Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework.

PubMed

French, Simon D; Green, Sally E; O'Connor, Denise A; McKenzie, Joanne E; Francis, Jill J; Michie, Susan; Buchbinder, Rachelle; Schattner, Peter; Spike, Neil; Grimshaw, Jeremy M

2012-04-24

There is little systematic operational guidance about how best to develop complex interventions to reduce the gap between practice and evidence. This article is one in a Series of articles documenting the development and use of the Theoretical Domains Framework (TDF) to advance the science of implementation research. The intervention was developed considering three main components: theory, evidence, and practical issues. We used a four-step approach, consisting of guiding questions, to direct the choice of the most appropriate components of an implementation intervention: Who needs to do what, differently? Using a theoretical framework, which barriers and enablers need to be addressed? Which intervention components (behaviour change techniques and mode(s) of delivery) could overcome the modifiable barriers and enhance the enablers? And how can behaviour change be measured and understood? A complex implementation intervention was designed that aimed to improve acute low back pain management in primary care. We used the TDF to identify the barriers and enablers to the uptake of evidence into practice and to guide the choice of intervention components. These components were then combined into a cohesive intervention. The intervention was delivered via two facilitated interactive small group workshops. We also produced a DVD to distribute to all participants in the intervention group. We chose outcome measures in order to assess the mediating mechanisms of behaviour change. We have illustrated a four-step systematic method for developing an intervention designed to change clinical practice based on a theoretical framework. The method of development provides a systematic framework that could be used by others developing complex implementation interventions. While this framework should be iteratively adjusted and refined to suit other contexts and settings, we believe that the four-step process should be maintained as the primary framework to guide researchers through a comprehensive intervention development process.

Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework

PubMed Central

2012-01-01

Background There is little systematic operational guidance about how best to develop complex interventions to reduce the gap between practice and evidence. This article is one in a Series of articles documenting the development and use of the Theoretical Domains Framework (TDF) to advance the science of implementation research. Methods The intervention was developed considering three main components: theory, evidence, and practical issues. We used a four-step approach, consisting of guiding questions, to direct the choice of the most appropriate components of an implementation intervention: Who needs to do what, differently? Using a theoretical framework, which barriers and enablers need to be addressed? Which intervention components (behaviour change techniques and mode(s) of delivery) could overcome the modifiable barriers and enhance the enablers? And how can behaviour change be measured and understood? Results A complex implementation intervention was designed that aimed to improve acute low back pain management in primary care. We used the TDF to identify the barriers and enablers to the uptake of evidence into practice and to guide the choice of intervention components. These components were then combined into a cohesive intervention. The intervention was delivered via two facilitated interactive small group workshops. We also produced a DVD to distribute to all participants in the intervention group. We chose outcome measures in order to assess the mediating mechanisms of behaviour change. Conclusions We have illustrated a four-step systematic method for developing an intervention designed to change clinical practice based on a theoretical framework. The method of development provides a systematic framework that could be used by others developing complex implementation interventions. While this framework should be iteratively adjusted and refined to suit other contexts and settings, we believe that the four-step process should be maintained as the primary framework to guide researchers through a comprehensive intervention development process. PMID:22531013

Developing a framework to guide the de-adoption of low-value clinical practices in acute care medicine: a study protocol.

PubMed

Parsons Leigh, Jeanna; Niven, Daniel J; Boyd, Jamie M; Stelfox, Henry T

2017-01-19

Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-value clinical practices (i.e. de-adoption). This study will develop a comprehensive list of barriers and facilitators to the de-adoption of low-value clinical practices in acute care facilities to inform the development of a framework to guide the de-adoption process. The proposed project is a multi-stage mixed methods study to develop a framework to guide the de-adoption of low-value clinical practices in acute care medicine that will be tested in a representative sample of acute care settings in Alberta, Canada. Specifically, we will: 1) conduct a systematic review of the de-adoption literature to identify published barriers and facilitators to the de-adoption of low-value clinical practices in acute care medicine and any associated interventions proposed (Phase one); 2) conduct focus groups with acute care stakeholders to identify important themes not published in the literature and obtain a comprehensive appreciation of stakeholder perspectives (Phase two); 3) extend the generalizability of focus group findings by conducting individual stakeholder surveys with a representative sample of acute care providers throughout the province to determine which barriers and facilitators identified in Phases one and two are most relevant in their clinical setting (Phase three). Identified barriers and facilitators will be catalogued and integrated with targeted interventions in a framework to guide the process of de-adoption in each of four targeted areas of acute care medicine (Emergency Medicine, Cardiovascular Health and Stroke, Surgery and Critical Care Medicine). Analyses will be descriptive using a combination of qualitative and quantitative analyses. There is a growing body of literature suggesting that the de-adoption of ineffective or harmful practices from patient care is integral to the delivery of high quality care and healthcare sustainability. The framework developed in this study will map barriers and facilitators to de-adoption to the most appropriate interventions, allowing stakeholders to effectively initiate, execute and sustain this process in an evidence-based manner.

Research as Profession and Practice: Frameworks for Guiding the Responsible Conduct of Research.

PubMed

Chen, Jiin-Yu

2016-01-01

Programs in the responsible conduct of research (RCR) vary between institutions, demonstrated by disparate structures and goals. These variations may be attributed to the absence of grounding frameworks within which to examine research and RCR education programs. This article examines research as a practice and a profession, using these frames to draw out defining features of research and the moral obligations entailed. Situating research within virtue ethics can clarify how researchers might cultivate the virtues necessary for meeting its obligations and aims. By elucidating these features, these perspectives can serve to guide the development of RCR education programs.

Solar Access to Public Capital (SAPC) Working Group: Best Practices in Commercial and Industrial (C&I) Solar Photovoltaic System Installation; Period of Performance: November 28, 2014-September 1, 2015

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

Doyle, Chris; Loomans, Len; Truitt, Andrew

2015-12-29

This Best Practices in Commercial and Industrial Solar Photovoltaic System Installation Guide is the second of a series of guides designed to standardize and improve solar asset transparency for investors and rating agencies, provide an industry framework for quality management, and reduce transaction costs in the solar asset securitization process. The Best Practices in C&I PV System Installation Guide is intended to outline the minimum requirements for commercial and industrial solar project developments. Adherence to the guide is voluntary. Providers that adhere to the guide are responsible for self-certifying that they have fulfilled the guide requirements. Investors and rating agenciesmore » should verify compliance.« less

Designing a Clinical Framework to Guide Gross Motor Intervention Decisions for Infants and Young Children with Hypotonia

ERIC Educational Resources Information Center

Darrah, Johanna; O'Donnell, Maureen; Lam, Joyce; Story, Maureen; Wickenheiser, Diane; Xu, Kaishou; Jin, Xiaokun

2013-01-01

Clinical practice frameworks are a valuable component of clinical education, promoting informed clinical decision making based on the best available evidence and/or clinical experience. They encourage standardized intervention approaches and evaluation of practice. Based on an international project to support the development of an enhanced service…

The Socio-Materiality of Learning Practices and Implications for the Field of Learning Technology

ERIC Educational Resources Information Center

Johri, Aditya

2011-01-01

Although the use of digital information technologies in education has become commonplace, there are few, if any, central guiding frameworks or theories that explicate the relationship between technology and learning practices. In this paper, I argue that such a theoretical framework can assist scholars and practitioners alike by working as a…

The Reading Turn-Around: A Five Part Framework for Differentiated Instruction. Practitioners Bookshelf, Language & Literacy Series

ERIC Educational Resources Information Center

Jones, Stephanie; Clarke, Lane; Enriquez, Grace

2009-01-01

This book demonstrates a five-part framework for teachers, reading specialists, and literacy coaches who want to help their least engaged students become powerful readers. Merging theory and practice, the guide offers successful strategies to reach your "struggling" learners. The authors show how you can "turn-around" your instructional practice,…

MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

PubMed

Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

2017-07-01

The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

Key Issues in the Practice of Youth Development

ERIC Educational Resources Information Center

Silliman, Benjamin

2004-01-01

Three significant trends in youth development practice are discussed: movement toward consensus in models guiding practice, movement toward science-based practice, and increasing resources available to practitioners. Consensus on an ecological framework for risk reduction and competence building among advocates for prevention, resilience, and…

Early Years Education Resource Guide. Early Education Support Series.

ERIC Educational Resources Information Center

Dunlop, Aline-Wendy, Comp.

The aim of this resource guide is to provide practitioners in preschool settings with information to help them plan, implement, augment with resources, and review practice based on the "Curriculum Framework for Children in Their Pre-School Year" issued by the Scottish Office Education and Industry Department. The guide presents a…

Principles for ecologically based invasive plant management

USDA-ARS?s Scientific Manuscript database

Land managers long have identified a critical need for a practical and effective framework to guide the implementation of successful restoration, especially where invasive plants dominate the ecosystem. A holistic, ecologically-based invasive plant management (EBIPM) framework that integrates ecosy...

Writing for Publication: A Guide for Counseling Practice Articles

ERIC Educational Resources Information Center

Falco, Lia D.; McCarthy, Christopher J.

2013-01-01

Practice articles are critical to scholarship in the counseling field. This article provides readers with practical guidelines for the content and organization of practice articles, with the broad objective of developing a framework for presenting such contributions that may be consistently utilized within the counseling literature. A consistent…

A Framework for Analysis of Case Studies of Reading Lessons

ERIC Educational Resources Information Center

Carlisle, Joanne F.; Kelcey, Ben; Rosaen, Cheryl; Phelps, Geoffrey; Vereb, Anita

2013-01-01

This paper focuses on the development and study of a framework to provide direction and guidance for practicing teachers in using a web-based case studies program for professional development in early reading; the program is called Case Studies Reading Lessons (CSRL). The framework directs and guides teachers' analysis of reading instruction by…

Has Technology Been Considered? A Guide for IEP Teams. CASE/TAM Assistive Technology Policy and Practice Series.

ERIC Educational Resources Information Center

Chambers, A. C.

This guide compiles information essential to a working knowledge of assistive technology for children with disabilities. It addresses the definition of assistive technology and provides information on laws which direct the provision of assistive technology. The manual provides a framework to guide the Individualized Education Program (IEP) team as…

Fundamental care guided by the Careful Nursing Philosophy and Professional Practice Model©.

PubMed

Meehan, Therese Connell; Timmins, Fiona; Burke, Jacqueline

2018-02-05

To propose the Careful Nursing Philosophy and Professional Practice Model © as a conceptual and practice solution to current fundamental nursing care erosion and deficits. There is growing awareness of the crucial importance of fundamental care. Efforts are underway to heighten nurses' awareness of values that motivate fundamental care and thereby increase their attention to effective provision of fundamental care. However, there remains a need for nursing frameworks which motivate nurses to bring fundamental care values to life in their practice and strengthen their commitment to provide fundamental care. This descriptive position paper builds on the Careful Nursing Philosophy and Professional Practice Model © (Careful Nursing). Careful Nursing elaborates explicit nursing values and addresses both relational and pragmatic aspects of nursing practice, offering an ideal guide to provision of fundamental nursing care. A comparative alignment approach is used to review the capacity of Careful Nursing to address fundamentals of nursing care. Careful Nursing provides a value-based comprehensive and practical framework which can strengthen clinical nurses' ability to articulate and control their practice and, thereby, more effectively fulfil their responsibility to provide fundamental care and measure its effectiveness. This explicitly value-based nursing philosophy and professional practice model offers nurses a comprehensive, pragmatic and engaging framework designed to strengthen their control over their practice and ability to provide high-quality fundamental nursing care. © 2018 John Wiley & Sons Ltd.

Automotive Technology. Career Education Guide.

ERIC Educational Resources Information Center

Dependents Schools (DOD), Washington, DC. European Area.

The curriculum guide is designed to provide students with realistic training in automotive technology theory and practice within the secondary educational framework and to prepare them for entry into an occupation or continuing postsecondary education. The learning modules are grouped into three areas: small engines, automotive technology, and…

Planning Resource Guide.

ERIC Educational Resources Information Center

RP Group of California Community Colleges, Santa Ana.

The Planning Resource Guide by the RP Group of California Community Colleges was created to provide practical planning assistance. It contains four sections, including: (1) a basic conceptual framework for planning; (2) common planning definitions for colleges; (3) planning steps and samples of planning structures; and (4) suggestions for linking…

The Effects of Coaching Using a Reflective Framework on Early Childhood Science Teachers' Depth of Reflection and Change in Practice

NASA Astrophysics Data System (ADS)

Bloomquist, Debra L.

This embedded-mixed methods study examined if the use of a reflective framework with guiding prompts could support early childhood science teachers in improving their reflective practice and subsequently changing their pedagogy. It further investigated whether type of cognitive coaching group, individual or collaborative, impacted teacher depth of reflection and change in practice. Data included teacher reflections that were rated using the Level of Reflection-On-Action Assessment, reflective codes and inductive themes, as well as videos of participants lessons coded using the SCIIENCE instrument. Findings demonstrated that through guided reflection, teachers developed reflective thinking skills, and through this reflection became more critical and began to improve their pedagogical practice. Further findings supported that collaborative cognitive coaching may not be the most effective professional development for all teachers; as some teachers in the study were found to have difficulty improving their reflectivity and thus their teaching practice. Based on these findings it is recommended that coaches and designers of professional development continue to use reflective frameworks with guiding prompts to support teachers in the reflective process, but take into consideration that coaching may need to be differentiated for the various reflective levels demonstrated by teachers. Future studies will be needed to establish why some teachers have difficulty with the reflective process and how coaches or designers of professional development can further assist these teachers in becoming more critical reflectors.

Everyday Excellence: A Framework for Professional Nursing Practice in Long-Term Care

PubMed Central

Lyons, Stacie Salsbury; Specht, Janet Pringle; Karlman, Susan E.

2009-01-01

Registered nurses make measurable contributions to the health and wellness of persons living in nursing homes. However, most nursing homes do not employ adequate numbers of professional nurses with specialized training in the nursing care of older adults to positively impact resident outcomes. As a result, many people never receive excellent geriatric nursing while living in a long-term care facility. Nurses have introduced various professional practice models into health care institutions as tools for leading nursing practice, improving client outcomes, and achieving organizational goals. Problematically, few professional practice models have been implemented in nursing homes. This article introduces an evidence-based framework for professional nursing practice in long-term care. The Everyday Excellence framework is based upon eight guiding principles: Valuing, Envisioning, Peopling, Securing, Learning, Empowering, Leading, and Advancing Excellence. Future research will evaluate the usefulness of this framework for professional nursing practice. PMID:20077966

Health information systems: a survey of frameworks for developing countries.

PubMed

Marcelo, A B

2010-01-01

The objective of this paper is to perform a survey of excellent research on health information systems (HIS) analysis and design, and their underlying theoretical frameworks. It classifies these frameworks along major themes, and analyzes the different approaches to HIS development that are practical in resource-constrained environments. Literature review based on PubMed citations and conference proceedings, as well as Internet searches on information systems in general, and health information systems in particular. The field of health information systems development has been studied extensively. Despite this, failed implementations are still common. Theoretical frameworks for HIS development are available that can guide implementers. As awareness, acceptance, and demand for health information systems increase globally, the variety of approaches and strategies will also follow. For developing countries with scarce resources, a trial-and-error approach can be very costly. Lessons from the successes and failures of initial HIS implementations have been abstracted into theoretical frameworks. These frameworks organize complex HIS concepts into methodologies that standardize techniques in implementation. As globalization continues to impact healthcare in the developing world, demand for more responsive health systems will become urgent. More comprehensive frameworks and practical tools to guide HIS implementers will be imperative.

[A framework for evaluating ethical issues of public health initiatives: practical aspects and theoretical implications].

PubMed

Petrini, Carlo

2015-01-01

The "Framework for the Ethical Conduct of Public Health Initiatives", developed by Public Health Ontario, is a practical guide for assessing the ethical implications of evidence-generating public health initiatives, whether research or non-research activities, involving people, their biological materials or their personal information. The Framework is useful not only to those responsible for determining the ethical acceptability of an initiative, but also to investigators planning new public health initiatives. It is informed by a theoretical approach that draws on widely shared bioethical principles. Two considerations emerge from both the theoretical framework and its practical application: the line between practice and research is often blurred; public health ethics and biomedical research ethics are based on the same common heritage of values.

Comprehensive Career Guidance. Methods Guide. K-6 Career.

ERIC Educational Resources Information Center

Moore, Earl J.; And Others

This methods guide is intended to assist elementary school guidance workers in implementing a comprehensive career guidance program. Three major areas are considered. First, the life career development perspective is examined as a framework for organizing guidance objectives and practices so that there is a developmental, integrative…

Health/Cosmetology. Career Education Guide.

ERIC Educational Resources Information Center

Dependents Schools (DOD), Washington, DC. European Area.

The curriculum guide is designed to provide students with realistic training in theory and practice within the secondary educational framework and prepare them for entry into an occupation or continuing postsecondary education. The learning modules are grouped into branches pertaining to the broad categories of health services and cosmetology.…

A Guide for applying a revised version of the PARIHS framework for implementation

PubMed Central

2011-01-01

Background Based on a critical synthesis of literature on use of the Promoting Action on Research Implementation in Health Services (PARIHS) framework, revisions and a companion Guide were developed by a group of researchers independent of the original PARIHS team. The purpose of the Guide is to enhance and optimize efforts of researchers using PARIHS in implementation trials and evaluations. Methods Authors used a planned, structured process to organize and synthesize critiques, discussions, and potential recommendations for refinements of the PARIHS framework arising from a systematic review. Using a templated form, each author independently recorded key components for each reviewed paper; that is, study definitions, perceived strengths/limitations of PARIHS, other observations regarding key issues and recommendations regarding needed refinements. After reaching consensus on these key components, the authors summarized the information and developed the Guide. Results A number of revisions, perceived as consistent with the PARIHS framework's general nature and intent, are proposed. The related Guide is composed of a set of reference tools, provided in Additional files. Its core content is built upon the basic elements of PARIHS and current implementation science. Conclusions We invite researchers using PARIHS for targeted evidence-based practice (EBP) implementations with a strong task-orientation to use this Guide as a companion and to apply the revised framework prospectively and comprehensively. Researchers also are encouraged to evaluate its use relative to perceived strengths and issues. Such evaluations and critical reflections regarding PARIHS and our Guide could thereby promote the framework's continued evolution. PMID:21878092

Practical Handbook of School Psychology: Effective Practices for the 21st Century

ERIC Educational Resources Information Center

Peacock, Gretchen Gimpel, Ed.; Ervin, Ruth A., Ed.; Daly, Edward J., III, Ed.; Merrell, Kenneth W., Ed.

2009-01-01

This authoritative guide addresses all aspects of school psychology practice in a response-to-intervention (RTI) framework. Thirty-four focused chapters present effective methods for problem-solving-based assessment, instruction, and intervention. Specific guidelines are provided for promoting success in core academic domains--reading, writing,…

The Development of a Quality Management Framework for Evaluating Medical Device Reprocessing Practice in Healthcare Facilities.

PubMed

Lorv, Bailey; Horodyski, Robin; Welton, Cynthia; Vail, John; Simonetto, Luca; Jokanovic, Danilo; Sharma, Richa; Mahoney, Angela Rea; Savoy-Bird, Shay; Bains, Shalu

2017-01-01

There is increasing awareness of the importance of medical device reprocessing (MDR) for the provision of safe patient care. Although industry service standards are available to guide MDR practices, there remains a lack of published key performance indicators (KPIs) and targets that are necessary to evaluate MDR quality for feedback and improvement. This article outlines the development of an initial framework that builds on established guidelines and includes service standards, KPIs and targets for evaluating MDR operations. This framework can support healthcare facilities in strengthening existing practices and enables a platform for collaboration towards better MDR performance management.

Disseminating research findings: what should researchers do? A systematic scoping review of conceptual frameworks

PubMed Central

2010-01-01

Background Addressing deficiencies in the dissemination and transfer of research-based knowledge into routine clinical practice is high on the policy agenda both in the UK and internationally. However, there is lack of clarity between funding agencies as to what represents dissemination. Moreover, the expectations and guidance provided to researchers vary from one agency to another. Against this background, we performed a systematic scoping to identify and describe any conceptual/organising frameworks that could be used by researchers to guide their dissemination activity. Methods We searched twelve electronic databases (including MEDLINE, EMBASE, CINAHL, and PsycINFO), the reference lists of included studies and of individual funding agency websites to identify potential studies for inclusion. To be included, papers had to present an explicit framework or plan either designed for use by researchers or that could be used to guide dissemination activity. Papers which mentioned dissemination (but did not provide any detail) in the context of a wider knowledge translation framework, were excluded. References were screened independently by at least two reviewers; disagreements were resolved by discussion. For each included paper, the source, the date of publication, a description of the main elements of the framework, and whether there was any implicit/explicit reference to theory were extracted. A narrative synthesis was undertaken. Results Thirty-three frameworks met our inclusion criteria, 20 of which were designed to be used by researchers to guide their dissemination activities. Twenty-eight included frameworks were underpinned at least in part by one or more of three different theoretical approaches, namely persuasive communication, diffusion of innovations theory, and social marketing. Conclusions There are currently a number of theoretically-informed frameworks available to researchers that can be used to help guide their dissemination planning and activity. Given the current emphasis on enhancing the uptake of knowledge about the effects of interventions into routine practice, funders could consider encouraging researchers to adopt a theoretically-informed approach to their research dissemination. PMID:21092164

Bridging the gap from values to actions: a family systems framework for family-centered AAC services.

PubMed

Mandak, Kelsey; O'Neill, Tara; Light, Janice; Fosco, Gregory M

2017-03-01

Despite the growing recognition of the importance of family involvement in augmentative and alternative communication (AAC) intervention, little guidance exists on how professionals can establish successful collaborative relationships with families. In this paper, we discuss family systems theory and ecological systems theory as a framework to guide family-centered AAC practice, review family-focused research in AAC, consider how AAC may impact the family system, and provide examples of the clinical implications of using the proposed family systems framework to improve family-centered AAC practice.

Business/Clerical/Sales. Career Education Guide.

ERIC Educational Resources Information Center

Dependents Schools (DOD), Washington, DC. European Area.

The curriculum guide is designed to provide students with realistic training in business/clerical/sales theory and practices within the secondary educational framework and to prepare them for entry into an occupation or continuing postsecondary education. Each unit plan consists of a description of the area under consideration, estimated hours of…

Creating a Framework of Guidance for Building Good Digital Collections.

ERIC Educational Resources Information Center

Cole, Timothy W.

2002-01-01

Presents the Framework of Guidance for Building Good Digital Collections that was developed by the Institute of Museum and Library Services with other organizations to guide museums and libraries in digitization collection practices. Highlights digital collections, digital objects, and metadata, and discusses reusability, persistence,…

The role of advanced nursing in lung cancer: A framework based development.

PubMed

Serena, A; Castellani, P; Fucina, N; Griesser, A-C; Jeanmonod, J; Peters, S; Eicher, M

2015-12-01

Advanced Practice Lung Cancer Nurses (APLCN) are well-established in several countries but their role has yet to be established in Switzerland. Developing an innovative nursing role requires a structured approach to guide successful implementation and to meet the overarching goal of improved nursing sensitive patient outcomes. The "Participatory, Evidence-based, Patient-focused process, for guiding the development, implementation, and evaluation of advanced practice nursing" (PEPPA framework) is one approach that was developed in the context of the Canadian health system. The purpose of this article is to describe the development of an APLCN model at a Swiss Academic Medical Center as part of a specialized Thoracic Cancer Center and to evaluate the applicability of PEPPA framework in this process. In order to develop and implement the APLCN role, we applied the first seven phases of the PEPPA framework. This article spreads the applicability of the PEPPA framework for an APLCN development. This framework allowed us to i) identify key components of an APLCN model responsive to lung cancer patients' health needs, ii) identify role facilitators and barriers, iii) implement the APLCN role and iv) design a feasibility study of this new role. The PEPPA framework provides a structured process for implementing novel Advanced Practice Nursing roles in a local context, particularly where such roles are in their infancy. Two key points in the process include assessing patients' health needs and involving key stakeholders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hmong American Adolescents' Perceptions of Ethnic Socialization Practices

ERIC Educational Resources Information Center

Moua, MyLou Y.; Lamborn, Susie D.

2010-01-01

Guided by an ecological framework, this study explored ethnic socialization practices from the perspective of Southeast Asian American adolescents. Defined as a multidimensional construct that is conceptually distinct from racial socialization, ethnic socialization involves parents' communication to children about their ethnic heritage. The…

Elementary Teachers' Participation in Edmodo as a Community of Practice: A Phenomenology

ERIC Educational Resources Information Center

Reasoner, Cynthia Rush

2017-01-01

The purpose of this phenomenological study was to describe the shared, lived experience of elementary teachers' participation in Edmodo as a community of practice. The theoretical framework guiding this research included Lave and Wenger's (1991) community of practice theory and Bandura's social learning theory (1977, 1984) which explained how…

Integrated and implicit: how residents learn CanMEDS roles by participating in practice.

PubMed

Renting, Nienke; Raat, A N Janet; Dornan, Tim; Wenger-Trayner, Etienne; van der Wal, Martha A; Borleffs, Jan C C; Gans, Rijk O B; Jaarsma, A Debbie C

2017-09-01

Learning outcomes for residency training are defined in competency frameworks such as the CanMEDS framework, which ultimately aim to better prepare residents for their future tasks. Although residents' training relies heavily on learning through participation in the workplace under the supervision of a specialist, it remains unclear how the CanMEDS framework informs practice-based learning and daily interactions between residents and supervisors. This study aimed to explore how the CanMEDS framework informs residents' practice-based training and interactions with supervisors. Constructivist grounded theory guided iterative data collection and analyses. Data were collected by direct observations of residents and supervisors, combined with formal and field interviews. We progressively arrived at an explanatory theory by coding and interpreting the data, building provisional theories and through continuous conversations. Data analysis drew on sensitising insights from communities of practice theory, which provided this study with a social learning perspective. CanMEDS roles occurred in an integrated fashion and usually remained implicit during interactions. The language of CanMEDS was not adopted in clinical practice, which seemed to impede explicit learning interactions. The CanMEDS framework seemed only one of many factors of influence in practice-based training: patient records and other documents were highly influential in daily activities and did not always correspond with CanMEDS roles. Additionally, the position of residents seemed too peripheral to allow them to learn certain aspects of the Health Advocate and Leader roles. The CanMEDS framework did not really guide supervisors' and residents' practice or interactions. It was not explicitly used as a common language in which to talk about resident performance and roles. Therefore, the extent to which CanMEDS actually helps improve residents' learning trajectories and conversations between residents and supervisors about residents' progress remains questionable. This study highlights the fact that the reification of competency frameworks into the complexity of practice-based learning is not a straightforward exercise. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

The Illicit Use of Prescription Stimulants on College Campuses

ERIC Educational Resources Information Center

Bavarian, Niloofar; Flay, Brian R.; Ketcham, Patricia L.; Smit, Ellen

2015-01-01

The illicit use of prescription stimulants (IUPS) is a substance use behavior that remains prevalent on college campuses. As theory can guide research and practice, we provide a systematic review of the college-based IUPS epidemiological literature guided by one ecological framework, the theory of triadic influence (TTI). We aim to assess…

The utility of vignettes to stimulate reflection on professionalism: theory and practice.

PubMed

Bernabeo, E C; Holmboe, E S; Ross, K; Chesluk, B; Ginsburg, S

2013-08-01

Professionalism remains a substantive theme in medical literature. There is an emerging emphasis on sociological and complex adaptive systems perspectives that refocuses attention from just the individual role to working within one's system to enact professionalism in practice. Reflecting on responses to professional dilemmas may be one method to help practicing physicians identify both internal and external factors contributing to (un) professional behavior. We present a rationale and theoretical framework that supports and guides a reflective approach to the self assessment of professionalism. Guided by principles grounded in this theoretical framework, we developed and piloted a set of vignettes on professionally challenging situations, designed to stimulate reflection in practicing physicians. Findings show that participants found the vignettes to be authentic and typical, and reported the group experience as facilitative around discussions of professional ambiguity. Providing an opportunity for physicians to reflect on professional behavior in an open and safe forum may be a practical way to guide physicians to assess themselves on professional behavior and engage with the complexities of their work. The finding that the focus groups led to reflection at a group level suggests that effective reflection on professional behavior may require a socially interactive process. Emphasizing both the behaviors and the internal and external context in which they occur can thus be viewed as critically important for understanding professionalism in practicing physicians.

How can a competency framework for advanced practice support care?

PubMed

Stanford, Pamela Elizabeth

2016-11-10

Aim To explore whether perception of nurse practitioners in relation to whether a competency framework for advanced practice can support their work. Method A qualitative cross-sectional design was used, embedded in an interpretative paradigm of research. A non-probability sample of eight experienced nurse practitioners took part in focus groups and answered questionnaires. A mixture of phenomenological and grounded theory approaches were used to collect the data. Findings Four major themes were identified: competency frameworks can identify individual strengths and weaknesses, they can be used to set clear goals and targets, they can improve how practice is organised, and they have the potential to limit practice in terms of narrowing boundaries. The study also found competency frameworks could provide an structure to guide the development and evaluation of educational programmes. Conclusion Competency frameworks can be used so to target the development of new advanced nurse practitioners. They can address workforce development and governance by ensuring nurse practitioners have the competencies to provide safe, autonomous practice. Competency frameworks have been shown to ensure consistency in clinical practice skills underpinned with nurse practitioners' theoretical knowledge. They provide a clear development structure for career development and advanced practice. However, internationally, there is still a lack of definition of advanced practice and its core competencies.

Using a Personal Learning Framework to Transform Middle Grades Teaching Practice

ERIC Educational Resources Information Center

Nagle, James; Taylor, Don

2017-01-01

In 2013 the Vermont legislature enacted Act 77 mandating that students in Grades 7-12 develop personalized learning plans (PLPs) to guide them toward high school graduation using proficiency-based requirements. In the present qualitative self-study, we document the impact of implementation of a personal learning framework integrating PLPs into a…

Argumentation, Dialogue Theory, and Probability Modeling: Alternative Frameworks for Argumentation Research in Education

ERIC Educational Resources Information Center

Nussbaum, E. Michael

2011-01-01

Toulmin's model of argumentation, developed in 1958, has guided much argumentation research in education. However, argumentation theory in philosophy and cognitive science has advanced considerably since 1958. There are currently several alternative frameworks of argumentation that can be useful for both research and practice in education. These…

The Dispositions, Abilities and Behaviours (DAB) Framework for Profiling Learners' Sustainability Competencies in Higher Education

ERIC Educational Resources Information Center

Besong, Frida; Holland, Charlotte

2015-01-01

The concepts of sustainability and sustainability competence are controversial, complex, difficult to define and measure, and have varied meanings for different people and practices. Given the complex nature of sustainability, there is limited availability of paradigmatic frameworks to guide educators in assessing sustainability competencies. This…

Constructing a clinical decision-making framework for image-guided radiotherapy using a Bayesian Network

NASA Astrophysics Data System (ADS)

Hargrave, C.; Moores, M.; Deegan, T.; Gibbs, A.; Poulsen, M.; Harden, F.; Mengersen, K.

2014-03-01

A decision-making framework for image-guided radiotherapy (IGRT) is being developed using a Bayesian Network (BN) to graphically describe, and probabilistically quantify, the many interacting factors that are involved in this complex clinical process. Outputs of the BN will provide decision-support for radiation therapists to assist them to make correct inferences relating to the likelihood of treatment delivery accuracy for a given image-guided set-up correction. The framework is being developed as a dynamic object-oriented BN, allowing for complex modelling with specific subregions, as well as representation of the sequential decision-making and belief updating associated with IGRT. A prototype graphic structure for the BN was developed by analysing IGRT practices at a local radiotherapy department and incorporating results obtained from a literature review. Clinical stakeholders reviewed the BN to validate its structure. The BN consists of a sub-network for evaluating the accuracy of IGRT practices and technology. The directed acyclic graph (DAG) contains nodes and directional arcs representing the causal relationship between the many interacting factors such as tumour site and its associated critical organs, technology and technique, and inter-user variability. The BN was extended to support on-line and off-line decision-making with respect to treatment plan compliance. Following conceptualisation of the framework, the BN will be quantified. It is anticipated that the finalised decision-making framework will provide a foundation to develop better decision-support strategies and automated correction algorithms for IGRT.

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

PubMed

Suchy, Kirsten

2010-01-01

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

Understanding childbirth practices as an organizational cultural phenomenon: a conceptual framework.

PubMed

Behruzi, Roxana; Hatem, Marie; Goulet, Lise; Fraser, William; Misago, Chizuru

2013-11-11

Understanding the main values and beliefs that might promote humanized birth practices in the specialized hospitals requires articulating the theoretical knowledge of the social and cultural characteristics of the childbirth field and the relations between these and the institution. This paper aims to provide a conceptual framework allowing examination of childbirth practices through the lens of an organizational culture theory. A literature review performed to extrapolate the social and cultural factors contribute to birth practices and the factors likely overlap and mutually reinforce one another, instead of complying with the organizational culture of the birth place. The proposed conceptual framework in this paper examined childbirth patterns as an organizational cultural phenomenon in a highly specialized hospital, in Montreal, Canada. Allaire and Firsirotu's organizational culture theory served as a guide in the development of the framework. We discussed the application of our conceptual model in understanding the influences of organizational culture components in the humanization of birth practices in the highly specialized hospitals and explained how these components configure both the birth practice and women's choice in highly specialized hospitals. The proposed framework can be used as a tool for understanding the barriers and facilitating factors encountered birth practices in specialized hospitals.

A DRDC Management Accountability Framework

DTIC Science & Technology

2009-09-01

51 A.2 Cultural Theory: Risk, Blame and Good Governance ................................................. 53 A.3...the MAF. These elements guide good management, enclosing the elements required to make good decisions. 18 In essence, the elements focus on the...of these areas.20 As a guide to good management practices, the elements focus on organizational capacity and capability within a department 21

A Framework for Analyzing Cognitive Demand and Content-Practices Integration: Task Analysis Guide in Science

ERIC Educational Resources Information Center

Tekkumru-Kisa, Miray; Stein, Mary Kay; Schunn, Christian

2015-01-01

Many countries, including the United States, emphasize the importance of developing students' scientific habits of mind and their capacity to think deeply about scientific ideas in an integrated fashion. Recent science education policies in the United States portray a related vision of science teaching and learning that is meant to guide the…

The Mentor's Guide: Facilitating Effective Learning Relationships. The Jossey-Bass Higher and Adult Education Series.

ERIC Educational Resources Information Center

Zachary, Lois J.

Intended for readers in the business world and in nonprofit and higher education settings, this guide offers a framework for informed mentoring practice. It combines discussion and exercises. Chapter 1 grounds the mentor's work in a learner-centered approach to mentoring and presents a mentoring paradigm consistent with andragogical principles and…

Consumer focus can spur group practice turnaround.

PubMed

Foreman, M S; Draper, A

2001-06-01

Many healthcare organizations have lost money on their employed group practices. The solution to this dilemma is not necessarily divestment of the group practices. Instead, some healthcare organizations should view their physicians as an asset. Healthcare organizations and physicians need to develop a new framework for their relationship to optimize their competitive advantage. Three guiding principles that will help accomplish this objective are to recast the healthcare organization-physician relationship to focus on the consumer, reconfigure the economic model to exceed consumer demands, and restructure the group practice to encourage fiscal and service excellence. In developing a new relationship framework, the stakeholders need to define the group practice's mission, strategic direction, composition, infrastructure, compensation model, and structure.

Understanding How Domestic Violence Support Services Promote Survivor Well-being: A Conceptual Model.

PubMed

Sullivan, Cris M

2018-01-01

Domestic violence (DV) victim service programs have been increasingly expected by legislators and funders to demonstrate that they are making a significant difference in the lives of those using their services. Alongside this expectation, they are being asked to describe the Theory of Change guiding how they believe their practices lead to positive results for survivors and their children. Having a widely accepted conceptual model is not just potentially useful to funders and policy makers as they help shape policy and practice -- it can also help programs continually reflect upon and improve their work. This paper describes the iterative and collaborative process undertaken to generate a conceptual model describing how DV victim services are expected to improve survivors' lives. The Social and Emotional Well-Being Framework guiding the model is an ideal structure to use to describe the goals and practices of DV programs because this framework: (1) accurately represents DV programs' goal of helping survivors and their children thrive; and (2) recognizes the importance of community, social, and societal context in influencing individuals' social and emotional well-being. The model was designed to guide practice and to generate new questions for research and evaluation that address individual, community, and systems factors that promote or hinder survivor safety and well-being.

The 'global health' education framework: a conceptual guide for monitoring, evaluation and practice

PubMed Central

2011-01-01

Background In the past decades, the increasing importance of and rapid changes in the global health arena have provoked discussions on the implications for the education of health professionals. In the case of Germany, it remains yet unclear whether international or global aspects are sufficiently addressed within medical education. Evaluation challenges exist in Germany and elsewhere due to a lack of conceptual guides to develop, evaluate or assess education in this field. Objective To propose a framework conceptualising 'global health' education (GHE) in practice, to guide the evaluation and monitoring of educational interventions and reforms through a set of key indicators that characterise GHE. Methods Literature review; deduction. Results and Conclusion Currently, 'new' health challenges and educational needs as a result of the globalisation process are discussed and linked to the evolving term 'global health'. The lack of a common definition of this term complicates attempts to analyse global health in the field of education. The proposed GHE framework addresses these problems and presents a set of key characteristics of education in this field. The framework builds on the models of 'social determinants of health' and 'globalisation and health' and is oriented towards 'health for all' and 'health equity'. It provides an action-oriented construct for a bottom-up engagement with global health by the health workforce. Ten indicators are deduced for use in monitoring and evaluation. PMID:21501519

Moving mountains together: strategic community leadership and systems change.

PubMed

Nissen, Laura Burney; Merrigan, Daniel M; Kraft, M Katherine

2005-01-01

Traditional leadership practice frameworks to guide systems change often fall short in today's practice environment. Reclaiming Futures is a national initiative to create an integrated, comprehensive, seamless system of care for teens with substance abuse problems involved in juvenile justice. It uses leadership and systems reform strategies to improve public health institutions. The premise is that interruption of the destructive cycle of drugs and delinquency can only be attained through the cultivation of shared strategic leadership. This article presents the limitations of traditional practice frameworks of leadership, describes the theory of this new approach to leadership development, and clarifies collaborative leadership and system change. The article includes an example of the framework in action, a discussion of lessons learned, and recommendations for community leadership development initiatives.

Primary Care Practice Transformation Is Hard Work

PubMed Central

Crabtree, Benjamin F.; Nutting, Paul A.; Miller, William L.; McDaniel, Reuben R.; Stange, Kurt C.; Jaén, Carlos Roberto; Stewart, Elizabeth

2010-01-01

Background Serious shortcomings remain in clinical care in the United States despite widespread use of improvement strategies for enhancing clinical performance based on knowledge transfer approaches. Recent calls to transform primary care practice to a patient-centered medical home present even greater challenges and require more effective approaches. Methods Our research team conducted a series of National Institutes of Health funded descriptive and intervention projects to understand organizational change in primary care practice settings, emphasizing a complexity science perspective. The result was a developmental research effort that enabled the identification of critical lessons relevant to enabling practice change. Results A summary of findings from a 15-year program of research highlights the limitations of viewing primary care practices in the mechanistic terms that underlie current or traditional approaches to quality improvement. A theoretical perspective that views primary care practices as dynamic complex adaptive systems with “agents” who have the capacity to learn, and the freedom to act in unpredictable ways provides a better framework for grounding quality improvement strategies. This framework strongly emphasizes that quality improvement interventions should not only use a complexity systems perspective, but also there is a need for continual reflection, careful tailoring of interventions, and ongoing attention to the quality of interactions among agents in the practice. Conclusions It is unlikely that current strategies for quality improvement will be successful in transforming current primary care practice to a patient-centered medical home without a stronger guiding theoretical foundation. Our work suggests that a theoretical framework guided by complexity science can help in the development of quality improvement strategies that will more effectively facilitate practice change. PMID:20856145

A Holistic Theoretical Approach to Intellectual Disability: Going Beyond the Four Current Perspectives.

PubMed

Schalock, Robert L; Luckasson, Ruth; Tassé, Marc J; Verdugo, Miguel Angel

2018-04-01

This article describes a holistic theoretical framework that can be used to explain intellectual disability (ID) and organize relevant information into a usable roadmap to guide understanding and application. Developing the framework involved analyzing the four current perspectives on ID and synthesizing this information into a holistic theoretical framework. Practices consistent with the framework are described, and examples are provided of how multiple stakeholders can apply the framework. The article concludes with a discussion of the advantages and implications of a holistic theoretical approach to ID.

The Evolution of the Social Roletaking and Guided Reflection Framework in Teacher Education: Recent Theory and Quantitative Synthesis of Research.

ERIC Educational Resources Information Center

Reiman, Alan J.

1999-01-01

Addresses the lack of theory and directing constructs for reflective practice in teacher education, reviewing Vygotskyian and Piagetian theoretical tenets, relating them to a developmental action/reflection framework for adult learners, and summarizing a taxonomy for differentiating reflection according to adult learners' needs. Summarizes the…

Addressing Disproportionate Discipline Practices within a School-Wide Positive Behavioral Interventions and Supports Framework: A Practical Guide for Calculating and Using Disproportionality Rates

ERIC Educational Resources Information Center

Boneshefski, Michael J.; Runge, Timothy J.

2014-01-01

Culturally responsible implementation of School-Wide Positive Behavioral Interventions and Supports (SWPBIS) requires that schools monitor indices of disciplinary practices among minority groups. School teams are encouraged to calculate risk indices and risk ratios to evaluate the extent to which students of all groups are removed from classrooms…

Embedding effective depression care: using theory for primary care organisational and systems change.

PubMed

Gunn, Jane M; Palmer, Victoria J; Dowrick, Christopher F; Herrman, Helen E; Griffiths, Frances E; Kokanovic, Renata; Blashki, Grant A; Hegarty, Kelsey L; Johnson, Caroline L; Potiriadis, Maria; May, Carl R

2010-08-06

Depression and related disorders represent a significant part of general practitioners (GPs) daily work. Implementing the evidence about what works for depression care into routine practice presents a challenge for researchers and service designers. The emerging consensus is that the transfer of efficacious interventions into routine practice is strongly linked to how well the interventions are based upon theory and take into account the contextual factors of the setting into which they are to be transferred. We set out to develop a conceptual framework to guide change and the implementation of best practice depression care in the primary care setting. We used a mixed method, observational approach to gather data about routine depression care in a range of primary care settings via: audit of electronic health records; observation of routine clinical care; and structured, facilitated whole of organisation meetings. Audit data were summarised using simple descriptive statistics. Observational data were collected using field notes. Organisational meetings were audio taped and transcribed. All the data sets were grouped, by organisation, and considered as a whole case. Normalisation Process Theory (NPT) was identified as an analytical theory to guide the conceptual framework development. Five privately owned primary care organisations (general practices) and one community health centre took part over the course of 18 months. We successfully developed a conceptual framework for implementing an effective model of depression care based on the four constructs of NPT: coherence, which proposes that depression work requires the conceptualisation of boundaries of who is depressed and who is not depressed and techniques for dealing with diffuseness; cognitive participation, which proposes that depression work requires engagement with a shared set of techniques that deal with depression as a health problem; collective action, which proposes that agreement is reached about how care is organised; and reflexive monitoring, which proposes that depression work requires agreement about how depression work will be monitored at the patient and practice level. We describe how these constructs can be used to guide the design and implementation of effective depression care in a way that can take account of contextual differences. Ideas about what is required for an effective model and system of depression care in primary care need to be accompanied by theoretically informed frameworks that consider how these can be implemented. The conceptual framework we have presented can be used to guide organisational and system change to develop common language around each construct between policy makers, service users, professionals, and researchers. This shared understanding across groups is fundamental to the effective implementation of change in primary care for depression.

Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues

PubMed Central

Bonneville, Luc; Bouchard, Louise

2018-01-01

Organizational health literacy is described as an organization-wide effort to transform organization and delivery of care and services to make it easier for people to navigate, understand, and use information and services to take care of their health. Several health literacy guides have been developed to assist healthcare organizations with this effort, but their content has not been systematically reviewed to understand the scope and practical implications of this transformation. The objective of this study was to review (1) theories and frameworks that inform the concept of organizational health literacy, (2) the attributes of organizational health literacy as described in the guides, (3) the evidence for the effectiveness of the guides, and (4) the barriers and facilitators to implementing organizational health literacy. Drawing on a metanarrative review method, 48 publications were reviewed, of which 15 dealt with the theories and operational frameworks, 20 presented health literacy guides, and 13 addressed guided implementation of organizational health literacy. Seven theories and 9 operational frameworks have been identified. Six health literacy dimensions and 9 quality-improvement characteristics were reviewed for each health literacy guide. Evidence about the effectiveness of health literacy guides is limited at this time, but experiences with the guides were positive. Thirteen key barriers (conceived also as facilitators) were identified. Further development of organizational health literacy requires a strong and a clear connection between its vision and operationalization as an implementation strategy to patient-centered care. For many organizations, becoming health literate will require multiple, simultaneous, and radical changes. Organizational health literacy has to make sense from clinical and financial perspectives in order for organizations to embark on such transformative journey. PMID:29569968

Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues.

PubMed

Farmanova, Elina; Bonneville, Luc; Bouchard, Louise

2018-01-01

Organizational health literacy is described as an organization-wide effort to transform organization and delivery of care and services to make it easier for people to navigate, understand, and use information and services to take care of their health. Several health literacy guides have been developed to assist healthcare organizations with this effort, but their content has not been systematically reviewed to understand the scope and practical implications of this transformation. The objective of this study was to review (1) theories and frameworks that inform the concept of organizational health literacy, (2) the attributes of organizational health literacy as described in the guides, (3) the evidence for the effectiveness of the guides, and (4) the barriers and facilitators to implementing organizational health literacy. Drawing on a metanarrative review method, 48 publications were reviewed, of which 15 dealt with the theories and operational frameworks, 20 presented health literacy guides, and 13 addressed guided implementation of organizational health literacy. Seven theories and 9 operational frameworks have been identified. Six health literacy dimensions and 9 quality-improvement characteristics were reviewed for each health literacy guide. Evidence about the effectiveness of health literacy guides is limited at this time, but experiences with the guides were positive. Thirteen key barriers (conceived also as facilitators) were identified. Further development of organizational health literacy requires a strong and a clear connection between its vision and operationalization as an implementation strategy to patient-centered care. For many organizations, becoming health literate will require multiple, simultaneous, and radical changes. Organizational health literacy has to make sense from clinical and financial perspectives in order for organizations to embark on such transformative journey.

A framework to develop a clinical learning culture in health facilities: ideas from the literature.

PubMed

Henderson, A; Briggs, J; Schoonbeek, S; Paterson, K

2011-06-01

Internationally, there is an increase in demand to educate nurses within the clinical practice environment. Clinical practice settings that encourage teaching and learning during episodes of care delivery can be powerful in educating both the existing nursing workforce and nursing students. This paper presents a framework, informed by the literature, that identifies the key factors that are needed to encourage the interactions fundamental to learning in clinical practice. Learning occurs when nurses demonstrate good practice, share their knowledge through conversations and discussions, and also provide feedback to learners, such as students and novices. These types of interactions occur when positive leadership practices encourage trust and openness between staff; when the management team provides sessions for staff to learn how to interact with learners, and also when partnerships provide support and guidance around learning in the workplace. APPLICATION OF CONCEPTS: This framework presents how the concepts of leadership, management and partnership interact to create and sustain learning environments. The feedback from proposed measurement tools can provide valuable information about the positive and negative aspects of these concepts in the clinical learning environment. Analysis of the subscales can assist in identifying appropriate recommended strategies outlined in the framework to guide nurses in improving the recognized deficits in the relationship between the concepts. Leadership, management and partnerships are pivotal for the creation and maintenance of positive learning environments. Diagnostic measurement tools can provide specific information about weaknesses across these areas. This knowledge can guide future initiatives. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Practical implementation science: developing and piloting the quality implementation tool.

PubMed

Meyers, Duncan C; Katz, Jason; Chien, Victoria; Wandersman, Abraham; Scaccia, Jonathan P; Wright, Annie

2012-12-01

According to the Interactive Systems Framework for Dissemination and Implementation, implementation is a major mechanism and concern in bridging research and practice. The growing number of implementation frameworks need to be synthesized and translated so that the science and practice of quality implementation can be furthered. In this article, we: (1) use the synthesis of frameworks developed by Meyers et al. (Am J Commun Psychol, 2012) and translate the results into a practical implementation science tool to use for improving quality of implementation (i.e., the Quality Implementation Tool; QIT), and (2) present some of the benefits and limitations of the tool by describing how the QIT was implemented in two different pilot projects. We discuss how the QIT can be used to guide collaborative planning, monitoring, and evaluation of how an innovation is implemented.

