of a self-management program. 'Challenge your arthritis' were found to be feasible and well appreciated by young adults with a rheumatic disease. Because these programs are likely to be a practical aid to health practices, a randomized controlled study to investigate the effects on patient outcomes is planned.

Parenting and the parallel processes in parents' counseling supervision for eating-related problems.

PubMed

Golan, Moria

2014-04-01

This paper presents an integrative model for supervising counselors of parents who face eating-related problems in their families. The model is grounded in the theory of parallel processes which occur during the supervision of health-care professionals as well as the counseling of parents and patients. The aim of this model is to conceptualize components and processes in the supervision space, in order to: (a) create a nurturing environment for health-care facilitators, parents and children, (b) better understand the complex and difficult nature of parenting, the challenge counselors face, and the skills and practices used in parenting and in counseling, and (c) better own practices and oppose the judgment that often dominates in counseling and supervision. This paper reflects upon the tradition of supervision and offers a comprehensive view of this process, including its challenges, skills and practices.

Brief report.

PubMed

Colnerud, Gunnel

2013-10-01

Most accounts of the ethical problems facing researchers across a broad spectrum of research fields come from ethicists, ethics committees, and specialists committed to the study of ethics in human research. In contrast, this study reports on the ethical questions that researchers, themselves, report facing in their everyday practice. Fifty-five Swedish researchers contributed 109 examples of ethical dilemmas, conflicts, and problems in research. They were all researchers at the postdoctoral level in the fields of medicine, the humanities, education, and the social sciences, who devoted at least 50 percent of their working hours to research. They reported issues they face before, during, and after gathering data. Their range of issues is broader than generally discussed and points to the importance of researchers' ethical sensitivity.

The Purebred and the Platypus: Disciplinarity and Site in Mass Communication Research.

ERIC Educational Resources Information Center

Kavoori, Anandam P.; Gurevitch, Michael

1993-01-01

Offers thoughts about some of the problems facing mass communication as a cultural practice by mapping briefly its historical constitutiveness (and the problems therein). Discusses the dimensions of communication research as site. Offers a diagnosis of how to view the avowed "fragmentation" of the field. (SR)

Methamphetamine and the Changing Face of Child Welfare: Practice Principles for Child Welfare Workers

ERIC Educational Resources Information Center

Connell-Carrick, Kelli

2007-01-01

Methamphetamine use and production is changing child welfare practice. Methamphetamine is a significant public health threat (National Institute of Justice, 1999) reaching epidemic proportions (Anglin, Burke, Perrochet, Stamper, & Dawud-Nouris, 2000). The manufacturing of methamphetamine is a serious problem for the child welfare system, yet…

Australian Schools and the Law: Principal, Teacher and Student.

ERIC Educational Resources Information Center

Knott, A. E.; And Others

This handbook on Australian school law is meant for practicing teachers, principals and other educators, parents, teacher training institutions, and lawyers in that country. It explains the basic principles underlying a large number of legal problems facing Australian teachers and offers practical guidance in dealing with them. Among the problems…

Understanding the use of email consultation in primary care using a retrospective observational study with data of Dutch electronic health records

PubMed Central

Huygens, Martine W J; Swinkels, Ilse C S; Verheij, Robert A; Friele, Roland D; van Schayck, Onno C P; de Witte, Luc P

2018-01-01

Objectives It is unclear why the use of email consultation is not more widespread in Dutch general practice, particularly because, since 2006, its costs can be reimbursed. To encourage further implementation, it is needed to understand the current use of email consultations. This study aims to understand the use of email consultation by different patient groups, compared with other general practice (GP) consultations. Setting For this retrospective observational study, we used Dutch routine electronic health record data obtained from NIVEL Primary Care Database for the years 2010 and 2014. Participants 200 general practices were included in 2010 (734 122 registered patients) and 434 in 2014 (1 630 386 registered patients). Primary outcome measures The number and percentage of email consultations and patient characteristics (age, gender, neighbourhood socioeconomic status and diagnoses) of email consultation users were investigated and compared with those who had a telephone or face-to-face consultation. General practice characteristics were also taken into account. Results 32.0% of the Dutch general practices had at least one email consultation in 2010, rising to 52.8% in 2014. In 2014, only 0.7% of the GP consultations were by email (the others comprised home visits, telephone and face-to-face consultations). Its use highly varied among general practices. Most email consultations were done for psychological (14.7%); endocrine, metabolic and nutritional (10.9%); and circulatory (10.7%) problems. These diagnosis categories appeared less frequently in telephone and face-to-face consultations. Patients who had an email consultation were older than patients who had a telephone or face-to-face consultation. In contrast, patients with diabetes who had an email consultation were younger. Conclusion Even though email consultation was done in half the general practices in the Netherlands in 2014, the actual use of it is extremely low. Patients who had an email consultation differ from those who had a telephone or face-to-face consultation. In addition, the use of email consultation by patients is dependent on its provision by GPs. PMID:29358442

Feasibility, acceptability and effectiveness of an online alternative to face-to-face consultation in general practice: a mixed-methods study of webGP in six Devon practices

PubMed Central

Carter, Mary; Fletcher, Emily; Sansom, Anna; Warren, Fiona C; Campbell, John L

2018-01-01

Objectives To evaluate the feasibility, acceptability and effectiveness of webGP as piloted by six general practices. Methods Mixed-methods evaluation, including data extraction from practice databases, general practitioner (GP) completion of case reports, patient questionnaires and staff interviews. Setting General practices in NHS Northern, Eastern and Western Devon Clinical Commissioning Group’s area approximately 6 months after implementing webGP (February–July 2016). Participants Six practices provided consultations data; 20 GPs completed case reports (regarding 61 e-consults); 81 patients completed questionnaires; 5 GPs and 5 administrators were interviewed. Outcome measures Attitudes and experiences of practice staff and patients regarding webGP. Results WebGP uptake during the evaluation was small, showing no discernible impact on practice workload. The completeness of cross-sectional data on consultation workload varied between practices. GPs judged 41/61 (72%) of webGP requests to require a face-to-face or telephone consultation. Introducing webGP appeared to be associated with shifts in responsibility and workload between practice staff and between practices and patients. 81/231 patients completed a postal survey (35.1% response rate). E-Consulters were somewhat younger and more likely to be employed than face-to-face respondents. WebGP appeared broadly acceptable to patients regarding timeliness and quality/experience of care provided. Similar problems were presented by all respondents. Both groups appeared equally familiar with other practice online services; e-consulters were somewhat more likely to have used them. From semistructured staff interviews, it appeared that, while largely acceptable within practice, introducing e-consults had potential for adverse interactions with pre-existing practice systems. Conclusions There is potential to assess the impact of new systems on consultation patterns by extracting routine data from practice databases. Staff and patients noticed subtle changes to responsibilities associated with online options. Greater uptake requires good communication between practice and patients, and organisation of systems to avoid conflicts and misuse. Further research is required to evaluate the full potential of webGP in managing practice workload. PMID:29449293

Advanced Tools for Smartphone-Based Experiments: Phyphox

ERIC Educational Resources Information Center

Staacks, S.; Hütz, S.; Stampfer, C.; Heinke, H.

2018-01-01

The sensors in modern smartphones are a promising and cost-effective tool for experimentation in physics education, but many experiments face practical problems. Often the phone is inaccessible during the experiment and the data usually needs to be analyzed subsequently on a computer. We address both problems by introducing a new app, called…

Bending Back on High School Programs for Youth with Learning Disabilities

ERIC Educational Resources Information Center

Edgar, Eugene

2005-01-01

In this opinion piece, the author views several major problems facing those who care about students labeled has having learning disabilities (LD). He believes that while there are technical problems that educators should be able to fix (definition of LD, best instructional practices for students so identified, powerful secondary programs that…

Projected Issues in the Practice of Educational Administration: The English Context.

ERIC Educational Resources Information Center

Browning, Peter

Current and incipient problems in educational administration in England can be grouped into two areas: those resulting from reorganization and those arising from social and political factors. Many problems faced by educational administrators result from school reorganization that is a result of an increase in the number of comprehensive schools.…

When Rural Meets Urban: The Transfer Problem Chinese Pre-Service Teachers Face in Teaching Practice

ERIC Educational Resources Information Center

Ye, Wangbei

2016-01-01

Traditional teacher education's supposed failure to prepare prospective teachers for classroom realities (the transfer problem) is a widely discussed topic in the teacher education literature. Previous studies have focused on causal relationships between teaching and such factors as pre-service teacher education programmes, contextual factors in…

Are the Editors faced with e-problems performing their duties and responsibilities satisfactorily?

PubMed

Ali Jawaid, Shaukat; Jawaid, Masood

2013-09-01

Astonishing revolution in information technology, developments in electronic publishing and availability of manuscript management software's has provided lot of facilities to authors, reviewers as well as editors but it has also given birth to lot of e-problems. This communication highlights some of these e-problems besides discussing the manuscript management system practiced by Pakistan Journal of Medical Sciences through modified Open Journal System. It also cautions the editors of small journals faced with financial and human resource constraints to keep themselves abreast of all these developments, go for automation in e publishing gradually as all the stake holders i.e. authors, reviewers and office management staff learns these and become used to it.

Training Design Conception and Reflexive Practice: How to Answer Teachers' Questions?

ERIC Educational Resources Information Center

Clottu, Régine

2017-01-01

This research studies the practices related to the conception of training "on demand" in the field of continuous training of teachers. Training "on demand" adapts itself to the problems of professionals. The analysis of the demand faces the complexity of the different contexts as well as the diversity of professionals'…

A Promising Practice: Using Facebook as a Communication and Social Networking Tool

ERIC Educational Resources Information Center

Schultz, Susan M.; Jacobs, Gloria; Schultz, Jacob

2013-01-01

Individuals with autism often face barriers to social interaction. Residing in a rural environment can compound these difficulties for individuals diagnosed with autism. Some of the reasons include transportation problems and small social networks, in addition to the characteristics of autism. This article discusses a promising practice for…

Childcare Practices among Construction Workers in Chira Chas, Jharkhand

ERIC Educational Resources Information Center

Dhar, Rajib

2012-01-01

This study aims at examining the childcare practices and issues experienced by the low-income construction workers in India. It is concerned with understanding varied aspects relating to problems that construction workers, as parents, face while bringing up their children in one of the small construction companies of eastern India, in the state of…

Ohio Vocational Consumer/Homemaking Curriculum Guide. Practical Action.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Instructional Materials Lab.

This curriculum guide helps students learn the technical skills of the occupation of homemaking. It also uses the process model of practical reasoning to assist men and women in taking action regarding the perennial problems that face individuals and families living in the world society. The first section provides the philosophy, aim, student…

Re-thinking pain educational strategies: Pain a new model using e-learning and PBL.

PubMed

Keyte, Donna; Richardson, Cliff

2011-02-01

Despite some high profile reorganisation including the introduction of acute pain teams, many patients still experience unnecessary pain. Traditional teaching and learning strategies seem to have made little impact in clinical practice. This paper explores the possible reasons for this and identifies the need to help postregistration students transfer (re-contextualise) what they are learning to practice. A new, more flexible pain management module utilising a blended face to face/e-learning approach within a problem-based learning philosophy was introduced to increase knowledge in pain management whilst also attempting to overcome the barriers to knowledge transfer into practice. This is done by challenging attitudes and encouraging students to explore their clinical practice alongside theoretical concepts. Copyright © 2010 Elsevier Ltd. All rights reserved.

The Changing Face of Agricultural Education in Nigeria: Challenges and Prospects

ERIC Educational Resources Information Center

Egun, A. C.

2010-01-01

Self sufficiency in food and raw material production for agro-based industries has been the thrust of Nigerian agricultural policy. Realizing the goals of the policy has been bedevilled with series of plethora problems. This paper took a look at agricultural reforms, examined the problems of agricultural practices and suggests education of the…

Multivariable feedback design - Concepts for a classical/modern synthesis

NASA Technical Reports Server (NTRS)

Doyle, J. C.; Stein, G.

1981-01-01

This paper presents a practical design perspective on multivariable feedback control problems. It reviews the basic issue - feedback design in the face of uncertainties - and generalizes known single-input, single-output (SISO) statements and constraints of the design problem to multiinput, multioutput (MIMO) cases. Two major MIMO design approaches are then evaluated in the context of these results.

Strengthening the Coordination of Pediatric Mental Health and Medical Care: Piloting a Collaborative Model for Freestanding Practices

ERIC Educational Resources Information Center

Greene, Carolyn A.; Ford, Julian D.; Ward-Zimmerman, Barbara; Honigfeld, Lisa; Pidano, Anne E.

2016-01-01

Background: Collaborative pediatric mental health and primary care is increasingly recognized as optimal for meeting the needs of children with mental health problems. This paper describes the challenges faced by freestanding specialty mental health clinics and pediatric health practices to provide such coordinated mind-and-body treatment. It…

Moderating Influence of Curriculum, Pedagogy, and Assessment Practices on Learning Outcomes in Indonesian Secondary Education

ERIC Educational Resources Information Center

Umami, Ida

2018-01-01

The purpose of this research was to examine the current situation and problems faced by Indonesian schools in curriculum, pedagogy, and assessment practices despite government's several legal initiatives. A questionnaire comprising both open and closed-ended questions was sent to the teachers and public education officers of the Indonesian…

A Theoretic and Research Basis for Reconceptualizing the Role of Professional Laboratory Experiences in Teacher Education.

ERIC Educational Resources Information Center

Haberman, Martin

A major problem in teacher education is the maintenance of beginning teachers' idealism in the face of practicing professionals' pragmatism. Teacher education programs train students in theories, concepts, and practices only to assign them to public schools, where the antithesis of everything the program attempted to teach is an accepted,…

Two management systems in a nursing private practice group.

PubMed

Zahourek, R P

1979-09-01

Entry into private practice can be rewarding for nurses who are willing to risk personal, financial, and professional security. Among the problems faced by the nurse in this new role is the administration of the practice, since few, if any, adequate models exist. This article describes the struggle of nurses in one private nursing practice, Creative Health Services, to meet their needs for individual freedom within an organization that is regulated sufficiently to maintain its viability.

Ethnicity identification from face images

NASA Astrophysics Data System (ADS)

Lu, Xiaoguang; Jain, Anil K.

2004-08-01

Human facial images provide the demographic information, such as ethnicity and gender. Conversely, ethnicity and gender also play an important role in face-related applications. Image-based ethnicity identification problem is addressed in a machine learning framework. The Linear Discriminant Analysis (LDA) based scheme is presented for the two-class (Asian vs. non-Asian) ethnicity classification task. Multiscale analysis is applied to the input facial images. An ensemble framework, which integrates the LDA analysis for the input face images at different scales, is proposed to further improve the classification performance. The product rule is used as the combination strategy in the ensemble. Experimental results based on a face database containing 263 subjects (2,630 face images, with equal balance between the two classes) are promising, indicating that LDA and the proposed ensemble framework have sufficient discriminative power for the ethnicity classification problem. The normalized ethnicity classification scores can be helpful in the facial identity recognition. Useful as a "soft" biometric, face matching scores can be updated based on the output of ethnicity classification module. In other words, ethnicity classifier does not have to be perfect to be useful in practice.

An early 19th-century Canadian surgical practice: the casebook of John Mackieson of Charlottetown, 1795–1885

PubMed Central

Shephard, David A.E.; Grogono, Basil J.S.

2002-01-01

A casebook written by Dr. John Mackieson (1795–1885), of Charlottetown, contains the records of 49 surgical cases he managed between 1826 and 1857. In view of the rarity of first-hand accounts of surgical practice in Canada in the mid-19th century, Mackieson’s case records are a significant source of information. These cases are discussed in order to delineate Mackieson’s approach to the surgical problems he faced in his general practice. His case records also illustrate some of the general problems that beset surgeons in that era. PMID:11939660

Effective chronic disease management: patients' perspectives on medication-related problems.

PubMed

Gordon, Karen; Smith, Felicity; Dhillon, Soraya

2007-03-01

To examine medication-related problems from the perspective of patients with a chronic condition and to identify how they may be supported in managing their medication. Patients prescribed medication for cardiovascular disease were recruited through five general medical surgeries and four community pharmacies in south London. Data were collected in 98 face-to-face interviews in participants' own homes. Interviews were designed to enable a detailed and holistic exploration of medication-related problems from participants' perspectives. Data were audio-recorded and transcribed verbatim to allow qualitative analysis. Five broad categories of medication-related problem emerged which were examined in the context of patients' perspectives on, and experiences of, the use of medicines and health services. These were concerns about and management of side effects; differing views regarding the use of medicines; cognitive, practical and sensory problems; lack of information or understanding; and problems with access to, and organisation of, services. All categories of problem had potential implications for the success of therapy in that they created barriers to adherence, access to medication or informed decision-making. The study demonstrated how patients actively engage in decision-making about their medicines in the home, if not in the consultation. The five categories of problem provide a focus for interventions by health professionals to support patients in achieving optimal theory outcomes. They demonstrate the need for a comprehensive approach, spanning patient education to the systems of delivery of care. Within the NHS in Britain, policy and practice initiatives are being designed to achieve this end. Further research should focus on the evaluation of professional practices and service developments in supporting patients in the self-management of their medicines.

Feasibility, acceptability and effectiveness of an online alternative to face-to-face consultation in general practice: a mixed-methods study of webGP in six Devon practices.

PubMed

Carter, Mary; Fletcher, Emily; Sansom, Anna; Warren, Fiona C; Campbell, John L

2018-02-15

To evaluate the feasibility, acceptability and effectiveness of webGP as piloted by six general practices. Mixed-methods evaluation, including data extraction from practice databases, general practitioner (GP) completion of case reports, patient questionnaires and staff interviews. General practices in NHS Northern, Eastern and Western Devon Clinical Commissioning Group's area approximately 6 months after implementing webGP (February-July 2016). Six practices provided consultations data; 20 GPs completed case reports (regarding 61 e-consults); 81 patients completed questionnaires; 5 GPs and 5 administrators were interviewed. Attitudes and experiences of practice staff and patients regarding webGP. WebGP uptake during the evaluation was small, showing no discernible impact on practice workload. The completeness of cross-sectional data on consultation workload varied between practices.GPs judged 41/61 (72%) of webGP requests to require a face-to-face or telephone consultation. Introducing webGP appeared to be associated with shifts in responsibility and workload between practice staff and between practices and patients.81/231 patients completed a postal survey (35.1% response rate). E-Consulters were somewhat younger and more likely to be employed than face-to-face respondents. WebGP appeared broadly acceptable to patients regarding timeliness and quality/experience of care provided. Similar problems were presented by all respondents. Both groups appeared equally familiar with other practice online services; e-consulters were somewhat more likely to have used them.From semistructured staff interviews, it appeared that, while largely acceptable within practice, introducing e-consults had potential for adverse interactions with pre-existing practice systems. There is potential to assess the impact of new systems on consultation patterns by extracting routine data from practice databases. Staff and patients noticed subtle changes to responsibilities associated with online options. Greater uptake requires good communication between practice and patients, and organisation of systems to avoid conflicts and misuse. Further research is required to evaluate the full potential of webGP in managing practice workload. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

ASP, Art and Science of Practice: Educating Military Operations Research Practitioners

DTIC Science & Technology

2015-04-01

the ships are relatively slow. This is a multiple traveling salesman problem with moving customers, where the Navy may consume a gallon of fuel to...Defense, in a unique relationship that ensures NPS students and faculty are focused on critical and important problems facing the military. Our students...integrate graduate education with a commitment to solving real military problems , and our programs have already been documented in the open literature

Food quality and safety: traceability and labeling.

PubMed

Lupien, John R

2005-01-01

This article discusses food systems in general, their development over the past 120 years, and realities and problems faced by a world population of over 6 billion people. Various food and feed problems are mentioned, and the concept of "traceability" is discussed in the context of the broader and more useful approach of using "good practices" at all levels of the food chain.

Practical Work in Ireland: A Time of Reform and Debate

ERIC Educational Resources Information Center

Kennedy, Declan

2012-01-01

This paper describes and discusses the role of practical work in science education in Ireland. The 2002 report of a government Task Force on the Physical Sciences, set up to consider the problems facing the teaching of the physical sciences in second-level schools in Ireland, has resulted in rapid reform of the science curriculum at both junior…

Facing Global Sustainability Issues: Teachers' Experiences of Their Own Practices in Environmental and Sustainability Education

ERIC Educational Resources Information Center

Sund, Louise

2016-01-01

Over the last 20 years, international organisations and national governments have stressed the need for education policies to be (re)oriented towards social change, sustainability and preparing students for life in a global society. This area of pedagogy is not problem free. When policy is turned into practice teachers need to take a number of…

School-Wide Discipline Policies: In-School Suspension in One Middle School.

ERIC Educational Resources Information Center

Chung, Gloria; Paul, Rachel

One of the more perplexing problems facing middle schools is the use of in-school suspension (ISS). So as to understand better the effects of this practice, one middle school's ISS program was studied and evaluated. Current research on ISS polices and practices is limited, and there is little evidence that supports its use or reform; however, in…

ASSESSING ALTERNATIVE FUTURES FOR AGRICULTURE IN IOWA, U.S.A.

EPA Science Inventory

The contributions of current industrial agricultural practices to environmental degradation and the social problems facing agricultural regions are well known. However, landscape-scale alternatives to current conditions have not been fully explored nor their potential impacts qua...

Design and Practices for Use of Automated Drilling and Sample Handling in MARTE While Minimizing Terrestrial and Cross Contamination

NASA Astrophysics Data System (ADS)

Miller, David P.; Bonaccorsi, Rosalba; Davis, Kiel

2008-10-01

Mars Astrobiology Research and Technology Experiment (MARTE) investigators used an automated drill and sample processing hardware to detect and categorize life-forms found in subsurface rock at Río Tinto, Spain. For the science to be successful, it was necessary for the biomass from other sources -- whether from previously processed samples (cross contamination) or the terrestrial environment (forward contamination) -- to be insignificant. The hardware and practices used in MARTE were designed around this problem. Here, we describe some of the design issues that were faced and classify them into problems that are unique to terrestrial tests versus problems that would also exist for a system that was flown to Mars. Assessment of the biomass at various stages in the sample handling process revealed mixed results; the instrument design seemed to minimize cross contamination, but contamination from the surrounding environment sometimes made its way onto the surface of samples. Techniques used during the MARTE Río Tinto project, such as facing the sample, appear to remove this environmental contamination without introducing significant cross contamination from previous samples.

Design and practices for use of automated drilling and sample handling in MARTE while minimizing terrestrial and cross contamination.

PubMed

Miller, David P; Bonaccorsi, Rosalba; Davis, Kiel

2008-10-01

Mars Astrobiology Research and Technology Experiment (MARTE) investigators used an automated drill and sample processing hardware to detect and categorize life-forms found in subsurface rock at Río Tinto, Spain. For the science to be successful, it was necessary for the biomass from other sources--whether from previously processed samples (cross contamination) or the terrestrial environment (forward contamination)-to be insignificant. The hardware and practices used in MARTE were designed around this problem. Here, we describe some of the design issues that were faced and classify them into problems that are unique to terrestrial tests versus problems that would also exist for a system that was flown to Mars. Assessment of the biomass at various stages in the sample handling process revealed mixed results; the instrument design seemed to minimize cross contamination, but contamination from the surrounding environment sometimes made its way onto the surface of samples. Techniques used during the MARTE Río Tinto project, such as facing the sample, appear to remove this environmental contamination without introducing significant cross contamination from previous samples.

From Theory to Practice: One Agency's Experience with Implementing an Evidence-Based Model.

PubMed

Murray, Maureen; Culver, Tom; Farmer, Betsy; Jackson, Leslie Ann; Rixon, Brian

2014-07-01

As evidence-based practice is becoming integrated into children's mental health services as a means of improving outcomes for children and youth with severe behavioral and emotional problems, therapeutic foster care (TFC) which is a specialized treatment program for such youth, is one of few community-based programs considered to be evidence-based. "Together Facing the Challenge" (TFTC) which was developed as a component of a randomized trial of TFC has been identified as an evidence-based model. We describe the experiences reported by one of the agencies that participated in our study and how they have incorporated TFTC into their on-going practice. They highlight key implementation strategies, challenges faced, and lessons learned as they moved forward towards full implementation of TFTC throughout their agency.

The Promise of Technology to Confront Dilemmas in Teacher Education: The Use of WebQuests in Problem-Based Methods Courses

ERIC Educational Resources Information Center

Smith, Leigh K.; Draper, Roni Jo; Sabey, Brenda L.

2005-01-01

This qualitative study examined the use of WebQuests as a teaching tool in problem-based elementary methods courses. We explored the potential of WebQuests to address three dilemmas faced in teacher education: (a) modeling instruction that is based on current learning theory and research-based practices, (b) providing preservice teachers with…

Still-to-video face recognition in unconstrained environments

NASA Astrophysics Data System (ADS)

Wang, Haoyu; Liu, Changsong; Ding, Xiaoqing

2015-02-01

Face images from video sequences captured in unconstrained environments usually contain several kinds of variations, e.g. pose, facial expression, illumination, image resolution and occlusion. Motion blur and compression artifacts also deteriorate recognition performance. Besides, in various practical systems such as law enforcement, video surveillance and e-passport identification, only a single still image per person is enrolled as the gallery set. Many existing methods may fail to work due to variations in face appearances and the limit of available gallery samples. In this paper, we propose a novel approach for still-to-video face recognition in unconstrained environments. By assuming that faces from still images and video frames share the same identity space, a regularized least squares regression method is utilized to tackle the multi-modality problem. Regularization terms based on heuristic assumptions are enrolled to avoid overfitting. In order to deal with the single image per person problem, we exploit face variations learned from training sets to synthesize virtual samples for gallery samples. We adopt a learning algorithm combining both affine/convex hull-based approach and regularizations to match image sets. Experimental results on a real-world dataset consisting of unconstrained video sequences demonstrate that our method outperforms the state-of-the-art methods impressively.

Handbook for Georgia Legislators, 6th Edition [And] Classroom Activities to Use with Handbook for Georgia Legislators, 6th Edition.

ERIC Educational Resources Information Center

Jackson, Edwin L.

This document contains a handbook and a booklet of classroom activities to use with the handbook. The handbook is a compilation of the law, procedures, and practices which govern the legislative process in Georgia. It addresses the practical problems faced by members of the Georgia legislature. Chapter one discusses the General Assembly, its…

TEACHING JAPANESE IN A SMALL LIBERAL ARTS COLLEGE, A PRACTICAL STUDY.

ERIC Educational Resources Information Center

ANTHONY, DAVID F.

THE AUTHOR, WHO IS A HISTORIAN, POINTS OUT THE PRACTICAL PROBLEMS OF TEACHERS IN SMALL COLLEGES WHO ARE FACED WITH TEACHING ASIAN LANGUAGES IN ADDITION TO SURVEY COURSES IN FAR EASTERN CULTURAL HISTORY. HE HAS FOUND THAT A COURSE IN THE CULTURAL HISTORY OF JAPAN OR CHINA WILL LEAD TO A DESIRE ON THE PART OF SOME STUDENTS TO LEARN SOMETHING ABOUT…

Correction for spatial averaging in laser speckle contrast analysis

PubMed Central

Thompson, Oliver; Andrews, Michael; Hirst, Evan

2011-01-01

Practical laser speckle contrast analysis systems face a problem of spatial averaging of speckles, due to the pixel size in the cameras used. Existing practice is to use a system factor in speckle contrast analysis to account for spatial averaging. The linearity of the system factor correction has not previously been confirmed. The problem of spatial averaging is illustrated using computer simulation of time-integrated dynamic speckle, and the linearity of the correction confirmed using both computer simulation and experimental results. The valid linear correction allows various useful compromises in the system design. PMID:21483623

Research and developing countries: hopes and hypes.

PubMed

Moazam, Farhat

2006-01-01

The paper outlines the universal problem of ensuring ethical practices in human subject research, and focuses on specific difficulties faced in the developing world with particular reference to Pakistan. It discusses the influence of traditional and hierarchical social norms of physician-patient relationships in heightening these problems. Two emerging issues of specific concern in Pakistan are described: an exponential rise in multinational clinical drug trials, and commercial ventures offering unproven stem cell "therapy" for all kinds of diseases. The importance of introducing ethical practices in research within the context of local cultural and socioeconomic realities is highlighted.

Increasing the relevance of research to health care managers: hospital CEO imperatives for improving quality and lowering costs.

PubMed

Alexander, Jeffrey A; Hearld, Larry R; Jiang, H Joanna; Fraser, Irene

2007-01-01

Evidence-based management assumes that available research evidence is consistent with the problems and decision-making conditions faced by those who will utilize this evidence in practice. This article attempts to identify how hospital leaders view key determinants of hospital quality and costs, as well as the fundamental ways these leaders "think" about solutions to quality and cost issues in their organizations. The objective of this analysis is to better inform the research agenda and approaches pursued by health services research so that this research reflects the "realities" of practice in hospitals. We conducted a series of semistructured interviews with a convenience sample of eight hospital and three health system leaders. Questions focused on current and future challenges facing hospitals as they relate to hospital quality, costs, and efficiency, and potential solutions to those challenges. Nine major organizational and managerial factors emerged from the interviews, including staffing, evidence-based practice, information technology, data availability and benchmarking, and leadership. Hospital leaders tend to think about these factors systemically and consider process-related factors as the important drivers of cost and quality. The results suggest a need to expand the methods utilized by health services researchers to make their research more relevant to health care managers. Expanding research methods to reflect the systemic way that managers view the challenges and solutions facing their organizations may enhance the application of research findings into management practice. Finally, better communication is needed between the research and practice communities. Researchers must learn to think more like managers if their research is to be relevant, and managers must learn to more effectively communicate their issues with the research community and frame their problems in researchable terms.

Veteran teachers' use of recommended practices in deaf education.

PubMed

Easterbrooks, Susan R; Stephenson, Brenda H; Gale, Elaine

2009-01-01

Deaf education teacher preparation programs face the likelihood that their graduates may not implement evidenced-based practices they were taught once they have graduated. The literature suggests that new teachers follow the school culture where they work rather than methods and strategies taught in their preparation programs. To investigate whether teachers of students who are deaf or hard of hearing (DHH) implement recommended practices, 23 teachers from three schools for the deaf were interviewed about their implementation and use of two recommended practices: independent reading and problem solving. The guiding questions were: Do teachers of students who are DHH use independent reading and problem solving after the enculturation process? If so, to what level? If not, can a review improve their level of use? Results demonstrated, at least regarding these two practices, that teachers of students who are DHH do implement evidence-based practices in their classrooms.

Still a difficult business? Negotiating alcohol-related problems in general practice consultations.

PubMed

Rapley, Tim; May, Carl; Frances Kaner, Eileen

2006-11-01

This paper describes general practitioners' (GPs) experiences of detecting and managing alcohol and alcohol-related problems in consultations. We undertook qualitative research in two phases in the North-East of England. Initially, qualitative interviews with 29 GPs explored their everyday work with patients with alcohol-related issues. We then undertook group interviews--two with GPs and one with a primary care team--where they discussed and challenged findings of the interviews. The GPs reported routinely discussing alcohol with patients with a range of alcohol-related problems. GPs believed that this work is important, but felt that until patients were willing to accept that their alcohol consumption was problematic they could achieve very little. They tentatively introduced alcohol as a potential problem, re-introduced the topic periodically, and then waited until the patient decided to change their behaviour. They were aware that they could identify and manage more patients. A lack of time and having to work with the multiple problems that patients brought to consultations were the main factors that stopped GPs managing more risky drinkers. Centrally, we compared the results of our study with [Thom, B., & Tellez, C. (1986). A difficult business-Detecting and managing alcohol-problems in general-practice. British Journal of Addiction, 81, 405-418] seminal study that was undertaken 20 years ago. We show how the intellectual, moral, emotional and practical difficulties that GPs currently face are quite similar to those faced by GPs from 20 years ago. As the definition of what could constitute abnormal alcohol consumption has expanded, so the range of consultations that they may have to negotiate these difficulties in has also expanded.

Knowledge of breast cancer and breast self-examination practice among Iranian women in Hamedan, Iran.

PubMed

Akhtari-Zavare, Mehrnoosh; Ghanbari-Baghestan, Abbas; Latiff, Latiffah A; Matinnia, Nasrin; Hoseini, Mozhgan

2014-01-01

In Iran, breast cancer is the most prevalent cancer in women and a major public health problem. A cross sectional study was carried out to determine knowledge on breast cancer and breast self- examination (BSE) practices of 384 females living in the city of Hamadan, Iran. A purposive sampling method was adopted and data were collected via face-to-face interviews based on a validated questionnaire developed for this study. Among respondents 268 (69.8%) were married and 144 (37.5%) of the respondents reported having a family history of breast cancer. One hundred respondents (26.0%) claimed they practiced BSE. Level of breast cancer knowledge was significantly associated with BSE practice (p=0.000). There was no association with demographic details (p<0.05). The findings showed that Iranian women's knowledge regarding breast cancer and the practice of BSE is inadequate. Targeted education should be implemented to improve early detection of breast cancer.

Assessing Leading ERP-SAP Implementation in Leading Firms in Indonesia

NASA Astrophysics Data System (ADS)

Syaiful, B.; Gunawan, W.

2017-01-01

Enterprise resource planning (ERP) enables to bring critical capabilities to an organisation, however, the implementation of such capabilities is often surrounded with problems. The implementing ERP-SAP in Indonesian enterprises are still facing tremendous challenges with the failure rate can reach more than 80% of the cases. The article examines the common problems faced by the consultants whenever they deal with their clients, from the practical perspectives. The article takes the multiple case studies of the leading enterprises in Indonesia, such as: KS (largest steel producer), GEM (large mining producer), and HS (large retailer), with the aim to identify the root of problems of SAP implementation. The outcome of the study is expected to provide the consultants with the guideline to understand the ERP implementation process in their clients and effective solutions to cope with it.

The Sociologist in Private Practice.

ERIC Educational Resources Information Center

Straus, Roger A.

The nature of professional sociological roles and the problems faced by the clinical sociologist are addressed. Professional sociologists are those whose primary occupational identity is that of counselor, consultant, or administrator working in a non-academic setting. Clinical sociology is defined as counseling or other actions for intervention…

Judging Interpretations: But Is It Rigorous? Trustworthiness and Authenticity in Naturalistic Evaluation

ERIC Educational Resources Information Center

Schwandt, Thomas A.; Lincoln, Yvonna S.; Guba, Egon G.

2007-01-01

Among the most knotty problems faced by investigators committed to interpretive practices in disciplines and fields such as sociocultural anthropology, jurisprudence, literary criticism, historiography, feminist studies, public administration, policy analysis, planning, educational research, and evaluation are deciding whether an interpretation is…

Developing Skills for Consultation with American Schools Overseas.

ERIC Educational Resources Information Center

Gerner, Michael E.

This compilation of information addresses various issues facing internationally mobile children and adolescents. Some of the topics include: the different characteristics of Third-Culture Kids (TCKs); assessment practices and language and learning differences among TCKs, including an analysis of language problems, norm groups, and test…

"I Understood the Words but I Didn't Know What They Meant": Japanese Online MBA Students' Experiences of British Assessment Practices

ERIC Educational Resources Information Center

Fenton-O'Creevy, Mark; van Mourik, Carien

2016-01-01

We report on a case study of high Japanese student failure rates in an online MBA programme. Drawing on interviews, and reviews of exam and assignment scripts we frame the problems faced by these students in terms of a "language as social practice" approach and highlight the students' failure to understand the specific language games…

A Noninferiority Trial of a Problem-Solving Intervention for Hospice Caregivers: In Person versus Videophone

PubMed Central

Parker Oliver, Debra; Wittenberg-Lyles, Elaine; Washington, Karla; Doorenbos, Ardith; Rue, Tessa; Berry, Donna

2012-01-01

Abstract Purpose of the study Problem-solving therapy (PST) has been found effective when delivered to informal caregivers of patients with various conditions. In hospice, however, its translation to practice is impeded by the increased resources needed for its delivery. The study purpose was to compare the effectiveness of a PST intervention delivered face-to-face with one delivered via videophone to hospice primary caregivers. Design and methods The study design was a randomized noninferiority trial with two groups, Group 1 in which caregivers received PST face-to-face, and Group 2 in which caregivers received PST via videophone. Family hospice caregivers were recruited from two urban hospice agencies and received the PST intervention (in three visits for Group 1 or three video-calls in Group 2) in an approximate period of 20 days after hospice admission. Standard caregiver demographic data were collected. Psychometric instruments administered to caregivers at baseline and at study completion included the CQLI-R (Caregiver Quality of Life Index–Revised), the STAI (State-Trait Anxiety Inventory), and the PSI (Problem-Solving Inventory). Results One hundred twenty-six caregivers were recruited in the study; 77 were randomly assigned to Group 1 and 49 to Group 2. PST delivered via video was not inferior to face-to-face delivery. The observed changes in scores were similar for each group. Caregiver quality of life improved and state anxiety decreased under both conditions. Conclusions The delivery of PST via videophone was not inferior to face-to-face. Audiovisual feedback captured by technology may be sufficient, providing a solution to the geographic barriers that often inhibit the delivery of these types of interventions to older adults in hospice. PMID:22536989

United States import safety, environmental health, and food safety regulation in China.

PubMed

Nyambok, Edward O; Kastner, Justin J

2012-01-01

China boasts a rapidly growing economy and is a leading food exporter. Since China has dominated world export markets in food, electronics, and toys, many safety concerns about Chinese exports have emerged. For example, many countries have had problems with Chinese food products and food-processing ingredients. Factors behind food safety and environmental health problems in China include poor industrial waste management, the use of counterfeit agricultural inputs, inadequate training of farmers on good farm management practices, and weak food safety laws and poor enforcement. In the face of rising import safety problems, the U.S. is now requiring certification of products and foreign importers, pursuing providing incentives to importers who uphold good safety practices, and considering publicizing the names of certified importers.

Burn disasters--an audit of the literature.

PubMed

Broeze, Carsten L; Falder, Sian; Rea, Suzanne; Wood, Fiona

2010-01-01

All events that result in disasters are unique, and it is impossible to become fully prepared. However, through thorough planning and preparedness, it is possible to gain a better understanding of the typical injury patterns and problems that arise from a variety of hazards. Such events have the potential to claim many lives and overwhelm local medical resources. Burn disasters vary in scope of injury and procedures required, and are much more labor and resource intensive than non-burn disasters. This review of the literature should help determine whether, despite each event having its own unique features, there still are common problems disaster responders face in the prehospital and hospital phases, what recommendations were made from these disasters, and whether these recommendations have been implemented into practice and the current disaster planning processes. The objective of this review was to assess: (1) prehospital and hospital responses used during past burn disasters; (2) problems faced during those disaster responses; (3) recommendations made following those disasters; (4) whether these recommendations were integrated into practice; and (5) the key characteristics of burn disasters and how they differ from other disasters. This review is important to determine why, despite having disaster plans, things still go wrong.

Strategies for Success: An Administrator's Guide to Writing.

ERIC Educational Resources Information Center

Yerkes, Diane; Morgan, Sharon

This booklet offers practical ideas, specific examples, and realistic solutions to the most common writing problems that administrators face. The booklet's four chapters are: (1) Writing Basics (ideas on organization, reasons to write, writers' responsibilities, getting personal, and writing for a particular occasion); (2) Getting Started (getting…

Problems in Office Management: Cases in Practice

ERIC Educational Resources Information Center

Hemby, K. Virginia; Smith, Vincent W.

2006-01-01

Office managers face an increasing array of job responsibilities in today's business environment. To prepare new office administration employees and managers, educational institutions must maintain a progressive curriculum to meet position demands. Using a population of members of the Association of Professional Office Managers, this study was…

Social Services in American High Schools.

ERIC Educational Resources Information Center

Farrar, Eleanor; Hampel, Robert L.

1987-01-01

School social services may seem highly bureaucratic, with staff members filling narrowly defined roles. In practice, the delivery of social services to high school students faced with pregnancy, alcoholism, divorce, suicide, and other problems is exceedingly informal. Considerable discretion and autonomy are needed to serve students with problems…

What's New in Elder Abuse Programming? Four Bright Ideas.

ERIC Educational Resources Information Center

Wolf, Rosalie S.; Pillemar, Karl

1994-01-01

Presents four "best practice models" that address problems faced by community agencies working with elder abuse cases: multidisciplinary case consultation team; senior advocate volunteer program; victim support group; and master's of social work degree specialization in adult protective services. Sees their relatively low cost, flexibility, and…

Psychotherapeutic issues with "kinky" clients: clinical problems, yours and theirs.

PubMed

Nichols, Margaret

2006-01-01

People whose sexual repertoire includes BDSM, fetish, or other "kinky" practices have become increasingly visible, on the Internet, in the real world, and in psychotherapists' offices. Unfortunately, the prevailing psychiatric view of BDSM remains a negative one: These sexual practices are usually considered paraphilias, i.e., de facto evidence of pathology. A different, affirming view of BDSM is taken in this paper. After defining BDSM and reviewing common misconceptions, a variety of issues the practitioner will face are described. These include problems of countertransference, of working with people with newly emerging sexual identities, working with spouses and partners, and discriminating between abuse and sexual "play."

A Blended Learning Approach to Teaching Basic Pharmacokinetics and the Significance of Face-to-Face Interaction

PubMed Central

Holbrook, Jane

2010-01-01

Objective To assess pharmacy students' attitudes towards a blended-learning pharmacokinetics course. Design Narrated visual presentations and animations that illustrated kinetic processes and guided students through the use of software programs used for calculations were created. Other learning techniques used included online self-assessment quizzes, practice problem sets, and weekly face-to-face problem-solving tutorials. Assessment A precourse questionnaire to assess students' level of enthusiasm towards the blended-learning course and to solicit any concerns they had was administered at the beginning of the course. A postcourse questionnaire that included the same 4 Likert-scale items from the precourse questionnaire and follow-up open-ended questions was administered. Individual changes in level of enthusiasm were compared for individuals who completed both the precourse and postcourse questionnaire. Students' concerns about the blended method of learning had decreased postcourse while their enthusiasm for the benefits of blended learning had increased. Conclusion Students' initial concerns about the blended learning experience were focused on their ability to communicate with the instructor about the online components, but shifted to their own time management skills at the end of the course. Face-to-face interactions with each other and with the instructor were more highly rated than online interactions in this course. PMID:20798797

A blended learning approach to teaching basic pharmacokinetics and the significance of face-to-face interaction.

PubMed

Edginton, Andrea; Holbrook, Jane

2010-06-15

To assess pharmacy students' attitudes towards a blended-learning pharmacokinetics course. Narrated visual presentations and animations that illustrated kinetic processes and guided students through the use of software programs used for calculations were created. Other learning techniques used included online self-assessment quizzes, practice problem sets, and weekly face-to-face problem-solving tutorials. A precourse questionnaire to assess students' level of enthusiasm towards the blended-learning course and to solicit any concerns they had was administered at the beginning of the course. A postcourse questionnaire that included the same 4 Likert-scale items from the precourse questionnaire and follow-up open-ended questions was administered. Individual changes in level of enthusiasm were compared for individuals who completed both the precourse and postcourse questionnaire. Students' concerns about the blended method of learning had decreased postcourse while their enthusiasm for the benefits of blended learning had increased. Students' initial concerns about the blended learning experience were focused on their ability to communicate with the instructor about the online components, but shifted to their own time management skills at the end of the course. Face-to-face interactions with each other and with the instructor were more highly rated than online interactions in this course.

ARSH 1: Reproductive and sexual health problems of adolescents and young adults: a cross sectional community survey on knowledge, attitude and practice.

PubMed

Nair, M K C; Leena, M L; Thankachi, Yamini; George, Babu; Russell, Paul Swamidhas Sudhakar

2013-11-01

To understand the problems faced and the difference in knowledge, attitude and practice of young people across the age group of 10-24 y on reproductive and sexual health issues and to get their suggestions regarding adolescent care services. This cross sectional community survey involving three districts in Kerala was conducted among adolescents and young adults of 10-24 y using a population proportion to sample size technique. The main problems faced by the young people between 10 and 24 y of age were financial, substance abuse in family, poor academic performance, difference of opinion, disease in self/family, mental problems, lack of talent, strict parents, difficulty in mingling, love failure, broken family, loneliness and problems at school/office in the descending order. As the age advances higher percentage of both boys (43.4%) and girls (61.7%) discuss reproductive sexual health issues among themselves. There was a statistically significant difference in personal hygiene practices like changing napkins/cloths more than once a day (94.3%), cleaning genital organs with soap every day (71.7%), washing after urination (69.2%), washing from front to back after defecation (62.2%) and washing hands with soap after defecation (73.2%) between 10-14, 15-19, and 20-24 y age group with higher percentages in the older groups. In order to make the service more useful, more of the older group participants suggested giving information on adolescent services to parents, adolescents and society as a whole by creating better societal acceptance and keeping confidentiality in service delivery. This study has shown an overall inadequacy in reproductive health knowledge in all age groups, but increasing knowledge gain and better attitude and practices on reproductive and sexual health as the age increases. The suggestions made by the group regarding need for adolescent reproductive sexual health (ARSH) and counseling services with privacy and confidentiality ensured, is useful for planning ARSH services under National Rural Health Mission.

Internationalisation of the Curriculum: Putting Theory into Practice in a Physiotherapy Program

ERIC Educational Resources Information Center

Das, Rebekah

2005-01-01

Increasing numbers of international students studying health sciences in Australia necessitates research into appropriate ways to support cultural diversity in teaching. International students commonly face problems in adapting to culturally different education and health care systems and this complicates the development of the discipline specific…

Andragogy Between Theory and Practice.

ERIC Educational Resources Information Center

Klapan, Anita

One of the main problems facing andragogy is that its systematic nature is more the result of other theoretical deliberations than those of its own. Until the mid-19th century, andragogy founded its development mainly on prevailing communal, social, economic, political, and cultural conditions in various countries. In the 1950s, andragogy turned…

Enrollment Management: A Key to Student Success.

ERIC Educational Resources Information Center

Spence, Charles C.; And Others

This four-part presentation examines the theory and practice of enrollment management at Florida Community College at Jacksonville (FCCJ). First, Charles C. Spence offers a brief description of FCCJ and reviews some of the problems facing the college when he assumed the presidency in 1985, including a significant enrollment decline and serious…

Social Implications of Spina Bifida.

ERIC Educational Resources Information Center

Woodburn, Margaret

Investigated in Southeast Scotland were the social and practical problems faced by the parents of 86 children (ages 18 months to 38 years) with spina bifida, 74 of whom were classified as myelomeningoceles (a more serious condition involving malformation of the spinal cord). Questionnaires and interviews were used to gather information in the…

Improving Bilingual Program Management. A Handbook for Title VII Directors.

ERIC Educational Resources Information Center

DeGeorge, George P., Ed.

Filled with practical advice and workable techniques and strategies to help bilingual program directors deal with the problems they face, this handbook brings together ideas and suggestions from Title VII program directors, state coordinators, and superintendents with experience in bilingual programs. The handbook, written in question and answer…

The Engineer and the Societal Dilemma: An Interdisciplinary Approach.

ERIC Educational Resources Information Center

Coleman, Robert J.

The University of North Carolina's Electrical Engineering Department developed and delivered a course for undergraduate engineering students. The course integrated technical, social, and ethical perspectives on problems and issues faced in the world of practicing engineers. It achieved this integration by making use of professors in engineering,…

Don't Give Up! Practical Strategies for Challenging Collaborations

ERIC Educational Resources Information Center

Cramer, Sharon; Stivers, Jan

2007-01-01

People faced with collaboration challenges are often reluctant to be honest about problems because in many schools collaboration is a norm. But whereas most special educators are intuitively skilled at working with others, "problematic professional encounters are inevitable barriers that will appear occasionally in the life of every special…

Cardiovascular Risk Reduction. The Problems Facing the School Age Population.

ERIC Educational Resources Information Center

Moller, James H.

1982-01-01

A comprehensive health education program stressing the development of sound health habits should be offered to all students from kindergarten through twelfth grade. Such programs could help to prevent the development of cardiovascular disease by educating students of current practices that add to the risk of disease. (CJ)

Counseling Older Women: Curriculum Guidelines and Strategies.

ERIC Educational Resources Information Center

Cavallaro, Marion L.

Since the population of older persons is predominantly female, counselor educators need to incorporate into their curriculum topics related to the unique issues faced by older women. Most counselors in their practice will be encountering at some point the problems of older women. Therefore, the preparation of counselors needs to incorporate…

Future-Centered Teacher Preparation: Putting Theory Into Practice.

ERIC Educational Resources Information Center

Beckner, Weldon E.

In this document the implications of rapid social change and the need for educators to prepare teachers and administrators for future educational innovation are discussed. Suggestions for change in schools of higher education are made in the following areas: (1) Anticipating problems. Educational change will inevitably be faced with criticism, and…

A novel glass slide filing system for pathology slides.

PubMed

Tsai, Steve; Kartono, Francisca; Shitabata, Paul K

2007-07-01

The availability of a collection of microscope glass slides for review is essential in the study and practice of pathology. A common problem facing many pathologists is the lack of a well-organized filing system. We present a novel system that would be easily accessible, informative, protective, and portable.

An Analysis of Enterprise Risk Management and IT Effectiveness Constructs

ERIC Educational Resources Information Center

Waithe, Errol

2016-01-01

One major problem many organizations are facing is balancing the risk-management practices of the organization with overall information technology (IT) effectiveness. The purpose of this non-experimental quantitative correlational study was to assess the constructs and correlations associated with enterprise risk management and IT effectiveness.…

"Way-Centered" versus "Truth-Centered" Epistemologies

ERIC Educational Resources Information Center

Horsthemke, Kai

2016-01-01

In recent years, a criticism of "indigenous knowledge" has been that this idea makes sense only in terms of acquaintance (or familiarity) type and practical (or skills-type) knowledge (knowledge-how). Understood in terms of theoretical knowledge (or knowledge-that), however, it faces the arguably insurmountable problems of relativism and…

Persuasive Pedagogy: A New Paradigm for Mathematics Education

ERIC Educational Resources Information Center

Hennessey, Maeghan N.; Higley, Kelli; Chesnut, Steven R.

2012-01-01

Mathematics teachers face a myriad of instructional obstacles. Since the early 1990s, mathematics education researchers have proposed the use of constructivist practices to counteract these ever-prevalent obstacles. While we do give credit to the choices of instructional activities the constructivist paradigm promotes, there are problems with its…

Exploring Models for Indigenizing Social Work Education in China

ERIC Educational Resources Information Center

Zhanghua, Wang; Liqun, Huang

2013-01-01

The article examines the theories of indigenization and examines the problems facing China's social work education. It shows that the quality of social work education and teaching staff is low. The curriculum emphasizes theory and overlooks practical training. "Using as is," not modifying Western theories, has remained strong. The…

Experiences with online consultation systems in primary care: case study of one early adopter site

PubMed Central

Casey, Michael; Shaw, Sara; Swinglehurst, Deborah

2017-01-01

Background There is a strong policy drive towards implementing alternatives to face-to-face consultations in general practice to improve access, efficiency, and cost-effectiveness. These alternatives embrace novel technologies that are assumed to offer potential to improve care. Aim To explore the introduction of one online consultation system (Tele-Doc) and how it shapes working practices. Design and setting Mixed methods case study in an inner-city general practice. Method The study was conducted through interviews with IT developers, clinicians, and administrative staff, and scrutiny of documents, websites, and demonstrator versions of Tele-Doc, followed by thematic analysis and discourse analysis. Results Three interrelated themes were identified: online consultation systems as innovation, managing the ‘messiness’ of general practice consultations, and redistribution of the work of general practice. These themes raise timely questions about what it means to consult in contemporary general practice. Uptake of Tele-Doc by patients was low. Much of the work of the consultation was redistributed to patients and administrators, sometimes causing misunderstandings. The ‘messiness’ of consultations was hard to eliminate. In-house training focused on the technical application rather than associated transformations to practice work that were not anticipated. GPs welcomed varied modes of consulting, but the aspiration of improved efficiency was not realised in practice. Conclusion Tele-Doc offers a new kind of consultation that is still being worked out in practice. It may offer convenience for patients with discrete, single problems, and a welcome variation to GPs’ workload. Tele-Doc’s potential for addressing more complex problems and achieving efficiency is less clear, and its adoption may involve unforeseeable consequences. PMID:28993306

Numerical Analysis on Seepage in the deep overburden CFRD

NASA Astrophysics Data System (ADS)

Zeyu, GUO; Junrui, CHAI; Yuan, QIN

2017-12-01

There are many problems in the construction of hydraulic structures on deep overburden because of its complex foundation structure and poor geological condition. Seepage failure is one of the main problems. The Combination of the seepage control system of the face rockfill dam and the deep overburden can effectively control the seepage of construction of the concrete face rockfill dam on the deep overburden. Widely used anti-seepage measures are horizontal blanket, waterproof wall, curtain grouting and so on, but the method, technique and its effect of seepage control still have many problems thus need further study. Due to the above considerations, Three-dimensional seepage field numerical analysis based on practical engineering case is conducted to study the seepage prevention effect under different seepage prevention methods, which is of great significance to the development of dam technology and the development of hydropower resources in China.