A framework for the design, implementation, and evaluation of interprofessional education.

PubMed

Pardue, Karen T

2015-01-01

The growing emphasis on teamwork and care coordination within health care delivery is sparking interest in interprofessional education (IPE) among nursing and health profession faculty. Faculty often lack firsthand IPE experience, which hinders pedagogical reform. This article proposes a theoretically grounded framework for the design, implementation, and evaluation of IPE. Supporting literature and practical advice are interwoven. The proposed framework guides faculty in the successful creation and evaluation of collaborative learning experiences.

Vegetarian food guide pyramid: a conceptual framework.

PubMed

Haddad, E H; Sabaté, J; Whitten, C G

1999-09-01

The purpose of this article and the accompanying vegetarian food guide pyramid graphic is to provide the conceptual framework for the development of a new and unique food guide. Food guides for vegetarians have tended to be adaptations of guides developed for the general nonvegetarian population instead of being designed to emphasize the healthy components of vegetarian dietary patterns. A subcommittee of the organizers of the Third International Congress on Vegetarian Nutrition began a process that led to the development of a pyramid-shaped graphic illustration and a supporting document, both of which were introduced at the congress. The 5 major plant-based food groups (whole grains, legumes, vegetables, fruit, nuts, and seeds) form the trapezoid-shaped lower portion of the pyramid. Optional food groups, which may be avoided by some vegetarians (vegetable oils, dairy, eggs, and sweets), form the smaller, separate, triangle-shaped top portion of the pyramid. The supporting document discusses the concepts that affect vegetarian food guidance and the rationale for selecting the food groups. It is hoped that this framework will provide the impetus for further research and discussion and will lead to the development of a guide that is nutritionally adequate, is conducive to good health, and can be adopted by vegetarians of diverse eating practices.

The Income Generation Handbook: A Practical Guide for Educational Institutions.

ERIC Educational Resources Information Center

Warner, David; Leonard, Charles

This book sets out the British policy context and theoretical framework for income generation by institutions of higher education and provides practical guidance in this area. Income generation is defined as all income generated over and above the core funding provided by an institution's primary funding body. Chapter 1 offers an overview of…

Minimizing the influence of unconscious bias in evaluations: a practical guide.

PubMed

Goldyne, Adam J

2007-01-01

The forensic psychiatrist's efforts to strive for objectivity may be impaired by unrecognized unconscious biases. The author presents a framework for understanding such biases. He then offers a practical approach for individual forensic psychiatrists who want to identify and minimize the influence of previously unrecognized biases on their evaluations.

Multi-Tiered System of Support: Best Differentiation Practices for English Language Learners in Tier 1

ERIC Educational Resources Information Center

Izaguirre, Cecilia

2017-01-01

Purpose: This qualitative case study explored the best practices of differentiation of Tier 1 instruction within a multi-tiered system of support for English Language Learners who were predominately Spanish speaking. Theoretical Framework: The zone of proximal development theory, cognitive theory, and the affective filter hypothesis guided this…

Personal and Professional Emotional Characteristics of Early Childhood Teachers and Their Proneness to Communicate with Parents and Colleagues about Children's Emotions

ERIC Educational Resources Information Center

Ciucci, Enrica; Baroncelli, Andrea; Toselli, Monica; Denham, Susanne A.

2018-01-01

Background: Early childhood teachers represent important socializers of children's emotions providing professional practices, such as communication about children's emotions, influencing children's development. According to an ecological framework, early childhood teachers' emotional practices are guided by both their personal and professional…

Mathematical Practices in a Technological Workplace: The Role of Tools

ERIC Educational Resources Information Center

Triantafillou, Chrissavgi; Potari, Despina

2010-01-01

This paper investigates the role of tools in the formation of mathematical practices and the construction of mathematical meanings in the setting of a telecommunication organization through the actions undertaken by a group of technicians in their working activity. The theoretical and analytical framework is guided by the first-generation activity…

Public Health Interventions for School Nursing Practice

ERIC Educational Resources Information Center

Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon

2016-01-01

School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

A Framework for Intentional Cultural Change

PubMed Central

Biglan, Anthony; Embry, Dennis D.

2013-01-01

We present a framework for a pragmatic science of cultural evolution. It is now possible for behavioral science to systematically influence the further evolution of cultural practices. As this science develops, it may become possible to prevent many of the problems affecting human wellbeing. By cultural practices, we refer to everything that humans do, above and beyond instinctual or unconditioned behaviors: not only art and literature, but also agriculture, manufacturing, recreation, war making, childrearing, science—everything. We can analyze cultural practices usefully in terms of the incidence and prevalence of individual behavior and group and organization actions. An effective science of intentional cultural evolution must guide efforts to influence the incidence and prevalence of individuals’ behaviors and the actions of groups and organizations. In this paper, we briefly sketch advances in scientific understanding of the influences on individual behavior. Then we describe principles that could guide efforts to influence groups and organizations. Finally, we discuss legitimate concerns about the use and misuse of a science for intentional cultural change. PMID:24363988

Teaching excellence in nursing education: a caring framework.

PubMed

Sawatzky, Jo-Ann V; Enns, Carol L; Ashcroft, Terri J; Davis, Penny L; Harder, B Nicole

2009-01-01

Nursing education plays a central role in the ability to practice effectively. It follows that an optimally educated nursing workforce begets optimal patient care. A framework for excellence in nursing education could guide the development of novice educators, establish the basis for evaluating teaching excellence, and provide the impetus for research in this area. However, a review of the social sciences and nursing literature as well as a search for existing models for teaching excellence revealed an apparent dearth of evidence specific to excellence in nursing education. Therefore, we developed the Caring Framework for Excellence in Nursing Education. This framework evolved from a review of the generic constructs that exemplify teaching excellence: excellence in teaching practice, teaching scholarship, and teaching leadership. Nursing is grounded in the ethic of caring. Hence, caring establishes the foundation for this uniquely nursing framework. Because a teaching philosophy is intimately intertwined with one's nursing philosophy and the ethic of caring, it is also fundamental to the caring framework. Ideally, this framework will contribute to excellence in nursing education and as a consequence excellence in nursing practice and optimal patient care.

Analyzing beliefs and practices of a Mexican high school biology teacher

NASA Astrophysics Data System (ADS)

Verjovsky, Janet; Waldegg, Guillermina

2005-04-01

This article explores the beliefs and practices of a high school biology teacher through three interrelated theoretical frameworks: common knowledge, collaborative learning, and communities of practice. The data were obtained from an in-depth case study of Maria, a biology teacher from a Mexican public high school that was participating in a 4-year international science project using collaborative learning and information and communication technology. Her beliefs and practices were explored by means of questionnaires, semi-structured interviews, and nonparticipant observation of classes. Through the use of the three-component framework, the degrees of coherence between practice and beliefs that guide the teacher's daily behavior became apparent, as well as the difficulties of incorporating innovations due to institutional constraints.

Understanding childbirth practices as an organizational cultural phenomenon: a conceptual framework

PubMed Central

2013-01-01

Understanding the main values and beliefs that might promote humanized birth practices in the specialized hospitals requires articulating the theoretical knowledge of the social and cultural characteristics of the childbirth field and the relations between these and the institution. This paper aims to provide a conceptual framework allowing examination of childbirth practices through the lens of an organizational culture theory. A literature review performed to extrapolate the social and cultural factors contribute to birth practices and the factors likely overlap and mutually reinforce one another, instead of complying with the organizational culture of the birth place. The proposed conceptual framework in this paper examined childbirth patterns as an organizational cultural phenomenon in a highly specialized hospital, in Montreal, Canada. Allaire and Firsirotu’s organizational culture theory served as a guide in the development of the framework. We discussed the application of our conceptual model in understanding the influences of organizational culture components in the humanization of birth practices in the highly specialized hospitals and explained how these components configure both the birth practice and women’s choice in highly specialized hospitals. The proposed framework can be used as a tool for understanding the barriers and facilitating factors encountered birth practices in specialized hospitals. PMID:24215446

Using humanising values to support care.

PubMed

Scammell, Janet; Tait, Desi

National responses to the Francis report recommendations call for a stronger emphasis on the service-user perspective. This article uses a client scenario to reflect on how dehumanised aspects of care can become humanised by basing our practice on a humanising values framework, and argues that the framework can, despite the system, provide a guide to support us "to do the right thing".

A Community-Building Framework for Collaborative Research Coordination across the Education and Biology Research Disciplines.

PubMed

Pelaez, Nancy; Anderson, Trevor R; Gardner, Stephanie M; Yin, Yue; Abraham, Joel K; Bartlett, Edward L; Gormally, Cara; Hurney, Carol A; Long, Tammy M; Newman, Dina L; Sirum, Karen; Stevens, Michael T

2018-06-01

Since 2009, the U.S. National Science Foundation Directorate for Biological Sciences has funded Research Coordination Networks (RCN) aimed at collaborative efforts to improve participation, learning, and assessment in undergraduate biology education (UBE). RCN-UBE projects focus on coordination and communication among scientists and educators who are fostering improved and innovative approaches to biology education. When faculty members collaborate with the overarching goal of advancing undergraduate biology education, there is a need to optimize collaboration between participants in order to deeply integrate the knowledge across disciplinary boundaries. In this essay we propose a novel guiding framework for bringing colleagues together to advance knowledge and its integration across disciplines, the "Five 'C's' of Collaboration: Commitment, Collegiality, Communication, Consensus, and Continuity." This guiding framework for professional network practice is informed by both relevant literature and empirical evidence from community-building experience within the RCN-UBE Advancing Competencies in Experimentation-Biology (ACE-Bio) Network. The framework is presented with practical examples to illustrate how it might be used to enhance collaboration between new and existing participants in the ACE-Bio Network as well as within other interdisciplinary networks.

A qualitative study of medical educators' perspectives on remediation: Adopting a holistic approach to struggling residents.

PubMed

Krzyzaniak, Sara M; Wolf, Stephen J; Byyny, Richard; Barker, Lisa; Kaplan, Bonnie; Wall, Stephen; Guerrasio, Jeannette

2017-09-01

During residency, some trainees require the identification and remediation of deficiencies to achieve the knowledge, skills and attitudes necessary for independent practice. Given the limited published frameworks for remediation, we characterize remediation from the perspective of educators and propose a holistic framework to guide the approach to remediation. We conducted semistructured focus groups to: explore methods for identifying struggling residents; categorize common domains of struggle; describe personal factors that contribute to difficulties; define remediation interventions and understand what constitutes successful completion. Data were analyzed through conventional content analysis. Nineteen physicians across multiple specialties and institutions participated in seven focus groups. Thirteen categories emerged around remediation. Some themes addressed practical components of remediation, while others reflected barriers to the process and the impact of remediation on the resident and program. The themes were used to inform development of a novel holistic framework for remediation. The approach to remediation requires comprehensive identification of individual factors impacting performance. The intervention should not only include a tailored learning plan but also address confounders that impact likelihood of remediation success. Our holistic framework intends to guide educators creating remediation plans to ensure all domains are addressed.

[Women are human: Brief guide on international human rights law for psychiatrists].

PubMed

Sobredo, Laura D

2017-07-01

Violence against women has gained public awareness in Argentina over the last few years. As any other social phenomena, gender violence is present in the work of psychiatrists, especially in the way they approach to clinical practice. International human rights' law enshrines the right of every women to live free from violence and to be treated with dignity and respect. This legal framework might nourish the practice of psychiatrists as a proposal for seeking cultural and social common grounds. The paper tries to get readers attention on the potentiality of this legal framework which ultimately, might in?uence not only everyday life but clinical practice as well.

Research governance: implications for health library and information professionals.

PubMed

Sen, Barbara A

2003-03-01

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

Knowledge, instruction and behavioural change: building a framework for effective eczema education in clinical practice.

PubMed

Thompson, Deryn Lee; Thompson, Murray John

2014-11-01

A discussion on the reasons educational interventions about eczema, by nurses, are successful, with the subsequent development of a theoretical framework to guide nurses to become effective patient educators. Effective child and parent education is the key to successful self-management of eczema. When diagnosed, children and parents should learn to understand the condition through clear explanations, seeing treatment demonstrations and have ongoing support to learn practical skills to control eczema. Dermatology nurses provide these services, but no one has proposed a framework of the concepts underpinning their successful eczema educational interventions. A discussion paper. A literature search of online databases was undertaken utilizing terms 'eczema OR atopic dermatitis', 'education', 'parent', 'nurs*', 'framework', 'knowledge', motivation', in Scopus, CINAHL, Web of Science, Medline and Pubmed. Limits were English language and 2003-2013. The framework can inform discussion on child and parent education, provide a scaffold for future research and guide non-specialist nurses, internationally, in providing consistent patient education about eczema. Founded on an understanding of knowledge, the framework utilizes essential elements of cognitive psychology and social cognitive theory leading to successful self-management of eczema. This framework may prove useful as a basis for future research in child and parent education, globally, in the healthcare community. A framework has been created to help nurses understand the essential elements of the learning processes at the foundation of effective child and parent education. The framework serves to explain the improved outcomes reported in previous nurse-led eczema educational interventions. © 2014 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

Using the Consolidated Framework for Implementation Research (CFIR) to produce actionable findings: a rapid-cycle evaluation approach to improving implementation.

PubMed

Keith, Rosalind E; Crosson, Jesse C; O'Malley, Ann S; Cromp, DeAnn; Taylor, Erin Fries

2017-02-10

Much research does not address the practical needs of stakeholders responsible for introducing health care delivery interventions into organizations working to achieve better outcomes. In this article, we present an approach to using the Consolidated Framework for Implementation Research (CFIR) to guide systematic research that supports rapid-cycle evaluation of the implementation of health care delivery interventions and produces actionable evaluation findings intended to improve implementation in a timely manner. To present our approach, we describe a formative cross-case qualitative investigation of 21 primary care practices participating in the Comprehensive Primary Care (CPC) initiative, a multi-payer supported primary care practice transformation intervention led by the Centers for Medicare and Medicaid Services. Qualitative data include observational field notes and semi-structured interviews with primary care practice leadership, clinicians, and administrative and medical support staff. We use intervention-specific codes, and CFIR constructs to reduce and organize the data to support cross-case analysis of patterns of barriers and facilitators relating to different CPC components. Using the CFIR to guide data collection, coding, analysis, and reporting of findings supported a systematic, comprehensive, and timely understanding of barriers and facilitators to practice transformation. Our approach to using the CFIR produced actionable findings for improving implementation effectiveness during this initiative and for identifying improvements to implementation strategies for future practice transformation efforts. The CFIR is a useful tool for guiding rapid-cycle evaluation of the implementation of practice transformation initiatives. Using the approach described here, we systematically identified where adjustments and refinements to the intervention could be made in the second year of the 4-year intervention. We think the approach we describe has broad application and encourage others to use the CFIR, along with intervention-specific codes, to guide the efficient and rigorous analysis of rich qualitative data. NCT02318108.

PUBLIC AND PATIENT INVOLVEMENT IN HEALTH TECHNOLOGY ASSESSMENT: A FRAMEWORK FOR ACTION.

PubMed

Abelson, Julia; Wagner, Frank; DeJean, Deirdre; Boesveld, Sarah; Gauvin, Franςois-Pierre; Bean, Sally; Axler, Renata; Petersen, Stephen; Baidoobonso, Shamara; Pron, Gaylene; Giacomini, Mita; Lavis, John

2016-01-01

As health technology assessment (HTA) organizations in Canada and around the world seek to involve the public and patients in their activities, frameworks to guide decisions about whom to involve, through which mechanisms, and at what stages of the HTA process have been lacking. The aim of this study was to describe the development and outputs of a comprehensive framework for involving the public and patients in a government agency's HTA process. The framework was informed by a synthesis of international practice and published literature, a dialogue with local, national and international stakeholders, and the deliberations of a government agency's public engagement subcommittee in Ontario, Canada. The practice and literature synthesis failed to identify a single, optimal approach to involving the public and patients in HTA. Choice of methods should be considered in the context of each HTA stage, goals for incorporating societal and/or patient perspectives into the process, and relevant societal and/or patient values at stake. The resulting framework is structured around four actionable elements: (i) guiding principles and goals for public and patient involvement (PPI) in HTA, (ii) the establishment of a common language to support PPI efforts, (iii) a flexible array of PPI approaches, and (iv) on-going evaluation of PPI to inform adjustments over time. A public and patient involvement framework has been developed for implementation in a government agency's HTA process. Core elements of this framework may apply to other organizations responsible for HTA and health system quality improvement.

Framework for continuous palliative sedation therapy in Canada.

PubMed

Dean, Mervyn M; Cellarius, Victor; Henry, Blair; Oneschuk, Doreen; Librach Canadian Society Of Palliative Care Physicians Taskforce, S Lawrence

2012-08-01

Canada does not have a standardized ethical and practice framework for continuous palliative sedation therapy (CPST). Although a number of institutional and regional guidelines exist, Canadian practice varies. Given the lack of international and national consensus on CPST, the Canadian Society for Palliative Care Physicians (CSPCP) formed a special task force to develop a consensus-based framework for CPST. Through a preliminary review of sedation practices nationally and internationally, it was determined that although considerable consensus was emerging on this topic, there remained both areas of contention and a lack of credible scientific evidence to support a definitive clinical practice guideline. This led to the creation of a framework to help guide policy, practice, and research. This framework was developed through the following steps: 1) literature review; 2) identification of issues; 3) preparation of a draft framework; 4) expert consultation and revision; 5) presentation at conferences and further revision; and 6) further revision and national consensus building. A thorough literature review, including gray literature, of sedation therapy at the end of life was conducted from which an initial framework was drafted. This document was reviewed by 30 multidisciplinary experts in Canada and internationally, revised several times, and then submitted to CSPCP members for review. Consensus was high on most parts of the framework. The framework for CPST will provide a basis for the development of safe, effective, and ethical use of CPST for patients in palliative care and at the end of life.

Pre-Service Elementary Teachers' Experience in a Community of Practice through a Place-Based Inquiry

ERIC Educational Resources Information Center

Cook, Kristin; Buck, Gayle

2014-01-01

With this case study, we explored efforts to connect pre-service elementary teachers (PSTs) and campus scientists through place-based inquiry instruction. Using the framework of Community of Practice (CoP), the research question guiding this study was: what features of our place-based inquiry course intervention (involving PSTs and scientists)…

Using Interactions among In-Service Music Teachers in a Graduate Programme for Teacher Support

ERIC Educational Resources Information Center

Shin, Jihae

2018-01-01

The purpose of this study was to examine interactions among in-service music teachers in a graduate music teacher education programme using Wenger, McDermott, and Snyder's [2002. "Cultivating Communities of Practice: A Guide to Managing Knowledge." Boston, MA: Harvard Business School Press] Communities of Practice (CoPs) framework. The…

A Community of Narratives: Developing Transracialized Selves through a Community of Practice

ERIC Educational Resources Information Center

Laughter, Judson; Han, Keonghee Tao; King, Donna; Madhuri, Marga; Nayan, Rohany; Williams, Toni

2015-01-01

The story presented here developed from a study group where we found space to explore and analyze ourselves and each other. In recounting our development from a Community of Interest to a Community of Practice (CoP), we first introduce a guiding theoretical framework building on a foundation of two concepts: "CoP" and…

Transforming State-of-the-Art into Best Practice: A Guide for High-Performance Energy Efficient Buildings in India

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

Singh, Reshma; Ravache, Baptiste; Sartor, Dale

India launched the Energy Conservation Building Code (ECBC) in 2007, and a revised version in 2017 as ambitious first steps towards promoting energy efficiency in the building sector. Pioneering early adopters—building owners, A&E firms, and energy consultants—have taken the lead to design customized solutions for their energy-efficient buildings. This Guide offers a synthesizing framework, critical lessons, and guidance to meet and exceed ECBC. Its whole-building lifecycle assurance framework provides a user-friendly methodology to achieve high performance in terms of energy, environmental, and societal impact. Class A offices are selected as a target typology, being a high-growth sector, with significant opportunitiesmore » for energy savings. The practices may be extrapolated to other commercial building sectors, as well as extended to other regions with similar cultural, climatic, construction, and developmental contexts« less

Illustrating anticipatory life cycle assessment for emerging photovoltaic technologies.

PubMed

Wender, Ben A; Foley, Rider W; Prado-Lopez, Valentina; Ravikumar, Dwarakanath; Eisenberg, Daniel A; Hottle, Troy A; Sadowski, Jathan; Flanagan, William P; Fisher, Angela; Laurin, Lise; Bates, Matthew E; Linkov, Igor; Seager, Thomas P; Fraser, Matthew P; Guston, David H

2014-09-16

Current research policy and strategy documents recommend applying life cycle assessment (LCA) early in research and development (R&D) to guide emerging technologies toward decreased environmental burden. However, existing LCA practices are ill-suited to support these recommendations. Barriers related to data availability, rapid technology change, and isolation of environmental from technical research inhibit application of LCA to developing technologies. Overcoming these challenges requires methodological advances that help identify environmental opportunities prior to large R&D investments. Such an anticipatory approach to LCA requires synthesis of social, environmental, and technical knowledge beyond the capabilities of current practices. This paper introduces a novel framework for anticipatory LCA that incorporates technology forecasting, risk research, social engagement, and comparative impact assessment, then applies this framework to photovoltaic (PV) technologies. These examples illustrate the potential for anticipatory LCA to prioritize research questions and help guide environmentally responsible innovation of emerging technologies.

What roles do middle managers play in implementation of innovative practices?

PubMed Central

Engle, Ryann L.; Lopez, Emily R.; Gormley, Katelyn E.; Chan, Jeffrey A.; Charns, Martin P.; Lukas, Carol VanDeusen

2017-01-01

Background: Middle managers play key roles in hospitals as the bridge between senior leaders and frontline staff. Yet relatively little research has focused on their role in implementing new practices. Purpose: The aim of this study was to expand the understanding of middle managers’ influence in organizations by looking at their activities through the lens of two complementary conceptual frameworks. Methodology/Approach: We analyzed qualitative data from 17 Veterans Affairs Medical Centers with high and low potential to change organizational practices. We analyzed 98 interviews with staff ranging from senior leaders to frontline staff to identify themes within an a priori framework reflecting middle manager activities. Findings: Analyses yielded 14 emergent themes that allowed us to classify specific expressions of middle manager commitment to implementation of innovative practices (e.g., facilitate improvement innovation, garner staff buy-in). In comparing middle manager behaviors in high and low change potential sites, we found that most emergent themes were present in both groups. However, the activities and interactions described differed between the groups. Practice Implications: Middle managers can use the promising strategies identified by our analyses to guide and improve their effectiveness in implementing new practices. These strategies can also inform senior leaders striving to guide middle managers in those efforts. PMID:26488239

The social worker as moral citizen: ethics in action.

PubMed

Manning, S S

1997-05-01

Social workers today face some of the most complex ethical dilemmas in the history of the profession. This article presents a framework of moral citizenship to guide ethical social work practice. The framework includes the action philosophies of philosopher Hannah Arendt and Lutheran theologian Paul Tillich integrated with concepts of professional responsibility and the unique contributions of social work pioneer Charlotte Towle. Social conscience and social consciousness, including awareness, thinking, feeling, and action, are major components of the framework.

Building America Top Innovations 2012: Building Science-Based Climate Maps

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

none,

2013-01-01

This Building America Top Innovations profile describes the Building America-developed climate zone map, which serves as a consistent framework for energy-efficiency requirements in the national model energy code starting with the 2004 IECC Supplement and the ASHRAE 90.1 2004 edition. The map also provides a critical foundation for climate-specific guidance in the widely disseminated EEBA Builder Guides and Building America Best Practice Guides.

Adverse outcome pathway (AOP) development: Guiding principles and best practices

EPA Science Inventory

Adverse outcome pathways (AOPs) represent a conceptual framework that can support greater application of mechanistic data in regulatory decision-making. However, in order for the scientific community to collectively address the daunting challenge of describing relevant toxicologi...

A framework for guiding sustainability assessment and on-farm strategic decision making

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

Coteur, Ine, E-mail: ine.coteur@ilvo.vlaanderen.be; Marchand, Fleur; University of Antwerp, Ecosystem Management Research Group and IMDO, Universiteitsplein 1, 2610 Wilrijk

Responding to future challenges and societal needs, various actions are taken in agriculture to evolve towards more sustainable farming practices. These actions imply strategic choices and suppose adequate sustainability assessments to identify, measure, evaluate and communicate sustainable development. However, literature is scarce on the link between strategic decision making and sustainability assessment. As questions emerge on how, what and when to measure, the objective of this paper is to construct a framework for guiding sustainability assessment and on-farm strategic decision making. Qualitative research on own experiences from the past and a recent project revealed four categories of actual needs farmers,more » advisors and experts have regarding sustainability assessment: context, flexibility, focus on farm and farmer and communication. These stakeholders' needs are then incorporated into a two-dimensional framework that marries the intrinsic complexity of sustainability assessment tools and the time frame of strategic decision making. The framework allows a farm-specific and flexible approach leading to harmonized actions towards sustainable farming. As this framework is mainly a procedural instrument to guide the use of sustainability assessment tools within strategic decision making, it fits to incorporate, even guide, future research on sustainability assessment tools themselves and on their adoption on farms. - Highlights: • How to link sustainability assessment and on-farm strategic decision making is unclear. • Two-dimensional framework incorporating stakeholders' needs regarding sustainability assessment • Linking complexity of sustainability assessment tools and the time frame of strategic decision making • Farm-specific and flexible approach to harmonize action towards sustainable farming.« less

Argumentation, critical thinking, nature of science and socioscientific issues: a dialogue between two researchers

NASA Astrophysics Data System (ADS)

Yacoubian, Hagop A.; Khishfe, Rola

2018-05-01

The purpose of this paper is to compare and contrast between two theoretical frameworks for addressing nature of science (NOS) and socioscientific issues (SSI) in school science. These frameworks are critical thinking (CT) and argumentation (AR). For the past years, the first and second authors of this paper have pursued research in this area using CT and AR as theoretical frameworks, respectively. Yacoubian argues that future citizens need to develop a critical mindset as they are guided to (1) practice making judgments on what views of NOS to acquire and (2) practice making decisions on SSI through applying their NOS understandings. Khishfe asserts that AR is an important component of decision making when dealing with SSI and the practice in AR in relation to controversial issues is needed for informed decision making. She argues that AR as a framework may assist in the development of more informed understandings of NOS. In this paper, the authors delve into a dialogue for (1) elucidating strengths and potential of each framework, (2) highlighting challenges that they face in their research using the frameworks in question, (3) exploring the extent to which the frameworks can overlap, and (4) proposing directions for future research.

Preclinical Feasibility of a Technology Framework for MRI-guided Iliac Angioplasty

PubMed Central

Rube, Martin A.; Fernandez-Gutierrez, Fabiola; Cox, Benjamin F.; Holbrook, Andrew B.; Houston, J. Graeme; White, Richard D.; McLeod, Helen; Fatahi, Mahsa; Melzer, Andreas

2015-01-01

Purpose Interventional MRI has significant potential for image guidance of iliac angioplasty and related vascular procedures. A technology framework with in-room image display, control, communication and MRI-guided intervention techniques was designed and tested for its potential to provide safe, fast and efficient MRI-guided angioplasty of the iliac arteries. Methods A 1.5T MRI scanner was adapted for interactive imaging during endovascular procedures using new or modified interventional devices such as guidewires and catheters. A perfused vascular phantom was used for testing. Pre-, intra- and post-procedural visualization and measurement of vascular morphology and flow was implemented. A detailed analysis of X-Ray fluoroscopic angiography workflow was conducted and applied. Two interventional radiologists and one physician in training performed 39 procedures. All procedures were timed and analyzed. Results MRI-guided iliac angioplasty procedures were successfully performed with progressive adaptation of techniques and workflow. The workflow, setup and protocol enabled a reduction in table time for a dedicated MRI-guided procedure to 6 min 33 s with a mean procedure time of 9 min 2 s, comparable to the mean procedure time of 8 min 42 s for the standard X-Ray guided procedure. Conclusions MRI-guided iliac vascular interventions were found to be feasible and practical using this framework and optimized workflow. In particular the real-time flow analysis was found to be helpful for pre- and post-interventional assessments. Design optimization of the catheters and in vivo experiments are required before clinical evaluation. PMID:25102933

Framework for Evaluating the Impact of Advanced Practice Nursing Roles.

PubMed

Bryant-Lukosius, Denise; Spichiger, Elisabeth; Martin, Jacqueline; Stoll, Hansruedi; Kellerhals, Sabine Degen; Fliedner, Monica; Grossmann, Florian; Henry, Morag; Herrmann, Luzia; Koller, Antje; Schwendimann, René; Ulrich, Anja; Weibel, Lukas; Callens, Betty; De Geest, Sabina

2016-03-01

To address the gap in evidence-based information required to support the development of advanced practice nursing (APN) roles in Switzerland, stakeholders identified the need for guidance to generate strategic evaluation data. This article describes an evaluation framework developed to inform decisions about the effective utilization of APN roles across the country. A participatory approach was used by an international group of stakeholders. Published literature and an evidenced-based framework for introducing APN roles were analyzed and applied to define the purpose, target audiences, and essential elements of the evaluation framework. Through subsequent meetings and review by an expert panel, the framework was developed and refined. A framework to evaluate different types of APN roles as they evolve to meet dynamic population health, practice setting, and health system needs was created. It includes a matrix of key concepts to guide evaluations across three stages of APN role development: introduction, implementation, and long-term sustainability. For each stage, evaluation objectives and questions examining APN role structures, processes, and outcomes from different perspectives (e.g., patients, providers, managers, policy-makers) were identified. A practical, robust framework based on well-established evaluation concepts and current understanding of APN roles can be used to conduct systematic evaluations. The evaluation framework is sufficiently generic to allow application in developed countries globally, both for evaluation as well as research purposes. © 2016 Sigma Theta Tau International.

Applying systems thinking to inform studies of wildlife trade in primates.

PubMed

Blair, Mary E; Le, Minh D; Thạch, Hoàng M; Panariello, Anna; Vũ, Ngọc B; Birchette, Mark G; Sethi, Gautam; Sterling, Eleanor J

2017-11-01

Wildlife trade presents a major threat to primate populations, which are in demand from local to international scales for a variety of uses from food and traditional medicine to the exotic pet trade. We argue that an interdisciplinary framework to facilitate integration of socioeconomic, anthropological, and biological data across multiple spatial and temporal scales is essential to guide the study of wildlife trade dynamics and its impacts on primate populations. Here, we present a new way to design research on wildlife trade in primates using a systems thinking framework. We discuss how we constructed our framework, which follows a social-ecological system framework, to design an ongoing study of local, regional, and international slow loris (Nycticebus spp.) trade in Vietnam. We outline the process of iterative variable exploration and selection via this framework to inform study design. Our framework, guided by systems thinking, enables recognition of complexity in study design, from which the results can inform more holistic, site-appropriate, and effective trade management practices. We place our framework in the context of other approaches to studying wildlife trade and discuss options to address foreseeable challenges to implementing this new framework. © 2017 Wiley Periodicals, Inc.

Using developmental evaluation as a system of organizational learning: An example from San Francisco.

PubMed

Shea, Jennifer; Taylor, Tory

2017-12-01

In the last 20 years, developmental evaluation has emerged as a promising approach to support organizational learning in emergent social programs. Through a continuous system of inquiry, reflection, and application of knowledge, developmental evaluation serves as a system of tools, methods, and guiding principles intended to support constructive organizational learning. However, missing from the developmental evaluation literature is a nuanced framework to guide evaluators in how to elevate the organizational practices and concepts most relevant for emergent programs. In this article, we describe and reflect on work we did to develop, pilot, and refine an integrated pilot framework. Drawing on established developmental evaluation inquiry frameworks and incorporating lessons learned from applying the pilot framework, we put forward the Evaluation-led Learning framework to help fill that gap and encourage others to implement and refine it. We posit that without explicitly incorporating the assessments at the foundation of the Evaluation-led Learning framework, developmental evaluation's ability to affect organizational learning in productive ways will likely be haphazard and limited. Copyright © 2017 Elsevier Ltd. All rights reserved.

Building health behavior models to guide the development of just-in-time adaptive interventions: A pragmatic framework

PubMed Central

Nahum-Shani, Inbal; Hekler, Eric B.; Spruijt-Metz, Donna

2016-01-01

Advances in wireless devices and mobile technology offer many opportunities for delivering just-in-time adaptive interventions (JITAIs)--suites of interventions that adapt over time to an individual’s changing status and circumstances with the goal to address the individual’s need for support, whenever this need arises. A major challenge confronting behavioral scientists aiming to develop a JITAI concerns the selection and integration of existing empirical, theoretical and practical evidence into a scientific model that can inform the construction of a JITAI and help identify scientific gaps. The purpose of this paper is to establish a pragmatic framework that can be used to organize existing evidence into a useful model for JITAI construction. This framework involves clarifying the conceptual purpose of a JITAI, namely the provision of just-in-time support via adaptation, as well as describing the components of a JITAI and articulating a list of concrete questions to guide the establishment of a useful model for JITAI construction. The proposed framework includes an organizing scheme for translating the relatively static scientific models underlying many health behavior interventions into a more dynamic model that better incorporates the element of time. This framework will help to guide the next generation of empirical work to support the creation of effective JITAIs. PMID:26651462

Person-centered nursing practice with older people in Ireland.

PubMed

Landers, Margaret G; McCarthy, Geraldine M

2007-01-01

This column presents an analysis of McCormack's conceptual framework for person-centered practice with older people as a theoretical basis for the delivery of care of older adults in an Irish context. The evaluative process is guided by the framework proposed by Fawcett (2000) for the analysis and evaluation of conceptual models of nursing. The historical evolution, philosophical claims, and an overview of the content of the model are addressed. The following criteria are then applied: logical congruence, the generation of the theory, the credibility of the model, and the contribution of the model to the discipline of nursing.

Viewing equitable practices through the lens of intersecting identities

NASA Astrophysics Data System (ADS)

Lyons, Renée; Dsouza, Nikeetha; Quigley, Cassie

2016-12-01

This review explores Archer, Dawson, Seakins, and Wong's "Disorienting, fun or meaningful? Disadvantaged families' experiences of a science museum visit" by examining the analytic frameworks guiding this study. To expand on Archer et al.'s use of feminist post-structuralist theories of identity we draw from the theory of intersectionality to provide a more robust framework for analyzing barriers to engagement within an informal learning space. Our response to this work ends by exploring the types of solutions generated from an intersectionality framework—solutions aimed at transforming institutional programs and practices to create more equitable spaces for learning.

Self-determination theory: a framework for clubhouse psychosocial rehabilitation research.

PubMed

Raeburn, Toby; Schmied, Virginia; Hungerford, Catherine; Cleary, Michelle

2015-02-01

The Clubhouse model is a widely used approach to psychosocial rehabilitation that has been a pioneer in supporting recovery-oriented programmes. Little consideration has been given however, to the theories that guide research of the recovery practices used by Clubhouses. In this paper, we provide a description of self-determination theory, including its philosophical background followed by explanation of its relevance to health care and Clubhouse contexts. We argue that self-determination theory provides a robust social constructionist theoretical framework that is well-suited to informing research related to psychosocial rehabilitation, recovery-oriented practices and the Clubhouse model.

Achieving Consensus on Principles of Good Practice for School Health in Independent Schools: A Delphi Study

ERIC Educational Resources Information Center

Marshall, Miguel G.; Allegrante, John P.

2017-01-01

Background: Although the 8 components of the coordinated school health (CSH) framework have been implemented to various degrees in the nation's public schools, principles of good practice (PGPs) to guide health promotion efforts in independent schools do not exist. The purpose of this study was to generate PGPs and rate their feasibility of…

The Process of Making Meaning: The Interplay between Teachers' Knowledge of Mathematical Proofs and Their Classroom Practices

ERIC Educational Resources Information Center

Paddack, Megan

2009-01-01

The purpose of this study was to investigate and describe how middle school mathematics teachers "make meaning" of proofs and the process of proving in the context of their classroom practices. A framework of "making meaning," created by the researcher, guided the data collection and analysis phases of the study. This framework…

Transforming a Fourth Year Modern Optics Course Using a Deliberate Practice Framework

ERIC Educational Resources Information Center

Jones, David J.; Madison, Kirk W.; Wieman, Carl E.

2015-01-01

We present a study of active learning pedagogies in an upper-division physics course. This work was guided by the principle of deliberate practice for the development of expertise, and this principle was used in the design of the materials and the orchestration of the classroom activities of the students. We present our process for efficiently…

Staff Development of Direct Care Workers in Pennsylvania: The Relationship between Organizational Structure and Culture and Best-Practices in Training

ERIC Educational Resources Information Center

Kemeny, M. Elizabeth

2010-01-01

Using the conceptual model of social structure and personality framework (House, 1981) as a theoretical guide, this cross sectional mixed-method design examined how organizational structure and culture relate to practices for training direct care workers in 328 aging and disability network service provider organizations in Pennsylvania. To…

Achieving the "triple aim" for inborn errors of metabolism: a review of challenges to outcomes research and presentation of a new practice-based evidence framework.

PubMed

Potter, Beth K; Chakraborty, Pranesh; Kronick, Jonathan B; Wilson, Kumanan; Coyle, Doug; Feigenbaum, Annette; Geraghty, Michael T; Karaceper, Maria D; Little, Julian; Mhanni, Aizeddin; Mitchell, John J; Siriwardena, Komudi; Wilson, Brenda J; Syrowatka, Ania

2013-06-01

Across all areas of health care, decision makers are in pursuit of what Berwick and colleagues have called the "triple aim": improving patient experiences with care, improving health outcomes, and managing health system impacts. This is challenging in a rare disease context, as exemplified by inborn errors of metabolism. There is a need for evaluative outcomes research to support effective and appropriate care for inborn errors of metabolism. We suggest that such research should consider interventions at both the level of the health system (e.g., early detection through newborn screening, programs to provide access to treatments) and the level of individual patient care (e.g., orphan drugs, medical foods). We have developed a practice-based evidence framework to guide outcomes research for inborn errors of metabolism. Focusing on outcomes across the triple aim, this framework integrates three priority themes: tailoring care in the context of clinical heterogeneity; a shift from "urgent care" to "opportunity for improvement"; and the need to evaluate the comparative effectiveness of emerging and established therapies. Guided by the framework, a new Canadian research network has been established to generate knowledge that will inform the design and delivery of health services for patients with inborn errors of metabolism and other rare diseases.

A Decision-Making Framework for Cleanup of Sites Impacted with Light Non-Aqueous Phase Liquids (LNAPL)

EPA Pesticide Factsheets

This document has been prepared by the Remediation Technologies Development Forum (RTDF) NAPL Cleanup Alliance to provide a guide to practicable and reasonable approaches for management of LNAPL petroleum hydrocarbons in the subsurface.

Exploring the potential of a capability framework as a vision and "sensemaking" tool for leaders of interprofessional education.

PubMed

Brewer, Margo

2016-09-01

Creating a vision (visioning) and sensemaking have been described as key leadership practices in the leadership literature. A vision provides clarity, motivation, and direction for staff, and is essential particularly in times of significant change. Closely related to visioning is sensemaking (the organisation of stimuli into a framework allowing people to understand, explain, attribute, extrapolate, and predict). The application of these strategies to leadership within the interprofessional field is yet to be scrutinised. This study examines an interprofessional capability framework as a visioning and sensemaking tool for use by leaders within a university health science curriculum. Interviews with 11 faculty members revealed that the framework had been embedded across multiple years and contexts within the curriculum. Furthermore, a range of responses to the framework were evoked in relation to its use to make sense of interprofessional practice and to provide a vision, guide, and focus for faculty. Overall the findings indicate that the framework can function as both a visioning and sensemaking tool.

The ontology model of FrontCRM framework

NASA Astrophysics Data System (ADS)

Budiardjo, Eko K.; Perdana, Wira; Franshisca, Felicia

2013-03-01

Adoption and implementation of Customer Relationship Management (CRM) is not merely a technological installation, but the emphasis is more on the application of customer-centric philosophy and culture as a whole. CRM must begin at the level of business strategy, the only level that thorough organizational changes are possible to be done. Changes agenda can be directed to each departmental plans, and supported by information technology. Work processes related to CRM concept include marketing, sales, and services. FrontCRM is developed as framework to guide in identifying business processes related to CRM in which based on the concept of strategic planning approach. This leads to processes and practices identification in every process area related to marketing, sales, and services. The Ontology model presented on this paper by means serves as tools to avoid framework misunderstanding, to define practices systematically within process area and to find CRM software features related to those practices.

The Accountability-Well-Being-Ethics framework: a new philosophical foundation for occupational therapy.

PubMed

Taff, Steven D; Bakhshi, Parul; Babulal, Ganesh M

2014-12-01

The context that supported occupational therapy's inception has been replaced with new challenges brought on by globalization and dramatic changes in health care. Thus, the profession's philosophical grounding needs to be reframed to (a) achieve balance between science-driven and holistic elements, (b) operate within larger contexts on problems brought on by sociopolitical and natural determinants of health, and (c) maintain an ethical identity across all arenas of practice. This paper presents a brief discussion of the philosophical underpinnings in occupational therapy's history, outlines new global challenges for the profession, and proposes a new framework to address these challenges through education, practice, and research. Occupational therapy finds itself practising in a growing number of middle- and low-income countries where its roles and values need to be context and culture specific. The Accountability-Well-Being-Ethics framework guides the three domains of education, research, and practice to be relevant in an increasingly complex world.

Building blocks for social accountability: a conceptual framework to guide medical schools.

PubMed

Preston, Robyn; Larkins, Sarah; Taylor, Judy; Judd, Jenni

2016-08-26

This paper presents a conceptual framework developed from empirical evidence, to guide medical schools aspiring towards greater social accountability. Using a multiple case study approach, seventy-five staff, students, health sector representatives and community members, associated with four medical schools, participated in semi-structured interviews. Two schools were in Australia and two were in the Philippines. These schools were selected because they were aspiring to be socially accountable. Data was collected through on-site visits, field notes and a documentary review. Abductive analysis involved both deductive and inductive iterative theming of the data both within and across cases. The conceptual framework for socially accountable medical education was built from analyzing the internal and external factors influencing the selected medical schools. These factors became the building blocks that might be necessary to assist movement to social accountability. The strongest factor was the demands of the local workforce situation leading to innovative educational programs established with or without government support. The values and professional experiences of leaders, staff and health sector representatives, influenced whether the organizational culture of a school was conducive to social accountability. The wider institutional environment and policies of their universities affected this culture and the resourcing of programs. Membership of a coalition of socially accountable medical schools created a community of learning and legitimized local practice. Communities may not have recognized their own importance but they were fundamental for socially accountable practices. The bedrock of social accountability, that is, the foundation for all building blocks, is shared values and aspirations congruent with social accountability. These values and aspirations are both a philosophical understanding for innovation and a practical application at the health systems and education levels. While many of these building blocks are similar to those conceptualized in social accountability theory, this conceptual framework is informed by what happens in practice - empirical evidence rather than prescriptions. Consequently it is valuable in that it puts some theoretical thinking around everyday practice in specific contexts; addressing a gap in the medical education literature. The building blocks framework includes guidelines for social accountable practice that can be applied at policy, school and individual levels.

Evidence-Based Evaluation of Practice and Innovation in Physical Therapy Using the IDEAL-Physio Framework.

PubMed

Beard, David; Hamilton, David; Davies, Loretta; Cook, Jonathan; Hirst, Allison; McCulloch, Peter; Paez, Arsenio

2018-02-01

The IDEAL framework is an established method for initial and ongoing evaluations of innovation and practice for complex health care interventions. First derived for surgical sciences and embedded at a global level for evaluating surgery/surgical devices, the IDEAL framework is based on the principle that innovation and evaluation in clinical practice can, and should, evolve together in an ordered manner: from conception to development and then to validation by appropriate clinical studies and, finally, longer-term follow-up. This framework is highly suited to other complex, nonpharmacological interventions, such as physical therapist interventions. This perspective outlines the application of IDEAL to physical therapy in the new IDEAL-Physio framework. The IDEAL-Physio framework comprises 5 stages. In stage 1, the idea phase, formal data collection should begin. Stage 2a is the phase for iterative improvement and adjustment with thorough data recording. Stage 2b involves the onset of formal evaluation using systematically collected group or cohort data. Stage 3 is the phase for formal comparative assessment of treatment, usually involving randomized studies. Stage 4 involves long-term follow-up. The IDEAL-Physio framework is recommended as a method for guiding and evaluating both innovation and practice in physical therapy, with the overall goal of providing better evidence-based care. © 2017 American Physical Therapy Association.

Theoretical Frameworks to Guide School Improvement

ERIC Educational Resources Information Center

Evans, Lisa; Thornton, Bill; Usinger, Janet

2012-01-01

A firm grounding in change theory can provide educational leaders with an opportunity to orchestrate meaningful organizational improvements. This article provides an opportunity for practicing leaders to review four major theories of organizational change--continuous improvement, two approaches to organizational learning, and appreciative inquiry.…

Spirituality and Comprehensive School Counseling Programs

ERIC Educational Resources Information Center

Sink, Christopher A.

2004-01-01

Comprehensive school counseling programs (CSCPs) have evolved into well-articulated organizational frameworks that will successfully guide school counseling practice for years to come (American School Counselor Association [ASCA], 2003; Gysbers & Henderson, 2000, 2005). At their heart, CSCPs emphasize that as society and families continue to…

Knowledge, instruction and behavioural change: building a framework for effective eczema education in clinical practice

PubMed Central

Thompson, Deryn Lee; Thompson, Murray John

2014-01-01

Aims A discussion on the reasons educational interventions about eczema, by nurses, are successful, with the subsequent development of a theoretical framework to guide nurses to become effective patient educators. Background Effective child and parent education is the key to successful self-management of eczema. When diagnosed, children and parents should learn to understand the condition through clear explanations, seeing treatment demonstrations and have ongoing support to learn practical skills to control eczema. Dermatology nurses provide these services, but no one has proposed a framework of the concepts underpinning their successful eczema educational interventions. Design A discussion paper. Data Sources A literature search of online databases was undertaken utilizing terms ‘eczema OR atopic dermatitis’, ‘education’, ‘parent’, ‘nurs*’, ‘framework’, ‘knowledge’, motivation’, in Scopus, CINAHL, Web of Science, Medline and Pubmed. Limits were English language and 2003–2013. Implications for Nursing The framework can inform discussion on child and parent education, provide a scaffold for future research and guide non-specialist nurses, internationally, in providing consistent patient education about eczema. Conclusion Founded on an understanding of knowledge, the framework utilizes essential elements of cognitive psychology and social cognitive theory leading to successful self-management of eczema. This framework may prove useful as a basis for future research in child and parent education, globally, in the healthcare community. A framework has been created to help nurses understand the essential elements of the learning processes at the foundation of effective child and parent education. The framework serves to explain the improved outcomes reported in previous nurse-led eczema educational interventions. PMID:25312442

From Pixel on a Screen to Real Person in Your Students' Lives: Establishing Social Presence Using Digital Storytelling

ERIC Educational Resources Information Center

Lowenthal, Patrick R.; Dunlap, Joanna C.

2010-01-01

The Community of Inquiry (CoI) framework is a comprehensive guide to the research "and" practice of online learning. One of the most challenging aspects of establishing a CoI in online courses is finding the best way to attend to each element of the CoI framework in a primarily text-based environment. In our online courses, we have examined the…

A Conceptual Framework for Graduate Teaching Assistant Professional Development Evaluation and Research

PubMed Central

Reeves, Todd D.; Marbach-Ad, Gili; Miller, Kristen R.; Ridgway, Judith; Gardner, Grant E.; Schussler, Elisabeth E.; Wischusen, E. William

2016-01-01

Biology graduate teaching assistants (GTAs) are significant contributors to the educational mission of universities, particularly in introductory courses, yet there is a lack of empirical data on how to best prepare them for their teaching roles. This essay proposes a conceptual framework for biology GTA teaching professional development (TPD) program evaluation and research with three overarching variable categories for consideration: outcome variables, contextual variables, and moderating variables. The framework’s outcome variables go beyond GTA satisfaction and instead position GTA cognition, GTA teaching practice, and undergraduate learning outcomes as the foci of GTA TPD evaluation and research. For each GTA TPD outcome variable, key evaluation questions and example assessment instruments are introduced to demonstrate how the framework can be used to guide GTA TPD evaluation and research plans. A common conceptual framework is also essential to coordinating the collection and synthesis of empirical data on GTA TPD nationally. Thus, the proposed conceptual framework serves as both a guide for conducting GTA TPD evaluation at single institutions and as a means to coordinate research across institutions at a national level. PMID:27193291

The Consolidated Framework for Implementation Research (CFIR): a useful theoretical framework for guiding and evaluating a guideline implementation process in a hospital-based nursing practice.

PubMed

Breimaier, Helga E; Heckemann, Birgit; Halfens, Ruud J G; Lohrmann, Christa

2015-01-01

Implementing clinical practice guidelines (CPGs) in healthcare settings is a complex intervention involving both independent and interdependent components. Although the Consolidated Framework for Implementation Research (CFIR) has never been evaluated in a practical context, it appeared to be a suitable theoretical framework to guide an implementation process. The aim of this study was to evaluate the comprehensiveness, applicability and usefulness of the CFIR in the implementation of a fall-prevention CPG in nursing practice to improve patient care in an Austrian university teaching hospital setting. The evaluation of the CFIR was based on (1) team-meeting minutes, (2) the main investigator's research diary, containing a record of a before-and-after, mixed-methods study design embedded in a participatory action research (PAR) approach for guideline implementation, and (3) an analysis of qualitative and quantitative data collected from graduate and assistant nurses in two Austrian university teaching hospital departments. The CFIR was used to organise data per and across time point(s) and assess their influence on the implementation process, resulting in implementation and service outcomes. Overall, the CFIR could be demonstrated to be a comprehensive framework for the implementation of a guideline into a hospital-based nursing practice. However, the CFIR did not account for some crucial factors during the planning phase of an implementation process, such as consideration of stakeholder aims and wishes/needs when implementing an innovation, pre-established measures related to the intended innovation and pre-established strategies for implementing an innovation. For the CFIR constructs reflecting & evaluating and engaging, a more specific definition is recommended. The framework and its supplements could easily be used by researchers, and their scope was appropriate for the complexity of a prospective CPG-implementation project. The CFIR facilitated qualitative data analysis and provided a structure that allowed project results to be organised and viewed in a broader context to explain the main findings. The CFIR was a valuable and helpful framework for (1) the assessment of the baseline, process and final state of the implementation process and influential factors, (2) the content analysis of qualitative data collected throughout the implementation process, and (3) explaining the main findings.

A unifying framework for systems modeling, control systems design, and system operation

NASA Technical Reports Server (NTRS)

Dvorak, Daniel L.; Indictor, Mark B.; Ingham, Michel D.; Rasmussen, Robert D.; Stringfellow, Margaret V.

2005-01-01

Current engineering practice in the analysis and design of large-scale multi-disciplinary control systems is typified by some form of decomposition- whether functional or physical or discipline-based-that enables multiple teams to work in parallel and in relative isolation. Too often, the resulting system after integration is an awkward marriage of different control and data mechanisms with poor end-to-end accountability. System of systems engineering, which faces this problem on a large scale, cries out for a unifying framework to guide analysis, design, and operation. This paper describes such a framework based on a state-, model-, and goal-based architecture for semi-autonomous control systems that guides analysis and modeling, shapes control system software design, and directly specifies operational intent. This paper illustrates the key concepts in the context of a large-scale, concurrent, globally distributed system of systems: NASA's proposed Array-based Deep Space Network.

Race, Power, and Language Criticism: The Case of Hawai'i

ERIC Educational Resources Information Center

Marlow, Mikaela Loyola

2009-01-01

Ethnolinguistic vitality, communication accommodation, and markedness model frameworks guided research assessing language ideologies, practices, and criticism among multi-ethnic Locals in the Hawaiian Islands. Results from Study 1 indicated that respondents draw from widespread ideologies that influence them to employ Standard English in…

Optimizing participation of children with autism spectrum disorder experiencing sensory challenges: a clinical reasoning framework.

PubMed

Ashburner, Jill K; Rodger, Sylvia A; Ziviani, Jenny M; Hinder, Elizabeth A

2014-02-01

Remedial sensory interventions currently lack supportive evidence and can be challenging to implement for families and clinicians. It may be timely to shift the focus to optimizing participation of children with autism spectrum disorders (ASD) through accommodation and self-regulation of their sensory differences. A framework to guide practitioners in selecting strategies is proposed based on clinical reasoning considerations, including (a) research evidence, (b) client- and family-centredness, (c) practice contexts, (d) occupation-centredness, and (e) risks. Information-sharing with families and coaching constitute the basis for intervention. Specific strategies are identified where sensory aversions or seeking behaviours, challenges with modulation of arousal, or sensory-related behaviours interfere with participation. Self-regulatory strategies are advocated. The application of universal design principles to shared environments is also recommended. The implications of this framework for future research, education, and practice are discussed. The clinical utility of the framework now needs to be tested.

Development of a framework for quantifying the environmental impacts of urban development and construction practices.

PubMed

Li, Ke; Zhang, Peng; Crittenden, John C; Guhathakurta, Subhrajit; Chen, Yongsheng; Fernando, Harindra; Sawhney, Anil; McCartney, Peter; Grimm, Nancy; Kahhat, Ramzy; Joshi, Himanshu; Konjevod, Goran; Choi, Yu-Jin; Fonseca, Ernesto; Allenby, Braden; Gerrity, Daniel; Torrens, Paul M

2007-07-15

To encourage sustainable development, engineers and scientists need to understand the interactions among social decision-making, development and redevelopment, land, energy and material use, and their environmental impacts. In this study, a framework that connects these interactions was proposed to guide more sustainable urban planning and construction practices. Focusing on the rapidly urbanizing setting of Phoenix, Arizona, complexity models and deterministic models were assembled as a metamodel, which is called Sustainable Futures 2100 and were used to predict land use and development, to quantify construction material demands, to analyze the life cycle environmental impacts, and to simulate future ground-level ozone formation.

Building health behavior models to guide the development of just-in-time adaptive interventions: A pragmatic framework.

PubMed

Nahum-Shani, Inbal; Hekler, Eric B; Spruijt-Metz, Donna

2015-12-01

Advances in wireless devices and mobile technology offer many opportunities for delivering just-in-time adaptive interventions (JITAIs)-suites of interventions that adapt over time to an individual's changing status and circumstances with the goal to address the individual's need for support, whenever this need arises. A major challenge confronting behavioral scientists aiming to develop a JITAI concerns the selection and integration of existing empirical, theoretical and practical evidence into a scientific model that can inform the construction of a JITAI and help identify scientific gaps. The purpose of this paper is to establish a pragmatic framework that can be used to organize existing evidence into a useful model for JITAI construction. This framework involves clarifying the conceptual purpose of a JITAI, namely, the provision of just-in-time support via adaptation, as well as describing the components of a JITAI and articulating a list of concrete questions to guide the establishment of a useful model for JITAI construction. The proposed framework includes an organizing scheme for translating the relatively static scientific models underlying many health behavior interventions into a more dynamic model that better incorporates the element of time. This framework will help to guide the next generation of empirical work to support the creation of effective JITAIs. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

A roadmap for knowledge exchange and mobilization research in conservation and natural resource management.

PubMed

Nguyen, Vivian M; Young, Nathan; Cooke, Steven J

2017-08-01

Scholars across all disciplines have long been interested in how knowledge moves within and beyond their community of peers. Rapid environmental changes and calls for sustainable management practices mean the best knowledge possible is needed to inform decisions, policies, and practices to protect biodiversity and sustainably manage vulnerable natural resources. Although the conservation literature on knowledge exchange (KE) and knowledge mobilization (KM) has grown in recent years, much of it is based on context-specific case studies. This presents a challenge for learning cumulative lessons from KE and KM research and thus effectively using knowledge in conservation and natural resources management. Although continued research on the gap between knowledge and action is valuable, overarching conceptual frameworks are now needed to enable summaries and comparisons across diverse KE-KM research. We propose a knowledge-action framework that provides a conceptual roadmap for future research and practice in KE/KM with the aim of synthesizing lessons learned from contextual case studies and guiding the development and testing of hypotheses in this domain. Our knowledge-action framework has 3 elements that occur at multiple levels and scales: knowledge production (e.g., academia and government), knowledge mediation (e.g., knowledge networks, actors, relational dimension, and contextual dimension), and knowledge-based action (e.g., instrumental, symbolic, and conceptual). The framework integrates concepts from the sociology of science in particular, and serves as a guide to further comprehensive understanding of knowledge exchange and mobilization in conservation and sustainable natural resource management. © 2016 Society for Conservation Biology.

Controlled growth and form of precipitating microsculptures

NASA Astrophysics Data System (ADS)

Kaplan, C. Nadir; Noorduin, Wim L.; Li, Ling; Sadza, Roel; Folkertsma, Laura; Aizenberg, Joanna; Mahadevan, L.

2017-03-01

Controlled self-assembly of three-dimensional shapes holds great potential for fabrication of functional materials. Their practical realization requires a theoretical framework to quantify and guide the dynamic sculpting of the curved structures that often arise in accretive mineralization. Motivated by a variety of bioinspired coprecipitation patterns of carbonate and silica, we develop a geometrical theory for the kinetics of the growth front that leaves behind thin-walled complex structures. Our theory explains the range of previously observed experimental patterns and, in addition, predicts unexplored assembly pathways. This allows us to design a number of functional base shapes of optical microstructures, which we synthesize to demonstrate their light-guiding capabilities. Overall, our framework provides a way to understand and control the growth and form of functional precipitating microsculptures.

A new perspective: a vulnerable population framework to guide research and practice for persons with traumatic brain injury.

PubMed

Bay, Esther; Kreulen, Grace J; Shavers, Clarissa Agee; Currier, Connie

2006-01-01

Recovery from traumatic brain injury (TBI) can be a tumultuous lifelong and expensive process. Guided therapies for community integration within community systems are a focus of treating therapists around the world, yet there are no published discussions concerning the most fitting community context. We propose a theoretical approach for practice and research using Flaskerud and Winslow's conceptual model of vulnerable populations. Using the model constructs of health status, resource availability, and increased relative risk, we offer empirical support for proposed construct relationships applied to persons with traumatic brain injury. We then propose that interventions for health promotion, acute care, and rehabilitation or chronic disease management have a community focus, and we identify relevant goals for community-based practice and research.

The Ottawa Model of Research Use: a guide to clinical innovation in the NICU.

PubMed

Hogan, Debora L; Logan, Jo

2004-01-01

To improve performance of a neonatal transport team by implementing a research-based family assessment instrument. Objectives included providing a structure for evaluating families and fostering the healthcare relationship. Neonatal transports are associated with family crises. Transport teams require a comprehensive framework to accurately assess family responses to adversity and tools to guide their practice toward parental mastery of the event. Currently, there are no assessment tools that merge family nursing expertise with neonatal transport. A family assessment tool grounded in contemporary family nursing theory and research was developed by a clinical nurse specialist. The Ottawa Model of Research Use guided the process of piloting the innovation with members of a transport team. Focus groups, interviews, and surveys were conducted to create profiles of barriers and facilitators to research use by team members. Tailored research transfer strategies were enacted based on the profile results. Formative evaluations demonstrated improvements in team members' perceptions of their knowledge, family centeredness, and ability to assess and intervene with families. The family assessment tool is currently being incorporated into Clinical Practice Guidelines for Transport and thus will be considered standard care. Use of a family assessment tool is an effective way of appraising families and addressing suffering. The Ottawa Model of Research Use provided a framework for implementing the clinical innovation. A key role of the clinical nurse specialist is to influence nursing practice by fostering research use by practitioners. When developing and implementing a clinical innovation, input from end users and consumers is pivotal. Incorporating the innovation into a practice guideline provides a structure to imbed research evidence into practice.

Delegation guided by school nursing values: comprehensive knowledge, trust, and empowerment.

PubMed

Gordon, Shirley C; Barry, Charlotte D

2009-10-01

As health care institutions in the United States respond to shrinking budgets and nursing shortages by increasing the use of unlicensed assistive personnel (UAP), school nursing practice is changing from providing direct care to supervising activities delegated to UAP. Therefore, delegation is a critical area of concern for school nurses. The purpose of this qualitative research study was to explore values guiding the delegation of health care tasks to UAP in school settings from the perspective of the school nurse. An inquiry focus group was conducted with 64 Florida school nurses. Values guiding delegation were comprehensive knowledge, trust, and empowerment. These values provided a framework for guiding the delegation process.

Tools for Reflection: Video-Based Reflection Within a Preservice Community of Practice

NASA Astrophysics Data System (ADS)

Hawkins, Susan; Park Rogers, Meredith

2016-06-01

Current reform in science education calls for teachers to understand student thinking within a lesson to effectively address students' needs (NRC in A framework for K-12 science education: practices, crosscutting concepts, and core ideas. National Academy Press, Washington, DC, 2012; NRC in Guide to implementing the Next Generation Science Standards. The National Academies Press, Washington, DC, 2015). This study investigates how to scaffold preservice teachers with learning to attend to students' thinking for the purpose of guiding curricular decisions. The study focuses on one team teaching a science unit during their early field experience. We sought to understand how participants' thoughts and abilities changed through participation in a moderated community of practice using video of their own teaching as a reflective tool. We examined how these changes affected both their classroom practice and their decision-making for future lessons. Evidence shows growth in participants' ability to identify opportunities to elicit, assess, and use students' thinking to guide instructional decisions. Implications for use of the approach used in this study to begin developing novice teachers' pedagogical content knowledge for teaching science are discussed.

Social research design: framework for integrating philosophical and practical elements.

PubMed

Cunningham, Kathryn Burns

2014-09-01

To provide and elucidate a comprehensible framework for the design of social research. An abundance of information exists concerning the process of designing social research. The overall message that can be gleaned is that numerable elements - both philosophical (ontological and epistemological assumptions and theoretical perspective) and practical (issue to be addressed, purpose, aims and research questions) - are influential in the process of selecting a research methodology and methods, and that these elements and their inter-relationships must be considered and explicated to ensure a coherent research design that enables well-founded and meaningful conclusions. There is a lack of guidance concerning the integration of practical and philosophical elements, hindering their consideration and explication. The author's PhD research into loneliness and cancer. This is a methodology paper. A guiding framework that incorporates all of the philosophical and practical elements influential in social research design is presented. The chronological and informative relationships between the elements are discussed. The framework presented can be used by social researchers to consider and explicate the practical and philosophical elements influential in the selection of a methodology and methods. It is hoped that the framework presented will aid social researchers with the design and the explication of the design of their research, thereby enhancing the credibility of their projects and enabling their research to establish well-founded and meaningful conclusions.

Continuous integration for concurrent MOOSE framework and application development on GitHub

DOE PAGES

Slaughter, Andrew E.; Peterson, John W.; Gaston, Derek R.; ...

2015-11-20

For the past several years, Idaho National Laboratory’s MOOSE framework team has employed modern software engineering techniques (continuous integration, joint application/framework source code repos- itories, automated regression testing, etc.) in developing closed-source multiphysics simulation software (Gaston et al., Journal of Open Research Software vol. 2, article e10, 2014). In March 2014, the MOOSE framework was released under an open source license on GitHub, significantly expanding and diversifying the pool of current active and potential future contributors on the project. Despite this recent growth, the same philosophy of concurrent framework and application development continues to guide the project’s development roadmap. Severalmore » specific practices, including techniques for managing multiple repositories, conducting automated regression testing, and implementing a cascading build process are discussed in this short paper. Furthermore, special attention is given to describing the manner in which these practices naturally synergize with the GitHub API and GitHub-specific features such as issue tracking, Pull Requests, and project forks.« less

Continuous integration for concurrent MOOSE framework and application development on GitHub

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

Slaughter, Andrew E.; Peterson, John W.; Gaston, Derek R.

For the past several years, Idaho National Laboratory’s MOOSE framework team has employed modern software engineering techniques (continuous integration, joint application/framework source code repos- itories, automated regression testing, etc.) in developing closed-source multiphysics simulation software (Gaston et al., Journal of Open Research Software vol. 2, article e10, 2014). In March 2014, the MOOSE framework was released under an open source license on GitHub, significantly expanding and diversifying the pool of current active and potential future contributors on the project. Despite this recent growth, the same philosophy of concurrent framework and application development continues to guide the project’s development roadmap. Severalmore » specific practices, including techniques for managing multiple repositories, conducting automated regression testing, and implementing a cascading build process are discussed in this short paper. Furthermore, special attention is given to describing the manner in which these practices naturally synergize with the GitHub API and GitHub-specific features such as issue tracking, Pull Requests, and project forks.« less

The Experiences and Personal Religious Beliefs of Egyptian Science Teachers as a Framework for Understanding the Shaping and Reshaping of Their Beliefs and Practices about Science-Technology-Society (STS)

ERIC Educational Resources Information Center

Mansour, Nasser

2008-01-01

This research investigates the role of experience in relation to teachers' beliefs and practices. The study adopted a social-cultural constructivist perspective using an interpretive approach. The research was guided by teachers' interpretations of their experiences related to teaching science through Science-Technology-Society (STS) issues. These…

Diffusing Innovations in Nursing Education: From PDAs to OERs.

PubMed

Doyle, Glynda; Budz, Bernice

2016-01-01

The Canadian educational and healthcare practice landscapes are ever-evolving technologically. In response to these changes, the British Columbia Institute of Technology (BCIT) has integrated various educational technologies using Rogers Diffusion of Innovation model as a guiding framework for this integration with considerable success. This poster describes BCIT's journey with diffusing innovations, discusses examples of these technological integrations in accordance with Roger's model, and outlines several implications for educational practice.

The Contribution of Conceptual Frameworks to Knowledge Translation Interventions in Physical Therapy

PubMed Central

Gervais, Mathieu-Joël; Hunt, Matthew

2015-01-01

There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated into clinical practice, and increasing numbers of knowledge translation interventions are being conducted. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used in physical therapy knowledge translation studies to date. Knowledge translation in physical therapy implicates multiple stakeholders and environments and involves numerous steps. In light of this complexity, the use of explicit conceptual frameworks by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. This perspective article argues that such frameworks are important resources to promote the uptake of new evidence in physical therapist practice settings. Four key benefits associated with the use of conceptual frameworks in designing and implementing knowledge translation interventions are identified, and limits related to their use are considered. A sample of 5 conceptual frameworks is evaluated, and how they address common barriers to knowledge translation in physical therapy is assessed. The goal of this analysis is to provide guidance to physical therapists seeking to identify a framework to support the design and implementation of a knowledge translation intervention. Finally, the use of a conceptual framework is illustrated through a case example. Increased use of conceptual frameworks can have a positive impact on the field of knowledge translation in physical therapy and support the development and implementation of robust and effective knowledge translation interventions that help span the research-practice gap. PMID:25060959

The contribution of conceptual frameworks to knowledge translation interventions in physical therapy.

PubMed

Hudon, Anne; Gervais, Mathieu-Joël; Hunt, Matthew

2015-04-01

There is growing recognition of the importance of knowledge translation activities in physical therapy to ensure that research findings are integrated into clinical practice, and increasing numbers of knowledge translation interventions are being conducted. Although various frameworks have been developed to guide and facilitate the process of translating knowledge into practice, these tools have been infrequently used in physical therapy knowledge translation studies to date. Knowledge translation in physical therapy implicates multiple stakeholders and environments and involves numerous steps. In light of this complexity, the use of explicit conceptual frameworks by clinicians and researchers conducting knowledge translation interventions is associated with a range of potential benefits. This perspective article argues that such frameworks are important resources to promote the uptake of new evidence in physical therapist practice settings. Four key benefits associated with the use of conceptual frameworks in designing and implementing knowledge translation interventions are identified, and limits related to their use are considered. A sample of 5 conceptual frameworks is evaluated, and how they address common barriers to knowledge translation in physical therapy is assessed. The goal of this analysis is to provide guidance to physical therapists seeking to identify a framework to support the design and implementation of a knowledge translation intervention. Finally, the use of a conceptual framework is illustrated through a case example. Increased use of conceptual frameworks can have a positive impact on the field of knowledge translation in physical therapy and support the development and implementation of robust and effective knowledge translation interventions that help span the research-practice gap. © 2015 American Physical Therapy Association.

Oak Ridge National Laboratory: Sustainable Landscapes Initiative 2020

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

Gardner, Leah; Rogers, Sam; Sipes, James L.

The goal of the ORNL Sustainable Landscapes Initiative 2020 is to provide a framework that guides future environmental resources and sustainable landscape practices on the ORNL campus. This document builds on the 2003 ORNL Conceptual Landscape Plan and is presented in the context of embracing new opportunities.

Supervision in School Psychology: The Developmental/Ecological/Problem-Solving Model

ERIC Educational Resources Information Center

Simon, Dennis J.; Cruise, Tracy K.; Huber, Brenda J.; Swerdlik, Mark E.; Newman, Daniel S.

2014-01-01

Effective supervision models guide the supervisory relationship and supervisory tasks leading to reflective and purposeful practice. The Developmental/Ecological/Problem-Solving (DEP) Model provides a contemporary framework for supervision specific to school psychology. Designed for the school psychology internship, the DEP Model is also…

A Framework for Integrating Qualitative and Quantitative Data in Knowledge, Attitude, and Practice Studies: A Case Study of Pesticide Usage in Eastern Uganda

PubMed Central

Muleme, James; Kankya, Clovice; Ssempebwa, John C.; Mazeri, Stella; Muwonge, Adrian

2017-01-01

Knowledge, attitude, and practice (KAP) studies guide the implementation of public health interventions (PHIs), and they are important tools for political persuasion. The design and implementation of PHIs assumes a linear KAP relationship, i.e., an awareness campaign results in the desirable societal behavioral change. However, there is no robust framework for testing this relationship before and after PHIs. Here, we use qualitative and quantitative data on pesticide usage to test this linear relationship, identify associated context specific factors as well as assemble a framework that could be used to guide and evaluate PHIs. We used data from a cross-sectional mixed methods study on pesticide usage. Quantitative data were collected using a structured questionnaire from 167 households representing 1,002 individuals. Qualitative data were collected from key informants and focus group discussions. Quantitative and qualitative data analysis was done in R 3.2.0 as well as qualitative thematic analysis, respectively. Our framework shows that a KAP linear relationship only existed for households with a low knowledge score, suggesting that an awareness campaign would only be effective for ~37% of the households. Context specific socioeconomic factors explain why this relationship does not hold for households with high knowledge scores. These findings are essential for developing targeted cost-effective and sustainable interventions on pesticide usage and other PHIs with context specific modifications. PMID:29276703

A Framework for Integrating Qualitative and Quantitative Data in Knowledge, Attitude, and Practice Studies: A Case Study of Pesticide Usage in Eastern Uganda.

PubMed

Muleme, James; Kankya, Clovice; Ssempebwa, John C; Mazeri, Stella; Muwonge, Adrian

2017-01-01

Knowledge, attitude, and practice (KAP) studies guide the implementation of public health interventions (PHIs), and they are important tools for political persuasion. The design and implementation of PHIs assumes a linear KAP relationship, i.e., an awareness campaign results in the desirable societal behavioral change. However, there is no robust framework for testing this relationship before and after PHIs. Here, we use qualitative and quantitative data on pesticide usage to test this linear relationship, identify associated context specific factors as well as assemble a framework that could be used to guide and evaluate PHIs. We used data from a cross-sectional mixed methods study on pesticide usage. Quantitative data were collected using a structured questionnaire from 167 households representing 1,002 individuals. Qualitative data were collected from key informants and focus group discussions. Quantitative and qualitative data analysis was done in R 3.2.0 as well as qualitative thematic analysis, respectively. Our framework shows that a KAP linear relationship only existed for households with a low knowledge score, suggesting that an awareness campaign would only be effective for ~37% of the households. Context specific socioeconomic factors explain why this relationship does not hold for households with high knowledge scores. These findings are essential for developing targeted cost-effective and sustainable interventions on pesticide usage and other PHIs with context specific modifications.

Putting Public Health Ethics into Practice: A Systematic Framework

PubMed Central

Marckmann, Georg; Schmidt, Harald; Sofaer, Neema; Strech, Daniel

2015-01-01

It is widely acknowledged that public health practice raises ethical issues that require a different approach than traditional biomedical ethics. Several frameworks for public health ethics (PHE) have been proposed; however, none of them provides a practice-oriented combination of the two necessary components: (1) a set of normative criteria based on an explicit ethical justification and (2) a structured methodological approach for applying the resulting normative criteria to concrete public health (PH) issues. Building on prior work in the field and integrating valuable elements of other approaches to PHE, we present a systematic ethical framework that shall guide professionals in planning, conducting, and evaluating PH interventions. Based on a coherentist model of ethical justification, the proposed framework contains (1) an explicit normative foundation with five substantive criteria and seven procedural conditions to guarantee a fair decision process, and (2) a six-step methodological approach for applying the criteria and conditions to the practice of PH and health policy. The framework explicitly ties together ethical analysis and empirical evidence, thus striving for evidence-based PHE. It can provide normative guidance to those who analyze the ethical implications of PH practice including academic ethicists, health policy makers, health technology assessment bodies, and PH professionals. It will enable those who implement a PH intervention and those affected by it (i.e., the target population) to critically assess whether and how the required ethical considerations have been taken into account. Thereby, the framework can contribute to assuring the quality of ethical analysis in PH. Whether the presented framework will be able to achieve its goals has to be determined by evaluating its practical application. PMID:25705615

Development of an oral care guide for patients undergoing autologous stem cell transplantation.

PubMed

Salvador, Prisco T

2006-01-01

Nurses identified oral mucositis as a recurring issue in clinical practice. To meet this challenge, a group of nurses took a leadership role in developing an oral care guide. The University Health Network Nursing Research Utilization Model and the Neuman Systems Model served as conceptual frameworks. A flowchart was developed to ensure a coordinated and continuous provision of oral care. Educational presentations were conducted to familiarize nurses and members of the multidisciplinary team of the practice changes. The introduction of the oral care regimen as primary prevention, plus systematic oral assessment and monitoring had the potential to reduce the occurrence and severity of oral mucositis in patients undergoing autologous stem cell transplantation.

The development of an adolescent smoking cessation intervention--an Intervention Mapping approach to planning.

PubMed

Dalum, Peter; Schaalma, Herman; Kok, Gerjo

2012-02-01

The objective of this project was to develop a theory- and evidence-based adolescent smoking cessation intervention using both new and existing materials. We used the Intervention Mapping framework for planning health promotion programmes. Based on a needs assessment, we identified important and changeable determinants of cessation behaviour, specified change objectives for the intervention programme, selected theoretical change methods for accomplishing intervention objectives and finally operationalized change methods into practical intervention strategies. We found that guided practice, modelling, self-monitoring, coping planning, consciousness raising, dramatic relief and decisional balance were suitable methods for adolescent smoking cessation. We selected behavioural journalism, guided practice and Motivational Interviewing as strategies in our intervention. Intervention Mapping helped us to develop as systematic adolescent smoking cessation intervention with a clear link between behavioural goals, theoretical methods, practical strategies and materials and with a strong focus on implementation and recruitment. This paper does not present evaluation data.

DOE handbook: Guide to good practices for training and qualification of maintenance personnel

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

NONE

1996-03-01

The purpose of this Handbook is to provide contractor training organizations with information that can be used to verify the adequacy of and/or modify existing maintenance training programs, or to develop new training programs. This guide, used in conjunction with facility-specific job analyses, provides a framework for training and qualification programs for maintenance personnel at DOE reactor and nonreactor nuclear facilities. Recommendations for qualification are made in four areas: education, experience, physical attributes, and training. The functional positions of maintenance mechanic, electrician, and instrumentation and control technician are covered by this guide. Sufficient common knowledge and skills were found tomore » include the three disciplines in one guide to good practices. Contents include: qualifications; on-the-job training; trainee evaluation; continuing training; training effectiveness evaluation; and program records. Appendices are included which relate to: administrative training; industrial safety training; fundamentals training; tools and equipment training; facility systems and component knowledge training; facility systems and component skills training; and specialized skills training.« less

Walking on the sunny side: what positive psychology can contribute to psychiatric rehabilitation concepts and practice.

PubMed

Moran, Galia S; Nemec, Patricia B

2013-09-01

This article suggests a positive psychology framework to strengthen and broaden psychiatric rehabilitation and recovery thought and practice. We inform about positive psychology concepts and measures that can be used to further knowledge, enhance practice, and guide research. Foundational concepts are drawn from the published literature. Specific positive psychology concepts and measures are highlighted: complete mental health, well being, flourishing, positive emotions, flow, self-determination, posttraumatic growth, and resilience. Employing a positive psychology framework can advance research on recovery phenomena and be used to assess rehabilitation outcomes. In addition we advocate positive psychology interventions in education and training of service providers that will enhance a positive focus and the culture of recovery. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Nursing students' early exposure to clinical practice: an innovation in curriculum development.

PubMed

Hoyles, A; Pollard, C; Lees, S; Glossop, D

2000-08-01

This paper describes a pilot study addressing issues surrounding the balance and status given to both theory and practice in the foundation part of a pre-registration programme. Contemporary thinking seems to suggest that there is a need to reverse recent trends which have placed an emphasis on theory. To facilitate this a framework for clinical learning was adapted to guide students' early exposure to clinical practice. The focus was to develop the students' observational and reflective skills whilst also providing the students with a frame of reference within which they could explore their theoretical studies. The information and experiences gained as a result of this study have led to the integration of an Orientation Framework to support students' early clinical experiences in a pre-registration programme.

Viewing Equitable Practices through the Lens of Intersecting Identities

ERIC Educational Resources Information Center

Lyons, Renée; Dsouza, Nikeetha; Quigley, Cassie

2016-01-01

This review explores Archer, Dawson, Seakins, and Wong's "Disorienting, fun or meaningful? Disadvantaged families' experiences of a science museum visit" by examining the analytic frameworks guiding this study. To expand on Archer et al.'s use of feminist post-structuralist theories of identity we draw from the theory of…

Studying Teacher Preparation: The Questions That Drive Research

ERIC Educational Resources Information Center

Cochran-Smith, Marilyn; Maria Villegas, Ana

2015-01-01

This article argues that research on teacher preparation over the last 100 years can be understood in terms of the major questions that researchers examined. The analysis is guided by the framework of "research as historically situated social practice," which emphasizes that researchers' interests, commitments, and social experiences…

Navigating the Complexity of Qualitative Research in Postmodern Contexts: Assemblage, Critical Reflexivity, and Communion as Guides

ERIC Educational Resources Information Center

Bettez, Silvia Cristina

2015-01-01

For graduate students and other emerging qualitative researchers, the ever-evolving and sometimes conflicting perspectives, methodologies, and practices within various post-positivist frameworks (e.g. feminist, critical, Indigenous, participatory) can be overwhelming. Qualitative researchers working within postmodern contexts of multiplicity and…

Institutional Change Strategies in Response to Multiculturalism.

ERIC Educational Resources Information Center

Department of the Secretary of State, Ottawa (Ontario). Multiculturalism Directorate.

This report provides a theoretical and practical framework to guide Canadian policymakers in instituting a long-lasting and enduring change in the federal government that will ensure social, economic, and political equity for all Canadians of all cultural and racial origins. The literature on organizational change was reviewed and summarized under…

Bringing Back Our Bayou Chico

ERIC Educational Resources Information Center

Mesa, Jennifer

2018-01-01

As an instructional framework, Universal Design for Learning (UDL) can guide science teachers to purposefully apply evidence-based instructional practices to increase engagement and learning of students with disabilities (Israel, Ribuffo, and Smith 2014; Marino et al. 2014; Ok et al. 2016). This article describes how to use the Universal Design…

Making the Shift in 21st Century Teaching

ERIC Educational Resources Information Center

Girlando, Gina

2013-01-01

Although educational systems have emphasized the importance of teaching 21st century skills and technology to prepare students for a successful future, educators often have difficulty using these skills in their daily teaching practices. The conceptual frameworks that guided this case study were constructivism, which postulates that development of…

How Do We Go about Investigating Test Fairness?

ERIC Educational Resources Information Center

Xi, Xiaoming

2010-01-01

Previous test fairness frameworks have greatly expanded the scope of fairness, but do not provide a means to fully integrate fairness investigations and set priorities. This article proposes an approach to guide practitioners on fairness research and practices. This approach treats fairness as an aspect of validity and conceptualizes it as…

Exploring conceptual and theoretical frameworks for nurse practitioner education: a scoping review protocol.

PubMed

Wilson, Rosemary; Godfrey, Christina M; Sears, Kim; Medves, Jennifer; Ross-White, Amanda; Lambert, Natalie

2015-10-01

The objective of this review is to examine conceptual and/or theoretical frameworks that are relevant to nurse practitioner education.The specific review question is: What conceptual and/or theoretical frameworks are available that are relevant to the structuring of nurse practitioner education? The use of conceptual and theoretical frameworks to organize the educational curriculum of nursing programs is essential to protect and preserve the focus and clarity of nursing's distinct contribution to health care. Conceptual frameworks of nursing provide a means to look at nursing in relationship to external factors, thereby assigning meaning to the practice. Graduate level nursing education in the preparation of Nurse Practitioners (NPs) specifically and Advanced Practice Nurses (APNs) in general, is significantly compromised by the tendency to conceptualize the learning in these complex programs as being primarily related to skills-based tasks and competencies alone. According to Baumann, advanced nursing education must focus on the uniqueness of the NP position, in contrast to other health care professions. To do this, Baumann suggests using a conceptual nursing model and nursing theory as opposed to a strictly biomedical model. This allows NPs to interpret information in a way that differs from the strict biomedical model, providing opportunities for the NPs to be truly present in the lives of their patients.Canadian Nurse Practitioner (NP) practice competency documents are based primarily on the Canadian Nurses Association (CNA) Nurse Practitioner (NP) Core Competency Framework. This document defines the core set of entry-level competencies required for all NPs to practice in all Canadian jurisdictions, settings and client populations. The Core Competencies in the CNA NP Framework are organized within four main categories: professional role, responsibility and accountability; health assessment and diagnosis; therapeutic management; and health promotion and prevention of illness and injury. Although vital to the organization of provincial entry-level registration standards, this framework provides little direction to educational providers for curricula organization and philosophical perspectives.The Canadian Association of Schools of Nursing developed a national framework for NP education following a multi-phase consultation and literature and curriculum synthesis project. While the task force addressed the guiding principles and essential components of NP education along with contextual factors that impact on the delivery of curricula in Canadian jurisdictions, the philosophical approaches guiding and organizing the education were not addressed.A similar set of documents has been created in the United States by the National Organization of Nurse Practitioner Faculties (NONPF). These documents are organized by six population level foci (including the specialty of family/individual across the lifespan) and outline core competencies for entry to practice and registration and educational standards. The Core Competency documents provided by the NONPF are presented in the same manner as the CNA NP Framework and likewise, do not provide a guiding or organizing framework or philosophy for NP education.A full curriculum overhaul based on the NONPF competency requirements was performed at a university center in Oregon. The new curriculum was based on competencies that students must acquire, rather than learning objectives. While the NONPF Framework does provide an extensive list of entry-level requirements for NPs, the challenges faced by the institution as it aimed to incorporate the framework into the curriculum clearly provide evidence that these overarching frameworks need to include both a philosophical and organizational component to help guide educators.Conceptual frameworks are useful for establishing a congruent relationship between program curricula, objectives and content. Walker and Avant advance the utility of conceptual frameworks as providing the logic behind the interrelationships of terms and variables, and improving explanation and understanding. Gold, Haas & King assert that conceptual frameworks facilitate grounding of a nursing lens in the curricula of advanced practice nursing programs. It has been noted that newly practicing NPs have demonstrated an allegiance withmedical model thinking, second only in importance to wellness/health promotion considerations. Blasdell and colleagues surveyed 188 practicing NPs to investigate the relationship between education and the use of theory in clinical practice. Educated graduate NPs rated the importance of nursing theory to the NP practice role significantly higher than did diploma and baccalaureate degree NPs (4.05±2.06 versus 2.65±1.69, p<.001) but both groups rated the nursing models as less important for practice than a medical model approach.Huckabay highlighted the need for the use of a harmonized nursing model at the undergraduate level to ensure that students have a thorough understanding of what nursing is and what nursing care entails. At the graduate level, Huckabay suggested the use of multiple nursing models, depending on specialty. Regardless of the educational level, a conceptual framework used for education must enable nurse educators to have sufficient guidelines to construct a curriculum and determine what knowledge and skills are needed by the nursing students. Further, Furlong identified the need for Advanced Practice Nursing (APN) curriculae to be innovative and critically reflective, preparing students to be readily adaptable to challenges in the work place. Furlong suggests that to do this, the curriculum must rely upon an interdisciplinary framework to deliver content. Gold, Haas & King suggest that core curricula based on a medical model or a skill-related task list do not reflect the critical thinking of nurses, nor the uniqueness of the profession. Thus, conceptual models used for curricula development must: encompass the distinct nursing worldview, promote learning, and be efficient and comprehensive.Frameworks have been proposed and tested to guide the development and implementation of inter-professional education (IPE) and collaborative practice curricula for NP and medical students. A qualitative assessment of a framework guided IPE module illustrated the benefit of improving the focus on role awareness in participating students. However, this particular curriculum was limited to a two-week period and not presented as a pervasive approach to the educational programs of each discipline.In education, an overarching philosophy can provide a road map for goal identification, teaching material development and the formulation of evaluation methods. For instance, when creating a curriculum that was a result of the collaboration of three different post-secondary institutions, the SHARE (students, humor, administrative support, resources, and educational technology) model was used. This model brings together resources, students and faculty, surrounding them with humor, which was viewed as a fundamental part of the process while the program was still in its early stages. According to the authors, the program has been widely successful and the reliance on humor as an underlying philosophy has enabled the students and faculty to deal with problems arising in the new program.Focusing on evaluation, Kapborg & Fischbein promoted the use of the Education Interaction Model. The model identifies how educational influences can interact with abilities of students and how the consequences of this interaction can be evaluated by observing changes in both students and programs. The authors argue that, while the educational interaction model is effective, it is not the only model that can be used to carry out evaluations. The authors stress that the model chosen to perform an evaluation should be based upon what or who is going to be evaluated.The standards outlined in the CNA NP framework are an essential part of organizing the education process for NPs and ensuring that NPs have acquired the necessary skills to practice in Canada as an NP. However, the framework is lacking philosophy and organization regarding NP education programs to ensure that the curriculum is preparing the NPs for the ever-changing work environment.An Australian survey of NP education documents from relevant universities as well as interviews with NPs and academic conveners from Australia and New Zealand found that, while NP educational programs need to have strong clinical and science based learning components, student directed and flexible learning models act to ensure the capability of NPs as they strive to adapt to practice situations. Capability, as an approach to the learning process, includes the flexibility to respond to the specific, self-identified learning needs of students. Knowing how to learn, having high self-efficacy, applying competencies to new tasks, collaborating with others, and being creative are all signs of a capable practitioner. Gardner et al. emphasized the need for a program that fosters both competent and capable NPs. In a follow-up study, using the same data, Gardner et al. confirmed that NPs viewed the attributes of a capable NP as imperative to practice. Thus, a framework for NP education must include both competency building elements, such as those currently found in the CNA NP framework and capability building elements which can be fostered through self-directed learning.Similarly, Schaefer investigated the role of caring in nursing practice through a class for APN students in which the students reflected on their narratives of caring for patients. This qualitative study revealed that when APN students provide care by meeting the complex needs of suffering patients, the art and science of nursing combine. (ABSTRACT TRUNCATED)

The Development of a Conceptual Framework for New K-12 Science Education Standards (Invited)

NASA Astrophysics Data System (ADS)

Keller, T.

2010-12-01

The National Academy of Sciences has created a committee of 18 National Academy of Science and Engineering members, academic scientists, cognitive and learning scientists, and educators, educational policymakers and researchers to develop a framework to guide new K-12 science education standards. The committee began its work in January, 2010, released a draft of the framework in July, 2010, and intends to have the final framework in the first quarter of 2011. The committee was helped in early phases of the work by consultant design teams. The framework is designed to help realize a vision for science and engineering education in which all students actively engage in science and engineering practices in order to deepen their understanding of core ideas in science over multiple years of school. These three dimensions - core disciplinary ideas, science and engineering practices, and cross-cutting elements - must blend together to build an exciting, relevant, and forward looking science education. The framework will be used as a base for development of next generation K-12 science education standards.

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

PubMed

Kitson, Alison L

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

Understanding the processes of writing papers reflectively.

PubMed

Regmi, Krishna; Naidoo, Jennie

2013-07-01

This paper explores the writing of research papers using reflective frameworks. Reflective practice is integral to professional education and development. However, healthcare students, academics and practitioners have given limited attention to how to write reflectively. In addition, there are limited resources on the practical aspects of writing papers reflectively. The following major databases were searched: PubMed, Medline, King's Library, Excerpta Medica Database, Department of Health database, Cumulative Index to Nursing and Allied Health Literature. The searches were conducted using 'free text' and 'index' terms. Only relevant papers published in English were reviewed and scrutinised. Unpublished reports, internal publications, snowballing from the reference lists and personal contacts were also included in the search. This is a review paper that critiques the frameworks used for reflective practice. Writing papers reflectively is a complex task. Healthcare professionals and researchers need to understand the meaning of reflection and make appropriate use of reflective frameworks. Demystifying the process of reflectively writing papers will help professionals develop skills and competencies. IMPLICATION FOR RESEARCH/PRACTICE: This article provides a practical guide to reflection and how nursing and allied healthcare students, academics and practitioners can practise it. The paper identifies four generic stages in frameworks: description, assessment, evaluation and action, which are illustrated by annotated 'skeletal' examples. It is hoped that this will assist the process of reflective practice, writing and learning.

From screening to synthesis: using nvivo to enhance transparency in qualitative evidence synthesis.

PubMed

Houghton, Catherine; Murphy, Kathy; Meehan, Ben; Thomas, James; Brooker, Dawn; Casey, Dympna

2017-03-01

To explore the experiences and perceptions of healthcare staff caring for people with dementia in the acute setting. This article focuses on the methodological process of conducting framework synthesis using nvivo for each stage of the review: screening, data extraction, synthesis and critical appraisal. Qualitative evidence synthesis brings together many research findings in a meaningful way that can be used to guide practice and policy development. For this purpose, synthesis must be conducted in a comprehensive and rigorous way. There has been previous discussion on how using nvivo can assist in enhancing and illustrate the rigorous processes involved. Qualitative framework synthesis. Twelve documents, or research reports, based on nine studies, were included for synthesis. The benefits of using nvivo are outlined in terms of facilitating teams of researchers to systematically and rigorously synthesise findings. nvivo functions were used to conduct a sensitivity analysis. Some valuable lessons were learned, and these are presented to assist and guide researchers who wish to use similar methods in future. Ultimately, good qualitative evidence synthesis will provide practitioners and policymakers with significant information that will guide decision-making on many aspects of clinical practice. The example provided explored how people with dementia are cared for acute settings. © 2016 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

An Automated DAKOTA and VULCAN-CFD Framework with Application to Supersonic Facility Nozzle Flowpath Optimization

NASA Technical Reports Server (NTRS)

Axdahl, Erik L.

2015-01-01

Removing human interaction from design processes by using automation may lead to gains in both productivity and design precision. This memorandum describes efforts to incorporate high fidelity numerical analysis tools into an automated framework and applying that framework to applications of practical interest. The purpose of this effort was to integrate VULCAN-CFD into an automated, DAKOTA-enabled framework with a proof-of-concept application being the optimization of supersonic test facility nozzles. It was shown that the optimization framework could be deployed on a high performance computing cluster with the flow of information handled effectively to guide the optimization process. Furthermore, the application of the framework to supersonic test facility nozzle flowpath design and optimization was demonstrated using multiple optimization algorithms.

Mobile technologies in medical education: AMEE Guide No. 105.

PubMed

Masters, Ken; Ellaway, Rachel H; Topps, David; Archibald, Douglas; Hogue, Rebecca J

2016-06-01

Mobile technologies (including handheld and wearable devices) have the potential to enhance learning activities from basic medical undergraduate education through residency and beyond. In order to use these technologies successfully, medical educators need to be aware of the underpinning socio-theoretical concepts that influence their usage, the pre-clinical and clinical educational environment in which the educational activities occur, and the practical possibilities and limitations of their usage. This Guide builds upon the previous AMEE Guide to e-Learning in medical education by providing medical teachers with conceptual frameworks and practical examples of using mobile technologies in medical education. The goal is to help medical teachers to use these concepts and technologies at all levels of medical education to improve the education of medical and healthcare personnel, and ultimately contribute to improved patient healthcare. This Guide begins by reviewing some of the technological changes that have occurred in recent years, and then examines the theoretical basis (both social and educational) for understanding mobile technology usage. From there, the Guide progresses through a hierarchy of institutional, teacher and learner needs, identifying issues, problems and solutions for the effective use of mobile technology in medical education. This Guide ends with a brief look to the future.

Mixing methodology, nursing theory and research design for a practice model of district nursing advocacy.

PubMed

Reed, Frances M; Fitzgerald, Les; Rae, Melanie

2016-01-01

To highlight philosophical and theoretical considerations for planning a mixed methods research design that can inform a practice model to guide rural district nursing end of life care. Conceptual models of nursing in the community are general and lack guidance for rural district nursing care. A combination of pragmatism and nurse agency theory can provide a framework for ethical considerations in mixed methods research in the private world of rural district end of life care. Reflection on experience gathered in a two-stage qualitative research phase, involving rural district nurses who use advocacy successfully, can inform a quantitative phase for testing and complementing the data. Ongoing data analysis and integration result in generalisable inferences to achieve the research objective. Mixed methods research that creatively combines philosophical and theoretical elements to guide design in the particular ethical situation of community end of life care can be used to explore an emerging field of interest and test the findings for evidence to guide quality nursing practice. Combining philosophy and nursing theory to guide mixed methods research design increases the opportunity for sound research outcomes that can inform a nursing model of care.

Transformational Leadership in Nursing Education: Making the Case.

PubMed

Fischer, Shelly Ann

2017-04-01

Transformational leadership is a trending style and competency that has been embraced by many industries and nursing practice settings. Similar positive influence on follower engagement, teamwork, and solidarity might be experienced if transformational leadership is employed by administration and faculty as a guiding framework for nursing education. The impact of embedding a teamwork culture in basic nursing education could be significant on students and ultimately on the nursing profession. Further research is needed to develop and test application of the transformational leadership framework in nursing education.

AMEE Education Guide no. 29: evaluating educational programmes.

PubMed

Goldie, John

2006-05-01

Evaluation has become an applied science in its own right in the last 40 years. This guide reviews the history of programme evaluation through its initial concern with methodology, giving way to concern with the context of evaluation practice and into the challenge of fitting evaluation results into highly politicized and decentralized systems. It provides a framework for potential evaluators considering undertaking evaluation. The role of the evaluator; the ethics of evaluation; choosing the questions to be asked; evaluation design, including the dimensions of evaluation and the range of evaluation approaches available to guide evaluators; interpreting and disseminating the findings; and influencing decision making are covered.

New and emerging patient-centered CT imaging and image-guided treatment paradigms for maxillofacial trauma.

PubMed

Dreizin, David; Nam, Arthur J; Hirsch, Jeffrey; Bernstein, Mark P

2018-06-20

This article reviews the conceptual framework, available evidence, and practical considerations pertaining to nascent and emerging advances in patient-centered CT-imaging and CT-guided surgery for maxillofacial trauma. These include cinematic rendering-a novel method for advanced 3D visualization, incorporation of quantitative CT imaging into the assessment of orbital fractures, low-dose CT imaging protocols made possible with contemporary scanners and reconstruction techniques, the rapidly growing use of cone-beam CT, virtual fracture reduction with design software for surgical pre-planning, the use of 3D printing for fabricating models and implants, and new avenues in CT-guided computer-aided surgery.

Using a cultural-ecological framework to explore dietary beliefs and practices during pregnancy and lactation among women in Adivasi communities in the Nilgiris Biosphere Reserve, India.

PubMed

Craig, Hope C; Jeyanthi, R; Pelto, Gretel; Willford, Andrew C; Stoltzfus, Rebecca J

2018-01-01

This article explores maternal dietary beliefs and practices gathered through interviews with mothers of infants and young children in Adivasi communities in the Nilgiris Biosphere Reserve, India. Guided by focused ethnographic study methods, interviews were conducted with 33 key informants. We used a cultural-ecological framework to analyze and interpret the texts that were elicited from women about dietary beliefs and eating patterns during pregnancy and lactation. We identify differences between what women were advised to eat, felt they should eat, and reported consuming. The findings offer guidance for interventions to improve maternal diets in this vulnerable population.