[The problems of antihypertensive balneotherapy].

PubMed

Vladimirskiĭ, E V; Fil'tsagina, T N

2013-01-01

This review is devoted to the challenging problems of balneotherapeutics, such as the mechanisms of antihypertensive balneotherapy and its optimization. The experience of the authors with the practical application of chloride - sodium, iodine - bromide, and hydrogen sulfide mineral baths is analysed in comparison with the literature data. The role, dosage regimen, and duration of balneotherapeutic treatment as well as the effectiveness of its combination with medicamental therapy are considered. The authors hope that the discussion of these issues will be conducive to the solution of problems currently facing modern antihypertensive balneotherapy.

Photocatalytic reduction of CO₂: from molecules to semiconductors.

PubMed

Yui, Tatsuto; Tamaki, Yusuke; Sekizawa, Keita; Ishitani, Osamu

2011-01-01

We are facing three serious problems related to fossil resources, i.e., shortage of energy, shortage of carbon resources, and the global worming problem. Development of practical systems for converting CO₂ to useful chemicals using solar light, i.e., photocatalytic CO₂ reduction systems, should be one of the best solutions for these problems. In this article, we review photocatalytic CO₂ reduction systems, which are classified in two categories: (1) homogeneous reaction systems mainly using transition metal complexes, and (2) heterogeneous systems mainly using inorganic semiconductor as a light absorber.

[Evidence based medicine. A new paradigm for medical practice].

PubMed

Carneiro, A V

1998-01-01

Modern medical practice is an ever-changing process, and the doctor's need for information has been partially met by continuous medical education (CME) activities. It has been shown that CME activities have not prevented clinical knowledge, as well as medical practice, from deteriorating with time. When faced with the need to get the most recent and relevant information possible, the busy clinician has two major problems: most of the published medical literature is either irrelevant or not useful; and there is little time to read it. Evidence-based medicine constitutes a new paradigm for medical practice in the sense that it tries to transform clinical problems into well formulated clinical questions, selecting and critically appraising scientific evidence with predefined and rigorous rules. It combines the expertise of the individual clinician with the best external evidence from clinical research for rational, ethical and efficacious practice. Evidence-based medicine can be taught and practiced by physicians with different degrees of autonomy, with several subspecialties, working in the hospital or in outpatient clinics, alone or in groups.

Robust fuel- and time-optimal control of uncertain flexible space structures

NASA Technical Reports Server (NTRS)

Wie, Bong; Sinha, Ravi; Sunkel, John; Cox, Ken

1993-01-01

The problem of computing open-loop, fuel- and time-optimal control inputs for flexible space structures in the face of modeling uncertainty is investigated. Robustified, fuel- and time-optimal pulse sequences are obtained by solving a constrained optimization problem subject to robustness constraints. It is shown that 'bang-off-bang' pulse sequences with a finite number of switchings provide a practical tradeoff among the maneuvering time, fuel consumption, and performance robustness of uncertain flexible space structures.

Evaluation of an action research project in ophthalmic nursing practice.

PubMed

Waterman, Heather; Harker, Rona; MacDonald, Heather; McLaughlan, Rita; Waterman, Christine

2005-11-01

This paper reports the evaluation phase of an action research project that promoted face-down posturing of patients following vitreo-retinal surgery for macular hole to enhance patient outcomes. The evaluation phase identified areas of practice needing further development from the perspectives of those involved with the care of patients. To achieve best results following surgical repair of macular hole, patients are required to posture face down for several weeks. As a consequence, patients complain of severe back and neck ache and find it difficult to persist with the posturing. Work to advance nursing practice as surgical developments occur has relevance beyond ophthalmology and the particular context of this project. The first three phases of this action research--problem identification, planning and action--have been reported in another paper. Throughout the project an action research group comprising of representatives of key stakeholders were actively involved in researching and changing practice. During the evaluation phase, a qualitative methodology was chosen. Interviews with 17 members of staff from the inpatient area were carried out to elicit their perspectives on the posturing of patients. Qualitative interviews were selected to facilitate comparison with interview data from Phase 1. Data analysis ran concurrently with data collection, so that one could inform the other. Overall, nurses and healthcare support workers felt that patients were more agreeable to posturing and after surgery began to posture more quickly. Communication was still an issue in some instances, and patients having urgent as opposed to planned surgery were found to be more difficult to prepare and the psychological care of patients still posed problems for nursing staff. The evaluation suggests that improvements in the care of this group of patients have occurred. A 10-point plan to promote face-down posturing has been developed which will be of use to practitioners in other settings. Some aspects of practice remain less well-understood, for example, the psychological care of patients.

When Students Drink Too Much: Whose Problem Is It Anyway?

ERIC Educational Resources Information Center

Foster, Holly A.

2017-01-01

This case is for use in graduate courses in student affairs and higher education administration. It presents the challenges faced by student affairs professionals at the University of Virginia where some students participate in an annual high-risk drinking practice that has resulted in injuries and even death. Student affairs professionals at the…

Face-Threatening Acts and Politeness Theory: Contrasting Speeches from Supervisory Conferences.

ERIC Educational Resources Information Center

Roberts, Jo

Discourse analysis describes a level of spoken text that lies between grammar and nonlinguistic organization. Using such an approach to understand the practical problems of communication in supervisory conferences, this paper explores two dimensions of the conference: risk and politeness levels. Level of risk is determined by the degrees of…

Performance Tasks and the Pedagogy of Broadway

ERIC Educational Resources Information Center

Chun, Marc

2012-01-01

If educators want students to practice and prepare for challenges they might eventually face, there are a number of useful strategies to connect academic learning to the "real world." One is to ask students to complete what are variously called "performance tasks," "case studies," "simulations," or "project- or problem-based learning units."…

Diversity in Information Technology Education: Issues and Controversies

ERIC Educational Resources Information Center

Trajkovski, Goran, Ed.

2006-01-01

"Diversity in Information Technology Education: Issues and Controversies" sheds light on the status of diversity in the field of IT education. It identifies a wide range of problems that educators face on a daily basis, and gives practical, applicable solutions, mainly by showcasing successful and replicable examples. The chapters in "Diversity in…

Understanding Student-Teachers' Performances within an Inquiry-Based Practicum

ERIC Educational Resources Information Center

Méndez Rivera, Pilar; Pérez Gómez, Francisco

2017-01-01

The role of an inquiry-based practicum in the education of future teachers has been identified as a key component to foster student-teachers' abilities to face problems, try to solve them, work on doubts and produce situated and valuable learning from their own practices (Cochran-Smith & Little, 2001; Beck, 2001). The interaction between…

Toward a Model of Academic Integrity Institutionalization: Informing Practice in Postsecondary Education

ERIC Educational Resources Information Center

Gallant, Tricia Bertram; Drinan, Patrick

2008-01-01

The strategic choices facing higher education in confronting problems of academic misconduct need to be rethought. Using institutional theory, a model of academic integrity institutionalization is proposed that delineates four stages and a pendulum metaphor. A case study is provided to illustrate how the model can be used by postsecondary…

Labour Force Inclusion of Parents Caring for Children with Disabilities.

ERIC Educational Resources Information Center

Roeher Inst., North York (Ontario).

This report discusses the outcomes of a study that sought to identify the particular problems Canadian parents caring for children with disabilities face in trying to make the transition to work in terms of their child care arrangements and employment-related factors, and best practices in child care arrangements and employment accommodations.…

Integrative Care for Adolescents with Dual Diagnosis: Considering Trauma and Attachment within an Innovative Model for Clinical Practice

ERIC Educational Resources Information Center

Gardiner, Emily; Iarocci, Grace; Moretti, Marlene

2017-01-01

Adolescents with intellectual disability are at significant risk for developing concomitant mental health and behavior problems. Youth who experience "dual diagnosis" face great challenges, and require interventions that will promote their autonomy, self-determination, and adaptive functioning. In this article, we devote attention to…

Islamic Studies or the Study of Islam?: From Parker to Rammell

ERIC Educational Resources Information Center

Dien, Mawil Izzi

2007-01-01

The paper reports and discusses some of the practical and contextual difficulties facing the teaching of Islamic studies within the British higher education environment. The main problems in the author's view stem from the haziness surrounding the discipline definition and the methodology employed in teaching it. This is particularly observed when…

Race, Politics, and Economic Development: Community Perspectives. Haymarket Series.

ERIC Educational Resources Information Center

Jennings, James, Ed.

The underlying causes of black urban poverty are examined, and means are recommended to escape the cycle of violence it creates. Black activists and scholars analyze theoretical and practical problems facing the black community in the United States in the following papers: (1) "Towards a Theory and Strategy for Black Economic…

Keeping Scores: Audited Self-Monitoring of High-Stakes Testing Environments

ERIC Educational Resources Information Center

Padilla, Raymond; Richards, Michael

2006-01-01

To address a public relations problem faced by a large urban public school district in Texas, we conducted action research that resulted in an audited self-monitoring system for high-stakes testing environments. The system monitors violations of testing protocols while identifying and disseminating best practices to improve the education of…

Development of Interactive Multimedia Courseware (e-CRAFT) for Craft Education

ERIC Educational Resources Information Center

Osman, Salyani; Sahari, Noraidah; Zin, Nor Azan Mat

2012-01-01

The way of teaching and learning traditional crafts have always used traditional apprenticeship learning methods where the expert facilitates transfer of practice skill sets to novices. As a craft has been taught in conventional approach, the students and experts have been facing several problems especially when expert needs to teach a group of…

Factors affecting food handling Practices among food handlers of Dangila town food and drink establishments, North West Ethiopia

PubMed Central

2014-01-01

Background Food borne diseases are major health problems in developed and developing countries including Ethiopia. The problem is more noticeable in developing countries due to prevailing poor food handling and sanitation practices, inadequate food safety laws, weak regulatory systems, lack of financial resources to invest on safer equipments, and lack of education for food handlers. Methods The objective of this study was to assess food handling practice and associated factors among food handlers working in food and drinking establishments of Dangila town, North West Ethiopia. Cross-sectional quantitative study design was conducted among 406 food handlers working in 105 food and drink establishments from July to August 2013 in Dangila town. Data were collected using face to face interview with pretested structured questionnaire and physical observation. Result The mean age of the respondents was 22.7 ± 4.2 years of which 62.8% of the food handlers were females. Two hundred thirteen (52.5%) of food handlers had good food handling practices. Marital status (AOR = 7.52, 95% CI, 1.45-38.97), monthly income (AOR = 0.395, 95% CI, 0.25-0.62), knowledge about food handling (AOR = 1.69, 95% CI, 1.05-2.73), existence of shower facility (AOR = 1.89, 95% CI, 1.12-3.21) and separate dressing room (AOR = 1.97, 95% CI, 1.11-3.49) were found to be significantly associated with good food handling Practices. Conclusion Above half of food handlers had good food handling practices. Marital status, monthly income, knowledge status, existence of shower facility, existence of separate dressing room and presence of insect and rodent were factors associated with food handling Practices. PMID:24908104

Advanced tools for smartphone-based experiments: phyphox

NASA Astrophysics Data System (ADS)

Staacks, S.; Hütz, S.; Heinke, H.; Stampfer, C.

2018-07-01

The sensors in modern smartphones are a promising and cost-effective tool for experimentation in physics education, but many experiments face practical problems. Often the phone is inaccessible during the experiment and the data usually needs to be analyzed subsequently on a computer. We address both problems by introducing a new app, called ‘phyphox’, which is specifically designed for utilizing experiments in physics teaching. The app is free and designed to offer the same set of features on Android and iOS.

Teachers' experiences of teaching in a blended learning environment.

PubMed

Jokinen, Pirkko; Mikkonen, Irma

2013-11-01

This paper considers teachers' experiences of teaching undergraduate nursing students in a blended learning environment. The basic idea of the study programme was to support students to reflect on theory and practice, and provide with access to expert and professional knowledge in real-life problem-solving and decision making. Learning was organised to support learning in and about work: students worked full-time and this provided excellent opportunities for learning both in practice, online and face-to-face sessions. The aim of the study was to describe teachers' experiences of planning and implementing teaching and learning in a blended-learning-based adult nursing programme. The research method was qualitative, and the data were collected by three focus group interviews, each with four to six participants. The data were analysed using qualitative content analysis. The results show that the blended learning environment constructed by the combination of face-to-face learning and learning in practice with technology-mediated learning creates challenges that must be taken into consideration when planning and implementing blended teaching and learning. However, it provides good opportunities to enhance students' learning in and about work. This is because such programmes support student motivation through the presence of "real-life" and their relevance to the students' own places of work. Nevertheless, teachers require knowledge of different pedagogical approaches; they need professional development support in redesigning teaching and learning. Copyright © 2013 Elsevier Ltd. All rights reserved.

Activist engineering: changing engineering practice by deploying praxis.

PubMed

Karwat, Darshan M A; Eagle, Walter E; Wooldridge, Margaret S; Princen, Thomas E

2015-02-01

In this paper, we reflect on current notions of engineering practice by examining some of the motives for engineered solutions to the problem of climate change. We draw on fields such as science and technology studies, the philosophy of technology, and environmental ethics to highlight how dominant notions of apoliticism and ahistoricity are ingrained in contemporary engineering practice. We argue that a solely technological response to climate change does not question the social, political, and cultural tenet of infinite material growth, one of the root causes of climate change. In response to the contemporary engineering practice, we define an activist engineer as someone who not only can provide specific engineered solutions, but who also steps back from their work and tackles the question, What is the real problem and does this problem "require" an engineering intervention? Solving complex problems like climate change requires radical cultural change, and a significant obstacle is educating engineers about how to conceive of and create "authentic alternatives," that is, solutions that differ from the paradigm of "technologically improving" our way out of problems. As a means to realize radically new solutions, we investigate how engineers might (re)deploy the concept of praxis, which raises awareness in engineers of the inherent politics of technological design. Praxis empowers engineers with a more comprehensive understanding of problems, and thus transforms technologies, when appropriate, into more socially just and ecologically sensitive interventions. Most importantly, praxis also raises a radical alternative rarely considered-not "engineering a solution." Activist engineering offers a contrasting method to contemporary engineering practice and leads toward social justice and ecological protection through problem solving by asking not, How will we technologize our way out of the problems we face? but instead, What really needs to be done?

OECD Thematic Review on Adult Learning: Norway. Background Report.

ERIC Educational Resources Information Center

Tangen, Fride

Adult learning in Norway was examined in a thematic review that focused on the following areas: the contexts of adult learning; the participants in, providers of, and returns from adult learning; issues and problems facing adult learning; and good practices. The following are among the main findings of the review: (1) adult learning has a long…

Tobacco Prevention Education in Schools for the Deaf: The Faculty Perspective

ERIC Educational Resources Information Center

Berman, Barbara A.; Guthmann, Debra S.; Liu, Weiqing; Streja, Leanne

2011-01-01

We report results of a survey of tobacco education practices and perspectives among faculty at four Schools for the Deaf participating in the trial of a tailored tobacco prevention curriculum. Few faculty (20.4%) included tobacco use among the three most important health problems facing their students, although 88.8% considered tobacco education…

The Safe Environment for Every Kid (SEEK) Model: Helping Promote Children's Health, Development, and Safety

ERIC Educational Resources Information Center

Dubowitz, Howard

2013-01-01

Child maltreatment affects millions of children each year. health care providers are increasingly called upon to address such psychosocial problems facing many families. In this article, the authors describe a practical approach to further enhance pediatric primary care and make it more responsive to the needs of children and families. The Safe…

Why Can't Families Be More Like Us?: Henry Higgins Confronts Eliza Doolittle in the World of Early Intervention.

ERIC Educational Resources Information Center

Vacca, John; Feinberg, Edward

2000-01-01

Discussion of problems faced by early interventionists in working with families offers practical guidelines for developing effective collaborations between early intervention programs and families. These include establishing family-centered services and rules for clinician/parent communication, encouraging the family to be a genuine coparticipant,…

Collaborative and Self-Directed Learning Strategies to Promote Fluent EFL Speakers

ERIC Educational Resources Information Center

Buitrago, Angela Gamba

2017-01-01

Speaking English with fluency is one of the most demanding challenges students and teachers face in many educational communities, and it has been claimed that fluency problems can derive from lack of practice during independent study. This research article reports on a mixed-methods study that analyzed the effects of using collaborative and…

An Empirical Analysis of the Development of China's Higher Vocational Education

ERIC Educational Resources Information Center

Minglun, Wang

2017-01-01

After more than 20 years of practice and construction, China's higher vocational education has developed into an important educational category and become an important force in the development of China's higher education. But in the course of this development, higher vocational education is facing problems such as excessively fast development,…

Learning Disabilities and Career Development. Practice Application Brief No. 20.

ERIC Educational Resources Information Center

Kerka, Sandra

The lifelong process of career development poses special challenges for people with learning disabilities (LD). Literature on employment issues for adults with LD frames on-the-job problems in terms of individual deficits or recasts the issues as a function of the significant societal barriers faced by those who do not fit the norm. Research on…

The Past, the Present, and the Future of Associate Degree Nursing Education.

ERIC Educational Resources Information Center

Arlton, Donna

A review of the history of associate degree nursing (ADN) education is presented, along with a discussion of contemporary problems faced by ADN educators. The paper first notes the practical, hospital-based nature of early nursing education programs; reviews early studies calling for school-based programs to prepare nurses for different levels of…

Planning Together: Positive Classroom Environments. Diversity in the Classroom Series, Number Four.

ERIC Educational Resources Information Center

Hindle, Doug

This document, the fourth in a series on diversity in the classroom, supports the belief that challenges faced by teachers working with diverse students can only be met through teacher practices that increase levels of positive teacher-student interaction and that create, in each student, effective social and problem solving skills. Section 1,…

Achieving Coherence in District Improvement: Managing the Relationship between the Central Office and Schools

ERIC Educational Resources Information Center

Johnson, Susan Moore; Marietta, Geoff; Higgins, Monica C.; Mapp, Karen L.; Grossman, Allen

2015-01-01

"Achieving Coherence in District Improvement" focuses on a problem of practice faced by educational leaders across the nation: how to effectively manage the relationship between the central office and schools. The book is based on a study of five large urban districts that have demonstrated improvement in student achievement. The…

Service Delivery to Young Handicapped Children in Rural Areas: A Review of Issues and Practices.

ERIC Educational Resources Information Center

Nash, Tina Eaton; And Others

The paper examines barriers faced by educators and administrators in serving young handicapped children in rural areas and suggests approaches to overcoming these barriers. Among problems identified are transportation; funding shortages due to a lower tax base and higher levels of poverty; unemployment, and seasonal employment; staff shortages;…

A Bermuda Triangle? A Case Study of the Disappearance of Competence-Based Vocational Training Policy in the Context of Practice.

ERIC Educational Resources Information Center

Bates, Inge; Dutson, Judith

1995-01-01

Observations of job training of special needs students were analyzed in terms of operational demands, staffing levels, resources, and trainee interaction. The competence approach often disappeared in the face of more pressing concerns; it serves to legitimate a political response rather than solve an educational problem. (SK)

Teaching for Very Long-Term Retention and Better Ways of Thinking

ERIC Educational Resources Information Center

Hardman, David

2008-01-01

Radford argues that psychology needs to be of greater value to psychology students, regardless of whether they intend to enter professional practice. He also suggests that psychology should be part of everybody's education, on the basis that human behaviour lies at the heart of the most serious problems facing humanity. This author agrees very…

Breaching the Walls of Academe: The Purposes, Problems, and Prospects of Military History

ERIC Educational Resources Information Center

Lynn, John A., II

2008-01-01

Military history faces a dire fate. Fewer and fewer colleges and universities today regard the historical study of military institutions and practices a worthy social, and therefore scholarly, charge. John Lynn enters this debate, examining the state of military history, which he defines in terms of three genres: popular, applied, and academic.…

Understanding Beginning Teacher Induction: A Contextualized Examination of Best Practice

ERIC Educational Resources Information Center

Kearney, Sean

2014-01-01

The problems that teachers face early in their careers are a major factor in growing rates of attrition among neophyte teachers. According to the Organisation for Economic Co-operation and Development, high rates of attrition, coupled with and aging teacher population in many countries in the developed world, may cause a teacher shortage crisis in…

Research Methods in Environmental Studies: A County Planning Application in Colorado.

ERIC Educational Resources Information Center

Gruntfest, Eve C.

To obtain practical experience, a research methods class at the University of Colorado (Colorado Springs) undertook a special project to help a nearby county (Park County), assess its planning needs. The county was chosen for its characteristics as a rapidly growing rural area faced with the problems created by mounting population pressure on…

Projected Issues in the Practice of Educational Administration: The Canadian Context.

ERIC Educational Resources Information Center

Green, Duncan

At the moment, most of Canada is faced with the problem of dealing with declining enrollments. This decline necessitates consideration of two major issues: the role of the educational system in Canadian society and the structure of educational governance in Canada. Although by law education is the prerogative of the provinces, the federal…

Psychometric Characteristics of the Social Justice Scale's Turkish Form and a Structural Equation Modeling

ERIC Educational Resources Information Center

Cirik, Ilker

2015-01-01

Problem Statement: In order to provide equal educational opportunities for students, teachers should encourage their students to have an effective voice concerning social justice. Studies reveal that teachers face trouble when transferring from the concept of social justice as theory to social justice as practice. A scale which will be developed…

Communication Challenges Learners Face Online: Why Addressing CMC and Language Proficiency Will Not Solve Learners' Problems

ERIC Educational Resources Information Center

Jung-Ivannikova, Liubov

2016-01-01

Computer-mediated communication (CMC) has been argued to cause (mis)communication issues. Research and practice suggest a range of tactics and strategies for educators focused on how to encourage and foster communication in a virtual learning environment (VLE) (eg, Salmon). However, while frameworks such as Salmon's support the effective…

Teaching Computing in a Multidisciplinary Way in Social Studies Classes in School--A Case Study

ERIC Educational Resources Information Center

von Wangenheim, Christiane Gresse; Alves, Nathalia Cruz; Rodrigues, Pedro Eurico; Hauck, Jean Carlo

2017-01-01

In order to be well-educated citizens in the 21st century, children need to learn computing in school. However, implementing computing education in schools faces several practical problems, such as lack of computing teachers and time in an already overloaded curriculum. A solution can be a multidisciplinary approach, integrating computing…

From a Disciplinary to an Interdisciplinary Design Research: Developing an Integrative Approach for Design

ERIC Educational Resources Information Center

Chou, Wen Huei; Wong, Ju-Joan

2015-01-01

As the new generation of designers face more complex design issues, the forms of design research start to shift towards a user-centred approach to problem-solving. The cooperation and communication among various fields and specialisations are becoming more complex; in many practical design cases, in particular, technology developers face…

Evaluation of telephone first approach to demand management in English general practice: observational study.

PubMed

Newbould, Jennifer; Abel, Gary; Ball, Sarah; Corbett, Jennie; Elliott, Marc; Exley, Josephine; Martin, Adam; Saunders, Catherine; Wilson, Edward; Winpenny, Eleanor; Yang, Miaoqing; Roland, Martin

2017-09-27

Objective  To evaluate a "telephone first" approach, in which all patients wanting to see a general practitioner (GP) are asked to speak to a GP on the phone before being given an appointment for a face to face consultation. Design  Time series and cross sectional analysis of routine healthcare data, data from national surveys, and primary survey data. Participants  147 general practices adopting the telephone first approach compared with a 10% random sample of other practices in England. Intervention  Management support for workload planning and introduction of the telephone first approach provided by two commercial companies. Main outcome measures  Number of consultations, total time consulting (59 telephone first practices, no controls). Patient experience (GP Patient Survey, telephone first practices plus controls). Use and costs of secondary care (hospital episode statistics, telephone first practices plus controls). The main analysis was intention to treat, with sensitivity analyses restricted to practices thought to be closely following the companies' protocols. Results  After the introduction of the telephone first approach, face to face consultations decreased considerably (adjusted change within practices -38%, 95% confidence interval -45% to -29%; P<0.001). An average practice experienced a 12-fold increase in telephone consultations (1204%, 633% to 2290%; P<0.001). The average duration of both telephone and face to face consultations decreased, but there was an overall increase of 8% in the mean time spent consulting by GPs, albeit with large uncertainty on this estimate (95% confidence interval -1% to 17%; P=0.088). These average workload figures mask wide variation between practices, with some practices experiencing a substantial reduction in workload and others a large increase. Compared with other English practices in the national GP Patient Survey, in practices using the telephone first approach there was a large (20.0 percentage points, 95% confidence interval 18.2 to 21.9; P<0.001) improvement in length of time to be seen. In contrast, other scores on the GP Patient Survey were slightly more negative. Introduction of the telephone first approach was followed by a small (2.0%) increase in hospital admissions (95% confidence interval 1% to 3%; P=0.006), no initial change in emergency department attendance, but a small (2% per year) decrease in the subsequent rate of rise of emergency department attendance (1% to 3%; P=0.005). There was a small net increase in secondary care costs. Conclusions  The telephone first approach shows that many problems in general practice can be dealt with over the phone. The approach does not suit all patients or practices and is not a panacea for meeting demand. There was no evidence to support claims that the approach would, on average, save costs or reduce use of secondary 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.

Evaluation of telephone first approach to demand management in English general practice: observational study

PubMed Central

Newbould, Jennifer; Abel, Gary; Ball, Sarah; Corbett, Jennie; Elliott, Marc; Exley, Josephine; Martin, Adam; Saunders, Catherine; Wilson, Edward; Winpenny, Eleanor; Yang, Miaoqing

2017-01-01

Objective To evaluate a “telephone first” approach, in which all patients wanting to see a general practitioner (GP) are asked to speak to a GP on the phone before being given an appointment for a face to face consultation. Design Time series and cross sectional analysis of routine healthcare data, data from national surveys, and primary survey data. Participants 147 general practices adopting the telephone first approach compared with a 10% random sample of other practices in England. Intervention Management support for workload planning and introduction of the telephone first approach provided by two commercial companies. Main outcome measures Number of consultations, total time consulting (59 telephone first practices, no controls). Patient experience (GP Patient Survey, telephone first practices plus controls). Use and costs of secondary care (hospital episode statistics, telephone first practices plus controls). The main analysis was intention to treat, with sensitivity analyses restricted to practices thought to be closely following the companies’ protocols. Results After the introduction of the telephone first approach, face to face consultations decreased considerably (adjusted change within practices −38%, 95% confidence interval −45% to −29%; P<0.001). An average practice experienced a 12-fold increase in telephone consultations (1204%, 633% to 2290%; P<0.001). The average duration of both telephone and face to face consultations decreased, but there was an overall increase of 8% in the mean time spent consulting by GPs, albeit with large uncertainty on this estimate (95% confidence interval −1% to 17%; P=0.088). These average workload figures mask wide variation between practices, with some practices experiencing a substantial reduction in workload and others a large increase. Compared with other English practices in the national GP Patient Survey, in practices using the telephone first approach there was a large (20.0 percentage points, 95% confidence interval 18.2 to 21.9; P<0.001) improvement in length of time to be seen. In contrast, other scores on the GP Patient Survey were slightly more negative. Introduction of the telephone first approach was followed by a small (2.0%) increase in hospital admissions (95% confidence interval 1% to 3%; P=0.006), no initial change in emergency department attendance, but a small (2% per year) decrease in the subsequent rate of rise of emergency department attendance (1% to 3%; P=0.005). There was a small net increase in secondary care costs. Conclusions The telephone first approach shows that many problems in general practice can be dealt with over the phone. The approach does not suit all patients or practices and is not a panacea for meeting demand. There was no evidence to support claims that the approach would, on average, save costs or reduce use of secondary care. PMID:28954741

Endourologic management of malignant ureteral obstruction: indications, results, and quality-of-life issues.

PubMed

Sountoulides, Petros; Pardalidis, Nikolaos; Sofikitis, Nikolaos

2010-01-01

Obstruction of the upper urinary tract is a problem commonly faced by practicing urologists. The constant evolution in endourology has effectively facilitated minimally invasive management of upper-tract obstruction. In a case in which malignancy is the cause of obstruction, however, the situation significantly changes. Questions arise regarding the need for relieving the obstruction, the means to accomplish this, and the benefits and drawbacks of each technique regarding both their efficacy and their impact on the patients well-being and the crucial issue of quality of life in the face of malignancy.

Exploring spirituality among youth in foster care: findings from the Casey Field Office Mental Health Study.

PubMed

Jackson, Lovie J; White, Catherine Roller; O'Brien, Kirk; DiLorenzo, Paul; Cathcart, Ernie; Wolf, Mary; Bruskas, Delilah; Pecora, Peter J; Nix-Early, Vivian; Cabrera, Jorge

2010-02-01

This study examined spiritual coping mechanisms, beliefs about spirituality and participation in spiritual activities and in other positive activities among adolescents in foster care. A multidimensional measure of spirituality was developed for face-to-face interviews with 188 youth (ages 14-17) from diverse racial/ethnic backgrounds in the United States. Findings revealed 95% of youth believe in God, over 70% believe God is 'creator' and God is 'love', and 79% considered prayer a spiritual practice. Most youth said love and forgiveness help them heal. Two-thirds (67%) reported responding to 'bad or tragic things happening' by spending time alone, and over half responded by praying (59%) or sharing the problem with someone else (56%). Youth's top three spiritual goals were to follow God's plan for them, become a better person, and know their purpose in life. Based on the value youth ascribed to spiritual coping mechanisms, recommendations for policy and practice focus on the integration of spirituality into practice and caregiving for youth in foster care.

Responses to concerns about child maltreatment: a qualitative study of GPs in England

PubMed Central

Woodman, Jenny; Gilbert, Ruth; Allister, Janice; Glaser, Danya; Brandon, Marian

2013-01-01

Objectives To provide a rich description of current responses to concerns related to child maltreatment among a sample of English general practitioners (GPs). Design In-depth, face-to-face interviews (November 2010 to September 2011). Participants selected and discussed families who had prompted ‘maltreatment-related concerns’. Thematic analysis of data. Setting 4 general practices in England. Participants 14 GPs, 2 practice nurses and 2 health visitors from practices with at least 1 ‘expert’ GP (expertise in child safeguarding/protection). Results The concerns about neglect and emotional abuse dominated the interviews. GPs described intense and long-term involvement with families with multiple social and medical problems. Narratives were distilled into seven possible actions that GPs took in response to maltreatment-related concerns. These were orientated towards whole families (monitoring and advocating), the parents (coaching) and children (opportune healthcare), and included referral to or working with other services and recording concerns. Facilitators of the seven actions were: trusting relationships between GPs and parents, good working relationships with health visitors and framing the problem/response as ‘medical’. Narratives indicated significant time and energy spent building facilitating relationships with parents with the aim of improving the child's well-being. Conclusions These GPs used core general practice skills for on-going management of families who prompted concerns about neglect and emotional abuse. Policy and research focus should be broadened to include strategies for direct intervention and on-going involvement by GPs, such as using their core skills during consultations and practice systems for monitoring families and encouraging presentation to general practice. Exemplars of current practice, such as those identified in our study, should be evaluated for feasibility and acceptability in representative general practice settings as well as tested for efficacy, safety and cost. The seven actions could form the basis for the ‘lead professional’ role in general practice as proposed in the 2013 version of ‘Working Together ’guidance. PMID:24302506

The orthodontic-periodontic interrelationship in integrated treatment challenges: a systematic review.

PubMed

Gkantidis, N; Christou, P; Topouzelis, N

2010-05-01

Orthodontic treatment aims at providing an acceptable functional and aesthetic occlusion with appropriate tooth movements. These movements are strongly related to interactions of teeth with their supportive periodontal tissues. In recent years, because of the increased number of adult patients seeking orthodontic treatment, orthodontists frequently face patients with periodontal problems. Aesthetic considerations, like uneven gingival margins or functional problems resulting from inflammatory periodontal diseases should be considered in orthodontic treatment planning. Furthermore, in cases with severe periodontitis, orthodontics may improve the possibilities of saving and restoring a deteriorated dentition. In modern clinical practice, the contribution of the orthodontist, the periodontist and the general dentist is essential for optimized treatment outcomes. The purpose of this systematic review is to highlight the relationship between orthodontics and periodontics in clinical practice and to improve the level of cooperation between dental practitioners. Potentials and limitations that derive from the interdisciplinary approach of complex orthodontic-periodontal clinical problems are discussed.

Testing the Feasibility of a Briefer School-based Preventive Intervention with Aggressive Children: A Hybrid Intervention with Face-to-Face and Internet Components

PubMed Central

Lochman, John E.; Boxmeyer, Caroline L.; Jones, Shannon; Qu, Lixin; Ewoldsen, David; Nelson, W. Michael

2017-01-01

This study describes the results from a feasibility study of an innovative indicated prevention intervention with hybrid face-to-face and web-based components for preadolescent youth. This intervention includes a considerably briefer set of face-to-face sessions from the evidence-based Coping Power program and a carefully integrated internet component with practice and teaching activities and cartoon videos for children and for parents. The Coping Power — Internet Enhanced (CP-IE) program introduces a set of cognitive-behavioral skills in 12 small group sessions for children delivered during the school day and 7 group sessions for parents. Eight elementary schools were randomly assigned to CP-IE or to Control, and six children at each school were identified each year based on 4th grade teacher ratings of aggressive behavior. Path analyses of teacher-rated disruptive behavior outcomes for 91 fifth grade children, across two annual cohorts, indicated Control children had significantly greater increases in conduct problem behaviors across the 5th grade year than did CP-IE children. This much briefer version of Coping Power provided beneficial preventive effects on children’s behavior in the school setting similar to the effects of the longer version of Coping Power. The website materials appeared to successfully engage children, and parents’ use of the website predicted children’s changes in conduct problems across the year. PMID:28646974

AITSO: A Tool for Spatial Optimization Based on Artificial Immune Systems

PubMed Central

Zhao, Xiang; Liu, Yaolin; Liu, Dianfeng; Ma, Xiaoya

2015-01-01

A great challenge facing geocomputation and spatial analysis is spatial optimization, given that it involves various high-dimensional, nonlinear, and complicated relationships. Many efforts have been made with regard to this specific issue, and the strong ability of artificial immune system algorithms has been proven in previous studies. However, user-friendly professional software is still unavailable, which is a great impediment to the popularity of artificial immune systems. This paper describes a free, universal tool, named AITSO, which is capable of solving various optimization problems. It provides a series of standard application programming interfaces (APIs) which can (1) assist researchers in the development of their own problem-specific application plugins to solve practical problems and (2) allow the implementation of some advanced immune operators into the platform to improve the performance of an algorithm. As an integrated, flexible, and convenient tool, AITSO contributes to knowledge sharing and practical problem solving. It is therefore believed that it will advance the development and popularity of spatial optimization in geocomputation and spatial analysis. PMID:25678911

Living With Diabetes in Appalachia: A Focus Group Study.

PubMed

Carpenter, Roger; Smith, Mary Jane

This article presents an innovative holistic practice application based on evidence from a focus group study on managing diabetes. The purpose of this study addressed the research question: How do persons with type 2 diabetes describe ways of managing the challenge of living with diabetes? A second purpose was to link the findings on ways to manage diabetes to holistic nursing practice through story theory. Nine adults with type 2 diabetes living in rural West Virginia participated in 3 focus groups. Using content analysis, the study findings integrated themes with core qualities, and are as follows: living life as an evolving process is awakening to the present and doing it your way, being on guard is a vigilant ongoing responsibility, attending to bodily experience is awareness of body and facing life stress, and knowing the consequences is awareness of potential problems and taking charge. Merging the study findings with the concepts of story theory led to the development of an innovative practice application for managing diabetes. Managing diabetes in this practice application goes beyond problem-centeredness to a patient-centered approach, offering attention to individual preferences. Since managing diabetes is a major problem in Appalachia, there a need for innovative approaches. This study adds to the body of knowledge on how persons from Appalachia manage diabetes. In addition, it offers a story practice approach for managing diabetes-replacing a problem focus to a more holistic approach to practice leading to more meaningful and fulfilling outcomes.

Elaboration of the Charge Constructions of Explosives for the Structure of Facing Stone

NASA Astrophysics Data System (ADS)

Khomeriki, Sergo; Mataradze, Edgar; Chikhradze, Nikoloz; Losaberidze, Marine; Khomeriki, Davit; Shatberashvili, Grigol

2017-12-01

Increased demand for high-strength facing material caused the enhancement of the volume of explosives use in modern technologies of blocks production. The volume of broken rocks and crushing quality depends on the rock characteristics and on the properties of the explosive, in particular on its brisance and serviceability. Therefore, the correct selection of the explosive for the specific massif is of a considerable practical importance. For efficient mining of facing materials by explosion method the solving of such problems as determination of the method of blasthole drilling as well as of the regime and charge values, selection of the explosive, blastholes distribution in the face and their order is necessary. This paper focuses on technical solutions for conservation of rock natural structure in the blocks of facing material, mined by the use of the explosives. It has been established that the efficient solving of mentioned problem is attained by reducing of shock pulse duration. In such conditions the rigidity of crystalline lattice increases in high pressure area. As a result, the hazard if crack formation in structural unites and the increases of natural cracks are excluded. Short-time action of explosion pulse is possible only by linear charges of the explosives, characterized by high detonation velocity which detonate by the velocity of 7-7.5 km/sec and are characterized by very small critical diameter.

A security/safety survey of long term care facilities.

PubMed

Acorn, Jonathan R

2010-01-01

What are the major security/safety problems of long term care facilities? What steps are being taken by some facilities to mitigate such problems? Answers to these questions can be found in a survey of IAHSS members involved in long term care security conducted for the IAHSS Long Term Care Security Task Force. The survey, the author points out, focuses primarily on long term care facilities operated by hospitals and health systems. However, he believes, it does accurately reflect the security problems most long term facilities face, and presents valuable information on security systems and practices which should be also considered by independent and chain operated facilities.

Sharing Action Research on Research Day: Students' Perceptions of a Command Performance

ERIC Educational Resources Information Center

Foulger, Teresa S.; Zambo, Debby

2015-01-01

This action research study involves two cycles of investigation of Research Day an event at the end of each semester where doctoral students share their latest cycle of action research focused on a problem of practice they are facing. The study sought to understand students' perspectives of Research Day in terms of its instructional intention, how…

Exploring Artistic Practice in Global Communities of the African Diaspora

ERIC Educational Resources Information Center

Ellis, Auburn E.

2014-01-01

In 2012 an African Centered single case study was conducted in the United States. The problem is as follows: K-12 practitioners in urban areas are faced with unique circumstances while serving marginalized students in urban areas. As a response to this issue, the purpose of this study was to identify and describe curricula used in three African…

An Analysis of Facebook Intensity and Privacy Management Practices of Public School Educators in the United States

ERIC Educational Resources Information Center

Neely, Laura Sue Perry

2011-01-01

Social networking sites like Facebook continue to gain popularity among all segments of the population (boyd & Ellison, 2007; Madden & Smith, 2010). Public school employees all over the country are finding themselves facing disciplinary action due to participation in this fast growing fad. The problem is that there is a lack of clarity in the…

The Transition from State Care to Adulthood: International Examples of Best Practices

ERIC Educational Resources Information Center

Reid, Carrie

2007-01-01

The issue of outcomes for youth who transition from state care to adulthood is not unique to any one country. Youth exiting the child welfare system, or aging out, face a plethora of problems and issues associated with the transition to adulthood. For the majority of youth, the transition to adulthood represents a process that takes place over a…

Platform for Rural America. Revised at the National Conference on Rural America (3rd, December 5-7, 1977).

ERIC Educational Resources Information Center

Rural America, Inc., Washington, DC.

Recommendations which emerged from the Second and Third National Conferences on Rural America are presented in this revised platform of principles and policy recommendations for rural America. Major goal of the document is to find practical solutions to problems facing rural people so that strategies of rural revitalization and action can be…

AMDIS Case Conference

PubMed Central

Graham, J.; Levick, D.; Schreiber, R.

2010-01-01

Clinical decision support that provides enhanced patient safety at the point of care frequently encounters significant pushback from clinicians who find the process intrusive or time-consuming. We present a hypothetical medical center’s dilemma about its allergy alerting system and discuss similar problems faced by real hospitals. We then share some lessons learned and best practices for institutions who wish to implement these tools themselves. PMID:23616828

Examining the Effectiveness of Dropout Prevention Practices and Their Implications for Intervention with Public School Students

ERIC Educational Resources Information Center

Pollack, Louisa

2010-01-01

Schools face the dilemma of transforming both the trend of students dropping out of school and the associated negative socioeconomic outcomes into a positive path of persistence and school completion. Despite ongoing efforts of the federal and state government, as well as those of the local school districts, this problem continues to burden the…

Restoring fire-adapted ecosystems: proceedings of the 2005 national silviculture workshop

Treesearch

Robert F. Powers

2007-01-01

Many federal forests are at risk to catastrophic wild fire owing to past management practices and policies. Mangers of these forests face the immense challenge of making their forests resilient to wild fire, and the problem is complicated by the specter of climate change that may affect wild fire frequency and intensity. Some of the Nation’s leading...

A Set of Vertically Integrated Inquiry-Based Practical Curricula that Develop Scientific Thinking Skills for Large Cohorts of Undergraduate Students

ERIC Educational Resources Information Center

Zimbardi, Kirsten; Bugarcic, Andrea; Colthorpe, Kay; Good, Jonathan P.; Lluka, Lesley J.

2013-01-01

Science graduates require critical thinking skills to deal with the complex problems they will face in their 21st century workplaces. Inquiry-based curricula can provide students with the opportunities to develop such critical thinking skills; however, evidence suggests that an inappropriate level of autonomy provided to under prepared students…

The challenge of pediatric cardiac services in the developing world.

PubMed

Hewitson, John; Brink, Johan; Zilla, Peter

2002-10-01

Pediatric cardiac services are too expensive for most developing nations. Problems other than cardiac disease take priority when it comes to budget allocations. Poor health infrastructure and referral systems, malnutrition, and the HIV/AIDS pandemic aggravate the situation, and the increasing economic divide is threatening what services do exist. We highlight how the practice of pediatric cardiac surgery in South Africa compares with first-world standards and outline some of the problems faced by pediatric cardiac services in developing nations. Copyright 2002, Elsevier Science (USA). All rights reserved.

Poverty and palliative care in the US: issues facing the urban poor.

PubMed

Hughes, Anne

2005-01-01

Poverty is a significant public health and social problem in the US. The urban poor living with life-limiting illnesses are a particularly vulnerable population. The literature related to the experiences of the urban poor at the end of life is sparse. Most relates to the experiences of patients with cancer. The purpose of this literature review is to describe the problem of poverty in the US, to identify challenges in providing palliative care to the urban poor, and lastly, to articulate implications for nursing practice and nursing research.

Alternatives to the face-to-face consultation in general practice: focused ethnographic case study.

PubMed

Atherton, Helen; Brant, Heather; Ziebland, Sue; Bikker, Annemieke; Campbell, John; Gibson, Andy; McKinstry, Brian; Porqueddu, Tania; Salisbury, Chris

2018-04-01

NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the 'one sheet of paper' mind-map method to identify the line of argument in each thematic report. Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other's practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal. Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team. © British Journal of General Practice 2018.

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

PubMed

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

2010-01-01

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

[Contributions by Conversation Analysis to healthcare studies: reflections based on patients' attributions].

PubMed

Ostermann, Ana Cristina; de Souza, Joseane

2009-07-01

This study is part of a larger research project aimed at investigating physician-patient interactions in women's health. In this article, by looking at naturalistic data, which consists of 144 fully transcribed audio recordings of face-to-face interactions between gynecologists/obstetricians and female patients, we propose to: (1) present the theoretical and methodological approach of Conversation Analysis to health studies in Brazil; (2) discuss how Conversation Analysis can reveal how 'macro' questions (e.g. National Policy for the Humanization of Healthcare) are (or are not) translated into interactional practices at the 'micro' level and, thus, emphasize the issues of language and communication, only briefly discussed in the HumanizaSUS documents; and (3) analyze how a specific interactional phenomenon, 'attribution' (i.e. voluntary explanations about the possible causes of their problems), might describe ordinary and concrete humanization practices in healthcare services.

Deconstructing an Online Community of Practice: Teachers' Actions in the Edmodo Math Subject Community

ERIC Educational Resources Information Center

Trust, Torrey

2015-01-01

New technologies seem to have expanded traditional face-to-face communities of practice across spatial and temporal boundaries into "online communities of practice." However, these virtual landscapes are significantly different from the context of face-to-face communities of practice that Lave and Wenger (1991) observed. This study…

Alternatives to the face-to-face consultation in general practice: focused ethnographic case study

PubMed Central

Atherton, Helen; Brant, Heather; Ziebland, Sue; Bikker, Annemieke; Campbell, John; Gibson, Andy; McKinstry, Brian; Porqueddu, Tania; Salisbury, Chris

2018-01-01

Background NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. Aim To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Design and setting Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Method Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the ‘one sheet of paper’ mind-map method to identify the line of argument in each thematic report. Results Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other’s practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal. Conclusion Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team. PMID:29378697

The Complexities of Implementing Cluster Supply Chain - Case Study of JCH

NASA Astrophysics Data System (ADS)

Xue, Xiao; Zhang, Jibiao; Wang, Yang

As a new type of management pattern, "cluster supply chain" (CSC) can help SMEs to face the global challenges through all kinds of collaboration. However, a major challenge in implementing CSC is the gap between theory and practice in the field. In an effort to provide a better understanding of this emerging phenomenon, this paper presents the implementation process of CSC in the context of JingCheng Mechanical & Electrical Holding co., ltd.(JCH) as a case study. The cast study of JCH suggests that the key problems in the practice of cluster supply chain: How do small firms use cluster supply chain? Only after we clarify the problem, the actual construction and operation of cluster supply chain does show successful results as it should be.

[Ethical problems experienced by nurses in primary health care: integrative literature review].

PubMed

Nora, Carlise Rigon Dalla; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida

2015-03-01

The aim of this study is to identify ethical problems experienced by nurses in primary health care and resources for coping based on publications on the subject. An integrative literature review was performed between the months of October and November 2013, using the databases: BDTD, CINAHL, LILACS, MEDLINE, Biblioteca Cochrane, PubMed, RCAAP and SciELO. Articles, dissertations and theses published in Portuguese, English and Spanish were included, totalling 31 studies published from 1992 to 2013. This analysis resulted in four categories: ethical problems in the relationship between team members, ethical problems in the relationship with the user, ethical problems in health services management and resources for coping with ethical problems. Results showed that nurses need to be prepared to face ethical problems, emphasizing the importance of ethics education during the education process before and during professional practice to enhance the development of ethical sensitivity and competence for problem resolution.

NASA flight cell and battery issues

NASA Technical Reports Server (NTRS)

Schulze, N. R.

1989-01-01

The author presents the important battery and cell problems, encompassing both test failures and accidents, which were encountered during the past year. Practical issues facing programs, which have to be considered in the development of a battery program strategy, are addressed. The problems of one program, the GRO (Gamma Ray Observatory), during the past year are focused on to illustrate the fundamental types of battery problems that occur. Problems encountered by other programs are briefly mentioned to complete the accounting. Two major categories of issues are defined, namely, whose which are quality and design related, i.e., problems having inherent manufacturing-process-related aspects with an impact on cell reliability, and these which are accident triggered or man induced, i.e., those operational issues having an impact on battery and cell reliability.

Strategic planning for disaster recovery with stochastic last mile distribution

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

Bent, Russell Whitford; Van Hentenryck, Pascal; Coffrin, Carleton

2010-01-01

This paper considers the single commodity allocation problem (SCAP) for disaster recovery, a fundamental problem faced by all populated areas. SCAPs are complex stochastic optimization problems that combine resource allocation, warehouse routing, and parallel fleet routing. Moreover, these problems must be solved under tight runtime constraints to be practical in real-world disaster situations. This paper formalizes the specification of SCAPs and introduces a novel multi-stage hybrid-optimization algorithm that utilizes the strengths of mixed integer programming, constraint programming, and large neighborhood search. The algorithm was validated on hurricane disaster scenarios generated by Los Alamos National Laboratory using state-of-the-art disaster simulation toolsmore » and is deployed to aid federal organizations in the US.« less

Context Oriented Information Integration

NASA Astrophysics Data System (ADS)

Mohania, Mukesh; Bhide, Manish; Roy, Prasan; Chakaravarthy, Venkatesan T.; Gupta, Himanshu

Faced with growing knowledge management needs, enterprises are increasingly realizing the importance of seamlessly integrating critical business information distributed across both structured and unstructured data sources. Academicians have focused on this problem but there still remain a lot of obstacles for its widespread use in practice. One of the key problems is the absence of schema in unstructured text. In this paper we present a new paradigm for integrating information which overcomes this problem - that of Context Oriented Information Integration. The goal is to integrate unstructured data with the structured data present in the enterprise and use the extracted information to generate actionable insights for the enterprise. We present two techniques which enable context oriented information integration and show how they can be used for solving real world problems.

Strategies for Limiting Engineers' Potential Liability for Indoor Air Quality Problems.

PubMed

von Oppenfeld, Rolf R; Freeze, Mark E; Sabo, Sean M

1998-10-01

Engineers face indoor air quality (IAQ) issues at the design phase of building construction as well as during the investigation and mitigation of potential indoor air pollution problems during building operation. IAQ issues that can be identified are "building-related illnesses" that may include problems of volatile organic compounds (VOCs). IAQ issues that cannot be identified are termed "sick building syndrome." Frequently, microorganism-caused illnesses are difficult to confirm. Engineers who provide professional services that directly or indirectly impact IAQ face significant potential liability to clients and third parties when performing these duties. Potential theories supporting liability claims for IAQ problems against engineers include breach of contract and various common law tort theories such as negligence and negligent misrepresentation. Furthermore, an increasing number of federal, state, and local regulations affect IAQ issues and can directly increase the potential liability of engineers. A duty to disclose potential or actual air quality concerns to third parties may apply for engineers in given circumstances. Such a duty may arise from judicial precedent, the Model Guide for Professional Conduct for Engineers, or the Code of Ethics for Engineers. Practical strategies engineers can use to protect themselves from liability include regular training and continuing education in relevant regulatory, scientific, and case law developments; detailed documentation and recordkeeping practices; adequate insurance coverage; contractual indemnity clauses; contractual provisions limiting liability to the scope of work performed; and contractual provisions limiting the extent of liability for engineers' negligence. Furthermore, through the proper use of building materials and construction techniques, an engineer or other design professional can effectively limit the potential for IAQ liability.

Bridging the gap between guidelines and practice in the management of emerging infectious diseases: a qualitative study of emergency nurses.

PubMed

Lam, Stanley Kk; Kwong, Enid Wy; Hung, Maria Sy; Pang, Samantha Mc

2016-10-01

To explore the difficulties and strategies regarding guideline implementation among emergency nurses. Emerging infectious diseases remain an underlying source of global health concern. Guidelines for accident and emergency departments would require adjustments for infectious disease management. However, disparities between guidelines and nurses' practice are frequently reported, which undermines the implementation of these guidelines into practice. This article explores the experience of frontline emergency nurses regarding guideline implementation and provides an in-depth account of their strategies in bridging guideline-practice gaps. A qualitative descriptive design was used. Semi-structured, face-to-face, individual interviews were conducted between November 2013-May 2014. A purposive sample of 12 frontline emergency nurses from five accident and emergency departments in Hong Kong were recruited. The audio-recorded interviews were transcribed verbatim and analysed with a qualitative content analysis approach. Four key categories associated with guideline-practice gaps emerged, including getting work done, adapting to accelerated infection control measures, compromising care standards and resolving competing clinical judgments across collaborating departments. The results illustrate that the guideline-practice gaps could be associated with inadequate provision of corresponding organisational supports after guidelines are established. The nurses' experiences have uncovered the difficulties in the implementation of guidelines in emergency care settings and the corresponding strategies used to address these problems. The nurses' experiences reflect their endeavour in adjusting accordingly and adapting themselves to their circumstances in the face of unfeasible guidelines. It is important to customise guidelines to the needs of frontline nurses. Maintaining cross-departmental consensus on guideline interpretation and operation is also indicated as an important component for effective guideline implementation. © 2016 John Wiley & Sons Ltd.