Leadership and priority setting: the perspective of hospital CEOs.

PubMed

Reeleder, David; Goel, Vivek; Singer, Peter A; Martin, Douglas K

2006-11-01

The role of leadership in health care priority setting remains largely unexplored. While the management leadership literature has grown rapidly, the growing literature on priority setting in health care has looked in other directions to improve priority setting practices--to health economics and ethical approaches. Consequently, potential for improvement in hospital priority setting practices may be overlooked. A qualitative study involving interviews with 46 Ontario hospital CEOs was done to describe the role of leadership in priority setting through the perspective of hospital leaders. For the first time, we report a framework of leadership domains including vision, alignment, relationships, values and process to facilitate priority setting practices in health services' organizations. We believe this fledgling framework forms the basis for the sharing of good leadership practices for health reform. It also provides a leadership guide for decision makers to improve the quality of their leadership, and in so doing, we believe, the fairness of their priority setting.

One Hundred Years of Psychiatry at Johns Hopkins: A Story of Meyer to McHugh.

PubMed

DePaulo, J Raymond

2017-04-01

This article describes a history of clinical methods and constructs that guide Psychiatry at Johns Hopkins Phipps Clinic today. The contributions of Adolf Meyer and Paul McHugh are central and closely connected. Both emphasize the clinical examination as the central practice of psychiatry as a specialty within medicine. Meyer's comprehensive examination of the patient became the centerpiece of his approach and was the standard for psychiatrists in the English-speaking world. McHugh, with Phillip Slavney, developed a pluralistic and practical framework for interpreting that history and examination. Both argued against the uncritical use of the modern disease construct. McHugh argues that the disease construct, although fundamental, is but one of four useful "perspectives of psychiatry" and is, thus, an insufficient basis for psychiatric practice. The perspectives could be used as an organizing framework by all physicians who seek a practical and truly personalized approach to the care of patients.

"It's the Way That You Do It": Developing an Ethical Framework for Community Psychology Research and Action.

PubMed

Campbell, Rebecca

2016-12-01

In the 50 years since the 1965 Swampscott conference, the field of community psychology has not yet developed a well-articulated ethical framework to guide research and practice. This paper reviews what constitutes an "ethical framework"; considers where the field of community psychology is at in its development of a comprehensive ethical framework; examines sources for ethical guidance (i.e., ethical principles and standards) across multiple disciplines, including psychology, evaluation, sociology, and anthropology; and recommends strategies for developing a rich written discourse on how community psychology researchers and practitioners can address ethical conflicts in our work. © Society for Community Research and Action 2016.

How best practices are copied, transferred, or translated between health care facilities: A conceptual framework.

PubMed

Guzman, Gustavo; Fitzgerald, Janna Anneke; Fulop, Liz; Hayes, Kathryn; Poropat, Arthur; Avery, Mark; Campbell, Steve; Fisher, Ron; Gapp, Rod; Herington, Carmel; McPhail, Ruth; Vecchio, Nerina

2015-01-01

In spite of significant investment in quality programs and activities, there is a persistent struggle to achieve quality outcomes and performance improvements within the constraints and support of sociopolitical parsimonies. Equally, such constraints have intensified the need to better understand the best practice methods for achieving quality improvements in health care organizations over time.This study proposes a conceptual framework to assist with strategies for the copying, transferring, and/or translation of best practice between different health care facilities. Applying a deductive logic, the conceptual framework was developed by blending selected theoretical lenses drawn from the knowledge management and organizational learning literatures. The proposed framework highlighted that (a) major constraints need to be addressed to turn best practices into everyday practices and (b) double-loop learning is an adequate learning mode to copy and to transfer best practices and deuteron learning mode is a more suitable learning mode for translating best practice. We also found that, in complex organizations, copying, transferring, and translating new knowledge is more difficult than in smaller, less complex organizations. We also posit that knowledge translation cannot happen without transfer and copy, and transfer cannot happen without copy of best practices. Hence, an integration of all three learning processes is required for knowledge translation (copy best practice-transfer knowledge about best practice-translation of best practice into new context). In addition, the higher the level of complexity of the organization, the more best practice is tacit oriented and, in this case, the higher the level of K&L capabilities are required to successfully copy, transfer, and/or translate best practices between organizations. The approach provides a framework for assessing organizational context and capabilities to guide copy/transfer/translation of best practices. A roadmap is provided to assist managers and practitioners to select appropriate learning modes for building success and positive systemic change.

The skin health and beauty pyramid: a clinically based guide to selecting topical skincare products.

PubMed

Mayoral, Flor A; Kenner, Julie R; Draelos, Zoe Diana

2014-04-01

The use of cosmeceuticals by patients is now commonplace. Without consultation and direction from an informed clinician, marketing pressures can lead consumers to make poor product choices that can result in wasted money and unsatisfactory outcomes. Skin professionals need a scientifically based, succinct tool to guide their patients toward best topical skincare practices. The Skin Health and Beauty Pyramid is an educational framework and product guide created from extensive scientific literature and study review on ingredients, formulations and technologies affecting skin biology. This clinical tool can simplify product choices for physicians and clinicians in the process of professionally guiding patients toward the optimal use of topical products to achieve best outcomes for skin health and beauty.

Maslow's needs hierarchy as a framework for evaluating hospitality houses' resources and services.

PubMed

Duncan, Mary Katherine Waibel; Blugis, Ann

2011-08-01

As hospitality houses welcome greater numbers of families and families requiring longer stays, they do so in the absence of a widely accepted theory to guide their understanding of guests' needs and evaluations of how well they meet those needs. We propose A. Maslow's (1970) Hierarchy of Needs as a conceptual framework for understanding what makes a hospitality house a home for families of pediatric patients and for guiding the activities of hospitality houses' boards of directors, staff, volunteers, and donors. This article presents findings from a theory-driven evaluation of one hospitality house's ability to meet guests' needs, describes the house's best practice standards for addressing guests' needs, and suggests areas for future research. Copyright © 2011 Elsevier Inc. All rights reserved.

Conceptualizing Telehealth in Nursing Practice: Advancing a Conceptual Model to Fill a Virtual Gap.

PubMed

Nagel, Daniel A; Penner, Jamie L

2016-03-01

Increasingly nurses use various telehealth technologies to deliver health care services; however, there has been a lag in research and generation of empirical knowledge to support nursing practice in this expanding field. One challenge to generating knowledge is a gap in development of a comprehensive conceptual model or theoretical framework to illustrate relationships of concepts and phenomena inherent to adoption of a broad range of telehealth technologies to holistic nursing practice. A review of the literature revealed eight published conceptual models, theoretical frameworks, or similar entities applicable to nursing practice. Many of these models focus exclusively on use of telephones and four were generated from qualitative studies, but none comprehensively reflect complexities of bridging nursing process and elements of nursing practice into use of telehealth. The purpose of this article is to present a review of existing conceptual models and frameworks, discuss predominant themes and features of these models, and present a comprehensive conceptual model for telehealth nursing practice synthesized from this literature for consideration and further development. This conceptual model illustrates characteristics of, and relationships between, dimensions of telehealth practice to guide research and knowledge development in provision of holistic person-centered care delivery to individuals by nurses through telehealth technologies. © The Author(s) 2015.

The Bobath concept in contemporary clinical practice.

PubMed

Graham, Julie Vaughan; Eustace, Catherine; Brock, Kim; Swain, Elizabeth; Irwin-Carruthers, Sheena

2009-01-01

Future development in neurorehabilitation depends upon bringing together the endeavors of basic science and clinical practice. The Bobath concept is widely utilized in rehabilitation following stroke and other neurological conditions. This concept was first developed in the 1950s, based on the neuroscience knowledge of those times. The theoretical basis of the Bobath concept is redefined based on contemporary neuroscience and rehabilitation science. The framework utilized in the Bobath concept for the analysis of movement and movement dysfunction is described. This framework focuses on postural control for task performance, the ability to move selectively, the ability to produce coordinated sequences of movement and vary movement patterns to fit a task, and the role of sensory input in motor behaviour and learning. The article describes aspects of clinical practice that differentiate this approach from other models of practice. Contemporary practice in the Bobath concept utilizes a problem-solving approach to the individual's clinical presentation and personal goals. Treatment is focused toward remediation, where possible, and guiding the individual towards efficient movement strategies for task performance. The aim of this article is to provide a theoretical framework on which future research into the Bobath concept can be based.

The what, when, and why of implementation frameworks for evidence-based practices in child welfare and child mental health service systems.

PubMed

Hanson, Rochelle F; Self-Brown, Shannon; Rostad, Whitney L; Jackson, Matthew C

2016-03-01

It is widely recognized that children in the child welfare system are particularly vulnerable to the adverse health and mental effects associated with exposure to abuse and neglect, making it imperative to have broad-based availability of evidence-based practices (EBPs) that can prevent child maltreatment and reduce the negative mental health outcomes for youth who are victims. A variety of EBPs exist for reducing child maltreatment risk and addressing the associated negative mental health outcomes, but the reach of these practices is limited. An emerging literature documents factors that can enhance or inhibit the success of EBP implementation in community service agencies, including how the selection of a theory-driven conceptual framework, or model, might facilitate implementation planning by providing guidance for best practices during implementation phases. However, limited research is available to guide decision makers in the selection of implementation frameworks that can boost implementation success for EBPs that focus on preventing child welfare recidivism and serving the mental health needs of maltreated youth. The aims of this conceptual paper are to (1) provide an overview of existing implementation frameworks, beginning with a discussion of definitional issues and the selection criteria for frameworks included in the review; and (2) offer recommendations for practice and policy as applicable for professionals and systems serving victims of child maltreatment and their families. Copyright © 2015 Elsevier Ltd. All rights reserved.

Using the Situated Clinical Decision-Making framework to guide analysis of nurses' clinical decision-making.

PubMed

Gillespie, Mary

2010-11-01

Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.

A paradigm to guide health promotion into the 21st century: the integral idea whose time has come.

PubMed

Lundy, Tam

2010-09-01

The field of health promotion and education is at a turning point as it steps up to address the interconnected challenges of health, equity and sustainable development. Professionals and policy makers recognize the need for an integrative thinking and practice approach to foster comprehensive and coherent action in each of these complex areas. An integrative approach to policy and practice builds bridges across disciplines and discourses, supporting our efforts to take important next steps to generate sustainability and health for all. Comprehensive and coherent practice requires comprehensive and coherent theory. This article offers a brief introduction to Ken Wilber's influential Integral model, inviting its consideration as a promising paradigmatic framework that can guide thinking, practice, research and evidence as health promotion and education enter a new era. Currently influencing thought and practice leaders in diverse disciplines and sectors, the Integral approach presents a practical response to the current call for cross-disciplinary collaboration to address health, equity and sustainability. In addition, it addresses the disciplinary call for evidence-based practice that is grounded in, and accountable to, robust theoretical foundations.

Talking with patients about spirituality and worldview: practical interviewing techniques and strategies.

PubMed

Josephson, Allan M; Peteet, John R

2007-06-01

Psychiatrists now recognize that religion and spirituality are important to much of the populace and that attending to them probably will improve clinical psychiatric practice. This article presents a practical guide for addressing some of the key interviewing skills needed to explore a patient's framework for meaning-the patient's religion, spirituality, and worldview. It offers guidelines on the process of the interview, including ways to initiate conversation in this area, with suggestions and specific questions for a more thorough exploration of the patient's religious and spiritual life.

Strategies for Achieving Whole-Practice Engagement and Buy-in to the Patient-Centered Medical Home

PubMed Central

Bleser, William K.; Miller-Day, Michelle; Naughton, Dana; Bricker, Patricia L.; Cronholm, Peter F.; Gabbay, Robert A.

2014-01-01

PURPOSE The current model of primary care in the United States limits physicians’ ability to offer high-quality care. The patient-centered medical home (PCMH) shows promise in addressing provision of high-quality care, but achieving a PCMH practice model often requires comprehensive organizational change. Guided by Solberg’s conceptual framework for practice improvement, which argues for shared prioritization of improvement and change, we describe strategies for obtaining organizational buy-in to and whole-staff engagement of PCMH transformation and practice improvement. METHODS Semistructured interviews with 136 individuals and 7 focus groups involving 48 individuals were conducted in 20 small- to mid-sized medical practices in Pennsylvania during the first regional rollout of a statewide PCMH initiative. For this study, we analyzed interview transcripts, monthly narrative reports, and observer notes from site visits to identify discourse pertaining to organizational buy-in and strategies for securing buy-in from personnel. Using a consensual qualitative research approach, data were reduced, synthesized, and managed using qualitative data management and analysis software. RESULTS We identified 13 distinct strategies used to obtain practice buy-in, reflecting 3 overarching lessons that facilitate practice buy-in: (1) effective communication and internal PCMH campaigns, (2) effective resource utilization, and (3) creation of a team environment. CONCLUSION Our study provides a list of strategies useful for facilitating PCMH transformation in primary care. These strategies can be investigated empirically in future research, used to guide medical practices undergoing or considering PCMH transformation, and used to inform health care policy makers. Our study findings also extend Solberg’s conceptual framework for practice improvement to include buy-in as a necessary condition across all elements of the change process. PMID:24445102

SEE Action Guide for States: Evaluation, Measurement, and Verification Frameworks$-$Guidance for Energy Efficiency Portfolios Funded by Utility Customers

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

Li, Michael; Dietsch, Niko

2018-01-01

This guide describes frameworks for evaluation, measurement, and verification (EM&V) of utility customer–funded energy efficiency programs. The authors reviewed multiple frameworks across the United States and gathered input from experts to prepare this guide. This guide provides the reader with both the contents of an EM&V framework, along with the processes used to develop and update these frameworks.

Academic Recognition: Status and Challenges

ERIC Educational Resources Information Center

Bergan, Sjur

2009-01-01

The Council of Europe/UNESCO Recognition Convention (also known as the Lisbon Recognition Convention) provides the legal framework for academic recognition in Europe, and it serves a double purpose: as a legal text and as a guide to good practice. The ENIC and NARIC Networks promote the implementation of the Convention and seek to develop a better…

A Flipped Classroom Approach to Teaching Systems Analysis, Design and Implementation

ERIC Educational Resources Information Center

Tanner, Maureen; Scott, Elsje

2015-01-01

This paper describes a flipped classroom approach followed to teach systems analysis, design and implementation at university level. The techniques employed are described. These techniques were underpinned by a theory of coherent practice: a pedagogy that provides a framework for the design of highly structured interventions to guide students in…

An Examination of the Impact of Harsh Parenting Contexts on Children's Adaptation within an Evolutionary Framework

ERIC Educational Resources Information Center

Sturge-Apple, Melissa L.; Davies, Patrick T.; Martin, Meredith J.; Cicchetti, Dante; Hentges, Rochelle F.

2012-01-01

The current study tests whether propositions set forth in an evolutionary model of temperament (Korte, Koolhaas, Wingfield, & McEwen, 2005) may enhance our understanding of children's differential susceptibility to unsupportive and harsh caregiving practices. Guided by this model, we examined whether children's behavioral strategies for coping…

Liberty, Power, and the American Constitutional Heritage.

ERIC Educational Resources Information Center

Madison, James H.

The principles, values, and issues of our constitutional heritage that should be emphasized in citizenship education are based on the concepts of liberty and power. The Constitution is not a sacred icon formulated by immortals, but rather a changing and controversial framework guided by a diverse group of practical politicians, sensitive to their…

Coherent District Reform: A Case Study of Two California School Districts

ERIC Educational Resources Information Center

Ezzani, Miriam

2015-01-01

The purpose of this paper is to enhance our understanding of districts that are implementing sustainable professional learning in data-driven decision-making (DDDM) to improve student achievement. The data-informed leadership framework, comprised of leadership practices that acknowledge the complexities that play into data use, guided the inquiry.…

Heart of the FCS Body of Knowledge: Relational Ethic

ERIC Educational Resources Information Center

Roubanis, Jody L.

2016-01-01

The Family and Consumer Sciences Body of Knowledge (FCS-BOK) provides an ideological stance that is universal to all practitioners of the profession, and it has major implications for the normative ethics that guide professional practice. The purpose of this article is to outline a conceptual framework to reveal the relational ethic inherent in…

The Confucian Educational Philosophy and Experienced Teachers' Resistance: A Narrative Study in Macau

ERIC Educational Resources Information Center

Hua, Huang; Vong, Sou Kuan

2016-01-01

This study investigates experienced teachers' resistance in an era of neoliberalism in Macau. The narratives of three experienced teachers are examined under a post-structuralist framework. The findings indicate that the traditional Chinese Confucian ideology of education guides the experienced teachers' professional practice and offers them an…

A Scientific Framework for Social Work Doctoral Education in the 21st Century

ERIC Educational Resources Information Center

Guerrero, Erick G.; Moore, Hadass; Pitt-Catsouphes, Marcie

2018-01-01

The emerging discourse about the science of social work has urged doctoral social work programs to reexamine assumptions about conducting research and responding to new expectations for scholarship. This article examines three promising models to guide scientific research in social work (evidence-based practice, team science, and multi- and…

Strengthening Reflective Capacity in Skilled Home Visitors

ERIC Educational Resources Information Center

Gilkerson, Linda; Imberger, Jaci

2016-01-01

This article describes the FAN (Facilitating Attuned Interactions) approach to attunement in relationships and how it serves as a framework for reflective practice in an exemplary home visiting program. The authors highlight the role of the FAN as a tool for "reflection-in-action" and as a guide for "reflection-on-action." The…

Virtue Ethics in School Counseling: A Framework for Decision Making

ERIC Educational Resources Information Center

Wilczenski, Felicia L.; Cook, Amy L.

2011-01-01

Virtue ethics focus on the motives that guide ethical decision making and action, and as such, are critical to the competent application of the counseling profession's ethical codes. Knowledge of virtue ethics deepens understanding of moral responsibilities and ethical reasoning in professional practice. This paper is an overview of virtue ethics…

Striking the Right Note: The Cultural Preparedness Approach to Developing Resonant Career Guidance Programmes

ERIC Educational Resources Information Center

Arulmani, G.

2011-01-01

Cultural preparedness is presented as a conceptual framework that could guide the development of culture-resonant interventions. The "Jiva" careers programme is presented as a case study to illustrate a method of career and livelihood planning based upon Indian epistemology and cultural practices. Social cognitive environments and career beliefs…

Safeguarding Your Technology: Practical Guidelines for Electronic Education Information Security.

ERIC Educational Resources Information Center

Szuba, Tom

This guide was developed specifically for educational administrators at the building, campus, district, system, and state levels, and is meant to serve as a framework to help them better understand why and how to effectively secure their organization's information, software, and computer and networking equipment. This document is organized into 10…

The Second Dimension--Crosscutting Concepts

ERIC Educational Resources Information Center

Duschl, Richard A.

2012-01-01

The recently published National Research Council (NRC) report "A Framework for K-12 Science Education: Practices, Crosscutting Concepts, and Core Ideas" (NRC 2011) offers a thoughtful research-based agenda that helps guide teachers in making the shift to a doing-led agenda in K-12 science education. In the December 2011 editions of the NSTA…

Butterflies in Formation: Predicting How Speech Order in College Public Speaking Affects Student Communication Apprehension

ERIC Educational Resources Information Center

Osmond, Erica R.

2013-01-01

This study addressed pedagogical practices in the public speaking classroom in an attempt to help control communication apprehension (CA) levels and improve retention rates among college students in the basic public speaking course. Guided by the theoretical frameworks of Berger and Calabrese's uncertainty reduction theory and Weiner's attribution…

Mitigating Errors of Representation: A Practical Case Study of the University Experience Survey

ERIC Educational Resources Information Center

Whiteley, Sonia

2014-01-01

The Total Survey Error (TSE) paradigm provides a framework that supports the effective planning of research, guides decision making about data collection and contextualises the interpretation and dissemination of findings. TSE also allows researchers to systematically evaluate and improve the design and execution of ongoing survey programs and…

Translating policies into practice: a framework to prevent childhood obesity in afterschool programs.

PubMed

Beets, Michael W; Webster, Collin; Saunders, Ruth; Huberty, Jennifer L

2013-03-01

Afterschool programs (3-6 p.m.) are positioned to play a critical role in combating childhood obesity. To this end, state and national organizations have developed policies related to promoting physical activity and guiding the nutritional quality of snacks served in afterschool programs. No conceptual frameworks, however, are available that describe the process of how afterschool programs will translate such policies into daily practice to reach eventual outcomes. Drawing from complex systems theory, this article describes the development of a framework that identifies critical modifiable levers within afterschool programs that can be altered and/or strengthened to reach policy goals. These include the policy environment at the national, state, and local levels; individual site, afterschool program leader, staff, and child characteristics; and existing outside organizational partnerships. Use of this framework and recognition of its constituent elements have the potential to lead to the successful and sustainable adoption and implementation of physical activity and nutrition policies in afterschool programs nationwide.

Corporate practices and health: a framework and mechanisms.

PubMed

Madureira Lima, Joana; Galea, Sandro

2018-02-15

The Global Burden of Disease estimates that approximately a third of deaths worldwide are attributable to behavioural risk factors that, at their core, have the consumption of unhealthful products and exposures produced by profit driven commercial entities. We use Steven Lukes' three-dimensional view of power to guide the study of the practices deployed by commercial interests to foster the consumption of these commodities. Additionally, we propose a framework to systematically study corporations and other commercial interests as a distal, structural, societal factor that causes disease and injury. Our framework offers a systematic approach to mapping corporate activity, allowing us to anticipate and prevent actions that may have a deleterious effect on population health. Our framework may be used by, and can have utility for, public health practitioners, researchers, students, activists and other members of civil society, policy makers and public servants in charge of policy implementation. It can also be useful to corporations who are interested in identifying key actions they can take towards improving population health.

Curriculum Recommendations of the AACP-PSSC Task Force on Caring for the Underserved

PubMed Central

Roche, Victoria F.; Assemi, Mitra; Conry, John M.; Shane-McWhorter, Laura; Sorensen, Todd D.

2008-01-01

A task force was convened by the American Association of Colleges of Pharmacy (AACP) and the Pharmaceutical Services Support Center (PSSC) and charged with the development of a curriculum framework to guide pharmacy programs in educating students on caring for the underserved. Utilizing a literature-based model, the task force constructed a framework that delineated evidence-based practice, clinical prevention and health promotion, health systems and policy, and community aspects of practice. Specific learning outcomes tailored to underserved populations were crafted and linked to resources readily available to the academy. The AACP-PSSC curriculum framework was shared with the academy in 2007. Schools and Colleges are urged to share experiences with implementation so that the impact of the tool can be evaluated. The task force recommends that the AACP Institutional Research Advisory Committee be involved in gathering assessment data. Implementation of the curriculum framework can help the academy fulfill the professional mandate to proactively provide the highest quality care to all, including underserved populations. PMID:18698398

Framework for Selecting Best Practices in Public Health: A Systematic Literature Review

PubMed Central

de Colombani, Pierpaolo

2015-01-01

Evidence-based public health has commonly relied on findings from empirical studies, or research-based evidence. However, this paper advocates that practice-based evidence derived from programmes implemented in real-life settings is likely to be a more suitable source of evidence for inspiring and guiding public health programmes. Selection of best practices from the array of implemented programmes is one way of generating such practice-based evidence. Yet the lack of consensus on the definition and criteria for practice-based evidence and best practices has limited their application in public health so far. To address the gap in literature on practice-based evidence, this paper hence proposes measures of success for public health interventions by developing an evaluation framework for selection of best practices. The proposed framework was synthesised from a systematic literature review of peer-reviewed and grey literature on existing evaluation frameworks for public health programmes as well as processes employed by health-related organisations when selecting best practices. A best practice is firstly defined as an intervention that has shown evidence of effectiveness in a particular setting and is likely to be replicable to other situations. Regardless of the area of public health, interventions should be evaluated by their context, process and outcomes. A best practice should hence meet most, if not all, of eight identified evaluation criteria: relevance, community participation, stakeholder collaboration, ethical soundness, replicability, effectiveness, efficiency and sustainability. Ultimately, a standardised framework for selection of best practices will improve the usefulness and credibility of practice-based evidence in informing evidence-based public health interventions. Significance for public health Best practices are a valuable source of practice-based evidence on effective public health interventions implemented in real-life settings. Yet, despite the frequent branding of interventions as best practices or good practices, there is no consensus on the definition and desirable characteristics of such best practices. Hence, this is likely to be the first systematic review on the topic of best practices in public health. Having a single widely accepted framework for selecting best practices will ensure that the selection processes by different agencies are fair and comparable, as well as enable public health workers to better appreciate and adopt best practices in different settings. Ultimately, standardisation will improve the credibility and usefulness of practice-based evidence to that of research-based evidence. PMID:26753159

Framework for Selecting Best Practices in Public Health: A Systematic Literature Review.

PubMed

Ng, Eileen; de Colombani, Pierpaolo

2015-11-17

Evidence-based public health has commonly relied on findings from empirical studies, or research-based evidence. However, this paper advocates that practice-based evidence derived from programmes implemented in real-life settings is likely to be a more suitable source of evidence for inspiring and guiding public health programmes. Selection of best practices from the array of implemented programmes is one way of generating such practice-based evidence. Yet the lack of consensus on the definition and criteria for practice-based evidence and best practices has limited their application in public health so far. To address the gap in literature on practice-based evidence, this paper hence proposes measures of success for public health interventions by developing an evaluation framework for selection of best practices. The proposed framework was synthesised from a systematic literature review of peer-reviewed and grey literature on existing evaluation frameworks for public health programmes as well as processes employed by health-related organisations when selecting best practices. A best practice is firstly defined as an intervention that has shown evidence of effectiveness in a particular setting and is likely to be replicable to other situations. Regardless of the area of public health, interventions should be evaluated by their context, process and outcomes. A best practice should hence meet most, if not all, of eight identified evaluation criteria: relevance, community participation, stakeholder collaboration, ethical soundness, replicability, effectiveness, efficiency and sustainability. Ultimately, a standardised framework for selection of best practices will improve the usefulness and credibility of practice-based evidence in informing evidence-based public health interventions. Significance for public healthBest practices are a valuable source of practice-based evidence on effective public health interventions implemented in real-life settings. Yet, despite the frequent branding of interventions as best practices or good practices, there is no consensus on the definition and desirable characteristics of such best practices. Hence, this is likely to be the first systematic review on the topic of best practices in public health. Having a single widely accepted framework for selecting best practices will ensure that the selection processes by different agencies are fair and comparable, as well as enable public health workers to better appreciate and adopt best practices in different settings. Ultimately, standardisation will improve the credibility and usefulness of practice-based evidence to that of research-based evidence.

Implementing change in primary care practices using electronic medical records: a conceptual framework.

PubMed

Nemeth, Lynne S; Feifer, Chris; Stuart, Gail W; Ornstein, Steven M

2008-01-16

Implementing change in primary care is difficult, and little practical guidance is available to assist small primary care practices. Methods to structure care and develop new roles are often needed to implement an evidence-based practice that improves care. This study explored the process of change used to implement clinical guidelines for primary and secondary prevention of cardiovascular disease in primary care practices that used a common electronic medical record (EMR). Multiple conceptual frameworks informed the design of this study designed to explain the complex phenomena of implementing change in primary care practice. Qualitative methods were used to examine the processes of change that practice members used to implement the guidelines. Purposive sampling in eight primary care practices within the Practice Partner Research Network-Translating Researching into Practice (PPRNet-TRIP II) clinical trial yielded 28 staff members and clinicians who were interviewed regarding how change in practice occurred while implementing clinical guidelines for primary and secondary prevention of cardiovascular disease and strokes. A conceptual framework for implementing clinical guidelines into primary care practice was developed through this research. Seven concepts and their relationships were modelled within this framework: leaders setting a vision with clear goals for staff to embrace; involving the team to enable the goals and vision for the practice to be achieved; enhancing communication systems to reinforce goals for patient care; developing the team to enable the staff to contribute toward practice improvement; taking small steps, encouraging practices' tests of small changes in practice; assimilating the electronic medical record to maximize clinical effectiveness, enhancing practices' use of the electronic tool they have invested in for patient care improvement; and providing feedback within a culture of improvement, leading to an iterative cycle of goal setting by leaders. This conceptual framework provides a mental model which can serve as a guide for practice leaders implementing clinical guidelines in primary care practice using electronic medical records. Using the concepts as implementation and evaluation criteria, program developers and teams can stimulate improvements in their practice settings. Investing in collaborative team development of clinicians and staff may enable the practice environment to be more adaptive to change and improvement.

Measure accurately, Act rapidly, and Partner with patients: An intuitive and practical three-part framework to guide efforts to improve hypertension control.

PubMed

Boonyasai, Romsai T; Rakotz, Michael K; Lubomski, Lisa H; Daniel, Donna M; Marsteller, Jill A; Taylor, Kathryn S; Cooper, Lisa A; Hasan, Omar; Wynia, Matthew K

2017-07-01

Hypertension is the leading cause of cardiovascular disease in the United States and worldwide. It also provides a useful model for team-based chronic disease management. This article describes the M.A.P. checklists: a framework to help practice teams summarize best practices for providing coordinated, evidence-based care to patients with hypertension. Consisting of three domains-Measure Accurately; Act Rapidly; and Partner With Patients, Families, and Communities-the checklists were developed by a team of clinicians, hypertension experts, and quality improvement experts through a multistep process that combined literature review, iterative feedback from a panel of internationally recognized experts, and pilot testing among a convenience sample of primary care practices in two states. In contrast to many guidelines, the M.A.P. checklists specifically target practice teams, instead of individual clinicians, and are designed to be brief, cognitively easy to consume and recall, and accessible to healthcare workers from a range of professional backgrounds. ©2017 Wiley Periodicals, Inc.

Conceptual and measurement issues in early parenting practices research: an epidemiologic perspective.

PubMed

Walker, Lorraine O; Kirby, Russell S

2010-11-01

Early parenting practices are significant to public health because of their linkages to child health outcomes. This paper focuses on the current state of the science regarding conceptual frameworks that incorporate early parenting practices in epidemiologic research and evidence supporting reliability and validity of self-report measures of such practices. Guided by a provisional definition of early parenting practices, literature searches were conducted using PubMed and Sociological Abstracts. Twenty-five published studies that included parent-report measures of early parenting practices met inclusion criteria. Findings on conceptual frameworks were analyzed qualitatively, whereas evidence of reliability and validity were organized into four domains (safety, feeding and oral health, development promotion, and discipline) and summarized in tabular form. Quantitative estimates of measures of reliability and validity were extracted, where available. We found two frameworks incorporating early parenting: one a program theory and the other a predictive model. We found no reported evidence of the reliability or validity of parent-report measures of safety or feeding and oral health practices. Evidence for reliability and validity were reported with greater frequency for development promotion and discipline practices, but report of the most pertinent type of reliability estimation, test-retest reliability, was rare. Failure to examine associations of early parenting practices with any child outcomes within most studies resulted in missed opportunities to indirectly estimate validity of parenting practice measures. Stronger evidence concerning specific measurement properties of early parenting practices is important to advancing maternal-child research, surveillance, and practice.

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

NASA Astrophysics Data System (ADS)

Finn, Rachel; Sveinsdottir, Thordis

2015-04-01

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

New paradigms for transcultural nursing: frameworks for studying African American women.

PubMed

Shambley-Ebron, Donna Z; Boyle, Joyceen S

2004-01-01

African American women continue to experience disparities in health status when compared to their European American counterparts, yet, often their unique perspectives are not presented in the nursing literature. This article will discuss various theoretical frameworks arising from Black women's thought and reality that can be used to enhance and expand transcultural nursing knowledge. Historical, sociocultural, and literary perspectives will be used to illuminate the realities of African American women's lives. Selected frameworks arising from these realities will be discussed that recognize the impact of race, class, and gender on the lives of African American women and have the potential to guide nursing research and practice.

Endeavoring to Contextualize Curricula Within an EBP Framework: A Grounded Theory Study.

PubMed

Malik, Gulzar; McKenna, Lisa; Griffiths, Debra

2018-01-01

Adopting evidence-based practice (EBP) principles in undergraduate education can facilitate nursing students' appreciation of EBP. Using grounded theory method, this study aimed to explore processes used by nurse academics while integrating EBP concepts in undergraduate nursing curricula across Australian universities. Twenty-three nurse academics were interviewed and nine were observed during teaching of undergraduate students. In addition, 20 unit/subject guides were analyzed using grounded theory approach of data analysis. The theory " On a path to success: Endeavoring to contextualize curricula within an EBP framework" reflects academics' endeavors toward linking EBP concepts to practice, aiming to contextualize curricula in a manner that engages students within an EBP framework. However, academics' journeys were influenced by several contextual factors which require strategies to accomplish their endeavors. In conclusion, initiatives to minimize barriers, faculty development, and provision of resources across educational and clinical settings are fundamental to achieving undergraduate curricula underpinned by EBP concepts.

Deliberate Practice as a Theoretical Framework for Interprofessional Experiential Education.

PubMed

Wang, Joyce M; Zorek, Joseph A

2016-01-01

The theory of deliberate practice has been applied to many skill-based performance activities. The primary aim of this project was to integrate synergistic principles from deliberate practice and consensus-derived competencies for interprofessional education into a framework upon which educational models to advance interprofessional experiential education (IEE) might be built. CINAHL, ERIC, and MEDLINE databases were searched using the keywords "deliberate practice" and "interprofessional education," both individually and in combination. Relevant articles were selected from the catalog based on support for the premise of the project. Defining characteristics of deliberate practice were distilled with particular emphasis on their application to the Interprofessional Education Collaborative's (IPEC) core competencies. Recommendations for IEE development were identified through the synthesis of deliberate practice principles and IPEC competencies. There is a high degree of synergy between deliberate practice principles and IPEC competencies. Our synthesis of the literature yielded a cyclical four-step process to advance IEE: (1) implement an IEE plan guided by the student's strengths/weaknesses and in consideration of the collaborative practice skills they wish to develop, (2) engage in IPE experiences that will challenge targeted skills according to the IEE plan, (3) embed frequent opportunities for student reflection and preceptor/team feedback within IEE plan, and (4) revise the IEE plan and the IPE experience based on insights gained during step 3. The cyclical four-step process synthesized through this literature review may be used to guide the development of new IEE models. The purposeful development of IEE models grounded in a theory that has already been operationalized in other skill-based performance areas is an important step to address expanding accreditation standards throughout the health professions mandating interprofessional education for pre-licensure health professional students.

Guided by Theory, Informed by Practice: Training and Support for the Good Behavior Game, a Classroom-based Behavior Management Strategy

PubMed Central

Poduska, Jeanne M.; Kurki, Anja

2015-01-01

Moving evidence-based practices for classroom behavior management into real-world settings is a high priority for education and public health. This paper describes the development and use of a model of training and support for the Good Behavior Game (GBG), one of the few preventive interventions shown to have positive outcomes for elementary school children lasting through to young adulthood, ages 19–21, including reductions in the use of drugs and alcohol, school-based mental health services, and suicide ideation and attempts. We first describe the conceptual framework guiding the development of the model of training and support. Data on implementation of the model, from an ongoing trial of GBG being conducted in partnership with the Houston Independent School District, are then presented. We end with a discussion of the lessons learned and the implications for the next stage of research and practice. PMID:26236144

Practice-Based Knowledge Discovery for Comparative Effectiveness Research: An Organizing Framework

PubMed Central

Lucero, Robert J.; Bakken, Suzanne

2014-01-01

Electronic health information systems can increase the ability of health-care organizations to investigate the effects of clinical interventions. The authors present an organizing framework that integrates outcomes and informatics research paradigms to guide knowledge discovery in electronic clinical databases. They illustrate its application using the example of hospital acquired pressure ulcers (HAPU). The Knowledge Discovery through Informatics for Comparative Effectiveness Research (KDI-CER) framework was conceived as a heuristic to conceptualize study designs and address potential methodological limitations imposed by using a single research perspective. Advances in informatics research can play a complementary role in advancing the field of outcomes research including CER. The KDI-CER framework can be used to facilitate knowledge discovery from routinely collected electronic clinical data. PMID:25278645

Development of a Self-Management Theory-Guided Discharge Intervention for Parents of Hospitalized Children.

PubMed

Sawin, Kathleen J; Weiss, Marianne E; Johnson, Norah; Gralton, Karen; Malin, Shelly; Klingbeil, Carol; Lerret, Stacee M; Thompson, Jamie J; Zimmanck, Kim; Kaul, Molly; Schiffman, Rachel F

2017-03-01

Parents of hospitalized children, especially parents of children with complex and chronic health conditions, report not being adequately prepared for self-management of their child's care at home after discharge. No theory-based discharge intervention exists to guide pediatric nurses' preparation of parents for discharge. To develop a theory-based conversation guide to optimize nurses' preparation of parents for discharge and self-management of their child at home following hospitalization. Two frameworks and one method influenced the development of the intervention: the Individual and Family Self-Management Theory, Tanner's Model of Clinical Judgment, and the Teach-Back method. A team of nurse scientists, nursing leaders, nurse administrators, and clinical nurses developed and field tested the electronic version of a nine-domain conversation guide for use in acute care pediatric hospitals. The theory-based intervention operationalized self-management concepts, added components of nursing clinical judgment, and integrated the Teach-Back method. Development of a theory-based intervention, the translation of theoretical knowledge to clinical innovation, is an important step toward testing the effectiveness of the theory in guiding clinical practice. Clinical nurses will establish the practice relevance through future use and refinement of the intervention. © 2017 Sigma Theta Tau International.

GUIDING PRINCIPLES FOR GOOD PRACTICES IN HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT UNITS.

PubMed

Sampietro-Colom, Laura; Lach, Krzysztof; Pasternack, Iris; Wasserfallen, Jean-Blaise; Cicchetti, Americo; Marchetti, Marco; Kidholm, Kristian; Arentz-Hansen, Helene; Rosenmöller, Magdalene; Wild, Claudia; Kahveci, Rabia; Ulst, Margus

2015-01-01

Health technology assessment (HTA) carried out for policy decision making has well-established principles unlike hospital-based HTA (HB-HTA), which differs from the former in the context characteristics and ways of operation. This study proposes principles for good practices in HB-HTA units. A framework for good practice criteria was built inspired by the EFQM excellence business model and information from six literature reviews, 107 face-to-face interviews, forty case studies, large-scale survey, focus group, Delphi survey, as well as local and international validation. In total, 385 people from twenty countries have participated in defining the principles for good practices in HB-HTA units. Fifteen guiding principles for good practices in HB-HTA units are grouped in four dimensions. Dimension 1 deals with principles of the assessment process aimed at providing contextualized information for hospital decision makers. Dimension 2 describes leadership, strategy and partnerships of HB-HTA units which govern and facilitate the assessment process. Dimension 3 focuses on adequate resources that ensure the operation of HB-HTA units. Dimension 4 deals with measuring the short- and long-term impact of the overall performance of HB-HTA units. Finally, nine core guiding principles were selected as essential requirements for HB-HTA units based on the expertise of the HB-HTA units participating in the project. Guiding principles for good practices set up a benchmark for HB-HTA because they represent the ideal performance of HB-HTA units; nevertheless, when performing HTA at hospital level, context also matters; therefore, they should be adapted to ensure their applicability in the local context.

Development and validation of a competency framework for veterinarians.

PubMed

Bok, Harold G J; Jaarsma, Debbie A D C; Teunissen, Pim W; van der Vleuten, Cees P M; van Beukelen, Peter

2011-01-01

Changing demands from society and the veterinary profession call for veterinary medical curricula that can deliver veterinarians who are able to integrate specific and generic competencies in their professional practice. This requires educational innovation directed by an integrative veterinary competency framework to guide curriculum development. Given the paucity of relevant information from the veterinary literature, a qualitative multi-method study was conducted to develop and validate such a framework. A competency framework was developed based on the analysis of focus group interviews with 54 recently graduated veterinarians and clients and subsequently validated in a Delphi procedure with a panel of 29 experts, representing the full range and diversity of the veterinary profession. The study resulted in an integrated competency framework for veterinary professionals, which consists of 16 competencies organized in seven domains: veterinary expertise, communication, collaboration, entrepreneurship, health and welfare, scholarship, and personal development. Training veterinarians who are able to use and integrate the seven domains in their professional practice is an important challenge for today's veterinary medical schools. The Veterinary Professional (VetPro) framework provides a sound empirical basis for the ongoing debate about the direction of veterinary education and curriculum development.

Using a High-Performance Planning Model to Increase Levels of Functional Effectiveness Within Professional Development.

PubMed

Winter, Peggi

2016-01-01

Nursing professional practice models continue to shape how we practice nursing by putting families and members at the heart of everything we do. Faced with enormous challenges around healthcare reform, models create frameworks for practice by unifying, uniting, and guiding our nurses. The Kaiser Permanente Practice model was developed to ensure consistency for nursing practice across the continuum. Four key pillars support this practice model and the work of nursing: quality and safety, leadership, professional development, and research/evidence-based practice. These four pillars form the foundation that makes transformational practice possible and aligns nursing with Kaiser Permanente's mission. The purpose of this article is to discuss the pillar of professional development and the components of the Nursing Professional Development: Scope and Standards of Practice model (American Nurses Association & National Nursing Staff Development Organization, 2010) and place them in a five-level development framework. This process allowed us to identify the current organizational level of practice, prioritize each nursing professional development component, and design an operational strategy to move nursing professional development toward a level of high performance. This process is suggested for nursing professional development specialists.

Content analysis to locate assistive technology in Queensland's motor injury insurance rehabilitation legislation and guidelines.

PubMed

Steel, Emily J

2018-06-08

Reforms to Australia's disability and rehabilitation sectors have espoused the potential of assistive technology as an enabler. As new insurance systems are being developed it is timely to examine the structure of existing systems. This exploratory study examined the policies guiding assistive technology provision in the motor accident insurance sector of one Australian state. Policy documents were analyzed iteratively with set of qualitative questions to understand the intent and interpretation of policies guiding assistive technology provision. Content analysis identified relevant sections and meaningful terminology, and context analysis explored the dominant perspectives informing policy. The concepts and language of assistive technology are not part of the policy frameworks guiding rehabilitation practice in Queensland's motor accident insurance sector. The definition of rehabilitation in the legislation is consistent contemporary international interpretations that focus on optimizing functioning in interaction with the environment. However, the supporting documents are focused on recovery from injuries where decisions are guided by clinical need and affordability. The policies frame rehabilitation in a medical model that assistive technology provision from the rehabilitation plan. The legislative framework provides opportunities to develop and improve assistive technology provision as part of an integrated approach to rehabilitation.

Competence, practical rationality and what a patient values.

PubMed

Craigie, Jillian

2011-07-01

According to the principle of patient autonomy, patients have the right to be self-determining in decisions about their own medical care, which includes the right to refuse treatment. However, a treatment refusal may legitimately be overridden in cases where the decision is judged to be incompetent. It has recently been proposed that in assessments of competence, attention should be paid to the evaluative judgments that guide patients' treatment decisions. In this paper I examine this claim in light of theories of practical rationality, focusing on the difficult case of an anorexic person who is judged to be competent and refuses treatment, thereby putting themselves at risk of serious harm. I argue that the standard criteria for competence assess whether a treatment decision satisfies the goals of practical decision-making, and that this same criterion can be applied to a patient's decision-guiding commitments. As a consequence I propose that a particular understanding of practical rationality offers a theoretical framework for justifying involuntary treatment in the anorexia case. © 2009 Blackwell Publishing Ltd.

Theory, Research, and Practice for Students Who Are Deaf and Hard of Hearing With Disabilities: Addressing the Challenges from Birth to Postsecondary Education.

PubMed

Guardino, Caroline; Cannon, Joanna E

2015-01-01

Students who are deaf with a disability or disabilities (DWD) constitute nearly half of the population of K-12 learners who are deaf or hard of hearing. However, there is a dearth of information on theory, research, and practice related to these learners. The authors present an overview of (a) how the field of education of students who are D/deaf and hard of hearing might refer to this unique population in a way that represents the learner, not the disability; (b) the demographic data that further define these learners; (c) a theoretical framework within which to guide research and practice; (d) prevalence and frequency of the existing research; and (e) the practices and resources available to guide practitioners and the parents of students who are DWD. Questions are posed to the field on how to continue to improve the theory, research, and pedagogy used with these students.

An open-source job management framework for parameter-space exploration: OACIS

NASA Astrophysics Data System (ADS)

Murase, Y.; Uchitane, T.; Ito, N.

2017-11-01

We present an open-source software framework for parameter-space exporation, named OACIS, which is useful to manage vast amount of simulation jobs and results in a systematic way. Recent development of high-performance computers enabled us to explore parameter spaces comprehensively, however, in such cases, manual management of the workflow is practically impossible. OACIS is developed aiming at reducing the cost of these repetitive tasks when conducting simulations by automating job submissions and data management. In this article, an overview of OACIS as well as a getting started guide are presented.

Expert consensus on best evaluative practices in community-based rehabilitation.

PubMed

Grandisson, Marie; Thibeault, Rachel; Hébert, Michèle; Cameron, Debra

2016-01-01

The objective of this study was to generate expert consensus on best evaluative practices for community-based rehabilitation (CBR). This consensus includes key features of the evaluation process and methods, and discussion of whether a shared framework should be used to report findings and, if so, which framework should play this role. A Delphi study with two predefined rounds was conducted. Experts in CBR from a wide range of geographical areas and disciplinary backgrounds were recruited to complete the questionnaires. Both quantitative and qualitative analyses were performed to generate the recommendations for best practices in CBR evaluation. A panel of 42 experts reached consensus on 13 recommendations for best evaluative practices in CBR. In regard to the critical qualities of sound CBR evaluation processes, panellists emphasized that these processes should be inclusive, participatory, empowering and respectful of local cultures and languages. The group agreed that evaluators should consider the use of mixed methods and participatory tools, and should combine indicators from a universal list of CBR indicators with locally generated ones. The group also agreed that a common framework should guide CBR evaluations, and that this framework should be a flexible combination between the CBR Matrix and the CBR Principles. An expert panel reached consensus on key features of best evaluative practices in CBR. Knowledge transfer initiatives are now required to develop guidelines, tools and training opportunities to facilitate CBR program evaluations. CBR evaluation processes should strive to be inclusive, participatory, empowering and respectful of local cultures and languages. CBR evaluators should strongly consider using mixed methods, participatory tools, a combination of indicators generated with the local community and with others from a bank of CBR indicators. CBR evaluations should be situated within a shared, but flexible, framework. This shared framework could combine the CBR Matrix and the CBR Principles.

The Integrated Behavioural Model for Water, Sanitation, and Hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings.

PubMed

Dreibelbis, Robert; Winch, Peter J; Leontsini, Elli; Hulland, Kristyna R S; Ram, Pavani K; Unicomb, Leanne; Luby, Stephen P

2013-10-26

Promotion and provision of low-cost technologies that enable improved water, sanitation, and hygiene (WASH) practices are seen as viable solutions for reducing high rates of morbidity and mortality due to enteric illnesses in low-income countries. A number of theoretical models, explanatory frameworks, and decision-making models have emerged which attempt to guide behaviour change interventions related to WASH. The design and evaluation of such interventions would benefit from a synthesis of this body of theory informing WASH behaviour change and maintenance. We completed a systematic review of existing models and frameworks through a search of related articles available in PubMed and in the grey literature. Information on the organization of behavioural determinants was extracted from the references that fulfilled the selection criteria and synthesized. Results from this synthesis were combined with other relevant literature, and from feedback through concurrent formative and pilot research conducted in the context of two cluster-randomized trials on the efficacy of WASH behaviour change interventions to inform the development of a framework to guide the development and evaluation of WASH interventions: the Integrated Behavioural Model for Water, Sanitation, and Hygiene (IBM-WASH). We identified 15 WASH-specific theoretical models, behaviour change frameworks, or programmatic models, of which 9 addressed our review questions. Existing models under-represented the potential role of technology in influencing behavioural outcomes, focused on individual-level behavioural determinants, and had largely ignored the role of the physical and natural environment. IBM-WASH attempts to correct this by acknowledging three dimensions (Contextual Factors, Psychosocial Factors, and Technology Factors) that operate on five-levels (structural, community, household, individual, and habitual). A number of WASH-specific models and frameworks exist, yet with some limitations. The IBM-WASH model aims to provide both a conceptual and practical tool for improving our understanding and evaluation of the multi-level multi-dimensional factors that influence water, sanitation, and hygiene practices in infrastructure-constrained settings. We outline future applications of our proposed model as well as future research priorities needed to advance our understanding of the sustained adoption of water, sanitation, and hygiene technologies and practices.

The Integrated Behavioural Model for Water, Sanitation, and Hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings

PubMed Central

2013-01-01

Background Promotion and provision of low-cost technologies that enable improved water, sanitation, and hygiene (WASH) practices are seen as viable solutions for reducing high rates of morbidity and mortality due to enteric illnesses in low-income countries. A number of theoretical models, explanatory frameworks, and decision-making models have emerged which attempt to guide behaviour change interventions related to WASH. The design and evaluation of such interventions would benefit from a synthesis of this body of theory informing WASH behaviour change and maintenance. Methods We completed a systematic review of existing models and frameworks through a search of related articles available in PubMed and in the grey literature. Information on the organization of behavioural determinants was extracted from the references that fulfilled the selection criteria and synthesized. Results from this synthesis were combined with other relevant literature, and from feedback through concurrent formative and pilot research conducted in the context of two cluster-randomized trials on the efficacy of WASH behaviour change interventions to inform the development of a framework to guide the development and evaluation of WASH interventions: the Integrated Behavioural Model for Water, Sanitation, and Hygiene (IBM-WASH). Results We identified 15 WASH-specific theoretical models, behaviour change frameworks, or programmatic models, of which 9 addressed our review questions. Existing models under-represented the potential role of technology in influencing behavioural outcomes, focused on individual-level behavioural determinants, and had largely ignored the role of the physical and natural environment. IBM-WASH attempts to correct this by acknowledging three dimensions (Contextual Factors, Psychosocial Factors, and Technology Factors) that operate on five-levels (structural, community, household, individual, and habitual). Conclusions A number of WASH-specific models and frameworks exist, yet with some limitations. The IBM-WASH model aims to provide both a conceptual and practical tool for improving our understanding and evaluation of the multi-level multi-dimensional factors that influence water, sanitation, and hygiene practices in infrastructure-constrained settings. We outline future applications of our proposed model as well as future research priorities needed to advance our understanding of the sustained adoption of water, sanitation, and hygiene technologies and practices. PMID:24160869

Public/Private Partnerships: Building Support for Employer-Sponsored Eldercare: A Guide for the Aging Network.

ERIC Educational Resources Information Center

Sheehy, Edward

This guidebook provides practical information to assist state and local aging agencies in developing strategic relationships with businesses in their communities. It focuses on the experiences of those state agencies and Area Agencies on Aging that are actively working with local employers and it presents a framework for other agencies. The book…

Practicing Learner-Centered Teaching: Pedagogical Design and Assessment of a Second Life Project

ERIC Educational Resources Information Center

Schiller, Shu Z.

2009-01-01

Guided by the principles of learner-centered teaching methodology, a Second Life project is designed to engage students in active learning of virtual commerce through hands-on experiences and teamwork in a virtual environment. More importantly, an assessment framework is proposed to evaluate the learning objectives and learning process of the…

A Methodological Framework for Instructional Design Model Development: Critical Dimensions and Synthesized Procedures

ERIC Educational Resources Information Center

Lee, Jihyun; Jang, Seonyoung

2014-01-01

Instructional design (ID) models have been developed to promote understandings of ID reality and guide ID performance. As the number and diversity of ID practices grows, implicit doubts regarding the reliability, validity, and usefulness of ID models suggest the need for methodological guidance that would help to generate ID models that are…

Revisiting Principles of Ethical Practice Using a Case Study Framework

ERIC Educational Resources Information Center

Combes, Bertina H.; Peak, Pamela W.; Barrio, Brenda L.; Lindo, Endia J.; Hovey, Katrina A.; Lim, Okyoung; Peterson-Ahmad, Maria; Dorel, Theresa G.; Goran, Lisa

2016-01-01

A code of ethics serves as a compass, guiding professionals as they perform the roles associated with their profession. These codes are evidence to the public that professionals are concerned about the services they provide and the individuals to whom they are provided. Codes of ethics should be living documents, changing focus as the fields they…

School Reform and the Transition to Middle School.

ERIC Educational Resources Information Center

Anderman, Eric M.; And Others

This paper presents findings of a study that used goal orientation theory as a guiding framework for a collaborative effort with middle school principals, teachers, and parents over a 3-year period. The intervention sought to change policies and practices so that they would reflect more of a task-goal orientation and less of an ability-goal…

Beyond Time Out: A Practical Guide to Understanding and Serving Students with Behavioral Impairments in the Public Schools. Second Edition.

ERIC Educational Resources Information Center

Stewart, John

This text is designed, through the use of a developmental framework, to support effective work with students with behavior disorders and students who have behavior disorders and additional disabilities. Presentation of developmental theory, case studies and illustrations explain many puzzling aspects of problem behavior and outline appropriate…

Communicating Chemistry: A Framework for Sharing Science: A Practical Evidence-Based Guide

ERIC Educational Resources Information Center

National Academies Press, 2016

2016-01-01

A growing body of evidence indicates that, increasingly, the public is engaging with science in a wide range of informal environments, which can be any setting outside of school such as community-based programs, festivals, libraries, or home. Yet undergraduate and graduate schools often don't prepare scientists for public communication. This…

Exploring How Research Experiences for Teachers Changes Their Understandings of the Nature of Science and Scientific Inquiry

ERIC Educational Resources Information Center

Buxner, Sanlyn R.

2014-01-01

The nature of science is a prevalent theme across United States national science education standards and frameworks as well as other documents that guide formal and informal science education reform. To support teachers in engaging their students in authentic scientific practices and reformed teaching strategies, research experiences for teachers…

Taking Action toward Inclusion: Organizational Change and the Inclusion of People with Disabilities in Museum Learning

ERIC Educational Resources Information Center

Reich, Christine A.

2014-01-01

This study examined organizational change in science museums toward practices that are inclusive of people with disabilities. Guided by two overarching frameworks, organizational learning and the social model of disability, this study sought to answer the following: What are the contexts and processes that facilitate, sustain, or impede a science…

Having a Go: Looking at Teachers' Experience of Risk-Taking in Technology Integration

ERIC Educational Resources Information Center

Howard, Sarah K.; Gigliotti, Amanda

2016-01-01

Risk is an integral part of change. Technology-related change in teachers' practice is guided by confidence engaging in and beliefs about integration. However, it is also affected by how teachers feel about taking risks, experimenting and change. This paper presents a theoretical framework of affect and emotion to understand how teachers…

Guiding Reflective Practice: An Auditing Framework to Assess Teaching Philosophy and Style

ERIC Educational Resources Information Center

Titus, Philip A.; Gremler, Dwayne D.

2010-01-01

Growing as an educator takes hard work and commitment. It requires the educator to engage in regular, objective self-examinations of instructional beliefs and behaviors. Although this task can be daunting, and unwieldy, due to the complexity of the teaching-learning exchange, it can also be undertaken in a systematic manner. This article proposes…

Learning in Social Networks: Rationale and Ideas for Its Implementation in Higher Education

ERIC Educational Resources Information Center

Alvarez, Ibis M.; Olivera-Smith, Marialexa

2013-01-01

The internet has fast become a prevalent medium for collaboration between people and social networks, in particular, have gained vast popularity and relevance over the past few years. Within this framework, our paper will analyse the role played by social networks in current teaching practices. Specifically, we focus on the principles guiding the…

Nurse Aide Empowerment Strategies and Staff Stability: Effects on Nursing Home Resident Outcomes

ERIC Educational Resources Information Center

Barry, Theresa; Brannon, Diane; Mor, Vincent

2005-01-01

Purpose: This study examines the moderating effect of staff stability on the relationship between management practices used to empower nurse aides and resident outcomes in a multistate sample of nursing homes. An adaptation of Kanter's theory of structural power in organizations guided the framework for the model used in this study. Design and…

How Elementary Teachers Use Classroom Mini-Economies When Guided by the C3 Framework

ERIC Educational Resources Information Center

Day, Stephen Harlan

2015-01-01

A mini-economy is an ongoing classroom project in which elementary school students apply for jobs, receive simulated income, go shopping at the classroom store, and ultimately create their own businesses. This study uses design-based research methodology to find out what classroom practices emerge when the College, Career, and Civic Life Framework…

A Collaborative Children's Literature Book Club for Teacher Candidates

ERIC Educational Resources Information Center

Scheffel, Tara-Lynn; Cameron, Claire; Dolmage, Lindsay; Johnston, Madisen; Lapensee, Jemanica; Solymar, Kirsten; Speedie, Emily; Wills, Meagan

2018-01-01

This paper highlights the two-year journey of an extra-curricular book club for teacher candidates as they explored children's literature in order to further their teaching practice. Initial themes were confirmed and refined as the journey of the book club concluded after two years. A sociocultural theoretical framework guided this work and…

Applying a Theory-Driven Framework to Guide Quality Improvement Efforts in Nursing Homes: The LOCK Model.

PubMed

Mills, Whitney L; Pimentel, Camilla B; Palmer, Jennifer A; Snow, A Lynn; Wewiorski, Nancy J; Allen, Rebecca S; Hartmann, Christine W

2018-05-08

Implementing quality improvement (QI) programs in nursing homes continues to encounter significant challenges, despite recognized need. QI approaches provide nursing home staff with opportunities to collaborate on developing and testing strategies for improving care delivery. We present a theory-driven and user-friendly adaptable framework and facilitation package to overcome existing challenges and guide QI efforts in nursing homes. The framework is grounded in the foundational concepts of strengths-based learning, observation, relationship-based teams, efficiency, and organizational learning. We adapted these concepts to QI in the nursing home setting, creating the "LOCK" framework. The LOCK framework is currently being disseminated across the Veterans Health Administration. The LOCK framework has five tenets: (a) Look for the bright spots, (b) Observe, (c) Collaborate in huddles, (d) Keep it bite-sized, and (e) facilitation. Each tenet is described. We also present a case study documenting how a fictional nursing home can implement the LOCK framework as part of a QI effort to improve engagement between staff and residents. The case study describes sample observations, processes, and outcomes. We also discuss practical applications for nursing home staff, the adaptability of LOCK for different QI projects, the specific role of facilitation, and lessons learned. The proposed framework complements national efforts to improve quality of care and quality of life for nursing home residents and may be valuable across long-term care settings and QI project types.

Development of a National Aboriginal and Torres Strait Islander Cancer Framework: A Shared Process to Guide Effective Policy and Practice

PubMed Central

Brands, Jenny; Garvey, Gail; Anderson, Kate; Cunningham, Joan; Chynoweth, Jennifer; Wallington, Isabella; Morris, Bronwyn; Knott, Vikki; Webster, Samantha; Kinsella, Lauren; Zorbas, Helen

2018-01-01

Indigenous Australians experience a substantially higher cancer mortality rate than non-Indigenous Australians. While cancer outcomes are improving for non-Indigenous Australians, they are worsening for Indigenous Australians. Reducing this disparity requires evidence-based and culturally-appropriate guidance. The purpose of this paper is to describe an initiative by Cancer Australia and Menzies School of Health Research (Menzies) to develop Australia’s first National Aboriginal and Torres Strait Islander Cancer Framework using a process of co-design with relevant stakeholders. The initiative was guided by three core principles: achieving policy-relevant evidence-based outcomes; engaging and maintaining trust with Indigenous Australians at every phase; and employing best-practice and appropriate research methods. Four components of research comprised the Framework development: evidence review; multifaceted stakeholder consultation and input; triangulation of findings; and direct stakeholder input in drafting and refining the Framework. The evidence review confirmed the increasing burden of cancer on Indigenous Australians, while stakeholder consultations facilitated comprehensive input from those with lived experience. The consultations revealed issues not identified in existing literature, and gave different emphases of priority, thus reinforcing the value of including stakeholder perspectives. This paper focuses primarily on documenting the methods used; findings are presented only in order to illustrate the results of the process. The published Framework is available at www.canceraustralia.gov.au; further description and analyses of findings from the consultations will be published elsewhere. The logistics inherent in large-scale consultation are considerable. However, the quality of data and the foundation for sustained partnership with stakeholders and knowledge translation vastly outweighed the challenges. The process of wide-ranging stakeholder consultation described in this paper offers a model for other areas of national and international Indigenous priority setting and policy and practice development that meets the needs of those most affected. The Framework, through the establishment of an agreed, shared and evidence-based agenda, provides guidance for jurisdictional cancer plans, optimal care pathways, and program and service planning for the multiple players across all levels of the health system. PMID:29747405

Nursing and genetic biobanks.

PubMed

Sanner, Jennifer E; Yu, Erica; Udtha, Malini; Williams, Pamela Holtzclaw

2013-12-01

Biobanks function as vital components in genetic research, which often requires large disease-based or population-based biospecimens and clinical data to study complex or rare diseases. Genetic biobanks aim to provide resources for translational research focusing on rapidly moving scientific findings from the laboratory into health care practice. The nursing profession must evolve as genetic biobanking practices advance. Nursing involvement in genetic biobanking practices comes with a distinct set of educational, ethical, and practice competencies. In response to these growing competency standards, nursing science developed a conceptual framework and continues to study ethical considerations to guide genetic biobanking initiatives. Copyright © 2013 Elsevier Inc. All rights reserved.

Rehabilitation goal setting with community dwelling adults with acquired brain injury: a theoretical framework derived from clinicians' reflections on practice.

PubMed

Prescott, Sarah; Fleming, Jennifer; Doig, Emmah

2017-06-11

The aim of this study was to explore clinicians' experiences of implementing goal setting with community dwelling clients with acquired brain injury, to develop a goal setting practice framework. Grounded theory methodology was employed. Clinicians, representing six disciplines across seven services, were recruited and interviewed until theoretical saturation was achieved. A total of 22 clinicians were interviewed. A theoretical framework was developed to explain how clinicians support clients to actively engage in goal setting in routine practice. The framework incorporates three phases: a needs identification phase, a goal operationalisation phase, and an intervention phase. Contextual factors, including personal and environmental influences, also affect how clinicians and clients engage in this process. Clinicians use additional strategies to support clients with impaired self-awareness. These include structured communication and metacognitive strategies to operationalise goals. For clients with emotional distress, clinicians provide additional time and intervention directed at new identity development. The goal setting practice framework may guide clinician's understanding of how to engage in client-centred goal setting in brain injury rehabilitation. There is a predilection towards a client-centred goal setting approach in the community setting, however, contextual factors can inhibit implementation of this approach. Implications for Rehabilitation The theoretical framework describes processes used to develop achievable client-centred goals with people with brain injury. Building rapport is a core strategy to engage clients with brain injury in goal setting. Clients with self-awareness impairment benefit from additional metacognitive strategies to participate in goal setting. Clients with emotional distress may need additional time for new identity development.

Writing-to-learn in undergraduate science education: a community-based, conceptually driven approach.

PubMed

Reynolds, Julie A; Thaiss, Christopher; Katkin, Wendy; Thompson, Robert J

2012-01-01

Despite substantial evidence that writing can be an effective tool to promote student learning and engagement, writing-to-learn (WTL) practices are still not widely implemented in science, technology, engineering, and mathematics (STEM) disciplines, particularly at research universities. Two major deterrents to progress are the lack of a community of science faculty committed to undertaking and applying the necessary pedagogical research, and the absence of a conceptual framework to systematically guide study designs and integrate findings. To address these issues, we undertook an initiative, supported by the National Science Foundation and sponsored by the Reinvention Center, to build a community of WTL/STEM educators who would undertake a heuristic review of the literature and formulate a conceptual framework. In addition to generating a searchable database of empirically validated and promising WTL practices, our work lays the foundation for multi-university empirical studies of the effectiveness of WTL practices in advancing student learning and engagement.

Considerations for use of dental photography and electronic media in dental education and clinical practice.

PubMed

Stieber, Jane C; Nelson, Travis; Huebner, Colleen E

2015-04-01

Photography and electronic media are indispensable tools for dental education and clinical practice. Although previous research has focused on privacy issues and general strategies to protect patient privacy when sharing clinical photographs for educational purposes, there are no published recommendations for developing a functional, privacy-compliant institutional framework for the capture, storage, transfer, and use of clinical photographs and other electronic media. The aims of this study were to research patient rights relating to electronic media and propose a framework for the use of patient media in education and clinical care. After a review of the relevant literature and consultation with the University of Washington's director of privacy and compliance and assistant attorney general, the researchers developed a privacy-compliant framework to ensure appropriate capture, storage, transfer, and use of clinical photography and electronic media. A four-part framework was created to guide the use of patient media that reflects considerations of patient autonomy and privacy, informed consent, capture and storage of media, and its transfer, use, and display. The best practices proposed for capture, storage, transfer, and use of clinical photographs and electronic media adhere to the health care code of ethics (based on patient autonomy, nonmaleficence, beneficence, justice, and veracity), which is most effectively upheld by a practical framework designed to protect patients and limit institutional liability. Educators have the opportunity and duty to convey these principles to students who will become the next generation of dentists, researchers, and educators.

Steps toward improving ethical evaluation in health technology assessment: a proposed framework.

PubMed

Assasi, Nazila; Tarride, Jean-Eric; O'Reilly, Daria; Schwartz, Lisa

2016-06-06

While evaluation of ethical aspects in health technology assessment (HTA) has gained much attention during the past years, the integration of ethics in HTA practice still presents many challenges. In response to the increasing demand for expansion of health technology assessment (HTA) methodology to include ethical issues more systematically, this article reports on a multi-stage study that aimed at construction of a framework for improving the integration of ethics in HTA. The framework was developed through the following phases: 1) a systematic review and content analysis of guidance documents for ethics in HTA; 2) identification of factors influencing the integration of ethical considerations in HTA; 3) preparation of an action-oriented framework based on the key elements of the existing guidance documents and identified barriers to and facilitators of their implementation; and 4) expert consultation and revision of the framework. The proposed framework consists of three main components: an algorithmic flowchart, which exhibits the different steps of an ethical inquiry throughout the HTA process, including: defining the objectives and scope of the evaluation, stakeholder analysis, assessing organizational capacity, framing ethical evaluation questions, ethical analysis, deliberation, and knowledge translation; a stepwise guide, which focuses on the task objectives and potential questions that are required to be addressed at each step; and a list of some commonly recommended or used tools to help facilitate the evaluation process. The proposed framework can be used to support and promote good practice in integration of ethics into HTA. However, further validation of the framework through case studies and expert consultation is required to establish its utility for HTA practice.

An overview of ethical frameworks in public health: can they be supportive in the evaluation of programs to prevent overweight?

PubMed Central

2010-01-01

Background The prevention of overweight sometimes raises complex ethical questions. Ethical public health frameworks may be helpful in evaluating programs or policy for overweight prevention. We give an overview of the purpose, form and contents of such public health frameworks and investigate to which extent they are useful for evaluating programs to prevent overweight and/or obesity. Methods Our search for frameworks consisted of three steps. Firstly, we asked experts in the field of ethics and public health for the frameworks they were aware of. Secondly, we performed a search in Pubmed. Thirdly, we checked literature references in the articles on frameworks we found. In total, we thus found six ethical frameworks. We assessed the area on which the available ethical frameworks focus, the users they target at, the type of policy or intervention they propose to address, and their aim. Further, we looked at their structure and content, that is, tools for guiding the analytic process, the main ethical principles or values, possible criteria for dealing with ethical conflicts, and the concrete policy issues they are applied to. Results All frameworks aim to support public health professionals or policymakers. Most of them provide a set of values or principles that serve as a standard for evaluating policy. Most frameworks articulate both the positive ethical foundations for public health and ethical constraints or concerns. Some frameworks offer analytic tools for guiding the evaluative process. Procedural guidelines and concrete criteria for solving important ethical conflicts in the particular area of the prevention of overweight or obesity are mostly lacking. Conclusions Public health ethical frameworks may be supportive in the evaluation of overweight prevention programs or policy, but seem to lack practical guidance to address ethical conflicts in this particular area. PMID:20969761

A generalized framework for nucleosynthesis calculations

NASA Astrophysics Data System (ADS)

Sprouse, Trevor; Mumpower, Matthew; Aprahamian, Ani

2014-09-01

Simulating astrophysical events is a difficult process, requiring a detailed pairing of knowledge from both astrophysics and nuclear physics. Astrophysics guides the thermodynamic evolution of an astrophysical event. We present a nucleosynthesis framework written in Fortran that combines as inputs a thermodynamic evolution and nuclear data to time evolve the abundances of nuclear species. Through our coding practices, we have emphasized the applicability of our framework to any astrophysical event, including those involving nuclear fission. Because these calculations are often very complicated, our framework dynamically optimizes itself based on the conditions at each time step in order to greatly minimize total computation time. To highlight the power of this new approach, we demonstrate the use of our framework to simulate both Big Bang nucleosynthesis and r-process nucleosynthesis with speeds competitive with current solutions dedicated to either process alone.

Community science, philosophy of science, and the practice of research.

PubMed

Tebes, Jacob Kraemer

2005-06-01

Embedded in community science are implicit theories on the nature of reality (ontology), the justification of knowledge claims (epistemology), and how knowledge is constructed (methodology). These implicit theories influence the conceptualization and practice of research, and open up or constrain its possibilities. The purpose of this paper is to make some of these theories explicit, trace their intellectual history, and propose a shift in the way research in the social and behavioral sciences, and community science in particular, is conceptualized and practiced. After describing the influence and decline of logical empiricism, the underlying philosophical framework for science for the past century, I summarize contemporary views in the philosophy of science that are alternatives to logical empiricism. These include contextualism, normative naturalism, and scientific realism, and propose that a modified version of contextualism, known as perspectivism, affords the philosophical framework for an emerging community science. I then discuss the implications of perspectivism for community science in the form of four propositions to guide the practice of research.

Aging in the Shadow of Violence: A Phenomenological Conceptual Framework for Understanding Elderly Women Who Experienced Lifelong IPV.

PubMed

Band-Winterstein, Tova

2015-01-01

This article suggests a heuristic framework for understanding elderly women's "lived experience" of lifelong intimate partner violence (IPV). This framework is based on the phenomenological qualitative studies of 31 women, aged 60-83, using a semistructured interview guide. From the results, a matrix emerged built on two axes. The first axis consists of three phenomenological dimensions: suffering, a "ticking clock," and life wisdom. The second axis consists of four themes that emerged from the content analysis: loneliness, regret, being in a state of waiting, and being a living monument to perpetual victimhood. The practical implications of these phenomenological findings are then discussed.

Clarifying assumptions to enhance our understanding and assessment of clinical reasoning.

PubMed

Durning, Steven J; Artino, Anthony R; Schuwirth, Lambert; van der Vleuten, Cees

2013-04-01

Deciding on a diagnosis and treatment is essential to the practice of medicine. Developing competence in these clinical reasoning processes, commonly referred to as diagnostic and therapeutic reasoning, respectively, is required for physician success. Clinical reasoning has been a topic of research for several decades, and much has been learned. However, there still exists no clear consensus regarding what clinical reasoning entails, let alone how it might best be taught, how it should be assessed, and the research and practice implications therein.In this article, the authors first discuss two contrasting epistemological views of clinical reasoning and related conceptual frameworks. They then outline four different theoretical frameworks held by medical educators that the authors believe guide educators' views on the topic, knowingly or not. Within each theoretical framework, the authors begin with a definition of clinical reasoning (from that viewpoint) and then discuss learning, assessment, and research implications. The authors believe these epistemologies and four theoretical frameworks also apply to other concepts (or "competencies") in medical education.The authors also maintain that clinical reasoning encompasses the mental processes and behaviors that are shared (or evolve) between the patient, physician, and the environment (i.e., practice setting). Clinical reasoning thus incorporates components of all three factors (patient, physician, environment). The authors conclude by outlining practical implications and potential future areas for research.

A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems.

PubMed

Atkins, Lou; Francis, Jill; Islam, Rafat; O'Connor, Denise; Patey, Andrea; Ivers, Noah; Foy, Robbie; Duncan, Eilidh M; Colquhoun, Heather; Grimshaw, Jeremy M; Lawton, Rebecca; Michie, Susan

2017-06-21

Implementing new practices requires changes in the behaviour of relevant actors, and this is facilitated by understanding of the determinants of current and desired behaviours. The Theoretical Domains Framework (TDF) was developed by a collaboration of behavioural scientists and implementation researchers who identified theories relevant to implementation and grouped constructs from these theories into domains. The collaboration aimed to provide a comprehensive, theory-informed approach to identify determinants of behaviour. The first version was published in 2005, and a subsequent version following a validation exercise was published in 2012. This guide offers practical guidance for those who wish to apply the TDF to assess implementation problems and support intervention design. It presents a brief rationale for using a theoretical approach to investigate and address implementation problems, summarises the TDF and its development, and describes how to apply the TDF to achieve implementation objectives. Examples from the implementation research literature are presented to illustrate relevant methods and practical considerations. Researchers from Canada, the UK and Australia attended a 3-day meeting in December 2012 to build an international collaboration among researchers and decision-makers interested in the advancing use of the TDF. The participants were experienced in using the TDF to assess implementation problems, design interventions, and/or understand change processes. This guide is an output of the meeting and also draws on the authors' collective experience. Examples from the implementation research literature judged by authors to be representative of specific applications of the TDF are included in this guide. We explain and illustrate methods, with a focus on qualitative approaches, for selecting and specifying target behaviours key to implementation, selecting the study design, deciding the sampling strategy, developing study materials, collecting and analysing data, and reporting findings of TDF-based studies. Areas for development include methods for triangulating data, e.g. from interviews, questionnaires and observation and methods for designing interventions based on TDF-based problem analysis. We offer this guide to the implementation community to assist in the application of the TDF to achieve implementation objectives. Benefits of using the TDF include the provision of a theoretical basis for implementation studies, good coverage of potential reasons for slow diffusion of evidence into practice and a method for progressing from theory-based investigation to intervention.

The Data-to-Action Framework: A Rapid Program Improvement Process.

PubMed

Zakocs, Ronda; Hill, Jessica A; Brown, Pamela; Wheaton, Jocelyn; Freire, Kimberley E

2015-08-01

Although health education programs may benefit from quality improvement methods, scant resources exist to help practitioners apply these methods for program improvement. The purpose of this article is to describe the Data-to-Action framework, a process that guides practitioners through rapid-feedback cycles in order to generate actionable data to improve implementation of ongoing programs. The framework was designed while implementing DELTA PREP, a 3-year project aimed at building the primary prevention capacities of statewide domestic violence coalitions. The authors describe the framework's main steps and provide a case example of a rapid-feedback cycle and several examples of rapid-feedback memos produced during the project period. The authors also discuss implications for health education evaluation and practice. © 2015 Society for Public Health Education.

Using the Knowledge to Action Framework in practice: a citation analysis and systematic review.

PubMed

Field, Becky; Booth, Andrew; Ilott, Irene; Gerrish, Kate

2014-11-23

Conceptual frameworks are recommended as a way of applying theory to enhance implementation efforts. The Knowledge to Action (KTA) Framework was developed in Canada by Graham and colleagues in the 2000s, following a review of 31 planned action theories. The framework has two components: Knowledge Creation and an Action Cycle, each of which comprises multiple phases. This review sought to answer two questions: 'Is the KTA Framework used in practice? And if so, how?' This study is a citation analysis and systematic review. The index citation for the original paper was identified on three databases-Web of Science, Scopus and Google Scholar-with the facility for citation searching. Limitations of English language and year of publication 2006-June 2013 were set. A taxonomy categorising the continuum of usage was developed. Only studies applying the framework to implementation projects were included. Data were extracted and mapped against each phase of the framework for studies where it was integral to the implementation project. The citation search yielded 1,787 records. A total of 1,057 titles and abstracts were screened. One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. In ten studies, the KTA Framework was integral to the design, delivery and evaluation of the implementation activities. All ten described using the Action Cycle and seven referred to Knowledge Creation. The KTA Framework was enacted in different health care and academic settings with projects targeted at patients, the public, and nursing and allied health professionals. The KTA Framework is being used in practice with varying degrees of completeness. It is frequently cited, with usage ranging from simple attribution via a reference, through informing planning, to making an intellectual contribution. When the framework was integral to knowledge translation, it guided action in idiosyncratic ways and there was theory fidelity. Prevailing wisdom encourages the use of theories, models and conceptual frameworks, yet their application is less evident in practice. This may be an artefact of reporting, indicating that prospective, primary research is needed to explore the real value of the KTA Framework and similar tools.

Critical Medical Anthropology in Midwifery Research: A Framework for Ethnographic Analysis.

PubMed

Newnham, Elizabeth C; Pincombe, Jan I; McKellar, Lois V

2016-01-01

In this article, we discuss the use of critical medical anthropology (CMA) as a theoretical framework for research in the maternity care setting. With reference to the doctoral research of the first author, we argue for the relevance of using CMA for research into the maternity care setting, particularly as it relates to midwifery. We then give an overview of an existing analytic model within CMA that we adapted for looking specifically at childbirth practices and which was then used in both analyzing the data and structuring the thesis. There is often no clear guide to the analysis or writing up of data in ethnographic research; we therefore offer this Critical analytic model of childbirth practices for other researchers conducting ethnographic research into childbirth or maternity care.

Standardized Competencies for Parenteral Nutrition Prescribing: The American Society for Parenteral and Enteral Nutrition Model.

PubMed

Guenter, Peggi; Boullata, Joseph I; Ayers, Phil; Gervasio, Jane; Malone, Ainsley; Raymond, Erica; Holcombe, Beverly; Kraft, Michael; Sacks, Gordon; Seres, David

2015-08-01

Parenteral nutrition (PN) provision is complex, as it is a high-alert medication and prone to a variety of potential errors. With changes in clinical practice models and recent federal rulings, the number of PN prescribers may be increasing. Safe prescribing of this therapy requires that competency for prescribers from all disciplines be demonstrated using a standardized process. A standardized model for PN prescribing competency is proposed based on a competency framework, the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)-published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines. This framework will guide institutions and agencies in developing and maintaining competency for safe PN prescription by their staff. © 2015 American Society for Parenteral and Enteral Nutrition.

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

PubMed

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

2013-01-01

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

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

PubMed Central

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

2016-01-01

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

The wicked question answered: positive deviance delivers patient-centered care.

PubMed

Gary, Jodie C

2014-01-01

How nurses respond when faced with the dilemma of providing patient-centered care in the absence of patient-centered practice guidelines remains relatively unreported. Standards may not be available to guide nurses or may not be realistic for implementation at the point of care. Nurses may be forced to react creatively to meet the needs of their patients. The purpose was to understand nursing care when standard practice guidelines did not meet patient-specific care needs and to develop various viewpoints related to the use of positive deviance in providing patient-centered care. Complexity theory and the framework of a wicked question were used to guide a 3-round online national Delphi study from November 2011 to February 2012. The panel was accessed through the American Association of Critical Care Nurses to expose the care provided when standard practice guidelines were lacking. Findings support the presence of positive deviance and expose care provided by nurses when standard practice guidelines lacked the ability to provide patient-centered care. Dominant themes of positive deviance are recommended as priorities for future research. Better guidelines are needed that work for nurses, instead of against them, that would not force a nurse into actions that are not patient centered. Guidelines should guide practice and assist in allowing nurses to provide care that is centered on the best needs of the patient in the specific care situation.

Strategic Planning in Higher Education: An Examination of Variation in Strategic Planning Practices and Their Effect on Success in NCAA Division I Athletic Departments

ERIC Educational Resources Information Center

Starsia, Gerald

2010-01-01

Higher education and intercollegiate athletics are operating in an era of heightened competition and diminishing resources. As these organizations increase in complexity, the need for highly professional staff and management strategies becomes critical. The theoretical framework guiding this research was generated from the literature in…

A Step-by-Step Guide to Publishing Journal Articles and Strategies for Securing Impactful Publications

ERIC Educational Resources Information Center

Onwuegbuzie, Anthony J.

2016-01-01

In the last few years, I have been presenting workshops on publishing (among other topics) in many countries across 6 continents. And presenting these workshops in various countries has allowed me to learn the policies and practices of editors of journals representing numerous countries, thereby helping me to broaden the framework for writing…

Stuck in the Middle: Examining the Intersection of Middle School Science Teachers' PCK and Classroom Practice

ERIC Educational Resources Information Center

Allen, Jared R.

2017-01-01

The purpose of this study was to explain middle school teachers' decisions for planning a science unit of instruction (reflection on action) and their decisions when enacting this planned unit (reflection in action) using the new teacher professional knowledge and skill (TPK&S) model as a guiding framework. In addition, this study specifically…

Always Being on Your Toes: Elementary School Dance Teachers' Perceptions of Inclusion and Their Roles in Creating Inclusive Dance Education Environments

ERIC Educational Resources Information Center

Zitomer, Michelle R.

2017-01-01

Teachers are key players in creating inclusive dance education environments. Guided by a conceptual framework of relational ethics, this qualitative study explored the perceptions and practices of four elementary school dance teachers teaching in public schools in two large school districts in Western Canada. Data collection involved interviews,…

Model-guided fieldwork: practical guidelines for multidisciplinary research on wildlife ecological and epidemiological dynamics

PubMed Central

Restif, Olivier; Hayman, David T S; Pulliam, Juliet R C; Plowright, Raina K; George, Dylan B; Luis, Angela D; Cunningham, Andrew A; Bowen, Richard A; Fooks, Anthony R; O'Shea, Thomas J; Wood, James L N; Webb, Colleen T

2012-01-01

Infectious disease ecology has recently raised its public profile beyond the scientific community due to the major threats that wildlife infections pose to biological conservation, animal welfare, human health and food security. As we start unravelling the full extent of emerging infectious diseases, there is an urgent need to facilitate multidisciplinary research in this area. Even though research in ecology has always had a strong theoretical component, cultural and technical hurdles often hamper direct collaboration between theoreticians and empiricists. Building upon our collective experience of multidisciplinary research and teaching in this area, we propose practical guidelines to help with effective integration among mathematical modelling, fieldwork and laboratory work. Modelling tools can be used at all steps of a field-based research programme, from the formulation of working hypotheses to field study design and data analysis. We illustrate our model-guided fieldwork framework with two case studies we have been conducting on wildlife infectious diseases: plague transmission in prairie dogs and lyssavirus dynamics in American and African bats. These demonstrate that mechanistic models, if properly integrated in research programmes, can provide a framework for holistic approaches to complex biological systems. PMID:22809422

Evaluating Comprehensive State Tobacco Prevention and Control Programs Using an Outcome Indicator Framework.

PubMed

Fulmer, Erika; Rogers, Todd; Glasgow, LaShawn; Brown, Susan; Kuiper, Nicole

2018-03-01

The outcome indicator framework helps tobacco prevention and control programs (TCPs) plan and implement theory-driven evaluations of their efforts to reduce and prevent tobacco use. Tobacco use is the single-most preventable cause of morbidity and mortality in the United States. The implementation of public health best practices by comprehensive state TCPs has been shown to prevent the initiation of tobacco use, reduce tobacco use prevalence, and decrease tobacco-related health care expenditures. Achieving and sustaining program goals require TCPs to evaluate the effectiveness and impact of their programs. To guide evaluation efforts by TCPs, the Centers for Disease Control and Prevention's Office on Smoking and Health developed an outcome indicator framework that includes a high-level logic model and evidence-based outcome indicators for each tobacco prevention and control goal area. In this article, we describe how TCPs and other community organizations can use the outcome indicator framework in their evaluation efforts. We also discuss how the framework is used at the national level to unify tobacco prevention and control efforts across varying state contexts, identify promising practices, and expand the public health evidence base.

Contemporary practice patterns of dynamic psychiatrists--survey results.

PubMed

Alfonso, César A; Olarte, Silvia W

2011-01-01

The authors examine the practice characteristics of dynamic psychiatrists, including the combined use of medication and psychotherapy, and adherence by self-report to psychodynamic, supportive, and cognitive behavioral therapy theoretical principles and techniques. Survey of 555 members of the American Academy of Psychoanalysis and Dynamic Psychiatry conducted in 2009. 24.1% response rate; 75% of respondents were between 61 and 80 years old, 61% had over 30 years of experience; 89% have a private practice but work on an average of 1.6 settings; 39% teach. Most respondents treat patients with complex comorbidities; 92.6% prescribe psychotropic medication. The preferred mode of practice is individual psychotherapy and the preferred frequency once a week; 94.5% of sessions are 45-60 minutes. Using Plakun's Y-model framework, psychoanalysts and dynamic psychiatrist subgroups equally support all core psychotherapy and psychodynamic features, with lesser emphasis but substantial endorsement of cognitive-behavioral psychotherapy features. Dynamic psychiatrists are committed to see most patients once a week for 45-60 minute sessions and use a variety of conceptual frameworks to guide their treatment plans. They endorse supportive and psychodynamic practice elements more than cognitive-behavioral principles.

Investigating the Phenomenological Matrix of Mindfulness-related Practices from a Neurocognitive Perspective

PubMed Central

Lutz, Antoine; Jha, Amishi P.; Dunne, John D.; Saron, Clifford D.

2015-01-01

There has been a great increase in literature concerned with the effects of a variety of mental training regimes that generally fall within what might be called contemplative practices, and a majority of these studies have focused on mindfulness. Mindfulness meditation practices can be conceptualized as a set of attention-based, regulatory and self-inquiry training regimes cultivated for various ends, including well-being and psychological health. This article examines the construct of mindfulness in psychological research and reviews recent, non-clinical work in this area. Instead of proposing a single definition of mindfulness, we interpret it as a continuum of practices involving states that can be mapped into a multidimensional phenomenological matrix which itself can be expressed in a neurocognitive framework. This phenomenological matrix of mindfulness is presented as a heuristic to guide formulation of next-generation research hypotheses from both cognitive/behavioral and neuroscientific perspectives. In relation to this framework, we review selected findings on mindfulness cultivated through practices in both traditional and research settings, and we conclude by identifying significant gaps in the literature and outlining new directions for research. PMID:26436313

What makes public health studies ethical? Dissolving the boundary between research and practice.

PubMed

Willison, Donald J; Ondrusek, Nancy; Dawson, Angus; Emerson, Claudia; Ferris, Lorraine E; Saginur, Raphael; Sampson, Heather; Upshur, Ross

2014-08-08

The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary - whether on grounds of primary purpose, temporality, underlying legal authority, departure from usual practice, or direct benefits to participants - have been unsatisfactory.Public Health Ontario has eschewed this distinction between research and other evaluative activities, choosing to adopt a common framework and process to guide ethical reflection on all public health evaluative projects throughout their lifecycle - from initial planning through to knowledge exchange. The Public Health Ontario framework was developed by a working group of public health and ethics professionals and scholars, in consultation with individuals representing a wide range of public health roles. The first part of the framework interprets the existing Canadian research ethics policy statement (commonly known as the TCPS 2) through a public health lens. The second part consists of ten questions that guide the investigator in the application of the core ethical principles to public health initiatives.The framework is intended for use by those designing and executing public health evaluations, as well as those charged with ethics review of projects. The goal is to move toward a culture of ethical integrity among investigators, reviewers and decision-makers, rather than mere compliance with rules. The framework is consonant with the perspective of the learning organization and is generalizable to other public health organizations, to health services organizations, and beyond. Public Health Ontario has developed an ethics framework that is applicable to any evidence-generating activity, regardless of whether it is labelled research. While developed in a public health context, it is readily adaptable to other health services organizations and beyond.

Concept mapping as a promising method to bring practice into science.

PubMed

van Bon-Martens, M J H; van de Goor, L A M; Holsappel, J C; Kuunders, T J M; Jacobs-van der Bruggen, M A M; te Brake, J H M; van Oers, J A M

2014-06-01

Concept mapping is a method for developing a conceptual framework of a complex topic for use as a guide to evaluation or planning. In concept mapping, thoughts and ideas are represented in the form of a picture or map, the content of which is determined by a group of stakeholders. This study aimed to explore the suitability of this method as a tool to integrate practical knowledge with scientific knowledge in order to improve theory development as a sound basis for practical decision-making. Following a short introduction to the method of concept mapping, five Dutch studies, serving different purposes and fields in public health, will be described. The aim of these studies was: to construct a theoretical framework for good regional public health reporting; to design an implementation strategy for a guideline for integral local health policy; to guide the evaluation of a local integral approach of overweight and obesity in youth; to guide the construction of a questionnaire to measure the quality of postdisaster psychosocial care; and to conceptualize an integral base for formulation of ambitions and targets for the new youth healthcare programme of a regional health service. The studies showed that concept mapping is a way to integrate practical and scientific knowledge with careful selection of participants that represent the different perspectives. Theory development can be improved through concept mapping; not by formulating new theories, but by highlighting the key issues and defining perceived relationships between topics. In four of the five studies, the resulting concept map was received as a sound basis for practical decision-making. Concept mapping is a valuable method for evidence-based public health policy, and a powerful instrument for facilitating dialogue, coherence and collaboration between researchers, practitioners, policy makers and the public. Development of public health theory was realized by a step-by-step approach, considering both scientific and practical knowledge. However, the external validity of the concept maps in place and time is of importance. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Developing a Palliative Care Competency Framework for Health Professionals and Volunteers: The Nova Scotian Experience.

PubMed

McCallum, Meg; Carver, Janet; Dupere, David; Ganong, Sharon; Henderson, J David; McKim, Ann; McNeil-Campbell, Lisa; Richardson, Holly; Simpson, Judy; Tschupruk, Cheryl; Jewers, Heather

2018-05-15

In 2014, Nova Scotia released a provincial palliative care strategy and implementation working groups were established. The Capacity Building and Practice Change Working Group, comprised of health professionals, public advisors, academics, educators, and a volunteer supervisor, was asked to select palliative care education programs for health professionals and volunteers. The first step in achieving this mandate was to establish competencies for health professionals and volunteers caring for patients with life-limiting illness and their families and those specializing in palliative care. In 2015, a literature search for palliative care competencies and an environmental scan of related education programs were conducted. The Irish Palliative Care Competence Framework serves as the foundation of the Nova Scotia Palliative Care Competency Framework. Additional disciplines and competencies were added and any competencies not specific to palliative care were removed. To highlight interprofessional practice, the framework illustrates shared and discipline-specific competencies. Stakeholders were asked to validate the framework and map the competencies to educational programs. Numerous rounds of review refined the framework. The framework includes competencies for 22 disciplines, 9 nursing specialties, and 4 physician specialties. The framework, released in 2017, and the selection and implementation of education programs were a significant undertaking. The framework will support the implementation of the Nova Scotia Integrated Palliative Care Strategy, enhance the interprofessional nature of palliative care, and guide the further implementation of education programs. Other jurisdictions have expressed considerable interest in the framework.

A characterization of clinical questions asked by rehabilitation therapists.

PubMed

Kloda, Lorie Andrea; Bartlett, Joan C

2014-04-01

This study explored the information needs of rehabilitation therapists (occupational therapists, physical therapists, and speech-language pathologists) working with patients who have had strokes in order to characterize their clinical questions, defined as their formalized information needs arising in the context of everyday clinical practice. The researchers took a constructivist, interpretive approach, in which fifteen rehabilitation therapists working in various settings were recruited. Data were gathered using diaries, followed by diary-guided interviews, and thematically analyzed using template analysis. Rehabilitation therapists' clinical questions were characterized as having one or more of twelve foci and containing one or more of eight possible structural elements. Findings demonstrate that the evidence-based practice framework currently applied for questions relating to rehabilitation is inadequate for representing rehabilitation therapists' clinical questions. A new framework that is more comprehensive and descriptive is proposed. Librarians working with students and clinicians in rehabilitation can employ knowledge of the twelve foci and the question structure for rehabilitation to guide the reference interview. Instruction on question formulation in evidence-based practice can employ the revised structure for rehabilitation, offering students and clinicians an alternative to the traditional patient, intervention, comparison, outcome (PICO) structure. Information products, including bibliographic databases and synopsis services, can tailor their interfaces according to question foci and prompt users to enter search terms corresponding to any of the eight possible elements found in rehabilitation therapists' clinical questions.

A university and health care organization partnership to prepare nurses for evidence-based practice.

PubMed

Missal, Bernita; Schafer, Beth Kaiser; Halm, Margo A; Schaffer, Marjorie A

2010-08-01

This article describes a partnership model between a university and health care organizations for teaching graduate nursing research from a framework of evidence-based practice. Nurses from health care organizations identified topics for graduate students to search the literature and synthesize evidence for guiding nursing practice. Nurse educators mentored graduate students in conducting critical appraisals of the literature. Students learned how to search for the evidence, summarize the existing research findings, and translate the findings into practice recommendations. Through presenting and discussing their findings with key stakeholders, students learned how nurses planned to integrate the evidence into practice. Nurses used the evidence-based results to improve their practice in the two partner hospitals. The partnership stimulated action for further inquiry into best practices.

Using trauma informed care as a nursing model of care in an acute inpatient mental health unit: A practice development process.

PubMed

Isobel, Sophie; Edwards, Clair

2017-02-01

Without agreeing on an explicit approach to care, mental health nurses may resort to problem focused, task oriented practice. Defining a model of care is important but there is also a need to consider the philosophical basis of any model. The use of Trauma Informed Care as a guiding philosophy provides a robust framework from which to review nursing practice. This paper describes a nursing workforce practice development process to implement Trauma Informed Care as an inpatient model of mental health nursing care. Trauma Informed Care is an evidence-based approach to care delivery that is applicable to mental health inpatient units; while there are differing strategies for implementation, there is scope for mental health nurses to take on Trauma Informed Care as a guiding philosophy, a model of care or a practice development project within all of their roles and settings in order to ensure that it has considered, relevant and meaningful implementation. The principles of Trauma Informed Care may also offer guidance for managing workforce stress and distress associated with practice change. © 2016 Australian College of Mental Health Nurses Inc.

Computational Design of Functionalized Metal–Organic Framework Nodes for Catalysis

PubMed Central

2017-01-01

Recent progress in the synthesis and characterization of metal–organic frameworks (MOFs) has opened the door to an increasing number of possible catalytic applications. The great versatility of MOFs creates a large chemical space, whose thorough experimental examination becomes practically impossible. Therefore, computational modeling is a key tool to support, rationalize, and guide experimental efforts. In this outlook we survey the main methodologies employed to model MOFs for catalysis, and we review selected recent studies on the functionalization of their nodes. We pay special attention to catalytic applications involving natural gas conversion. PMID:29392172

Context-Based Pedagogy: A Framework From Experience.

PubMed

Kantar, Lina D

2016-07-01

Attempts to transform teaching practice are inadvertently subjected to several hurdles, mostly attributed to the lack of a guiding framework. This study aimed at unraveling the conceptual underpinnings of the context-based pedagogy, being perceived the pedagogy that prepares professionals for future practice. Through focus group interviews, data were collected from 16 nursing students who had case studies as the main instructional format in three major courses. The participants were divided into three focus groups, and interview questions were based on three educational parameters: the learning environment, instructional format, and instructional process. Initial findings revealed an array of classroom activities that characterize each parameter. An in-depth analysis of these activities converged on four concepts: (a) dynamic learning environment, (b) realism, (c) thinking dispositions, and (d) professional formation. These concepts improvise a beginning framework for educators and curriculum leaders that can be used to integrate cases in the curriculum and to facilitate the contextualization of knowledge. [J Nurs Educ. 2016;55(7):391-395.]. Copyright 2016, SLACK Incorporated.

Case study: reconciling the quality and safety gap through strategic planning.

PubMed

Jeffs, Lianne; Merkley, Jane; Jeffrey, Jana; Ferris, Ella; Dusek, Janice; Hunter, Catherine

2006-05-01

An essential outcome of professional practice environments is the provision of high-quality, safe nursing care. To mitigate the quality and safety chasm, nursing leadership at St. Michael's Hospital undertook a strategic plan to enhance the nursing professional practice environment. This case study outlines the development of the strategic planning process: the driving forces (platform); key stakeholders (process and players); vision, guiding principles, strategic directions, framework for action and accountability (plan); lessons learned (pearls); and next steps to moving forward the vision, strategic directions and accountability mechanisms (passion and perseverance).

Representational Approach: A Conceptual Framework to Guide Patient Education Research and Practice.

PubMed

Arida, Janet A; Sherwood, Paula R; Flannery, Marie; Donovan, Heidi S

2016-11-01

Illness representations are cognitive structures that individuals rely on to understand and explain their illnesses and associated symptoms. The Representational Approach (RA) to patient education offers a theoretically based, clinically useful model that can support oncology nurses to develop a shared understanding of patients' illness representations to collaboratively develop highly personalized plans for symptom management and other important self-management behaviors. This article discusses theoretical underpinnings, practical applications, challenges, and future directions for incorporating illness representations and the RA in clinical and research endeavors.

Guide to thoracic imaging.