Sociocultural aspects of arsenicosis in Bangladesh: community perspective.

PubMed

Ahmad, Sheikh A; Sayed, Muhammad H S; Khan, Manzurul H; Karim, Muhammad N; Haque, Muhammad A; Bhuiyan, Mohammad S A; Rahman, Muhammad S; Faruquee, Mahmud H

2007-10-01

This was a cross-sectional study under taken to explore the socioeconomic perspective of the arsenicosis problem, carried out in arsenic contaminated Upazillas where at least 100 arsenicosis patients had been identified. Two of the Upazillas with significant arsenic mitigation intervention and three of the Upazillas with limited interventions were selected for the study. Seven hundred fifty respondents were included in the study from 25 villages of the 5 Upazillas. Arsenicosis became a serious problem for the affected communities. Majority (71.31%) of respondents obtained their drinking water from tubewells, almost one third (29%) of the respondents still knowingly using arsenic contaminated water. Primary reason identified for this practice was distance of safe water source. Majority (58.6%) of the respondents said to face economic and 17.9% said to face social problem of varied range. Patients of lower income group were particularly more likely to face economic problems (P< .001) as well as social problem (P< .01). About half (50.7%) of the arsenicosis patients faced difficulty whilst receiving treatment, particularly female patients were more likely to face problem than male (P< .05). Several concerns also were surfaced regarding the heath care service provider particularly to the women patients, some of which are: long waiting time for receiving treatment (15%), discrimination in service delivery (10.7%) and inadequate separate facility for female patients (14.3%). Moreover the issues of financial burden raised by the respondents seem to have emerged as significant in terms of health care access. Access to Health service was particularly difficult for poor patients, as they often had to face problems associated with accessing service like, non availability of medicines in the hospitals (50.7%), traveling long distance (26.7%), purchasing medicine in most cases (32.4%) etc. Their dissatisfaction was compounded by negligent behavior of health care staff and nature of treatment provided. Furthermore length of time needed for reversal of symptoms led to loosing faith on efficacy of treatment, which cascades to negligence of patient's part in seeking health care. Women are less likely to get treatment for arsenicosis than men (P< .01). As there appear to be specific difficulties for women particularly for poor women in accessing health care, social and cultural values make it difficult for them to attend to their own health needs and to travel to service providers. Study findings suggest that a significant proportion (79.9%) of arsenicosis patient was found to access alternative health care. This includes; Homeopath, village doctors, Kabiraj and local pharmacists. Respondents in high intervention Upazillas were significantly more likely to get treatment (P< .05), to face fewer problems and to be satisfied with the facility (P< .001). Provision of safe water options, periodic screening of water source for arsenic, availability of trained doctor, regular availability of medicine, doorstep treatment, follow up on severe patients were the suggestions came from community for improvement.

Common Core Implementation: A Quantitative Study Measuring the Change of Instructional Practices Due to Common Core

ERIC Educational Resources Information Center

Berg, John Sonje

2017-01-01

The philosophy behind the Common Core State Standards (CCSS) and its tenets of critical thought, creativity, and application of knowledge require a shift from a focus on content knowledge to how that knowledge is applied across the curriculum and why it forms the foundation of education. The problem now facing educators is that CCSS has changed…

The Puerto Rico Gap Analysis Project Volume 1: land cover, vertebrate species distributions, and land stewardship

Treesearch

W. A. Gould; C. Alarcon; B. Fevold; M.E. Jimenez; S. Martinuzzi; G. Potts; M. Quinones; M. Solórzano; E. Ventosa

2008-01-01

Puerto Rico faces a number of problems common to much of the world. Population is increasing while land area is not, and there are reassessments of land use policy and practice to accommodate growing populations, shifting economies, and changing public value systems. Puerto Rico shares similarities with the Eastern United States with its history of agricultural...

A semi-operational agricultural inventory using small scale aerial photography

NASA Technical Reports Server (NTRS)

Draeger, W. C.; Pettinger, L. R.

1970-01-01

The feasibility of performing inventories of agricultural resources using very small scale aerial or space photography was studied. The results were encouraging on two counts: (1) The very practical problems of an operational survey are being faced and solutions are being found. (2) It seems that a fully operational agricultural inventory using space photography is not beyond the scope of present technology.

From Policy to Practice: The Challenges of Providing High Quality Physical Education and School Sport Faced by Head Teachers within Primary Schools

ERIC Educational Resources Information Center

Rainer, Paul; Cropley, Brendan; Jarvis, Stuart; Griffiths, Rob

2012-01-01

Background: Despite considerable investment in UK government initiatives (e.g., the Physical Education School Sport [PESS] plan) aimed at improving the delivery and quality of physical education (PE) in primary schools, many remaining problems have been highlighted (e.g., facilities; staff training). It is suggested that the head teacher (school…

Preparing Underprepared Students for Higher Education and Beyond: The Development and Implementation of an Integrated Project

ERIC Educational Resources Information Center

Mungal, Avika; Cloete, Melanie

2016-01-01

A current problem faced in South Africa is that university graduates are weak and underprepared for the work environment. The purpose of this study was to assist students in bridging the aforementioned gap and to ease the transition from theory to practice. The aim of the study was to critically analyse the development and implementation of the…

AMDIS Case Conference: Intrusive Medication Safety Alerts.

PubMed

Graham, J; Levick, D; Schreiber, R

2010-01-01

Clinical decision support that provides enhanced patient safety at the point of care frequently encounters significant pushback from clinicians who find the process intrusive or time-consuming. We present a hypothetical medical center's dilemma about its allergy alerting system and discuss similar problems faced by real hospitals. We then share some lessons learned and best practices for institutions who wish to implement these tools themselves.

Specific problems in visual cognition of dyslexic readers: Face discrimination deficits predict dyslexia over and above discrimination of scrambled faces and novel objects.

PubMed

Sigurdardottir, Heida Maria; Fridriksdottir, Liv Elisabet; Gudjonsdottir, Sigridur; Kristjánsson, Árni

2018-06-01

Evidence of interdependencies of face and word processing mechanisms suggest possible links between reading problems and abnormal face processing. In two experiments we assessed such high-level visual deficits in people with a history of reading problems. Experiment 1 showed that people who were worse at face matching had greater reading problems. In experiment 2, matched dyslexic and typical readers were tested, and difficulties with face matching were consistently found to predict dyslexia over and above both novel-object matching as well as matching noise patterns that shared low-level visual properties with faces. Furthermore, ADHD measures could not account for face matching problems. We speculate that reading difficulties in dyslexia are partially caused by specific deficits in high-level visual processing, in particular for visual object categories such as faces and words with which people have extensive experience. Copyright © 2018 Elsevier B.V. All rights reserved.

Conceptual and operational understanding of learning for sustainability: a case study of the beef industry in north-eastern Australia.

PubMed

Lankester, Ally J

2013-04-15

Extensive attention has been given to understanding learning processes that foster sustainability. Despite this focus there is still limited knowledge of learning processes that create changes in perspectives and practices. This paper aims to increase understanding of learning processes in the context of sustainability and refers to the beef industry in north-eastern Australia. A framework based on adult learning theories was developed and used to analyse the what, why and how of beef producers' learning to improve land condition. Twenty-eight producers were interviewed face-to-face and another 91 participated in a telephone survey. Most beef producers were motivated to learn due to perceived problems with existing practices and described mainly learning new skills and techniques to improve production. Beef producers main learning sources were their own experiences, observing others' practices and sharing experiences with peers and family members. Results showed that organised collective learning, adversity and active experimentation with natural resource management skills and techniques can facilitate critical reflection of practices, questioning of the self, others and cultural norms and an enhanced sense of environmental responsibility. Copyright © 2013 Elsevier Ltd. All rights reserved.

Blending online therapy into regular face-to-face therapy for depression: content, ratio and preconditions according to patients and therapists using a Delphi study.

PubMed

van der Vaart, Rosalie; Witting, Marjon; Riper, Heleen; Kooistra, Lisa; Bohlmeijer, Ernst T; van Gemert-Pijnen, Lisette J E W C

2014-12-14

Blending online modules into face-to-face therapy offers perspectives to enhance patient self-management and to increase the (cost-)effectiveness of therapy, while still providing the support patients need. The aim of this study was to outline optimal usage of blended care for depression, according to patients and therapists. A Delphi method was used to find consensus on suitable blended protocols (content, sequence and ratio). Phase 1 was an explorative phase, conducted in two rounds of online questionnaires, in which patients' and therapists' preferences and opinions about online psychotherapy were surveyed. In phase 2, data from phase 1 was used in face-to-face interviews with therapists to investigate how blended therapy protocols could be set up and what essential preconditions would be. Twelve therapists and nine patients completed the surveys. Blended therapy was positively perceived among all respondents, especially to enhance the self-management of patients. According to most respondents, practical therapy components (assignments, diaries and psycho-education) may be provided via online modules, while process-related components (introduction, evaluation and discussing thoughts and feelings), should be supported face-to-face. The preferred blend of online and face-to-face sessions differs between therapists and patients; most therapists prefer 75% face-to-face sessions, most patients 50 to 60%. The interviews showed that tailoring treatment to individual patients is essential in secondary mental health care, due to the complexity of their problems. The amount and ratio of online modules needs to be adjusted according to the patient's problems, skills and characteristics. Therapists themselves should also develop skills to integrate online and face-to-face sessions. Blending online and face-to-face sessions in an integrated depression therapy is viewed as a positive innovation by patients and therapists. Following a standard blended protocol, however, would be difficult in secondary mental health care. A database of online modules could provide flexibility to tailor treatment to individual patients, which asks motivation and skills of both patients and therapists. Further research is necessary to determine the (cost-)effectiveness of blended care, but this study provides starting points and preconditions to blend online and face-to-face sessions and create a treatment combining the best of both worlds.

On actuator placement for robust time-optimal control of uncertain flexible spacecraft

NASA Technical Reports Server (NTRS)

Wie, Bong; Sinha, Ravi; Liu, Qiang

1992-01-01

The problem of computing open-loop, on-off jet firing logic for flexible spacecraft in the face of plant modeling uncertainty is investigated. The primary control objective is to achieve a fast maneuvering time with a minimum of structural vibrations during and/or after a maneuver. This paper is also concerned with the problem of selecting a proper pair of jets for practical trade-offs among the maneuvering time, fuel consumption, structural mode excitation, and performance robustness. A time-optimal control problem subject to parameter robustness constraints is formulated. A three-mass-spring model of flexible spacecraft with a rigid-body mode and two flexible modes is used to illustrate the concept.

Partners in public health law: elected officials, health directors, and attorneys.

PubMed

Benjamin, Georges; Lopez, Wilfredo; Monson, Angela Zoe

2002-01-01

The partnership that has developed over the years between elected officials, health directors, and attorneys came about through necessity and practicality. This article examines this partnership and some of the conflicts and problems it contains. The article discusses the problems of overlap of authority between public health departments and elected officials. It also emphasizes that existing laws and regulations often provide sufficiently flexible authority, and that such laws and regulations can be exercised in new ways to address current public health problems. The article concludes with a discussion of the challenges faced by public health officials and legislators in forming a partnership to secure necessary financial support and legal authority for public health activities.

Sexual discrimination in academia. Implications for dental hygiene faculty.

PubMed

Shuman, D; Tolle, S L

1989-02-01

Despite anti-discriminatory legislation, academic women in the 1980s have not achieved equality, and continue to face diverse problems advancing in an academic system based on a patriarchal paradigm. The purpose of this paper is to provide dental hygiene faculty with insight, awareness, and understanding into four major problem areas that influence women's academic success: values and attitudes learned through socialization; blocks to administrative positions; the male locus of decision making; and double standards of performance evaluation. Additionally, examples of solutions to these problems are discussed in three categories: individual, internal to the university, and external to the university; in an effort to better prepare women in dental hygiene education to succeed in academia despite discriminatory practices.

Telemedicine in rural areas: general practitioners’ representations and experiences

PubMed

Durupt, Maxime; Bouchy, Olivier; Christophe, Sonia; Kivits, Joëlle; Boivin, Jean-Marc

2016-10-19

Introduction: Telemedicine is a rapidly growing new mode of healthcare practice. It is particularly used and needed in remote areas in Lorraine (North East of France) that currently face a shortage of general practitioners and specialists. The objective of this study was to analyse general practitioner’s representations of telemedicine and teleconsultation. The study also identified the advantages and disadvantages of this new mode of medical practice. Methods: A qualitative research was led: 5 focus groups were conducted with 32 doctors in areas faced with the problems of health professional shortages between June 2014 and July 2015. Results: This study reveals a general ignorance of telemedicine. Doctors want to play a central role in this new form of medical practice which must remain optional. Their reluctance essentially concerns financial and legal aspects that constitute obstacles to the development of telemedicine. Finally, this new mode of medical practice must comply with a legal framework regarding medical responsibility and personal data protection. Discussion.More than 100 medical procedures are delivered by telemedicine in Lorraine each month. This new technology is a solution to provide healthcare services in medically underserved areas. However, general practitioners want to preserve the “doctor-patient” relationship and do not wish to change their practice.

Exploring spirituality among youth in foster care: findings from the Casey Field Office Mental Health Study

PubMed Central

Jackson, Lovie J.; White, Catherine Roller; O'Brien, Kirk; DiLorenzo, Paul; Cathcart, Ernie; Wolf, Mary; Bruskas, Delilah; Pecora, Peter J.; Nix-Early, Vivian; Cabrera, Jorge

2014-01-01

This study examined spiritual coping mechanisms, beliefs about spirituality and participation in spiritual activities and in other positive activities among adolescents in foster care. A multidimensional measure of spirituality was developed for face-to-face interviews with 188 youth (ages 14–17) from diverse racial/ethnic backgrounds in the United States. Findings revealed 95% of youth believe in God, over 70% believe God is ‘creator’ and God is ‘love’, and 79% considered prayer a spiritual practice. Most youth said love and forgiveness help them heal. Two-thirds (67%) reported responding to ‘bad or tragic things happening’ by spending time alone, and over half responded by praying (59%) or sharing the problem with someone else (56%). Youth's top three spiritual goals were to follow God's plan for them, become a better person, and know their purpose in life. Based on the value youth ascribed to spiritual coping mechanisms, recommendations for policy and practice focus on the integration of spirituality into practice and caregiving for youth in foster care. PMID:25057258

The school curriculum for ethnic minority pupils: A contribution to a debate

NASA Astrophysics Data System (ADS)

Saunders, Malcolm

1980-03-01

This paper discusses some of the canicular needs of children of migrant parents in the United Kingdom (in particular those of South Asian and West Indian origins), against the background of current provision. The author argues the merits of a "cultural accommodation" strategy and outlines the "human rights" model of education which that strategy implies. He then analyses three major problem areas faced by children of migrant workers: conflicts of identity, communication difficulties, and unequal access to employment opportunities. In a final section, tentative but practical suggestions are given of how the school curriculum can address these problems.

Practical problems which women encounter with available contraception in Australia.

PubMed

Weisberg, E

1994-06-01

Australian women face major difficulties with contraception because of the limited range of choices, the need for meticulous attention to compliance with most available methods and because of cost limitations for a significant minority of the population. The most commonly used methods are oral contraceptive pills and barrier methods, and each has substantial compliance problems which can be minimized with care and counselling. There is an urgent need for a wider range of options in Australia and for good information and publicity about them. Present progress in this direction gives some hope for the near future.

South Asian women's coping strategies in the face of domestic violence in the United States.

PubMed

Bhandari, Shreya

2018-02-01

We conducted in-depth telephone interviews with a convenience sample of 20 South Asian women experiencing domestic violence in the United States. Utilizing the emotion-focused and problem-focused coping framework, the researchers analyzed the narratives of abused South Asian women. Emotion-focused coping strategies include (a) spirituality and/or religion and (b) the role of children. Problem-focused coping strategies include (c) informal and formal support and (d) strategies of resisting, pacifying, safety planning. Implications for practice and future research in the United States and internationally are discussed.

Using alternatives to face-to-face consultations: a survey of prevalence and attitudes in general practice.

PubMed

Brant, Heather; Atherton, Helen; Ziebland, Sue; McKinstry, Brian; Campbell, John L; Salisbury, Chris

2016-07-01

The ubiquitous use of communication technologies has led to an expectation that a similar approach should extend to health care. Despite considerable rhetoric about the need for general practices to offer alternatives to face-to-face consultations, such as telephone, email, and internet video consultations, the extent to which such technologies are actually used at present is unclear. The aim of the survey was to identify the frequency and range of ways in which general practices are providing (or planning) alternatives to face-to-face consultations. A postal survey of practices around Bristol, Oxford, Lothian, the Highlands, and the Western Isles of Scotland. A postal questionnaire survey was sent to each of the GPs and practice managers of 421 practices between January and May 2015. A response was received from 319/421 practices (76%). Although the majority of the practices reported that they were conducting telephone consultations frequently (n = 211/318, 66%), fewer were implementing email consultations (n = 18/318, 6%), and most (n = 169/318, 53%) had no plans to introduce this. None were currently using internet video, and 86% (n = 273/318) had no plans to introduce internet video consultations. These findings were repeated in the reported use of alternatives to face-to-face consultations at an individual GP level. Optional free text responses were completed by 28% of responders, and offered an explanation for the (often perceived) barriers and incentives for implementation. Despite policy pressure to introduce consultations by email and internet video, there is a general reluctance among GPs to implement alternatives to face-to-face consultations. This identifies a substantial gap between rhetoric and reality in terms of the likelihood of certain alternatives (email, video) changing practice in the near future. © British Journal of General Practice 2016.

Veterinary public health capacity in the United States: opportunities for improvement.

PubMed

Jarman, Dwayne W; Liang, Jennifer L; Luce, Richard R; Wright, Jennifer G; Stennies, Gail M; Bisgard, Kristine M

2011-01-01

In 2006, the Association of American Veterinary Medical Colleges reported that the shortage (≥ 1,500) of public health veterinarians is expected to increase tenfold by 2020. In 2008, the Centers for Disease Control and Prevention (CDC) Preventive Medicine Fellows conducted a pilot project among CDC veterinarians to identify national veterinary public health workforce concerns and potential policy strategies. Fellows surveyed a convenience sample (19/91) of public health veterinarians at CDC to identify veterinary workforce recruitment and retention problems faced by federal agencies; responses were categorized into themes. A focus group (20/91) of staff veterinarians subsequently prioritized the categorized themes from least to most important. Participants identified activities to address the three recruitment concerns with the highest combined weight. Participants identified the following three highest prioritized problems faced by federal agencies when recruiting veterinarians to public health: (1) lack of awareness of veterinarians' contributions to public health practice, (2) competitive salaries, and (3) employment and training opportunities. Similarly, key concerns identified regarding retention of public health practice veterinarians included: (1) lack of recognition of veterinary qualifications, (2) competitive salaries, and (3) seamless integration of veterinary and human public health. Findings identified multiple barriers that can affect recruitment and retention of veterinarians engaged in public health practice. Next steps should include replicating project efforts among a national sample of public health veterinarians. A committed and determined long-term effort might be required to sustain initiatives and policy proposals to increase U.S. veterinary public health capacity.

The Need for Screening, Assessment, and Treatment for Cognitive Dysfunction in Multiple Sclerosis

PubMed Central

Benedict, Ralph H.B.; Gromisch, Elizabeth S.; DeLuca, John

2012-01-01

Cognitive dysfunction is observed in about half of people with multiple sclerosis (MS), and MS health-care professionals face the challenge of screening, assessing, and treating patients for cognitive problems. Considering the inconsistent or limited empirical evidence to assist in this task, a multidisciplinary consensus conference of MS experts, sponsored by the Consortium of Multiple Sclerosis Centers (CMSC), was held on September 24, 2010, to address these issues. Key articles from the literature on these topics were distributed prior to the meeting, and CMSC member professionals were surveyed on clinical practices related to screening, assessment, and treatment for cognitive problems. The purpose of the meeting was threefold: 1) to achieve a multidisciplinary perspective on practices for screening, monitoring, evaluating, and treating MS patients for cognitive problems; 2) to propose consensus candidate measures for screening and/or monitoring for cognitive problems in MS that neurologists or nurses might administer on a regular basis; and 3) to propose consensus treatment approaches from a multidisciplinary perspective. This article summarizes the conclusions of the conference participants and provides preliminary suggestions for screening and brief assessment. PMID:24453735

Conformal mapping for multiple terminals

PubMed Central

Wang, Weimin; Ma, Wenying; Wang, Qiang; Ren, Hao

2016-01-01

Conformal mapping is an important mathematical tool that can be used to solve various physical and engineering problems in many fields, including electrostatics, fluid mechanics, classical mechanics, and transformation optics. It is an accurate and convenient way to solve problems involving two terminals. However, when faced with problems involving three or more terminals, which are more common in practical applications, existing conformal mapping methods apply assumptions or approximations. A general exact method does not exist for a structure with an arbitrary number of terminals. This study presents a conformal mapping method for multiple terminals. Through an accurate analysis of boundary conditions, additional terminals or boundaries are folded into the inner part of a mapped region. The method is applied to several typical situations, and the calculation process is described for two examples of an electrostatic actuator with three electrodes and of a light beam splitter with three ports. Compared with previously reported results, the solutions for the two examples based on our method are more precise and general. The proposed method is helpful in promoting the application of conformal mapping in analysis of practical problems. PMID:27830746

On Murray Jackson's 1961 'Chair, couch and countertransference'.

PubMed

Connolly, Angela

2015-09-01

One of the problems facing psychoanalysts of all schools is that theory has evolved at a much faster pace than practice. Whereas there has been an explosion of theory, practice has remained, at least officially, static and unchanging. It is in this sense that Murray Jackson's 1961 paper is still relevant today. Despite the rise of the new relational and intersubjective paradigms, most psychoanalysts, and not a few Jungian analysts, still seem to feel that the couch is an essential component of the analytical setting and process. If the use of the couch is usually justified by the argument that it favours regression, facilitates analytical reverie and protects the patient from the influence of the analyst, over time many important psychoanalysts have come to challenge this position. Increasingly these analysts suggest that the use of the couch may actually be incompatible with the newer theoretical models. This contention is strengthened by some of the findings coming from the neurosciences and infant research. This underlines the necessity of empirical research to verify the clinical effectiveness of these different positions, couch or face-to-face, but it is exactly this type of research that is lacking. © 2015, The Society of Analytical Psychology.

A Study of High School Attendance Representing Mexican Culture from the Perspective of Students, Parents, and Teachers: A Policy Recommendation for Student Vacations

ERIC Educational Resources Information Center

Jenkins, Tomorrow S.

2009-01-01

Kennett High School faces an attendance problem with a portion of its Mexican student population. These students vacation for a period of time beyond the winter break established by the district's school calendar. A practice was implemented when staff members noticed that students "disappeared" mostly in December and January. This project took a…

A Report on the Need for a College of Veterinary Medicine in New England.

ERIC Educational Resources Information Center

New England Board of Higher Education, Winchester, MA.

New England faces a critical shortage of over 1,200 veterinarians by 1980. In 1968 there were only 8.2 practicing veterinarians for every 100,000 New Englanders--5 fewer than the national average, and less than half as many as will be needed by the end of the present decade. The major problem arises from the fact that there has been no college of…

A Roadmap for True Accountability: Reconceptualizing Language-Learning Services, Reclassification Practices and Monitoring Systems for English Language Learners in U.S. Public Schools

ERIC Educational Resources Information Center

Slama, Rachel B.

2012-01-01

A major problem facing educators in the United States is how to determine when the nation's five million English language learners (ELL) are ready to exit language-learning programs, i.e. to be "reclassified" as fluent English proficient (R-FEP) and placed in mainstream classrooms without additional language support. No Child Left Behind…

Integration a la population active des parents s'occupant d'enfants ayant des incapacites (Labour Force Inclusion of Parents Caring for Children with Disabilities).

ERIC Educational Resources Information Center

Roeher Inst., North York (Ontario).

This report discusses the outcomes of a study that sought to identify the particular problems Canadian parents caring for children with disabilities face in trying to make the transition to work in terms of their child care arrangements and employment-related factors, and best practices in child care arrangements and employment accommodations.…

What Studying Problems Are Faced by the Adolescent Grade Repeaters in Macao: Uncovering Underlying Mechanisms Based on Evidences from the PISA 2012 Study

ERIC Educational Resources Information Center

Sit, Pou-seong; Cheung, Kwok-cheung; Cheong, Wai-cheong; Mak, Soi-kei; Soh, Kay-cheng; Ieong, Man-kai

2015-01-01

Most schools in Macao are private schools, and there is a variety of grade repetition policy practiced in the 45 secondary schools. The policies are translated into school-based accountability of some kind of minimum competency standards. The objective of this study is to uncover the mediation mechanisms accounting for the influences of grade…

Facilitating collaboration between pharmacists and physicians using an iterative interview process

PubMed Central

Chui, Michelle A.; Stone, Jamie A.; Odukoya, Olufumilola K.; Maxwell, Leigh

2014-01-01

Objective To elicit and describe mutually agreed upon common problems and subsequent solutions resulting from a facilitated face-to-face meeting between pharmacists and physicians. Design Descriptive, exploratory, non-experimental study. Setting Wisconsin from October to December 2011. Participants Physicians and community pharmacists Intervention Face-to-face semi-structured interviews with pharmacists and physicians from the same community, informed by previous individual interviews. Main outcome measure Methods to enhance collaboration and barriers to implementing collaboration between pharmacists and physicians Results Physicians and pharmacists generated ideas in which collaboration could improve patient care, including controlled substance monitoring, medication adherence, collaborative practice agreements for point of service issues, and a mechanism for urgent communication. Methods on how to collaborate on these issues were also discussed. Conclusions Bringing physicians and pharmacists together for a face-to-face interaction that was informed by information gained in previous individual interviews successfully stimulated conversation on ways in which each profession could help the other provide optimal patient care. This interaction appeared to dispel assumptions and build trust. Results of this project may provide pharmacists with the confidence to reach out to their physician colleagues. PMID:24362573

[Moral problems in home health care--a descriptive ethical study].

PubMed

Lauxen, Oliver

2009-12-01

In Germany there is an increasing importance of home health care and nurses that are employed in the home care sector often have to face ethical issues. The purpose of this ethnographic study was to explore moral problems in the daily practice of these nurses. The method used was qualitative interviews with 20 nurses which have been analysed by content analysis. The results showed that the ethical principle of beneficence was the core concept for the participants. Moral problems arise when nurses cannot act in accordance to this principle or when they cannot determine the good in a situation. In particular, there were four types of moral problems: "beneficence vs. autonomy", "beneficence vs. justice", "beneficence vs. loyalty" and "The good cannot be determined". The way nurses in home health care address moral problems should be improved. Some participants lack ethical competencies. Furthermore, appropriate support services for dealing with moral problems have to be designed.

Managing Your Team's Weakest Link.

PubMed

Hills, Laura

2015-01-01

Do you have a poor-performing employee on your medical practice team? If so, you're not alone. Unfortunately, this is a problem that many medical practice managers face. This article describes the best strategies for managing your team's weakest link. It explores common yet very difficult circumstances that cause low employee performance and that test the patience, heart, and skills of a practice manager. It guides readers through a process of self-discovery to determine whether their negative biases or grudges may be causing employees to perform poorly. It suggests several possible other reasons for weak employee performance, including problems with the job, practice, leadership, communication, and fit between the employee and the job. This article also suggests the best strategy for communicating concerns about performance to the weakest-link employee. It offers guidance to practice managers about protecting their time and energy when handling a poor performer. It provides a simple formula for calculating the cost of a low-performing employee, 10 possible personal reasons for the employee's poor work performance, specific questions to ask to uncover the reasons for poor performance, and an eight-rule strategy for confronting poor performance effectively. Finally, this article offers practice managers a practical strategy for handling resistance from their weakest link, illustrated with a sample dialogue.

Cosmetic head and face surgery--ethnic considerations.

PubMed

Pierce, H E

1980-05-01

In recent years there has developed an "image awareness" among various racial and ethnic groups throughout the world. Perhaps because people live longer, a greater sense of self-esteem based on the way one looks has developed. The communications media are highly promotional of interest in one's self. People want to feel good and look good, even if it requires blepharoplasty, face-lift, rhinoplasty, dermabrasion, or other types of cosmetic surgery. It is interesting that persons born in one place, and for business or personal reasons transposed to another part of the world, soon desire to remold their physical and cultural images in accordance with the practices and customs of their new milieux. This paper addresses these problems.

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

PubMed

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

2018-02-01

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

Blending Face-to-Face and Distance Learning Methods in Adult and Career-Technical Education. Practice Application Brief No. 23.

ERIC Educational Resources Information Center

Wonacott, Michael E.

Both face-to-face and distance learning methods are currently being used in adult education and career and technical education. In theory, the advantages of face-to-face and distance learning methods complement each other. In practice, however, both face-to-face and information and communications technology (ICT)-based distance programs often rely…

Technology Confidence, Competence and Problem Solving Strategies: Differences within Online and Face-to-Face Formats

ERIC Educational Resources Information Center

Peterson, Sharon L.; Palmer, Louann Bierlein

2011-01-01

This study identified the problem solving strategies used by students within a university course designed to teach pre-service teachers educational technology, and whether those strategies were influenced by the format of the course (i.e., face-to-face computer lab vs. online). It also examined to what extent the type of problem solving strategies…

[Living in hemodialysis without social insurance: The voices of renal sick people and their families].

PubMed

Mercado-Martínez, Francisco J; Correa-Mauricio, Mauricio E

2015-01-01

To examine the perspectives and practices of renal sick people and their families without social insurance regarding problems faced while on dialysis treatment. A qualitative research was developed in Guadalajara, Mexico. Thirty-seven renal sick people on hemodialysis and 50 relatives participated; all affiliated to Seguro Popular. Information was gathered through individual and group interviews. Directed content analysis was carried out. Renal sick people and their families face multiple difficulties while on hemodialysis treatment; nevertheless, economic ones are perceived as a priority due to treatment expenses, lack of financial resources and non-coverage of kidney disease by Seguro Popular. Multiple actions are combined in a circular searching for help process to face the economic burden. Hemodialysis treatment is an unbearable economic burden for renal sick people and their families without social insurance. Universal access to renal therapies should be implemented urgently.

Effectiveness of the Vital Aging program to promote active aging in Mexican older adults.

PubMed

Mendoza-Ruvalcaba, Neyda Ma; Fernández-Ballesteros, Rocío

2016-01-01

Aging is not only a population phenomenon but also an experience and an individual reality. Vital Aging ® is a program that considers active aging as the lifelong adaptation process of maximizing health and independence, physical and cognitive functioning, positive affect regulation and control, and social engagement. Through its different versions and editions, it has demonstrated being an effective program to promote active aging. The aim of this study is to determine the effectiveness of the "face-to-face" and "combined" versions of the program to promote active aging in Mexican older adults trial. Seventy-six older adults aged 60 years and over participated in a quasi-experimental study and were recruited in a senior center to participate in the two experimental conditions: Vital Aging face-to-face (VA-FF) (n=35) and Vital Aging combined (VA-C; multimedia/face-to-face) (n=15), and the remaining 26 adults were assigned to a control group. Pretest and posttest assessments were performed after the theoretical-practical intervention. Mean differences and size effects were calculated for estimating the effect of the program. At the end of the study, participants showed improvements in the active aging outcome measures. Positive effects were observed in the frequency of intellectual, cultural - artistic, and social activities, perceptions of aging, satisfaction with social relationships, and self-efficacy for aging. Additionally, those who participated in VA-FF showed better memory performance, meta-memory, and a trend to report less memory problems, while older persons in VA-C showed a trend to have better life satisfaction. No effects were observed in physical activity, frequency of social relationships, and subjective health. Findings show that the Vital Aging program in face-to-face and combined versions encourages active aging in Mexican older persons. These results are in general similar to those found in editions performed in Spain, revealing its consistency as a cross-cultural practical initiative for promoting active aging.

Methods for solving reasoning problems in abstract argumentation – A survey

PubMed Central

Charwat, Günther; Dvořák, Wolfgang; Gaggl, Sarah A.; Wallner, Johannes P.; Woltran, Stefan

2015-01-01

Within the last decade, abstract argumentation has emerged as a central field in Artificial Intelligence. Besides providing a core formalism for many advanced argumentation systems, abstract argumentation has also served to capture several non-monotonic logics and other AI related principles. Although the idea of abstract argumentation is appealingly simple, several reasoning problems in this formalism exhibit high computational complexity. This calls for advanced techniques when it comes to implementation issues, a challenge which has been recently faced from different angles. In this survey, we give an overview on different methods for solving reasoning problems in abstract argumentation and compare their particular features. Moreover, we highlight available state-of-the-art systems for abstract argumentation, which put these methods to practice. PMID:25737590

How to save distressed IDS-physician marriages: a case study.

PubMed

Collins, H; Johnson, B A

1998-04-01

A hospital-driven IDS that encounters serious problems resulting from ownership of a physician practice should address those problems by focusing on three core areas: vision and leadership, effectiveness of operations, and physician compensation arrangements. If changes in these areas do not lead to improvements, the IDS may need to consider organizational restructuring. In one case study, a hospital-driven IDS faced the problem of owning a poorly performing MSO with a captive physician group. The IDS's governing board determined that the organization lacked effective communication with the physicians and that realization of the organization's vision would require greater physician involvement in organizational decision making. The organization is expected to undergo some corporate reorganization in which physicians will acquire an equity interest in the enterprise.

The physics of custody

NASA Astrophysics Data System (ADS)

Gomberoff, Andrés; Muñoz, Víctor; Romagnoli, Pierre Paul

2014-02-01

Divorced individuals face complex situations when they have children with different ex-partners, or even more, when their new partners have children of their own. In such cases, and when kids spend every other weekend with each parent, a practical problem emerges: is it possible to have such a custody arrangement that every couple has either all of the kids together or no kids at all? We show that in general, it is not possible, but that the number of couples that do can be maximized. The problem turns out to be equivalent to finding the ground state of a spin glass system, which is known to be equivalent to what is called a weighted max-cut problem in graph theory, and hence it is NP-complete.

Lean Management—The Journey from Toyota to Healthcare

PubMed Central

Teich, Sorin T.; Faddoul, Fady F.

2013-01-01

The evolution of production systems is tightly linked to the story of Toyota Motor Company (TMC) that has its roots around 1918. The term “lean” was coined in 1990 following the exploration of the Toyota model that led to the “transference” thesis sustaining the concept that manufacturing problems and technologies are universal problems faced by management and that these concepts can be emulated in non-Japanese enterprises. Lean is a multi-faceted concept and requires organizations to exert effort along several dimensions simultaneously; some consider a successful implementation either achieving major strategic components of lean, implementing practices to support operational aspects, or providing evidence that the improvements are sustainable in the long term. The article explores challenges and opportunities faced by organizations that intend incorporating lean management principles and presents the specific context of the healthcare industry. Finally, the concepts of “essential few” and customer value are illustrated through a simple example of process change following lean principles, which was implemented in a dental school in the United States. PMID:23908857

Externalizing Behaviors of Ukrainian Children: The Role of Parenting

PubMed Central

Burlaka, Viktor

2016-01-01

The purpose of this study was to assess the association of positive and negative parenting with child externalizing problems. Quantitative data were collected during face-to-face interviews with 320 parents of children 9–16 years of age (50% males) in 11 communities in Eastern, Southern and Central Ukraine. The study estimated the relationship between parenting practices and child externalizing behaviors, such as aggression, delinquency and attention problems. Results revealed that positive parenting, child monitoring, and avoidance of corporal punishment were associated with fewer child externalizing symptoms. Results also indicated that child male gender and single parenting had significant and positive association with child externalizing behaviors. This study extends international psychosocial knowledge on children and families. These findings can be used to design programs and foster dialogues about the role of family and social environments in the development of externalizing disorder among researchers, representatives of governmental and non-governmental organizations and mass media that work with child abuse prevention in Ukraine. PMID:26907365

Lean management-the journey from toyota to healthcare.

PubMed

Teich, Sorin T; Faddoul, Fady F

2013-04-01

The evolution of production systems is tightly linked to the story of Toyota Motor Company (TMC) that has its roots around 1918. The term "lean" was coined in 1990 following the exploration of the Toyota model that led to the "transference" thesis sustaining the concept that manufacturing problems and technologies are universal problems faced by management and that these concepts can be emulated in non-Japanese enterprises. Lean is a multi-faceted concept and requires organizations to exert effort along several dimensions simultaneously; some consider a successful implementation either achieving major strategic components of lean, implementing practices to support operational aspects, or providing evidence that the improvements are sustainable in the long term. The article explores challenges and opportunities faced by organizations that intend incorporating lean management principles and presents the specific context of the healthcare industry. Finally, the concepts of "essential few" and customer value are illustrated through a simple example of process change following lean principles, which was implemented in a dental school in the United States.

Externalizing behaviors of Ukrainian children: The role of parenting.

PubMed

Burlaka, Viktor

2016-04-01

The purpose of this study was to assess the association of positive and negative parenting with child externalizing problems. Quantitative data were collected during face-to-face interviews with 320 parents of children 9-16 years of age (50% males) in 11 communities in Eastern, Southern, and Central Ukraine. The study estimated the relationship between parenting practices and child externalizing behaviors such as aggression, delinquency, and attention problems. Results revealed that positive parenting, child monitoring, and avoidance of corporal punishment were associated with fewer child externalizing symptoms. Results also indicated that child male gender and single parenting had significant and positive association with child externalizing behaviors. This study extends international psychosocial knowledge on children and families. These findings can be used to design programs and foster dialogs about the role of family and social environments in the development of externalizing disorder among researchers, representatives of governmental and nongovernmental organizations, and mass media that work with child abuse prevention in Ukraine. Copyright © 2016 Elsevier Ltd. All rights reserved.

N²E: Envisioning a process to support transition from nurse to educator.

PubMed

McAllister, Margaret; Oprescu, Florin; Jones, Christian

2014-01-01

Rising health inequities, continuing nursing shortages, and overlooked professional development needs of nurse educators are three important issues facing nursing in Australia. This paper argues for an innovative and proactive strategy that could transform the nurse education workforce into one that is repopulated, reinvigorated and refocused. The problem facing nurse educators, and subsequently affecting nurses' preparation for practice and longevity in the profession, was identified by drawing on findings from the literature, extensive educational experience, and an exploratory study of nurse educators working in universities, colleges and health services. A solution has been devised by drawing together the tenets of critical social theory, transformative learning, communities of practice and social media. Nursing educators, refocused around a social justice agenda, may be the remedy that the Australian Health Care System requires to embark on effective action that can benefit everyone, from the health service staff to our most vulnerable groups in society. This refocusing can be achieved in a structured and strategic process that builds confidence and professional capabilities.

N2E: Envisioning a process to support transition from nurse to educator.

PubMed

McAllister, Margaret; Oprescu, Florin; Jones, Christian

2013-11-21

Abstract Rising health inequities, continuing nursing shortages, and overlooked professional development needs of nurse educators are three important issues facing nursing in Australia. This paper argues for an innovative and proactive strategy that could transform the nurse education workforce into one that is repopulated, reinvigorated and refocused. The problem facing nurse educators, and subsequently affecting nurses' preparation for practice and longevity in the profession, was identified by drawing on findings from the literature, extensive educational experience, and an exploratory study of nurse educators working in universities, colleges and health services. A solution has been devised by drawing together the tenets of critical social theory, transformative learning, communities of practice and social media. Nursing educators, refocused around a social justice agenda, may be the remedy that the Australian Health Care System requires to embark on effective action that can benefit everyone, from the health service staff to our most vulnerable groups in society. This refocusing can be achieved in a structured and strategic process that builds confidence and professional capabilities.

Research requirements to reduce maintenance costs of civil helicopters

NASA Technical Reports Server (NTRS)

Million, D. J.; Waters, K. T.

1978-01-01

The maintenance problems faced by the operators of civil helicopters that result in high costs are documented. Existing technology that can be applied to reduce maintenance costs and research that should be carried out were identified. Good design practice and application of existing technology were described as having a significant impact on reducing maintenance costs immediately. The research and development that have potential for long range reduction of maintenance costs are presented.

The "new genetics": an ethical perspective from family practice.

PubMed

Sugiyama, J

1988-04-01

The new genetic technologies are becoming increasingly applicable to clinical medicine. At present, however, diagnostic capabilities far exceed treatment options. Pregnancy termination, with its attendant moral-ethical problems, remains the major therapeutic option for mothers bearing fetuses with genetic abnormalities. In this article, the author outlines the major ethical issues facing family physicians, in the context of our expanding genetic diagnostic and therapeutic capabilities, and their possible effects on the traditional physician-patient relationship.

Opinion: Is science really facing a reproducibility crisis, and do we need it to?

PubMed Central

Fanelli, Daniele

2018-01-01

Efforts to improve the reproducibility and integrity of science are typically justified by a narrative of crisis, according to which most published results are unreliable due to growing problems with research and publication practices. This article provides an overview of recent evidence suggesting that this narrative is mistaken, and argues that a narrative of epochal changes and empowerment of scientists would be more accurate, inspiring, and compelling. PMID:29531051

Big Data Challenges for Large Radio Arrays

NASA Technical Reports Server (NTRS)

Jones, Dayton L.; Wagstaff, Kiri; Thompson, David; D'Addario, Larry; Navarro, Robert; Mattmann, Chris; Majid, Walid; Lazio, Joseph; Preston, Robert; Rebbapragada, Umaa

2012-01-01

Future large radio astronomy arrays, particularly the Square Kilometre Array (SKA), will be able to generate data at rates far higher than can be analyzed or stored affordably with current practices. This is, by definition, a "big data" problem, and requires an end-to-end solution if future radio arrays are to reach their full scientific potential. Similar data processing, transport, storage, and management challenges face next-generation facilities in many other fields.

Space Acquisitions: DOD Faces Challenges in Fully Realizing Benefits of Satellite Acquisition Improvements

DTIC Science & Technology

2012-03-21

Test Program ( STP ) was targeted for termination in the fiscal year 2013 budget. STP was created in 1965 to serve as an integrator to provide launch...been lagging behind schedule and it had taken positive actions to instill better practices and more focused leadership for space. Progress has...instance, the second Global Positioning System (GPS) IIF satellite experienced technical problems that could shorten its operational lifetime. The

Nursing students' experiences of ethical issues in clinical practice: A New Zealand study.

PubMed

Sinclair, J; Papps, E; Marshall, B

2016-03-01

Nursing students experience ethical problems in clinical practice in a different way from registered nurses. In order to develop ethical reasoning and competence in nursing students, nurse educators must recognise the unique issues students face. This research described the occurrence of ethical issues in clinical practice for 373 undergraduate nursing students who responded to a national questionnaire investigating the frequency of pre-determined ethical issues and the corresponding level of distress. Over two thirds of respondents experienced breaches of a patient's right to confidentiality, privacy, dignity or respect and 87% experienced unsafe working conditions. The most distressing issues were those that compromised patient safety, including unsafe healthcare practices, working conditions and suspected abuse or neglect. Themes that emerged from an open-ended question included lack of support and supervision, bullying and end of life issues. This research found the frequency at which ethical issues are experienced was highest in year three participants. However, the overall distress levels were lower for the majority of issues for those participants in the later part of their degree. Recommendations from this research include developing ethics education around the main concerns that students face in order to enhance students' understanding, resilience and ability to respond appropriately. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ecological literacy and beyond: Problem-based learning for future professionals.

PubMed

Lewinsohn, Thomas M; Attayde, José Luiz; Fonseca, Carlos Roberto; Ganade, Gislene; Jorge, Leonardo Ré; Kollmann, Johannes; Overbeck, Gerhard E; Prado, Paulo Inácio; Pillar, Valério D; Popp, Daniela; da Rocha, Pedro L B; Silva, Wesley Rodrigues; Spiekermann, Annette; Weisser, Wolfgang W

2015-03-01

Ecological science contributes to solving a broad range of environmental problems. However, lack of ecological literacy in practice often limits application of this knowledge. In this paper, we highlight a critical but often overlooked demand on ecological literacy: to enable professionals of various careers to apply scientific knowledge when faced with environmental problems. Current university courses on ecology often fail to persuade students that ecological science provides important tools for environmental problem solving. We propose problem-based learning to improve the understanding of ecological science and its usefulness for real-world environmental issues that professionals in careers as diverse as engineering, public health, architecture, social sciences, or management will address. Courses should set clear learning objectives for cognitive skills they expect students to acquire. Thus, professionals in different fields will be enabled to improve environmental decision-making processes and to participate effectively in multidisciplinary work groups charged with tackling environmental issues.

[Controversy in the treatment of a critically ill neonate in a rural health service].

PubMed

Márquez-González, Horacio; Valdez-Martínez, Edith

2015-01-01

Cardiopulmonary resuscitation of newborns with perinatal hypoxia faces serious ethical, moral, medical and legal problems, particularly in rural areas. Ethical and moral issues have to do with the medical-parents relationship; with values, preferences and priorities of each of these groups; and with the scarce resources situation. Medical-technical problems are related to asphyxia complications, and their prognostic and therapeutic implications. Legal considerations arising from the fact of killing or letting die. In this article is analyzed the real case of a neonate with severe perinatal hypoxia in order to enhance the understanding of the incorporation of ethics in everyday clinical practice.

Training for Efficiency: Work, Time and Systems-based Practice in Medical Residency*

PubMed Central

Szymczak, Julia E.; Bosk, Charles L.

2013-01-01

Medical residency is a period of intense socialization with a heavy workload. Previous sociological studies have identified efficiency as a practical skill necessary for success. However, many contextual features of the training environment have undergone dramatic change since these studies were conducted. What are the consequences of these changes for the socialization of residents to time management and the development of a professional identity? Based on observations of and interviews with internal medicine residents at 3 training programs, we find that efficiency is both a social norm and strategy that residents employ to manage a workload for which the demand for work exceeds the supply of time available to accomplish it. We found that residents struggle to be efficient in the face of seemingly intractable “systems” problems. Residents work around these problems, and in doing so develop a tolerance for organizational vulnerabilities. PMID:22863601

Scenario analysis and strategic planning: practical applications for radiology practices.

PubMed

Lexa, Frank James; Chan, Stephen

2010-05-01

Modern business science has many tools that can be of great value to radiologists and their practices. One of the most important and underused is long-term planning. Part of the problem has been the pace of change. Making a 5-year plan makes sense only if your develop robust scenarios of possible future conditions you will face. Scenario analysis is one of many highly regarded tools that can improve your predictive capability. However, as with many tools, it pays to have some training and to get practical tips on how to improve their value. It also helps to learn from other people's mistakes rather than your own. The authors discuss both theoretical and practical issues in using scenario analysis to improve your planning process. They discuss actionable ways this set of tools can be applied in a group meeting or retreat. Copyright (c) 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

New hope for the health care field.

PubMed

Mabbett, P

1993-03-01

Creativity is required for solving many of the problems that face the health care system. As a group, caregivers tend to underestimate their own creativity and its potential impact on the systems in which they work. This article reviews common misconceptions about creativity and describes forces that erode its expression. Suggestions are made for how creativity can be increased within traditional-practice settings. Steps in a creative process are reviewed as well as internal and external factors that support the occurrence of creative moments. The benefits to be gained from increased creativity range from practical improvements within the system to personal gratification for individual caregivers.

Using a Learning Collaborative Strategy With Office-based Practices to Increase Access and Improve Quality of Care for Patients With Opioid Use Disorders.

PubMed

Nordstrom, Benjamin R; Saunders, Elizabeth C; McLeman, Bethany; Meier, Andrea; Xie, Haiyi; Lambert-Harris, Chantal; Tanzman, Beth; Brooklyn, John; King, Gregory; Kloster, Nels; Lord, Clifton Frederick; Roberts, William; McGovern, Mark P

2016-01-01

Rapidly escalating rates of heroin and prescription opioid use have been widely observed in rural areas across the United States. Although US Food and Drug Administration-approved medications for opioid use disorders exist, they are not routinely accessible to patients. One medication, buprenorphine, can be prescribed by waivered physicians in office-based practice settings, but practice patterns vary widely. This study explored the use of a learning collaborative method to improve the provision of buprenorphine in the state of Vermont. We initiated a learning collaborative with 4 cohorts of physician practices (28 total practices). The learning collaborative consisted of a series of 4 face-to-face and 5 teleconference sessions over 9 months. Practices collected and reported on 8 quality-improvement data measures, which included the number of patients prescribed buprenorphine, and the percent of unstable patients seen weekly. Changes from baseline to 8 months were examined using a p-chart and logistic regression methodology. Physician engagement in the learning collaborative was favorable across all 4 cohorts (85.7%). On 6 of the 7 quality-improvement measures, there were improvements from baseline to 8 months. On 4 measures, these improvements were statistically significant (P < 0.001). Importantly, practice variation decreased over time on all measures. The number of patients receiving medication increased only slightly (3.4%). Results support the effectiveness of a learning collaborative approach to engage physicians, modestly improve patient access, and significantly reduce practice variation. The strategy is potentially generalizable to other systems and regions struggling with this important public health problem.

The Effects of Health Education through Face To Face Teaching and Educational Movies, on Suburban Women in Childbearing Age.

PubMed

Vameghi, R; Mohammad, K; Karimloo, M; Soleimani, F; Sajedi, F

2010-01-01

The aim of the study was to compare the effects of 'face-to-face education' and 'educational movies' on 'knowledge' and 'practice' of women of child-bearing-age, in terms of health-care during pregnancy and during infancy in a suburban region near Tehran City, Iran. In this quasi-experimental study, the sample included 873 married women. Questionnaires for knowledge and practice assessment were designed. The women were assigned to three groups: control (group I), face-to-face education (group II), and educational movie (group III). Knowledge questionnaires were completed before and immediately after intervention. Practice questionnaires were completed before and three months after intervention. Both questionnaires consisted of two types of questions: type A (concerning infant care issues) and type B (concerning prenatal health care). There was a significant difference in post-test knowledge between groups I and II and between groups I and III, but not between groups II and III. In terms of post-test practice, the changes were determined for every individual question, and significantly, better results were seen in group II, especially concerning type B questions. Face to face education lead to better practice than educational movies. In addition, significantly better practice occurred regarding child health care issues rather than prenatal issues in both groups. Realistic and tangible issues, those easy to practice, and with little or no economical burden imposed on the family, progressed from the knowledge state to the practice state more successfully in both groups.

[E-health within the Dutch mental health services: what is the current situation?].

PubMed

Smeets, Odile; Martin Abello, Katherina; Zijlstra-Vlasveld, Moniek; Boon, Brigitte

2014-01-01

The 'e-mental health' currently available, which also covers m-health and i-health, varies from psycho-education and self-tests to self-help, treatment and contact with fellow sufferers. Many programs are based on cognitive behavioural therapy, but other types of therapy are also used. Research shows that online programs for depression, alcohol problems and anxiety can reduce these symptoms and can be cost effective. This applies to both self-help and treatment programs. Many e-programs in the Netherlands have been developed for the Dutch Association of Mental Health and Addiction Care (GGZ) and for treatment of addiction problems. One problem with e-mental-health is that provision is fragmented, and there is no national overview, while insight into quality is important for patients and professionals. The quality hallmark 'Onlinehulpstempel.nl' ('Online help hallmark') provides this insight. The use of e-mental-health within Dutch healthcare services is still in its infancy. New financing methods are stimulating general practitioners to use it. The consolidation of online and face-to-face care ('blended e-health') provides an opportunity for patients and GGZ support personnel within general practice to start to use e-health.