PubMed

Skinner, Sarah

2015-08-01

Thoracic imaging is commonly ordered in general practice. Guidelines exist for ordering thoracic imaging but few are specific for general practice. This article summarises current indications for imaging the thorax with chest X-ray and computed tomography. A simple frame-work for interpretation of the chest X-ray, suitable for trainees and practitioners providing primary care imaging in rural and remote locations, is presented. Interpretation of thoracic imaging is best done using a systematic approach. Radiological investigation is not warranted in un-complicated upper respiratory tract infections or asthma, minor trauma or acute-on-chronic chest pain.

Decision-making theories and their usefulness to the midwifery profession both in terms of midwifery practice and the education of midwives.

PubMed

Jefford, Elaine; Fahy, Kathleen; Sundin, Deborah

2011-06-01

What are the strengths and limitations of existing Decision-Making Theories as a basis for guiding best practice clinical decision-making within a framework of midwifery philosophy? Each theory is compared in relation with how well they provide a teachable framework for midwifery clinical reasoning that is consistent with midwifery philosophy. Hypothetico-Deductive Theory, from which medical clinical reasoning is based; intuitive decision-making; Dual Processing Theory; The International Confederation of Midwives Clinical Decision-Making Framework; Australian Nursing and Midwifery Council Midwifery Practice Decisions Flowchart and Midwifery Practice. Best practice midwifery clinical Decision-Making Theory needs to give guidance about: (i) effective use of cognitive reasoning processes; (ii) how to include contextual and emotional factors; (iii) how to include the interests of the baby as an integral part of the woman; (iv) decision-making in partnership with woman; and (v) how to recognize/respond to clinical situations outside the midwife's legal/personal scope of practice. No existing Decision-Making Theory meets the needs of midwifery. Medical clinical reasoning has a good contribution to make in terms of cognitive reasoning processes. Two limitations of medical clinical reasoning are its reductionistic focus and privileging of reason to the exclusion of emotional and contextual factors. Hypothetico-deductive clinical reasoning is a necessary but insufficient condition for best practice clinical decision-making in midwifery. © 2011 Blackwell Publishing Asia Pty Ltd.

Clinical Nurse Leader Integration Into Practice: Developing Theory To Guide Best Practice.

PubMed

Bender, Miriam

2016-01-01

Numerous policy bodies have identified the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards. Although there is growing evidence of improved care environment and patient safety and quality outcomes after redesigning care delivery microsystems to integrate CNL practice, significant variation in CNL implementation has been noted across reports, making it difficult to causally link CNL practice to reported outcomes. This variability reflects the overall absence in the literature of a well-defined CNL theoretical framework to help guide standardized application in practice. To address this knowledge gap, an interpretive synthesis with a grounded theory analysis of CNL narratives was conducted to develop a theoretical model for CNL practice. The model clarifies CNL practice domains and proposes mechanisms by which CNL-integrated care delivery microsystems improve health care quality. The model highlights the need for a systematic approach to CNL implementation including a well-thought out strategy for care delivery redesign; a consistent, competency-based CNL workflow; and sustained macro-to-micro system leadership support. CNL practice can be considered an effective approach to organizing nursing care that maximizes the scope of nursing to influence the ways care is delivered by all professions within a clinical microsystem. Copyright © 2016 Elsevier Inc. All rights reserved.

Attributes of innovations and approaches to scalability - lessons from a national program to extend the scope of practice of health professionals.

PubMed

Masso, Malcolm; Thompson, Cristina

2016-01-01

The context for the paper was the evaluation of a national program in Australia to investigate extended scopes of practice for health professionals (paramedics, physiotherapists, and nurses). The design of the evaluation involved a mixed-methods approach with multiple data sources. Four multidisciplinary models of extended scope of practice were tested over an 18-month period, involving 26 organizations, 224 health professionals, and 36 implementation sites. The evaluation focused on what could be learned to inform scaling up the extended scopes of practice on a national scale. The evaluation findings were used to develop a conceptual framework for use by clinicians, managers, and policy makers to determine appropriate strategies for scaling up effective innovations. Development of the framework was informed by the literature on the diffusion of innovations, particularly an understanding that certain attributes of innovations influence adoption. The framework recognizes the role played by three groups of stakeholders: evidence producers, evidence influencers, and evidence adopters. The use of the framework is illustrated with four case studies from the evaluation. The findings demonstrate how the scaling up of innovations can be influenced by three quite distinct approaches - letting adoption take place in an uncontrolled, unplanned, way; actively helping the process of adoption; or taking deliberate steps to ensure that adoption takes place. Development of the conceptual framework resulted in two sets of questions to guide decisions about scalability, one for those considering whether to adopt the innovation (evidence adopters), and the other for those trying to decide on the optimal strategy for dissemination (evidence influencers).

A Conceptual Framework for Understanding Unintended Prolonged Opioid Use.

PubMed

Hooten, W Michael; Brummett, Chad M; Sullivan, Mark D; Goesling, Jenna; Tilburt, Jon C; Merlin, Jessica S; St Sauver, Jennifer L; Wasan, Ajay D; Clauw, Daniel J; Warner, David O

2017-12-01

An urgent need exists to better understand the transition from short-term opioid use to unintended prolonged opioid use (UPOU). The purpose of this work is to propose a conceptual framework for understanding UPOU that posits the influence of 3 principal domains that include the characteristics of (1) individual patients, (2) the practice environment, and (3) opioid prescribers. Although no standardized method exists for developing a conceptual framework, the process often involves identifying corroborative evidence, leveraging expert opinion to identify factors for inclusion in the framework, and developing a graphic depiction of the relationships between the various factors and the clinical problem of interest. Key patient characteristics potentially associated with UPOU include (1) medical and mental health conditions; (2) pain etiology; (3) individual affective, behavioral, and neurophysiologic reactions to pain and opioids; and (4) sociodemographic factors. Also, UPOU could be influenced by structural and health care policy factors: (1) the practice environment, including the roles of prescribing clinicians, adoption of relevant practice guidelines, and clinician incentives or disincentives, and (2) the regulatory environment. Finally, characteristics inherent to clinicians that could influence prescribing practices include (1) training in pain management and opioid use; (2) personal attitudes, knowledge, and beliefs regarding the risks and benefits of opioids; and (3) professionalism. As the gatekeeper to opioid access, the behavior of prescribing clinicians directly mediates UPOU, with the 3 domains interacting to determine this behavior. This proposed conceptual framework could guide future research on the topic and allow plausible hypothesis-based interventions to reduce UPOU. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

"Change in Schools It's More Like Sort of Turning an Oil Tanker": Creating Readiness for Health Promoting Schools

ERIC Educational Resources Information Center

Gardner, Belinda; Ollis, Debbie

2015-01-01

Purpose: The purpose of this paper is to add to the evidence of best practice in the implementation of the Health Promoting Schools (HPS) framework by examining the process of creating readiness for change in a large international school in South-East Asia. Using a settings-based approach and guided by readiness for change theory the data…

End of life issues in a palliative care framework for a critically ill adult African American with cystic fibrosis: a case study.

PubMed

McNeal, Gloria J

2002-01-01

The purpose of this investigation, using case study methodology, was to explore the end of life issues and to give meaning to the biopsychosocial experiences of the study participant, an adult African American female patient diagnosed with Cystic Fibrosis. Two theoretical frameworks were used to guide the investigation of the study: Kubler-Ross Model of the Stages of Dying and the Conceptual Framework for Palliative Care Practice. Data analysis included review of medical records and patient journals, interviews, observations and clinical assessment. The findings indicated that end of life issues can be articulated within the context of a palliative care framework and that the biopsychosocial experiences of the dying person acquire meaning when situated within life history, ethical values and metaphysical belief systems.

Knowledge for the good of the individual and society: linking philosophy, disciplinary goals, theory, and practice.

PubMed

McCurry, Mary K; Revell, Susan M Hunter; Roy, Sr Callista

2010-01-01

Nursing as a profession has a social mandate to contribute to the good of society through knowledge-based practice. Knowledge is built upon theories, and theories, together with their philosophical bases and disciplinary goals, are the guiding frameworks for practice. This article explores a philosophical perspective of nursing's social mandate, the disciplinary goals for the good of the individual and society, and one approach for translating knowledge into practice through the use of a middle-range theory. It is anticipated that the integration of the philosophical perspective and model into nursing practice will strengthen the philosophy, disciplinary goal, theory, and practice links and expand knowledge within the discipline. With the focus on humanization, we propose that nursing knowledge for social good will embrace a synthesis of the individual and the common good. This approach converges vital and agency needs described by Hamilton and the primacy of maintaining the heritage of the good within the human species as outlined by Maritain. Further, by embedding knowledge development in a changing social and health care context, nursing focuses on the goals of clinical reasoning and action. McCubbin and Patterson's Double ABCX Model of Family Adaptation was used as an example of a theory that can guide practice at the community and global level. Using the theory-practice link as a foundation, the Double ABCX model provides practising nurses with one approach to meet the needs of individuals and society. The integration of theory into nursing practice provides a guide to achieve nursing's disciplinary goals of promoting health and preventing illness across the globe. When nursing goals are directed at the synthesis of the good of the individual and society, nursing's social and moral mandate may be achieved.

Anti-Oppressive Practice and Reflexive Lifeworld-Led Approaches to Care: A Framework for Teaching Nurses about Social Justice

PubMed Central

Hutchison, Jacqueline Sarah

2015-01-01

This paper was initially written for a European Academy of Caring Science workshop and aimed to provide clarity and direction about Caring Science by offering some ideas emerging from the philosophy, themes, and projects of EACS. An underpinning concept for the work of the Academy is the lifeworld. The focus of the workshop was to explore the lifeworld of the patient, student, and carer. The intention was to promote discussion around the need to provide alternative ways to conceptualise caring relevant knowledge, naming phenomena and practices central to caring sciences, and the educational curriculum and its adequacy for caring science. This paper seeks to identify concepts and approaches to understanding oppression, power, and justice which enable nurses to challenge the structures in health care environments which discriminate or disempower clients. Anti-oppressive practice theory and reflexive lifeworld-led approaches to care enable nurses to be critical of their practice. A framework for teaching social justice in health care is offered to augment teaching students to challenge oppressive practice and to assist nurses to reflect and develop conceptual models to guide practices which are central to promoting caring interactions. PMID:25838944

Anti-Oppressive Practice and Reflexive Lifeworld-Led Approaches to Care: A Framework for Teaching Nurses about Social Justice.

PubMed

Hutchison, Jacqueline Sarah

2015-01-01

This paper was initially written for a European Academy of Caring Science workshop and aimed to provide clarity and direction about Caring Science by offering some ideas emerging from the philosophy, themes, and projects of EACS. An underpinning concept for the work of the Academy is the lifeworld. The focus of the workshop was to explore the lifeworld of the patient, student, and carer. The intention was to promote discussion around the need to provide alternative ways to conceptualise caring relevant knowledge, naming phenomena and practices central to caring sciences, and the educational curriculum and its adequacy for caring science. This paper seeks to identify concepts and approaches to understanding oppression, power, and justice which enable nurses to challenge the structures in health care environments which discriminate or disempower clients. Anti-oppressive practice theory and reflexive lifeworld-led approaches to care enable nurses to be critical of their practice. A framework for teaching social justice in health care is offered to augment teaching students to challenge oppressive practice and to assist nurses to reflect and develop conceptual models to guide practices which are central to promoting caring interactions.

A Conceptual Framework for Graduate Teaching Assistant Professional Development Evaluation and Research.

PubMed

Reeves, Todd D; Marbach-Ad, Gili; Miller, Kristen R; Ridgway, Judith; Gardner, Grant E; Schussler, Elisabeth E; Wischusen, E William

2016-01-01

Biology graduate teaching assistants (GTAs) are significant contributors to the educational mission of universities, particularly in introductory courses, yet there is a lack of empirical data on how to best prepare them for their teaching roles. This essay proposes a conceptual framework for biology GTA teaching professional development (TPD) program evaluation and research with three overarching variable categories for consideration: outcome variables, contextual variables, and moderating variables. The framework's outcome variables go beyond GTA satisfaction and instead position GTA cognition, GTA teaching practice, and undergraduate learning outcomes as the foci of GTA TPD evaluation and research. For each GTA TPD outcome variable, key evaluation questions and example assessment instruments are introduced to demonstrate how the framework can be used to guide GTA TPD evaluation and research plans. A common conceptual framework is also essential to coordinating the collection and synthesis of empirical data on GTA TPD nationally. Thus, the proposed conceptual framework serves as both a guide for conducting GTA TPD evaluation at single institutions and as a means to coordinate research across institutions at a national level. © 2016 T. D. Reeves et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

The SPIRIT Action Framework: A structured approach to selecting and testing strategies to increase the use of research in policy.

PubMed

Redman, Sally; Turner, Tari; Davies, Huw; Williamson, Anna; Haynes, Abby; Brennan, Sue; Milat, Andrew; O'Connor, Denise; Blyth, Fiona; Jorm, Louisa; Green, Sally

2015-07-01

The recent proliferation of strategies designed to increase the use of research in health policy (knowledge exchange) demands better application of contemporary conceptual understandings of how research shapes policy. Predictive models, or action frameworks, are needed to organise existing knowledge and enable a more systematic approach to the selection and testing of intervention strategies. Useful action frameworks need to meet four criteria: have a clearly articulated purpose; be informed by existing knowledge; provide an organising structure to build new knowledge; and be capable of guiding the development and testing of interventions. This paper describes the development of the SPIRIT Action Framework. A literature search and interviews with policy makers identified modifiable factors likely to influence the use of research in policy. An iterative process was used to combine these factors into a pragmatic tool which meets the four criteria. The SPIRIT Action Framework can guide conceptually-informed practical decisions in the selection and testing of interventions to increase the use of research in policy. The SPIRIT Action Framework hypothesises that a catalyst is required for the use of research, the response to which is determined by the capacity of the organisation to engage with research. Where there is sufficient capacity, a series of research engagement actions might occur that facilitate research use. These hypotheses are being tested in ongoing empirical work. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Strategic environmental assessment and national development plans in Turkey: Towards legal framework and operational procedure

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

Say, Nuriye Peker; Yuecel, Muzaffer

National development plans were started to be prepared in Turkey in 1963. These plans are mandatory for public investments and guiding principles for private investments. They have a quality which guides and sets objectives for other plans in the country. Therefore, they can be evaluated as the main reason of successes and failures of sectoral investments or the problems that they cause directly or indirectly. Turkey is undergoing rapid industrialization, urbanization and population growth, thus environmental problems are on the increase. Although Environmental Impact Assessment (EIA) has been applied to individual investments in Turkey since 1993, natural environment has continuedmore » to be affected because of human activities. Today, parallel to the developments in the world, it has been discussed that it is necessary to strengthen project-level Environmental Assessment (EA) and to practice Strategic Environmental Assessment (SEA). The interest in SEA, that is, EA at the level of proposed policies, plans and programs has grown significantly since 2000 in the country. Discussions and preparations have started about regulation which provides the legal and institutional framework for SEA in The Ministry of Environment and Forestry. However, since the scientific approach into the subject is very new in Turkey, it will take time to answer the questions about how and in what fields to practice. This research project aims at analyzing the possible practice opportunities of SEA in Turkey and the practicability of SEA into the National Five-Year Development Plan (FYDP) which is assumed at the highest level of planning hierarchy in the country. The research is conducted on two sections. In the first section, procedural approaches to SEA on national development plans are investigated and a framework for these approaches is adapted at the institutional level. In the second section, SEA form for energy sector in the development plans is developed. In this article, the findings related to the first part of the project are given.« less

Passing the baton: a grounded practical theory of handoff communication between multidisciplinary providers in two Department of Veterans Affairs outpatient settings.

PubMed

Koenig, Christopher J; Maguen, Shira; Daley, Aaron; Cohen, Greg; Seal, Karen H

2013-01-01

Handoffs are communication processes that enact the transfer of responsibility between providers across clinical settings. Prior research on handoff communication has focused on inpatient settings between provider teams and has emphasized patient safety. This study examines handoff communication within multidisciplinary provider teams in two outpatient settings. To conduct an exploratory study that describes handoff communication among multidisciplinary providers, to develop a theory-driven descriptive framework for outpatient handoffs, and to evaluate the strengths and weaknesses of different handoff types. Qualitative, in-depth, semi-structured interviews with 31 primary care, mental health, and social work providers in two Department of Veterans Affairs (VA) Medical Center outpatient clinics. Audio-recorded interviews were transcribed and analyzed using Grounded Practical Theory to develop a theoretical model of and a descriptive framework for handoff communication among multidisciplinary providers. Multidisciplinary providers reported that handoff decisions across settings were made spontaneously and without clear guidelines. Two situated values, clinic efficiency and patient-centeredness, shaped multidisciplinary providers' handoff decisions. Providers reported three handoff techniques along a continuum: the electronic handoff, which was the most clinically efficient; the provider-to-provider handoff, which balanced clinic efficiency and patient-centeredness; and the collaborative handoff, which was the most patient-centered. Providers described handoff choice as a practical response to manage constituent features of clinic efficiency (time, space, medium of communication) and patient-centeredness (information continuity, management continuity, relational continuity, and social interaction). We present a theoretical and descriptive framework to help providers evaluate differential handoff use, reflect on situated values guiding clinic communication, and guide future research. Handoff communication reflected multidisciplinary providers' efforts to balance clinic efficiency with patient-centeredness within the constraints of day-to-day clinical practice. Evaluating the strengths and weaknesses among alternative handoff options may enhance multidisciplinary provider handoff decision-making and may contribute to increased coordination and continuity of care across outpatient settings.

Frameworks for change in healthcare organisations: a formative evaluation of the NHS Change Model.

PubMed

Martin, Graham P; Sutton, Elizabeth; Willars, Janet; Dixon-Woods, Mary

2013-08-01

Organisational change in complex healthcare systems is a multifaceted process. The English National Health Service recently introduced a 'Change Model' that seeks to offer an evidence-based framework for guiding change. We report findings from a formative evaluation of the NHS Change Model and make recommendations for those developing the Model and its users. The evaluation involved 28 interviews with managers and clinicians making use of the Change Model in relation to a variety of projects. Interviews were fully transcribed and were analysed using an approach based on the Framework method. Participants saw the Change Model as valuable and practically useful. Fidelity to core principles of the Model was variable: participants often altered the Model, especially when using it to orchestrate the work of others. In challenging organisational contexts, the Change Model was sometimes used to delegitimise opposition rather than identify shared purpose among different interest groups. Those guiding change may benefit from frameworks, guidance and toolkits to structure and inform their planning and activities. Participants' experiences suggested the Change Model has much potential. Further work on its design and on supporting materials may optimise the approach, but its utility rests in particular on organisational cultures that support faithful application. © The Author(s) 2013 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

Looking and listening for learning in arts- and humanities-based creations.

PubMed

Varpio, Lara; Grassau, Pamela; Hall, Pippa

2017-02-01

The arts and humanities are gradually gaining a foothold in health professions education as a means of supporting the development of future clinicians who are compassionate, critical and reflexive thinkers, while also strengthening clinical skills and practices that emphasise patient-centredness, collaboration and interprofessional practices. Assignments that tap into trainee creativity are increasingly used both to prepare learners for the demands of clinical work and to understand the personal and professional challenges learners face in these contexts. Health professions educators need methods for interpreting these creations in order to understand each learner's expressions. This paper describes two theoretical frameworks that can be used to understand trainees' unique learning experiences as they are expressed in arts- and humanities-based creations. The authors introduce the philosophical underpinnings and interpretation procedures of two theoretical frameworks that enable educators to 'hear' and 'see' the multilayered expressions embedded within arts- and humanities-based student creations: Gilligan's Listening Guide and Kress and van Leeuwen's approach to visual rhetoric. To illustrate how these frameworks can be used, the authors apply them to two creative summaries that learners made as part of a humanities-informed, interprofessional education intervention that took place in a non-acute-care teaching hospital. The interpretations of two creative summaries, a poem and a pair of paintings, highlight how applying these theoretical frameworks can offer important insights into learners' experiences. This cross-cutting edge paper describes how the Listening Guide and visual rhetoric can help health professions educators listen to and read the arts- and humanities-based creative expressions made by learners. Insights gained from these interpretations can advance the understanding of students' personal experiences in different learning environments and can inform curriculum development. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Treating frailty-a practical guide

PubMed Central

2011-01-01

Frailty is a common syndrome that is associated with vulnerability to poor health outcomes. Frail older people have increased risk of morbidity, institutionalization and death, resulting in burden to individuals, their families, health care services and society. Assessment and treatment of the frail individual provide many challenges to clinicians working with older people. Despite frailty being increasingly recognized in the literature, there is a paucity of direct evidence to guide interventions to reduce frailty. In this paper we review methods for identification of frailty in the clinical setting, propose a model for assessment of the frail older person and summarize the current best evidence for treating the frail older person. We provide an evidence-based framework that can be used to guide the diagnosis, assessment and treatment of frail older people. PMID:21733149

Using the knowledge-to-action framework to guide the timing of dialysis initiation.

PubMed

Sood, Manish M; Manns, Braden; Nesrallah, Gihad

2014-05-01

The optimal time at which to initiate chronic dialysis remains unknown. Using a contemporary knowledge translation approach (the knowledge-to-action framework), a pan-Canadian collaboration (CANN-NET) set out to study the scope of the problem, then develop and disseminate evidence-based guidelines addressing the timing of dialysis initiation. The purpose of this review is to summarize the key findings and describe the planned Canadian knowledge translation strategy for improving knowledge and practices pertaining to the timing dialysis initiation. New research has provided considerable insights regarding the initiation of dialysis. A Canadian cohort study identified significant variation in the estimated glomerular filtration rate level at dialysis initiation, and a survey of providers identified related knowledge gaps that might be amenable to knowledge translation interventions. A recent knowledge synthesis/guideline concluded that early dialysis initiation is costly, and provides no measureable clinical benefits. A systematic knowledge translation intervention including a multifaceted approach may aid in reducing variation in practice and improving the quality of care. Utilizing the knowledge-to-action framework, we identified practice variation and key barriers to the optimal timing for dialysis initiation that may be amenable to knowledge translation strategies.

An argument for competency-based training in pelvic floor physiotherapy practice.

PubMed

Frawley, Helena C; Neumann, Patricia; Delany, Clare

2018-05-10

Pelvic floor dysfunction has been described as "a silent epidemic," affecting many people in the community yet under-recognized and insufficiently managed. There is evidence that pelvic floor physiotherapy can manage many of these disorders, however a competency framework to guide and inform pelvic floor physiotherapy training and practice is lacking. The assessment and management of the pelvic floor complex is not addressed as a core component of most entry-to-practice physiotherapy programs despite being within the scope of physiotherapy practice which is in contrast with the knowledge and skills that physiotherapists graduate with in core areas of clinical practice. This results in a registration-competency gap, and the need for post-graduation training to ensure clinicians are appropriately skilled to practice safely and effectively in this area. In addition, there are potential ethical and legal issues unique to this area of physiotherapy practice to be considered. We use a series of clinical scenarios to highlight the domains of knowledge, skills and communication required for practice in this area, based on our experience in Australia. We propose a framework for the future which defines competence in pelvic floor physiotherapy to provide clarity to clinicians about their clinical, ethical and legal obligations to the public, our referrers and third-party payers.

A practical guide for implementing and maintaining value-added clinical systems learning roles for medical students using a diffusion of innovations framework.

PubMed

Gonzalo, Jed D; Graaf, Deanna; Ahluwalia, Amarpreet; Wolpaw, Dan R; Thompson, Britta M

2018-03-21

After emphasizing biomedical and clinical sciences for over a century, US medical schools are expanding experiential roles that allow students to learn about health care delivery while also adding value to patient care. After developing a program where all 1st-year medical students are integrated into interprofessional care teams to contribute to patient care, authors use a diffusion of innovations framework to explore and identify barriers, facilitators, and best practices for implementing value-added clinical systems learning roles. In 2016, authors conducted 32 clinical-site observations, 29 1:1 interviews with mentors, and four student focus-group interviews. Data were transcribed verbatim, and a thematic analysis was used to identify themes. Authors discussed drafts of the categorization scheme, and agreed upon results and quotations. Of 36 sites implementing the program, 17 (47%) remained, 8 (22%) significantly modified, and 11 (31%) withdrew from the program. Identified strategies for implementing value-added roles included: student education, patient characteristics, patient selection methods, activities performed, and resources. Six themes influencing program implementation and maintenance included: (1) educational benefit, (2) value added to patient care from student work, (3) mentor time and site capacity, (4) student engagement, (5) working relationship between school, site, and students, and, (6) students' continuity at the site. Health systems science is an emerging focus for medical schools, and educators are challenged to design practice-based roles that enhance education and add value to patient care. Health professions' schools implementing value-added roles will need to invest resources and strategize about best-practice strategies to guide efforts.

Policies on pets for healthy cities: a conceptual framework

PubMed Central

Rock, Melanie J.; Adams, Cindy L.; Degeling, Chris; Massolo, Alessandro; McCormack, Gavin R.

2015-01-01

Drawing on the One Health concept, and integrating a dual focus on public policy and practices of caring from the Ottawa Charter for Health Promotion, we outline a conceptual framework to help guide the development and assessment of local governments' policies on pets. This framework emphasizes well-being in human populations, while recognizing that these outcomes relate to the well-being of non-human animals. Five intersecting spheres of activity, each associated with local governments' jurisdiction over pets, are presented: (i) preventing threats and nuisances from pets, (ii) meeting pets' emotional and physical needs, (iii) procuring pets ethically, (iv) providing pets with veterinary services and (v) licensing and identifying pets. This conceptual framework acknowledges the tenets of previous health promotion frameworks, including overlapping and intersecting influences. At the same time, this framework proposes to advance our understanding of health promotion and, more broadly, population health by underscoring interdependence between people and pets as well as the dynamism of urbanized ecologies. PMID:24694682

Development of a practice tool for community-based nurses: the Heart Failure Palliative Approach to Care (HeFPAC).

PubMed

Strachan, Patricia H; Joy, Cathy; Costigan, Jeannine; Carter, Nancy

2014-04-01

Patients living with advanced heart failure (HF) require a palliative approach to reduce suffering. Nurses have described significant knowledge gaps about the disease-specific palliative care (PC) needs of these patients. An intervention is required to facilitate appropriate end-of-life care for HF patients. The purpose of this study was to develop a user-friendly, evidence-informed HF-specific practice tool for community-based nurses to facilitate care and communication regarding a palliative approach to HF care. Guided by the Knowledge to Action framework, we identified key HF-specific issues related to advanced HF care provision within the context of a palliative approach to care. Informed by current evidence and subsequent iterative consultation with community-based and specialist PC and HF nurses, a pocket guide tool for community-based nurses was created. We developed the Heart Failure Palliative Approach to Care (HeFPAC) pocket guide to promote communication and a palliative approach to care for HF patients. The HeFPAC has potential to improve the quality of care and experiences for patients with advanced HF. It will be piloted in community-based practice and in a continuing education program for nurses. The HeFPAC pocket guide offers PC nurses a concise, evidence-informed and practical point-of care tool to communicate with other clinicians and patients about key HF issues that are associated with improving disease-specific HF palliative care and the quality of life of patients and their families. Pilot testing will offer insight as to its utility and potential for modification for national and international use.

Writing-to-Learn in Undergraduate Science Education: A Community-Based, Conceptually Driven Approach

PubMed Central

Reynolds, Julie A.; Thaiss, Christopher; Katkin, Wendy; Thompson, Robert J.

2012-01-01

Despite substantial evidence that writing can be an effective tool to promote student learning and engagement, writing-to-learn (WTL) practices are still not widely implemented in science, technology, engineering, and mathematics (STEM) disciplines, particularly at research universities. Two major deterrents to progress are the lack of a community of science faculty committed to undertaking and applying the necessary pedagogical research, and the absence of a conceptual framework to systematically guide study designs and integrate findings. To address these issues, we undertook an initiative, supported by the National Science Foundation and sponsored by the Reinvention Center, to build a community of WTL/STEM educators who would undertake a heuristic review of the literature and formulate a conceptual framework. In addition to generating a searchable database of empirically validated and promising WTL practices, our work lays the foundation for multi-university empirical studies of the effectiveness of WTL practices in advancing student learning and engagement. PMID:22383613

Translating Life Course Theory to Clinical Practice to Address Health Disparities

PubMed Central

Solomon, Barry S.

2013-01-01

Life Course Theory (LCT) is a framework that explains health and disease across populations and over time and in a powerful way, conceptualizes health and health disparities to guide improvements. It suggests a need to change priorities and paradigms in our healthcare delivery system. In “Rethinking Maternal and Child Health: The Life Course Model as an Organizing Framework,” Fine and Kotelchuck identify three areas of rethinking that have relevance to clinical care: (1) recognition of context and the “whole-person, whole-family, whole-community systems approach;” (2) longitudinal approach with “greater emphasis on early (“upstream”) determinants of health”; and (3) need for integration and “developing integrated, multi-sector service systems that become lifelong “pipelines” for healthy development”. This paper discusses promising clinical practice innovations in these three areas: addressing social influences on health in clinical practice, longitudinal and vertical integration of clinical services and horizontal integration with community services and resources. In addition, barriers and facilitators to implementation are reviewed. PMID:23677685

Professionally Responsible Disclosure of Genomic Sequencing Results in Pediatric Practice

PubMed Central

Brothers, Kyle B.; Chung, Wendy K.; Joffe, Steven; Koenig, Barbara A.; Wilfond, Benjamin; Yu, Joon-Ho

2015-01-01

Genomic sequencing is being rapidly introduced into pediatric clinical practice. The results of sequencing are distinctive for their complexity and subsequent challenges of interpretation for generalist and specialist pediatricians, parents, and patients. Pediatricians therefore need to prepare for the professionally responsible disclosure of sequencing results to parents and patients and guidance of parents and patients in the interpretation and use of these results, including managing uncertain data. This article provides an ethical framework to guide and evaluate the professionally responsible disclosure of the results of genomic sequencing in pediatric practice. The ethical framework comprises 3 core concepts of pediatric ethics: the best interests of the child standard, parental surrogate decision-making, and pediatric assent. When recommending sequencing, pediatricians should explain the nature of the proposed test, its scope and complexity, the categories of results, and the concept of a secondary or incidental finding. Pediatricians should obtain the informed permission of parents and the assent of mature adolescents about the scope of sequencing to be performed and the return of results. PMID:26371191

Patient Autonomy in a High-Tech Care Context - A Theoretical Framework.

PubMed

Lindberg, Catharina; Fagerström, Cecilia; Willman, Ania

2018-06-12

To synthesise and interpret previous findings with the aim of developing a theoretical framework for patient autonomy in a high-tech care context. Putting the somewhat abstract concept of patient autonomy into practice can prove difficult since when it is highlighted in healthcare literature the patient perspective is often invisible. Autonomy presumes that a person has experience, education, self-discipline and decision-making capacity. Reference to autonomy in relation to patients in high-tech care environments could therefore be considered paradoxical, as in most cases these persons are vulnerable, with impaired physical and/or metacognitive capacity, thus making extended knowledge of patient autonomy for these persons even more important. Theory development. The basic approaches in theory development by Walker and Avant were used to create a theoretical framework through an amalgamation of the results from three qualitative studies conducted previously by the same research group. A theoretical framework - the control-partnership-transition framework - was delineated disclosing different parts co-creating the prerequisites for patient autonomy in high-tech care environments. Assumptions and propositional statements that guide theory development were also outlined, as were guiding principles for use in day-to-day nursing care. Four strategies used by patients were revealed: the strategy of control, the strategy of partnership, the strategy of trust, and the strategy of transition. An extended knowledge base, founded on theoretical reasoning about patient autonomy, could facilitate nursing care that would allow people to remain/become autonomous in the role of patient in high-tech care environments. The control-partnership-transition framework would be of help in supporting and defending patient autonomy when caring for individual patients, as it provides an understanding of the strategies employed by patients to achieve autonomy in high-tech care contexts. The guiding principles for patient autonomy presented could be used in nursing guidelines. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Going Global: Toward Competency-Based Best Practices for Global Health in Dental Education.

PubMed

Seymour, Brittany; Shick, Elizabeth; Chaffee, Benjamin W; Benzian, Habib

2017-06-01

The Global Oral Health Interest Group of the Consortium of Universities for Global Health (GOHIG-CUGH) published recommended competencies to support development of competency-based global health education in dental schools. However, there has been no comprehensive, systematically derived, or broadly accepted framework for creating and delivering competency-based global health education to dental students. This article describes the results of a collaborative workshop held at the 2016 American Dental Education Association (ADEA) Annual Session & Exhibition designed to build on the GOHIG-CUGH competencies and start to develop systematic approaches for their practical application. Workshop organizers developed a preliminary theoretical framework for guiding the development of global health in dental education, grounded in published research. Collectively, workshop participants developed detailed outcomes for the theoretical framework with a focus on three educational practices: didactic, experiential, and research learning and how each can meet the competencies. Participants discussed learning objectives, keys to implementation, ethical considerations, challenges, and examples of success. Outcomes demonstrated that no educational practice on its own meets all 33 recommended competencies for dental students; however, the three educational practices combined may potentially cover all 33. Participants emphasized the significance of sustainable approaches to student learning for both students and communities, with identified partners in the communities to collaborate on the development, implementation, evaluation, and long-term maintenance of any student global health activity. These findings may represent early steps toward professional consensus and best practices for global health in dental education in the United States.

How to practice person-centred care: A conceptual framework.

PubMed

Santana, Maria J; Manalili, Kimberly; Jolley, Rachel J; Zelinsky, Sandra; Quan, Hude; Lu, Mingshan

2018-04-01

Globally, health-care systems and organizations are looking to improve health system performance through the implementation of a person-centred care (PCC) model. While numerous conceptual frameworks for PCC exist, a gap remains in practical guidance on PCC implementation. Based on a narrative review of the PCC literature, a generic conceptual framework was developed in collaboration with a patient partner, which synthesizes evidence, recommendations and best practice from existing frameworks and implementation case studies. The Donabedian model for health-care improvement was used to classify PCC domains into the categories of "Structure," "Process" and "Outcome" for health-care quality improvement. The framework emphasizes the structural domain, which relates to the health-care system or context in which care is delivered, providing the foundation for PCC, and influencing the processes and outcomes of care. Structural domains identified include: the creation of a PCC culture across the continuum of care; co-designing educational programs, as well as health promotion and prevention programs with patients; providing a supportive and accommodating environment; and developing and integrating structures to support health information technology and to measure and monitor PCC performance. Process domains describe the importance of cultivating communication and respectful and compassionate care; engaging patients in managing their care; and integration of care. Outcome domains identified include: access to care and Patient-Reported Outcomes. This conceptual framework provides a step-wise roadmap to guide health-care systems and organizations in the provision PCC across various health-care sectors. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

Supporting new graduate professional development: a clinical learning framework.

PubMed

Fitzgerald, Cate; Moores, Alis; Coleman, Allison; Fleming, Jennifer

2015-02-01

New graduate occupational therapists are required to competently deliver health-care practices within complex care environments. An occupational therapy clinical education programme within a large public sector health service sought to investigate methods to support new graduates in their clinical learning and professional development. Three cycles of an insider action research approach each using the steps of planning, action, critical observation and reflection were undertaken to investigate new graduate learning strategies, develop a learning framework and pilot its utility. Qualitative research methods were used to analyse data gathered during the action research cycles. Action research identified variations in current practices to support new graduate learning and to the development of the Occupational Therapy Clinical Learning Framework (OTCLF). Investigation into the utility of the OTCLF revealed two themes associated with its implementation namely (i) contribution to learning goal development and (ii) compatibility with existing learning supports. The action research cycles aimed to review current practices to support new graduate learning. The learning framework developed encourages reflection to identify learning needs and the review, discussion of, and engagement in, goal setting and learning strategies. Preliminary evidence indicates that the OTCLF has potential as an approach to guide new graduate goal development supported by supervision. Future opportunity to implement a similar learning framework in other allied health professions was identified, enabling a continuation of the cyclical nature of enquiry, integral to this research approach within the workplace. © 2014 Occupational Therapy Australia.

Using the International Classification of Functioning, Disability and Health in Assessment and Intervention of School-Aged Children With Language Impairments.

PubMed

Westby, Carol; Washington, Karla N

2017-07-26

The aim of this tutorial is to support speech-language pathologists' (SLPs') application of the International Classification of Functioning, Disability and Health (ICF) in assessment and treatment practices with children with language impairment. This tutorial reviews the framework of the ICF, describes the implications of the ICF for SLPs, distinguishes between students' capacity to perform a skill in a structured context and the actual performance of that skill in naturalistic contexts, and provides a case study of an elementary school child to demonstrate how the principles of the ICF can guide assessment and intervention. The Scope of Practice and Preferred Practice documents for the American Speech-Language-Hearing Association identify the ICF as the framework for practice in speech-language pathology. This tutorial will facilitate clinicians' ability to identify personal and environmental factors that influence students' skill capacity and skill performance, assess students' capacity and performance, and develop impairment-based and socially based language goals linked to Common Core State Standards that build students' language capacity and their communicative performance in naturalistic contexts.

A structured approach to a diagnostic of collective practices

PubMed Central

Bicchieri, Cristina; Lindemans, Jan W.; Jiang, Ting

2014-01-01

“How social norms change” is not only a theoretical question but also an empirical one. Many organizations have implemented programs to abandon harmful social norms. These programs are standardly monitored and evaluated with a set of empirical tools. While monitoring and evaluation (M&E) of changes in objective outcomes and behaviors is well-developed, we will argue that M&E of changes in the wide range of beliefs and preferences important to social norms is still problematic. In this paper, we first present a theoretical framework and then show how it should guide social norms measurement. As a case study, we focus on the harmful practice of child marriage. We show how an operational theory of social norms can guide the design of surveys, experiments, and vignettes. We use examples from existing research to illustrate how to study social norms change. PMID:25538666

A Preliminary Insight into an Islamic Mechanism for Neuroethics

PubMed Central

Baharuddin, Azizan; Musa, Mohd Noor; Salleh, SM Saifuddeen SM

2016-01-01

Muslim relies on the structure or guideline of shari’ah or the maqasid al-shariah, which consist of five essential values, namely preservation/protection of faith, life, intellect, property, and dignity/lineage – to guide them in discovering guiding principles for new concerns such as posed by neuroscience. Like in the case of brain imaging technology, there is in need for proper explanation within Islamic and among the Muslim scientists/scholars on how Islamic beliefs, values, and practices might cumulatively provide ‘different’ meanings to the practice and application of this technology, or whether it is in line with the shari’ah – in the context of preservation of health and protection of disease. This paper highlights the Islamic mechanism for neuroethics as basis for a holistic ethical framework of neuroscience to cope with its new, modern, and emerging technologies in the globalised world, and how Muslim should response to such changes. PMID:27540319

Developing an interprofessional capability framework for teaching healthcare students in a primary healthcare setting.

PubMed

Gum, Lyn Frances; Lloyd, Andrea; Lawn, Sharon; Richards, Janet Noreen; Lindemann, Iris; Sweet, Linda; Ward, Helena; King, Alison; Bramwell, Donald

2013-11-01

This article is based on a partnership between a primary health service and a university whose shared goal was to prepare students and graduates for interprofessional practice (IPP). This collaborative process led to the development of consensus on an interprofessional capability framework. An action research methodology was adopted to study the development and progress of the partnership between university and health service providers. The initial aim was to understand their perceptions of IPP. Following this, the findings and draft capabilities were presented back to the groups. Finalisation of the capabilities took place with shared discussion and debate on how to implement them in the primary care setting. Several ideas and strategies were generated as to how to prepare effective interprofessional learning experiences for students in both environments (university and primary health care setting). Extensive stakeholder consultation from healthcare providers and educators has produced a framework, which incorporates the shared views and understandings, and can therefore be widely used in both settings. Development of a framework of capabilities for IPP, through a collaborative process, is a useful strategy for achieving agreement. Such a framework can guide curriculum for use in university and health service settings to assist incorporation of interprofessional capabilities into students' learning and practice.

Sustaining life or prolonging dying? Appropriate choice of conservative care for children in end-stage renal disease: an ethical framework.

PubMed

Dionne, Janis M; d'Agincourt-Canning, Lori

2015-10-01

Due to technological advances, an increasing number of infants and children are surviving with multi-organ system dysfunction, and some are reaching end-stage renal disease (ESRD). Many have quite limited life expectancies and may not be eligible for kidney transplantation but families request dialysis as alternative. In developed countries where resources are available there is often uncertainty by the medical team as to what should be done. After encountering several of these scenarios, we developed an ethical decision-making framework for the appropriate choice of conservative care or renal replacement therapy in infants and children with ESRD. The framework is a practical tool to help determine if the burdens of dialysis would outweigh the benefits for a particular patient and family. It is based on the four topics approach of medical considerations, quality-of-life determinants, patient and family preferences and contextual features tailored to pediatric ESRD. In this article we discuss the basis of the criteria, provide a practical framework to guide these difficult conversations, and illustrate use of the framework with a case example. While further research is needed, through this approach we hope to reduce the moral distress of care providers and staff as well as potential conflict with the family in these complex decision-making situations.

Developing mathematical practices through reflection cycles

NASA Astrophysics Data System (ADS)

Reinholz, Daniel L.

2016-09-01

This paper focuses on reflection in learning mathematical practices. While there is a long history of research on reflection in mathematics, it has focused primarily on the development of conceptual understanding. Building on notion of learning as participation in social practices, this paper broadens the theory of reflection in mathematics learning. To do so, it introduces the concept of reflection cycles. Each cycle begins with prospective reflection, which guides one's actions during an experience, and ends with retrospective reflection, which consolidates the experience and informs the next reflection cycle. Using reflection cycles as an organizing framework, this paper synthesizes the literature on reflective practices at a variety of levels: (1) metacognition, (2) self-assessment, (3) noticing, and (4) lifelong learning. These practices represent a spectrum of reflection, ranging from the micro level (1) to macro level (4).

Interventional radiology virtual simulator for liver biopsy.

PubMed

Villard, P F; Vidal, F P; ap Cenydd, L; Holbrey, R; Pisharody, S; Johnson, S; Bulpitt, A; John, N W; Bello, F; Gould, D

2014-03-01

Training in Interventional Radiology currently uses the apprenticeship model, where clinical and technical skills of invasive procedures are learnt during practice in patients. This apprenticeship training method is increasingly limited by regulatory restrictions on working hours, concerns over patient risk through trainees' inexperience and the variable exposure to case mix and emergencies during training. To address this, we have developed a computer-based simulation of visceral needle puncture procedures. A real-time framework has been built that includes: segmentation, physically based modelling, haptics rendering, pseudo-ultrasound generation and the concept of a physical mannequin. It is the result of a close collaboration between different universities, involving computer scientists, clinicians, clinical engineers and occupational psychologists. The technical implementation of the framework is a robust and real-time simulation environment combining a physical platform and an immersive computerized virtual environment. The face, content and construct validation have been previously assessed, showing the reliability and effectiveness of this framework, as well as its potential for teaching visceral needle puncture. A simulator for ultrasound-guided liver biopsy has been developed. It includes functionalities and metrics extracted from cognitive task analysis. This framework can be useful during training, particularly given the known difficulties in gaining significant practice of core skills in patients.

What Are the Principles That Guide Behaviors in the Operating Room?: Creating a Framework to Define and Measure Performance.

PubMed

Madani, Amin; Vassiliou, Melina C; Watanabe, Yusuke; Al-Halabi, Becher; Al-Rowais, Mohammed S; Deckelbaum, Dan L; Fried, Gerald M; Feldman, Liane S

2017-02-01

To identify the core principles that guide expert intraoperative behaviors and to use these principles to develop a universal framework that defines intraoperative performance. Surgical outcomes are associated with intraoperative cognitive skills. Yet, our understanding of factors that control intraoperative judgment and decision-making are limited. As a result, current methods for training and measuring performance are somewhat subjective-more task rather than procedure-oriented-and usually not standardized. They thus provide minimal insight into complex cognitive processes that are fundamental to patient safety. Cognitive task analyses for 6 diverse surgical procedures were performed using semistructured interviews and field observations to describe the thoughts, behaviors, and actions that characterize and guide expert performance. Verbal data were transcribed, supplemented with content from published literature, coded, thematically analyzed using grounded-theory by 4 independent reviewers, and synthesized into a list of items. A conceptual framework was developed based on 42 semistructured interviews lasting 45 to 120 minutes, 5 expert panels and 51 field observations involving 35 experts, and 135 sources from the literature. Five domains of intraoperative performance were identified: psychomotor skills, declarative knowledge, advanced cognitive skills, interpersonal skills, and personal resourcefulness. Within the advanced cognitive skills domain, 21 themes were perceived to guide the behaviors of surgeons: 18 for surgical planning and error prevention, and 3 for error/injury recognition, rescue, and recovery. The application of these thought patterns was highly case-specific and variable amongst subspecialties, environments, and individuals. This study provides a comprehensive definition of intraoperative expertise, with greater insight into the complex cognitive processes that seem to underlie optimal performance. This framework provides trainees and other nonexperts with the necessary information to use in deliberate practice and the creation of effective thought habits that characterize expert performance. It may help to identify gaps in performance, and to isolate root causes of surgical errors with the ultimate goal of improving patient safety.

The Pedagogy of Primary Historical Sources in Mathematics: Classroom Practice Meets Theoretical Frameworks

NASA Astrophysics Data System (ADS)

Barnett, Janet Heine; Lodder, Jerry; Pengelley, David

2014-01-01

We analyze our method of teaching with primary historical sources within the context of theoretical frameworks for the role of history in teaching mathematics developed by Barbin, Fried, Jahnke, Jankvist, and Kjeldsen and Blomhøj, and more generally from the perspective of Sfard's theory of learning as communication. We present case studies for two of our guided student modules that are built around sequences of primary sources and are intended for learning core curricular material, one on logical implication, the other on the concept of a group. Additionally, we propose some conclusions about the advantages and challenges of using primary sources in teaching mathematics.

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

PubMed

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

2015-06-01

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

How do we know if a clinical practice guideline is good? A response to Djulbegovic and colleagues' use of fast-and-frugal decision trees to improve clinical care strategies.

PubMed

Mercuri, Mathew

2018-04-17

Clinical practice guidelines (CPGs) and clinical pathways have become important tools for improving the uptake of evidence-based care. Where CPGs are good, adherence to the recommendations within is thought to result in improved patient outcomes. However, the usefulness of such tools for improving patient important outcomes depends both on adherence to the guideline and whether or not the CPG in question is good. This begs the question of what it is that makes a CPG good? In this issue of the Journal, Djulbegovic and colleagues offer a theory to help guide the development of CPGs. The "fast-and-frugal tree" (FFT) heuristic theory is purported to provide the theoretical structure needed to quantitatively assess clinical guidelines in practice, something that the lack of theory to guide CPG development has precluded. In this paper, I examine the role of FFTs in providing an adequate theoretical framework for developing CPGs. In my view, positioning guideline development within the FFT framework may help with problems related to adherence. However, I believe that FTTs fall short in providing panel members with the theoretical basis needed to justify which factors should be considered when developing a CPG, how information on those factors derived from research studies should be interpreted, and how those factors should be integrated into the recommendation. © 2018 John Wiley & Sons, Ltd.

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

PubMed Central

2012-01-01

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

The Ontario Psychosocial Oncology Framework: a quality improvement tool.

PubMed

Li, Madeline; Green, Esther

2013-05-01

To overview the newly developed Psychosocial Health Care for Cancer Patients and Their Families: A Framework to Guide Practice in Ontario and Guideline Recommendations in the context of Canadian psychosocial oncology care and propose strategies for guideline uptake and implementation. Recommendations from the 2008 Institute of Medicine standard Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs were adapted into the Ontario Psychosocial Oncology (PSO) Framework. Existing practice guidelines developed by the Canadian Partnership against Cancer and Cancer Care Ontario and standards developed by the Canadian Association of Psychosocial Oncology are supporting resources for adopting a quality improvement (QI) approach to the implementation of the framework in Ontario. The developed PSO Framework, including 31 specific actionable recommendations, is intended to improve the quality of comprehensive cancer care at both the provider and system levels. Important QI change management processes are described as Educate - raising awareness among medical teams of the significance of psychosocial needs of patients, Evidence - developing a research evidence base for patient care benefits from psychosocial interventions, and Electronics - using technology to collect patient reported outcomes of both physical and emotional symptoms. The Ontario PSO Framework is unique and valuable in providing actionable recommendations that can be implemented through QI processes. Overall, the result will be improved psychosocial health care for the cancer population. Copyright © 2012 John Wiley & Sons, Ltd.