Using alternatives to face-to-face consultations: a survey of prevalence and attitudes in general practice

PubMed Central

Brant, Heather; Atherton, Helen; Ziebland, Sue; McKinstry, Brian; Campbell, John L; Salisbury, Chris

2016-01-01

Background The ubiquitous use of communication technologies has led to an expectation that a similar approach should extend to health care. Despite considerable rhetoric about the need for general practices to offer alternatives to face-to-face consultations, such as telephone, email, and internet video consultations, the extent to which such technologies are actually used at present is unclear. Aim The aim of the survey was to identify the frequency and range of ways in which general practices are providing (or planning) alternatives to face-to-face consultations. Design and setting A postal survey of practices around Bristol, Oxford, Lothian, the Highlands, and the Western Isles of Scotland. Method A postal questionnaire survey was sent to each of the GPs and practice managers of 421 practices between January and May 2015. Results A response was received from 319/421 practices (76%). Although the majority of the practices reported that they were conducting telephone consultations frequently (n = 211/318, 66%), fewer were implementing email consultations (n = 18/318, 6%), and most (n = 169/318, 53%) had no plans to introduce this. None were currently using internet video, and 86% (n = 273/318) had no plans to introduce internet video consultations. These findings were repeated in the reported use of alternatives to face-to-face consultations at an individual GP level. Optional free text responses were completed by 28% of responders, and offered an explanation for the (often perceived) barriers and incentives for implementation. Conclusion Despite policy pressure to introduce consultations by email and internet video, there is a general reluctance among GPs to implement alternatives to face-to-face consultations. This identifies a substantial gap between rhetoric and reality in terms of the likelihood of certain alternatives (email, video) changing practice in the near future. PMID:27215571

Assessment of elderly people in general practice. 2. Functional abilities and medical problems.

PubMed Central

Iliffe, S; Haines, A; Gallivan, S; Booroff, A; Goldenberg, E; Morgan, P

1991-01-01

A random sample of 239 patients aged 75 years and over registered with general practitioners in north and north west London was selected for home assessment to determine the functional abilities and medical problems of this group of patients. Nearly one in five of the patients were incontinent of urine (18.4%), although this was on a daily basis for only 4.1%. Around one in 20 patients were incontinent of faeces (5.9%), yet only one patient had laundry service support. Unassisted mobility outdoors was reported as possible by 81.2% of the patients. Fourteen different types of aids were present in the participants' homes, the commonest being walking sticks, bath aids and stair rails. Only a small proportion of aids seemed to be currently unused. The major functional problems were bathing, housework, shopping, washing and ironing, and cooking main meals, but the level of demand for extra help was low. One in five patients had a hearing aid (19.8%) but for only 30% of these patients was it in continuous use. Polypharmacy was common, with 29.7% of patients taking three or more prescribed medicines. The workload implications of this approach to anticipatory care of elderly people are considerable. In an average practice of 2000 patients with 130 patients aged 75 years and over the primary care team would need over 150 hours of face-to-face contact per year with these patients to fulfil the new contractual obligation and the yield of new information leading to effective medical or social intervention is limited.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2003950

Developing professional identity in nursing academics: the role of communities of practice.

PubMed

Andrew, Nicola; Ferguson, Dorothy; Wilkie, George; Corcoran, Terry; Simpson, Liz

2009-08-01

This paper analyses the current standing of nursing within the wider United Kingdom (UK) higher education (HE) environment and considers the development of academic identity within the sector, introducing a technology mediated approach to professional learning and development. A community of practice (CoP) is a way of learning based on collaboration among peers. Individuals come together virtually or physically, with a common purpose, defined by knowledge rather than task [Wenger, E., 1998. Communities of Practice: Learning, Meaning and Identity, sixth ed. Cambridge University Press, Cambridge]. In 2008, a small team of academics at Glasgow Caledonian University, School of Nursing, Midwifery and Community Health created and implemented iCoP, a project undertaken to pilot an international CoP, where novices and expert academics collaborated to debate and discuss the complex transition from clinician to academic. Although not intended as a conventional research project, the developmental journey and emerging online discussion provide an insight into the collective thoughts and opinions of a multi-national group of novice academics. The article also highlights the key challenges, problems and limitations of working in an international online arena with professionals who traditionally work and thrive in a face to face, real time environment.

Veterinary Public Health Capacity in the United States: Opportunities for Improvement

PubMed Central

Jarman, Dwayne W.; Liang, Jennifer L.; Luce, Richard R.; Wright, Jennifer G.; Stennies, Gail M.; Bisgard, Kristine M.

2011-01-01

Objectives In 2006, the Association of American Veterinary Medical Colleges reported that the shortage (≥1,500) of public health veterinarians is expected to increase tenfold by 2020. In 2008, the Centers for Disease Control and Prevention (CDC) Preventive Medicine Fellows conducted a pilot project among CDC veterinarians to identify national veterinary public health workforce concerns and potential policy strategies. Methods Fellows surveyed a convenience sample (19/91) of public health veterinarians at CDC to identify veterinary workforce recruitment and retention problems faced by federal agencies; responses were categorized into themes. A focus group (20/91) of staff veterinarians subsequently prioritized the categorized themes from least to most important. Participants identified activities to address the three recruitment concerns with the highest combined weight. Results Participants identified the following three highest prioritized problems faced by federal agencies when recruiting veterinarians to public health: (1) lack of awareness of veterinarians' contributions to public health practice, (2) competitive salaries, and (3) employment and training opportunities. Similarly, key concerns identified regarding retention of public health practice veterinarians included: (1) lack of recognition of veterinary qualifications, (2) competitive salaries, and (3) seamless integration of veterinary and human public health. Conclusions Findings identified multiple barriers that can affect recruitment and retention of veterinarians engaged in public health practice. Next steps should include replicating project efforts among a national sample of public health veterinarians. A committed and determined long-term effort might be required to sustain initiatives and policy proposals to increase U.S. veterinary public health capacity. PMID:22043103

Counting to 20: Online Implementation of a Face-to-Face, Elementary Mathematics Methods Problem-Solving Activity

ERIC Educational Resources Information Center

Schwartz, Catherine Stein

2012-01-01

This study describes implementation of the same problem-solving activity in both online and face-to-face environments. The activity, done in the first class period or first module of a K-2 mathematics methods course, was initially used in a face-to-face class and then adapted later for use in an online class. While the task was originally designed…

Interprofessional practices of physiotherapists working with adults with low back pain in Québec’s private sector: results of a qualitative study

PubMed Central

2014-01-01

Background Collaboration and interprofessional practices are highly valued in health systems, because they are thought to improve outcomes of care for persons with complex health problems, such as low back pain. Physiotherapists, like all health providers, are encouraged to take part in interprofessional practices. However, little is known about these practices, especially for private sector physiotherapists. This study aimed to: 1) explore how physiotherapists working in the private sector with adults with low back pain describe their interprofessional practices, 2) identify factors that influence their interprofessional practices, and 3) identify their perceived effects. Methods Participants were 13 physiotherapists, 10 women/3 men, having between 3 and 21 years of professional experience. For this descriptive qualitative study, we used face-to-face semi-structured interviews and conducted content analysis encompassing data coding and thematic regrouping. Results Physiotherapists described interprofessional practices heterogeneously, including numerous processes such as sharing information and referring. Factors that influenced physiotherapists’ interprofessional practices were related to patients, providers, organizations, and wider systems (e.g. professional system). Physiotherapists mostly viewed positive effects of interprofessional practices, including elements such as gaining new knowledge as a provider and being valued in one’s own role, as well as improvements in overall treatment and outcome. Conclusions This qualitative study offers new insights into the interprofessional practices of physiotherapists working with adults with low back pain, as perceived by the physiotherapists’ themselves. Based on the results, the development of strategies aiming to increase interprofessionalism in the management of low back pain would most likely require taking into consideration factors associated with patients, providers, the organizations within which they work, and the wider systems. PMID:24884757

Knowledge, Practices, and Restrictions Related to Menstruation among Young Women from Low Socioeconomic Community in Mumbai, India

PubMed Central

Thakur, Harshad; Aronsson, Annette; Bansode, Seema; Stalsby Lundborg, Cecilia; Dalvie, Suchitra; Faxelid, Elisabeth

2014-01-01

The main objective was to assess knowledge, practices, and restrictions faced by young women regarding their menstrual hygiene. The views of adult women having young daughters were also included and both views were compared. In addition, the factors influencing the menstrual hygiene practices were also studied. The study was carried out during 2008 in Mumbai, India. The mixed methods approach was followed for the data collection. Both qualitative and quantitative methods were used to collect the data. For quantitative survey, totally 192 respondents (96 adult and 96 younger women) were selected. While young women were asked about questions related to their menstruation, adult women were asked questions to find out how much they know about menstrual history of their daughters. The qualitative data helped to supplement the findings from the quantitative survey and to study the factors affecting menstrual practices in young women. The mean age at menarche reported was 13.4 years and 30–40% of young girls did not receive any information about menstruation before menarche. It is thus seen that very few young girls between the age group 15 and 24 years did receive any information before the onset of menstruation. Among those who received some information, it was not adequate enough. The source of information was also not authentic. Both young and adult women agreed on this. Due to the inadequate knowledge, there were certain unhygienic practices followed by the young girls resulting in poor menstrual hygiene. It also leads to many unnecessary restrictions on young girls and they faced many health problems and complaints, which were either ignored or managed inappropriately. The role of health sector was almost negligible from giving information to the management of health problems of these young girls. This paper reemphasizes the important, urgent, and neglected need of providing correct knowledge to the community including adolescent girls. PMID:25072044

Observational analysis of near-peer and faculty tutoring in problem-based learning groups.

PubMed

Cianciolo, Anna T; Kidd, Bryan; Murray, Sean

2016-07-01

Near-peer and faculty staff tutors may facilitate problem-based learning (PBL) through different means. Near-peer tutors are thought to compensate for their lack of subject matter expertise with greater adeptness at group facilitation and a better understanding of their learners. However, theoretical explanations of tutor effectiveness have been developed largely from recollections of tutor practices gathered through student evaluation surveys, focus groups and interviews. A closer look at what happens during PBL sessions tutored by near-peers and faculty members seems warranted to augment theory from a grounded perspective. We conducted an observational study to explore interactional practices during PBL tutorials at our medical school, at which near-peer tutoring of Year 2 students is an established practice. Between October 2014 and May 2015, video-recordings were made of nine purposively sampled tutor groups using three tutor types (near-peer, clinical faculty and basic science faculty staff) across three systems-based units. An investigator team comprising a Year 2 student, a Year 4 student and a behavioural scientist independently analysed the videos until their observations reached saturation and then met face to face to discuss their detailed field notes. Through constant comparison, narratives of tutor practices and group dynamics were generated for each of the nine tutor groups, representing the collective impressions of the members of the investigator team. Variation was greater within than across tutor types. Tutors' practices idiosyncratically and sometimes substantially diverged from PBL principles, yet all tutors attempted to convey authority or 'insider' status with respect to the short- and long-term goals of medical education. Students prompted these status demonstrations by expressing gratitude, asking questions and exhibiting analogous status demonstrations themselves. Understanding the socio-cognitive nature of tutoring from a grounded perspective may provide a means to develop faculty staff of all types to better meet learner needs in a principled fashion. © 2016 John Wiley & Sons Ltd.

"The Refer Less Resolve More" Initiative: A Five-year Experience from CMC Vellore, India.

PubMed

Velavan, Jachin

2012-01-01

India's one billion plus strong population presents huge health care needs. Presently, approximately 250,000 general practitioners and 30,000 Government doctors are a part of the Indian healthcare workforce, but 80% of them are based in urban India. Problems which plague healthcare delivery and attributed to physician practice may be enumerated as - physicians (1) lack competencies, (2) lack updating, (3) prescribe irrationally (pressures from pharmaceutical companies and patients), (4) practice unethically, (5) refer excessively to specialists and other clinical professionals, and (6) investigate for diseases without justification. A multi-competent Family Physician who could provide a single-window, ethical, and holistic healthcare to patients and families is the need of the hour. Therefore, training, equipping, and empowering these 250,000 doctors to become such physicians will reduce health costs considerably. Distance medical education using all the andragogic methods can be used to train large number of individuals without displacing them from their work-places. Distance learning provides a useful interface for rapidly developing a specialized pool of doctors practicing and advocating family medicine as most-needed discipline. This motivated CMC Vellore, a premier institution for medical education in India, to start a the "refer less resolve more initiative" by offering "two year family medicine diploma course" by distance mode. This is an innovatively-written program consisting of problem-based self-learning modules, video-lectures, video-conferencing, and face-to-face contact programs. Ten secondary level hospitals, across the country, under the supervision of national and international family medicine faculty form the pillars of this program. This distance learning program offered by CMC Vellore has become the platform for change as there is special focus is on ethics, rational prescribing, consultation skills, application of family medicine principles; and practical demonstration of compassionate, cost-effective and high-quality care. The change in attitude has resulted in transformation in three major aspects of practice: professional, ethical, and patient care. So far, 942 private practitioners and 177 government doctors have been enrolled.

Translating learning into practice

PubMed Central

Armson, Heather; Kinzie, Sarah; Hawes, Dawnelle; Roder, Stefanie; Wakefield, Jacqueline; Elmslie, Tom

2007-01-01

PROBLEM ADDRESSED The need for effective and accessible educational approaches by which family physicians can maintain practice competence in the face of an overwhelming amount of medical information. OBJECTIVE OF PROGRAM The practice-based small group (PBSG) learning program encourages practice changes through a process of small-group peer discussion—identifying practice gaps and reviewing clinical approaches in light of evidence. PROGRAM DESCRIPTION The PBSG uses an interactive educational approach to continuing professional development. In small, self-formed groups within their local communities, family physicians discuss clinical topics using prepared modules that provide sample patient cases and accompanying information that distils the best evidence. Participants are guided by peer facilitators to reflect on the discussion and commit to appropriate practice changes. CONCLUSION The PBSG has evolved over the past 15 years in response to feedback from members and reflections of the developers. The success of the program is evidenced in effect on clinical practice, a large and increasing number of members, and the growth of interest internationally. PMID:17872876

Face recognition based on symmetrical virtual image and original training image

NASA Astrophysics Data System (ADS)

Ke, Jingcheng; Peng, Yali; Liu, Shigang; Li, Jun; Pei, Zhao

2018-02-01

In face representation-based classification methods, we are able to obtain high recognition rate if a face has enough available training samples. However, in practical applications, we only have limited training samples to use. In order to obtain enough training samples, many methods simultaneously use the original training samples and corresponding virtual samples to strengthen the ability of representing the test sample. One is directly using the original training samples and corresponding mirror samples to recognize the test sample. However, when the test sample is nearly symmetrical while the original training samples are not, the integration of the original training and mirror samples might not well represent the test samples. To tackle the above-mentioned problem, in this paper, we propose a novel method to obtain a kind of virtual samples which are generated by averaging the original training samples and corresponding mirror samples. Then, the original training samples and the virtual samples are integrated to recognize the test sample. Experimental results on five face databases show that the proposed method is able to partly overcome the challenges of the various poses, facial expressions and illuminations of original face image.

Dynamic Flow Management Problems in Air Transportation

NASA Technical Reports Server (NTRS)

Patterson, Sarah Stock

1997-01-01

In 1995, over six hundred thousand licensed pilots flew nearly thirty-five million flights into over eighteen thousand U.S. airports, logging more than 519 billion passenger miles. Since demand for air travel has increased by more than 50% in the last decade while capacity has stagnated, congestion is a problem of undeniable practical significance. In this thesis, we will develop optimization techniques that reduce the impact of congestion on the national airspace. We start by determining the optimal release times for flights into the airspace and the optimal speed adjustment while airborne taking into account the capacitated airspace. This is called the Air Traffic Flow Management Problem (TFMP). We address the complexity, showing that it is NP-hard. We build an integer programming formulation that is quite strong as some of the proposed inequalities are facet defining for the convex hull of solutions. For practical problems, the solutions of the LP relaxation of the TFMP are very often integral. In essence, we reduce the problem to efficiently solving large scale linear programming problems. Thus, the computation times are reasonably small for large scale, practical problems involving thousands of flights. Next, we address the problem of determining how to reroute aircraft in the airspace system when faced with dynamically changing weather conditions. This is called the Air Traffic Flow Management Rerouting Problem (TFMRP) We present an integrated mathematical programming approach for the TFMRP, which utilizes several methodologies, in order to minimize delay costs. In order to address the high dimensionality, we present an aggregate model, in which we formulate the TFMRP as a multicommodity, integer, dynamic network flow problem with certain side constraints. Using Lagrangian relaxation, we generate aggregate flows that are decomposed into a collection of flight paths using a randomized rounding heuristic. This collection of paths is used in a packing integer programming formulation, the solution of which generates feasible and near-optimal routes for individual flights. The algorithm, termed the Lagrangian Generation Algorithm, is used to solve practical problems in the southwestern portion of United States in which the solutions are within 1% of the corresponding lower bounds.

Evaluation of patient and doctor perception toward the use of telemedicine in Apollo Tele Health Services, India.

PubMed

Acharya, Rajesh V; Rai, Jasuma J

2016-01-01

Telemedicine incorporates electronic information and medical technology. It connects healthcare through vast distances which would benefit both patients and doctors. The aim of this questionnaire study was to evaluate the effects of telemedicine on patients and medical specialists. A cross-sectional study was conducted among 122 participants (71 patients and 51 doctors) on satisfaction in quality of service, cost-effectiveness, and problems encountered in healthcare provided by the telemedicine in Apollo Tele Health Services, Hyderabad, Telangana, India. The data for each group were calculated and compared. About 80% patients and all the doctors reported their satisfaction on the quality of treatment given through telemedicine. Approximately, 90% of the participants found telemedicine cost-effective and 61% of the doctors found an increase in patient's inflow apart for their regular practice. Problems encountered in telemedicine were 47% in technical issues and 39% in time scheduling by doctors and 31% of patients were uncomfortable to face the camera, and 24% had technical issues. The results of the present study showed that telemedicine in healthcare could prove to be useful to patients in distant regions and to rural doctors in India. In the near future, telemedicine can be considered as an alternate to face to face patient care.

Effectiveness of the Vital Aging program to promote active aging in Mexican older adults

PubMed Central

Mendoza-Ruvalcaba, Neyda Ma; Fernández-Ballesteros, Rocío

2016-01-01

Introduction Aging is not only a population phenomenon but also an experience and an individual reality. Vital Aging® is a program that considers active aging as the lifelong adaptation process of maximizing health and independence, physical and cognitive functioning, positive affect regulation and control, and social engagement. Through its different versions and editions, it has demonstrated being an effective program to promote active aging. The aim of this study is to determine the effectiveness of the “face-to-face” and “combined” versions of the program to promote active aging in Mexican older adults trial. Methods Seventy-six older adults aged 60 years and over participated in a quasi-experimental study and were recruited in a senior center to participate in the two experimental conditions: Vital Aging face-to-face (VA-FF) (n=35) and Vital Aging combined (VA-C; multimedia/face-to-face) (n=15), and the remaining 26 adults were assigned to a control group. Pretest and posttest assessments were performed after the theoretical–practical intervention. Mean differences and size effects were calculated for estimating the effect of the program. Results At the end of the study, participants showed improvements in the active aging outcome measures. Positive effects were observed in the frequency of intellectual, cultural – artistic, and social activities, perceptions of aging, satisfaction with social relationships, and self-efficacy for aging. Additionally, those who participated in VA-FF showed better memory performance, meta-memory, and a trend to report less memory problems, while older persons in VA-C showed a trend to have better life satisfaction. No effects were observed in physical activity, frequency of social relationships, and subjective health. Conclusion Findings show that the Vital Aging program in face-to-face and combined versions encourages active aging in Mexican older persons. These results are in general similar to those found in editions performed in Spain, revealing its consistency as a cross-cultural practical initiative for promoting active aging. PMID:27881913

Summit of the Research Coordination Networks for Undergraduate Biology Education

PubMed Central

Eaton, Carrie Diaz; Allen, Deborah; Anderson, Laurel J.; Bowser, Gillian; Pauley, Mark A.; Williams, Kathy S.; Uno, Gordon E.

2016-01-01

The first summit of projects funded by the National Science Foundation’s Research Coordination Networks for Undergraduate Biology Education (RCN-UBE) program was held January 14–16, 2016, in Washington, DC. Sixty-five scientists and science educators from 38 of the 41 Incubator and Full RCN-UBE awards discussed the value and contributions of RCNs to the national biology education reform effort. The summit illustrated the progress of this innovative UBE track, first awarded in 2009. Participants shared experiences regarding network development and growth, identified best practices and challenges faced in network management, and discussed work accomplished. We report here on key aspects of network evaluation, characteristics of successful networks, and how to sustain and broaden participation in networks. Evidence from successful networks indicates that 5 years (the length of a Full RCN-UBE) may be insufficient time to produce a cohesive and effective network. While online communication promotes the activities of a network and disseminates effective practices, face-to-face meetings are critical for establishing ties between network participants. Creation of these National Science Foundation–funded networks may be particularly useful for consortia of faculty working to address problems or exchange novel solutions discovered while introducing active-learning methods and/or course-based research into their curricula.

Seven ways to make a hypertext project fail

NASA Technical Reports Server (NTRS)

Glushko, Robert J.

1990-01-01

Hypertext is an exciting concept, but designing and developing hypertext applications of practical scale is hard. To make a project feasible and successful 'hypertext engineers' must overcome the following problems: (1) developing realistic expectations in the face of hypertext hype; (2) assembling a multidisciplinary project team; (3) establishing and following design guidelines; (4) dealing with installed base constraints; (5) obtaining usable source files; (6) finding appropriate software technology and methods; and (7) overcoming legal uncertainties about intellectual property concerns.

Critical Problems Facing Technology Education: Perceptions of Indiana Teachers

ERIC Educational Resources Information Center

Lazaros, Edward J.; Rogers, George E.

2006-01-01

In 1993 Wicklein conducted a study to determine the present and the future critical issues and problems facing the technology education (TE) profession. The Wicklein study questioned 25 panelists from 15 states and the District of Columbia to ascertain the issues and problems facing TE. However, in the Wicklein study, only seven of the panelists…

Factors influencing recording of drug misuse in primary care: a qualitative study of GPs in England.

PubMed

Davies-Kershaw, Hilary; Petersen, Irene; Nazareth, Irwin; Stevenson, Fiona

2018-04-01

Drug misuse is a serious public health problem. Evidence from previous epidemiological studies show that GPs are recording drug misuse in electronic patient records (EPR). However, although the recording trends are similar to national surveys, recording rates are much lower. To explore the factors that influence GPs to record drug misuse in the EPR, and to gain a clearer understanding of the gap between the amount of drug misuse recorded in primary care and that in national surveys and other studies. A semi-structured qualitative interview study of GPs working in general practices across England. Purposive sampling was employed to recruit 12 GPs, both with and without a special interest in drug misuse, from across England. Semi-structured face-to-face interviews were conducted to consider whether and why GPs record drug misuse, which methods GPs use for recording, GPs' actions if a patient asks for the information not to be recorded, and GPs' actions if they think a patient misuses drugs but does not disclose the information. Resulting data were analysed using a combination of inductive and deductive thematic analysis. The complexity of asking about drug misuse preceded GPs' decision to record. They described how the context of the general practice protocols, interaction between GP and patient, and the questioning process affected whether, how, and in which circumstances they asked about drug use. This led to GPs making a clinical decision on whether, who, and how to record in the EPR. When making decisions about whether or not to record drug misuse, GPs face complex choices. Aside from their own views, they reported feelings of pressure from the general practice environment in which they worked and their clinical commissioning group, as well as government policies. © British Journal of General Practice 2018.

Telephone triage by GPs in out-of-hours primary care in Denmark: a prospective observational study of efficiency and relevance

PubMed Central

Huibers, Linda; Moth, Grete; Carlsen, Anders H; Christensen, Morten B; Vedsted, Peter

2016-01-01

Background In the UK, telephone triage in out-of-hours primary care is mostly managed by nurses, whereas GPs perform triage in Denmark. Aim To describe telephone contacts triaged to face-to-face contacts, GP-assessed relevance, and factors associated with triage to face-to-face contact. Design and setting A prospective observational study in Danish out-of-hours primary care, conducted from June 2010 to May 2011. Method Information on patients was collected from the electronic patient administration system and GPs completed electronic questionnaires about the contacts. The GPs conducting the face-to-face contacts assessed relevance of the triage to face-to-face contacts. The authors performed binomial regression analyses, calculating relative risk (RR) and 95% confidence intervals. Results In total, 59.2% of calls ended with a telephone consultation. Factors associated with triage to a face-to-face contact were: patient age >40 years (40–64: RR = 1.13; >64: RR = 1.34), persisting problem for 12–24 hours (RR = 1.15), severe problem (RR = 2.60), potentially severe problem (RR = 5.81), and non-severe problem (RR = 2.23). Face-to-face contacts were assessed as irrelevant for 12.7% of clinic consultations and 11.7% of home visits. A statistically significantly higher risk of irrelevant face-to-face contact was found for a persisting problem of >24 hours (RR = 1.25), contact on weekday nights (RR = 1.25), and contact <2 hours before the patient’s own GP’s opening time (RR = 1.80). Conclusion Around 12% of all face-to-face consultations in the study are assessed as irrelevant by GP colleagues, suggesting that GP triage is efficient. Knowledge of the factors influencing triage can provide better education for GPs, but future studies are needed to investigate other quality aspects of GP telephone triage. PMID:27432608

Quality of HbA1c Measurement in the Practice

PubMed Central

Freckmann, Guido

2015-01-01

Hemoglobin A1c (HbA1c) measurement has come to be a cornerstone in modern diabetes therapy. However, the methodological aspects of this type of measurement have been given little attention lately due to its position as an established method of choice. Nevertheless, quite a number of issues face practical application, such as clinically relevant differences between different measurement methods—both lab-based and point-of-care (POCT) systems will show better or worse diabetes management results after switching methods; and there are a number of possible reasons that need to be known and observed in practice. The aim of this review is to draw attention to these problems from a German point of view and provide suggestions for appropriate measures to improve the situation. PMID:25691655

Intuition in medical practice: A reflection on Donald Schön's reflective practitioner.

PubMed

Mickleborough, Tim

2015-01-01

In a recent commentary, Dr. Abhishek Biswas asks the question whether physicians should rely on their "gut feeling" when making clinical decisions. Biswas describes a situation where his intuition resulted in an immediate course of action that prompted urgent medical attention for a patient who had "routine" pain. Inspired by the author's account, I would like to further Biswas' discussion and examine its importance using the educational theories of Donald Schön and his concept of the reflective practitioner. Schön argues that technical knowledge alone is not sufficient to solve the complex problems that professionals face on a daily basis and intuition, developed through a reflective practice, is crucial for any professional's practice, especially in a time of greater uncertainty in the workplace.

Fix and forget or fix and report: a qualitative study of tensions at the front line of incident reporting.

PubMed

Hewitt, Tanya Anne; Chreim, Samia

2015-05-01

Practitioners frequently encounter safety problems that they themselves can resolve on the spot. We ask: when faced with such a problem, do practitioners fix it in the moment and forget about it, or do they fix it in the moment and report it? We consider factors underlying these two approaches. We used a qualitative case study design employing in-depth interviews with 40 healthcare practitioners in a tertiary care hospital in Ontario, Canada. We conducted a thematic analysis, and compared the findings with the literature. 'Fixing and forgetting' was the main choice that most practitioners made in situations where they faced problems that they themselves could resolve. These situations included (A) handling near misses, which were seen as unworthy of reporting since they did not result in actual harm to the patient, (B) prioritising solving individual patients' safety problems, which were viewed as unique or one-time events and (C) encountering re-occurring safety problems, which were framed as inevitable, routine events. In only a few instances was 'fixing and reporting' mentioned as a way that the providers dealt with problems that they could resolve. We found that generally healthcare providers do not prioritise reporting if a safety problem is fixed. We argue that fixing and forgetting patient safety problems encountered may not serve patient safety as well as fixing and reporting. The latter approach aligns with recent calls for patient safety to be more preventive. We consider implications for practice. 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.

The Intersection of Online and Face-to-Face Teaching: Implications for Virtual School Teacher Practice and Professional Development

ERIC Educational Resources Information Center

Garrett Dikkers, Amy

2015-01-01

This mixed-method study reports perspectives of virtual school teachers on the impact of online teaching on their face-to-face practice. Data from a large-scale survey of teachers in the North Carolina Virtual Public School (n = 214), focus groups (n = 7), and interviews (n = 5) demonstrate multiple intersections between online and face-to-face…

The dual-use problem, scientific isolationism and the division of moral labour.

PubMed

Douglas, Thomas

2014-01-01

The dual-use problem is an ethical quandary sometimes faced by scientists and others in a position to influence the creation or dissemination of scientific knowledge. It arises when (i) an agent is considering whether to pursue some project likely to result in the creation or dissemination of scientific knowledge, (ii) that knowledge could be used in both morally desirable and morally undesirable ways, and (iii) the risk of undesirable use is sufficiently high that it is not clear that the agent may permissibly pursue the project or policy. Agents said to be faced with dual-use problems have frequently responded by appealing to a view that I call scientific isolationism. This is, roughly, the view that scientific decisions may be made without morally appraising the likely uses of the scientific knowledge whose production or dissemination is at stake. I consider whether scientific isolationism can be justified in a form that would indeed provide a way out of dual-use problems. I first argue for a presumption against a strong form of isolationism, and then examine four arguments that might be thought to override this presumption. The most promising of these arguments appeals to the idea of a division of moral labour, but I argue that even this argument can sustain at most a highly attenuated form of scientific isolationism and that this variant of isolationism has little practical import for discussions of the dual-use problem.

Can ill-structured problems reveal beliefs about medical knowledge and knowing? A focus-group approach

PubMed Central

Roex, Ann; Clarebout, Geraldine; Dory, Valerie; Degryse, Jan

2009-01-01

Background Epistemological beliefs (EB) are an individual's cognitions about knowledge and knowing. In several non-medical domains, EB have been found to contribute to the way individuals reason when faced with ill-structured problems (i.e. problems with no clear-cut, right or wrong solutions). Such problems are very common in medical practice. Determining whether EB are also influential in reasoning processes with regard to medical issues to which there is no straightforward answer, could have implications for medical education. This study focused on 2 research questions: 1. Can ill-structured problems be used to elicit general practice trainees' and trainers' EB? and 2. What are the views of general practice trainees and trainers about knowledge and how do they justify knowing? Methods 2 focus groups of trainees (n = 18) were convened on 3 occasions during their 1st year of postgraduate GP training. 2 groups of GP trainers (n = 11) met on one occasion. Based on the methodology of the Reflective Judgement Interview (RJI), participants were asked to comment on 11 ill-structured problems. The sessions were audio taped and transcribed and an adapted version of the RJI scoring rules was used to assess the trainees' reasoning about ill-structured problems. Results Participants made a number of statements illustrating their EB and their importance in clinical reasoning. The level of EB varied widely form one meeting to another and depending on the problem addressed. Overall, the EB expressed by trainees did not differ from those of trainers except on a particular ill-structured problem regarding shoulder pain. Conclusion The use of focus groups has entailed some difficulties in the interpretation of the results, but a number of preliminary conclusions can be drawn. Ill-structured medical problems can be used to elicit EB. Most trainees and trainers displayed pre-reflective and quasi-reflective EB. The way trainees and doctors view and justify knowledge are likely to be involved in medical reasoning processes. PMID:19775425

The Social Problem-Solving Questionnaire: Evaluation of Psychometric Properties among Turkish Primary School Students

ERIC Educational Resources Information Center

Dereli Iman, Esra

2013-01-01

Problem Statement: Children, like adults, face numerous problems and conflicts in their everyday lives, including issues with peers, siblings, older children, parents, teachers, and other adults. The methods children use to solve such problems are more important than actually facing the problems. The lack of effective social problem-solving skills…

Readership survey. A big welcome for Diagnostics in Africa.

PubMed

Chinnock, P

1994-09-01

Targeted to physicians, Africa Health is circulated free to 5600 readers in 23 African countries. Diagnostics in Africa (DIA) is a young publication included as a supplement of Africa Health aimed at laboratory personnel. Readers of DIA were surveyed in the first two issues to find out what they thought of the supplement, how it could be improved, and which problems they currently faced in their work. 98 questionnaires were returned from twelve African countries. 46% of respondents were qualified in laboratory science and 41% were physicians; the others were unqualified laboratory staff and other medical personnel. 73% responded that DIA was very useful and 27% useful, with 80% finding the articles of appropriate depth and complexity. Respondents would like to read about clinical chemistry, histopathology/histology, immunology, management issues, serology, and education/professional development, and would particularly enjoy material in the form of readers' letters and quizzes. Readers responded variously that they were regularly exposed to either Medicine Digest, Dialogue on Diarrhea, Postgraduate Doctor, Labmedica, Lancet, International Diabetes Digest, New England Journal of Medicine, British Medical Journal, or ARI News. Problems typically faced in their work include lack of resources, problems related to HIV testing/screening, poor access to literature, problems with professional development, and difficulty understanding the theory and practice of Western blot tests. These findings confirm assessments of the situation in Africa's medical labs which led to the launching of DIA.

See More, Do More, Teach More: Surgical Resident Autonomy and the Transition to Independent Practice.

PubMed

Hashimoto, Daniel A; Bynum, William E; Lillemoe, Keith D; Sachdeva, Ajit K

2016-06-01

The graduate medical education system is tasked with training competent and autonomous health care providers while also improving patient safety, delivering more efficient care, and cutting costs. Concerns about resident autonomy and preparation for independent and safe practice appear to be growing, and the field of surgery faces unique challenges in preparing graduates for independent practice. Multiple factors are contributing to an erosion of resident autonomy and decreased operative experience, including differing views of autonomy, financial forces, duty hours regulations, and diverse community health care needs. Identifying these barriers and developing solutions to overcome them are vital first steps in reversing the trend of diminishing autonomy in surgical residency training. This Commentary highlights the problem of decreasing autonomy, outlines specific threats to resident autonomy, and discusses potential solutions to mitigate their impact on the successful transition to independent practice.

A Survey on Sentiment Classification in Face Recognition

NASA Astrophysics Data System (ADS)

Qian, Jingyu

2018-01-01

Face recognition has been an important topic for both industry and academia for a long time. K-means clustering, autoencoder, and convolutional neural network, each representing a design idea for face recognition method, are three popular algorithms to deal with face recognition problems. It is worthwhile to summarize and compare these three different algorithms. This paper will focus on one specific face recognition problem-sentiment classification from images. Three different algorithms for sentiment classification problems will be summarized, including k-means clustering, autoencoder, and convolutional neural network. An experiment with the application of these algorithms on a specific dataset of human faces will be conducted to illustrate how these algorithms are applied and their accuracy. Finally, the three algorithms are compared based on the accuracy result.

Using a Learning Collaborative Strategy With Office-based Practices to Increase Access and Improve Quality of Care for Patients With Opioid Use Disorders

PubMed Central

Nordstrom, Benjamin R.; Saunders, Elizabeth C.; McLeman, Bethany; Meier, Andrea; Xie, Haiyi; Lambert-Harris, Chantal; Tanzman, Beth; Brooklyn, John; King, Gregory; Kloster, Nels; Lord, Clifton Frederick; Roberts, William; McGovern, Mark P.

2016-01-01

Objectives Rapidly escalating rates of heroin and prescription opioid use have been widely observed in rural areas across the United States. Although US Food and Drug Administration-approved medications for opioid use disorders exist, they are not routinely accessible to patients. One medication, buprenorphine, can be prescribed by waivered physicians in office-based practice settings, but practice patterns vary widely. This study explored the use of a learning collaborative method to improve the provision of buprenorphine in the state of Vermont. Methods We initiated a learning collaborative with 4 cohorts of physician practices (28 total practices). The learning collaborative consisted of a series of 4 face-to-face and 5 teleconference sessions over 9 months. Practices collected and reported on 8 quality-improvement data measures, which included the number of patients prescribed buprenorphine, and the percent of unstable patients seen weekly. Changes from baseline to 8 months were examined using a p-chart and logistic regression methodology. Results Physician engagement in the learning collaborative was favorable across all 4 cohorts (85.7%). On 6 of the 7 quality-improvement measures, there were improvements from baseline to 8 months. On 4 measures, these improvements were statistically significant (P < 0.001). Importantly, practice variation decreased over time on all measures. The number of patients receiving medication increased only slightly (3.4%). Conclusions Results support the effectiveness of a learning collaborative approach to engage physicians, modestly improve patient access, and significantly reduce practice variation. The strategy is potentially generalizable to other systems and regions struggling with this important public health problem. PMID:26900669

The paper crisis: from hospitals to medical practices.

PubMed

Park, Gregory; Neaveill, Rodney S

2009-01-01

Hospitals, not unlike physician practices, are faced with an increasing burden of managing piles of hard copy documents including insurance forms, requests for information, and advance directives. Healthcare organizations are moving to transform paper-based forms and documents into digitized files in order to save time and money and to have those documents available at a moment's notice. The cost of these document management/imaging systems can be easily justified with the significant savings of resources realized from the implementation of these systems. This article illustrates the enormity of the "paper problem" in healthcare and outlines just a few of the required processes that could be improved with the use of automated document management/imaging systems.

Exclusive breast feeding (EBF) in Jordan: prevalence, duration, practices, and barriers.

PubMed

Abuidhail, Jamila; Al-Modallal, Hanan; Yousif, Rania; Almresi, Neamat

2014-03-01

of this study is to investigate the prevalence, duration, practices and barriers of Exclusive breast feeding (EBF) among Jordanian mothers in three major governorates. longitudinal, prospective design was used in this study. convenience sample of 572 pairs of postpartum mothers-infants were recruited from postpartum wards at three governmental hospitals and three private hospitals in major Jordanian governorate. data were collected in two phases. In the first phase, trained research assistants conducted face to face structured interviews with participating mothers at the hospital. In the second phase, the research assistants conducted follow up phone interviews at the end of first, fourth and sixth months after birth. The findings of this study showed that the prevalence of EBF as recommended by WHO was 1%. The average duration of EBF was one month. The main barriers of EBF were: infants feel hungry after breast feeding, short period between pregnancies, and breast problems. postpartum mothers initiated EBF practice within the first hour after giving birth; however, this practice declined gradually as the infant grew up within the first six months after birth. antenatal education sessions in the Jordanian governmental hospitals about EBF are required to meet the WHO recommendations. Furthermore, midwives and nurses have to focus on effective breast feeding process to overcome the barriers of EBF during antenatal education and postnatal care. Copyright © 2013 Elsevier Ltd. All rights reserved.

Skin and mucosal ischemia as a complication after inferior alveolar nerve block.

PubMed

Aravena, Pedro Christian; Valeria, Camila; Nuñez, Nicolás; Perez-Rojas, Francisco; Coronado, Cesar

2016-01-01

The anesthetic block of the inferior alveolar nerve (IAN) is one of the most common techniques used in dental practice. The local complications are due to the failures on the anesthetic block or to anatomic variations in the tap site such as intravascular injection, skin ischemia and ocular problems. The aim of this article is to present a case and discuss the causes of itching and burning sensation, blanching, pain and face ischemia in the oral cavity during the IAN block.

The Training of Teachers of the Children of Migrant Workers: Cultural Values and Education in a Multi-cultural Society. Report of the European Teachers' Seminar (13th, Donaueschingen, Federal Republic of Germany, 19-24 October 1981).

ERIC Educational Resources Information Center

Nielsen, Jorgen S., Comp.

Summaries of seven reports presented at the teachers' seminar focus on teacher training for a multi-cultural society, with an emphasis on Muslim migrant children. Three papers discuss the general circumstances of Muslim immigrants in Europe, the implications for educational practice and structures, a Muslim view of the problems faced by Muslim…

The Changing Face of the Federal Workforce: A Symposium on Diversity. Proceedings Held at Washington, DC on 17 Feb 1993

DTIC Science & Technology

1993-02-17

lead to sexism , racism , and discrimi- We are very fortunate in the Great Lakes Region nation, including discrimination based upon that we had the ...workshop and are more denial where racism and sexism are concerned, attuned to the problem. 35 ho 11 d _~ Diversity Pops.. In Fedft-aI Apadies This...that lead to sexism , racism , and NASA appointed a Culture Review and Practices other forms of discrimination, such as that Team to assess workforce

An example of branching in a variational problem. [shape of liquid suspended from wire in zero gravity

NASA Technical Reports Server (NTRS)

Darbro, W.

1978-01-01

In an experiment in space it was found that when a cubical frame was slowly withdrawn from a soap solution, the wire frame retained practically a full cube of liquid. Removed from the frame (by shaking), the faces of the cube became progressively more concave, until adjacent faces became tangential. In the present paper a mathematical model describing the shape a liquid takes due to its surface tension while suspended on a wire frame in zero-g is solved by use of Lagrange multipliers. It is shown how the configuration of soap films so bounded is dependent upon the volume of liquid trapped in the films. A special case of the solution is a soap film naturally formed on a cubical wire frame.

The changing landscape of care: does ethics education have a new role to play in health practice?

PubMed

Wintrup, Julie

2015-05-08

In the UK, higher education and health care providers share responsibility for educating the workforce. The challenges facing health practice also face health education and as educators we are implicated, by the way we design curricula and through students' experiences and their stories. This paper asks whether ethics education has a new role to play, in a context of major organisational change, a global and national austerity agenda and the ramifications of disturbing reports of failures in care. It asks: how would it be different if equal amounts of attention were given to the conditions in which health decisions are made, if the ethics of organisational and policy decisions were examined, and if guiding collaborations with patients and others who use services informed ethics education and its processes? This is in three parts. In part one an example from an inspection report is used to question the ways in which clinical events are decontextualised and constructed for different purposes. Ramifications of a decision are reflected upon and a case made for different kinds of allegiances to be developed. In part two I go on to broaden the scope of ethics education and make a case for beginning with the messy realities of practice rather than with overarching moral theories. The importance of power in ethical practice is introduced, and in part three the need for greater political and personal awareness is proposed as a condition of moral agency. This paper proposes that ethics education has a new contribution to make, in supporting and promoting ethical practice - as it is defined in and by the everyday actions and decisions of practitioners and people who need health services. Ethics education that promotes moral agency, rather than problem solving approaches, would explore not only clinical problems, but also the difficult and contested arenas in which they occur. It would seek multiple perspectives and would begin with places and people, and their priorities. It would support students to locate their practice in imperfect global contexts, and to understand how individual and collective forms of power can influence healthcare quality.

Instruments to Explore Blended Learning: Modifying a Method to Analyse Online Communication for the Analysis of Face-to-Face Communication

ERIC Educational Resources Information Center

de Leng, Bas A.; Dolmans, Diana H. J. M.; Donkers, H. H. L. M.; Muijtjens, Arno M. M.; van der Vleuten, Cees P. M.

2010-01-01

In the complex practice of today's blended learning, educators need to be able to evaluate both online and face-to-face communication in order to get the full picture of what is going on in blended learning scenarios. The aim of this study was to investigate the reliability and feasibility of a practical instrument for analysing face-to-face…

Diversifying the secondary school curriculum: The African experience

NASA Astrophysics Data System (ADS)

Sifuna, Daniel N.

1992-01-01

The paper discusses some African experiences in the diversification of secondary education, which is taken to mean curriculum change in a practical or vocational direction. This approach is intended to provide a wider set of future career options than is offered in the more uniform academic curriculum. The diversification policy has generally been seen as a solution to a number of economic and social problems facing the independent African countries, notably the increasing youth unemployment and the escalating costs of formal education. Studies which have so far been carried out have, however, revealed that diversification programmes have not met the intended objectives, although there is sustained interest in vocationalising formal education. Problems which commonly face these programmes include high unit costs, an absence of clarity in aims and objectives, a shortage of qualified teachers and the low status of vocational subjects as viewed by the students and the community. For future development, it is suggested that diversification programmes be reorganised to relate to more realistic goals through wider community participation and through the work-orientation of post-school training programmes.

From iPSC towards cardiac tissue-a road under construction.

PubMed

Peischard, Stefan; Piccini, Ilaria; Strutz-Seebohm, Nathalie; Greber, Boris; Seebohm, Guiscard

2017-10-01

The possibility to generate induced pluripotent stem cells (iPSC) opens the way to generate virtually all cell types of our human body. In combination with modern gene editing techniques like CRISPR/CAS, a new set of powerful tools becomes available for life science. Scientific fields like genotype and cell type-specific pharmacology, disease modeling, stem cell biology, and developmental biology have been dramatically fostered and their faces have been changed. However, as golden as the age of iPSC-derived cells and their manipulation has started, the shine begins to tarnish. Researchers face more and more practical problems intrinsic to the system. These problems are related to the specific culturing conditions which are not yet sufficient to mimic the natural environment of native stem cells differentiating towards adult cells. However, researchers work hard to uncover these factors. Here, we review a common standard approach to generate iPSCs and transduce these to iPSC cardiomyocytes. Further, we review recent achievements and discuss their current limitations and future perspectives. We are on track, but the road is still under construction.

Can E-Learning Change Work Practices?

ERIC Educational Resources Information Center

Noesgaard, Signe Schack

2016-01-01

Stand-alone e-learning is unlikely to change work practices. This claim contrasts with a comprehensive body of research arguing that e-learning is at least as effective as face-to-face instruction in improving work performance. Such a comparison is, however, problematic. On the one hand, it relies on the premise that face-to-face instruction is…

Yoga Adherence in Older Women Six Months Post–Osteoarthritis Intervention

PubMed Central

Justice, Catherine; Peden-McAlpine, Cynthia

2015-01-01

Background/Objective: Osteoarthritis (OA) is a highly prevalent condition worldwide. Yoga is potentially a safe and feasible option for managing OA; however, the extent of long-term yoga adherence is unknown. The purpose of this study was to examine yoga adherence 6 months after participants completed an OA intervention program. Methods: This follow-up study employed a cross-sectional descriptive design using survey, interview, and video recordings to collect both quantitative and qualitative data. A total of 31 participants completed and returned the survey, and 10 videotaped their yoga practice for 1 week and participated in a face-to-face interview. Results: A majority of participants (n=19, 61%) reported that they were still practicing yoga 6 months after the intervention program. On average, participants reported practicing 21 to 30 minutes of yoga per day (32%) 3 to 4 days per week (47%). “Feeling good or feeling better after yoga practice” (50%) and “set aside a time” (31%) were the most common motivating factors for yoga adherence. Dealing with health problems (42%), having pain (25%), and being too busy (25%) were the major barriers. Qualitative data revealed that participants: (1) used mindful yoga movement, (2) incorporated other forms of exercise and resources during yoga practice, and (3) created personalized yoga programs. Additionally, the participants reported less OA pain, increased physical endurance, and more relaxation. Conclusion: Many participants adhered to yoga practice 6 months post-intervention although not at the frequency and sequence as prescribed. Feeling better after practice motivated participants, but other factors remained key barriers. PMID:25984414

A Meta-Analytic and Qualitative Review of Online versus Face-to-Face Problem-Based Learning

ERIC Educational Resources Information Center

Jurewitsch, Brian

2012-01-01

Problem-based learning (PBL) is an instructional strategy that is poised for widespread application in the current, growing, on-line digital learning environment. While enjoying a track record as a defensible strategy in face-to-face learning settings, the research evidence is not clear regarding PBL in on-line environments. A review of the…

[Social trauma: Clinical practice and analysis of subjectivity].

PubMed

Lagos, Mariana; Bekerman, Silvana; Sosa, Noemí

2017-07-01

Clinical and psychosocial assistance demand that we try and understand the complex effect traumatic events have on people and their subjectivity, as well as on our own stance and reference framework. Traumatic situations of social origin affect groups of individuals and the State is to some extent responsible for their genesis and the resolution of their effects. In our professional practice we are faced with problems that concern both the individuals and the relationships they establish. The way highly traumatic events are dealt with is in?uenced by various factors that challenge our therapeutic theories and approaches. The crisis of our time, characterized by uncertainty, violence patterns, intolerance of differences, fracture of social bonds, combined with major technological developments and subjective changes, triggers new and complex ways of connection -even hyperconnectivity- through social media. These vicissitudes of our time confront us with new expressions of discomfort about our own place in the world, deeply affect our identities and reinforce the suffering we experience when faced with the emergency of the devastating power of social trauma. Thus, they become part of our current challenge as professionals.

The maps problem and the mapping problem: Two challenges for a cognitive neuroscience of speech and language

PubMed Central

Poeppel, David

2012-01-01

Research on the brain basis of speech and language faces theoretical and empirical challenges. The majority of current research, dominated by imaging, deficit-lesion, and electrophysiological techniques, seeks to identify regions that underpin aspects of language processing such as phonology, syntax, or semantics. The emphasis lies on localization and spatial characterization of function. The first part of the paper deals with a practical challenge that arises in the context of such a research program. This maps problem concerns the extent to which spatial information and localization can satisfy the explanatory needs for perception and cognition. Several areas of investigation exemplify how the neural basis of speech and language is discussed in those terms (regions, streams, hemispheres, networks). The second part of the paper turns to a more troublesome challenge, namely how to formulate the formal links between neurobiology and cognition. This principled problem thus addresses the relation between the primitives of cognition (here speech, language) and neurobiology. Dealing with this mapping problem invites the development of linking hypotheses between the domains. The cognitive sciences provide granular, theoretically motivated claims about the structure of various domains (the ‘cognome’); neurobiology, similarly, provides a list of the available neural structures. However, explanatory connections will require crafting computationally explicit linking hypotheses at the right level of abstraction. For both the practical maps problem and the principled mapping problem, developmental approaches and evidence can play a central role in the resolution. PMID:23017085

Conceptual and practical problems of moral enhancement.

PubMed

Beck, Birgit

2015-05-01

Recently, the debate on human enhancement has shifted from familiar topics like cognitive enhancement and mood enhancement to a new and - to no one's surprise - controversial subject, namely moral enhancement. Some proponents from the transhumanist camp allude to the 'urgent need' of improving the moral conduct of humankind in the face of ever growing technological progress and the substantial dangers entailed in this enterprise. Other thinkers express more sceptical views about this proposal. As the debate has revealed so far, there is no shared opinion among philosophers (or scientists) about the meaning, prospects, and ethical evaluation of moral enhancement. In this article I will address several conceptual and practical problems of this issue, in order to encourage discussion about the prospects of (thinking about) moral enhancement in the future. My assumption is that (i) for the short term, there is little chance of arriving at an agreement on the proper understanding of morality and the appropriateness of one single (meta-)ethical theory; (ii) apart from this, there are further philosophical puzzles loosely referred to in the debate which add to theoretical confusion; and (iii) even if these conceptual problems could be solved, there are still practical problems to be smoothed out if moral enhancement is ever to gain relevance apart from merely theoretical interest. My tentative conclusion, therefore, will be that moral enhancement is not very likely to be made sense of - let alone realized - in the medium-term future. © 2014 John Wiley & Sons Ltd.

Implementing a new drug record system: a qualitative study of difficulties perceived by physicians and nurses.

PubMed

Andersen, S E

2002-03-01

To identify organisational difficulties faced by physicians and nurses when using drug prescribing sheets for recording both drug prescriptions and drug administration. Qualitative interview study. Two general internal medicine wards. Seven physicians and eight nurses. Difficulties explicitly identified by the participants during the interviews. The implementation of procedures conflicted with existing structure, culture, and routines. Insufficient competence within the system to use the drug prescribing sheets created resistance and made people down the line create their own interpretations and solutions to the problems they faced. A total of nine problems were identified: (1) insufficient knowledge and uncertainty about procedures, (2) ignorance of sources of error, (3) unclear responsibilities, (4) low community spirit, (5) insufficient communication, (6) clinician autonomy and low acceptance of change, (7) strong professional identity, (8) low priority task, and (9) logistical problems. Unawareness of procedures, insufficient dissemination of knowledge, and insufficient cooperation and skepticism among those who put drug handling into practice is likely to have an impact on the quality of health care. The identification of these obstacles may help managers to improve the quality of the drug handling process on internal medicine wards and make it possible to select a framework for changing the clinical behaviour of doctors and nurses.

Reentry challenges facing women with mental health problems.