Attributes of innovations and approaches to scalability – lessons from a national program to extend the scope of practice of health professionals

PubMed Central

Masso, Malcolm; Thompson, Cristina

2016-01-01

The context for the paper was the evaluation of a national program in Australia to investigate extended scopes of practice for health professionals (paramedics, physiotherapists, and nurses). The design of the evaluation involved a mixed-methods approach with multiple data sources. Four multidisciplinary models of extended scope of practice were tested over an 18-month period, involving 26 organizations, 224 health professionals, and 36 implementation sites. The evaluation focused on what could be learned to inform scaling up the extended scopes of practice on a national scale. The evaluation findings were used to develop a conceptual framework for use by clinicians, managers, and policy makers to determine appropriate strategies for scaling up effective innovations. Development of the framework was informed by the literature on the diffusion of innovations, particularly an understanding that certain attributes of innovations influence adoption. The framework recognizes the role played by three groups of stakeholders: evidence producers, evidence influencers, and evidence adopters. The use of the framework is illustrated with four case studies from the evaluation. The findings demonstrate how the scaling up of innovations can be influenced by three quite distinct approaches – letting adoption take place in an uncontrolled, unplanned, way; actively helping the process of adoption; or taking deliberate steps to ensure that adoption takes place. Development of the conceptual framework resulted in two sets of questions to guide decisions about scalability, one for those considering whether to adopt the innovation (evidence adopters), and the other for those trying to decide on the optimal strategy for dissemination (evidence influencers). PMID:27616889

Reducing social inequities in health through settings-related interventions -- a conceptual framework.

PubMed

Shareck, Martine; Frohlich, Katherine L; Poland, Blake

2013-06-01

The creation of supportive environments for health is a basic action principle of health promotion, and equity is a core value. A settings approach offers an opportunity to bridge these two, with its focus on the interplay between individual, environmental and social determinants of health. We conducted a scoping review of the literature on theoretical bases and practical applications of the settings approach. Interventions targeting social inequities in health through action on various settings were analyzed to establish what is done in health equity research and action as it relates to settings. Four elements emerged as central to an equity-focused settings approach: a focus on social determinants of health, addressing the needs of marginalized groups, effecting change in a setting's structure, and involving stakeholders. Each came with related challenges. To offer potential solutions to these challenges we developed a conceptual framework that integrates theoretical and methodological approaches, along with six core guiding principles, into a 'settings praxis'. Reducing social inequities in health through the creation of supportive environments requires the application of the settings approach in an innovative way. The proposed conceptual framework can serve as a guide to do so, and help develop, implement and evaluate equity-focused settings-related interventions.

Development and implementation of clinical algorithms in occupational health practice.

PubMed

Ghafur, Imran; Lalloo, Drushca; Macdonald, Ewan B; Menon, Manju

2013-12-01

Occupational health (OH) practice is framed by legal, ethical, and regulatory requirements. Integrating this information into daily practice can be a difficult task. We devised evidence-based framework standards of good practice that would aid clinical management, and assessed their impact. The clinical algorithm was the method deemed most appropriate to our needs. Using "the first OH consultation" as an example, the development, implementation, and evaluation of an algorithm is described. The first OH consultation algorithm was developed. Evaluation demonstrated an overall improvement in recording of information, specifically consent, recreational drug history, function, and review arrangements. Clinical algorithms can be a method for assimilating and succinctly presenting the various facets of OH practice, for use by all OH clinicians as a practical guide and as a way of improving quality in clinical record-keeping.

[Expert investigation on food safety standard system framework construction in China].

PubMed

He, Xiang; Yan, Weixing; Fan, Yongxiang; Zeng, Biao; Peng, Zhen; Sun, Zhenqiu

2013-09-01

Through investigating food safety standard framework among food safety experts, to summarize the basic elements and principles of food safety standard system, and provide policy advices for food safety standards framework. A survey was carried out among 415 experts from government, professional institutions and the food industry/enterprises using the National Food Safety Standard System Construction Consultation Questionnaire designed in the name of the Secretariat of National Food Safety Standard Committee. Experts have different advices in each group about the principles of food product standards, food additive product standards, food related product standards, hygienic practice, test methods. According to the results, the best solution not only may reflect experts awareness of the work of food safety standards situation, but also provide advices for setting and revision of food safety standards for the next. Through experts investigation, the framework and guiding principles of food safety standard had been built.

Using planned adaptation to implement evidence-based programs with new populations.

PubMed

Lee, Shawna J; Altschul, Inna; Mowbray, Carol T

2008-06-01

The Interactive Systems Framework (ISF) for Dissemination and Implementation (Wandersman et al. 2008) elaborates the functions and structures that move evidence-based programs (EBPs) from research to practice. Inherent in that process is the tension between implementing programs with fidelity and the need to tailor programs to fit the target population. We propose Planned Adaptation as one approach to resolve this tension, with the goal of guiding practitioners in adapting EBPs so that they maintain core components of program theory while taking into account the needs of particular populations. Planned Adaptation is a form of capacity building within the Prevention Support System that provides a framework to guide practitioners in adapting programs while encouraging researchers to provide information relevant to adaptation as a critical aspect of dissemination research, with the goal of promoting wider dissemination and better implementation of EBPs. We illustrate Planned Adaptation using the JOBS Program (Caplan et al. 1989), which was developed for recently laid-off, working- and middle-class workers and subsequently implemented with welfare recipients.

Managing crises through organisational development: a conceptual framework.

PubMed

Lalonde, Carole

2011-04-01

This paper presents a synthesis of the guiding principles in crisis management in accordance with the four configurational imperatives (strategy, structure, leadership and environment) defined by Miller (1987) and outlines interventions in organisational development (OD) that may contribute to their achievement. The aim is to build a conceptual framework at the intersection of these two fields that could help to strengthen the resilient capabilities of individuals, organisations and communities to face crises. This incursion into the field of OD--to generate more efficient configurations of practices in crisis management--seems particularly fruitful considering the system-wide application of OD, based on open-systems theory (Burke, 2008). Various interventions proposed by OD in terms of human processes, structural designs and human resource management, as well as strategy, may help leaders, members of organisations and civil society apply effectively, and in a more sustainable way, the crisis management guiding principles defined by researchers. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

Health care priority setting: principles, practice and challenges

PubMed Central

Mitton, Craig; Donaldson, Cam

2004-01-01

Background Health organizations the world over are required to set priorities and allocate resources within the constraint of limited funding. However, decision makers may not be well equipped to make explicit rationing decisions and as such often rely on historical or political resource allocation processes. One economic approach to priority setting which has gained momentum in practice over the last three decades is program budgeting and marginal analysis (PBMA). Methods This paper presents a detailed step by step guide for carrying out a priority setting process based on the PBMA framework. This guide is based on the authors' experience in using this approach primarily in the UK and Canada, but as well draws on a growing literature of PBMA studies in various countries. Results At the core of the PBMA approach is an advisory panel charged with making recommendations for resource re-allocation. The process can be supported by a range of 'hard' and 'soft' evidence, and requires that decision making criteria are defined and weighted in an explicit manner. Evaluating the process of PBMA using an ethical framework, and noting important challenges to such activity including that of organizational behavior, are shown to be important aspects of developing a comprehensive approach to priority setting in health care. Conclusion Although not without challenges, international experience with PBMA over the last three decades would indicate that this approach has the potential to make substantial improvement on commonly relied upon historical and political decision making processes. In setting out a step by step guide for PBMA, as is done in this paper, implementation by decision makers should be facilitated. PMID:15104792

Application of theory to enhance audit and feedback interventions to increase the uptake of evidence-based transfusion practice: an intervention development protocol.

PubMed

Gould, Natalie J; Lorencatto, Fabiana; Stanworth, Simon J; Michie, Susan; Prior, Maria E; Glidewell, Liz; Grimshaw, Jeremy M; Francis, Jill J

2014-07-29

Audits of blood transfusion demonstrate around 20% transfusions are outside national recommendations and guidelines. Audit and feedback is a widely used quality improvement intervention but effects on clinical practice are variable, suggesting potential for enhancement. Behavioural theory, theoretical frameworks of behaviour change and behaviour change techniques provide systematic processes to enhance intervention. This study is part of a larger programme of work to promote the uptake of evidence-based transfusion practice. The objectives of this study are to design two theoretically enhanced audit and feedback interventions; one focused on content and one on delivery, and investigate the feasibility and acceptability. Study A (Content): A coding framework based on current evidence regarding audit and feedback, and behaviour change theory and frameworks will be developed and applied as part of a structured content analysis to specify the key components of existing feedback documents. Prototype feedback documents with enhanced content and also a protocol, describing principles for enhancing feedback content, will be developed. Study B (Delivery): Individual semi-structured interviews with healthcare professionals and observations of team meetings in four hospitals will be used to specify, and identify views about, current audit and feedback practice. Interviews will be based on a topic guide developed using the Theoretical Domains Framework and the Consolidated Framework for Implementation Research. Analysis of transcripts based on these frameworks will form the evidence base for developing a protocol describing an enhanced intervention that focuses on feedback delivery. Study C (Feasibility and Acceptability): Enhanced interventions will be piloted in four hospitals. Semi-structured interviews, questionnaires and observations will be used to assess feasibility and acceptability. This intervention development work reflects the UK Medical Research Council's guidance on development of complex interventions, which emphasises the importance of a robust theoretical basis for intervention design and recommends systematic assessment of feasibility and acceptability prior to taking interventions to evaluation in a full-scale randomised study. The work-up includes specification of current practice so that, in the trials to be conducted later in this programme, there will be a clear distinction between the control (usual practice) conditions and the interventions to be evaluated.

Development of FOCUS-GC: Framework for Outcomes of Clinical Communication Services in Genetic Counseling.

PubMed

Cragun, Deborah; Zierhut, Heather

2018-02-01

Conceptual frameworks bring together existing theories and models in order to identify, consolidate, and fill in gaps between theory, practice, and evidence. Given the vast number of possible outcomes that could be studied in genetic counseling, a framework for organizing outcomes and postulating relationships between communication services and genetic counseling outcomes was sought. Through an iterative approach involving literature review, thematic analysis, and consolidation, outcomes and processes were categorized to create and define components of a conceptual framework. The final product, "Framework for Outcomes of Clinical commUnication Services" (FOCUS) contains the following domains: communication strategy; communication process measures; patient care experience, patient changes, patient health; and family changes. A website was created to allow easier access and ongoing modifications to the framework. In addition, a step-by-step guide and two examples were created to show flexibility in how the framework can be used. FOCUS may help in conceptualizing, organizing and summarizing outcomes research related to risk communication and counseling in genetic service delivery as well as other healthcare settings.

A framework for the evaluation of new interventional procedures.

PubMed

Lourenco, Tania; Grant, Adrian M; Burr, Jennifer M; Vale, Luke

2012-03-01

The introduction of new interventional procedures is less regulated than for other health technologies such as pharmaceuticals. Decisions are often taken on evidence of efficacy and short-term safety from small-scale usually observational studies. This reflects the particular challenges of evaluating interventional procedures - the extra facets of skill and training and the difficulty defining a 'new' technology. Currently, there is no framework to evaluate new interventional procedures before they become available in clinical practice as opposed to new pharmaceuticals. This paper proposes a framework to guide the evaluation of a new interventional procedure. A framework was developed consisting of a four-stage progressive evaluation for a new interventional procedure: Stage 1: Development; Stage 2: Efficacy and short-term safety; Stage 3: Effectiveness and cost-effectiveness; and Stage 4: Implementation. The framework also suggests the types of studies or data collection methods that can be used to satisfy each stage. This paper makes a first step on a framework for generating evidence on new interventional procedures. The difficulties and limitations of applying such a framework are discussed. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Psychological Trauma and LGBT Caregivers: A Conceptual Framework to Guide Practice.

PubMed

Glaesser, Richard S; Patel, Bina R

2016-01-01

LGBT adults face unique risk factors such as social isolation, discrimination, and victimization, and occasionally th ey engage in detrimental behaviors like high alcohol and drug use and risky sexual activity that negatively impacts psychological/physical health. These risks can affect their overall health and stress the relationship with an older caregiver/recipient-partner following exposure to acute medical event. The experience of an acute medical event among a LGBT caregiving partner can result in psychological trauma. In this article the authors present a conceptual framework involving stress process theory, life course theory, and family systems perspective to understand the effect of stressors on LGBT caregiving partners. Implications for social work practice include assessing, coordinating care, counseling and negotiating services at micro level, engaging family-centered approaches to support positive transition to caregiving role at mezzo level, and advocating for policy and cultural shifts to supports and diminish stigma of this group.

Intraoperative Image-based Multiview 2D/3D Registration for Image-Guided Orthopaedic Surgery: Incorporation of Fiducial-Based C-Arm Tracking and GPU-Acceleration

PubMed Central

Armand, Mehran; Armiger, Robert S.; Kutzer, Michael D.; Basafa, Ehsan; Kazanzides, Peter; Taylor, Russell H.

2012-01-01

Intraoperative patient registration may significantly affect the outcome of image-guided surgery (IGS). Image-based registration approaches have several advantages over the currently dominant point-based direct contact methods and are used in some industry solutions in image-guided radiation therapy with fixed X-ray gantries. However, technical challenges including geometric calibration and computational cost have precluded their use with mobile C-arms for IGS. We propose a 2D/3D registration framework for intraoperative patient registration using a conventional mobile X-ray imager combining fiducial-based C-arm tracking and graphics processing unit (GPU)-acceleration. The two-stage framework 1) acquires X-ray images and estimates relative pose between the images using a custom-made in-image fiducial, and 2) estimates the patient pose using intensity-based 2D/3D registration. Experimental validations using a publicly available gold standard dataset, a plastic bone phantom and cadaveric specimens have been conducted. The mean target registration error (mTRE) was 0.34 ± 0.04 mm (success rate: 100%, registration time: 14.2 s) for the phantom with two images 90° apart, and 0.99 ± 0.41 mm (81%, 16.3 s) for the cadaveric specimen with images 58.5° apart. The experimental results showed the feasibility of the proposed registration framework as a practical alternative for IGS routines. PMID:22113773

A human-oriented framework for developing assistive service robots.

PubMed

McGinn, Conor; Cullinan, Michael F; Culleton, Mark; Kelly, Kevin

2018-04-01

Multipurpose robots that can perform a range of useful tasks have the potential to increase the quality of life for many people living with disabilities. Owing to factors such as high system complexity, as-yet unresolved research questions and current technology limitations, there is a need for effective strategies to coordinate the development process. Integrating established methodologies based on human-centred design and universal design, a framework was formulated to coordinate the robot design process over successive iterations of prototype development. An account is given of how the framework was practically applied to the problem of developing a personal service robot. Application of the framework led to the formation of several design goals which addressed a wide range of identified user needs. The resultant prototype solution, which consisted of several component elements, succeeded in demonstrating the performance stipulated by all of the proposed metrics. Application of the framework resulted in the development of a complex prototype that addressed many aspects of the functional and usability requirements of a personal service robot. Following the process led to several important insights which directly benefit the development of subsequent prototypes. Implications for Rehabilitation This research shows how universal design might be used to formulate usability requirements for assistive service robots. A framework is presented that guides the process of designing service robots in a human-centred way. Through practical application of the framework, a prototype robot system that addressed a range of identified user needs was developed.

Strategy making and power in environmental assessments. Lessons from the establishment of an out-of-town shopping centre in Vaesteras, Sweden

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

Isaksson, Karolina, E-mail: karolina.isaksson@vti.se; Storbjoerk, Sofie, E-mail: sofie.storbjork@liu.se

This paper seeks to provide deeper insights into how EA ineffectiveness is produced in land use planning practice. This is explored in a study of local development planning in the city of Vaesteras, Sweden. The case in question is the development of a large out-of-town shopping centre, propelled by the establishment of a new IKEA furniture store. The Healey (2007) framework of planning as strategy making is applied as an analytical framework, together with a focus on power-knowledge relations. In the analysis, we identify a range of mechanisms that produced ineffectiveness by limiting the role of environmental knowledge throughout themore » planning process. The specific mechanisms we identified were related to the overall consensus perspective in local development strategies and plans, a lack of concretisation and integration of various policies and strategies, a range of exclusion mechanisms and an overall focus on mitigation and benefits of the process in question. In practice, these mechanisms were closely intertwined. Our main conclusion is, consequently, that increased effectiveness of EA would require fundamental transformation of the norms, frameworks and routines that implicitly and explicitly guide land use planning in practice. - Highlights: Black-Right-Pointing-Pointer We analyse how EA-ineffectiveness is produced in land use planning practice. Black-Right-Pointing-Pointer Several mechanisms produce EA-ineffectiveness throughout the whole planning process. Black-Right-Pointing-Pointer These mechanisms are often closely intertwined and mutually reinforcing each other. Black-Right-Pointing-Pointer Enhancing EA-effectiveness requires a fundamental shift of the norms, frameworks and routines shaping planning practice.« less

Knowledge brokering for healthy aging: a scoping review of potential approaches.

PubMed

Van Eerd, Dwayne; Newman, Kristine; DeForge, Ryan; Urquhart, Robin; Cornelissen, Evelyn; Dainty, Katie N

2016-10-19

Developing a healthcare delivery system that is more responsive to the future challenges of an aging population is a priority in Canada. The World Health Organization acknowledges the need for knowledge translation frameworks in aging and health. Knowledge brokering (KB) is a specific knowledge translation approach that includes making connections between people to facilitate the use of evidence. Knowledge gaps exist about KB roles, approaches, and guiding frameworks. The objective of the scoping review is to identify and describe KB approaches and the underlying conceptual frameworks (models, theories) used to guide the approaches that could support healthy aging. Literature searches were done in PubMed, EMBASE, PsycINFO, EBM reviews (Cochrane Database of systematic reviews), CINAHL, and SCOPUS, as well as Google and Google Scholar using terms related to knowledge brokering. Titles, abstracts, and full reports were reviewed independently by two reviewers who came to consensus on all screening criteria. Documents were included if they described a KB approach and details about the underlying conceptual basis. Data about KB approach, target stakeholders, KB outcomes, and context were extracted independently by two reviewers. Searches identified 248 unique references. Screening for inclusion revealed 19 documents that described 15 accounts of knowledge brokering and details about conceptual guidance and could be applied in healthy aging contexts. Eight KB elements were detected in the approaches though not all approaches incorporated all elements. The underlying conceptual guidance for KB approaches varied. Specific KB frameworks were referenced or developed for nine KB approaches while the remaining six cited more general KT frameworks (or multiple frameworks) as guidance. The KB approaches that we found varied greatly depending on the context and stakeholders involved. Three of the approaches were explicitly employed in the context of health aging. Common elements of KB approaches that could be conducted in healthy aging contexts focussed on acquiring, adapting, and disseminating knowledge and networking (linkage). The descriptions of the guiding conceptual frameworks (theories, models) focussed on linkage and exchange but varied across approaches. Future research should gather KB practitioner and stakeholder perspectives on effective practices to develop KB approaches for healthy aging.

A framework for the design and development of physical employment tests and standards.

PubMed

Payne, W; Harvey, J

2010-07-01

Because operational tasks in the uniformed services (military, police, fire and emergency services) are physically demanding and incur the risk of injury, employment policy in these services is usually competency based and predicated on objective physical employment standards (PESs) based on physical employment tests (PETs). In this paper, a comprehensive framework for the design of PETs and PESs is presented. Three broad approaches to physical employment testing are described and compared: generic predictive testing; task-related predictive testing; task simulation testing. Techniques for the selection of a set of tests with good coverage of job requirements, including job task analysis, physical demands analysis and correlation analysis, are discussed. Regarding individual PETs, theoretical considerations including measurability, discriminating power, reliability and validity, and practical considerations, including development of protocols, resource requirements, administrative issues and safety, are considered. With regard to the setting of PESs, criterion referencing and norm referencing are discussed. STATEMENT OF RELEVANCE: This paper presents an integrated and coherent framework for the development of PESs and hence provides a much needed theoretically based but practically oriented guide for organisations seeking to establish valid and defensible PESs.

Exploring the oxygen supply and demand framework as a learning tool in undergraduate nursing education.

PubMed

Gillespie, Mary; Shackell, Eileen

2017-11-01

In nursing education, physiological concepts are typically presented within a body 'systems' framework yet learners are often challenged to apply this knowledge in the holistic and functional manner needed for effective clinical decision-making and safe patient care. A nursing faculty addressed this learning challenge by developing an advanced organizer as a conceptual and integrative learning tool to support learners in diverse learning environments and practice settings. A mixed methods research study was conducted that explored the effectiveness of the Oxygen Supply and Demand Framework as a learning tool in undergraduate nursing education. A pretest/post-test assessment and reflective journal were used to gather data. Findings indicated the Oxygen Supply and Demand Framework guided the development of pattern recognition and thinking processes and supported knowledge development, knowledge application and clinical decision-making. The Oxygen Supply and Demand Framework supports undergraduate students learning to provide safe and effective nursing care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of a Rural Health Framework: Implications for Program Service Planning and Delivery

PubMed Central

White, Deanna

2013-01-01

Purpose: To describe the development and application of an evidence-based Rural Health Framework to guide rural health program, policy and service planning. Methods: A literature review of rural health programs, focusing on health promotion, chronic disease prevention and population health, was conducted using several bibliographic databases. Findings: Thirty papers met the criteria for review, describing chronic disease interventions and public health policies in rural settings. Twenty-one papers demonstrated effective intervention programs and highlighted potential good practices for rural health programs, which were used to define key elements of a Rural Health Framework. Conclusions: The Rural Health Framework was applied to an influenza immunization program to demonstrate its utility in assisting public health providers to increase uptake of the vaccine. This Rural Health Framework provides an opportunity for program planners to reflect on the key issues facing rural communities to ensure the development of policies and strategies that will prudently and effectively meet population health needs. PMID:23968625

Goal setting practice in services delivering community-based stroke rehabilitation: a United Kingdom (UK) wide survey.

PubMed

Scobbie, Lesley; Duncan, Edward A; Brady, Marian C; Wyke, Sally

2015-01-01

We investigated the nature of services providing community-based stroke rehabilitation across the UK, and goal setting practice used within them, to inform evaluation of a goal setting and action planning (G-AP) framework. We designed, piloted and electronically distributed a survey to health professionals working in community-based stroke rehabilitation settings across the UK. We optimised recruitment using a multi-faceted strategy. Responses were analysed from 437 services. Services size, composition and input was highly variable; however, most were multi-disciplinary (82%; n = 335/407) and provided input to a mixed diagnostic group of patients (71%; n = 312/437). Ninety one percent of services (n = 358/395) reported setting goals with "all" or "most" stroke survivors. Seventeen percent (n = 65/380) reported that no methods were used to guide goal setting practice; 47% (n = 148/315) reported use of informal methods only. Goal setting practice varied, e.g. 98% of services (n = 362/369) reported routinely asking patients about goal priorities; 39% (n = 141/360) reported routinely providing patients with a copy of their goals. Goal setting is embedded within community-based stroke rehabilitation; however, practice varies and is potentially sub-optimal. Further evaluation of the G-AP framework is warranted to inform optimal practice. Evaluation design will take account of the diverse service models that exist. Implications for Rehabilitation Community-based stroke rehabilitation services across the UK are diverse and tend to see a mixed diagnostic group of patients. Goal setting is implemented routinely within community-based stroke rehabilitation services; however, practice is variable and potentially sub-optimal. Further evaluation of the G-AP framework is warranted to assess its effectiveness in practice.

What makes public health studies ethical? Dissolving the boundary between research and practice

PubMed Central

2014-01-01

Background The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary – whether on grounds of primary purpose, temporality, underlying legal authority, departure from usual practice, or direct benefits to participants – have been unsatisfactory. Public Health Ontario has eschewed this distinction between research and other evaluative activities, choosing to adopt a common framework and process to guide ethical reflection on all public health evaluative projects throughout their lifecycle – from initial planning through to knowledge exchange. Discussion The Public Health Ontario framework was developed by a working group of public health and ethics professionals and scholars, in consultation with individuals representing a wide range of public health roles. The first part of the framework interprets the existing Canadian research ethics policy statement (commonly known as the TCPS 2) through a public health lens. The second part consists of ten questions that guide the investigator in the application of the core ethical principles to public health initiatives. The framework is intended for use by those designing and executing public health evaluations, as well as those charged with ethics review of projects. The goal is to move toward a culture of ethical integrity among investigators, reviewers and decision-makers, rather than mere compliance with rules. The framework is consonant with the perspective of the learning organization and is generalizable to other public health organizations, to health services organizations, and beyond. Summary Public Health Ontario has developed an ethics framework that is applicable to any evidence-generating activity, regardless of whether it is labelled research. While developed in a public health context, it is readily adaptable to other health services organizations and beyond. PMID:25104180

An eHealth Capabilities Framework for Graduates and Health Professionals: Mixed-Methods Study

PubMed Central

McGregor, Deborah; Keep, Melanie; Janssen, Anna; Spallek, Heiko; Quinn, Deleana; Jones, Aaron; Tseris, Emma; Yeung, Wilson; Togher, Leanne; Solman, Annette; Shaw, Tim

2018-01-01

Background The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. Objective This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. Methods A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. Results Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. Conclusions The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development programs. PMID:29764794

Why patients self-refer to the Emergency Department: A qualitative interview study.

PubMed

Kraaijvanger, Nicole; Rijpsma, Douwe; Willink, Lisa; Lucassen, Peter; van Leeuwen, Henk; Edwards, Michael

2017-06-01

There have been multiple studies investigating reasons for patients to self-refer to the Emergency Department (ED). The majority made use of questionnaires and excluded patients with urgent conditions. The goal of this qualitative study is to explore what motives patients have to self-refer to an ED, also including patients in urgent triage categories. In a large teaching hospital in the Netherlands, a qualitative interview study focusing on reasons for self-referring to the ED was performed. Self-referred patients were included until no new reasons for attending the ED were found. Exclusion criteria were as follows: not mentally able to be interviewed or not speaking Dutch. Patients who were in need of urgent care were treated first, before being asked to participate. Interviews followed a predefined topic guide. Practicing cyclic analysis, the interview topic guide was modified during the inclusion period. Interviews were recorded on an audio recorder, transcribed verbatim, and anonymized. Two investigators independently coded the information and combined the codes into meaningful clusters. Subsequently, these were categorized into themes to build a framework of reasons for self-referral to the ED. Characteristic quotes were used to illustrate the acquired theoretical framework. Thirty self-referred patients were interviewed. Most of the participants were male (63%), with a mean age of 46 years. Two main themes emerged from the interviews that are pertinent to the patients' decisions to attend the ED: (1) health concerns and (2) practical issues. This study found that there are 2 clearly distinctive reasons for self-referral to the ED: health concerns or practical motives. Self-referral because of practical motives is probably most suitable for strategies that aim to reduce inappropriate ED visits. © 2016 John Wiley & Sons, Ltd.

Decision-making in nursing practice: An integrative literature review.

PubMed

Nibbelink, Christine W; Brewer, Barbara B

2018-03-01

To identify and summarise factors and processes related to registered nurses' patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in naturalistic decision making (NDM). Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue to lead to poor patient outcomes. Naturalistic decision making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. PubMed and CINAHL databases were searched, and research meeting criteria was included. Data were identified from all included articles, and themes were developed based on these data. Key findings in this review include nursing experience and associated factors; organisation and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Acute care nurses employ a variety of decision-making factors and processes and informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that naturalistic decision making may be applicable to decision-making nursing research. Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using naturalistic decision making as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient outcomes. © 2017 John Wiley & Sons Ltd.

The European Society of Therapeutic Radiology and Oncology-European Institute of Radiotherapy (ESTRO-EIR) report on 3D CT-based in-room image guidance systems: a practical and technical review and guide.

PubMed

Korreman, Stine; Rasch, Coen; McNair, Helen; Verellen, Dirk; Oelfke, Uwe; Maingon, Philippe; Mijnheer, Ben; Khoo, Vincent

2010-02-01

The past decade has provided many technological advances in radiotherapy. The European Institute of Radiotherapy (EIR) was established by the European Society of Therapeutic Radiology and Oncology (ESTRO) to provide current consensus statement with evidence-based and pragmatic guidelines on topics of practical relevance for radiation oncology. This report focuses primarily on 3D CT-based in-room image guidance (3DCT-IGRT) systems. It will provide an overview and current standing of 3DCT-IGRT systems addressing the rationale, objectives, principles, applications, and process pathways, both clinical and technical for treatment delivery and quality assurance. These are reviewed for four categories of solutions; kV CT and kV CBCT (cone-beam CT) as well as MV CT and MV CBCT. It will also provide a framework and checklist to consider the capability and functionality of these systems as well as the resources needed for implementation. Two different but typical clinical cases (tonsillar and prostate cancer) using 3DCT-IGRT are illustrated with workflow processes via feedback questionnaires from several large clinical centres currently utilizing these systems. The feedback from these clinical centres demonstrates a wide variability based on local practices. This report whilst comprehensive is not exhaustive as this area of development remains a very active field for research and development. However, it should serve as a practical guide and framework for all professional groups within the field, focussed on clinicians, physicists and radiation therapy technologists interested in IGRT. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Improving preventive health care in Aboriginal and Torres Strait Islander primary care settings.

PubMed

Bailie, Jodie; Matthews, Veronica; Laycock, Alison; Schultz, Rosalie; Burgess, Christopher P; Peiris, David; Larkins, Sarah; Bailie, Ross

2017-07-14

Like other colonised populations, Indigenous Australians experience poorer health outcomes than non-Indigenous Australians. Preventable chronic disease is the largest contributor to the health differential between Indigenous and non-Indigenous Australians, but recommended best-practice preventive care is not consistently provided to Indigenous Australians. Significant improvement in health care delivery could be achieved through identifying and minimising evidence-practice gaps. Our objective was to use clinical audit data to create a framework of the priority evidence-practice gaps, strategies to address them, and drivers to support these strategies in the delivery of recommended preventive care. De-identified preventive health clinical audit data from 137 primary health care (PHC) centres in five jurisdictions were analysed (n = 17,108 audited records of well adults with no documented major chronic disease; 367 system assessments; 2005-2014), together with stakeholder survey data relating to interpretation of these data, using a mixed-methods approach (n = 152 responses collated in 2015-16). Stakeholders surveyed included clinicians, managers, policy officers, continuous quality improvement (CQI) facilitators and academics. Priority evidence-practice gaps and associated barriers, enablers and strategies to address the gaps were identified and reported back through two-stages of consultation. Further analysis and interpretation of these data were used to develop a framework of strategies and drivers for health service improvement. Stakeholder identified priorities were: following-up abnormal test results; completing cardiovascular risk assessments; timely recording of results; recording enquiries about living conditions, family relationships and substance use; providing support for clients identified with emotional wellbeing risk; enhancing systems to enable team function and continuity of care. Drivers identified for improving care in these areas included: strong Indigenous participation in the PHC service; appropriate team structure and function to support preventive care; meaningful use of data to support quality of care and CQI; and corporate support functions and structures. The framework should be useful for guiding development and implementation of barrier-driven, tailored interventions for primary health care service delivery and policy contexts, and for guiding further research. While specific strategies to improve the quality of preventive care need to be tailored to local context, these findings reinforce the requirement for multi-level action across the system. The framework and findings may be useful for similar purposes in other parts of the world, with appropriate attention to context in different locations.

Voices of chief nursing executives informing a doctor of nursing practice program.

PubMed

Embree, Jennifer L; Meek, Julie; Ebright, Patricia

The purpose of this article is to describe the business case framework used to guide doctor of nursing practice (DNP) program enhancements and to discuss methods used to gain chief nurse executives' (CNEs) perspectives for desired curricular and experiential content for doctor of nursing practice nurses in health care system executive roles. Principal results of CNE interview responses were closely aligned to the knowledge, skills and/or attitudes identified by the national leadership organizations. Major conclusions of this article are that curriculum change should include increased emphasis on leadership, implementation science, and translation of evidence into practice methods. Business, information and technology management, policy, and health care law content would also need to be re-balanced to facilitate DNP graduates' health care system level practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Resource allocation on the frontlines of public health preparedness and response: report of a summit on legal and ethical issues.

PubMed

Barnett, Daniel J; Taylor, Holly A; Hodge, James G; Links, Jonathan M

2009-01-01

In the face of all-hazards preparedness challenges, local and state health department personnel have to date lacked a discrete set of legally and ethically informed public health principles to guide the distribution of scarce resources in crisis settings. To help address this gap, we convened a Summit of academic and practice experts to develop a set of principles for legally and ethically sound public health resource triage decision-making in emergencies. The invitation-only Summit, held in Washington, D.C., on June 29, 2006, assembled 20 experts from a combination of academic institutions and nonacademic leadership, policy, and practice settings. The Summit featured a tabletop exercise designed to highlight resource scarcity challenges in a public health infectious disease emergency. This exercise served as a springboard for Summit participants' subsequent identification of 10 public health emergency resource allocation principles through an iterative process. The final product of the Summit was a set of 10 principles to guide allocation decisions involving scarce resources in public health emergencies. The principles are grouped into three categories: obligations to community; balancing personal autonomy and community well-being/benefit; and good preparedness practice. The 10 Summit-derived principles represent an attempt to link law, ethics, and real-world public health emergency resource allocation practices, and can serve as a useful starting framework to guide further systematic approaches and future research on addressing public health resource scarcity in an all-hazards context.

Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care.

PubMed

Quanbeck, Andrew; Brown, Randall T; E Zgierska, Aleksandra; A Johnson, Roberta; Robinson, James M; Jacobson, Nora

2016-01-27

Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy - systems consultation -intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy - translation of a clinical practice guideline into a checklist-based implementation guide, the use of physician peer coaches ('systems consultants') to help clinics implement the guide, and a focus on reducing variation in practices across prescribers and clinics. The implementation strategy will be applied to improving opioid prescribing practices in primary care, which may help ultimately mitigate the increasing prevalence of opioid abuse and addiction. The pilot test will compare four intervention clinics to four control clinics in a matched-pairs design. A leading clinical guideline for opioid prescribing has been translated into a checklist-based implementation guide in a systematic process that involved experts who wrote the guideline in consultation with implementation experts and primary care physicians. Two physicians with expertise in family and addiction medicine are serving as the systems consultants. Each systems consultant will guide two intervention clinics, using two site visits and follow-up communication by phone and email, to implement the translated guideline. Mixed methods will be used to test the feasibility, acceptability, and preliminary effectiveness of the implementation strategy in an evaluation that meets standards for 'fully developed use' of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The clinic will be the primary unit of analysis. The systems consultation implementation strategy is intended to generalize to the adoption of other clinical guidelines. This pilot test is intended to prepare for a large randomized clinical trial that will test the strategy against other implementation strategies, such as audit/feedback and academic detailing, used to close the gap between knowledge and practice. The systems consultation approach has the potential to shorten the famously long time it takes to implement evidence-based practices and clinical guidelines in healthcare.

Doing Better: Illuminating a Framework of Equitable Science Pedagogy through a Cross- Case Analysis of Urban High School Science Teachers

NASA Astrophysics Data System (ADS)

Sheth, Manali J.

Students of color are routinely asked to participate in science education that is less intellectually rich and self-affirming. Additionally, teachers have trouble embarking on professional growth related to issues of equity and diversity in science. The purpose of this dissertation research is to develop a multi-dimensional framework for equitable science pedagogy (ESP) through analyzing the efforts and struggles of high school science teachers. This study is grounded in a conceptual framework derived from scholarship in science education, multicultural education, critical science studies, and teacher learning. The following questions guide this research: 1) What visions and enactments emerge in teachers' practices towards equitable science pedagogy? 2) How are teachers' practice decisions towards ESP influenced by their personal theories of race/culture, science, and learning and sociocultural contexts? 3) Why are there consistencies and variances across teachers' practices? This study employs a qualitative multiple case study design with ethnographic data collection to explore the practices of three urban high school science teachers who were identified as being committed to nurturing the science learning of students of color. Data include over 120 hours of classroom observation, 60 hours of teacher interviews, and 500 teacher- and student-generated artifacts. Data analysis included coding teachers' practices using theory- and participant generated codes, construction of themes based on emergent patterns, and cross-case analysis. The affordances and limitations of the participants' pedagogical approaches inform the following framework for equitable science pedagogy: 1) Seeing race and culture and sharing responsibility for learning form foundational dimensions. Practices from the other three dimensions--- nurturing students' identities, re-centering students' epistemologies, and critiquing structural inequities---emerge from the foundation. As emergent practices, they are constituted by but not reduced to practices in the initial dimensions. 2) Ideas from the foundational dimensions are filtered through teachers' stances on science. Thus, teachers' practices in the emergent dimensions and the foundational dimensions are mediated by teachers' pedagogical ideas about science and school science. 3) Teachers' articulations of practice influence the possibility of on-going work towards equitable science pedagogy.

Policies on pets for healthy cities: a conceptual framework.

PubMed

Rock, Melanie J; Adams, Cindy L; Degeling, Chris; Massolo, Alessandro; McCormack, Gavin R

2015-12-01

Drawing on the One Health concept, and integrating a dual focus on public policy and practices of caring from the Ottawa Charter for Health Promotion, we outline a conceptual framework to help guide the development and assessment of local governments' policies on pets. This framework emphasizes well-being in human populations, while recognizing that these outcomes relate to the well-being of non-human animals. Five intersecting spheres of activity, each associated with local governments' jurisdiction over pets, are presented: (i) preventing threats and nuisances from pets, (ii) meeting pets' emotional and physical needs, (iii) procuring pets ethically, (iv) providing pets with veterinary services and (v) licensing and identifying pets. This conceptual framework acknowledges the tenets of previous health promotion frameworks, including overlapping and intersecting influences. At the same time, this framework proposes to advance our understanding of health promotion and, more broadly, population health by underscoring interdependence between people and pets as well as the dynamism of urbanized ecologies. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Societal interventions to prevent child abuse and neglect.

PubMed

Hay, T; Jones, L

1994-01-01

A framework for understanding child maltreatment in terms of complex and interacting factors from the individual to the societal level can aid in conceptualizing and implementing prevention efforts. Research on interventions at the societal level can guide a broad range of activities, increasing their effectiveness and viability. Fundamental approaches include evaluation of specific interventions and systems-level research on implementation and development of best practice in prevention activities for different portions of society. Research can indicate the roles that each individual, agency, organization, community, and level of government can play. The U.N. Convention on the Rights of the Child provides a useful framework for societal level change to improve the welfare of children and families.

Designing computer learning environments for engineering and computer science: The scaffolded knowledge integration framework

NASA Astrophysics Data System (ADS)

Linn, Marcia C.

1995-06-01

Designing effective curricula for complex topics and incorporating technological tools is an evolving process. One important way to foster effective design is to synthesize successful practices. This paper describes a framework called scaffolded knowledge integration and illustrates how it guided the design of two successful course enhancements in the field of computer science and engineering. One course enhancement, the LISP Knowledge Integration Environment, improved learning and resulted in more gender-equitable outcomes. The second course enhancement, the spatial reasoning environment, addressed spatial reasoning in an introductory engineering course. This enhancement minimized the importance of prior knowledge of spatial reasoning and helped students develop a more comprehensive repertoire of spatial reasoning strategies. Taken together, the instructional research programs reinforce the value of the scaffolded knowledge integration framework and suggest directions for future curriculum reformers.

Towards a Duty of Care for Biodiversity

NASA Astrophysics Data System (ADS)

Earl, G.; Curtis, A.; Allan, C.

2010-04-01

The decline in biodiversity is a worldwide phenomenon, with current rates of species extinction more dramatic than any previously recorded. Habitat loss has been identified as the major cause of biodiversity decline. In this article we suggest that a statutory duty of care would complement the current mix of policy options for biodiversity conservation. Obstacles hindering the introduction of a statutory duty of care include linguistic ambiguity about the terms ‘duty of care’ and ‘stewardship’ and how they are applied in a natural resource management context, and the absence of a mechanism to guide its implementation. Drawing on international literature and key informant interviews we have articulated characteristics of duty of care to reduce linguistic ambiguity, and developed a framework for implementing a duty of care for biodiversity at the regional scale. The framework draws on key elements of the common law ‘duty of care’, the concepts of ‘taking reasonable care’ and ‘avoiding foreseeable harm’, in its logic. Core elements of the framework include desired outcomes for biodiversity, supported by current recommended practices. The focus on outcomes provides opportunities for the development of innovative management practices. The framework incorporates multiple pathways for the redress of non-compliance including tiered negative sanctions, and positive measures to encourage compliance. Importantly, the framework addresses the need for change and adaptation that is a necessary part of biodiversity management.

Towards a duty of care for biodiversity.

PubMed

Earl, G; Curtis, A; Allan, C

2010-04-01

The decline in biodiversity is a worldwide phenomenon, with current rates of species extinction more dramatic than any previously recorded. Habitat loss has been identified as the major cause of biodiversity decline. In this article we suggest that a statutory duty of care would complement the current mix of policy options for biodiversity conservation. Obstacles hindering the introduction of a statutory duty of care include linguistic ambiguity about the terms 'duty of care' and 'stewardship' and how they are applied in a natural resource management context, and the absence of a mechanism to guide its implementation. Drawing on international literature and key informant interviews we have articulated characteristics of duty of care to reduce linguistic ambiguity, and developed a framework for implementing a duty of care for biodiversity at the regional scale. The framework draws on key elements of the common law 'duty of care', the concepts of 'taking reasonable care' and 'avoiding foreseeable harm', in its logic. Core elements of the framework include desired outcomes for biodiversity, supported by current recommended practices. The focus on outcomes provides opportunities for the development of innovative management practices. The framework incorporates multiple pathways for the redress of non-compliance including tiered negative sanctions, and positive measures to encourage compliance. Importantly, the framework addresses the need for change and adaptation that is a necessary part of biodiversity management.

Towards inclusive occupational therapy: Introducing the CORE approach for inclusive and occupation-focused practice.

PubMed

Pereira, Robert B

2017-12-01

Occupation is a human right and a social determinant of health. It is also taken for granted. Having access to, and participating in, occupation, is intricately linked to positive health and wellbeing. Despite theory and evidence to support the link between occupation, health and wellbeing, occupational therapists can struggle with applying an occupation focus in practice and knowing how to use occupational frameworks to enable occupation. The purpose of this paper is to introduce the Capabilities, Opportunities, Resources and Environments (CORE) approach for inclusive and occupation-focused practice. It provides occupational therapists with a means of operationalising occupational enablement and facilitating social inclusion. The CORE approach is introduced by linking its main ideas to Economist and Nobel Prize Laureate Amartya Sen's capabilities approach, as well as findings from the author's doctoral research into entrenched disadvantage and social inclusion. Practical questions guided by the CORE approach's acronym are given to explore how the approach can be utilised alongside other occupational models and frameworks to encourage strategies for effective enablement through occupation for social inclusion. As experts in enabling occupation, occupational therapists can use the CORE approach to design occupation-focused interventions and promote inclusive occupational therapy. © 2017 Occupational Therapy Australia.

A knowledge translation project on community-centred approaches in public health.

PubMed

Stansfield, J; South, J

2018-03-01

This article examines the development and impact of a national knowledge translation project aimed at improving access to evidence and learning on community-centred approaches for health and wellbeing. Structural changes in the English health system meant that knowledge on community engagement was becoming lost and a fragmented evidence base was seen to impact negatively on policy and practice. A partnership started between Public Health England, NHS England and Leeds Beckett University in 2014 to address these issues. Following a literature review and stakeholder consultation, evidence was published in a national guide to community-centred approaches. This was followed by a programme of work to translate the evidence into national strategy and local practice.The article outlines the key features of the knowledge translation framework developed. Results include positive impacts on local practice and national policy, for example adoption within National Institute for Health and Care Evidence (NICE) guidance and Local Authority public health plans and utilization as a tool for local audit of practice and commissioning. The framework was successful in its non-linear approach to knowledge translation across a range of inter-connected activity, built on national leadership, knowledge brokerage, coalition building and a strong collaboration between research institute and government agency.

How Community Clergy Provide Spiritual Care: Toward a Conceptual Framework for Clergy End-of-Life Education

PubMed Central

LeBaron, Virginia T.; Smith, Patrick T.; Quiñones, Rebecca; Nibecker, Callie; Sanders, Justin J.; Timms, Richard; Shields, Alexandra E.; Balboni, Tracy A.; Balboni, Michael J.

2018-01-01

Context Community-based clergy are highly engaged in helping terminally ill patients address spiritual concerns at the end of life (EOL). Despite playing a central role in EOL care, clergy report feeling ill-equipped to spiritually support patients in this context. Significant gaps exist in understanding how clergy beliefs and practices influence EOL care. Objectives The objective of this study was to propose a conceptual framework to guide EOL educational programming for community-based clergy. Methods This was a qualitative, descriptive study. Clergy from varying spiritual backgrounds, geographical locations in the U.S., and race/ethnicities were recruited and asked about optimal spiritual care provided to patients at the EOL. Interviews were audio taped, transcribed, and analyzed following principles of grounded theory. A final set of themes and subthemes were identified through an iterative process of constant comparison. Participants also completed a survey regarding experiences ministering to the terminally ill. Results A total of 35 clergy participated in 14 individual interviews and two focus groups. Primary themes included Patient Struggles at EOL and Clergy Professional Identity in Ministering to the Terminally Ill. Patient Struggles at EOL focused on existential questions, practical concerns, and difficult emotions. Clergy Professional Identity in Ministering to the Terminally Ill was characterized by descriptions of Who Clergy Are (“Being”), What Clergy Do (“Doing”), and What Clergy Believe (“Believing”). “Being” was reflected primarily by manifestations of presence; “Doing” by subthemes of religious activities, spiritual support, meeting practical needs, and mistakes to avoid; “Believing” by subthemes of having a relationship with God, nurturing virtues, and eternal life. Survey results were congruent with interview and focus group findings. Conclusion A conceptual framework informed by clergy perspectives of optimal spiritual care can guide EOL educational programming for clergy. PMID:26706624

How Community Clergy Provide Spiritual Care: Toward a Conceptual Framework for Clergy End-of-Life Education.

PubMed

LeBaron, Virginia T; Smith, Patrick T; Quiñones, Rebecca; Nibecker, Callie; Sanders, Justin J; Timms, Richard; Shields, Alexandra E; Balboni, Tracy A; Balboni, Michael J

2016-04-01

Community-based clergy are highly engaged in helping terminally ill patients address spiritual concerns at the end of life (EOL). Despite playing a central role in EOL care, clergy report feeling ill-equipped to spiritually support patients in this context. Significant gaps exist in understanding how clergy beliefs and practices influence EOL care. The objective of this study was to propose a conceptual framework to guide EOL educational programming for community-based clergy. This was a qualitative, descriptive study. Clergy from varying spiritual backgrounds, geographical locations in the U.S., and race/ethnicities were recruited and asked about optimal spiritual care provided to patients at the EOL. Interviews were audio taped, transcribed, and analyzed following principles of grounded theory. A final set of themes and subthemes were identified through an iterative process of constant comparison. Participants also completed a survey regarding experiences ministering to the terminally ill. A total of 35 clergy participated in 14 individual interviews and two focus groups. Primary themes included Patient Struggles at EOL and Clergy Professional Identity in Ministering to the Terminally Ill. Patient Struggles at EOL focused on existential questions, practical concerns, and difficult emotions. Clergy Professional Identity in Ministering to the Terminally Ill was characterized by descriptions of Who Clergy Are ("Being"), What Clergy Do ("Doing"), and What Clergy Believe ("Believing"). "Being" was reflected primarily by manifestations of presence; "Doing" by subthemes of religious activities, spiritual support, meeting practical needs, and mistakes to avoid; "Believing" by subthemes of having a relationship with God, nurturing virtues, and eternal life. Survey results were congruent with interview and focus group findings. A conceptual framework informed by clergy perspectives of optimal spiritual care can guide EOL educational programming for clergy. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

A Framework for Guiding Future Citizens to Think Critically about Nature of Science and Socioscientific Issues

ERIC Educational Resources Information Center

Yacoubian, Hagop A.

2015-01-01

In this article, I introduce a framework for guiding future citizens to think critically about nature of science (NOS) and "with" NOS as they engage in socioscientific decision making. The framework, referred to as the critical thinking--nature of science (CT-NOS) framework, explicates and targets both NOS as a learning objective and NOS…

Towards a conceptual framework for preceptorship in the clinical education of undergraduate nursing students.