PubMed

Visher, Christy A; Bakken, Nicholas W

2014-01-01

Women entering the correctional system represent a population at high risk for mental health and the body of research on the mental health needs of women offenders is growing. These mental health problems pose challenges for women at every stage of the criminal justice process, from arrest to incarceration to community reentry and reintegration. In this article, we examined mental health status among a sample of 142 women leaving confinement and the role that mental health problems played in shaping their reentry outcomes using data collected between 2002 and 2005 in Houston, Texas. In the year after leaving prison, women with mental health problems reported poorer health, more hospitalizations, more suicidal thoughts, greater difficulties securing housing and employment, more involvement in criminal behavior, and less financial support from family than women with no indication of mental health problems. However, mental health status did not increase the likelihood of substance use relapse or reincarceration. The article concludes with a discussion of recommendations for improved policy and practice.

Approximation algorithms for a genetic diagnostics problem.

PubMed

Kosaraju, S R; Schäffer, A A; Biesecker, L G

1998-01-01

We define and study a combinatorial problem called WEIGHTED DIAGNOSTIC COVER (WDC) that models the use of a laboratory technique called genotyping in the diagnosis of an important class of chromosomal aberrations. An optimal solution to WDC would enable us to define a genetic assay that maximizes the diagnostic power for a specified cost of laboratory work. We develop approximation algorithms for WDC by making use of the well-known problem SET COVER for which the greedy heuristic has been extensively studied. We prove worst-case performance bounds on the greedy heuristic for WDC and for another heuristic we call directional greedy. We implemented both heuristics. We also implemented a local search heuristic that takes the solutions obtained by greedy and dir-greedy and applies swaps until they are locally optimal. We report their performance on a real data set that is representative of the options that a clinical geneticist faces for the real diagnostic problem. Many open problems related to WDC remain, both of theoretical interest and practical importance.

Amygdala hypoactivity to fearful faces in boys with conduct problems and callous-unemotional traits.

PubMed

Jones, Alice P; Laurens, Kristin R; Herba, Catherine M; Barker, Gareth J; Viding, Essi

2009-01-01

Although early-onset conduct problems predict both psychiatric and health problems in adult life, little research has been done to index neural correlates of conduct problems. Emerging research suggests that a subgroup of children with conduct problems and elevated levels of callous-unemotional traits may be genetically vulnerable to manifesting disturbances in neural reactivity to emotional stimuli indexing distress. Using functional MRI, the authors evaluated differences in neural response to emotional stimuli between boys with conduct problems and elevated levels of callous-unemotional traits and comparison boys. Seventeen boys with conduct problems and elevated levels of callous-unemotional traits and 13 comparison boys of equivalent age (mean=11 years) and IQ (mean=100) viewed blocked presentations of fearful and neutral faces. For each face, participants distinguished the sex of the face via manual response. Relative to the comparison group, boys with conduct problems and elevated levels of callous-unemotional traits manifested lesser right amygdala activity to fearful faces. This finding is in line with data from studies of adults with antisocial behavior and callous-unemotional traits (i.e., psychopaths), as well as from a recent study of adolescents with callous-unemotional traits, and suggests that the neural substrates of emotional impairment associated with callous-unemotional antisocial behavior are already present in childhood.

Practice of laryngectomy rehabilitation interventions: a perspective from Hong Kong.

PubMed

Chan, Jimmy Y W

2013-06-01

To review the current practice of rehabilitation for laryngectomees in Hong Kong. Factors affecting the quality of life of laryngectomees include their performance in speech restoration, the presence of complications of treatment, as well as the availability of psycho-social support. In Hong Kong, more than 90% of laryngectomees have speech restoration by various means, the commonest of which being tracheo-oesophageal puncture and electrolaryngeal speech. However, they face special problems in communication using the current alaryngeal speech modalities, as it is difficult to produce variation in tones, which is important to express different meanings in Cantonese. The responsibility of surgeons to follow-up patients after surgery and the practice of management of common complications after laryngectomy are also discussed. The New Voice Club of Hong Kong promotes self-help and mutual help between laryngectomees, with the aim of helping new members to regain normal speech and to re-integrate into society. Quality-of-life study in Hong Kong shows that although the mean global health score is satisfactory, the social functioning domain is most severely affected after surgery. Cantonese-speaking laryngectomees in Hong Kong are facing unique challenges in speech restoration and re-integration into society after surgery. Surgeons should take the leading role in the multidisciplinary management of these patients.

A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers.

PubMed

Prior, Yeliz; Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison

2015-08-01

Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey - Rheumatic Conditions. Face-to-face semi-structured interviews were conducted with occupational therapists ( n  = 9), followed by telephone interviews with their line managers ( n  = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. The main themes emerging from the occupational therapists' interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers' interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. The Work Experience Survey - Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased.

A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers

PubMed Central

Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison

2015-01-01

Introduction Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey – Rheumatic Conditions. Method Face-to-face semi-structured interviews were conducted with occupational therapists (n = 9), followed by telephone interviews with their line managers (n = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. Results The main themes emerging from the occupational therapists’ interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers’ interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. Conclusion The Work Experience Survey – Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased. PMID:26321786

Practical solutions when facing cost sharing: the American Cancer Society's Health Insurance Assistance Service.

PubMed

Sharpe, Katherine; Shaw, Beverly; Battaglia Seiler, Mandi

2016-03-01

The American Cancer Society (ACS) has been a leading voice for healthcare reform and an informed advocate for effective health insurance reforms. Since the implementation of the Affordable Care Act (ACA), the ACS has observed a shift in inquiries to its Health Insurance Assistance Service (HIAS) from individuals seeking coverage, to a growing problem of individuals presenting issues from being underinsured. Underinsured patients with cancer face serious financial challenges due to large co-pays and coinsurance costs. HIAS was created to help these patients identify potential options for insurance coverage while tracking patient trends. The types of calls received by HIAS have been captured as part of an internal database that allows for the analysis of trends and emerging issues. By evaluating several case studies that illustrate common issues faced by underinsured individuals, we identified solutions ranging from exploring financial assistance programs, such as co-pay relief and providing appeal information, to searching for more adequate or affordable insurance options. Additionally, the ACS has worked to find strong partnerships with other nonprofit organizations to aid in cost relief. Although the ACA has made plans available to many patients and their families, the maximum for an individual's in-network out-of-pocket costs are still too high for many individuals. New approaches are needed to improve the cost protection of health plans. By documenting access problems faced by patients with cancer, the ACS is better positioned to tell policy makers about the concerns of real patients and work toward policy solutions.

Use of face masks in a primary care outpatient setting in Hong Kong: Knowledge, attitudes and practices.

PubMed

Ho, H S W

2012-12-01

To assess if a knowledge gap exists in the correct use of face masks, and to explore the correlations between knowledge, attitudes and practices regarding the use of face masks among outpatients and their caregivers in an outpatient clinic in Hong Kong. Cross-sectional study. Outpatients and their caregivers who were present at an outpatient setting in Hong Kong were invited to participate in this survey. All participants were asked to complete a self-administered closed-ended questionnaire about their knowledge, attitudes and practices regarding the use of face masks. Data were described using descriptive statistics and correlation coefficients. Among the 399 respondents, 52% knew the correct steps in wearing a face mask, and their attitudes toward face masks were generally positive. Further analyses showed that respondents were more likely to wear a face mask at a clinic than in a public place or at home. Moreover, respondents were more likely to wear a face mask to protect others against influenza-like illness (ILI) than for self-protection. There was low to moderate correlation between attitudes and practices (correlation coefficient 0.26, P < 0.05). This study identified a knowledge gap in the correct use of face masks among outpatients and their caregivers; attitudes and practices regarding the use of face masks were generally positive, but correlation was not high. It is recommended that public health education campaigns should tailor efficient programmes to combat ILI transmission among outpatient clinic populations by improving knowledge about the correct use of face masks. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

[Strategies to prevent the transmission of multidrug-resistant pathogens and their practical implementation in oupatient care].

PubMed

Adler, A C; Spegel, H; Wilke, J; Höller, C; Herr, C

2012-10-01

Multidrugresistant pathogens which are highly relevant for infection control in hospitals and other health-care facilities are a serious public health problem and a big challenge for all players in the health sector. In order to prevent the spread of multi-resistant pathogens the Commission for Hospital Hygiene of the Robert Koch-Institute (RKI) has published guidelines. These recommendations refer to the consequent implementation of an infection control management in all health care settings, including outpatient care. In Germany there are only few data available concerning infection control management and the implementation of preventive strategies in outpatient care. To what extent are national guidelines concerning infection control of multidrugresistant pathogens (i.e. methicillin-resistant Staphylococcus aureus, MRSA) feasible and practicable in outpatient care? And what are the reasons not to practice these strategies. In outpatient care the status of the infection control management and the implementation of prevention strategies was surveyed and assessed. Data were collected by structured interviews - a face to face method. Guidelines concerning infection control management are not always sufficiently implemented in outpatient care. There are multiple reasons for this, such as, e.g., lack of compliance with the recommendations as well as structural problems in the health-care system, and special challenges of outpatient care. Implementation of an infection control management concerning multidrug-resistant pathogens in outpatient care is problematic. Prevention strategies are commonly not known or not adequately implemented into daily practice. Actions to improve the situation should focus at the individual level (e.g., trainings in the context of the initiative "clean hands" ), the institutional level (improving networking, bonus schemes) and the social level (financial and legal support for outpatient care centres to bear the expenses of infection control management, "search and destroy"). © Georg Thieme Verlag KG Stuttgart · New York.

[General Strategies for Implementation of Clinical Practice Guidelines].

PubMed

Valenzuela-Flores, Adriana Abigail; Viniegra-Osorio, Arturo; Torres-Arreola, Laura Laura

2015-01-01

The need to use clinical practice guidelines (CPG) arises from the health conditions and problems that public health institutions in the country face. CPG are informative documents that help improve the quality of care processes and patient safety; having among its objectives, to reduce the variability of medical practice. The Instituto Mexicano del Seguro Social designed a strategic plan for the dissemination, implementation, monitoring and control of CPG to establish an applicable model in the medical units in the three levels of care at the Instituto. This paper summarizes some of the strategies of the plan that were made with the knowledge and experience of clinicians and managers, with which they intend to promote the adoption of the key recommendations of the guidelines, to promote a sense of belonging for health personnel, and to encourage changes in organizational culture.

Blended Learning: A Mixed-Methods Study on Successful Schools and Effective Practices

ERIC Educational Resources Information Center

Mathews, Anne

2017-01-01

Blended learning is a teaching technique that utilizes face-to-face teaching and online or technology-based practice in which the learner has the ability to exert some level of control over the pace, place, path, or time of learning. Schools that employ this method of teaching often demonstrate larger gains than traditional face-to-face programs…

The most common problem facing by the maintenance department: A case Study between Universiti Tun Hussein Onn Malaysia (UTHM) and Universiti Teknologi Malaysia (UTM)

NASA Astrophysics Data System (ADS)

Norazam Yasin, Mohd; Mohamad Zin, Rosli; Halid Abdullah, Abd; Shafiq Mahmad, Muhammad; Fikri Hasmori, Muhammad

2017-11-01

From time to time, the maintenance works become more challenging due to construction of new building and also aging of the existing buildings. University buildings without any exception require proper maintenance services to support their function requirements and this can be considered as major responsibilities to be fulfilled by the maintenance department in the universities. Maintenance department specifically will face various kinds of problems in their operation works and thus this might influence the maintenance work operations itself. This study purposely to identify the common problem facing by the maintenance department and also to examine the current status of the maintenance department. In addition, this study would also propose any suitable approach that could be implemented to overcome the problem facing by the maintenance department. To achieve the objectives of this study, a combination of deep literature study and carrying out a survey is necessary. Literature study aimed to obtain deeper information about this study, meanwhile a survey aimed at identifying the common problem facing by the maintenance department and also to provide the information of the maintenance department’s organization. Several methods will be used in analyzing the data obtained through the survey, including Microsoft Office Excel and also using mean index formula. This study has identified three categories of problem in the maintenance department, which are management problems, human resource problem, and technical problems. Following the findings, several solutions being proposed which can be implemented as the solution to the problem facing. These suggestions have the potential to improve the maintenance department work efficiency, thus could help to increase the department productivity.

The cool seal system: a practical solution to the shaft seal problem and heat related complications with implantable rotary blood pumps.

PubMed

Yamazaki, K; Mori, T; Tomioka, J; Litwak, P; Antaki, J F; Tagusari, O; Koyanagi, H; Griffith, B P; Kormos, R L

1997-01-01

A critical issue facing the development of an implantable, rotary blood pump is the maintenance of an effective seal at the rotating shaft. Mechanical seals are the most versatile type of seal in wide industrial applications. However, in a rotary blood pump, typical seal life is much shorter than required for chronic support. Seal failure is related to adhesion and aggregation of heat denatured blood proteins that diffuse into the lubricating film between seal faces. Among the blood proteins, fibrinogen plays an important role due to its strong propensity for adhesion and low transition temperature (approximately 50 degrees C). Once exposed to temperature exceeding 50 degrees C, fibrinogen molecules fuse together by multi-attachment between heat denatured D-domains. This quasi-polymerized fibrin increases the frictional heat, which proliferates the process into seal failure. If the temperature of the seal faces is maintained well below 50 degrees C, a mechanical seal would not fail in blood. Based on this "Cool-Seal" concept, we developed a miniature mechanical seal made of highly thermally conductive material (SiC), combined with a recirculating purge system. A large supply of purge fluid is recirculated behind the seal face to augment convective heat transfer to maintain the seal temperature below 40 degrees C. It also cools all heat generating pump parts (motor coil, bearing, seal). The purge consumption has been optimized to virtually nil (< 0.5 cc/day). An ultrafiltration unit integrated in the recirculating purge system continuously purifies and sterilizes the purge fluid for more than 5 months without filter change. The seal system has now been incorporated into our intraventricular axial flow blood pump (IVAP) and newly designed centrifugal pump. Ongoing in vivo evaluation of these systems has demonstrated good seal integrity for more than 160 days. The Cool-Seal system can be applied to any type of rotary blood pump (axial, diagonal, centrifugal, etc.) and offers a practical solution to the shaft seal problem and heat related complications, which currently limit the use of implantable rotary blood pumps.

DNA-testing for BRCA1/2 prior to genetic counselling in patients with breast cancer: design of an intervention study, DNA-direct.

PubMed

Sie, Aisha S; Spruijt, Liesbeth; van Zelst-Stams, Wendy A G; Mensenkamp, Arjen R; Ligtenberg, Marjolijn J; Brunner, Han G; Prins, Judith B; Hoogerbrugge, Nicoline

2012-05-08

Current practice for patients with breast cancer referred for genetic counseling, includes face-to-face consultations with a genetic counselor prior to and following DNA-testing. This is based on guidelines regarding Huntington's disease in anticipation of high psychosocial impact of DNA-testing for mutations in BRCA1/2 genes. The initial consultation covers generic information regarding hereditary breast cancer and the (im)possibilities of DNA-testing, prior to such testing. Patients with breast cancer may see this information as irrelevant or unnecessary because individual genetic advice depends on DNA-test results. Also, verbal information is not always remembered well by patients. A different format for this information prior to DNA-testing is possible: replacing initial face-to-face genetic counseling (DNA-intake procedure) by telephone, written and digital information sent to patients' homes (DNA-direct procedure). In this intervention study, 150 patients with breast cancer referred to the department of Clinical Genetics of the Radboud University Nijmegen Medical Centre are given the choice between two procedures, DNA-direct (intervention group) or DNA-intake (usual care, control group). During a triage telephone call, patients are excluded if they have problems with Dutch text, family communication, or of psychological or psychiatric nature. Primary outcome measures are satisfaction and psychological distress. Secondary outcome measures are determinants for the participant's choice of procedure, waiting and processing times, and family characteristics. Data are collected by self-report questionnaires at baseline and following completion of genetic counseling. A minority of participants will receive an invitation for a 30 min semi-structured telephone interview, e.g. confirmed carriers of a BRCA1/2 mutation, and those who report problems with the procedure. This study compares current practice of an intake consultation (DNA-intake) to a home informational package of telephone, written and digital information (DNA-direct) prior to DNA-testing in patients with breast cancer. The aim is to determine whether DNA-direct is an acceptable procedure for BRCA1/2 testing, in order to provide customized care to patients with breast cancer, cutting down on the period of uncertainty during this diagnostic process.

Simultaneous Calibration: A Joint Optimization Approach for Multiple Kinect and External Cameras.

PubMed

Liao, Yajie; Sun, Ying; Li, Gongfa; Kong, Jianyi; Jiang, Guozhang; Jiang, Du; Cai, Haibin; Ju, Zhaojie; Yu, Hui; Liu, Honghai

2017-06-24

Camera calibration is a crucial problem in many applications, such as 3D reconstruction, structure from motion, object tracking and face alignment. Numerous methods have been proposed to solve the above problem with good performance in the last few decades. However, few methods are targeted at joint calibration of multi-sensors (more than four devices), which normally is a practical issue in the real-time systems. In this paper, we propose a novel method and a corresponding workflow framework to simultaneously calibrate relative poses of a Kinect and three external cameras. By optimizing the final cost function and adding corresponding weights to the external cameras in different locations, an effective joint calibration of multiple devices is constructed. Furthermore, the method is tested in a practical platform, and experiment results show that the proposed joint calibration method can achieve a satisfactory performance in a project real-time system and its accuracy is higher than the manufacturer's calibration.

Simultaneous Calibration: A Joint Optimization Approach for Multiple Kinect and External Cameras

PubMed Central

Liao, Yajie; Sun, Ying; Li, Gongfa; Kong, Jianyi; Jiang, Guozhang; Jiang, Du; Cai, Haibin; Ju, Zhaojie; Yu, Hui; Liu, Honghai

2017-01-01

Camera calibration is a crucial problem in many applications, such as 3D reconstruction, structure from motion, object tracking and face alignment. Numerous methods have been proposed to solve the above problem with good performance in the last few decades. However, few methods are targeted at joint calibration of multi-sensors (more than four devices), which normally is a practical issue in the real-time systems. In this paper, we propose a novel method and a corresponding workflow framework to simultaneously calibrate relative poses of a Kinect and three external cameras. By optimizing the final cost function and adding corresponding weights to the external cameras in different locations, an effective joint calibration of multiple devices is constructed. Furthermore, the method is tested in a practical platform, and experiment results show that the proposed joint calibration method can achieve a satisfactory performance in a project real-time system and its accuracy is higher than the manufacturer’s calibration. PMID:28672823

Clinical-outcome-based demand management in health services.

PubMed

Brogan, C; Lawrence, D; Mayhew, L

2008-01-01

THE PROBLEM OF MANAGING DEMAND: Most healthcare systems have 'third-party payers' who face the problem of keeping within budgets despite pressures to increase resources due to the ageing population, new technologies and patient demands to lower thresholds for care. This paper uses the UK National Health Service as a case study to suggest techniques for system-based demand management, which aims to control demand and costs whilst maintaining the cost-effectiveness of the system. The technique for managing demand in primary, elective and urgent care consists of managing treatment thresholds for appropriate care, using a whole-systems approach and costing the care elements in the system. It is important to analyse activity in relation to capacity and demand. Examples of using these techniques in practice are given. The practical effects of using such techniques need evaluation. If these techniques are not used, managing demand and limiting healthcare expenditure will be at the expense of clinical outcomes and unmet need, which will perpetuate financial crises.

Mental Health Problems in Parents of Children with Congenital Heart Disease.

PubMed

Kolaitis, Gerasimos A; Meentken, Maya G; Utens, Elisabeth M W J

2017-01-01

This review will provide a concise description of mental health problems in parents of children with a (non-syndromic) congenital heart disease (CHD) during different stressful periods. Predictors of these problems and also implications for clinical practice will be mentioned. Having a child with CHD can be very stressful for parents, who have to face overwhelming emotions and also extra physical, financial, and other practical challenges. Parental distress has been reported in 30-80% of parents and appears not to be related to severity of CHD. Parental mental health, parenting, the parent-child relationship, and parental quality of life can all be affected. Parents, and especially mothers, are at risk of psychological distress, anxiety, depression, somatization, hopelessness, and posttraumatic stress symptoms, which in turn may influence mother's responsiveness. In the long term, the majority of parents adapt successfully to living with a child with CHD, but approximately 40% report a need for psychosocial care. These families may be helped by early psychosocial interventions to alleviate stress and reduce children's emotional and behavioral problems. A holistic approach to early psychosocial interventions should aim at improving coping and enhance parenting. During routine medical checkups, medical professionals should ask about parental stress, family functioning, and psychosocial functioning of the child and, when needed, adequate psychosocial care should be provided.

Race-specific perceptual discrimination improvement following short individuation training with faces

PubMed Central

McGugin, Rankin Williams; Tanaka, James W.; Lebrecht, Sophie; Tarr, Michael J.; Gauthier, Isabel

2010-01-01

This study explores the effect of individuation training on the acquisition of race-specific expertise. First, we investigated whether practice individuating other-race faces yields improvement in perceptual discrimination for novel faces of that race. Second, we asked whether there was similar improvement for novel faces of a different race for which participants received equal practice, but in an orthogonal task that did not require individuation. Caucasian participants were trained to individuate faces of one race (African American or Hispanic) and to make difficult eye luminance judgments on faces of the other race. By equating these tasks we are able to rule out raw experience, visual attention or performance/success-induced positivity as the critical factors that produce race-specific improvements. These results indicate that individuation practice is one mechanism through which cognitive, perceptual, and/or social processes promote growth of the own-race face recognition advantage. PMID:21429002

An Architectural Model of Visual Motion Understanding

DTIC Science & Technology

1989-08-01

of the Center for Visual Sciences of the University of Rochester. Their courage in the face of the overwhelming com- plexity of the human visual...analysis should perform better than either approach by itself. Notice that the problems of the two approaches are non-overlapping. Continuous methods face no...success. This is not terribly surprising, as the problem is inherently very difficult. Consider the problems faced by a unit that is trying to compute the

Outsourcing issues for nurse practitioner practices.

PubMed

Mackey, Thomas A; McNiel, Nancy O; Klingensmith, Kenneth

2004-01-01

Nurse practitioner managed practices face multiple business and clinical processes. While most practice managers are prepared as clinicians, they are not well prepared to deal with the daily multiple business infrastructure issues they face. To provide for increased efficiency and effectiveness, nurse practitioner practices should consider outsourcing context business functions.

Are Australasian academic physicians an endangered species?

PubMed

Wilson, A

2007-11-01

It has been stated that academic medicine is in a worldwide crisis. Is this decline in hospital academic practice a predictable consequence of modern clinical practice with its emphasis on community and outpatient-based services as well as a corporate health-care ethos or does it relate to innate problems in the training process and career structure for academic clinicians? A better understanding of the barriers to involvement in academic practice, including the effect of gender, the role and effect of overseas training, expectation of further research degrees and issues pertaining to the Australian academic workplace will facilitate recruitment and retention of the next generation of academic clinicians. Physician-scientists remain highly relevant as medical practice and education evolves in the 21st century. Hospital-based academics carry out a critical role in the ongoing mentoring of trainees and junior colleagues, whose training is still largely hospital based in most specialty programmes. Academic clinicians are uniquely placed to translate the rapid advances in medical biology into the clinical sphere, by guiding and carrying out translational research as well as leading clinical studies. Academic physicians also play key leadership in relations with government and industry, in professional groups and medical colleges. Thus, there is a strong case to assess the problems facing recruitment and retention of physician-scientists in academic practice and to develop workable solutions.

Comparing Online and Face-to-Face Student Counselling: What Therapeutic Goals Are Identifed and What Are the Implications for Educational Providers?

ERIC Educational Resources Information Center

Hanley, Terry; Ersahin, Zehra; Sefi, Aaron; Hebron, Judith

2017-01-01

Online counselling is increasingly being used as an alternative to face-to-face student counselling. Using an exploratory mixed methods design, this project investigated the practice by examining the types of therapeutic goals that 11- to 25-year-olds identify online in routine practice. These goals were then compared to goals identified in…

Semisupervised kernel marginal Fisher analysis for face recognition.

PubMed

Wang, Ziqiang; Sun, Xia; Sun, Lijun; Huang, Yuchun

2013-01-01

Dimensionality reduction is a key problem in face recognition due to the high-dimensionality of face image. To effectively cope with this problem, a novel dimensionality reduction algorithm called semisupervised kernel marginal Fisher analysis (SKMFA) for face recognition is proposed in this paper. SKMFA can make use of both labelled and unlabeled samples to learn the projection matrix for nonlinear dimensionality reduction. Meanwhile, it can successfully avoid the singularity problem by not calculating the matrix inverse. In addition, in order to make the nonlinear structure captured by the data-dependent kernel consistent with the intrinsic manifold structure, a manifold adaptive nonparameter kernel is incorporated into the learning process of SKMFA. Experimental results on three face image databases demonstrate the effectiveness of our proposed algorithm.

Problems Facing Rural Schools.

ERIC Educational Resources Information Center

Stewart, C. E.; And Others

Problems facing rural Scottish schools range from short term consideration of daily operation to long term consideration of organizational alternatives. Addressed specifically, such problems include consideration of: (1) liaison between a secondary school and its feeder primary schools; (2) preservice teacher training for work in small, isolated…

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

NASA Astrophysics Data System (ADS)

Martin, Deloris

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

Multi-Dimensional, Non-Pyrolyzing Ablation Test Problems

NASA Technical Reports Server (NTRS)

Risch, Tim; Kostyk, Chris

2016-01-01

Non-pyrolyzingcarbonaceous materials represent a class of candidate material for hypersonic vehicle components providing both structural and thermal protection system capabilities. Two problems relevant to this technology are presented. The first considers the one-dimensional ablation of a carbon material subject to convective heating. The second considers two-dimensional conduction in a rectangular block subject to radiative heating. Surface thermochemistry for both problems includes finite-rate surface kinetics at low temperatures, diffusion limited ablation at intermediate temperatures, and vaporization at high temperatures. The first problem requires the solution of both the steady-state thermal profile with respect to the ablating surface and the transient thermal history for a one-dimensional ablating planar slab with temperature-dependent material properties. The slab front face is convectively heated and also reradiates to a room temperature environment. The back face is adiabatic. The steady-state temperature profile and steady-state mass loss rate should be predicted. Time-dependent front and back face temperature, surface recession and recession rate along with the final temperature profile should be predicted for the time-dependent solution. The second problem requires the solution for the transient temperature history for an ablating, two-dimensional rectangular solid with anisotropic, temperature-dependent thermal properties. The front face is radiatively heated, convectively cooled, and also reradiates to a room temperature environment. The back face and sidewalls are adiabatic. The solution should include the following 9 items: final surface recession profile, time-dependent temperature history of both the front face and back face at both the centerline and sidewall, as well as the time-dependent surface recession and recession rate on the front face at both the centerline and sidewall. The results of the problems from all submitters will be collected, summarized, and presented at a later conference.

Exploring responses to transformative group therapy for orphaned children in the context of mass orphaning in Botswana.

PubMed

Thamuku, Masego; Daniel, Marguerite

2013-01-01

In the context of AIDS, the Botswana Government has adopted a group therapy program to help large numbers of orphaned children cope with bereavement. This study explores the effectiveness of the therapy and examines how it interacts with cultural attitudes and practices concerning death. Ten orphaned children were involved in five rounds of data collection during a therapeutic retreat; eight social workers completed questionnaires concerning the effectiveness of the therapy. Most children were able to come to terms with their loss, face problems in their home and school environments, and envision ways of solving problems. All the children described benefits of group formation and the support it would provide when they returned to their home situations.

Estimating costs in the economic evaluation of medical technologies.

PubMed

Luce, B R; Elixhauser, A

1990-01-01

The complexities and nuances of evaluating the costs associated with providing medical technologies are often underestimated by analysts engaged in economic evaluations. This article describes the theoretical underpinnings of cost estimation, emphasizing the importance of accounting for opportunity costs and marginal costs. The various types of costs that should be considered in an analysis are described; a listing of specific cost elements may provide a helpful guide to analysis. The process of identifying and estimating costs is detailed, and practical recommendations for handling the challenges of cost estimation are provided. The roles of sensitivity analysis and discounting are characterized, as are determinants of the types of costs to include in an analysis. Finally, common problems facing the analyst are enumerated with suggestions for managing these problems.

NRC says integrated approach needed to understand, protect environment

NASA Astrophysics Data System (ADS)

Kolb, Charles E.; Loehr, Raymond C.; Gopnik, Morgan

A recent study by the National Research Council (NRC) advocates a more comprehensive and integrated approach to our nation's environmental research and development (R&D) activities. Because we face environmental problems of unprecedented complexity, the study maintains that the traditional practice of studying isolated environmental problems and devising narrowly focused control or remediation strategies to manage them will no longer suffice.In the report, Building a Foundation for Sound Environmental Decisions [National Academy Press, 1997], an NRC committee highlighted the need for developing a deeper scientific understanding of ecosystems, as well as the sociological and economic aspects of human interactions with the environment. To achieve these goals, the committee recommended a core research agenda for the Environmental Protection Agency (EPA) that has three components.

Research, empiricism and clinical practice in low-income countries.

PubMed

Isaac, Mohan; Chand, Prabhat; Murthy, Pratima

2007-10-01

Mental health problems are relevant for every country. They are particularly important for low-income countries which face a high burden of illness due to infectious disease, greater socio-economic disparities, and have limited resources for mental health care. There is a great mismatch in the areas of mental health research, practice, policy and services in comparison to developed countries. There have been a few studies that have investigated major mental health problems prevailing in these countries but missed out significant health problems. Studies have tended to be more donor driven and conducted in tertiary centres. The low priority accorded to mental health by the policy makers, scarcity of human resources, lack of culture-specific study instruments, lack of support from scientific journals have been some of the impediments to mental health research in these countries. In addition, lack of community participation and absence of sound mental health policies have deprived the vast majority of the benefit of modern psychiatric treatments. Recently, with increase in collaboration in research, availability of treatment including low-priced psychotropics, and a growing emphasis on the need for mental health policy in some low-income countries, the bleak scenario is expected to change.

Transfer path analysis: Current practice, trade-offs and consideration of damping

NASA Astrophysics Data System (ADS)

Oktav, Akın; Yılmaz, Çetin; Anlaş, Günay

2017-02-01

Current practice of experimental transfer path analysis is discussed in the context of trade-offs between accuracy and time cost. An overview of methods, which propose solutions for structure borne noise, is given, where assumptions, drawbacks and advantages of methods are stated theoretically. Applicability of methods is also investigated, where an engine induced structure borne noise of an automobile is taken as a reference problem. Depending on this particular problem, sources of measurement errors, processing operations that affect results and physical obstacles faced in the application are analysed. While an operational measurement is common in all stated methods, when it comes to removal of source, or the need for an external excitation, discrepancies are present. Depending on the chosen method, promised outcomes like independent characterisation of the source, or getting information about mounts also differ. Although many aspects of the problem are reported in the literature, damping and its effects are not considered. Damping effect is embedded in the measured complex frequency response functions, and it is needed to be analysed in the post processing step. Effects of damping, reasons and methods to analyse them are discussed in detail. In this regard, a new procedure, which increases the accuracy of results, is also proposed.

Controversies in oncologist-patient communication: a nuanced approach to autonomy, culture, and paternalism.

PubMed

Cherny, Nathan I

2012-01-01

Difficult dialogues with patients facing life-changing decisions are an intrinsic part of oncologic practice and a major source of stress. Having a sophisticated approach to the concepts of autonomy, paternalism, and culture can help in addressing difficult dilemmas that arise around the issues of disclosure and decision making. This article addresses some of the most common major challenges in oncologist-patient communication with a nuanced approach to the concepts of autonomy, paternalism, and culture. It introduces the new concept of"voluntary diminished autonomy" and describes the implications this concept has for the consent process. It also attempts to bring clarity to common problems and misconceptions relating to culture, paternalism, and therapeutic privilege as these pertain to the communication practices of oncologists.

Implementation of Sustainable Soil Management Practices to Improve Crop Production in the Different Ethiopian Agro Systems

NASA Astrophysics Data System (ADS)

García Moreno, R.; Gameda, S.; Diaz Alvarez, M. C.; Selasie, Y. G.

2012-04-01

Agriculture in Ethiopia is one of first priority since close to 10 In this context, the Ethiopian crop production faces to the following soil management challenges: lack of updated soil data, macro and micro nutrient depletion, acidity, salinity and soil surface erosion and crusting. One of the biggest issues is the loss of arable land, above 137 T/yr, reaching during some particularly dried periods until 300 T/yr. In this context, the authors constituted a working group of experts from Spanish and Ethiopian universities, local producers and international and governmental organisms to analyse the problems related to the different agro ecological zones found in Ethiopia and the management practices of different local producers. The study produced the trends to implement in the different areas to improve soil management practices in order to contribute to increase the crop production mainly to achieve food security problems. The analyse produced different working fields for the next years for addressing soil degradation, improving land resources management practices, increasing agricultural productivity, updating the available soil data, developing an international program of education, transferring of knowledge from similar study cases and implementing economical tools to help producers to assure income after severe edapho-climatic events. The practical work and the projects developed for the next period is addressed to smallholder farms belonging to the different 34 agro ecological zones identified in Ethiopia, each of them with very specific environmental, cultural and soil management practices.

Balancing Bologna: opportunities for university teaching that integrates academic and practical learning outcomes

NASA Astrophysics Data System (ADS)

Probst, Lorenz; Pflug, Verena; Brandenburg, Christiane; Guggenberger, Thomas; Mentler, Axel; Wurzinger, Maria

2014-05-01

In the course of the Bologna Process, the quality of university teaching has become more prominent in the discourse on higher education. More attention is now paid to didactics and methods and learner-oriented modes of teaching are introduced. The application of knowledge, practical skills and in consequence the employability of university graduates have become requirements for university teaching. Yet, the lecture-style approach still dominates European universities, although empirical evidence confirms that student-centred, interdisciplinary and experiential learning is more effective. Referring to the learning taxonomy introduced by Bloom, we argue that standard approaches rarely move beyond the learning level of comprehension and fail to reach the levels of application, analysis, synthesis and evaluation. Considering the rapid changes and multiple challenges society faces today, responsible practitioners and scientists who can improve the current management of natural resources are urgently needed. Universities are expected to equip their graduates with the necessary skills to reflect and evaluate their actions when addressing 'real world' problems in order to improve impact and relevance of their work. Higher education thus faces the challenge of providing multi-level learning opportunities for students with diverse practical and theoretical learning needs. In this study, we reflect on three cases of university teaching attempting to bridge theory and practice and based on the principles of systemic, problem based learning. The described courses focus on organic farming, rural development and landscape planning and take place in Uganda, Nicaragua and Italy. We show that being part of a real-world community of stakeholders requires hands-on learning and the reflection and evaluation of actions. This prepares students in a more effective and realistic way for their future roles as responsible decision makers in complex social, economic and ecological systems. We thus conclude that in order (1) to meet the goals of the Bologna process; and (2) to bridge the gap between theory and practice in higher education, university teaching needs to radically reconsider its standard forms of teaching. We propose a fundamental shift towards action learning in real-world settings, empowering students to become responsible actors.

Study protocol: the sleeping sound with attention-deficit/hyperactivity disorder project.

PubMed

Sciberras, Emma; Efron, Daryl; Gerner, Bibi; Davey, Margot; Mensah, Fiona; Oberklaid, Frank; Hiscock, Harriet

2010-12-30

Up to 70% of children with Attention-Deficit/Hyperactivity Disorder (ADHD) experience sleep problems including difficulties initiating and maintaining sleep. Sleep problems in children with ADHD can result in poorer child functioning, impacting on school attendance, daily functioning and behaviour, as well as parental mental health and work attendance. The Sleeping Sound with ADHD trial aims to investigate the efficacy of a behavioural sleep program in treating sleep problems experienced by children with ADHD. We have demonstrated the feasibility and the acceptability of this treatment program in a pilot study. This randomised controlled trial (RCT) is being conducted with 198 children (aged between 5 to 12 years) with ADHD and moderate to severe sleep problems. Children are recruited from public and private paediatric practices across the state of Victoria, Australia. Upon receiving informed written consent, families are randomised to receive either the behavioural sleep intervention or usual care. The intervention consists of two individual, face-to-face consultations and a follow-up phone call with a trained clinician (trainee consultant paediatrician or psychologist), focusing on the assessment and management of child sleep problems. The primary outcome is parent- and teacher-reported ADHD symptoms (ADHD Rating Scale IV). Secondary outcomes are child sleep (actigraphy and parent report), behaviour, daily functioning, school attendance and working memory, as well as parent mental health and work attendance. We are also assessing the impact of children's psychiatric comorbidity (measured using a structured diagnostic interview) on treatment outcome. To our knowledge, this is the first RCT of a behavioural intervention aiming to treat sleep problems in children with ADHD. If effective, this program will provide a feasible non-pharmacological and acceptable intervention improving child sleep and ADHD symptoms in this patient group. Current Controlled Trials ISRCTN68819261. ISRCTN: ISRCTN68819261.

Can we match ultraviolet face images against their visible counterparts?

NASA Astrophysics Data System (ADS)

Narang, Neeru; Bourlai, Thirimachos; Hornak, Lawrence A.

2015-05-01

In law enforcement and security applications, the acquisition of face images is critical in producing key trace evidence for the successful identification of potential threats. However, face recognition (FR) for face images captured using different camera sensors, and under variable illumination conditions, and expressions is very challenging. In this paper, we investigate the advantages and limitations of the heterogeneous problem of matching ultra violet (from 100 nm to 400 nm in wavelength) or UV, face images against their visible (VIS) counterparts, when all face images are captured under controlled conditions. The contributions of our work are three-fold; (i) We used a camera sensor designed with the capability to acquire UV images at short-ranges, and generated a dual-band (VIS and UV) database that is composed of multiple, full frontal, face images of 50 subjects. Two sessions were collected that span over the period of 2 months. (ii) For each dataset, we determined which set of face image pre-processing algorithms are more suitable for face matching, and, finally, (iii) we determined which FR algorithm better matches cross-band face images, resulting in high rank-1 identification rates. Experimental results show that our cross spectral matching (the heterogeneous problem, where gallery and probe sets consist of face images acquired in different spectral bands) algorithms achieve sufficient identification performance. However, we also conclude that the problem under study, is very challenging, and it requires further investigation to address real-world law enforcement or military applications. To the best of our knowledge, this is first time in the open literature the problem of cross-spectral matching of UV against VIS band face images is being investigated.

Memory for angry faces, impulsivity, and problematic behavior in adolescence.

PubMed

d'Acremont, Mathieu; Van der Linden, Martial

2007-04-01

Research has shown that cognitive processes like the attribution of hostile intention or angry emotion to others contribute to the development and maintenance of conduct problems. However, the role of memory has been understudied in comparison with attribution biases. The aim of this study was thus to test if a memory bias for angry faces was related to conduct problems in youth. Adolescents from a junior secondary school were presented with angry and happy faces and were later asked to recognize the same faces with a neutral expression. They also completed an impulsivity questionnaire. A teacher assessed their behavior. The results showed that a better recognition of angry faces than happy faces predicted conduct problems and hyperactivity/inattention as reported by the teacher. The memory bias effect was more pronounced for impulsive adolescents. It is suggested that a memory bias for angry faces favors disruptive behavior but that a good ability to control impulses may moderate the negative impact of this bias.

The theory-practice gap and skill acquisition: an issue for nursing education.

PubMed

Scully, Natashia Josephine

2011-01-01

Matching textbook descriptions of clinical situations with the reality of practice is an ongoing problem faced by members of the nursing profession and is commonly referred to as the "theory-practice gap". This ubiquitous gap is inevitably encountered by all nurses at various times; yet it is widely agreed that it is student nurses--given their novice, rule governed status--who find themselves in the midst of the theory-practice void. This paper will discuss the nature of the theory-practice gap and skill acquisition, in relation to a personal experience of mine as an undergraduate nursing student, and its significance in relation to student anxiety levels, nurse education (specifically the roles of the classroom teacher and clinical educators), teaching methods and the responsibility of the student to become accountable for their own education. I intend to communicate how my personal situation was dealt with and evaluate that experience in relation to current nursing literature. Ultimately, this discussion will demonstrate the value of reflection underpinning the development of competency in nursing and its role in bridging the theory-practice gap.

Interactive training model of TRIZ for mechanical engineers in China

NASA Astrophysics Data System (ADS)

Tan, Runhua; Zhang, Huangao

2014-03-01

Innovation is a process of taking an original idea and converting it into a business value, in which the engineers face some inventive problems which can be solved hardly by experience. TRIZ, as a new theory for companies in China, provides both conceptual and procedural knowledge for finding and solving inventive problems. Because the government plays a leading role in the diffusion of TRIZ, too many companies from different industries are waiting to be trained, but the quantity of the trainers mastering TRIZ is incompatible with that requirement. In this context, to improve the training effect, an interactive training model of TRIZ for the mechanical engineers in China is developed and the implementation in the form of training classes is carried out. The training process is divided into 6 phases as follows: selecting engineers, training stage-1, finding problems, training stage-2, finding solutions and summing up. The government, TRIZ institutions and companies to join the programs interact during the process. The government initiates and monitors a project in form of a training class of TRIZ and selects companies to join the programs. Each selected companies choose a few engineers to join the class and supervises the training result. The TRIZ institutions design the training courses and carry out training curriculum. With the beginning of the class, an effective communication channel is established by means of interview, discussion face to face, E-mail, QQ and so on. After two years training practices, the results show that innovative abilities of the engineers to join and pass the final examinations increased distinctly, and most of companies joined the training class have taken congnizance of the power of TRIZ for product innovation. This research proposes an interactive training model of TRIZ for mechanical engineers in China to expedite the knowledge diffusion of TRIZ.

"Peer2Peer" - A university program for knowledge transfer and consultation in dealing with psychosocial crises in med-school and medical career.

PubMed

Vajda, Christian

2016-01-01

Medical students are exposed to various psychosocial problems and challenges. Specific consultations services and programs can support them. "Peer2Peer" is such a consultation program and was implemented at the Medical University of Graz. It focusses on crisis intervention, psychosocial stress management, junior mentoring as well as student education in this field. Besides, it also offers student tutors of the program practical skills trainings. The program was restructured in winter term 2014/15. On the one hand, "Peer2Peer" gives insights into topics such as the current state of research concerning the students' psychological strain and psychosocial crises in acutely stressful situations and preventive approaches for coping with these kinds of situations on the other hand. These aspects are taught by means of elective courses, lectures and workshops. Furthermore, "Peer2Peer" provides consultation services by student tutors who give face-to-face advice if required. These tutors receive ongoing training in organizational and professional issues. Since the summer term of 2015, 119 students have been trained (via lectures and elective courses), while 61 contacts (short consultation) and 33 contacts (full consultation) have been supervisied. In total, two psychotherapeutic and one psychosocial follow ups were recommended. There are seven students who participate as tutors in the program. The "Peer2Peer" program is intended to enable a low-threshold access for medical students facing psychosocial crises situations and to help them in dealing with stress and learning problems. An increase in support contacts from the summer term of 2015 to the winter term of 2015/16 can be considered a success. A first evaluation of the different components of the program started in the winter semester of 2015/16. The student tutors have not only acquired practical skills in dealing with students in crises situations but also various organizational skills.

Improving math and science education in charter secondary schools through the use of technology

NASA Astrophysics Data System (ADS)

Ojose, Bobby

This study was conducted to examine the promising practices of using technology in teaching math and science in charter schools in California. The study was conducted under the auspices of the Center for Educational Governance (CEG) which hopes to compile the promising practices into an Internet-based compendium to be replicated by others. The research employed an in-depth qualitative case study method. It was conducted in two secondary schools in different school districts in the state of California over a two-month period. The main participants were principals, lead teachers, teachers, and support staff. Interviews, observations, and archival documents were the main data collection tools. Face to face interviews were conducted with the principals, lead teachers of technology, teachers, and a support staff (Network Administrator). Technology lab and professional development activities were observed. Interviews were tape-recorded and transcribed. The study found that one school (MSA) has the promising practice of using technology to enhance the subject matter knowledge of students by using computers to further explore concepts already learned in the regular classroom. The other school (CART) has the promising practice of applying technology to real life situations as a teaching pedagogy. The result of these practices is the positive outcomes in the following areas: Increased student achievement in standardized teat scores, increased motivation, growth in mean GPA, less behavior problems from students, and improved school attendance by students. The implications for policy and practice include: Teachers having the knowledge of the benefits of constructive teaching in the classroom; principals understanding that professional development activities for technology integration will vary in complexities and depends on needs of teachers; policy makers identifying needs and establishing goals; and researchers conducting more qualitative studies to gather evidence to demonstrate the progression of learning in the technology classroom.

Analysing policy delivery in the United Kingdom: the case of street crime and anti-social behaviour.

PubMed

Smith, Martin; Richards, David; Geddes, Andrew; Mathers, Helen

2011-01-01

For all governments, the principle of how and whether policies are implemented as intended is fundamental. The aim of this paper is to examine the difficulties for governments in delivering policy goals when they do not directly control the processes of implementation. This paper examines two case studies – anti-social behaviour and street crime – and demonstrates the difficulties faced by policy-makers in translating policy into practice when the policy problems are complex and implementation involves many actors.

Empirical and Face Validity of Software Maintenance Defect Models Used at the Jet Propulsion Laboratory

NASA Technical Reports Server (NTRS)

Taber, William; Port, Dan

2014-01-01

At the Mission Design and Navigation Software Group at the Jet Propulsion Laboratory we make use of finite exponential based defect models to aid in maintenance planning and management for our widely used critical systems. However a number of pragmatic issues arise when applying defect models for a post-release system in continuous use. These include: how to utilize information from problem reports rather than testing to drive defect discovery and removal effort, practical model calibration, and alignment of model assumptions with our environment.

Applying Physics: Opportunities in Semiconductor Technology Companies

NASA Astrophysics Data System (ADS)

Redinbo, Greg

2011-03-01

While many physicists practice in university settings, physics skills can also be applied outside the traditional academic track. ~Identifying these opportunities requires a clear understanding of how your physics training can be used in an industrial setting, understanding what challenges technology companies face, and identifying how your problem solving skills can be broadly applied in technology companies. ~In this talk I will highlight the common features of such companies, discuss what specific skills are useful for an industrial physicist, and explain roles (possibly unfamiliar) that may be available to you.

Simultaneous personnel and vehicle shift scheduling in the waste management sector.

PubMed

Ghiani, Gianpaolo; Guerriero, Emanuela; Manni, Andrea; Manni, Emanuele; Potenza, Agostino

2013-07-01

Urban waste management is becoming an increasingly complex task, absorbing a huge amount of resources, and having a major environmental impact. The design of a waste management system consists in various activities, and one of these is related to the definition of shift schedules for both personnel and vehicles. This activity has a great incidence on the tactical and operational cost for companies. In this paper, we propose an integer programming model to find an optimal solution to the integrated problem. The aim is to determine optimal schedules at minimum cost. Moreover, we design a fast and effective heuristic to face large-size problems. Both approaches are tested on data from a real-world case in Southern Italy and compared to the current practice utilized by the company managing the service, showing that simultaneously solving these problems can lead to significant monetary savings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Finding order in complexity: themes from the career of Dr. Robert F. Wagner

NASA Astrophysics Data System (ADS)

Myers, Kyle J.

2009-02-01

Over the course of his long and productive career, Dr. Robert F. Wagner built a framework for the evaluation of imaging systems based on a task-based, decision theoretic approach. His most recent contributions involved the consideration of the random effects associated with multiple readers of medical images and the logical extension of this work to the problem of the evaluation of multiple competing classifiers in statistical pattern recognition. This contemporary work expanded on familiar themes from Bob's many SPIE presentations in earlier years. It was driven by the need for practical solutions to current problems facing FDA'S Center for Devices and Radiological Health and the medical imaging community regarding the assessment of new computer-aided diagnosis tools and Bob's unique ability to unify concepts across a range of disciplines as he gave order to increasingly complex problems in our field.

Academic training and clinical placement problems to achieve nursing competency

PubMed Central

RAHMATI SHARGHI, NARJES; ALAMI, ALI; KHOSRAVAN, SHAHLA; MANSOORIAN, MOHAMMAD REZA; EKRAMI, ALI

2015-01-01

Introduction: High quality of care is one of the requirements of nursing which depends on the nursing competency. In this connection, the aim of this research was to determine the problems related to the academic training (nursing' educational program) and clinical practice to achieve competency from the viewpoint of nurses, faculty members, and nursing students. Methods: the study was an analytical cross-sectional one. The sample consisted of the academic staff, the third and the fourth year nursing students and nurses in practice. The instrument of the study was a two-part researcher-made questionnaire with 22 questions in the theoretical- clinical realm to assess  problems related to the theoretical and clinical teaching in nursing, and 23 questions to assess the clinical functions. The questionnaire was validated in terms of both face and content validity. Its reliability, using Cronbach's Alpha coefficient, was 0.72 in the theoretical-clinical and 0.73 in the clinical realm. Both descriptive and analytical statistics were used to analyze the data, using SPSS software. Results: The results of this study indicated that from the participants’ viewpoints, the most important problems in the academic education for nursea to acquire competency were as follows: lack of academic research the clinical period (88.9%), no application of theoretical aspects of the nursing process in practice (85.6%), insufficient knowledgeable and professional educators (81.1%), the use of traditional routine-oriented methods on the wards (75.6%); also insufficient time for performance based on knowledge in relation to  the nurse's workload (86.5%), weakness and usefulness of scientific function encouragement systems in clinic (85.2%), and learnt theoretical subjects not coming into practice in clinical fields after graduation (75.6%). Conclusion: Efforts to reduce the gap between the theoretical and practical (clinical function) knowledge in educational and work environment are required to improve the training of qualified nurses. PMID:25587550

Examining Information Problem-Solving, Knowledge, and Application Gains within Two Instructional Methods: Problem-Based and Computer-Mediated Participatory Simulation

ERIC Educational Resources Information Center

Newell, Terrance S.

2008-01-01

This study compared the effectiveness of two instructional methods--problem-based instruction within a face-to-face context and computer-mediated participatory simulation--in increasing students' content knowledge and application gains in the area of information problem-solving. The instructional methods were implemented over a four-week period. A…

Clinical innovation for promoting family care in paediatric intensive care: demonstration, role modelling and reflective practice.

PubMed

Tomlinson, Patricia S; Thomlinson, Elizabeth; Peden-McAlpine, Cynthia; Kirschbaum, Mark

2002-04-01

To explore family caregiving problems in paediatric crisis care and methods that could be applied to move the abstraction of family care to development of specific family interventions. Family centred care has been accepted as the ideal philosophy for holistic health care of children, but methods for its implementation are not well established. In paediatric health crises, family care requires special sensitivity to family needs and a type of complex nursing care for which many practitioners are not sufficiently prepared. Developing family sensitive models of intervention and finding a strategy for transfer of this knowledge to clinical practice is an important challenge facing family nursing today. Social learning theory provides a rich background to explore these issues. Specific techniques of role modelling and reflective practice are suggested as effective approaches to teach family sensitive care in clinical settings where families are part of the care environment.

Hierarchical Spatio-Temporal Probabilistic Graphical Model with Multiple Feature Fusion for Binary Facial Attribute Classification in Real-World Face Videos.

PubMed

Demirkus, Meltem; Precup, Doina; Clark, James J; Arbel, Tal

2016-06-01

Recent literature shows that facial attributes, i.e., contextual facial information, can be beneficial for improving the performance of real-world applications, such as face verification, face recognition, and image search. Examples of face attributes include gender, skin color, facial hair, etc. How to robustly obtain these facial attributes (traits) is still an open problem, especially in the presence of the challenges of real-world environments: non-uniform illumination conditions, arbitrary occlusions, motion blur and background clutter. What makes this problem even more difficult is the enormous variability presented by the same subject, due to arbitrary face scales, head poses, and facial expressions. In this paper, we focus on the problem of facial trait classification in real-world face videos. We have developed a fully automatic hierarchical and probabilistic framework that models the collective set of frame class distributions and feature spatial information over a video sequence. The experiments are conducted on a large real-world face video database that we have collected, labelled and made publicly available. The proposed method is flexible enough to be applied to any facial classification problem. Experiments on a large, real-world video database McGillFaces [1] of 18,000 video frames reveal that the proposed framework outperforms alternative approaches, by up to 16.96 and 10.13%, for the facial attributes of gender and facial hair, respectively.

Understanding enabling capacities for managing the 'wicked problem' of nonpoint source water pollution in catchments: a conceptual framework.

PubMed

Patterson, James J; Smith, Carl; Bellamy, Jennifer

2013-10-15

Nonpoint source (NPS) water pollution in catchments is a 'wicked' problem that threatens water quality, water security, ecosystem health and biodiversity, and thus the provision of ecosystem services that support human livelihoods and wellbeing from local to global scales. However, it is a difficult problem to manage because water catchments are linked human and natural systems that are complex, dynamic, multi-actor, and multi-scalar in nature. This in turn raises questions about understanding and influencing change across multiple levels of planning, decision-making and action. A key challenge in practice is enabling implementation of local management action, which can be influenced by a range of factors across multiple levels. This paper reviews and synthesises important 'enabling' capacities that can influence implementation of local management action, and develops a conceptual framework for understanding and analysing these in practice. Important enabling capacities identified include: history and contingency; institutional arrangements; collaboration; engagement; vision and strategy; knowledge building and brokerage; resourcing; entrepreneurship and leadership; and reflection and adaptation. Furthermore, local action is embedded within multi-scalar contexts and therefore, is highly contextual. The findings highlight the need for: (1) a systemic and integrative perspective for understanding and influencing change for managing the wicked problem of NPS water pollution; and (2) 'enabling' social and institutional arenas that support emergent and adaptive management structures, processes and innovations for addressing NPS water pollution in practice. These findings also have wider relevance to other 'wicked' natural resource management issues facing similar implementation challenges. Copyright © 2013 Elsevier Ltd. All rights reserved.

Values-based practice in mental health and psychiatry.

PubMed

Woodbridge-Dodd, Kim

2012-11-01

Values-based practice (VBP) challenges traditions of clinical practice and moral decision-making and the literature published over the last 18 months demonstrates a growing momentum for its use. The VBP model has become part of the narrative of health and social care practice. It features in a range of publications and has been subject to philosophical analysis in relation to its theoretical rigour, and applied to clinical practice through education and training, implementation in the field and policy development. From a philosophical perspective the model faces several challenges; from a practice perspective it is welcomed as a necessary partner to Evidence-Based Practice. Both perspectives suggest VBP requires significant adjustment to professional ideas of good practice, expectations of the clinician service user relationship and notions of what constitutes good care. VBP is both a solution and a problem for clinicians. Whether VBP is seen as providing a much needed clinical skill for working with the complexity of mental health and psychiatry which is steeped in values or a solution to a dominant sociopolitical neoliberal ideology demand for choice and personalization of care, VBP will require clinicians to make personal changes to their values base that reach to the depths of their professional identity.

When health systems are barriers to health care: challenges faced by uninsured Mexican kidney patients.

PubMed

Kierans, Ciara; Padilla-Altamira, Cesar; Garcia-Garcia, Guillermo; Ibarra-Hernandez, Margarita; Mercado, Francisco J

2013-01-01

Chronic Kidney Disease disproportionately affects the poor in Low and Middle Income Countries (LMICs). Mexico exemplifies the difficulties faced in supporting Renal Replacement Therapy (RRT) and providing equitable patient care, despite recent attempts at health reform. The objective of this study is to document the challenges faced by uninsured, poor Mexican families when attempting to access RRT. The article takes an ethnographic approach, using interviewing and observation to generate detailed accounts of the problems that accompany attempts to secure care. The study, based in the state of Jalisco, comprised interviews with patients, their caregivers, health and social care professionals, among others. Observations were carried out in both clinical and social settings. In the absence of organised health information and stable pathways to renal care, patients and their families work extraordinarily hard and at great expense to secure care in a mixed public-private healthcare system. As part of this work, they must navigate challenging health and social care environments, negotiate treatments and costs, resource and finance healthcare and manage a wide range of formal and informal health information. Examining commonalities across pathways to adequate healthcare reveals major failings in the Mexican system. These systemic problems serve to reproduce and deepen health inequalities. A system, in which the costs of renal care are disproportionately borne by those who can least afford them, faces major difficulties around the sustainability and resourcing of RRTs. Attempts to increase access to renal therapies, therefore, need to take into account the complex social and economic demands this places on those who need access most. This paper further shows that ethnographic studies of the concrete ways in which healthcare is accessed in practice provide important insights into the plight of CKD patients and so constitute an important source of evidence in that effort.

Varying face occlusion detection and iterative recovery for face recognition

NASA Astrophysics Data System (ADS)

Wang, Meng; Hu, Zhengping; Sun, Zhe; Zhao, Shuhuan; Sun, Mei

2017-05-01

In most sparse representation methods for face recognition (FR), occlusion problems were usually solved via removing the occlusion part of both query samples and training samples to perform the recognition process. This practice ignores the global feature of facial image and may lead to unsatisfactory results due to the limitation of local features. Considering the aforementioned drawback, we propose a method called varying occlusion detection and iterative recovery for FR. The main contributions of our method are as follows: (1) to detect an accurate occlusion area of facial images, an image processing and intersection-based clustering combination method is used for occlusion FR; (2) according to an accurate occlusion map, the new integrated facial images are recovered iteratively and put into a recognition process; and (3) the effectiveness on recognition accuracy of our method is verified by comparing it with three typical occlusion map detection methods. Experiments show that the proposed method has a highly accurate detection and recovery performance and that it outperforms several similar state-of-the-art methods against partial contiguous occlusion.

An Awful and Impressive Spectacle: Crime Scene Executions in Scotland, 1801-1841

PubMed Central

Bennett, Rachel

2018-01-01

Early nineteenth-century Britain witnessed rising numbers of offenders facing capital punishment and a plethora of legal and public discourse debating the criminal justice system. This article will examine a distinct Scottish response to the problem in the form of crime scene executions. By the turn of the nineteenth century it had long been the established practice of the Scottish courts to order that capitally convicted offenders would be executed at an established ‘common place’. However, between 1801 and 1841, the decision was taken to execute 37 offenders at the scene of their crimes. This article argues that in the face of an unprecedented number of offenders facing the hangman’s noose the Scottish judges chose to exercise this penal option which had not been used to a similar extent since the mid-eighteenth century. In turn these events had a multiplicity of impact and provoked responses ranging from a morbid curiosity to witness the spectacle to anxiety and outright disdain at its intrusion into areas previously unsullied by the last punishment of the law. PMID:29780278

A pilot programme of clinical practice improvement for future consultant doctors.

PubMed

Oates, Kim; Vinters, Cathy; Cass-Verco, John; Fletcher, Mandy; Kaur, Narinder; Mherekumombe, Martha; Tang, Alice

2017-04-01

To provide junior doctors with tools to improve patient care in their workplace, a partnership was developed between the Clinical Excellence Commission (CEC) and the Royal Australasian College of Physicians (RACP) to help trainee consultants carry out clinical practice improvement (CPI) projects during clinical work. Based on a patient-care problem they wished to resolve, trainee consultants attended a 2-day face-to-face workshop to learn quality-improvement methods, describe their proposals and refine them using CPI methodology. They were provided with continuing supervision, participated in a mid-point review and were responsible for driving their projects. Trainee consultants attended a 2-day face-to-face workshop to learn quality-improvement methods RESULTS: Examples of five projects are: reducing mislabelled specimens leaving an emergency department, from 82 in the baseline period to 18 following the intervention; creating a multidisciplinary team to reduce hypoglycaemic episodes on a diabetic ward, from 23 episodes at baseline to three episodes over the same time period after the intervention; establishing an acute paediatric review clinic that reduced avoidable admissions of pneumonia by 74 per cent; providing 100 per cent of patients in a palliative care unit with an effective pain-management plan; developing an education package to increase staff confidence in recognising and responding to anaphylaxis in children, producing an increase in confidence from 51 per cent at baseline to 100 per cent after the intervention. Involving a learned college such as the RACP in patient-care improvement, with educational input from a partner organisation, shows how junior staff can become effective leaders in improving patient care. © 2016 John Wiley & Sons Ltd.

On the Cutting Edge Professional Development Program - An effective model built from years of experience

NASA Astrophysics Data System (ADS)

Bruckner, M. Z.; Macdonald, H.; Beane, R. J.; Manduca, C. A.; Mcconnell, D. A.; Mogk, D. W.; Tewksbury, B. J.; Wiese, K.; Wysession, M. E.; Iverson, E. A. R.; Fox, S.

2015-12-01

The On the Cutting Edge (CE) program offers a successful model for designing and convening professional development events. Information about the model is now available on the CE website. The program model has evolved from more than 12 years of experience, building with input from strong leaders and participants. CE offers face-to-face, virtual, and hybrid events, and features a rich website that supports these professional development events as well as a growing community with a shared interest in effective geoscience teaching. Data from national surveys, participant feedback, and self-report data indicate the program's success in improving undergraduate geoscience education. Successes are also demonstrated in classroom observations using RTOP, indicating a significant difference in teaching style among participants and non-participants. A suite of web pages, with a planning timeline, provides guidance to those interested in designing and convening face-to-face or virtual events based on the CE model. The pages suggest ways to develop robust event goals and evaluation tools, how to choose strong leaders and recruit diverse participants, advice for designing effective event programs that utilize participant expertise, websites, and web tools, and suggestions for effectively disseminating event results and producing useful products. The CE model has been successfully transferred to projects that vary in scale and discipline. Best practices from the CE model include (1) thinking of the workshop as shared enterprise among conveners and participants; (2) incorporating conveners and participants who bring diverse viewpoints and approaches; (3) promoting structured discussions that utilize participants' expertise; (4) emphasizing practical strategies to effect change; and (5) using the website as a platform to prepare for the workshop, share ideas, and problem-solve challenges. Learn more about how to utilize this model for your project at:serc.carleton.edu/NAGTWorkshops/workshops/convene

Sexual harassment of female chiropractors by their patients: a pilot survey of faculty at the Canadian Memorial Chiropractic College

PubMed Central

Gleberzon, Brian; Statz, Rachel; Pym, Matthew

2015-01-01

Background: The purpose of this study was to survey a group of female chiropractors and inquire as to whether or not they had been sexually harassed by their patients. Methods: An online questionnaire was emailed via Survey Monkey to 47 female faculty members at the Canadian Memorial Chiropractic College (CMCC). Respondents were asked if they had been sexual harassed and, if so, the characteristics of the incident(s), their response to it, how serious they perceived the problem to be and whether or not they felt prepared to deal with it. Results: Nineteen of 47 questionnaires were completed and returned. Of these 19, eight respondents reported being sexually harassed by a patient (all male), most commonly within the first 5 years of practice and most commonly involving a ‘new’ patient. It was rarely anticipated. The nature of the harassment varied and respondents often ignored the incident. Most respondents perceive this to be a problem facing female chiropractors. Discussion: Although this is the first survey of its kind, this is a significant problem facing other healthcare professionals. Conclusions: Among this group of respondents, sexual harassment by patients was a common occurrence. More training on how to handle it, during either a student’s chiropractic education or offered as a continuing education program, may be warranted. PMID:26136603

New media, old media: The technologies of international development

NASA Astrophysics Data System (ADS)

Ingle, Henry T.

1986-09-01

The research, theory and practice of educational technology over the past 75 years provide convincing evidence that this process offers a comprehensive and integrated approach to solving educational and social problems. The use of media and technology in development has shifted from an emphasis on mass media to personal media. A variety of electronic delivery systems are being used and are usually coordinated by centralized governmental agencies. There are no patterns of use since the problems vary and the medium used is responsive to the problem. Computers are used most frequently and satellite telecommunication networks follow. The effective use of these and other technologies requires a long-term commitment to financial support and training of personnel. The extension model of face-to-face contact still prevails in developing nations whether in agriculture, education or rural development. Low-cost technologies are being used in local projects while major regional and national companies use radio, film and related video technologies. The use of all available and cost-effective media and technologies make possible appropriate communications for specific goals with specific audiences. There appears to be no conflict among proponents of various media formats. Development in education and other sectors has much to gain from old and new communication technologies and has hardly been tapped. Several new educational technology developments are discussed as potential contributors to formal and nonformal education.

Problem and Pathological Gambling in Schizophrenia: Exploring Links with Substance Use and Impulsivity.

PubMed

Fortgang, Rebecca G; Hoff, Rani A; Potenza, Marc N

2018-02-16

High rates of both problem and pathological gambling (PPG) and substance-use disorders (SUDs) have been reported in schizophrenia, and yet PPG frequently goes undetected in clinical practice and unexamined in research. Here, we aimed to examine the relationship between PPG and SUDs in a large sample of patients across several factors related to both gambling and substance use, including poly-substance use. Additionally, delay discounting is a form of impulsivity known to positively associate with both PPG and SUDs and thought to underlie mechanisms of addiction in both contexts. We aimed to investigate the relationship between PPG and delay discounting in schizophrenia. 337 individuals with schizophrenia completed structured face-to-face interviews regarding gambling behaviors, substance use, and delay discounting. PPG in schizophrenia was associated with substance use, in particular with poly-substance use, and with delay discounting among males. Factors related to substance use were strongly linked with gambling in this sample, but not always with PPG more than recreational gambling. Our findings overall support the notions that multiple forms of gambling in schizophrenia are clinically relevant, that gambling may share common substrates with substance use, and that delay discounting represents a potential mechanism of this association in males.

Professional boundaries: the perspective of the third year medical student in negotiating three boundary challenges.

PubMed

Gaufberg, Elizabeth; Baumer, Nicole; Hinrichs, Margaret; Krupat, Ed

2008-01-01

The negotiation and maintenance of professional boundaries is a central developmental challenge for medical students in clinical training. The purpose of this study is to assess problem solving strategies, decisions made, level of confidence, and language used by beginning third year medical students when faced with professional boundary challenges. Forty-two students in the first quarter of their third year at Harvard Medical School viewed three brief audiovisual "trigger" tapes, each depicting a medical student faced with a boundary challenge (the offer of a gift, a personal question from a patient, an errand request by a supervisor). There was a high degree of agreement and confidence among students about how to negotiate a monetary gift (reject) and how to respond to a patient's "too personal" question (not answer and/or redirect). However, the students were less confident and more divided on the issue of whether or not to run a personal errand for the team at the request of a superior. Our findings have implications for medical professionalism curricula, especially regarding the importance of mentorship and role modeling in medical education. Effective professional boundaries curricula allow the student to problem solve and practice communication skills in boundary challenging situations.

Confronting Unsuccessful Practices: Repositioning Teacher Identities in English Education

ERIC Educational Resources Information Center

Vetter, Amy; Hartman, Shana V.; Reynolds, Jeanie M.

2016-01-01

Teacher education programs attempt to prepare preservice teachers for the various challenges faced in the classroom. One particular challenge new teachers face is how to handle unsuccessful practices. This paper argues that confronting ineffective practices require that teachers respond to complex and dynamic challenges, making change difficult…

Insightful practice: a reliable measure for medical revalidation

PubMed Central

Guthrie, Bruce; Sullivan, Frank M; Mercer, Stewart W; Russell, Andrew; Bruce, David A

2012-01-01

Background Medical revalidation decisions need to be reliable if they are to reassure on the quality and safety of professional practice. This study tested an innovative method in which general practitioners (GPs) were assessed on their reflection and response to a set of externally specified feedback. Setting and participants 60 GPs and 12 GP appraisers in the Tayside region of Scotland, UK. Methods A feedback dataset was specified as (1) GP-specific data collected by GPs themselves (patient and colleague opinion; open book self-evaluated knowledge test; complaints) and (2) Externally collected practice-level data provided to GPs (clinical quality and prescribing safety). GPs' perceptions of whether the feedback covered UK General Medical Council specified attributes of a ‘good doctor’ were examined using a mapping exercise. GPs' professionalism was examined in terms of appraiser assessment of GPs' level of insightful practice, defined as: engagement with, insight into and appropriate action on feedback data. The reliability of assessment of insightful practice and subsequent recommendations on GPs' revalidation by face-to-face and anonymous assessors were investigated using Generalisability G-theory. Main outcome measures Coverage of General Medical Council attributes by specified feedback and reliability of assessor recommendations on doctors' suitability for revalidation. Results Face-to-face assessment proved unreliable. Anonymous global assessment by three appraisers of insightful practice was highly reliable (G=0.85), as were revalidation decisions using four anonymous assessors (G=0.83). Conclusions Unlike face-to-face appraisal, anonymous assessment of insightful practice offers a valid and reliable method to decide GP revalidation. Further validity studies are needed. PMID:22653078

Evaluating the impact of Getting To Outcomes-Underage Drinking on prevention capacity and alcohol merchant attitudes and selling behaviors

PubMed Central

Chinman, Matthew; Ebener, Patricia; Burkhart, Q; Osilla, Karen Chan; Imm, Pamela; Paddock, Susan M.; Wright, Patricia Ann

2017-01-01

Underage drinking is a significant problem facing US communities. Several environmental alcohol prevention (EAP) strategies (laws, regulations, responsible beverage service training and practices) successfully address underage drinking. Communities, however, face challenges carrying out these EAP strategies effectively. This small-scale, three-year, randomized controlled trial assessed whether providing prevention coalitions with Getting To Outcomes-Underage Drinking (GTO-UD), a tool kit and implementation support intervention, helped improve implementation of two common EAP strategies, responsible beverage service training (RBS) and Compliance Checks. Three coalitions in South Carolina and their RBS and Compliance Check programs received the 16 month GTO-UD intervention, including the GTO-UD manual, training, and onsite technical assistance, while another three in South Carolina maintained routine operations. The measures, collected at baseline and after the intervention, were a structured interview assessing how well coalitions carried out their work and a survey of merchant attitudes and practices in the six counties served by the participating coalitions. Over time, the quality of some RBS and Compliance Check activities improved more in GTO-UD coalitions than in the control sites. No changes in merchant practices or attitudes significantly differed between the GTO-UD and control groups, although merchants in the GTO-UD counties did significantly improve on refusing sales to minors while control merchants did not. PMID:23564504

A Framework for Web-Based Interprofessional Education for Midwifery and Medical Students.

PubMed

Reis, Pamela J; Faser, Karl; Davis, Marquietta

2015-01-01

Scheduling interprofessional team-based activities for health sciences students who are geographically dispersed, with divergent and often competing schedules, can be challenging. The use of Web-based technologies such as 3-dimensional (3D) virtual learning environments in interprofessional education is a relatively new phenomenon, which offers promise in helping students come together in online teams when face-to-face encounters are not possible. The purpose of this article is to present the experience of a nurse-midwifery education program in a Southeastern US university in delivering Web-based interprofessional education for nurse-midwifery and third-year medical students utilizing the Virtual Community Clinic Learning Environment (VCCLE). The VCCLE is a 3D, Web-based, asynchronous, immersive clinic environment into which students enter to meet and interact with instructor-controlled virtual patient and virtual preceptor avatars and then move through a classic diagnostic sequence in arriving at a plan of care for women throughout the lifespan. By participating in the problem-based management of virtual patients within the VCCLE, students learn both clinical competencies and competencies for interprofessional collaborative practice, as described by the Interprofessional Education Collaborative Core Competencies for Interprofessional Collaborative Practice. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.

Colonel Blotto Games and Lancaster's Equations: A Novel Military Modeling Combination

NASA Technical Reports Server (NTRS)

Collins, Andrew J.; Hester, Patrick T.

2012-01-01

Military strategists face a difficult task when engaged in a battle against an adversarial force. They have to predict both what tactics their opponent will employ and the outcomes of any resultant conflicts in order to make the best decision about their actions. Game theory has been the dominant technique used by analysts to investigate the possible actions that an enemy will employ. Traditional game theory can be augmented by use of Lanchester equations, a set of differential equations used to determine the outcome of a conflict. This paper demonstrates a novel combination of game theory and Lanchester equations using Colonel Blotto games. Colonel Blotto games, which are one of the oldest applications of game theory to the military domain, look at the allocation of troops and resources when fighting across multiple areas of operation. This paper demonstrates that employing Lanchester equations within a game overcomes some of practical problems faced when applying game theory.

Risky communication: pitfalls in counseling about risk, and how to avoid them.

PubMed

O'Doherty, K; Suthers, G K

2007-08-01

A genetic counselor is often faced with the difficult task of conveying a set of complex and highly abstract factors associated with the client's risk of developing a familial disorder. The client is faced with the even more difficult task of making significant health-related decisions about an event which may or may not eventuate. Although there is a large corpus of research on this topic, much of the knowledge on risk communication is difficult to apply in a practical context. In this paper we draw together some insights on risk communication and decision-making under conditions of uncertainty, and apply them directly to the problem of communicating familial cancer risk. In particular, we focus on the distinction between individual risk and observed frequencies of adverse events, various framing effects, and contextualizing risk communication. We draw attention to some of the potential pitfalls in counseling about risk and offer avenues for circumventing them.

Health information technology knowledge and skills needed by HIT employers.

PubMed

Fenton, S H; Gongora-Ferraez, M J; Joost, E

2012-01-01

To evaluate the health information technology (HIT) workforce knowledge and skills needed by HIT employers. Statewide face-to-face and online focus groups of identified HIT employer groups in Austin, Brownsville, College Station, Dallas, El Paso, Houston, Lubbock, San Antonio, and webinars for rural health and nursing informatics. HIT employers reported needing an HIT workforce with diverse knowledge and skills ranging from basic to advanced, while covering information technology, privacy and security, clinical practice, needs assessment, contract negotiation, and many other areas. Consistent themes were that employees needed to be able to learn on the job and must possess the ability to think critically and problem solve. Many employers wanted persons with technical skills, yet also the knowledge and understanding of healthcare operations. The HIT employer focus groups provided valuable insight into employee skills needed in this fast-growing field. Additionally, this information will be utilized to develop a statewide HIT workforce needs assessment survey.

Return of Individual Research Results & Incidental Findings: Facing the Challenges of Translational Science

PubMed Central

Wolf, Susan M.

2014-01-01

The debate over return of individual research results and incidental findings to research participants is a key frontier in research ethics and practice. Fundamentally, this is a problem of translational science, a question of when information about an individual that is generated in research should be communicated for clinical attention, as the technology itself is moving into clinical care. There is growing consensus that investigators should offer participants at least those individual findings of high clinical importance and actionability. Increasing attention to what information biobanks and secondary researchers owe people who provide data and samples offers an opportunity to treat these source individuals as research partners. Cutting-edge issues include return of results in pediatric populations and return to kin and family, including after death of the proband. Progress will require facing the continuum linking research and clinical care and developing standards and models for return. PMID:23875796

Students meeting with caregivers of cancer patient: results of an experience-based learning project.

PubMed

Atasoy, Beste M; Sarikaya, Ozlem; Kuscu, M Kemal; Yondem, Merve; Buyukkara, Elif; Eken, E Gokcen; Kahyaoglu, Figen

2012-12-01

The communication between medical students and cancer caregivers, and the problems they have experienced as well as the outcomes for their professional development before starting clinical practice was assessed in the context of a student research project. Data were collected by questionnaires or by 20 to 40-min long interviews with cancer caregivers. Their communications with physicians, hearing the bad news, and health service satisfaction were questioned. Therefore, the caregivers trusted the professional approach of their physician. However, they expected more empathic communication in the process of diagnosis and therapy. Development of empathy and trust-based communication between patients and physicians and enhancement of the quality of devoted time to cancer patients and caregivers may have an effect on the course of disease. Interviewer students mentioned that they developed communication skills about difficult clinical tasks and in delivering bad news face to face to cancer caregivers before starting their clinical education.

Ergonomics and accessibility for people with visual impairment in hotels.

PubMed

Dos Santos, Larissa Nascimento; de Carvalho, Ricardo José Matos

2012-01-01

This article presents a diagnosis of luxury or superior hotels in the city of Natal, located in the state of Rio Grande do Norte, in northeastern Brazil, in what concerns accessibility to the visually impaired. The main objective is to present the guiding principles to design actions and interventions that must be considered in the preparation or revision of technical standards and manuals of good practice in accessibility related to people with visual impairments who are hotel users. The survey showed that the hotels do not meet the normative indications of accessibility, their facilities are in-accessible (have prevented access) or of reduced accessibility and its employees are not prepared to provide adequate hospital services for people with visual impairment. It was concluded that some of the accessibility problems faced by people with visual impairments are also faced by people in general.

An abridged photographic history of organ transplantation.

PubMed

Marino, Ignazio R; Cirillo, Claudia

2014-03-01

Organ transplantation is one of the most remarkable therapeutic advances in modern medicine; it started as an experiment and has become a life-saving practice. We briefly describe the major milestones of this multidisciplinary clinical science, the challenges that it still faces, and we consider the crucial contribution that its example could set for other medical fields. A review of the literature was conducted and a selection of images was made to complete a brief history of organ transplantation, with a particular focus on liver transplantation. The largest problem affecting organ transplantation today is the shortage of organs. Attention should be given to preserving the peculiar high ethical value that characterizes the very nature of organ transplantation. Methods successfully adopted by organ transplantation during the past 60 years can inspire promising fields, such as stem cell research, and provide useful tools to face the ethical challenges posed by scientific discoveries.

Medicine and Mind-Body Dualism: A Reply to Mehta's Critique

PubMed Central

Joubert, Callie

2014-01-01

Neeta Mehta recently advanced the thesis that medical practice is facing a crisis today. In her paper “Mind-body dualism: a critique from a health perspective” she attributes the crisis to the philosophy of Descartes and set out to understand why this dualism is still alive despite its disavowal from philosophers, health practitioners and lay people. The aim of my reply to her critique is three-fold. First, I draw attention to a more fundamental problem and show that dualism is inescapable—scientifically and commonsensically. I then focus on the self-conscious emotions of shame, guilt and remorse, and argue that the self is not identical with a brain. The third section draws attention to the crisis in psychiatry and stipulates some of the main reasons why this is so. Contrary to Mehta's thesis, the health profession faces a crisis because of physicalism and biological reductionism. PMID:24891801

Black women talk about workplace stress and how they cope.

PubMed

Hall, J Camille; Everett, Joyce E; Hamilton-Mason, Johnnie

2012-01-01

Black women face the same struggles as White women; however, they have to face issues of diversity on top of inequality. The purpose of this study was to explore work-related stressors that affect the lives of Black women and how they cope with them. Using an exploratory design with grounded-theory methods, five basic themes emerged that identify when racism and sexism are experienced as stressors for African American women in the workplace. The themes are: (1) being hired or promoted in the workplace, (2) defending one’s race and lack of mentorship, (3) shifting or code switching to overcome barriers to employment, (4) coping with racism and discrimination, and (5) being isolated and/or excluded. The results from this study indicate African American women use emotion- and problem-focused coping responses to manage stress (e.g., racism and sexism) in the workplace. The article concludes with a discussion of practice implications of these findings.

Medicine and Mind-Body Dualism: A Reply to Mehta's Critique.

PubMed

Joubert, Callie

2014-01-01

Neeta Mehta recently advanced the thesis that medical practice is facing a crisis today. In her paper "Mind-body dualism: a critique from a health perspective" she attributes the crisis to the philosophy of Descartes and set out to understand why this dualism is still alive despite its disavowal from philosophers, health practitioners and lay people. The aim of my reply to her critique is three-fold. First, I draw attention to a more fundamental problem and show that dualism is inescapable-scientifically and commonsensically. I then focus on the self-conscious emotions of shame, guilt and remorse, and argue that the self is not identical with a brain. The third section draws attention to the crisis in psychiatry and stipulates some of the main reasons why this is so. Contrary to Mehta's thesis, the health profession faces a crisis because of physicalism and biological reductionism.

Pharmacists' Assessment of the Difficulty and Frequency of Ethical Issues Encountered in Community Pharmacy Settings.

PubMed

Crnjanski, Tatjana; Krajnovic, Dusanka; Savic, Mirko

2017-05-23

Researching ethical problems and their frequency could give us a complex picture and greater insight into the types of ethical issues that pharmacists face in providing health care. The overall aim of this study was to assess the pharmacist's perception of difficulty and frequency of selected ethical issues encountered by the community pharmacists in their everyday practice. A quantitative cross sectional multicenter study was performed using a validated survey instrument - Ethical Issue Scale for Community Pharmacy (EISP). The results of the analysis of 690 completely filled out instruments (response rate 78.49%) showed the difference between the ethical issues which always occurred ("A pharmacist is prevented from dispensing a medicine to the patient due to an administrative error in the prescription"), and the ones that pharmacists found most difficult ("A pharmacist dispenses a medicine he/she personally considers inadequate for the therapeutic treatment of the patient, in order to avoid any conflicts with the physician" and "A pharmacist is considering violating the rules and regulations in order to perform an act of humanity"). The majority of respondents (84.78%) were familiar with the Code of Ethics but the correlation between the familiarity and the perceived usefulness of the code in resolving problems in everyday practice was negative (ρ = -0.17, p < 0.001). Results showed that patients' well-being had a high influence on pharmacists' behavior. The results provided quantitative data by the examination of specific ethical issues and their occurrence. Further empirical research is recommended in order to systematically identify the ethical issues faced by community pharmacists.

Cyberbullying victimization and mental health in adolescents and the moderating role of family dinners.

PubMed

Elgar, Frank J; Napoletano, Anthony; Saul, Grace; Dirks, Melanie A; Craig, Wendy; Poteat, V Paul; Holt, Melissa; Koenig, Brian W

2014-11-01

This study presents evidence that cyberbullying victimization relates to internalizing, externalizing, and substance use problems in adolescents and that the frequency of family dinners attenuate these associations. To examine the unique association between cyberbullying victimization and adolescent mental health (after controlling differences in involvement in traditional, face-to-face bullying) and to explore the potential moderating role of family contact in this association. This cross-sectional, observational study used survey data on 18,834 students (aged 12-18 years) from 49 schools in a Midwestern US state. Logistic regression analysis tested associations between cyberbullying victimization and the likelihood of mental health and substance use problems. Negative binomial regression analysis tested direct and synergistic contributions of cyberbullying victimization and family dinners on the rates of mental health and substance use problems. Frequency of cyberbullying victimization during the previous 12 months; victimization by traditional (face-to-face) bullying; and perpetration of traditional bullying. Five internalizing mental health problems (anxiety, depression, self-harm, suicide ideation, and suicide attempt), 2 externalizing problems (fighting and vandalism), and 4 substance use problems (frequent alcohol use, frequent binge drinking, prescription drug misuse, and over-the-counter drug misuse). About one-fifth (18.6%) of the sample experienced cyberbullying during the previous 12 months. The frequency of cyberbullying positively related to all 11 internalizing, externalizing, and substance use problems (odds ratios from 2.6 [95% CI, 1.7-3.8] to 4.5 [95% CI, 3.0-6.6]). However, victimization related more closely to rates of problems in adolescents that had fewer family dinners. Cyberbullying relates to mental health and substance use problems in adolescents, even after their involvement in face-to-face bullying is taken into account. Although correlational, these results suggest that family dinners (ie, family contact and communication) are beneficial to adolescent mental health and may help protect adolescents from the harmful consequences of cyberbullying.

Cultural considerations for treatment of childhood obesity.

PubMed

Davis, S P; Northington, L; Kolar, K

2000-01-01

Childhood obesity has become one of the most common health problems facing children in America. Results from the Third National Health and Nutrition Examination Survey reveal that ethnic minority children in the United States are at particular risk for development of cardiovascular disease due to their disproportionate levels of obesity. In treating childhood obesity among ethnic minorities, practitioners need to be mindful of the cultural norms surrounding body size. Additional concerns that must be addressed include the effects of target marketing of unhealthy foods toward ethnic minorities and environmental deterrents to outside physical activities, to name a few. Strategies given to address the problem of childhood obesity among ethnic minorities include, increasing the child's physical activity, reducing television viewing and the adoption and maintenance of healthy lifestyle practices for the entire family.

Chemical water shutoff profile research status and development trends

NASA Astrophysics Data System (ADS)

Xu, L. T.

2017-08-01

Excess water production is now a common problem encountered in almost every water flooding mature oilfield. The exploitation of oil field is faced with great challenge because of the decrease of oil field production. For the development of high water cut rare the status quo chemical water shutoff profile control technology is an important solution to solve this problem. Oilfield chemical water shutoff has important application prospects. This paper analyzes the water shutoff profile control and water shutoff profile control agent currently oilfield applications, moreover the use and development of blocking agent profile technology is to improve reservoir recovery and propose solutions. With the constant increase in water cut, profile technology should be simple, efficient, practical and profile control agent of development should be economic, environmental, and long period

Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue

PubMed Central

Hirsch, Jennifer S.; Nathanson, Constance; Parker, Richard G.

2015-01-01

In recent years, the menstrual hygiene management challenges facing schoolgirls in low-income-country contexts have gained global attention. We applied Gusfield’s sociological analysis of the culture of public problems to better understand how this relatively newly recognized public health challenge rose to the level of global public health awareness and action. We similarly applied the conceptualization by Dorfman et al. of the role of public health messaging in changing corporate practice to explore the conceptual frames and the news frames that are being used to shape the perceptions of menstrual hygiene management as an issue of social justice within the context of public health. Important lessons were revealed for getting other public health problems onto the global-, national-, and local-level agendas. PMID:25973831

Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue.

PubMed

Sommer, Marni; Hirsch, Jennifer S; Nathanson, Constance; Parker, Richard G

2015-07-01

In recent years, the menstrual hygiene management challenges facing schoolgirls in low-income-country contexts have gained global attention. We applied Gusfield's sociological analysis of the culture of public problems to better understand how this relatively newly recognized public health challenge rose to the level of global public health awareness and action. We similarly applied the conceptualization by Dorfman et al. of the role of public health messaging in changing corporate practice to explore the conceptual frames and the news frames that are being used to shape the perceptions of menstrual hygiene management as an issue of social justice within the context of public health. Important lessons were revealed for getting other public health problems onto the global-, national-, and local-level agendas.

Translation of an experimental oral vaccine formulation into a commercial product.

PubMed

Carter, K C; Ferro, V A; Alexander, J; Mullen, A B

2006-02-01

An effective experimental vaccine may fail to become a therapeutic reality for a number of scientific, regulatory or commercial reasons. In this review, we share some of our personal experiences as University-based researchers and provide an account of some of the problems that we have encountered during preliminary scale-up and assessment of an oral influenza vaccine formulation. Many of the problems we have faced have been non-scientific and related to identifying project-funding sources, finding suitable contract manufacturing companies that are GMP compliant, and protecting intellectual property generated from the scientific studies. The review is intended as a practical guide that will allow other researchers to adopt effective strategies to permit the translation of an effective experimental formulation to a viable commercial product.

Collaborative Accounting Problem Solving via Group Support Systems in a Face-to-Face versus Distant Learning Environment.

ERIC Educational Resources Information Center

Burke, Jacqueline A.

2001-01-01

Accounting students (n=128) used either face-to-face or distant Group support systems to complete collaborative tasks. Participation and social presence perceptions were significantly higher face to face. Task difficulty did not affect participation in either environment. (Contains 54 references.) (JOW)

Preservice and Inservice Teachers' Challenges in the Planning of Practical Work in Physics

NASA Astrophysics Data System (ADS)

Nivalainen, Ville; Asikainen, Mervi A.; Sormunen, Kari; Hirvonen, Pekka E.

2010-06-01

Practical work in school science plays many essential roles that have been discussed in the literature. However, less attention has been paid to how teachers learn the different roles of practical work and to the kind of challenges they face in their learning during laboratory courses designed for teachers. In the present study we applied the principles of grounded theory to frame a set of factors that seem to set major challenges concerning both successful work in the school physics laboratory and also in the preparation of lessons that exploit practical work. The subject groups of the study were preservice and inservice physics teachers who participated in a school laboratory course. Our results derived from a detailed analysis of tutoring discussions between the instructor and the participants in the course, which revealed that the challenges in practical or laboratory work consisted of the limitations of the laboratory facilities, an insufficient knowledge of physics, problems in understanding instructional approaches, and the general organization of practical work. Based on these findings, we present our recommendations on the preparation of preservice and inservice teachers for the more effective use of practical work in school science and in school physics.

[The parenting practices of transnational marriage mothers in Taiwan].

PubMed

Chuang, Li-Yu; Shu, Bih-Ching; Huang, Chiung-Chen

2013-02-01

Childhood experience is a cornerstone of personality development. A child's cognitive function, self-concept, and behavioral development relate significantly to parental attitudes as well as to the way they were treated during childhood. The literature suggests a significant association between parenting practices and the mental health of the parents, temperament of the child, and socio-cultural factors. Raising children is typically central to the life of transnational marriage women living in Taiwan. They view parenting children as a life transforming experience. However, they must invest more effort than local mothers to survive in Taiwan. Thus, it is worth investigating the parenting practices of this significant subset of Taiwan's population. This paper applied parenting concepts to describe the condition and possible problems of immigrant women in parenting children. Based on study results, we summarize transnational marriage and its impact on parenting practices. The authors hope this paper provides information useful to identifying parenting difficulties faced by immigrant mothers so that healthcare professionals can provide relevant information and assistance to improve overall parenting practices and benefit the development of Taiwan's youngest generation.

Organisational innovation and control practices: the case of public-private mix in tuberculosis control in India.

PubMed

Engel, Nora; van Lente, Harro

2014-07-01

Partnerships between public and private healthcare providers are often seen as an important way to improve health care in resource-constrained settings. Despite the reconfirmed policy support for including private providers into public tuberculosis control in India, the public-private mix (PPM) activities continue to face apprehension at local implementation sites. This article investigates the causes for those difficulties by examining PPM initiatives as cases of organisational innovation. It examines findings from semi-structured interviews, observations and document analyses in India around three different PPM models and the attempts of innovating and scaling up. The results reveal that in PPM initiatives underlying problem definitions and different control practices, including supervision, standardisation and culture, continue to clash and ultimately hinder the scaling up of PPM. Successful PPM initiatives require organisational control practices which are rooted in different professions to be bridged. This entails difficult balancing acts between innovation and control. The innovators handle those differently, based on their own ideas of the problem that PPM should address and their own control practices. We offer new perspectives on why collaboration is so difficult and show a possible way to mitigate the established apprehensions between professions in order to make organisational innovations, such as PPM, sustainable and scalable. © 2013 The Authors Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Learning algorithm in restricted Boltzmann machines using Kullback-Leibler importance estimation procedure

NASA Astrophysics Data System (ADS)

Yasuda, Muneki; Sakurai, Tetsuharu; Tanaka, Kazuyuki

Restricted Boltzmann machines (RBMs) are bipartite structured statistical neural networks and consist of two layers. One of them is a layer of visible units and the other one is a layer of hidden units. In each layer, any units do not connect to each other. RBMs have high flexibility and rich structure and have been expected to applied to various applications, for example, image and pattern recognitions, face detections and so on. However, most of computational models in RBMs are intractable and often belong to the class of NP-hard problem. In this paper, in order to construct a practical learning algorithm for them, we employ the Kullback-Leibler Importance Estimation Procedure (KLIEP) to RBMs, and give a new scheme of practical approximate learning algorithm for RBMs based on the KLIEP.

Final Report: Resolving and Discriminating Overlapping Anomalies from Multiple Objects in Cluttered Environments

DTIC Science & Technology

2015-12-15

UXO community . NAME Total Number: PERCENT_SUPPORTEDNAME FTE Equivalent: Total Number: Irma Shamatava 0.50 0.50 1 Resolving and Discriminating...Distinguishing an object of interest from innocuous items is the main problem that the UXO community is facing currently. This inverse problem...innocuous items is the main problem that the UXO community is facing currently. This inverse problem demands fast and accurate representation of

The transition from resident to private practice--important financial decisions.

PubMed

Wherry, Jeffrey E; Thomalla, Kenneth

2008-02-01

A newly graduated resident faces many new challenges in the first year of practice. Foremost among these is how to handle the newfound wealth that typically accompanies the transition from residency to a successful practice. The ramifications of these decisions are not insignificant. This article explains the important financial considerations a new practitioner must face in the transition from resident to private practice.

Pose-Invariant Face Recognition via RGB-D Images.

PubMed

Sang, Gaoli; Li, Jing; Zhao, Qijun

2016-01-01

Three-dimensional (3D) face models can intrinsically handle large pose face recognition problem. In this paper, we propose a novel pose-invariant face recognition method via RGB-D images. By employing depth, our method is able to handle self-occlusion and deformation, both of which are challenging problems in two-dimensional (2D) face recognition. Texture images in the gallery can be rendered to the same view as the probe via depth. Meanwhile, depth is also used for similarity measure via frontalization and symmetric filling. Finally, both texture and depth contribute to the final identity estimation. Experiments on Bosphorus, CurtinFaces, Eurecom, and Kiwi databases demonstrate that the additional depth information has improved the performance of face recognition with large pose variations and under even more challenging conditions.

Online Continuing Education for Health Professionals: Does Sticky Design Promote Practice-Relevance?

ERIC Educational Resources Information Center

Zaghab, Roxanne Ward; Maldonado, Carlos; Whitehead, Dongsook; Bartlett, Felicia; de Bittner, Magaly Rodriguez

2015-01-01

Online continuing education (CE) holds promise as an effective method for rapid dissemination of emerging evidence-based practices in health care. Yet, the field of CE continues to develop and delivery is predominately face-to-face programs. Practice-oriented online educational methods and e-learning platforms are not fully utilized. Educational…

Blended-Format Professional Development and the Emergence of Communities of Practice

ERIC Educational Resources Information Center

Hodges, Thomas E.; Cady, JoAnn

2013-01-01

In this paper, we draw on Wenger's (1998) conception of communities of practice to observe the emergence of a community of practice among middle grades mathematics teachers who participated in a two-year blended-format (online synchronous, online asynchronous, and face to face) professional development program designed to increase middle-grades…

Challenges Faced by Teachers Implementing Socio-Scientific Issues as Core Elements in Their Classroom Practices

ERIC Educational Resources Information Center

Bossér, Ulrika; Lundin, Mattias; Lindahl, Mats; Linder, Cedric

2015-01-01

Teachers may face considerable challenges when implementing socio-scientific issues (SSI) in their classroom practices, such as incorporating student-centred teaching practices and exploring knowledge and values in the context of socioscientific issues. This year-long study explores teachers' reflections on the process of developing their…

Communication is the key to success in pragmatic clinical trials in Practice-based Research Networks (PBRNs).

PubMed

Bertram, Susan; Graham, Deborah; Kurland, Marge; Pace, Wilson; Madison, Suzanne; Yawn, Barbara P

2013-01-01

Effective communication is the foundation of feasibility and fidelity in practice-based pragmatic research studies. Doing a study with practices spread over several states requires long-distance communication strategies, including E-mails, faxes, telephone calls, conference calls, and texting. Compared with face-to-face communication, distance communication strategies are less familiar to most study coordinators and research teams. Developing and ensuring comfort with distance communications requires additional time and use of different talents and expertise than those required for face-to-face communication. It is necessary to make sure that messages are appropriate for the medium, clearly crafted, and presented in a manner that facilitates practices receiving and understanding the information. This discussion is based on extensive experience of 2 groups who have worked collaboratively on several large, federally funded, pragmatic trials in a practice-based research network. The goal of this article is to summarize lessons learned to facilitate the work of other research teams.

Solving the Supreme Problem: 100 years of selection and recruitment at the Journal of Applied Psychology.

PubMed

Ployhart, Robert E; Schmitt, Neal; Tippins, Nancy T

2017-03-01

This article reviews 100 years of research on recruitment and selection published in the Journal of Applied Psychology. Recruitment and selection research has been present in the Journal from the very first issue, where Hall (1917) suggested that the challenge of recruitment and selection was the Supreme Problem facing the field of applied psychology. As this article shows, the various topics related to recruitment and selection have ebbed and flowed over the years in response to business, legal, and societal changes, but this Supreme Problem has captivated the attention of scientist-practitioners for a century. Our review starts by identifying the practical challenges and macro forces that shaped the sciences of recruitment and selection and helped to define the research questions the field has addressed. We then describe the evolution of recruitment and selection research and the ways the resulting scientific advancements have contributed to staffing practices. We conclude with speculations on how recruitment and selection research may proceed in the future. Supplemental material posted online provides additional depth by including a summary of practice challenges and scientific advancements that affected the direction of selection and recruitment research and an outline of seminal articles published in the Journal and corresponding time line. The 100-year anniversary of the Journal of Applied Psychology is very much the celebration of recruitment and selection research, although predictions about the future suggest there is still much exciting work to be done. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Centre-based restricted nearest feature plane with angle classifier for face recognition

NASA Astrophysics Data System (ADS)

Tang, Linlin; Lu, Huifen; Zhao, Liang; Li, Zuohua

2017-10-01

An improved classifier based on the nearest feature plane (NFP), called the centre-based restricted nearest feature plane with the angle (RNFPA) classifier, is proposed for the face recognition problems here. The famous NFP uses the geometrical information of samples to increase the number of training samples, but it increases the computation complexity and it also has an inaccuracy problem coursed by the extended feature plane. To solve the above problems, RNFPA exploits a centre-based feature plane and utilizes a threshold of angle to restrict extended feature space. By choosing the appropriate angle threshold, RNFPA can improve the performance and decrease computation complexity. Experiments in the AT&T face database, AR face database and FERET face database are used to evaluate the proposed classifier. Compared with the original NFP classifier, the nearest feature line (NFL) classifier, the nearest neighbour (NN) classifier and some other improved NFP classifiers, the proposed one achieves competitive performance.

A modified active appearance model based on an adaptive artificial bee colony.

PubMed

Abdulameer, Mohammed Hasan; Sheikh Abdullah, Siti Norul Huda; Othman, Zulaiha Ali

2014-01-01

Active appearance model (AAM) is one of the most popular model-based approaches that have been extensively used to extract features by highly accurate modeling of human faces under various physical and environmental circumstances. However, in such active appearance model, fitting the model with original image is a challenging task. State of the art shows that optimization method is applicable to resolve this problem. However, another common problem is applying optimization. Hence, in this paper we propose an AAM based face recognition technique, which is capable of resolving the fitting problem of AAM by introducing a new adaptive ABC algorithm. The adaptation increases the efficiency of fitting as against the conventional ABC algorithm. We have used three datasets: CASIA dataset, property 2.5D face dataset, and UBIRIS v1 images dataset in our experiments. The results have revealed that the proposed face recognition technique has performed effectively, in terms of accuracy of face recognition.

Developing A Transdisciplinary Process and Community Partnerships to Anticipate Climate Change at the Local Level: The Role of Biophysical and Sociocultural Calendars

NASA Astrophysics Data System (ADS)

Kassam, K. A.; Samimi, C.; Trabucco, A.

2017-12-01

Difference is essential to solving the most complex problems faced by humanity. Anthropogenic climate change is one such "wicked problem" that demands cognitive diversity. Biophysical and social scientists must collaborate with scholars from the humanities to address practical issues of concern to local communities, which are at the forefront of impacts of climatic variation. As such, communities of inquirers (e.g. biophysical and social sciences, humanities) must work in tandem with communities of practice (e.g. farmers, fishers, gatherers, herders, hunters). This leads to co-generated knowledge where an adaptation strategy to climatic variation is locally grounded in the biophysical and sociocultural context of the communities where the impacts of climatic variation are most felt. We will present an innovative and `real time' example participatory and transdisciplinary research from an international project where we are developing integrated biophysical and sociocultural calendars, in short, ecological calendars, which are ecologically and culturally grounded in the local context to develop anticipatory capacity to anthropogenic climate change.

An approximate stationary solution for multi-allele neutral diffusion with low mutation rates.

PubMed

Burden, Conrad J; Tang, Yurong

2016-12-01

We address the problem of determining the stationary distribution of the multi-allelic, neutral-evolution Wright-Fisher model in the diffusion limit. A full solution to this problem for an arbitrary K×K mutation rate matrix involves solving for the stationary solution of a forward Kolmogorov equation over a (K-1)-dimensional simplex, and remains intractable. In most practical situations mutations rates are slow on the scale of the diffusion limit and the solution is heavily concentrated on the corners and edges of the simplex. In this paper we present a practical approximate solution for slow mutation rates in the form of a set of line densities along the edges of the simplex. The method of solution relies on parameterising the general non-reversible rate matrix as the sum of a reversible part and a set of (K-1)(K-2)/2 independent terms corresponding to fluxes of probability along closed paths around faces of the simplex. The solution is potentially a first step in estimating non-reversible evolutionary rate matrices from observed allele frequency spectra. Copyright © 2016 Elsevier Inc. All rights reserved.

Nurses' roles in screening for intimate partner violence: a phenomenological study.

PubMed

Al-Natour, A; Qandil, A; Gillespie, G L

2016-09-01

To describe Jordanian nurses' roles and practices in screening for intimate partner violence. Intimate partner violence is a recognized global health problem with a prevalence of 37% for the Eastern Mediterranean region. Jordanian nurses screening for intimate partner violence is as low as 10.8%. Nurses have encountered institutional and personal barriers hindering their screening practice. A descriptive phenomenological design was used for this study. A purposive sample of 12 male and female Jordanian nurses working at a university hospital in Jordan participated. Participants were interviewed in 2014 using a semi-structured, face-to-face interview. Steps of Colaizzi's phenomenological method were used to analyse the qualitative data. Four themes were derived from the data: (1) screening practices and roles for suspected IPV cases, (2) advantages for screening and disadvantages for not screening for intimate partner violence, (3) factors hindering screening practice and (4) feelings towards screening and not screening for intimate partner violence. Increasing Jordanian nurses' awareness of the need for intimate partner violence screening in this sample was needed. Professional education and training may facilitate the adoption of intimate partner violence screening practices. A key barrier to intimate partner violence screening is Jordanian nurses' personal beliefs. Overcoming these personal beliefs will necessitate a multi-faceted approach starting with schools of nursing and bridging into healthcare settings. Healthcare professionals including nursing and policy makers at health institutions should enforce screening policies and protocols for all receipt of care at first contact. In addition, an emphasis on modelling culturally congruent approaches to develop the trusting nurse-patient relationships and process for screening patients for intimate partner violence. © 2016 International Council of Nurses.

Breast Cancer Knowledge, Perception and Breast Self- Examination Practices among Yemeni Women: an Application of the Health Belief Model.

PubMed

Al-Sakkaf, Khaled Abdulla; Basaleem, Huda Omer

2016-01-01

The incidence of breast cancer is rapidly increasing in Yemen with recent indications of constituting one-third of female cancers. The main problem in Yemen remains very late presentation of breast cancer, most of which should have been easily recognisable. Since stage of disease at diagnosis is the most important prognostic variable, early diagnosis is an important option to be considered for control of breast cancer in low resourced settings like Yemen. In the present study, we aimed at describing breast cancer knowledge, perceptions and breast self-examination (BSE) practices among a sample of Yemeni women. This cross-sectional study covered 400 women attending four reproductive health centres in Aden, Yemen through face-to-face interview using a structured questionnaire during April - July 2014. We collected data on sociodemographic characteristics, knowledge about breast cancer, and screening practices as well as respondents' perceptions based on the five sub scales of the Health Belief Model (HBM): perceived susceptibility; perceived severity; perceived barriers; perceived benefits; and self-efficacy. The response format was a fivepoint Likert scale. Statistical Package for Social Sciences (SPSS 20) was used for statistical analysis. Statistical significance was set at p<0.05. Logistic regression analysis was conducted with BSE as a dependent variable. The mean age of women was 26.5 (S.D=5.6) years. The majority (89.0%) had never ever performed any screening. Two-thirds of respondents had poor knowledge. Perceived BSE benefits and self-efficacy and lower BSE barriers perception were significant independent predictors of BSE practice. Poor knowledge and inadequate BSE practices are prevailing in Yemen. The need for implementing culturally sensitive targeted education measures is mandatory in the effort to improve early detection and reduce the burden of breast cancer.

A study of Web-based instructional strategies in post-secondary sciences

NASA Astrophysics Data System (ADS)

Stanley, Scott A.

There is a large demand for web-based instruction offered by post secondary institutions (U.S. Department of Education, 2003), but only recently have post secondary science faculty begun to develop courses for this medium (Carr, 2000). Research evaluating the effectiveness of this type of instruction suggests that there is no significant difference in the grades between students in traditional and online courses (Russell, 1999; Spooner, Jordan, Agozzine, & Spooner, 1999; Verduin & Clark, 1991; Wideman & Owston, 1999). It is important to note that while grades may be similar in face-to-face (FTF) and web-based science courses, it cannot be implied that student learning is identical in both environments. Experts in web-based instruction claim that teaching practices for web-based instruction are similar to those used in a FTF environment (Bronack & Riedl, 1998; Ragan, 1999). This is troublesome when viewed in context with the data on instructional strategies used in FTF post-secondary science courses. It is well documented that undergraduate students perceive science pedagogy as ineffective (NSF, 1996; Seymour & Hewitt, 1997; Tobias, 1990). This research examined web-based instructional strategies in post secondary science courses. Using a web-based questionnaire, this study collected data in order to examine the frequency of use of previously identified effective FTF instructional strategies, and the difference in use of instructional strategies in the different fields of science. One hundred and thirty respondents completed the web-based questionnaire. Data from faculty (N=122) who teach more than 75% of their course online were analyzed. Data analyses revealed the frequency of use of effective face-to-face instructional strategies is variable. Science faculty do not regularly assess students' conceptual understandings prior to the presentation of new concepts. Faculty frequently made connections to the real-world and incorporated problem solving using real-life problems. Emphasis on discovering things and devising an investigation tended to be conducted individually and not as part of a collaborative group. Instructor-student interaction tended to be asynchronous in nature. Course discussions frequently centered on course concepts and conceptual problems. There was no significant difference in the use of instructional strategies in online science courses for the different fields of science. The results of this study indicate post secondary science faculty utilization of previously identified effective face-to-face instructional strategies in online science courses was variable. Specific recommendations for faculty development and future research are included in the study.

Assessment of the efficacy of blended learning in an introductory pharmacy class

NASA Astrophysics Data System (ADS)

Munson, Christina Elizabeth

Blended learning is the convergence between traditional face-to-face learning typically seen in a university setting and a computer-mediated learning environment, and is increasingly being seen as a viable alternative for learning instruction. Pharmaceutical calculations (PC) is a course taken by students in the first year in the school of pharmacy at the University of Kansas (KU SOP). One of the objectives of the PC class is that students are able to perform calculations with minimal error consistently. This requires repetitive drill which is a poor use of class time. By moving presentation of material online and using class time for small learning group problem solving as well as practice exams, the transformation of the course to a blended or hybrid course is assessed for efficacy and found to have student outcomes which are comparable to previous face-to-face (F2F) classes. As KU SOP expands it class sizes from 105 to ˜150 students and its campuses (building a satellite campus in Wichita, Kansas), being able to provide quality instruction at a reasonable cost is desirable. By redesigning PC to be a hybrid course, the need to hire additional instructors and/or increase available resources is minimized. Instructors remain for the large part on the main campus in Lawrence while students are learning at remote locations, a cost-effective measure for all parties involved. Using small learning groups (consisting of not more than 3 or 4 students) to work problems in PC was demonstrated to be an effective use of F2F class time in the fall semester, 2008 at KU. The class was taught by the same instructor in the fall of 2009 using blended learning as the class format. The current computer Learning Management System (LMS) in use at KU is Blackboard((c)2010). By using Blackboard to deliver lectures and have students work through tutorials to learn the material, class time was devoted to highly-focused problem solving. Due to unequal data distribution, the non-parametric tests Kruskal-Wallis and Mann-Whitney were used to assess student outcomes from three different classes (years) of students. The only significant differences were between groups of males in two different face-to-face classes. There was no significant difference between BL and F2F class formats. In general, blended learning was found to be as effective as a traditional F2F class format when comparing final student outcomes.

Tackling Complex Emergency Response Solutions Evaluation Problems in Sustainable Development by Fuzzy Group Decision Making Approaches with Considering Decision Hesitancy and Prioritization among Assessing Criteria.

PubMed

Qi, Xiao-Wen; Zhang, Jun-Ling; Zhao, Shu-Ping; Liang, Chang-Yong

2017-10-02

In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE) as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM) approaches to ERSE have been facing simultaneous challenging characteristics of decision hesitancy and prioritization relations among assessing criteria, due to the complexity in practical ERSE problems. Therefore, aiming at the special type of ERSE problems that hold the two characteristics, we investigate effective MCGDM approaches by hiring interval-valued dual hesitant fuzzy set (IVDHFS) to comprehensively depict decision hesitancy. To exploit decision information embedded in prioritization relations among criteria, we firstly define an fuzzy entropy measure for IVDHFS so that its derivative decision models can avoid potential information distortion in models based on classic IVDHFS distance measures with subjective supplementing mechanism; further, based on defined entropy measure, we develop two fundamental prioritized operators for IVDHFS by extending Yager's prioritized operators. Furthermore, on the strength of above methods, we construct two hesitant fuzzy MCGDM approaches to tackle complex scenarios with or without known weights for decision makers, respectively. Finally, case studies have been conducted to show effectiveness and practicality of our proposed approaches.

Tackling Complex Emergency Response Solutions Evaluation Problems in Sustainable Development by Fuzzy Group Decision Making Approaches with Considering Decision Hesitancy and Prioritization among Assessing Criteria

PubMed Central

Qi, Xiao-Wen; Zhang, Jun-Ling; Zhao, Shu-Ping; Liang, Chang-Yong

2017-01-01

In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE) as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM) approaches to ERSE have been facing simultaneous challenging characteristics of decision hesitancy and prioritization relations among assessing criteria, due to the complexity in practical ERSE problems. Therefore, aiming at the special type of ERSE problems that hold the two characteristics, we investigate effective MCGDM approaches by hiring interval-valued dual hesitant fuzzy set (IVDHFS) to comprehensively depict decision hesitancy. To exploit decision information embedded in prioritization relations among criteria, we firstly define an fuzzy entropy measure for IVDHFS so that its derivative decision models can avoid potential information distortion in models based on classic IVDHFS distance measures with subjective supplementing mechanism; further, based on defined entropy measure, we develop two fundamental prioritized operators for IVDHFS by extending Yager’s prioritized operators. Furthermore, on the strength of above methods, we construct two hesitant fuzzy MCGDM approaches to tackle complex scenarios with or without known weights for decision makers, respectively. Finally, case studies have been conducted to show effectiveness and practicality of our proposed approaches. PMID:28974045

Query-oriented evidence extraction to support evidence-based medicine practice.

PubMed

Sarker, Abeed; Mollá, Diego; Paris, Cecile

2016-02-01

Evidence-based medicine practice requires medical practitioners to rely on the best available evidence, in addition to their expertise, when making clinical decisions. The medical domain boasts a large amount of published medical research data, indexed in various medical databases such as MEDLINE. As the size of this data grows, practitioners increasingly face the problem of information overload, and past research has established the time-associated obstacles faced by evidence-based medicine practitioners. In this paper, we focus on the problem of automatic text summarisation to help practitioners quickly find query-focused information from relevant documents. We utilise an annotated corpus that is specialised for the task of evidence-based summarisation of text. In contrast to past summarisation approaches, which mostly rely on surface level features to identify salient pieces of texts that form the summaries, our approach focuses on the use of corpus-based statistics, and domain-specific lexical knowledge for the identification of summary contents. We also apply a target-sentence-specific summarisation technique that reduces the problem of underfitting that persists in generic summarisation models. In automatic evaluations run over a large number of annotated summaries, our extractive summarisation technique statistically outperforms various baseline and benchmark summarisation models with a percentile rank of 96.8%. A manual evaluation shows that our extractive summarisation approach is capable of selecting content with high recall and precision, and may thus be used to generate bottom-line answers to practitioners' queries. Our research shows that the incorporation of specialised data and domain-specific knowledge can significantly improve text summarisation performance in the medical domain. Due to the vast amounts of medical text available, and the high growth of this form of data, we suspect that such summarisation techniques will address the time-related obstacles associated with evidence-based medicine. Copyright © 2015 Elsevier Inc. All rights reserved.

Patients' experiences of breathing retraining for asthma: a qualitative process analysis of participants in the intervention arms of the BREATHE trial.

PubMed

Arden-Close, Emily; Yardley, Lucy; Kirby, Sarah; Thomas, Mike; Bruton, Anne

2017-10-05

Poor symptom control and impaired quality of life are common in adults with asthma, and breathing retraining exercises may be an effective method of self-management. This study aimed to explore the experiences of participants in the intervention arms of the BREATHE trial, which investigated the effectiveness of breathing retraining as a mode of asthma management. Sixteen people with asthma (11 women, 8 per group) who had taken part in the intervention arms of the BREATHE trial (breathing retraining delivered by digital versatile disc (DVD) or face-to-face sessions with a respiratory physiotherapist) took part in semi-structured telephone interviews about their experiences. Interviews were analysed using thematic analysis. Breathing retraining was perceived positively as a method of asthma management. Motivations for taking part included being asked, to enhance progress in research, to feel better/reduce symptoms, and to reduce medication. Participants were positive about the physiotherapist, liked having the materials tailored, found meetings motivational, and liked the DVD and booklet. The impact of breathing retraining following regular practice included increased awareness of breathing and development of new habits. Benefits of breathing retraining included increased control over breathing, reduced need for medication, feeling more relaxed, and improved health and quality of life. Problems included finding time to practice the exercises, and difficulty mastering techniques. Breathing retraining was acceptable and valued by almost all participants, and many reported improved wellbeing. Face to face physiotherapy was well received. However, some participants in the DVD group mentioned being unable to master techniques. PATIENTS RECEPTIVE TO BREATHING RETRAINING: Patients with asthma taught how to change their unconscious breathing patterns generally like non-pharmacological interventions. Researchers in the UK, led by Mike Thomas from the University of Southampton, interviewed 16 people about their experiences in a trial that tested breathing retraining exercises delivered by DVD or face-to-face sessions with a respiratory physiotherapist. Overwhelmingly, trial participants reported that breathing retraining sessions gave them greater control over their symptoms, helped them relax, improved their quality of life and reduced the need for medications. Some participants who received DVD instruction said they had trouble mastering the techniques, and many in both groups found it hard to find time to practice the exercises. Overall, however, patients were positive about the experience. The authors conclude that breathing exercises are likely to be a well-received method of asthma management.

Knowledge, attitudes, beliefs, and practices about HIV/AIDS in Kuwait.

PubMed

al-Owaish, R; Moussa, M A; Anwar, S; al-Shoumer, H; Sharma, P

1999-04-01

This survey is aimed at assessing knowledge, attitudes, beliefs and practices in Kuwait regarding AIDS/HIV. Structured face-to-face interviews were conducted during the year 1995 on a sample of 2,219 subjects, aged 18 to 60, health professionals were excluded. The survey instrument included 26 questions on AIDS/HIV knowledge, 6 about attitudes and beliefs, and 6 about behavior and practice. The remaining 22 items dealt with sociodemographic characteristics, role of religion, source of information, and satisfaction about AIDS control programs. Two thirds of subjects had good knowledge about the main modes of HIV/AIDS transmission. Using a multiple regression model, the knowledge score was positively associated with level of education, age, years of hearing about AIDS, and socioeconomic status. The multiple logistic regression showed that subjects tend not to change their behavior related to AIDS if they were less than 40 years old, had low education, were females, single, had a lower socioeconomic status, had heard about AIDS for less than 3 years, and had a low level of knowledge about AIDS. More than half of the participants were satisfied with the government's action for AIDS prevention. The majority of subjects thought that religion was important in dealing with daily life problems. In conclusion, while most of the people in Kuwait were aware of the main modes of AIDS transmission, a gap existed about modes that did not transmit the disease. This was reflected in their attitudes and practice toward AIDS patients. The study calls for a greater role for medical professionals, mass media, and religion in AIDS prevention and control.

Data-Aware Retrodiction for Asynchronous Harmonic Measurement in a Cyber-Physical Energy System.

PubMed

Liu, Youda; Wang, Xue; Liu, Yanchi; Cui, Sujin

2016-08-18

Cyber-physical energy systems provide a networked solution for safety, reliability and efficiency problems in smart grids. On the demand side, the secure and trustworthy energy supply requires real-time supervising and online power quality assessing. Harmonics measurement is necessary in power quality evaluation. However, under the large-scale distributed metering architecture, harmonic measurement faces the out-of-sequence measurement (OOSM) problem, which is the result of latencies in sensing or the communication process and brings deviations in data fusion. This paper depicts a distributed measurement network for large-scale asynchronous harmonic analysis and exploits a nonlinear autoregressive model with exogenous inputs (NARX) network to reorder the out-of-sequence measuring data. The NARX network gets the characteristics of the electrical harmonics from practical data rather than the kinematic equations. Thus, the data-aware network approximates the behavior of the practical electrical parameter with real-time data and improves the retrodiction accuracy. Theoretical analysis demonstrates that the data-aware method maintains a reasonable consumption of computing resources. Experiments on a practical testbed of a cyber-physical system are implemented, and harmonic measurement and analysis accuracy are adopted to evaluate the measuring mechanism under a distributed metering network. Results demonstrate an improvement of the harmonics analysis precision and validate the asynchronous measuring method in cyber-physical energy systems.

Natural Hazard Resilience - A Large-scale Transdisciplinary "National Science Challenge" for New Zealand

NASA Astrophysics Data System (ADS)

Cronin, S. J.

2017-12-01

The National Science Challenges are initiatives to address the most important public science issues that face New Zealand with long-term funding and the combined strength of a coordinated science-sector behind them. Eleven major topics are tackled, across our human, natural and built environments. In the "Resilience Challenge" we address New Zealand's natural hazards. Alongside severe metrological threats, New Zealand also faces one of the highest levels of earthquake and volcanic hazard in the world. Resilience is a hotly discussed concept, here, we take the view: Resilience encapsulates the features of a system to anticipate threats, acknowledge there will be impacts (no matter how prepared we are), quickly pick up the pieces, as well as learn and adapt from the experience to better absorb and rebound from future shocks. Our research must encompass innovation in building and lifelines engineering, planning and regulation, emergency management practice, alongside understanding how our natural hazard systems work, how we monitor them and how our communities/governance/industries can be influenced and encouraged (e.g., via economic incentives) to develop and implement resilience practice. This is a complex interwoven mix of areas and is best addressed through case-study areas where researchers and the users of the research can jointly identify problems and co-develop science solutions. I will highlight some of the strengths and weaknesses of this coordinated approach to an all-hazard, all-country problem, using the example of the Resilience Challenge approach after its first two and a half years of operation. Key issues include balancing investment into high-profile (and often high consequence), but rare hazards against the frequent "monthly" hazards that collectively occupy regional and local governance. Also, it is clear that despite increasingly sophisticated hazard and hazard mitigation knowledge being generated in engineering and social areas, a range of policy, economic and knowledge barriers to adoption often lead to hazard mitigation practice lagging far behind its potential.

[Challenges for the future of psychiatry and psychiatric medical care].

PubMed

Higuchi, Teruhiko

2013-01-01

In addition to the prolonged economic recession and global financial crisis, the Great East Japan Earthquake of March 2011 has caused great fear and devastation in Japan. In the midst of these, Japanese people have felt to lose the traditional values and common sense they used to share, and it has become necessary to build a new consciousness. Engaged in psychiatry and psychiatric care under these circumstances, we have to analyze the challenges we face and to brainstorm on appropriate prescriptions that can be applied to solve the problems. Five points in particular were brought up: [1] The persistently high number of suicides. [2] The increase in depression and overflowing numbers of patients visiting clinics and outpatient departments at hospitals. [3] The absolute shortage of child psychiatrists. [4] Little progress with the transition from hospitalization-centered to community-centered medical care. [5] The disappearance of beds for psychiatry patients from general hospitals. The situations surrounding these five issues were briefly analyzed and problems were pointed out. The following are five problems that psychiatry is facing: 1) A lack of large clinical trials compared to the rest of the world. 2) The drug lag and handling of global trials. 3) The lack of staff involved in education and research (in the field of psychiatry). 4) Following the DSM diagnostic criteria dogmatically, without differentiating therapeutics. 5) Other medical departments, the industry, patients, and their families are demanding objective diagnostic techniques. After analyzing the problems, and discussing to some extent what kind of prescription may be considered to solve the problems, I gave my opinion. (1) The first problem is the deep-rooted prejudice and discrimination against psychiatric disorders that continue to be present among Japanese people. The second problem is the government's policy of low remuneration (fees) for psychiatric services. The third problem, symbolic of the situation, is the fact that the "psychiatry exception" system (unbalanced ratio of staff to psychiatric patients) is still present today. (2) To reach a fundamental solution, the policy of low fees for psychiatric services has to be abolished. (3) Multi-disciplinary medical teams, as practiced in other developed countries, is not yet adequately applied in Japan. From the aspect of medical fees, it is not adequately encouraged either. The only place where team medicine is actually practiced is in the "forced hospitalization" ward, but, as stated in the supplementary resolution of the Japanese diet (national assembly), high-quality medicine should not only be practiced in the "forced hospitalization" ward, but also in general psychiatry. (4) The policy of transition from hospitalization-centered to community-centered medical care, which was initiated a long time ago by the Japanese government, is not proceeding in reality, and it is time that we put our heads together and find ways to overcome this problem. It is significant that "psychiatric disorders" have been included as one of the "five diseases," (a system adopted by the government concerning community health care), and now we have the best opportunity to improve community-centered psychiatric care.

Using Clickers for Deliberate Practice in Five Large Science Courses

ERIC Educational Resources Information Center

Hodges, Linda C.; Anderson, Eric C.; Carpenter, Tara S.; Cui, Lili; Feeser, Elizabeth A.; Gierasch, Tiffany Malinky

2017-01-01

Clickers are often used as an active learning tool in face-to-face classes to enhance student engagement and assess student learning. In this article we share the variety of ways that we use clicker questions to promote deliberate practice in large science courses. Deliberate practice is the use of specifically structured exercises that develop…

Power and Authority in the Student-Instructor Relationship in a Restorative Practices-Based Graduate Program

ERIC Educational Resources Information Center

Bailie, John W., III

2012-01-01

This study examined power and authority in the student-instructor relationship in a restorative practices-based graduate program. This qualitative investigation utilized a narrative approach. Ten alumni of the International Institute for Restorative Practices master's degree programs were engaged in a one-time face-to-face interview and document…

Developing, delivering and evaluating primary mental health care: the co-production of a new complex intervention.

PubMed

Reeve, Joanne; Cooper, Lucy; Harrington, Sean; Rosbottom, Peter; Watkins, Jane

2016-09-06

Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention. The project was a collaboration between a local mental health charity, an academic unit, and GP practices. The aim was to translate the charity's model of care into practice-based evidence describing delivery and impact. Normalisation Process Theory (NPT) was used to support the implementation of the new model of primary mental health care into six GP practices. An integrated process evaluation evaluated the process and impact of care. Implementation quickly stalled as we identified problems with the described model of care when applied in a changing and variable primary care context. The team therefore switched to using the NPT framework to support the systematic identification and modification of the components of the complex intervention: including the core components that made it distinct (the consultation approach) and the variable components (organisational issues) that made it work in practice. The extra work significantly reduced the time available for outcome evaluation. However findings demonstrated moderately successful implementation of the model and a suggestion of hypothesised changes in outcomes. The BounceBack project demonstrates the development of a complex intervention from practice. It highlights the use of Normalisation Process Theory to support development, and not just implementation, of a complex intervention; and describes the use of the research process in the generation of practice-based evidence. Implications for future translational complex intervention research supporting practice change through scholarship are discussed.

Educational outreach visits: effects on professional practice and health care outcomes.

PubMed

Thomson O'Brien, M A; Oxman, A D; Davis, D A; Haynes, R B; Freemantle, N; Harvey, E L

2000-01-01

Outreach visits have been identified as an intervention that may improve the practice of health care professionals, in particular prescribing. This type of 'face to face' visit has been referred to as university-based educational detailing, public interest detailing, and academic detailing. To assess the effects of outreach visits on improving health professional practice or patient outcomes. We searched MEDLINE up to March 1997, the Research and Development Resource Base in Continuing Medical Education, and reference lists of related systematic reviews and articles. Randomised trials of outreach visits (defined as a personal visit by a trained person to a health care provider in his or her own setting). The participants were health care professionals. Two reviewers independently extracted data and assessed study quality. Eighteen studies were included involving more than 1896 physicians. All of the outreach visit interventions consisted of several components, including written materials and conferences. Reminders or audit and feedback complemented some visits. In 13 studies, the targeted behaviours were prescribing practices. In three studies, the behaviours were preventive services, including counselling for smoking cessation. In two studies, the outreach visits were directed toward improving the general management of common problems encountered in general practice, including asthma, diabetes, otitis media, hypertension, anxiety, and acute bronchitis. All studies examined physician behaviour and in three studies other health professionals such as nurses, nursing home attendants or health care workers were targeted. Positive effects on practice were observed in all studies. Only one study measured a patient outcome. Few studies examined the cost effectiveness of outreach. Educational outreach visits, particularly when combined with social marketing, appear to be a promising approach to modifying health professional behaviour, especially prescribing. Further research is needed to assess the effects of outreach visits for other aspects of practice and to identify key characteristics of outreach visits that are important to its success. The cost-effectiveness of outreach visits is not well evaluated.

Knowledge engineering in volcanology: Practical claims and general approach

NASA Astrophysics Data System (ADS)

Pshenichny, Cyril A.

2014-10-01

Knowledge engineering, being a branch of artificial intelligence, offers a variety of methods for elicitation and structuring of knowledge in a given domain. Only a few of them (ontologies and semantic nets, event/probability trees, Bayesian belief networks and event bushes) are known to volcanologists. Meanwhile, the tasks faced by volcanology and the solutions found so far favor a much wider application of knowledge engineering, especially tools for handling dynamic knowledge. This raises some fundamental logical and mathematical problems and requires an organizational effort, but may strongly improve panel discussions, enhance decision support, optimize physical modeling and support scientific collaboration.

Safe prescribing practices in pregnancy and lactation.

PubMed

Hansen, Wendy F; Peacock, Anne E; Yankowitz, Jerome

2002-01-01

Midwives and other health care providers face a dilemma when a pregnant woman develops a condition that usually is treated with a pharmacologic agent. Understanding of basic teratology associated with drugs as well as the FDA categorization of agents can assist professionals in recognizing which pharmaceuticals should be used or avoided. In addition to reviewing teratology, this article addresses the use of common drugs for the treatment of upper respiratory conditions, minor pain, gastrointestinal problems, psychiatric illnesses, and neurologic disorders. In each category, current evidence is presented pertaining to which agents should be recommended for pregnant women.

Virtue ethics - an old answer to a new dilemma? Part 1. Problems with contemporary medical ethics.

PubMed

Misselbrook, David

2015-02-01

The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis. © The Royal Society of Medicine.

IDENTIFYING PERFORMANCE ASSURANCE CHALLENGES FOR SMART MANUFACTURING.

PubMed

Helu, Moneer; Morris, Katherine; Jung, Kiwook; Lyons, Kevin; Leong, Swee

2015-10-01

Smart manufacturing has the potential to address many of the challenges faced by industry. However, the manufacturing community often needs assistance to leverage available technologies to improve their systems. To assure the performance of these technologies, this paper proposes a shared knowledge base that collects problem areas, solutions, and best practices for manufacturing technology. An Implementation Risk Assessment Framework (IRAF) is also described to identify the primary weaknesses of technologies in specific manufacturing contexts. Such approaches have the potential to stimulate new ideas and drive standardization activities critical to scale up and deploy smart manufacturing technologies successfully and quickly.

IDENTIFYING PERFORMANCE ASSURANCE CHALLENGES FOR SMART MANUFACTURING

PubMed Central

Helu, Moneer; Morris, Katherine; Jung, Kiwook; Lyons, Kevin; Leong, Swee

2015-01-01

Smart manufacturing has the potential to address many of the challenges faced by industry. However, the manufacturing community often needs assistance to leverage available technologies to improve their systems. To assure the performance of these technologies, this paper proposes a shared knowledge base that collects problem areas, solutions, and best practices for manufacturing technology. An Implementation Risk Assessment Framework (IRAF) is also described to identify the primary weaknesses of technologies in specific manufacturing contexts. Such approaches have the potential to stimulate new ideas and drive standardization activities critical to scale up and deploy smart manufacturing technologies successfully and quickly. PMID:26783512

Managing the professional nurse. Part I. The organizational theories.

PubMed

McClure, M L

1984-02-01

How do employment organizations outside the hospital field deal with issues such as staff productivity, motivation, burnout, and high turnover? In Part I of this two-part article, the author presents an overview of modern management theory and practice, drawn from the literature on organizational behavior. She shows how nursing administrators can use this scholarly foundation to better understand the organizing principles and problems of their departments. In Part II (to be published in March 1984), the author applies these classic and relevant theories to the specific challenges that face the manager of professional nurses.

Virtue ethics – an old answer to a new dilemma? Part 1. Problems with contemporary medical ethics

PubMed Central

2015-01-01

The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis. PMID:25721113

The Qur’ān and the development of rational thinking

PubMed Central

Abdel-Maguid, Thoraya E.; Abdel-Halim, Rabie E.

2015-01-01

In this study, the means utilized by the Qur’ān in actualizing the possibilities of all intellect to face the problem of blind imitation of ancestors were elaborated. Rationality as meant by the Qur’ān and embodied in its unique style is presented. Furthermore, the Qur’ānic documentation of the role of practical demonstration on the individual's mind as well as the societies’ collective mind is pointed out. In addition, the study shows how the Qur’ān guides people to the proper use of reason within a scientific framework of mind. PMID:25837451

Health problems related to early discharge of Turkish women.

PubMed

Gözüm, Sebahat; Kiliç, Dilek

2005-12-01

to determine women's problems when discharged early from hospital after normal vaginal birth among a simple convenience sample of mothers in one part of Turkey. a descriptive interview study. primary health-care unit in Erzurum, Turkey. 112 mothers who came to the primary health-care unit for vaccination of their 2-month old babies between May and June 2000. Data were collected by structured face-to-face interviews. A symptom checklist was used to determine health problems. length of hospital stay after delivery was a mean of 7.1+/-7.0 hrs, and 66.1% (n=74) of mothers did not receive appropriate education about potential postpartum health problems. The findings indicated that the morbidity rate of mothers in the postpartum period was high. Among the most prevalent problems experienced by mothers were fatigue (86.6%; n=97), insomnia (80.4%; n=90), breast problems [engorged breast, tenderness and pain] 71.4%; n=80) and constipation 61.7%; n=69). Vaginal infection was reported by 16 mothers (14.3%; n=16). The prevalence of the use of medical services resulting from postnatal health problems in the postpartum period was 42.0% (n=47). About half of the mothers (51.8%; n=58) were not visited by midwives during the first postpartum week after discharge from hospital because both the maternity hospital and mother had not reported any health problems to the midwife. RECOMMENDATIONS FOR PRACTICE: mothers can experience many problems in the postpartum period. It is not possible to predict which mother will experience risks, such as an infection or mastitis. Therefore, women discharged from hospital in the first 24 hrs after birth should be educated about the problems that may arise during the postpartum period. They should also be given professional care and help in their own home by midwives working in the primary-care unit. Mothers should be told to notify their midwives about delivery and discharge in order to receive early follow-up in their homes. We suggest promoting maternal health education that encourages women to seek appropriate and timely care.

Exploration on the matching between Optical Comprehensive Design Experiment and Washington Accord

NASA Astrophysics Data System (ADS)

Cao, Yiping; Chen, Wenjing; Zhang, Qican; Liu, Yuankun; Li, Dahai; Zhou, Xinzhi; Wei, Jun

2017-08-01

Common problems faced in optical comprehensive design experiment and going against the Washington Accord are pointed out. For resolving these problems, an instructional and innovative teaching scheme for Optics Comprehensive Design Experiment is proposed. We would like to understand the student that can improve the hands-on practical ability, theory knowledge understanding ability, complex problem solving ability, engineering application ability, cooperative ability after tracking and researching the student who have attended the class about Optical Comprehensive Design Experiment, We found that there are some problems on the course such as the experiment content vague, the student beginning less time, phase separation theory and engineering application, the experiment content lack of selectivity and so on. So we have made some improvements reference to the Washington Accord for the class teaching plan about Optical Comprehensive Design Experiment. This class must relevant to the engineering basic courses, professional foundation course and the major courses, so far as to the future study and work that which can play a role in inheriting and continuity to the students. The Optical Comprehensive Design Experiment teaching program requires students learning this course to have learnt basic courses like analog electronics technique, digital electronic technique, applied optics and computer and other related courses which students are required to comprehensively utilize. This teaching scheme contains six practical complex engineering problems which are respectively optical system design, light energy meter design, illuminometer design, material refractive index measuring system design, light intensity measuring system design and open design. Establishing the optional experiment and open experiment can provide students with a greater choice and enhance the students' creativity, vivid teaching experimental teachers and enriching contents of experiment can make the experiment more interesting, providing students with more opportunities to conduct experiment and improving students' practical ability with long learning time, putting emphasis on student's understanding of complex engineering problems and the cognitive of the process to solve complex engineering problems with actual engineering problems. Applying the scheme in other courses and improving accordingly will be able to ensure the quality of engineering education. Look forward to offering useful reference for the curriculum system construction in colleges and universities.

Wearing face masks in public during the influenza season may reflect other positive hygiene practices in Japan.

PubMed

Wada, Koji; Oka-Ezoe, Kuniko; Smith, Derek R

2012-12-10

Although the wearing of face masks in public has not been recommended for preventing influenza, these devices are often worn in many Asian countries during the influenza season. In Japan, it is thought that such behavior may be an indicator of other positive hygiene practices. The aim of this study, therefore, was to determine if wearing a face mask in public is associated with other positive hygiene practices and health behaviors among Japanese adults. We initially recruited around 3,000 Japanese individuals ranging from 20 to 69 years of age who were registered with a web survey company. Participants were asked to recall their personal hygiene practices during the influenza season of the previous year. Logistic regression analysis was then used to examine the associations between wearing a face mask in public and personal hygiene practices and health behaviors. A total of 3,129 persons responded to the survey, among whom 38% reported that they had worn a face mask in public during the previous influenza season. Wearing a face mask in public was associated with various self-reported hygiene practices including: frequent hand washing (adjusted Odds Ratio [OR]: 1.67; 95% Confidence Interval [95%CI]: 1.34-1.96), occasional hand washing (OR: 1.43; 95%CI: 1.10-1.75), frequently avoiding crowds (OR: 1.85; 95%CI: 1.70-1.98), occasionally avoiding crowds (OR: 1.65; 95%CI: 1.53-1.76), frequent gargling (OR: 1.68; 95%CI: 1.51-1.84), occasional gargling (OR: 1.46; 95%CI: 1.29-1.62), regularly avoiding close contact with an infected person (OR: 1.50; 95%CI: 1.33-1.67), occasionally avoiding close contact with an infected person (OR: 1.31; 95%CI: 1.16-1.46), and being vaccinated of influenza in the last season (OR: 1.31; 95%CI: 1.17-1.45). Overall, this study suggests that wearing a face mask in public may be associated with other personal hygiene practices and health behaviors among Japanese adults. Rather than preventing influenza itself, face mask use might instead be a marker of additional, positive hygiene practices and other favorable health behaviors in the same individuals.

Practice management: observations, issues, and empirical evidence.

PubMed

Wong, H M; Braithwaite, J

2001-02-01

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

My practice evolution: an appreciation of the discrepancies between the idealism of nursing education and the realities of hospital practice.

PubMed

Perkins, Danielle E K

2010-01-01

Newly graduated registered nurses face a barrage of physical and mental challenges in their first few years of practice, especially in the hospital setting. This article explores discrepancies between student nurse practice and professional nursing practice and the challenges that new nurses face in bridging the gap between idealistic theory and realistic practice. The author's subsequent graduate nursing education and continued practice in the field resulted in a personal evolution of practice that elicited a profound sense of appreciation for the field and a desire to share these experiences with other practicing nurses and students.

Universities Face Wide-Ranging Changes

ERIC Educational Resources Information Center

Krieger, James H.

1976-01-01

Discusses problems facing the research university, including declining enrollments and funds, fewer opportunities for graduates, and the complexity of research problems. Recommends making more efficient use of resources, improving communications with the broader public, and reducing economic and social barriers to obtaining a higher education.…

You're Not Alone in Facing These Board-Related Bugaboos.

ERIC Educational Resources Information Center

Van Loozen, Luann F.

1982-01-01

School board service can have detrimental effects on members' personal lives. The most frequent and pervasive problems faced by board members are lack of time, loneliness, stress, alienation from community life, abuse, and fatigue. Problem-solving tips are offered. (Author/MLF)

Problems Facing Native American Youths. Hearing before the Committee on Indian Affairs, United States Senate, One Hundred Seventh Congress, Second Session, on Oversight Hearing on Problems Facing Native American Youths (August 1, 2002).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Indian Affairs.

A Senate committee hearing received testimony on the problems of Native American youth and programs addressing those problems. Speakers included representatives of the American Academy of Pediatrics, United National Indian Tribal Youth (UNITY), Boys and Girls Clubs of America, the Bureau of Indian Affairs (BIA), and the Office of National Drug…

The effect of non-neovascular age-related macular degeneration on face recognition performance.

PubMed

Taylor, Deanna J; Smith, Nicholas D; Binns, Alison M; Crabb, David P

2018-04-01

There is a well-established research base surrounding face recognition in patients with age-related macular degeneration (AMD). However, much of this existing research does not differentiate between results obtained for 'wet' AMD and 'dry' AMD. Here, we test the hypothesis that face recognition performance is worse in patients with dry AMD compared with visually healthy peers. Patients (>60 years of age, logMAR binocular visual acuity 0.7 or better) with dry AMD of varying severity and visually healthy age-related peers (controls) completed a modified version of the Cambridge Face Memory Test (CFMT). Percentage of correctly identified faces was used as an outcome measure for performance for each participant. A 90% normative reference limit was generated from the distribution of CFMT scores recorded in the visually healthy controls. Scores for AMD participants were then specifically compared to this limit, and comparisons between average scores in the AMD severity groups were investigated. Thirty patients (median [interquartile range] age of 76 [70, 79] years) and 34 controls (median age of 70 [64, 75] years) were examined. Four, seventeen and nine patients were classified as having early, intermediate and late AMD (geographic atrophy) respectively. Five (17%) patients recorded a face recognition performance worse than the 90% limit (Fisher's exact test, p = 0.46) set by controls; four of these had geographic atrophy. Patients with geographic atrophy identified fewer faces on average (±SD) (61% ± 22%) than those with early and intermediate AMD (75 ± 11%) and controls (74% ± 11%). People with dry AMD may not suffer from problems with face recognition until the disease is in its later stages; those with late AMD (geographic atrophy) are likely to have difficulty recognising faces. The results from this study should influence the management and expectations of patients with dry AMD in both community practice and hospital clinics.

Rural physician assistants: a survey of graduates of MEDEX Northwest.

PubMed Central

Larson, E H; Hart, L G; Hummel, J

1994-01-01

Graduates of MEDEX Northwest, the physician assistant training program at the University of Washington, were surveyed to describe differences between physician assistants practicing in rural settings and those practicing in urban settings. Differences in demography, satisfaction with practice and community, practice history, and practice content were explored. Of the 341 traceable graduates, 295 (86.5 percent) responded to the mail survey. Although rural- and urban-practicing physician assistants are remarkably similar in most respects--income, hours worked, levels of practice satisfaction, for example--those in rural primary care reported performing a much wider range of medical and administrative tasks than those in urban practice. Half of the physician assistants who grew up in small towns were practicing in rural places compared with 18 percent of those from large towns. The broader scope of practice available to primary care physician assistants in rural areas may be of particular interest to those considering rural careers, to people who train physician assistants, and to rural communities trying to recruit and retain physician assistants. Results also suggest that recruitment of students for rural practice should focus on rural residents. Some problems that rural practitioners are more likely to face than urban ones, such as unreasonable night call schedules and lack of acknowledgement and respect for them as professionals, need to be addressed if rural communities are to be able to attract and retain physician assistants. PMID:7908746

"I Never Feel Alone in My Classroom": Teacher Professional Growth within a Blended Community of Practice

ERIC Educational Resources Information Center

Trust, Torrey; Horrocks, Brian

2017-01-01

Well-designed face-to-face and virtual communities of practice provide opportunities for teachers to learn, grow as professionals and make changes to their practice with the support of peers. However, as more K-12 teachers become Connected Educators and act as conduits between online spaces and communities in their schools, the boundaries between…

Advancing Work Practices: Rethinking Online Professional Development in the Context of the Intervention-Based Sustainable Change

ERIC Educational Resources Information Center

Noesgaard, Signe Schack

2016-01-01

Purpose: The paper aims to discuss the effectiveness of e-Learning in advancing work practices. The paper investigates the assumption that e-Learning is as effective as face-to-face interventions when stimulating change. It also examines the assumption that well-designed and well-executed instructional interventions will advance work practices.…

Teaching and Practicing Transformational Politics.

ERIC Educational Resources Information Center

Abalos, David T.

This conference paper asserts that there are four faces to the stories of people's lives: (1) a personal face; (2) a political face; (3) a historical face; and (4) a sacred face. The study explains how each of these faces interacts in society and is used to analyze and to teach multicultural literary works as archetypal stories from the…

Taking It Online--The Effects of Delivery Medium and Facilitator on Student Achievement in Problem-Based Learning

ERIC Educational Resources Information Center

Schoenfeld-Tacher, Regina; McConnell, Sherry; Kogan, Lori R.

2004-01-01

This study compares the effects of delivery medium (online vs. face-to-face) and facilitator content expertise on academic outcomes in a problem-based learning (PBL) course in anatomy for pre-health/medical majors. The content of online PBL sessions was examined to gain insight into the problem-solving process taking place in these situations.…

The Problem of Science Education in Minority Areas--Based on a Study in Gansu Province of China

ERIC Educational Resources Information Center

Liang, Bai

2017-01-01

After 60 years of development, minority education not only has made great achievements in China, but also faces many problems. Among them is the problem of science education. The students learning in high school in the basic education in minority areas have faced particular difficulties in learning science. The teaching quality is not high,…

DoD Implementation of the Better Buying Power Initiatives

DTIC Science & Technology

2012-12-01

statutory measures (Budget Control Act of 2011), Congress has been directed to face this problem and provide a workable solution or face the evils...Defense Support Program (DSP) to provide the capabilities that the SBIRS has had problems delivering (Richelson, 2007; Werner, 2011). The purpose of the...Defense David Packard took office. They were keen on addressing the problems plaguing defense acquisition: excessive centralization, inefficiencies

The teaching of medical ethics to medical students.

PubMed Central

Glick, S M

1994-01-01

Teaching medical ethics to medical students in a pluralistic society is a challenging task. Teachers of ethics have obligations not just to teach the subject matter but to help create an academic environment in which well motivated students have reinforcement of their inherent good qualities. Emphasis should be placed on the ethical aspects of daily medical practice and not just on the dramatic dilemmas raised by modern technology. Interdisciplinary teaching should be encouraged and teaching should span the entire duration of medical studies. Attention should be paid particularly to ethical problems faced by the students themselves, preferably at the time when the problems are most on the students' minds. A high level of academic demands, including critical examination of students' progress is recommended. Finally, personal humility on the part of teachers can help set a good example for students to follow. PMID:7861430

Stem cell research: applicability in dentistry.

PubMed

Mathur, Shivani; Chopra, Rahul; Pandit, I K; Srivastava, Nikhil; Gugnani, Neeraj

2014-01-01

In the face of extraordinary advances in the prevention, diagnosis, and treatment of human diseases, the inability of most tissues and organs to repair and regenerate after damage is a problem that needs to be solved. Stem cell research is being pursued in the hope of achieving major medical breakthroughs. Scientists are striving to create therapies that rebuild or replace damaged cells with tissues grown from stem cells that will offer hope to people suffering from various ailments. Regeneration of damaged periodontal tissue, bone, pulp, and dentin is a problem that dentists face today. Stem cells present in dental pulp, periodontal ligament, and alveolar bone marrow have the potential to repair and regenerate teeth and periodontal structures. These stem cells can be harvested from dental pulp, periodontal ligament, and/or alveolar bone marrow; expanded; embedded in an appropriate scaffold; and transplanted back into a defect to regenerate bone and tooth structures. These cells have the potential to regenerate dentin, periodontal ligament, and cementum and can also be used to restore bone defects. The kind of scaffold, the source of cells, the type of in vitro culturing, and the type of surgical procedure to be used all require careful consideration. The endeavor is clearly multidisciplinary in nature, and the practicing dental surgeon has a critical role in it. Playing this role in the most effective way requires awareness of the huge potential associated with the use of stem cells in a clinical setting, as well as a proper understanding of the related problems.

Recognizing the Two Faces of Gambling: The Lived Experiences of Korean Women Gamblers.

PubMed

Kim, Sungjae; Kim, Wooksoo; Dickerson, Suzanne S

2016-10-01

The aim of this study was to explore the lived experiences of women problem gamblers, focusing on the meaning of gambling to them, how and why these women continue to gamble or stop gambling, and their needs and concerns. In order to effectively help women problem gamblers, practical in-depth knowledge is necessary to develop intervention programs for prevention, treatment, and recovery among women problem gamblers. The hermeneutic phenomenology approach was used to guide in-depth interviews and team interpretation of data. Sixteen women gamblers who chose to live in the casino area were recruited through snowball sampling with help from a counseling center. Participants were individually interviewed from February to April 2013 and asked to tell their stories of gambling. Transcribed interviews provided data for interpretive analysis. In the study analysis one constitutive pattern was identified: moving beyond addiction by recognizing the two faces of gambling in their life. Four related themes emerged in the analysis-gambling as alluring; gambling as 'ugly'; living in contradictions; and moving beyond. Loneliness and isolation play a critical role in gambling experiences of women gamblers in Korea. In other words, they are motivated to gamble in order to escape from loneliness, to stop gambling for fear of being lonely as they get older, and to stay in the casnio area so as not to be alone. The need for acceptance is one fo the important factors that should be considered in developing intervention program for women.

Effects of Flipped Learning Using Online Materials in a Surgical Nursing Practicum: A Pilot Stratified Group-Randomized Trial

PubMed Central

Lee, Myung Kyung

2018-01-01

Objectives This study examined the effect of flipped learning in comparison to traditional learning in a surgical nursing practicum. Methods The subjects of this study were 102 nursing students in their third year of university who were scheduled to complete a clinical nursing practicum in an operating room or surgical unit. Participants were randomly assigned to either a flipped learning group (n = 51) or a traditional learning group (n = 51) for the 1-week, 45-hour clinical nursing practicum. The flipped-learning group completed independent e-learning lessons on surgical nursing and received a brief orientation prior to the commencement of the practicum, while the traditional-learning group received a face-to-face orientation and on-site instruction. After the completion of the practicum, both groups completed a case study and a conference. The student's self-efficacy, self-leadership, and problem-solving skills in clinical practice were measured both before and after the one-week surgical nursing practicum. Results Participants' independent goal setting and evaluation of beliefs and assumptions for the subscales of self-leadership and problem-solving skills were compared for the flipped learning group and the traditional learning group. The results showed greater improvement on these indicators for the flipped learning group in comparison to the traditional learning group. Conclusions The flipped learning method might offer more effective e-learning opportunities in terms of self-leadership and problem-solving than the traditional learning method in surgical nursing practicums. PMID:29503755

Effects of Flipped Learning Using Online Materials in a Surgical Nursing Practicum: A Pilot Stratified Group-Randomized Trial.

PubMed

Lee, Myung Kyung; Park, Bu Kyung

2018-01-01

This study examined the effect of flipped learning in comparison to traditional learning in a surgical nursing practicum. The subjects of this study were 102 nursing students in their third year of university who were scheduled to complete a clinical nursing practicum in an operating room or surgical unit. Participants were randomly assigned to either a flipped learning group (n = 51) or a traditional learning group (n = 51) for the 1-week, 45-hour clinical nursing practicum. The flipped-learning group completed independent e-learning lessons on surgical nursing and received a brief orientation prior to the commencement of the practicum, while the traditional-learning group received a face-to-face orientation and on-site instruction. After the completion of the practicum, both groups completed a case study and a conference. The student's self-efficacy, self-leadership, and problem-solving skills in clinical practice were measured both before and after the one-week surgical nursing practicum. Participants' independent goal setting and evaluation of beliefs and assumptions for the subscales of self-leadership and problem-solving skills were compared for the flipped learning group and the traditional learning group. The results showed greater improvement on these indicators for the flipped learning group in comparison to the traditional learning group. The flipped learning method might offer more effective e-learning opportunities in terms of self-leadership and problem-solving than the traditional learning method in surgical nursing practicums.

Adaptive building skin structures

NASA Astrophysics Data System (ADS)

Del Grosso, A. E.; Basso, P.

2010-12-01

The concept of adaptive and morphing structures has gained considerable attention in the recent years in many fields of engineering. In civil engineering very few practical applications are reported to date however. Non-conventional structural concepts like deployable, inflatable and morphing structures may indeed provide innovative solutions to some of the problems that the construction industry is being called to face. To give some examples, searches for low-energy consumption or even energy-harvesting green buildings are amongst such problems. This paper first presents a review of the above problems and technologies, which shows how the solution to these problems requires a multidisciplinary approach, involving the integration of architectural and engineering disciplines. The discussion continues with the presentation of a possible application of two adaptive and dynamically morphing structures which are proposed for the realization of an acoustic envelope. The core of the two applications is the use of a novel optimization process which leads the search for optimal solutions by means of an evolutionary technique while the compatibility of the resulting configurations of the adaptive envelope is ensured by the virtual force density method.

[Telemedicine in dermatological practice: teledermatology].

PubMed

Danis, Judit; Forczek, Erzsébet; Bari, Ferenc

2016-03-06

Technological advances in the fields of information and telecommunication technologies have affected the health care system in the last decades, and lead to the emergence of a new discipline: telemedicine. The appearance and rise of internet and smart phones induced a rapid progression in telemedicine. Several new applications and mobile devices are published every hour even for medical purposes. Parallel to these changes in the technical fields, medical literature about telemedicine has grown rapidly. Due to its visual nature, dermatology is ideally suited to benefit from this new technology and teledermatology became one of the most dynamically evolving fields of telemedicine by now. Teledermatology is not routinely practiced in Hungary yet, however, it promises the health care system to become better, cheaper and faster, but we have to take notice on the experience and problems faced in teledermatologic applications so far, summarized in this review.

Relationship between Family Adaptability, Cohesion and Adolescent Problem Behaviors: Curvilinearity of Circumplex Model.

PubMed

Joh, Ju Youn; Kim, Sun; Park, Jun Li; Kim, Yeon Pyo

2013-05-01

The Family Adaptability and Cohesion Evaluation Scale (FACES) III using the circumplex model has been widely used in investigating family function. However, the criticism of the curvilinear hypothesis of the circumplex model has always been from an empirical point of view. This study examined the relationship between adolescent adaptability, cohesion, and adolescent problem behaviors, and especially testing the consistency of the curvilinear hypotheses with FACES III. We used the data from 398 adolescent participants who were in middle school. A self-reported questionnaire was used to evaluate the FACES III and Youth Self Report. According to the level of family adaptability, significant differences were evident in internalizing problems (P = 0.014). But, in externalizing problems, the results were not significant (P = 0.305). Also, according to the level of family cohesion, significant differences were in internalizing problems (P = 0.002) and externalizing problems (P = 0.004). The relationship between the dimensions of adaptability, cohesion and adolescent problem behaviors was not curvilinear. In other words, adolescents with high adaptability and high cohesion showed low problem behaviors.

Relationship between Family Adaptability, Cohesion and Adolescent Problem Behaviors: Curvilinearity of Circumplex Model

PubMed Central

Joh, Ju Youn; Kim, Sun; Park, Jun Li

2013-01-01

Background The Family Adaptability and Cohesion Evaluation Scale (FACES) III using the circumplex model has been widely used in investigating family function. However, the criticism of the curvilinear hypothesis of the circumplex model has always been from an empirical point of view. This study examined the relationship between adolescent adaptability, cohesion, and adolescent problem behaviors, and especially testing the consistency of the curvilinear hypotheses with FACES III. Methods We used the data from 398 adolescent participants who were in middle school. A self-reported questionnaire was used to evaluate the FACES III and Youth Self Report. Results According to the level of family adaptability, significant differences were evident in internalizing problems (P = 0.014). But, in externalizing problems, the results were not significant (P = 0.305). Also, according to the level of family cohesion, significant differences were in internalizing problems (P = 0.002) and externalizing problems (P = 0.004). Conclusion The relationship between the dimensions of adaptability, cohesion and adolescent problem behaviors was not curvilinear. In other words, adolescents with high adaptability and high cohesion showed low problem behaviors. PMID:23730484

A Modified Active Appearance Model Based on an Adaptive Artificial Bee Colony

PubMed Central

Othman, Zulaiha Ali

2014-01-01

Active appearance model (AAM) is one of the most popular model-based approaches that have been extensively used to extract features by highly accurate modeling of human faces under various physical and environmental circumstances. However, in such active appearance model, fitting the model with original image is a challenging task. State of the art shows that optimization method is applicable to resolve this problem. However, another common problem is applying optimization. Hence, in this paper we propose an AAM based face recognition technique, which is capable of resolving the fitting problem of AAM by introducing a new adaptive ABC algorithm. The adaptation increases the efficiency of fitting as against the conventional ABC algorithm. We have used three datasets: CASIA dataset, property 2.5D face dataset, and UBIRIS v1 images dataset in our experiments. The results have revealed that the proposed face recognition technique has performed effectively, in terms of accuracy of face recognition. PMID:25165748

The Role of Independent V&V in Upstream Software Development Processes

NASA Technical Reports Server (NTRS)

Easterbrook, Steve

1996-01-01

This paper describes the role of Verification and Validation (V&V) during the requirements and high level design processes, and in particular the role of Independent V&V (IV&V). The job of IV&V during these phases is to ensure that the requirements are complete, consistent and valid, and to ensure that the high level design meets the requirements. This contrasts with the role of Quality Assurance (QA), which ensures that appropriate standards and process models are defined and applied. This paper describes the current state of practice for IV&V, concentrating on the process model used in NASA projects. We describe a case study, showing the processes by which problem reporting and tracking takes place, and how IV&V feeds into decision making by the development team. We then describe the problems faced in implementing IV&V. We conclude that despite a well defined process model, and tools to support it, IV&V is still beset by communication and coordination problems.

Knowledge and practice of iranians toward colorectal cancer, and barriers to screening.

PubMed

Salimzadeh, Hamideh; Delavari, Alireza; Montazeri, Ali; Mirzazadeh, Ali

2012-01-01

Colorectal cancer (CRC) is the third most common malignancy in Iran. Limited data are available on knowledge and barriers in regard to CRC and screening tests in Iran. The aim of the study was to characterize knowledge, practice, and barriers toward CRC and its screening tests among an Iranian at-risk population. This cross-sectional study was conducted with participation of 200 individuals of both genders aged 50 years or older in a teaching hospital in Tehran, Iran. Data were collected via face-to-face interviews. A questionnaire containing demographics; knowledge about CRC and screening tests; screening practice; and reasons for not being screened was administered. The reliability alpha for knowledge items was 0.52. The age of the participants ranged from 50 to 83 years (mean 60.13). Overall, 11% of the respondents reported prior screening by either fecal occult blood test (6.5%) or colonoscopy (4.5%). The majority of individuals had poor knowledge although respondents with prior screening obtained slightly higher score in comparison with nonparticipants in screening (26.74 vs. 23.24; P<0.05). Four commonly cited reasons for not having CRC tests were "doctor did not recommend the test," "did not think it was needed," "never think of the test," and "no symptoms/problems" which were reported by 29%, 26%, 20%, and 17% of the participants, respectively. It is necessary to design appropriate educational interventions to increase the general population's knowledge about CRC and screening before implementing preventive programs in Iran.

Rebuilding self-confidence after cancer: a feasibility study of life-coaching.

PubMed

Wagland, Richard; Fenlon, Deborah; Tarrant, Ruth; Howard-Jones, Gilly; Richardson, Alison

2015-03-01

Cancer survivors often experience decreased self-confidence which impacts negatively on their ability to self-manage the practical, social and emotional problems frequently faced as they emerge from end of treatment. This was a feasibility study of a life-coaching intervention, designed to rebuild confidence of survivors and support transition to life after cancer treatment. A one group pre-test, post-test design was used, recruiting participants from community organisations. Eligibility criteria are as follows: <1 year of completion of primary cancer treatment, aged >18, no metastases, and no mental health problems. Participants received one individualised face-to-face and five telephone coaching sessions over 3 months. Outcome measures are as follows: New General Self-Efficacy Scale, Hope Scale, Personal Well-being Index, Assessment of Survivorship Concerns, Quality of Life in Adult Cancer Survivors, Hospital Anxiety and Depression Scale, Social Difficulties Index, and a goal attainment score. Interviews explored feasibility, acceptability and impact of life-coaching and research design. Nine women and two men were recruited, representing varying cancer diagnoses. All outcome measures were sensitive to change and indicated positive trends post-intervention. Participant interviews indicated the intervention was well received and had a positive impact. Lessons were learnt about study design, recruitment and intervention delivery. Life-coaching has a potential to enable cancer survivors to manage the transition to life beyond cancer and effect change on a range of outcomes. The intervention was feasible to deliver and acceptable to survivors at a time when many struggle to make sense of life. It merits further evaluation through a randomised controlled trial.

When the globe is your classroom: teaching and learning about large-scale environmental change online

NASA Astrophysics Data System (ADS)

Howard, E. A.; Coleman, K. J.; Barford, C. L.; Kucharik, C.; Foley, J. A.

2005-12-01

Understanding environmental problems that cross physical and disciplinary boundaries requires a more holistic view of the world - a "systems" approach. Yet it is a challenge for many learners to start thinking this way, particularly when the problems are large in scale and not easily visible. We will describe our online university course, "Humans and the Changing Biosphere," which takes a whole-systems perspective for teaching regional to global-scale environmental science concepts, including climate, hydrology, ecology, and human demographics. We will share our syllabus and learning objectives and summarize our efforts to incorporate "best" practices for online teaching. We will describe challenges we have faced, and our efforts to reach different learner types. Our goals for this presentation are: (1) to communicate how a systems approach ties together environmental sciences (including climate, hydrology, ecology, biogeochemistry, and demography) that are often taught as separate disciplines; (2) to generate discussion about challenges of teaching large-scale environmental processes; (3) to share our experiences in teaching these topics online; (4) to receive ideas and feedback on future teaching strategies. We will explain why we developed this course online, and share our experiences about benefits and challenges of teaching over the web - including some suggestions about how to use technology to supplement face-to-face learning experiences (and vice versa). We will summarize assessment data about what students learned during the course, and discuss key misconceptions and barriers to learning. We will highlight the role of an online discussion board in creating classroom community, identifying misconceptions, and engaging different types of learners.

Online data on opening hours of general practices in England: a comparison with telephone survey data

PubMed Central

Richards, Emma C; Cowling, Thomas E; Gunning, Elinor J; Harris, Matthew J; Soljak, Michael A; Nowlan, Naomi; Dharmayat, Kanika; Johari, Nur; Majeed, Azeem

2015-01-01

Background The NHS Choices website (www.nhs.uk) provides data on the opening hours of general practices in England. If the data are accurate, they could be used to examine the benefits of extended hours. Aim To determine whether online data on the opening times of general practices in England are accurate regarding the number of hours in which GPs provide face-to-face consultations. Design and setting Cross-sectional comparison of data from NHS Choices and telephone survey data reported by general practice staff, for a nationally representative sample of 320 general practices (December 2013 to September 2014). Method GP face-to-face consultation times were collected by telephone for each sampled practice for each day of the week. NHS Choices data on surgery times were available online. Analysis was based on differences in the number of surgery hours (accounting for breaks) and the times of the first and last consultations of the day only between the two data sources. Results The NHS Choices data recorded 8.8 more hours per week than the survey data on average (40.1 versus 31.2; 95% confidence interval [CI] = 7.4 to 10.3). This was largely accounted for by differences in the recording of breaks between sessions. The data were more similar when only the first and last consultation times were considered (mean difference = 1.6 hours; 95% CI = 0.9 to 2.3). Conclusion NHS Choices data do not accurately measure the number of hours in which GPs provide face-to-face consultations. They better record the hours between the first and last consultations of the day. PMID:26622033

Consultation Focus: Identification of Issues.

ERIC Educational Resources Information Center

Pian, Canta

This paper discusses some of the problems faced by Asian Americans. Major topics addressed include: (1) the lack of accurate census statistics on minorities, especially Asian and Pacific Americans; (2) the employment, health, and stereotypic portrayal problems faced by Asian and Pacific American women; (3) racially discriminatory immigration laws…

Plagiarism Due to Misunderstanding: Online Instructor Perceptions

ERIC Educational Resources Information Center

Greenberger, Scott; Holbeck, Rick; Steele, John; Dyer, Thomas

2016-01-01

Plagiarism is an ongoing problem in higher education. This problem exists in both online and face-to-face modalities. The literature indicates that there are three ways higher education institutions define plagiarism, which includes theft, deception, and misunderstanding. Plagiarism due to misunderstanding has received less attention in the…

Disclosing the truth: a dilemma between instilling hope and respecting patient autonomy in everyday clinical practice.

PubMed

Sarafis, Pavlos; Tsounis, Andreas; Malliarou, Maria; Lahana, Eleni

2013-12-20

While medical ethics place a high value on providing truthful information to patients, disclosure practices are far from being the norm in many countries. Transmitting bad news still remains a big problem that health care professionals face in their every day clinical practice. Through the review of relevant literature, an attempt to examine the trends in this issue worldwide will be made. Various electronic databases were searched by the authors and through systematic selection 51 scientific articles were identified that this literature review is based on. There are many parameters that lead to the concealment of truth. Factors related to doctors, patients and their close environment, still maintain a strong resistance against disclosure of diagnosis and prognosis in terminally ill patients, while cultural influences lead to different approaches in various countries. Withholding the truth is mainly based in the fear of causing despair to patients. However, fostering a spurious hope, hides the danger of its' total loss, while it can disturb patient-doctor relationship.

Meanings of sex, concepts of risk and sexual practices among migrant coal miners in Quang Ninh, Vietnam.

PubMed

Van Tuan, Ta

2010-08-01

The study explores the meanings of sex among migrant coal miners in Vietnam and identifies contextual factors influencing engagement in unsafe sexual practices. Findings reveal that sex carries a number of social meanings in the lives of migrant miners: sex is relaxation and reward for their risk and hard work; access to sex is an incentive for miners to continue working in the mine; sex strengthens identity and social networks; sex helps miners to affirm manhood, group membership and masculinity; and sex workers are confidants with whom they can share their problems. Facing accidents at work on a daily basis, miners are less inclined to worry about the long-term risks of HIV infection. In addition, being excluded from access to relevant information, miners feel distant from HIV infection. Findings suggest that interventions on sexual behaviour and practices should be sensitive to the concepts of risk and meanings of sex among migrant groups such as coal miners.

Neuro-proprioceptive facilitation in the re-education of functional problems in facial paralysis. A practical approach.

PubMed

Sardaru, D; Pendefunda, L

2013-01-01

Facial paralysis, in the form of Bell's syndrome, is an acute paralysis of idiopathic origin. Disability in patients with this medical condition is the result of impairment or loss of complex and multidimensional functions of the face like emotion expression through facial mimics, facial identity and communication. This study aimed to present new and improved practical manual techniques in the area of facial neuromuscular facilitations and to review the literature for disability indexes and facial nerve grading. We present the practical modality of using neuro-proprioceptive facilitation techniques, such as rhythmic initiation, repeated stretch (repeated contractions), combination of isotonics and percussion, and also report the effects of these techniques in three Bell's syndrome patients which were previously evaluated. Recovery from facial paralysis can be a difficult and long lasting process and the utilization of a grading system may help the physical therapist. The effects of this type of therapy may help_benefit the patient if the therapist is well trained and familiar with the neurophysiological background.

Addressing the paradox of the team innovation process: A review and practical considerations.

PubMed

Thayer, Amanda L; Petruzzelli, Alexandra; McClurg, Caitlin E

2018-01-01

Facilitating team innovation is paramount to promoting progress in the science, technology, engineering, and math fields, as well as advancing national health, safety, prosperity, and welfare. However, innovation teams face a unique set of challenges due to the novelty and uncertainty that is core to the definition of innovation, as well as the paradoxical nature of idea generation and idea implementation processes. These and other challenges must be overcome for innovation teams to realize their full potential for producing change. The purpose of this review is, thus, to provide insight into the unique context that these teams function within and provide an integrative, evidence-based, and practically useful, organizing heuristic that focuses on the most important considerations for facilitating team innovation. Finally, we provide practical guidance for psychologists, organizations, practitioners, scientists, educators, policymakers, and others who employ teams to produce novel, innovative solutions to today's problems. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Oral Health Care for Children in Countries Using Dental Therapists in Public, School-Based Programs, Contrasted with That of the United States, Using Dentists in a Private Practice Model

PubMed Central

Friedman, Jay W.; Nash, David A.

2013-01-01

The United States faces a significant problem with access to oral health care, particularly for children. More than 50 countries have developed an alternative dental provider, a dental therapist, practicing in public, school-based programs, to address children’s access to care. This delivery model has been demonstrated to improve access to care and oral health outcomes while providing quality care economically. We summarize elements of a recent major review of the global literature on the use of dental therapists, “A Review of the Global Literature on Dental Therapists: In the Context of the Movement to Add Dental Therapists to the Oral Health Workforce in the United States.” We contrast the success of a school-based model of caring for children by dental therapists with that of the US model of dentists providing care for children in private practices. PMID:23865650

“A memorable consultation”: Writing reflective accounts articulates students’ learning in general practice

PubMed Central

Svenberg, Kristian; Wahlqvist, Mats; Mattsson, Bengt

2007-01-01

Objectives To explore and analyse students’ learning experiences of a memorable consultation during a final-year attachment in general practice. Setting After a two-week primary care attachment in the undergraduate curriculum, students were invited to write a reflective account of a memorable consultation. Design A total of 52 reflective accounts were read and processed according to qualitative content analysis. Credibility of the analysis was validated by two co-authors reading the descriptions separately and trustworthiness was tested at local seminars. Results Three main themes emerged. In “The person beyond symptoms” the students recognize the individual properties of a consultation. “Facing complexity” mirrors awareness of changing tracks in problem-solving and strategies of handling unclear conditions. “In search of a professional role” reflects the interest in role modelling and the relation to the supervisor. Conclusion Involving students in writing reflective accounts appears to stimulate them to articulate practice experiences of the consultation. PMID:17497483

Development of forensic medicine in post reform Indonesia.

PubMed

Syukriani, Yoni Fuadah; Novita, Nita; Sunjaya, Deni K

2018-05-03

Forensic medicine practice in Indonesia was introduced through the Dutch colonial criminal justice system in the early twentieth century. After more than 70 years of national independence, the development of forensic medicine still faces fundamental challenges, including confusion in the distribution of responsibility with law enforcement agencies, difficulties in managing conflicts of interest, and impediments in scientific practice and professional development. Despite of the golden opportunity from the Indonesian Reform movement in the late 1990s, the impact on forensic medicine development has been less than expected. It is thus important to identify the scope of the problems plaguing the development of forensic medicine, as well as its causes. We conducted a qualitative study to explain the problems and propose solutions. The results show that the standards of practice have developed more slowly than those in many other branches of medicine, despite its increasing popularity from its role in counterterrorism and disaster victim identification. A strong thriving spirit exists in forensic science, although growth in forensic research activities should be facilitated more. The 2009 Health Law has included forensic medicine practice in the health system to cover the role of forensic medicine for health and medical education purposes. It also potentially provides a way to support the justice system without exposing forensic practitioners to possible conflicts of interest, for instance, by utilizing a tiered referral system. To this aim, an alternative is proposed: to place forensic medicine practice within the context of the health system. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Barriers to exclusive breastfeeding in the Ayeyarwaddy Region in Myanmar: Qualitative findings from mothers, grandmothers, and husbands.

PubMed

Thet, May Me; Khaing, Ei Ei; Diamond-Smith, Nadia; Sudhinaraset, May; Oo, Sandar; Aung, Tin

2016-01-01

Myanmar has low rates of exclusive breastfeeding despite many decades of efforts to increase this practice. The purpose of this study is to examine the barriers to exclusive breastfeeding and how different household members participate in decision-making. We conducted semi-structured interviews with mothers with an infant 6-12 months (24), and a subset of their husbands (10) and their mothers/mothers-in-laws (grandmothers) (10) in rural and urban areas of Laputta, Myanmar. Respondents had high levels of knowledge about exclusive breastfeeding, but low adherence. One of the primary barriers to exclusive breastfeeding was that mothers, husbands, and grandmothers believed that exclusive breastfeeding was not sufficient for babies and solid foods and water were necessary. Water and mashed up rice were commonly introduced before 6 months of age. Mothers also faced barriers to exclusive breastfeeding due to the need to return to work outside the home and health related problems. Other family members provide support for mothers in their breastfeeding, however, most respondents stated that decisions about breastfeeding and child feeding were made by the mother herself. Mothers in this part of Myanmar know about exclusive breastfeeding, but need more knowledge about its importance and benefits to encourage them to practice it. More information for other family members could improve adherence to exclusive breastfeeding, as family members often provide food to children and support to breastfeeding mothers. Support for mothers to be able to continue breastfeeding once they return to work and in the face of health problems is also important. Finally, additional information about the types of foods that infants need once they cease breastfeeding could improve infant and child health. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Why won't they listen: Negotiating the technological and social context for science teaching

NASA Astrophysics Data System (ADS)

Liuzzo, Anna M.

The purpose of this study was to gather information to identify the obstacles and the impact an implementation of technology had in a middle school science classroom. This study explored a teaching environment where the teacher planned on using a variety of technology tools including laptops, probeware, hardware and software to promote scientific study. This study took place in two phases consisting of three consecutive years. In phase one the teacher reported great success. In phase two a shift in the school implementation created a significant impact on the learning taking place. This study identified the obstacles faced by a teacher providing an environment that combined her pedagogy with technology implementation. This teacher's pedagogy included research-based practices such a authentic problem-based learning, scientific inquiry, conceptual understanding of problem solving, connections to real-life situations and the use of metacognition in her practice. This study looked to determined if this implementation had an effect on student engagement and achievement; how the nature of technical and professional development impacted the implementation; and the barriers that were faced in creating a student-centered, technology rich approach to science. This qualitative study was conducted meeting the criteria of a case study of one teacher. The participant teacher's accounts of events through interviews were the primary source of data. In addition, multiple sources of information were also gathered. These included the teacher's reflective journal, student interviews, student focus groups, student artifacts, classroom observations, field notes, e-mail correspondences and students' test scores. This study proposes to contribute to the growing research evidence of implementation in the classroom and to identify specific obstacles that hinder success. The current state of education is calling for reform.

Elder Abuse and Neglect Intervention in the Clinical Setting: Perceptions and Barriers Faced by Primary Care Physicians in Malaysia.

PubMed

Mohd Mydin, Fadzilah Hanum; Othman, Sajaratulnisah

2017-08-01

This qualitative study attempts to explore the definition, perceptions, practice experience, and barriers of primary care physicians (PCPs) in identifying and intervening in cases of elder abuse and neglect at the primary care level. Semistructured in-depth interview was conducted among 10 PCPs. Participants were selected by purposive sampling. The interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis. In general, PCPs showed consistency in defining elder abuse and neglect. PCPs considered that they were optimally positioned to intervene in cases of elder abuse and neglect, but indicated the potential of overlooking such problems. The hurdles faced by PCPs in the identification and intervention of elder abuse were determined to be occurring at three levels: clinical, organizational, and policy. At the clinical level, PCPs recognize that they are lacking both the confidence and knowledge of elder abuse and neglect intervention. PCPs' conflicting personal and professional beliefs create barriers during the clinical practice. Time constraints, patients' other clinical problems, and, in addition, the preservation of a good doctor-patient relationship overshadow the importance of addressing and intervening in elder abuse and neglect issues during the consultation. This is further exacerbated by the barriers perceived by the patients: their nondisclosure and reluctance to accept outside intervention. At the organizational level, the lack of efficient interagency networks or support for the health system poses barriers. At the policy level, the absence of legislation specifically addressing elder abuse also creates considerable difficulties. However, PCPs gave differing responses when asked about a law concerning the elderly and mandatory reporting. Addressing these multilevel barriers is critical for ensuring that opportunities arising at the primary care level for elder maltreatment intervention are correctly utilized.

[Implementation of a new prescription system. A qualitative survey of organizational barriers].

PubMed

Andersen, Stig Ejdrup

2002-09-16

The aim of this study was to identify organisational difficulties faced by physicians and nurses when using drug prescribing sheets for the recording of both drug prescriptions and drug administration. Qualitative interviews with seven physicians and eight nurses from two general internal medicine wards. Main outcome measures were the difficulties explicitly identified during the interviews. The implementation of procedures conflicted with existing structure, culture, and routines. Insufficient competence within the system to use the drug prescribing sheets created resistance and made people create their own solutions to the problems they faced. A total of nine difficulties were identified: 1) insufficient knowledge and uncertainty about procedures, 2) ignorance of sources of error, 3) unclear responsibilities, 4) low community spirit, 5) insufficient communication, 6) clinician autonomy and low acceptance of change, 7) strong professional identity, 8) low priority task, and 9) logistic problems. Unawareness of procedures, insufficient dissemination of knowledge, and insufficient cooperation and skepticism among those who put drug handling into practice is likely to have an impact on the quality of health care. The identification of these obstacles may help managers to improve the quality of the drug handling process and make it possible to select a framework for changing the clinical behavior of doctors and nurses.

Non-face-to-face consultations and communications in primary care: the role and perspective of general practice managers in Scotland.

PubMed

Hanna, Lisa; May, Carl; Fairhurst, Karen

2011-01-01

Practice managers play an important role in the organisation and delivery of primary care, including uptake and implementation of technologies. Little is currently known about practice managers' attitudes to the use of information and communication technologies, such as email or text messaging, to communicate or consult with patients. To investigate practice managers' attitudes to non-face-to-face consultation/communication technologies in the routine delivery of primary care and their role in the introduction and normalisation of these technologies. We carried out a mixed-methods study in Scotland, UK. We invited all practice managers in Scotland to take part in a postal questionnaire survey. A maximum variation sample of 20 survey respondents participated subsequently in in-depth qualitative interviews. Practice managers supported the use of new technologies for routine tasks to manage workload and maximise convenience for patients, but a range of contextual factors such as practice list size, practice deprivation area and geographical location affected whether managers would pursue the introduction of these technologies in the immediate future. The most common objections were medico-legal concerns and lack of perceived patient demand. Practice managers are likely to play a central role in the introduction of new consultation/communication technologies within general practice. They hold varying views on the appropriateness of these technologies, influenced by a complex mix of contextual characteristics. Managers from areas in which the ethos of the practice prioritises personalised care in service delivery are less enthusiastic about the adoption of remote consultation/communication technologies.

Victimisation through bullying and cyberbullying: Emotional intelligence, severity of victimisation and technology use in different types of victims.

PubMed

Beltrán-Catalán, María; Zych, Izabela; Ortega-Ruiz, Rosario; Llorent, Vicente J

2018-05-01

Bullying and cyberbullying are global public health problems. However, very few studies described prevalence, similarities and differences among face-to-face victims, cybervictims and students who are victimised through both bullying and cyberbullying. This study was conducted to describe these different patterns of victimisation and severity of victimisation, emotional intelligence and technology use in different types of victims. A total number of 2,139 secondary school students from 22 schools, randomly selected from all provinces of Andalusia, Spain, participated in this study. Information about bullying, cyberbullying, social networking sites use and perceived emotional intelligence was collected. Face-to-face victimisation only is the most common type of victimisation followed by mixed victimisation. Cybervictimisation only is rare. Mixed victims score higher in severity of bullying and present higher emotional attention than face-to-face victims. Most victims of cyberbullying are also face-to-face victims. Holistic approach that focuses on different problems at the same time seems to be needed to tackle these behaviours.

Perceived Benefits and Drawbacks of Disclosure Practices: An Analysis of PLWHAs' Strategies for Disclosing HIV Status.

PubMed

Catona, Danielle; Greene, Kathryn; Magsamen-Conrad, Kate

2015-01-01

People living with HIV/AIDS must make decisions about how, where, when, what, and to whom to disclose their HIV status. This study explores their perceptions of benefits and drawbacks of various HIV disclosure strategies. The authors interviewed 53 people living with HIV/AIDS from a large AIDS service organization in a northeastern U.S. state and used a combination of deductive and inductive coding to analyze disclosure strategies and advantages and disadvantages of disclosure strategies. Deductive codes consisted of eight strategies subsumed under three broad categories: mode (face-to-face, non-face-to-face, and third-party disclosure), context (setting, bringing a companion, and planning a time), and content (practicing and incremental disclosure). Inductive coding identified benefits and drawbacks for enacting each specific disclosure strategy. The discussion focuses on theoretical explanations for the reasons for and against disclosure strategy enactment and the utility of these findings for practical interventions concerning HIV disclosure practices and decision making.

What is a virtual multidisciplinary team (vMDT)?

PubMed Central

Munro, A J; Swartzman, S

2013-01-01

Background: Multidisciplinary team meetings (MDTs), also known as tumour boards or multidisciplinary case conferences, are an integral component of contemporary cancer care. There are logistical problems with setting up and maintaining participation in these meetings. An ill-defined concept, the virtual MDT (vMDT), has arisen in response to these difficulties. We have, in order to provide clarity and to generate discussion, attempted to define the concept of the vMDT, outline its advantages and disadvantages, and consider some of the practical aspects involved in setting up a virtual MDT. Methods: This is an unstructured review of published evidence and personal experience relating to virtual teams in general, and to MDTs in particular. Results: We have devised a simple taxonomy for MDTs, discussed some of the practicalities involved in setting up a vMDT, and described some of the potential advantages and disadvantages associated with vMDTs. Conclusion: The vMDT may be useful for discussions concerning rare or unusual tumours, or for helping guide the assessment and management of patients with uncommon complications related to treatment. However, the vMDT is a niche concept and is currently unlikely to replace the more traditional face-to-face MDT in the management of common tumours at specific sites. PMID:23756866

Blending Learning: The Evolution of Online and Face-to-Face Education from 2008-2015. Promising Practices in Blended and Online Learning Series

ERIC Educational Resources Information Center

Powell, Allison; Watson, John; Staley, Patrick; Patrick, Susan; Horn, Michael; Fetzer, Leslie; Hibbard, Laura; Oglesby, Jonathan; Verma, Sue

2015-01-01

In 2008, the International Association for K-12 Online Learning (iNACOL) produced a series of papers documenting promising practices identified throughout the field of K-12 online learning. Since then, we have witnessed a tremendous acceleration of transformative policy and practice driving personalized learning in the K-12 education space. State,…

Virtual science instructional strategies: A set of actual practices as perceived by secondary science educators

NASA Astrophysics Data System (ADS)

Gillette, Tammy J.

2009-12-01

The purpose of this proposed research study was to identify actual teaching practices/instructional strategies for online science courses. The identification of these teaching practices/instructional strategies could be used to compile a set of teaching practices/instructional strategies for virtual high school and online academy science instructors. This study could assist online science instructors by determining which teaching practices/instructional strategies were preferred for the online teaching environment. The literature reviewed the role of online and face-to-face instructional strategies, then discussed and elaborated on the science instructional strategies used by teachers, specifically at the secondary level. The current literature did not reflect an integration of these areas of study. Therefore, the connectedness of these two types of instructional strategies and the creation of a set of preferred instructional practices for online science instruction was deemed necessary. For the purpose of this study, the researcher designed a survey for face-to-face and online teachers to identify preferred teaching practices, instructional strategies, and types of technology used when teaching high school science students. The survey also requested demographic data information from the faculty members, including years of experience, subject(s) taught, and whether the teacher taught in a traditional classroom or online, to determine if any of those elements affect differences in faculty perceptions with regard to the questions under investigation. The findings from the current study added to the literature by demonstrating the differences and the similarities that exist between online and face-to-face instruction. Both forms of instruction tend to rely on student-centered approaches to teaching. There were many skills that were similar in that both types of instructors tend to focus on implementing the scientific method. The primary difference is the use of technology tools that were used by online instructors. Online instructors tend to rely on more technological tools such as virtual labs. A list of preferred instructional practices was generated from the qualitative responses to the open-ended questions. Research concerned with this line of inquiry should continue in order to enhance both theory and practice in regard to online instruction.

3D face recognition based on multiple keypoint descriptors and sparse representation.

PubMed

Zhang, Lin; Ding, Zhixuan; Li, Hongyu; Shen, Ying; Lu, Jianwei

2014-01-01

Recent years have witnessed a growing interest in developing methods for 3D face recognition. However, 3D scans often suffer from the problems of missing parts, large facial expressions, and occlusions. To be useful in real-world applications, a 3D face recognition approach should be able to handle these challenges. In this paper, we propose a novel general approach to deal with the 3D face recognition problem by making use of multiple keypoint descriptors (MKD) and the sparse representation-based classification (SRC). We call the proposed method 3DMKDSRC for short. Specifically, with 3DMKDSRC, each 3D face scan is represented as a set of descriptor vectors extracted from keypoints by meshSIFT. Descriptor vectors of gallery samples form the gallery dictionary. Given a probe 3D face scan, its descriptors are extracted at first and then its identity can be determined by using a multitask SRC. The proposed 3DMKDSRC approach does not require the pre-alignment between two face scans and is quite robust to the problems of missing data, occlusions and expressions. Its superiority over the other leading 3D face recognition schemes has been corroborated by extensive experiments conducted on three benchmark databases, Bosphorus, GavabDB, and FRGC2.0. The Matlab source code for 3DMKDSRC and the related evaluation results are publicly available at http://sse.tongji.edu.cn/linzhang/3dmkdsrcface/3dmkdsrc.htm.

Student Experiences of Problem-Based Learning in Pharmacy: Conceptions of Learning, Approaches to Learning and the Integration of Face-to-Face and On-Line Activities

ERIC Educational Resources Information Center

Ellis, Robert A.; Goodyear, Peter; Brillant, Martha; Prosser, Michael

2008-01-01

This study investigates fourth-year pharmacy students' experiences of problem-based learning (PBL). It adopts a phenomenographic approach to the evaluation of problem-based learning, to shed light on the ways in which different groups of students conceive of, and approach, PBL. The study focuses on the way students approach solving problem…

Integrated Maintenance Information System (IMIS): A Maintenance Information Delivery Concept.

DTIC Science & Technology

1987-11-01

InterFace Figure 2. Portable Maintenance Computer Concept. provide advice for difficult fault-isolation problems . The technician will be able to accomplish...faced with an ever-growing number of paper-based technical orders (TOs). This has greatly increased costs and distribution problems . In addition, it has...compounded problems associ- ated with ensuring accurate data and the lengthy correction times involved. To improve the accuracy of technical data and

Problems faced and coping strategies used by adolescents with mentally ill parents in Delhi.

PubMed

George, Shoba; Shaiju, Bindu; Sharma, Veena

2012-01-01

The present study was conducted to assess the problems faced by adolescents whose parents suffer from major mental illness at selected mental health institutes of Delhi. The objectives also included assessment of the coping strategies of the adolescents in dealing with these problems. The Stuart Stress Adaptation Model of Psychiatric Nursing Care was used as the conceptual framework. A descriptive survey approach with cross-sectional design was used in the study. A structured interview schedule was prepared. Purposive non-probability sampling technique was employed to interview 50 adolescents whose parents suffer from major mental illness. Data gathered was analysed and interpreted using both descriptive and inferential statistics. The study showed that majority of the adolescents had moderate problems as a result of their parent's mental illness. Area-wise analysis of the problems revealed that the highest problems faced were in family relationship and support and majority of the adolescents used maladaptive coping strategies. A set of guidelines on effective coping strategies was disseminated to these adolescents.

Exact solution for a two-phase Stefan problem with variable latent heat and a convective boundary condition at the fixed face

NASA Astrophysics Data System (ADS)

Bollati, Julieta; Tarzia, Domingo A.

2018-04-01

Recently, in Tarzia (Thermal Sci 21A:1-11, 2017) for the classical two-phase Lamé-Clapeyron-Stefan problem an equivalence between the temperature and convective boundary conditions at the fixed face under a certain restriction was obtained. Motivated by this article we study the two-phase Stefan problem for a semi-infinite material with a latent heat defined as a power function of the position and a convective boundary condition at the fixed face. An exact solution is constructed using Kummer functions in case that an inequality for the convective transfer coefficient is satisfied generalizing recent works for the corresponding one-phase free boundary problem. We also consider the limit to our problem when that coefficient goes to infinity obtaining a new free boundary problem, which has been recently studied in Zhou et al. (J Eng Math 2017. https://doi.org/10.1007/s10665-017-9921-y).

The Familial Road to Healthy Societies: New and Converging Modes of Re-Development.

ERIC Educational Resources Information Center

Dyson, William A.

This discussion focuses on problems facing developing and developed nations and describes social changes required to meet human needs in the economic condition of scarcity facing industrializing and postindustrial societies. Current problems of developed societies are emphasized. For example, traditional health care provision in western societies…

Developing Effective In-School-Suspension Programs.

ERIC Educational Resources Information Center

Vanderslice, Ronna

Discipline--the most serious problem faced by teachers today--has consistently appeared at or near the top of the public's attitudes toward the public schools. This paper discusses the difficulty of discipline and one of the most perplexing problems facing administrators today--the use of suspension as a discipline alternative. Out-of-school…

Facing Life, English: 5113.30.

ERIC Educational Resources Information Center

Singleton, Clifford G.; Rice, M. Paul

The outline of a course in the investigation of literature (both fiction and nonfiction) which concerns youth facing and overcoming problems of life, with stress upon the novel and biography, is presented. The student is expected, through reading selected literary works, to (1) examine the problems confronted by youth, (2) examine youth's needs…

Analysis of Five Instructional Methods for Teaching Sketchpad to Junior High Students

ERIC Educational Resources Information Center

Wright, Geoffrey; Shumway, Steve; Terry, Ronald; Bartholomew, Scott

2012-01-01

This manuscript addresses a problem teachers of computer software applications face today: What is an effective method for teaching new computer software? Technology and engineering teachers, specifically those with communications and other related courses that involve computer software applications, face this problem when teaching computer…

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

Flintoff, F.

With the advent of industrialisation and urbanisation, developing countries are faced with numerous problems, one of the biggest being the provision of an effective solid wastes system appropriate to their varying climates and economies. The problems facing third world countries are discussed, these include the lack of a network of district depots, inadequate automotive servicing facilities and technical expertise.

People Considerations in Word Processing.

ERIC Educational Resources Information Center

Diamond, Marion L.

1984-01-01

Business educators preparing students for jobs in business and industry should become aware of the problems faced by workers in a typical large office environment. Word processor operators face many of the same problems as factory assembly line workers--lack of personalization, lack of incentive, and removal from the mainstream. (JOW)

The Big Picture and Specifics of College General Education

ERIC Educational Resources Information Center

Gan, Yang

2018-01-01

In recent years, general education has developed considerably in Chinese universities, but it still faces many challenges and problems. Among the various negative factors, four problems may be the greatest challenges currently faced by Chinese university general education and ordinary undergraduate education: (1) In the era of massified higher…

An Official American Thoracic Society Research Statement: Current Challenges Facing Research and Therapeutic Advances in Airway Remodeling.

PubMed

Prakash, Y S; Halayko, Andrew J; Gosens, Reinoud; Panettieri, Reynold A; Camoretti-Mercado, Blanca; Penn, Raymond B

2017-01-15

Airway remodeling (AR) is a prominent feature of asthma and other obstructive lung diseases that is minimally affected by current treatments. The goals of this Official American Thoracic Society (ATS) Research Statement are to discuss the scientific, technological, economic, and regulatory issues that deter progress of AR research and development of therapeutics targeting AR and to propose approaches and solutions to these specific problems. This Statement is not intended to provide clinical practice recommendations on any disease in which AR is observed and/or plays a role. An international multidisciplinary group from within academia, industry, and the National Institutes of Health, with expertise in multimodal approaches to the study of airway structure and function, pulmonary research and clinical practice in obstructive lung disease, and drug discovery platforms was invited to participate in one internet-based and one face-to-face meeting to address the above-stated goals. Although the majority of the analysis related to AR was in asthma, AR in other diseases was also discussed and considered in the recommendations. A literature search of PubMed was performed to support conclusions. The search was not a systematic review of the evidence. Multiple conceptual, logistical, economic, and regulatory deterrents were identified that limit the performance of AR research and impede accelerated, intensive development of AR-focused therapeutics. Complementary solutions that leverage expertise of academia and industry were proposed to address them. To date, numerous factors related to the intrinsic difficulty in performing AR research, and economic forces that are disincentives for the pursuit of AR treatments, have thwarted the ability to understand AR pathology and mechanisms and to address it clinically. This ATS Research Statement identifies potential solutions for each of these factors and emphasizes the importance of educating the global research community as to the extent of the problem as a critical first step in developing effective strategies for: (1) increasing the extent and impact of AR research and (2) developing, testing, and ultimately improving drugs targeting AR.

An investigation of the effects of interventions on problem-solving strategies and abilities

NASA Astrophysics Data System (ADS)

Cox, Charles Terrence, Jr.

Problem-solving has been described as being the "heart" of the chemistry classroom, and students' development of problem-solving skills is essential for their success in chemistry. Despite the importance of problem-solving, there has been little research within the chemistry domain, largely because of the lack of tools to collect data for large populations. Problem-solving was assessed using a software package known as IMMEX (for Interactive Multimedia Exercises) which has an HTML tracking feature that allows for collection of problem-solving data in the background as students work the problems. The primary goal of this research was to develop methods (known as interventions) that could promote improvements in students' problem-solving and most notably aid in their transition from the novice to competent level. Three intervention techniques that were incorporated within the chemistry curricula: collaborative grouping (face-to-face and distance), concept mapping, and peer-led team learning. The face-to-face collaborative grouping intervention was designed to probe the factors affecting the quality of the group interaction. Students' logical reasoning abilities were measured using the Group Assessment of Logical Thinking (GALT) test which classifies students as formal, transitional, or concrete. These classifications essentially provide a basis for identifying scientific aptitude. These designations were used as the basis for forming collaborative groups of two students. The six possibilities (formal-formal, formal-transitional, etc.) were formed to determine how the group composition influences the gains in student abilities observed from collaborative grouping interventions. Students were given three assignments (an individual pre-collaborative, an individual post collaborative, and a collaborative assignment) each requiring them to work an IMMEX problem set. Similar gains in performance of 10% gains were observed for each group with two exceptions. The transitional students who were paired with concrete students had a 15% gain, and the concrete students paired with other concrete students had only a marginal gain. In fact, there was no statistical difference in the pre-collaborative and post-collaborative student abilities for concrete-concrete groups. The distance collaborative intervention was completed using a new interface for the IMMEX software designed to mimic face-to-face collaboration. A stereochemistry problem set which had a solved rate of 28% prior to collaboration was chosen for incorporation into this distance collaboration study. (Abstract shortened by UMI.)

Face-to-Face versus Distance Learning: Psychological Consequences and Practical Implications.

ERIC Educational Resources Information Center

Kahl, Thomas N.; Cropley, Arthur J.

1986-01-01

Summarizes differences between face-to-face and distance learners at Fernuniversitat (West Germany) in terms of demographics, motivation, study conditions, and personal consequences, in order to provide some empirically derived insights into the psychological consequences of distance learning for learners. (MBR)

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

PubMed

Edwards, Ian; Richardson, Barbara

2008-01-01

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

Identification of good practices for teachers and students training activity in the ENVRIPLUS project

NASA Astrophysics Data System (ADS)

D'Addezio, Giuliana; Marsili, Antonella; Beranzoli, Laura

2016-04-01

We elaborated basic guiding principles that will be used to improve the content of the ENVRIPLUS e-Training Platform for multimedia education of Secondary School level teachers and students. The purpose is to favour teacher training and consequently students training on selected scientific themes faced within the ENVRIPLUS Research Infrastructures. "Best practices" could positively impacts on students by providing motivation on promoting scientific research and to increase the awareness of the Earth System complexity and Environmental challenges for its preservation and sustainability. Best practice teaching strategies represent an inherent part of a curriculum that exemplifies the connection and relevance identified in education research. The actions are designed to develop thinking and problem-solving skill through integration and active learning. Relationships are built though opportunities for communication and teamwork. Best practices motivate, engage and prompt student to learn and achieve. A starting list of principles is discussed in respect of the following main Best Practices pillars: • Identify the conceptual framework of the subject of the dissemination • Increase personal awareness of the individual potential • Easy personal elaboration and the connection of the subject with the school curriculum.

A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients

PubMed Central

Sellors, John; Kaczorowski, Janusz; Sellors, Connie; Dolovich, Lisa; Woodward, Christel; Willan, Andrew; Goeree, Ron; Cosby, Roxanne; Trim, Kristina; Sebaldt, Rolf; Howard, Michelle; Hardcastle, Linda; Poston, Jeff

2003-01-01

Background Pharmacists can improve patient outcomes in institutional and pharmacy settings, but little is known about their effectiveness as consultants to primary care physicians. We examined whether an intervention by a specially trained pharmacist could reduce the number of daily medication units taken by elderly patients, as well as costs and health care use. Methods We conducted a randomized controlled trial in family practices in 24 sites in Ontario. We randomly allocated 48 randomly selected family physicians (69.6% participation rate) to the intervention or the control arm, along with 889 (69.5% participation rate) of their randomly selected community-dwelling, elderly patients who were taking 5 or more medications daily. In the intervention group, pharmacists conducted face-to-face medication reviews with the patients and then gave written recommendations to the physicians to resolve any drug-related problems. Process outcomes included the number of drug-related problems identified among the senior citizens in the intervention arm and the proportion of recommendations implemented by the physicians. Results After 5 months, seniors in the intervention and control groups were taking a mean of 12.4 and 12.2 medication units per day respectively (p = 0.50). There were no statistically significant differences in health care use or costs between groups. A mean of 2.5 drug-related problems per senior was identified in the intervention arm. Physicians implemented or attempted to implement 72.3% (790/1093) of the recommendations. Interpretation The intervention did not have a significant effect on patient outcomes. However, physicians were receptive to the recommendations to resolve drug-related problems, suggesting that collaboration between physicians and pharmacists is feasible. PMID:12847034

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

PubMed

Koehler, Nicole; McMenamin, Christine

2016-07-01

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

Blending Our Practice: Using Online and Face-to-Face Methods to Sustain Community among Faculty in an Extended Length Professional Development Program

ERIC Educational Resources Information Center

Paskevicius, Michael; Bortolin, Kathleen

2016-01-01

This paper outlines the design and implementation of a nine-month faculty development programme delivered using a combination of face-to-face and online methods. Participants from a range of disciplines met at regular intervals throughout the year. Between the face-to-face meetings, participants engaged in online activities such as discussions,…

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

PubMed Central

Ma, Yina; Han, Shihui

2012-01-01

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

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

PubMed

Ma, Yina; Han, Shihui

2012-01-01

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

Council tax valuation band of patient residence and clinical contacts in a general practice

PubMed Central

Beale, Norman; Taylor, Gordon; Straker-Cook, Dawn; Peart, Carole; Gwynne, Mark

2005-01-01

Background There is a dearth of data relating UK general practice workload to personal and social markers of individual patients. Aim To test whether there is a significant association between general practice patient contact rates and the council tax valuation band of their residential address. Design of study Cross-sectional analyses using data recorded, over 1 year, for over 3300 general practice patients. Setting One medium-sized group practice in an industrialised English market town. Method Face-to-face contacts between the patients and the doctors and nurses in the practice were compared by patient age, sex, registration period, distance from surgery, Underprivileged Area 8 (UPA8) score, and council tax valuation band. Results Patient sex, age, recent registration, distance from surgery, and council tax valuation band were each significantly associated with face-to-face contact rate in univariate analyses. UPA8 score was not significantly associated with contact rates. On multivariate testing, sex, age, recent registration, and council tax valuation band remained significantly associated with contact rates. The last is a new finding. Conclusion Council tax valuation bands predict contact rate in general practice; the lower the band, the higher the contact rate. Council tax valuation band could be a useful marker of workload that is linked to socioeconomic status. This is a pilot study and multipractice research is advocated. PMID:15667763

Practical Applications and Experiences in K-20 Blended Learning Environments

ERIC Educational Resources Information Center

Kyei-Blankson, Lydia, Ed.; Ntuli, Esther, Ed.

2014-01-01

Learning environments continue to change considerably and is no longer confined to the face-to-face classroom setting. As learning options have evolved, educators must adopt a variety of pedagogical strategies and innovative technologies to enable learning. "Practical Applications and Experiences in K-20 Blended Learning Environments"…

Tools to overcome potential barriers to chlamydia screening in general practice: Qualitative evaluation of the implementation of a complex intervention.

PubMed

Ricketts, Ellie J; Francischetto, Elaine O'Connell; Wallace, Louise M; Hogan, Angela; McNulty, Cliodna A M

2016-03-22

Chlamydia trachomatis remains a significant public health problem. We used a complex intervention, with general practice staff, consisting of practice based workshops, posters, computer prompts and testing feedback and feedback to increase routine chlamydia screening tests in under 25 year olds in South West England. We aimed to evaluate how intervention components were received by staff and to understand what determined their implementation into ongoing practice. We used face-to-face and telephone individual interviews with 29 general practice staff analysed thematically within a Normalisation Process Theory Framework which explores: 1. Coherence (if participants understand the purpose of the intervention); 2. Cognitive participation (engagement with and implementation of the intervention); 3. Collective action (work actually undertaken that drives the intervention forwards); 4. Reflexive monitoring (assessment of the impact of the intervention). Our results showed coherence as all staff including receptionists understood the purpose of the training was to make them aware of the value of chlamydia screening tests and how to increase this in their general practice. The training was described by nearly all staff as being of high quality and responsible for creating a shared understanding between staff of how to undertake routine chlamydia screening. Cognitive participation in many general practice staff teams was demonstrated through their engagement by meeting after the training to discuss implementation, which confirmed the role of each staff member and the use of materials. However several participants still felt unable to discuss chlamydia in many consultations or described sexual health as low priority among colleagues. National targets were considered so high for some general practice staff that they didn't engage with the screening intervention. Collective action work undertaken to drive the intervention included use of computer prompts which helped staff remember to make the offer, testing rate feedback and having a designated lead. Ensuring patients collected samples when still in the general practice was not attained in most general practices. Reflexive monitoring showed positive feedback from patients and other staff about the value of screening, and feedback about the general practices testing rates helped sustain activity. A complex intervention including interactive workshops, materials to help implementation and feedback can help chlamydia screening testing increase in general practices.

When Health Systems Are Barriers to Health Care: Challenges Faced by Uninsured Mexican Kidney Patients

PubMed Central

Kierans, Ciara; Padilla-Altamira, Cesar; Garcia-Garcia, Guillermo; Ibarra-Hernandez, Margarita; Mercado, Francisco J.

2013-01-01

Background Chronic Kidney Disease disproportionately affects the poor in Low and Middle Income Countries (LMICs). Mexico exemplifies the difficulties faced in supporting Renal Replacement Therapy (RRT) and providing equitable patient care, despite recent attempts at health reform. The objective of this study is to document the challenges faced by uninsured, poor Mexican families when attempting to access RRT. Methods The article takes an ethnographic approach, using interviewing and observation to generate detailed accounts of the problems that accompany attempts to secure care. The study, based in the state of Jalisco, comprised interviews with patients, their caregivers, health and social care professionals, among others. Observations were carried out in both clinical and social settings. Results In the absence of organised health information and stable pathways to renal care, patients and their families work extraordinarily hard and at great expense to secure care in a mixed public-private healthcare system. As part of this work, they must navigate challenging health and social care environments, negotiate treatments and costs, resource and finance healthcare and manage a wide range of formal and informal health information. Conclusions Examining commonalities across pathways to adequate healthcare reveals major failings in the Mexican system. These systemic problems serve to reproduce and deepen health inequalities. A system, in which the costs of renal care are disproportionately borne by those who can least afford them, faces major difficulties around the sustainability and resourcing of RRTs. Attempts to increase access to renal therapies, therefore, need to take into account the complex social and economic demands this places on those who need access most. This paper further shows that ethnographic studies of the concrete ways in which healthcare is accessed in practice provide important insights into the plight of CKD patients and so constitute an important source of evidence in that effort. PMID:23349868

A Robust Shape Reconstruction Method for Facial Feature Point Detection.

PubMed

Tan, Shuqiu; Chen, Dongyi; Guo, Chenggang; Huang, Zhiqi

2017-01-01

Facial feature point detection has been receiving great research advances in recent years. Numerous methods have been developed and applied in practical face analysis systems. However, it is still a quite challenging task because of the large variability in expression and gestures and the existence of occlusions in real-world photo shoot. In this paper, we present a robust sparse reconstruction method for the face alignment problems. Instead of a direct regression between the feature space and the shape space, the concept of shape increment reconstruction is introduced. Moreover, a set of coupled overcomplete dictionaries termed the shape increment dictionary and the local appearance dictionary are learned in a regressive manner to select robust features and fit shape increments. Additionally, to make the learned model more generalized, we select the best matched parameter set through extensive validation tests. Experimental results on three public datasets demonstrate that the proposed method achieves a better robustness over the state-of-the-art methods.

Health Information Technology Knowledge and Skills Needed by HIT Employers

PubMed Central

Fenton, S.H.; Gongora-Ferraez, M.J.; Joost, E.

2012-01-01

Objective To evaluate the health information technology (HIT) workforce knowledge and skills needed by HIT employers. Methods Statewide face-to-face and online focus groups of identified HIT employer groups in Austin, Brownsville, College Station, Dallas, El Paso, Houston, Lubbock, San Antonio, and webinars for rural health and nursing informatics. Results HIT employers reported needing an HIT workforce with diverse knowledge and skills ranging from basic to advanced, while covering information technology, privacy and security, clinical practice, needs assessment, contract negotiation, and many other areas. Consistent themes were that employees needed to be able to learn on the job and must possess the ability to think critically and problem solve. Many employers wanted persons with technical skills, yet also the knowledge and understanding of healthcare operations. Conclusion The HIT employer focus groups provided valuable insight into employee skills needed in this fast-growing field. Additionally, this information will be utilized to develop a statewide HIT workforce needs assessment survey. PMID:23646090

Ethical challenges in pain management post-surgery.

PubMed

Rejeh, Nahid; Ahmadi, Fazlollah; Mohamadi, Eesa; Anoosheh, Moniereh; Kazemnejad, Anooshirvan

2009-03-01

This qualitative study describes ethical challenges faced by Iranian nurses in the process of pain management in surgical units. To address this issue, semistructured interviews were conducted with 26 nurses working in surgery units in three large university hospitals in Tehran. An analysis of the transcripts revealed three main categories: institutional limitations; nurses' proximity to and involvement with pain and suffering; and nurses' fallibility. Specific themes identified within the categories were: insufficient resources, medical hierarchy; difficulties with believing patients' complaints regarding pain and suffering; and experiencing the consequences of poor judgments. Our findings lead us to conclude that, as nurses are much closer to patients' pain and suffering than other health professionals, being aware of their ethical problems, and being able to reflect on them and discuss and learn from them, will reduce the burden of the ethical challenges faced. The findings will help nurses in other countries to devise suitable ways to reduce the ethical burdens they bear in their daily practice.

Family medicine practice performance and knowledge management.

PubMed

Orzano, A John; McInerney, Claire R; Tallia, Alfred F; Scharf, Davida; Crabtree, Benjamin F

2008-01-01

Knowledge management (KM) is the process by which people in organizations find, share, and develop knowledge for action. KM affects performance by influencing work relationships to enhance learning and decision making. To identify how family medicine practices exhibit KM. A model and a template of KM concepts were derived from a comprehensive organizational literature review. Two higher and two lower performing family medicine practices were purposefully selected from existing comparative case studies based on prevention delivery rates and innovation. Interviews, fieldnotes of operations, and clinical encounters were coded independently using the template. Face-to-face discussions resolved coding differences. All practices had processes and tools for finding, sharing, and developing knowledge; however, KM overall was limited despite implementation of expensive technologies like an electronic medical record. Where present, KM processes and tools were used by individuals but not integrated throughout the organization. Loss of information was prominent, and finding knowledge was underdeveloped. The use of technical tools and developing knowledge by reconfiguration and measurement were particularly limited. Socially related tools, such as face-to-face-communication for sharing and developing knowledge, were more developed. As in other organizations, tool use was tailored for specific outcomes and leveraged by other organizational capacities. Differences in KM occur within family practices and between family practices and other organizations and may have implications for improving practice performance. Understanding interaction patterns of work relationships and KM may explain why costly technical or externally imposed "one size fits all" practice organizational interventions have had mixed results and limited sustainability.

The inadvertent breach of confidentiality.

PubMed

Erlen, J A

1998-01-01

Patients believe that personal information that they share with their health care providers will be kept strictly confidential. Safeguarding a confidence has been and continues to be an expected professional behavior. Yet, a common ethical problem that nurses face in their everyday practice is the inadvertent disclosure of private information about particular patients to individuals who have no need for this information. This article discusses the inadvertent breach of confidentiality and its related ethical concepts: privacy, respect for persons, trust and fidelity, and the potential for harm or injury. Recommendations are provided to enable nurses to avoid and manage situations that involve an inadvertent breach of confidentiality.

On Study of Teaching Reform of Organic Chemistry Course in Applied Chemical Industry Technology

NASA Astrophysics Data System (ADS)

Zhang, Yunshen

2017-11-01

with the implementation of new curriculum reform, the education sees great changes in teaching methods. Teaching reform is profound in organic chemistry course in applied chemical industry technology. However, many problems which have never been noticed before occur when reform programs are implemented which harm students’ ability for learning and enthusiasm in side face. This paper proposes reform measures like combining theory and practice, improving professional quality, supplementing professional needs and integrating teaching into life after analyzing organic chemistry course teaching in applied chemical industry technology currently, hoping to play a role of reference for organic chemistry course teaching reform in applied chemical industry technology.

The user's view of commercially available medical technology

NASA Technical Reports Server (NTRS)

Harrison, D. C.

1975-01-01

The potential user of new medical equipment for imaging the cardiovascular system is often faced with the problem of deciding whether or not to accept a new piece of equipment or a new technological concept into the practice of cardiology. Considerations for acquiring new medical technology are discussed in some detail. Acquisition of new technology should depend on whether the equipment provides more and relevant clinical data, is for research or for limited use, is properly engineered for patient use, presents information in easily storable and retrievable form, is tested and validated clinically, is fabricated by a reliable manufacturer, is cost effective, and may be readily replaced by a new technology.

Affirmative action and the allocation of health care.

PubMed

Francis, L P

1999-09-01

The justifications of affirmative action, the compensatory, corrective and redistributive, have been widely recognized in legal thinking. They have been applied, principally, to employment practices. They can also be applied to health care. Arguments for affirmative action in health care allocation shift the burden of proof to those who deny that racism is the root cause of differential morbidity and mortality experienced by, for example, African Americans. At the very least, these arguments mandate much needed research into the causes of minorities' poor health. Without such research, racism remains the presumptive cause of, and affirmative action the appropriate remedy for, the health care problems minorities face.

Hunger strike among detainees: guidance for good medical practice.

PubMed

Gétaz, Laurent; Rieder, Jean-Pierre; Nyffenegger, Laurent; Eytan, Ariel; Gaspoz, Jean-Michel; Wolff, Hans

2012-09-17

Hunger strike is a regularly reported problem in prison. Although clinical situations are rarely severe, hospitalisation is often considered. In consequence, it is not only physicians working in prisons, but also hospital medical teams who face challenges related to hunger strike, involving somatic, psychological, legal and human rights aspects. Furthermore, deontological rules must be strictly respected when delivering care, particularly in prison setting. Starvation involves metabolic changes and can cause severe, and sometimes even irreversible or fatal complications. Moreover, the phase of re-alimentation should not be trivialised, as re-feeding syndrome is a potentially fatal phenomenon. This article provides guidance for monitoring and management of patients on hunger strike.

Mission feasibility study of a very long baseline interferometer utilizing the space shuttle

NASA Technical Reports Server (NTRS)

Burke, B. F.

1978-01-01

An introductory overview of very long baseline interferometry (VLBI) as it exists and is used today is given and the scientific advances that have been achieved with this technique in the past decade are described. The report briefly reviews developments now in progress that will improve ground station VLBI in the next few years, and the limitations that still will exist. The advantages and the scientific return on investment that may be expected from a VLBI terminal in space are described. Practical problems that have to be faced range from system design through hardware implementation, to data recovery and analysis.