PubMed

Zilembo, Melanie; Monterosso, Leanne

2008-08-01

A recent study undertaken by the authors (2007) highlighted that undergraduate nursing students were subjected to varying experiences in clinical practice, which were mediated by a number of factors. Mediating factors included continuity of preceptors, student attitudes, the clinical setting environment, student and preceptor expectations of the clinical practice experience and interactions between the student and preceptor. Of note, interactions with preceptors were seen to 'make or break' the practical experience. Therefore, the relationship that is forged between preceptor and student is vital in shaping the student's experience of the clinical area and of the real world of nursing work. Early positive socialisation experiences have been shown to improve retention rates of new nurses (Greene & Puetzer 2002), which are issues of prime concern in an era of worsening nursing shortages at all levels of the profession. A conceptual framework designed to guide preceptorship may help alleviate some of the difficulties experienced by undergraduate nurses in building relationships within the complex interactions of the nursing environment. The framework proposed in this paper offers a conceptual model that links positive preceptor leadership qualities (such as compassion, care and empathy) with student characteristics. This model proposes that synergistic interactions between nursing students and preceptors results in positive implications for the nursing workforce. This framework also has the potential for further development to fill the void created by a lack of conceptual guidance for supervisory interactions within the undergraduate clinical context.

A strategy for translating evidence into policy and practice to close the gap - developing essential service standards for Aboriginal and Torres Strait Islander cardiovascular care.

PubMed

Brown, Alex; O'Shea, Rebekah L; Mott, Kathy; McBride, Katharine F; Lawson, Tony; Jennings, Garry L R

2015-02-01

The development and application of essential standards for cardiovascular care for Aboriginal and Torres Strait Islander people creates a strategic platform on which to systematically close the gap in the health outcomes and life expectancy between Aboriginal and Torres Strait Islander and non-Indigenous people in Australia. We outline six developmental stages that can be used to enhance the effective translation of evidence into practice that reduces life expectancy differentials. Focussing efforts where the biggest gain can be made; considering how to make a policy-relevant difference with an emphasis on translation into policy and practice; establishing a foundation for action by engaging with stakeholders throughout the process; developing a framework to guide action; drafting policy-relevant and framework-appropriate essential service standards; and defining standards that help policy decision makers achieve current priority policy targets. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Measurement and monitoring of safety: impact and challenges of putting a conceptual framework into practice.

PubMed

Chatburn, Eleanor; Macrae, Carl; Carthey, Jane; Vincent, Charles

2018-03-06

The Measurement and Monitoring of Safety Framework provides a conceptual model to guide organisations in assessing safety. The Health Foundation funded a large-scale programme to assess the value and impact of applying the Framework in regional and frontline care settings. We explored the experiences and reflections of key participants in the programme. The study was conducted in the nine healthcare organisations in England and Scotland testing the Framework (three regional improvement bodies, six frontline settings). Post hoc interviews with clinical and managerial staff were analysed using template analysis. Participants reported that the Framework promoted a substantial shift in their thinking about how safety is actively managed in their environment. It provided a common language, facilitated a more inquisitive approach and encouraged a more holistic view of the components of safety. These changes in conceptual understanding, however, did not always translate into broader changes in practice, with many sites only addressing some aspects of the Framework. One of the three regions did embrace the Framework in its entirety and achieved wider impact with a range of interventions. This region had committed leaders who took time to fully understand the concepts, who maintained a flexible approach to exploring the utility of the Framework and who worked with frontline staff to translate the concepts for local settings. The Measuring and Monitoring of Safety Framework has the potential to support a broader and richer approach to organisational safety. Such a conceptually based initiative requires both committed leaders who themselves understand the concepts and more time to establish understanding and aims than might be needed in a standard improvement programme. © 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.

An intervention fidelity framework for technology-based behavioral interventions.

PubMed

Devito Dabbs, Annette; Song, Mi-Kyung; Hawkins, Robert; Aubrecht, Jill; Kovach, Karen; Terhorst, Lauren; Connolly, Mary; McNulty, Mary; Callan, Judith

2011-01-01

Despite the proliferation of health technologies, descriptions of the unique considerations and practical guidance for evaluating the intervention fidelity of technology-based behavioral interventions are lacking. The aims of this study were to (a) discuss how technology-based behavioral interventions challenge conventions about how intervention fidelity is conceptualized and evaluated, (b) propose an intervention fidelity framework that may be more appropriate for technology-based behavioral interventions, and (c) present a plan for operationalizing each concept in the framework using the intervention fidelity monitoring plan for Pocket PATH (Personal Assistant for Tracking Health), a mobile health technology designed to promote self-care behaviors after lung transplantation, as an exemplar. The literature related to intervention fidelity and technology acceptance was used to identify the issues that are unique to the fidelity of technology-based behavioral interventions and thus important to include in a proposed intervention fidelity framework. An intervention fidelity monitoring plan for technology-based behavioral interventions was developed as an example. The intervention fidelity monitoring plan was deemed feasible and practical to implement and showed utility in operationalizing the concepts such as assessing interventionists' delivery and participants' acceptance of the technology-based behavioral intervention. The framework has the potential to guide the development of implementation fidelity monitoring tools for other technology-based behavioral interventions. Further application and testing of this framework will allow for a better understanding of the role that technology acceptance plays in the adoption and enactment of the behaviors that technology-based behavioral interventions are intended to promote.

Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes.

PubMed

Clarinval, Caroline; Biller-Andorno, Nikola

2014-06-23

This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context.

The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework.

PubMed

Rycroft-Malone, Jo; Seers, Kate; Chandler, Jackie; Hawkes, Claire A; Crichton, Nicola; Allen, Claire; Bullock, Ian; Strunin, Leo

2013-03-09

The case has been made for more and better theory-informed process evaluations within trials in an effort to facilitate insightful understandings of how interventions work. In this paper, we provide an explanation of implementation processes from one of the first national implementation research randomized controlled trials with embedded process evaluation conducted within acute care, and a proposed extension to the Promoting Action on Research Implementation in Health Services (PARIHS) framework. The PARIHS framework was prospectively applied to guide decisions about intervention design, data collection, and analysis processes in a trial focussed on reducing peri-operative fasting times. In order to capture a holistic picture of implementation processes, the same data were collected across 19 participating hospitals irrespective of allocation to intervention. This paper reports on findings from data collected from a purposive sample of 151 staff and patients pre- and post-intervention. Data were analysed using content analysis within, and then across data sets. A robust and uncontested evidence base was a necessary, but not sufficient condition for practice change, in that individual staff and patient responses such as caution influenced decision making. The implementation context was challenging, in which individuals and teams were bounded by professional issues, communication challenges, power and a lack of clarity for the authority and responsibility for practice change. Progress was made in sites where processes were aligned with existing initiatives. Additionally, facilitators reported engaging in many intervention implementation activities, some of which result in practice changes, but not significant improvements to outcomes. This study provided an opportunity for reflection on the comprehensiveness of the PARIHS framework. Consistent with the underlying tenant of PARIHS, a multi-faceted and dynamic story of implementation was evident. However, the prominent role that individuals played as part of the interaction between evidence and context is not currently explicit within the framework. We propose that successful implementation of evidence into practice is a planned facilitated process involving an interplay between individuals, evidence, and context to promote evidence-informed practice. This proposal will enhance the potential of the PARIHS framework for explanation, and ensure theoretical development both informs and responds to the evidence base for implementation.

HIV/AIDS, beersellers and critical community health psychology in Cambodia: a case study.

PubMed

Lubek, Ian; Lee, Helen; Kros, Sarath; Wong, Mee Lian; Van Merode, Tiny; Liu, James; McCreanor, Tim; Idema, Roel; Campbell, Catherine

2014-01-01

This case study illustrates a participatory framework for confronting critical community health issues using 'grass-roots' research-guided community-defined interventions. Ongoing work in Cambodia has culturally adapted research, theory and practice for particular, local health-promotion responses to HIV/AIDS, alcohol abuse and other challenges in the community of Siem Reap. For resource-poor communities in Cambodia, we recycle such 'older' concepts as 'empowerment' and 'action research'. We re-imagine community health psychology, when confronted with 'critical', life-and-death issues, as adjusting its research and practices to local, particular ontological and epistemological urgencies of trauma, morbidity and mortality.

A practical guide to density matrix embedding theory in quantum chemistry

DOE PAGES

Wouters, Sebastian; Jimenez-Hoyos, Carlos A.; Sun, Qiming; ...

2016-05-09

Density matrix embedding theory (DMET) (Knizia, G.; Chan, G. K.-L. Phys. Rev. Lett. 2012, 109, 186404) provides a theoretical framework to treat finite fragments in the presence of a surrounding molecular or bulk environment, even when there is significant correlation or entanglement between the two. In this work, we give a practically oriented and explicit description of the numerical and theoretical formulation of DMET. Here, we also describe in detail how to perform self-consistent DMET optimizations. We explore different embedding strategies with and without a self-consistency condition in hydrogen rings, beryllium rings, and a sample SN2 reaction.

Multiple case studies of STEM teachers' orientations to science teaching through engineering design

NASA Astrophysics Data System (ADS)

Rupp, Madeline

The following master's thesis is composed of two manuscripts describing STEM teachers' orientations to science teaching through engineering within the context of the Science Learning through Engineering Design (SLED) partnership. The framework guiding both studies was science teaching orientations, a component of pedagogical content knowledge. Data were collected via semi-structured interviews, multi-day classroom observations, pre- and post-observation interviews, implementation plans, and written reflections. Data sources were analyzed to generate two orientations to science teaching through engineering design for each participant. The first manuscript illustrates a single case study conducted with a sixth grade STEM teacher. Results of this study revealed a detailed picture of the teacher's goals, practices, assessments, and general views when teaching science through engineering design. Common themes across the teacher's instruction were used to characterize her orientations to science teaching through engineering design. Overall, the teacher's orientations showed a shift in her practice from didactic to student-centered methods of teaching as a result of integrating engineering design-based curriculum. The second manuscript describes a comparative case study of two sixth grade SLED participants. Results of this study revealed more complex and diverse relationships between the teachers' orientations to teaching science through engineering design and their instruction. Participants' orientations served as filters for instruction, guided by their divergent purposes for science teaching. Furthermore, their orientations and resulting implementation were developed from knowledge gained in teacher education, implying that teacher educators and researchers can use this framework to learn more about how teachers' knowledge is used to integrate engineering and science practices in the K-12 classroom.

Organizational Context Matters: A Research Toolkit for Conducting Standardized Case Studies of Integrated Care Initiatives

PubMed Central

Grudniewicz, Agnes; Gray, Carolyn Steele; Wodchis, Walter P.; Carswell, Peter; Baker, G. Ross

2017-01-01

Introduction: The variable success of integrated care initiatives has led experts to recommend tailoring design and implementation to the organizational context. Yet, organizational contexts are rarely described, understood, or measured with sufficient depth and breadth in empirical studies or in practice. We thus lack knowledge of when and specifically how organizational contexts matter. To facilitate the accumulation of evidence, we developed a research toolkit for conducting case studies using standardized measures of the (inter-)organizational context for integrating care. Theory and Methods: We used a multi-method approach to develop the research toolkit: (1) development and validation of the Context and Capabilities for Integrating Care (CCIC) Framework, (2) identification, assessment, and selection of survey instruments, (3) development of document review methods, (4) development of interview guide resources, and (5) pilot testing of the document review guidelines, consolidated survey, and interview guide. Results: The toolkit provides a framework and measurement tools that examine 18 organizational and inter-organizational factors that affect the implementation and success of integrated care initiatives. Discussion and Conclusion: The toolkit can be used to characterize and compare organizational contexts across cases and enable comparison of results across studies. This information can enhance our understanding of the influence of organizational contexts, support the transfer of best practices, and help explain why some integrated care initiatives succeed and some fail. PMID:28970750

The leadership continuum: a framework for organizational and individual assessment relative to the advancement of women physicians and scientists.

PubMed

Morahan, Page S; Rosen, Sally E; Richman, Rosalyn C; Gleason, Katharine A

2011-03-01

In the United States, women have attained near gender equity at the entry stages in academic medicine; however, progress has been much slower at senior leadership levels. The paucity of women leaders inhibits the ability of academic medicine to adequately meet the needs of an increasingly diverse body of students, faculty, staff, and patients. Research indicates that until a critical mass of women with sustained success as leaders is achieved, it is unlikely that this deficit will be corrected. To promote the attainment of a critical mass of women leaders, the authors integrate two approaches to advancing women--the concept of a leadership continuum and a framework of practical approaches for moving toward gender equity at all ranks. An institutional guide is presented that can be used to promote dialogue about gender equity, noting areas of success and opportunities for additional improvement as well as an assessment of progress. A corresponding checklist has been developed that women faculty can use as a reflection guide for their career planning and to assess their position and progress along the leadership continuum. Proactive, ongoing use of these frameworks can promote reflective dialogue and provide direction and accountability for institutions working to advance women into leadership positions.

Using an interdisciplinary approach to identify factors that affect clinicians' compliance with evidence-based guidelines.

PubMed

Gurses, Ayse P; Marsteller, Jill A; Ozok, A Ant; Xiao, Yan; Owens, Sharon; Pronovost, Peter J

2010-08-01

Our objective was to identify factors that affect clinicians' compliance with the evidence-based guidelines using an interdisciplinary approach and develop a conceptual framework that can provide a comprehensive and practical guide for designing effective interventions. A literature review and a brainstorming session with 11 researchers from a variety of scientific disciplines were used to identify theoretical and conceptual models describing clinicians' guideline compliance. MEDLINE, EMBASE, CINAHL, and the bibliographies of the papers identified were used as data sources for identifying the relevant theoretical and conceptual models. Thirteen different models that originated from various disciplines including medicine, rural sociology, psychology, human factors and systems engineering, organizational management, marketing, and health education were identified. Four main categories of factors that affect compliance emerged from our analysis: clinician characteristics, guideline characteristics, system characteristics, and implementation characteristics. Based on these findings, we developed an interdisciplinary conceptual framework that specifies the expected interrelationships among these four categories of factors and their impact on clinicians' compliance. An interdisciplinary approach is needed to improve clinicians' compliance with evidence-based guidelines. The conceptual framework from this research can provide a comprehensive and systematic guide to identify barriers to guideline compliance and design effective interventions to improve patient safety.

Developing an organizing framework to guide nursing research in the Children’s Oncology Group (COG)

PubMed Central

Kelly, Katherine Patterson; Hooke, Mary C.; Ruccione, Kathleen; Landier, Wendy; Haase, Joan

2014-01-01

Objectives To describe the development and application of an organizing research framework to guide COG Nursing research. Data Sources Research articles, reports and meeting minutes Conclusion An organizing research framework helps to outline research focus and articulate the scientific knowledge being produced by nurses in the pediatric cooperative group. Implication for Nursing Practice The use of an organizing framework for COG nursing research can facilitate clinical nurses’ understanding of how children and families sustain or regain optimal health when faced with a pediatric cancer diagnosis through interventions designed to promote individual and family resilience. The Children’s Oncology Group (COG) is the sole National Cancer Institute (NCI)-supported cooperative pediatric oncology clinical trials group and the largest organization in the world devoted exclusively to pediatric cancer research. It was founded in 2000 following the merger of the four legacy NCI-supported pediatric clinical trials groups (Children’s Cancer Group [CCG], Pediatric Oncology Group [POG], National Wilms Tumor Study Group, and Intergroup Rhabdomyosarcoma Study Group). The COG currently has over 200 member institutions across North America, Australia, New Zealand and Europe and a multidisciplinary membership of over 8,000 pediatric, radiation, and surgical oncologists, nurses, clinical research associates, pharmacists, behavioral scientists, pathologists, laboratory scientists, patient/parent advocates and other pediatric cancer specialists. The COG Nursing Discipline was formed from the merger of the legacy CCG and POG Nursing Committees, and current membership exceeds 2000 registered nurses. The discipline has a well-developed infrastructure that promotes nursing involvement throughout all levels of the organization, including representation on disease, protocol, scientific, executive and other administrative committees (e.g., nominating committee, data safety monitoring boards). COG nurses facilitate delivery of protocol-based treatments for children enrolled on COG protocols, and Nursing Discipline initiatives support nursing research, professional and patient/family education, evidence-based practice, and a patient-reported outcomes resource center. The research agenda of the Nursing Discipline is enacted through a well-established nursing scholar program. PMID:24559776

Tried and True: Self-Regulation Theory as a Guiding Framework for Teaching Parents Diabetes Education Using Human Patient Simulation

PubMed Central

Sullivan-Bolyai, Susan; Johnson, Kimberly; Cullen, Karen; Hamm, Terry; Bisordi, Jean; Blaney, Kathleen; Maguire, Laura; Melkus, Gail

2014-01-01

Parents become emotionally upset when learning their child has Type 1 Diabetes, yet they are expected to quickly learn functional diabetes management. The purpose of this article is to describe the application of Self-Regulation theory to guide a family-focused education intervention using human patient simulation to enhance the initial education of parents in diabetes management. A brief description is provided of the intervention framed by Self-Regulation theory. Based on the literature, we describe the educational vignettes used based on Self-Regulation in the randomized controlled trial entitled Parent Education Through Simulation-Diabetes. Examples of theory-in-practice will be illustrated by parental learning responses to this alternative educational innovation. PMID:25365286

Adopting the sensemaking perspective for chronic disease self-management.

PubMed

Mamykina, Lena; Smaldone, Arlene M; Bakken, Suzanne R

2015-08-01

Self-monitoring is an integral component of many chronic diseases; however few theoretical frameworks address how individuals understand self-monitoring data and use it to guide self-management. To articulate a theoretical framework of sensemaking in diabetes self-management that integrates existing scholarship with empirical data. The proposed framework is grounded in theories of sensemaking adopted from organizational behavior, education, and human-computer interaction. To empirically validate the framework the researchers reviewed and analyzed reports on qualitative studies of diabetes self-management practices published in peer-reviewed journals from 2000 to 2015. The proposed framework distinguishes between sensemaking and habitual modes of self-management and identifies three essential sensemaking activities: perception of new information related to health and wellness, development of inferences that inform selection of actions, and carrying out daily activities in response to new information. The analysis of qualitative findings from 50 published reports provided ample empirical evidence for the proposed framework; however, it also identified a number of barriers to engaging in sensemaking in diabetes self-management. The proposed framework suggests new directions for research in diabetes self-management and for design of new informatics interventions for data-driven self-management. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Improving Quality and Reducing Waste in Allied Health Workplace Education Programs: A Pragmatic Operational Education Framework Approach.

PubMed

Golder, Janet; Farlie, Melanie K; Sevenhuysen, Samantha

2016-01-01

Efficient utilisation of education resources is required for the delivery of effective learning opportunities for allied health professionals. This study aimed to develop an education framework to support delivery of high-quality education within existing education resources. This study was conducted in a large metropolitan health service. Homogenous and purposive sampling methods were utilised in Phase 1 (n=43) and 2 (n=14) consultation stages. Participants included 25 allied health professionals, 22 managers, 1 educator, and 3 executives. Field notes taken during 43 semi-structured interviews and 4 focus groups were member-checked, and semantic thematic analysis methods were utilised. Framework design was informed by existing published framework development guides. The framework model contains governance, planning, delivery, and evaluation and research elements and identifies performance indicators, practice examples, and support tools for a range of stakeholders. Themes integrated into framework content include improving quality of education and training provided and delivery efficiency, greater understanding of education role requirements, and workforce support for education-specific knowledge and skill development. This framework supports efficient delivery of allied health workforce education and training to the highest standard, whilst pragmatically considering current allied health education workforce demands.

Wavelet neural networks: a practical guide.

PubMed

Alexandridis, Antonios K; Zapranis, Achilleas D

2013-06-01

Wavelet networks (WNs) are a new class of networks which have been used with great success in a wide range of applications. However a general accepted framework for applying WNs is missing from the literature. In this study, we present a complete statistical model identification framework in order to apply WNs in various applications. The following subjects were thoroughly examined: the structure of a WN, training methods, initialization algorithms, variable significance and variable selection algorithms, model selection methods and finally methods to construct confidence and prediction intervals. In addition the complexity of each algorithm is discussed. Our proposed framework was tested in two simulated cases, in one chaotic time series described by the Mackey-Glass equation and in three real datasets described by daily temperatures in Berlin, daily wind speeds in New York and breast cancer classification. Our results have shown that the proposed algorithms produce stable and robust results indicating that our proposed framework can be applied in various applications. Copyright © 2013 Elsevier Ltd. All rights reserved.

Siblings of Children with Autism: the Siblings Embedded Systems Framework.

PubMed

Kovshoff, Hanna; Cebula, Katie; Tsai, Hsiao-Wei Joy; Hastings, Richard P

2017-01-01

A range of interacting factors/mechanisms at the individual, family, and wider systems levels influences siblings living in families where one sibling has autism. We introduce the Sibling Embedded Systems Framework which aims to contextualise siblings' experience and characterise the multiple and interacting factors influencing family and, in particular, sibling outcomes. Findings from studies that have reported outcomes for siblings of children with autism are equivocal, ranging from negative impact, no difference, to positive experience. This is likely due to the complex nature of understanding the sibling experience. We focus on particular elements of the framework and review recent novel literature to help guide future directions for research and practice including the influence of culture, methodological considerations, and wider participatory methods. The Siblings Embedded System Framework can be used to understand interactive factors that affect sibling adjustment and to develop clinically, educationally and empirically based work that aims to enhance and support sibling adjustment, relationships, and well-being in families of children with autism.

International migration and dietary change in Mexican women from a social practice framework.

PubMed

Bojorquez, Ietza; Rosales, Cecilia; Angulo, Alexandra; de Zapien, Jill; Denman, Catalina; Madanat, Hala

2018-06-01

Migration from lower- and middle-income to high-income countries is associated with dietary change, and especially with the adoption of a modern, less healthy diet. In this article we analyze the dietary changes experienced by Mexican migrants, employing as a theoretical framework the concept of social practice. According to this framework, practices integrate material elements, meanings and competences that provide their conditions of possibility. Practices are shared by members of social groups, and interact with other competing or reinforcing practices. Between 2014 and 2015, we conducted semi-structured interviews with 27 women, international return migrants living in Tijuana, Mexico. The interview guide asked about history of migration and dietary change. We found three main areas of dietary change: from subsistence farming to ready meals, abundance vs. restriction, and adoption of new food items. The first one was associated with changes in food procurement and female work: when moving from rural to urban areas, participants substituted self-produced for purchased food; and as migrant women joined the labor force, consumption of ready meals increased. The second was the result of changes in income: participants of lower socioeconomic position modified the logic of food acquisition from restriction to abundance and back, depending on the available resources. The third change was relatively minor, with occasional consumption of new dishes or food items, and was associated with exposure to different cuisines and with learning how to cook them. Public health efforts to improve the migrants' diets should take into account the constitutive elements of dietary practices, instead of isolating individuals from their social contexts. Copyright © 2018 Elsevier Ltd. All rights reserved.

Clinical Practice Models for the Use of E-Mental Health Resources in Primary Health Care by Health Professionals and Peer Workers: A Conceptual Framework

PubMed Central

Griffiths, Kathleen M; Cunningham, John A; Bennett, Kylie; Bennett, Anthony

2015-01-01

Background Research into e-mental health technologies has developed rapidly in the last 15 years. Applications such as Internet-delivered cognitive behavioral therapy interventions have accumulated considerable evidence of efficacy and some evidence of effectiveness. These programs have achieved similar outcomes to face-to-face therapy, while requiring much less clinician time. There is now burgeoning interest in integrating e-mental health resources with the broader mental health delivery system, particularly in primary care. The Australian government has supported the development and deployment of e-mental health resources, including websites that provide information, peer-to-peer support, automated self-help, and guided interventions. An ambitious national project has been commissioned to promote key resources to clinicians, to provide training in their use, and to evaluate the impact of promotion and training upon clinical practice. Previous initiatives have trained clinicians to use a single e-mental health program or a suite of related programs. In contrast, the current initiative will support community-based service providers to access a diverse array of resources developed and provided by many different groups. Objective The objective of this paper was to develop a conceptual framework to support the use of e-mental health resources in routine primary health care. In particular, models of clinical practice are required to guide the use of the resources by diverse service providers and to inform professional training, promotional, and evaluation activities. Methods Information about service providers’ use of e-mental health resources was synthesized from a nonsystematic overview of published literature and the authors’ experience of training primary care service providers. Results Five emerging clinical practice models are proposed: (1) promotion; (2) case management; (3) coaching; (4) symptom-focused treatment; and (5) comprehensive therapy. We also consider the service provider skills required for each model and the ways that e-mental health resources might be used by general practice doctors and nurses, pharmacists, psychologists, social workers, occupational therapists, counselors, and peer workers Conclusions The models proposed in the current paper provide a conceptual framework for policy-makers, researchers and clinicians interested in integrating e-mental health resources into primary care. Research is needed to establish the safety and effectiveness of the models in routine care and the best ways to support their implementation. PMID:26543912

Best practice principles for community-based obesity prevention: development, content and application.

PubMed

King, L; Gill, T; Allender, S; Swinburn, B

2011-05-01

Best practice in obesity prevention has generally been defined in terms of 'what' needs to be done while neglecting 'how'. A multifaceted definition of best practice, which combines available evidence on what actions to take, with an established process for interpreting this information in a specific community context, provides a more appropriate basis for defining the principles of best practice in community-based obesity prevention. Based on analysis of a range of literature, a preliminary set of principles was drafted and progressively revised through further analyses of published literature and a series of consultations. The framework for best practice principles comprises: community engagement, programme design and planning, evaluation, implementation and sustainability, and governance. Specific principles were formulated within this framework. While many principles were generic, distinctive features of obesity prevention were also covered. The engagement of end-users influenced the design of the formatting of the outputs, which represent three levels of knowledge transfer: detailed evidence summaries, guiding questions for programme planners and a briefer set of questions for simpler communication purposes. The best practice principles provide a valuable mechanism for the translation of existing evidence and experience into the decision-making processes for planning, implementing and evaluating the complex community-based interventions needed for successful obesity prevention. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

Narratives about illness and medication: a neglected theme/new methodology within pharmacy practice research. Part II: medication narratives in practice.

PubMed

Ryan, Kath; Bissell, Paul; Morecroft, Charles

2007-08-01

Part 2 of this paper aims to provide a methodological framework for the study of medication narratives, including a semi-structured interview guide and suggested method of analysis, in an attempt to aid the development of narrative scholarship within pharmacy practice research. Examples of medication narratives are provided to illustrate their diversity and usefulness. The framework is derived from the work of other researchers and adapted for our specific purpose. It comes from social psychology, narrative psychology, narrative anthropology, sociology and critical theory and fits within the social constructionist paradigm. The suggested methods of analysis could broadly be described as narrative analysis and discourse analysis. Examples of medication narratives are chosen from a variety of sources and brief interpretations are presented by way of illustration. Narrative analysis, a neglected area of research in pharmacy practice, has the potential to provide new understanding about how people relate to their medicines, how pharmacists are engaged in producing narratives and the importance of narrative in the education of students. IMPACT OF THE ARTICLE: This article aims to have the following impact on pharmacy practice research: Innovative approach to researching and conceptualising the use of medicines. Introduction of a new theoretical perspective and methodology. Incorporation of social science research methods into pharmacy practice research. Development of narrative scholarship within pharmacy.

Medicine as a Community of Practice: Implications for Medical Education.

PubMed

Cruess, Richard L; Cruess, Sylvia R; Steinert, Yvonne

2018-02-01

The presence of a variety of independent learning theories makes it difficult for medical educators to construct a comprehensive theoretical framework for medical education, resulting in numerous and often unrelated curricular, instructional, and assessment practices. Linked with an understanding of identity formation, the concept of communities of practice could provide such a framework, emphasizing the social nature of learning. Individuals wish to join the community, moving from legitimate peripheral to full participation, acquiring the identity of community members and accepting the community's norms.Having communities of practice as the theoretical basis of medical education does not diminish the value of other learning theories. Communities of practice can serve as the foundational theory, and other theories can provide a theoretical basis for the multiple educational activities that take place within the community, thus helping create an integrated theoretical approach.Communities of practice can guide the development of interventions to make medical education more effective and can help both learners and educators better cope with medical education's complexity. An initial step is to acknowledge the potential of communities of practice as the foundational theory. Educational initiatives that could result from this approach include adding communities of practice to the cognitive base; actively engaging students in joining the community; creating a welcoming community; expanding the emphasis on explicitly addressing role modeling, mentoring, experiential learning, and reflection; providing faculty development to support the program; and recognizing the necessity to chart progress toward membership in the community.

Technosciences in Academia: Rethinking a Conceptual Framework for Bioinformatics Undergraduate Curricula

NASA Astrophysics Data System (ADS)

Symeonidis, Iphigenia Sofia

This paper aims to elucidate guiding concepts for the design of powerful undergraduate bioinformatics degrees which will lead to a conceptual framework for the curriculum. "Powerful" here should be understood as having truly bioinformatics objectives rather than enrichment of existing computer science or life science degrees on which bioinformatics degrees are often based. As such, the conceptual framework will be one which aims to demonstrate intellectual honesty in regards to the field of bioinformatics. A synthesis/conceptual analysis approach was followed as elaborated by Hurd (1983). The approach takes into account the following: bioinfonnatics educational needs and goals as expressed by different authorities, five undergraduate bioinformatics degrees case-studies, educational implications of bioinformatics as a technoscience and approaches to curriculum design promoting interdisciplinarity and integration. Given these considerations, guiding concepts emerged and a conceptual framework was elaborated. The practice of bioinformatics was given a closer look, which led to defining tool-integration skills and tool-thinking capacity as crucial areas of the bioinformatics activities spectrum. It was argued, finally, that a process-based curriculum as a variation of a concept-based curriculum (where the concepts are processes) might be more conducive to the teaching of bioinformatics given a foundational first year of integrated science education as envisioned by Bialek and Botstein (2004). Furthermore, the curriculum design needs to define new avenues of communication and learning which bypass the traditional disciplinary barriers of academic settings as undertaken by Tador and Tidmor (2005) for graduate studies.

Interpersonal Privacy Management in Distributed Collaboration: Situational Characteristics and Interpretive Influences

NASA Astrophysics Data System (ADS)

Patil, Sameer; Kobsa, Alfred; John, Ajita; Brotman, Lynne S.; Seligmann, Doree

To understand how collaborators reconcile the often conflicting needs of awareness and privacy, we studied a large software development project in a multinational corporation involving individuals at sites in the U.S. and India. We present a theoretical framework describing privacy management practices and their determinants that emerged from field visits, interviews, and questionnaire responses. The framework identifies five relevant situational characteristics: issue(s) under consideration, physical place(s) involved in interaction(s), temporal aspects, affordances and limitations presented by technology, and nature of relationships among parties. Each actor, in turn, interprets the situation based on several simultaneous influences: self, team, work site, organization, and cultural environment. This interpretation guides privacy management action(s). Past actions form a feedback loop refining and/or reinforcing the interpretive influences. The framework suggests that effective support for privacy management will require that designers follow a socio-technical approach incorporating a wider scope of situational and interpretive differences.

Breaking up is hard to do: why disinvestment in medical technology is harder than investment.

PubMed

Haas, Marion; Hall, Jane; Viney, Rosalie; Gallego, Gisselle

2012-05-01

Healthcare technology is a two-edged sword - it offers new and better treatment to a wider range of people and, at the same time, is a major driver of increasing costs in health systems. Many countries have developed sophisticated systems of health technology assessment (HTA) to inform decisions about new investments in new healthcare interventions. In this paper, we question whether HTA is also the appropriate framework for guiding or informing disinvestment decisions. In exploring the issues related to disinvestment, we first discuss the various HTA frameworks which have been suggested as a means of encouraging or facilitating disinvestment. We then describe available means of identifying candidates for disinvestment (comparative effectiveness research, clinical practice variations, clinical practice guidelines) and for implementing the disinvestment process (program budgeting and marginal analysis (PBMA) and related techniques). In considering the possible reasons for the lack of progress in active disinvestment, we suggest that HTA is not the right framework as disinvestment involves a different decision making context. The key to disinvestment is not just what to stop doing but how to make it happen - that is, decision makers need to be aware of funding disincentives.

Using a partnership between academic faculty and a physical therapist liaison to develop a framework for an evidence-based journal club: a discussion.

PubMed

Austin, Tricia M; Richter, Randy R; Frese, Tracy

2009-12-01

Evidence-based practice (EBP) in rehabilitation is increasingly recognized as important. Despite the importance of EBP, physical therapists' knowledge of EBP varies. Journal clubs have been used to educate clinicians about EBP. This discussion paper describes the partnership between academic faculty members and a physical therapist at a community hospital, and the process used to develop a framework to implement an evidence-based journal club. The partnership blended the expertise of academic faculty members and a physical therapist with knowledge of EBP who served as the liaison between members of the partnership team and the clinicians at the community hospital. The three-step framework developed enabled the clinicians to learn about critical appraisal, participate in guided practice of critical appraisal with the liaison, and lead critical appraisal of a paper with the assistance of the liaison as needed. This process could be easily replicated by other partnerships between academic faculty members and clinicians. Developing partnerships like the one described enables academicians to provide service to the profession, may enhance physical therapists' knowledge of the principles of EBP and may encourage EBP.

A Conceptual Framework for the Evaluation of Emergency Risk Communications

PubMed Central

Lin, Leesa; Gamhewage, Gaya M.

2017-01-01

Objectives. To articulate a conceptual framework in support of evaluation activities in emergency risk communications (ERC). Methods. The framework proposed is based on a systematic review of the scientific literature (2001–2016) combined with data derived from a series of semistructured interviews with experts and practitioners in ERC, and it is designed to support local, national, and international public health organizations in implementing evaluation studies in ERC. Results. We identified a list of ERC outcomes from the full-text review of 152 articles and categorized these into 3 groups, depending upon the level at which the outcome was measured: (1) information environment, (2) population, and (3) public health system. We analyzed interviewees’ data from 18 interviews to identify practices and processes related to the effectiveness of ERC and included these as key structural components and processes in the developed evaluation framework. Conclusions. Researchers and public health practitioners interested in the evaluation of ERC can use the conceptual framework described in this article to guide the development of evaluation studies and methods for assessing communication outcomes related to public health emergencies. PMID:28892436

A Conceptual Framework for the Evaluation of Emergency Risk Communications.

PubMed

Savoia, Elena; Lin, Leesa; Gamhewage, Gaya M

2017-09-01

To articulate a conceptual framework in support of evaluation activities in emergency risk communications (ERC). The framework proposed is based on a systematic review of the scientific literature (2001-2016) combined with data derived from a series of semistructured interviews with experts and practitioners in ERC, and it is designed to support local, national, and international public health organizations in implementing evaluation studies in ERC. We identified a list of ERC outcomes from the full-text review of 152 articles and categorized these into 3 groups, depending upon the level at which the outcome was measured: (1) information environment, (2) population, and (3) public health system. We analyzed interviewees' data from 18 interviews to identify practices and processes related to the effectiveness of ERC and included these as key structural components and processes in the developed evaluation framework. Researchers and public health practitioners interested in the evaluation of ERC can use the conceptual framework described in this article to guide the development of evaluation studies and methods for assessing communication outcomes related to public health emergencies.

Empowerment: A Framework to Develop Advocacy in African American Grandmothers Providing Care for Their Grandchildren

PubMed Central

Carr, Gloria F.

2011-01-01

Purpose. Based on a review of the literature, this paper presents a unique and innovative model that offers an empowerment framework, which may be used to develop advocacy in African American (AA) grandmother caregivers. This proposed framework centers on education as a catalyst to the empowerment process in these grandmothers. Application of this model has potential to guide the practice of healthcare providers as they assist these caregivers in managing their own lives. Methodology. Various empowerment definitions and research were used to develop this empowerment framework. Discussion. This framework offers an empowerment education program for AA grandmothers providing care for their grandchildren on topics that they feel are necessary to appropriately care for themselves and their grandchildren. Outcomes of this empowerment education are to develop skills within these grandmothers so that they will be able to advocate for themselves, their grandchildren, and others within their communities. This education will ultimately produce skillful AA grandmothers who will develop abilities to empower themselves and other AA grandmothers who are in similar circumstances. PMID:21994894

A practical guide for the fabrication of microfluidic devices using glass and silicon

PubMed Central

Iliescu, Ciprian; Taylor, Hayden; Avram, Marioara; Miao, Jianmin; Franssila, Sami

2012-01-01

This paper describes the main protocols that are used for fabricating microfluidic devices from glass and silicon. Methods for micropatterning glass and silicon are surveyed, and their limitations are discussed. Bonding methods that can be used for joining these materials are summarized and key process parameters are indicated. The paper also outlines techniques for forming electrical connections between microfluidic devices and external circuits. A framework is proposed for the synthesis of a complete glass/silicon device fabrication flow. PMID:22662101

Middle School Science Teachers' Confidence and Pedagogical Practice of New Literacies

NASA Astrophysics Data System (ADS)

Hsu, Hui-Yin; Wang, Shiang-Kwei; Runco, Lisa

2013-06-01

Due to the rapid advancements of information and communication technologies (ICTs), educational researchers argue that multimodal and new literacies should become common practices in schools. As new ICTs emerge and evolve, students need the new literacies skills and practices to successfully participate fully in the civic life of a global community. Are teachers prepared to integrate ICTs in the classroom to develop students' new literacies skills? The purpose of this study is to suggest a new literacies framework that guides ICTs integration and supports scientific inquiry, as well as investigate middle school teachers' confidence to practice new literacies in science classrooms. The study adopted mixed-methodology design, surveyed 32 middle school science teachers' ICTs and new literacies skills, and randomly observed 15 teachers' new literacies practices in the classrooms. The results revealed that even though teachers have high confidence in using ICTs, the meaningful technology integration and new literacies practices were scarcely observed in their classroom practices.

Knowledge integration: conceptualizing communications in cancer control systems.

PubMed

Best, Allan; Hiatt, Robert A; Norman, Cameron D

2008-06-01

This paper was prepared by the National Cancer Institute of Canada (NCIC) Working Group on Translational Research and Knowledge Transfer. The goal was to nurture common ground upon which to build a platform for translating what we know about cancer into what we do in practice and policy. Methods included expert panels, literature review, and concept mapping, to develop a framework that built on earlier cancer control conceptualizations of communications that have guided researchers and end users. The concept of 'knowledge integration' is used to describe the resulting refinement and the nature of evidence necessary for decision-making to at the systems level. Current evidence for knowledge integration in cancer control is presented across the levels of individual, organizational and systems level interventions and across basic, clinical and population science knowledge bases. A systems-oriented approach to integrating evidence into action assists organizations to conduct research and policy and practice. Practitioners can use this framework to understand the challenges of implementing and evaluating cancer control strategies.

Astrobiological complexity with probabilistic cellular automata.

PubMed

Vukotić, Branislav; Ćirković, Milan M

2012-08-01

The search for extraterrestrial life and intelligence constitutes one of the major endeavors in science, but has yet been quantitatively modeled only rarely and in a cursory and superficial fashion. We argue that probabilistic cellular automata (PCA) represent the best quantitative framework for modeling the astrobiological history of the Milky Way and its Galactic Habitable Zone. The relevant astrobiological parameters are to be modeled as the elements of the input probability matrix for the PCA kernel. With the underlying simplicity of the cellular automata constructs, this approach enables a quick analysis of large and ambiguous space of the input parameters. We perform a simple clustering analysis of typical astrobiological histories with "Copernican" choice of input parameters and discuss the relevant boundary conditions of practical importance for planning and guiding empirical astrobiological and SETI projects. In addition to showing how the present framework is adaptable to more complex situations and updated observational databases from current and near-future space missions, we demonstrate how numerical results could offer a cautious rationale for continuation of practical SETI searches.

Introductory guide to integrated ecological framework.

DOT National Transportation Integrated Search

2014-10-01

This guide introduces the Integrated Ecological Framework (IEF) to Texas Department of Transportation : (TxDOT) engineers and planners. IEF is step-by-step approach to integrating ecological and : transportation planning with the goal of avoiding imp...

Implementation guide for monitoring work zone safety and mobility impacts

DOT National Transportation Integrated Search

2009-01-01

This implementation guide describes the conceptual framework, data requirements, and computational procedures for determining the safety and mobility impacts of work zones in Texas. Researchers designed the framework and procedures to assist district...

Men's Intentions to Engage in Behaviors to Protect Against Human Papillomavirus (HPV): Testing the Risk Perception Attitude Framework.

PubMed

Pask, Elizabeth B; Rawlins, Sarah T

2016-01-01

Guided by the risk perception attitude framework (RPA), this study examined men's perceptions of risk and efficacy beliefs as predictors of their intentions to engage in self-protective behaviors. The results of multiple regression analyses did not provide support for the RPA prediction that efficacy beliefs moderate the relationship between risk perceptions and self-protective behavior. However, the results provide support for the main effects of risk and efficacy on all four behavioral intentions examined (i.e., Internet information seeking, communication with a health provider, HPV vaccination, and condom use). Risk and efficacy were positively related to (and significant individual predictors of) all four behavioral intentions. Scholarly and practical implications of these findings are discussed.

Development and Use of Engineering Standards for Computational Fluid Dynamics for Complex Aerospace Systems

NASA Technical Reports Server (NTRS)

Lee, Hyung B.; Ghia, Urmila; Bayyuk, Sami; Oberkampf, William L.; Roy, Christopher J.; Benek, John A.; Rumsey, Christopher L.; Powers, Joseph M.; Bush, Robert H.; Mani, Mortaza

2016-01-01

Computational fluid dynamics (CFD) and other advanced modeling and simulation (M&S) methods are increasingly relied on for predictive performance, reliability and safety of engineering systems. Analysts, designers, decision makers, and project managers, who must depend on simulation, need practical techniques and methods for assessing simulation credibility. The AIAA Guide for Verification and Validation of Computational Fluid Dynamics Simulations (AIAA G-077-1998 (2002)), originally published in 1998, was the first engineering standards document available to the engineering community for verification and validation (V&V) of simulations. Much progress has been made in these areas since 1998. The AIAA Committee on Standards for CFD is currently updating this Guide to incorporate in it the important developments that have taken place in V&V concepts, methods, and practices, particularly with regard to the broader context of predictive capability and uncertainty quantification (UQ) methods and approaches. This paper will provide an overview of the changes and extensions currently underway to update the AIAA Guide. Specifically, a framework for predictive capability will be described for incorporating a wide range of error and uncertainty sources identified during the modeling, verification, and validation processes, with the goal of estimating the total prediction uncertainty of the simulation. The Guide's goal is to provide a foundation for understanding and addressing major issues and concepts in predictive CFD. However, this Guide will not recommend specific approaches in these areas as the field is rapidly evolving. It is hoped that the guidelines provided in this paper, and explained in more detail in the Guide, will aid in the research, development, and use of CFD in engineering decision-making.

Ethical Issues in Public Health Practice in Michigan

PubMed Central

Gollust, Sarah E.; Goold, Susan D.; Jacobson, Peter D.

2009-01-01

Objectives. We sought to ascertain the types of ethical challenges public health practitioners face in practice and to identify approaches used to resolve such challenges. Methods. We conducted 45 semistructured interviews with public health practitioners across a range of occupations (e.g., health officers, medical directors, sanitarians, nurses) at 13 health departments in Michigan. Results. Through qualitative analysis, we identified 5 broad categories of ethical issues common across occupations and locations: (1) determining appropriate use of public health authority, (2) making decisions related to resource allocation, (3) negotiating political interference in public health practice, (4) ensuring standards of quality of care, and (5) questioning the role or scope of public health. Participants cited a variety of values guiding their decision-making that did not coalesce around core values often associated with public health, such as social justice or utilitarianism. Public health practitioners relied on consultations with colleagues to resolve challenges, infrequently using frameworks for decision-making. Conclusions. Public health practitioners showed a nuanced understanding of ethical issues and navigated ethical challenges with minimal formal assistance. Decision-making guides that are empirically informed and tailored for practitioners might have some value. PMID:19059850

Development of a conceptual policy framework for advanced practice nursing: an ethnographic study.

PubMed

Schober, Madrean M; Gerrish, Kate; McDonnell, Ann

2016-06-01

To report on a study examining policy development for advanced practice nursing from intent of policy to realization in practice. Inclusion of advanced practice nursing roles in the healthcare workforce is a worldwide trend. Optimal advanced nursing practice requires supportive policies. Little is known about how policy is developed and implemented. Ethnography using an instrumental case study approach was selected to give an in-depth understanding of the experiences of one country (Singapore) to contribute to insight into development elsewhere. The four-phase study was conducted from 2008-2012 and included document analysis (n = 47), interviews with key policy decision makers (n = 12), interviews with nursing managers and medical directors (n = 11), interviews and participant observation with advanced practice nurses (n = 15). Key policymakers in positions of authority were able to promote policy development. However, this was characterized by lack of strategic planning for implementation. A vague understanding by nursing managers and medical directors of policies, the role and its position in the healthcare workforce led to indecision and uncertainty in execution. Advanced practice nurses developed their role based on theory acquired in their academic programme but were unsure what role to assume in practice. Lack of clear guidelines led to unanticipated difficulties for institutions and healthcare systems. Strategic planning could facilitate integration of advanced practice nurses into the healthcare workforce. A Conceptual Policy Framework is proposed as a guide for a coordinated approach to policy development and implementation for advanced practice nursing. © 2016 John Wiley & Sons Ltd.

Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes

PubMed Central

Clarinval, Caroline; Biller-Andorno, Nikola

2014-01-01

Introduction: This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Methods: Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. Discussion: These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. Conclusion: This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context. PMID:24987575

Development of an Interdisciplinary Team Communication Framework and Quality Metrics for Home-Based Medical Care Practices.

PubMed

Fathi, Roya; Sheehan, Orla C; Garrigues, Sarah K; Saliba, Debra; Leff, Bruce; Ritchie, Christine S

2016-08-01

The unique needs of homebound adults receiving home-based medical care (HBMC) (ie, home-based primary care and home-based palliative care services) are ideally provided by interdisciplinary care teams (IDTs) that provide coordinated care. The composition of team members from an array of organizations and the unique dimension of providing care in the home present specific challenges to timely access and communication of patient care information. The objective of this work was to develop a conceptual framework and corresponding quality indicators (QIs) that assess how IDT members for HBMC practices access and communicate key patient information with each other. A systematic review of peer-reviewed and gray literature was performed to inform a framework for care coordination in the home and the development of candidate QIs to assess processes by which all IDT members optimally access and use patient information. A technical expert panel (TEP) participated in a modified Delphi process to assess the validity and feasibility of each QI and to identify which would be most suitable for testing in the field. Thematic analysis of literature revealed 4 process themes for how HBMC practices might engage in high-quality care coordination: using electronic medical records, conducting interdisciplinary team meetings, sharing standardized patient assessments, and communicating via secure e-messaging. Based on these themes, 9 candidate QIs were developed to reflect these processes. Three candidate QIs were assessed by the TEP as valid and feasible to measure in an HBMC practice setting. These indicators focused on use of IDT meetings, standardized patient assessments, and secure e-messaging. Translating the complex issue of care coordination into QIs will improve care delivered to vulnerable home-limited adults who receive HBMC. Guided by the literature, we developed a framework to reflect optimal care coordination in the home setting and identified 3 candidate QIs to field-test in HBMC practices. Published by Elsevier Inc.

Understanding practice: the factors that influence management of mild traumatic brain injury in the emergency department--a qualitative study using the Theoretical Domains Framework.

PubMed

Tavender, Emma J; Bosch, Marije; Gruen, Russell L; Green, Sally E; Knott, Jonathan; Francis, Jill J; Michie, Susan; O'Connor, Denise A

2014-01-13

Mild traumatic brain injury is a frequent cause of presentation to emergency departments. Despite the availability of clinical practice guidelines in this area, there is variation in practice. One of the aims of the Neurotrauma Evidence Translation program is to develop and evaluate a targeted, theory- and evidence-informed intervention to improve the management of mild traumatic brain injury in Australian emergency departments. This study is the first step in the intervention development process and uses the Theoretical Domains Framework to explore the factors perceived to influence the uptake of four key evidence-based recommended practices for managing mild traumatic brain injury. Semi-structured interviews were conducted with emergency staff in the Australian state of Victoria. The interview guide was developed using the Theoretical Domains Framework to explore current practice and to identify the factors perceived to influence practice. Two researchers coded the interview transcripts using thematic content analysis. A total of 42 participants (9 Directors, 20 doctors and 13 nurses) were interviewed over a seven-month period. The results suggested that (i) the prospective assessment of post-traumatic amnesia was influenced by: knowledge; beliefs about consequences; environmental context and resources; skills; social/professional role and identity; and beliefs about capabilities; (ii) the use of guideline-developed criteria or decision rules to inform the appropriate use of a CT scan was influenced by: knowledge; beliefs about consequences; environmental context and resources; memory, attention and decision processes; beliefs about capabilities; social influences; skills and behavioral regulation; (iii) providing verbal and written patient information on discharge was influenced by: beliefs about consequences; environmental context and resources; memory, attention and decision processes; social/professional role and identity; and knowledge; (iv) the practice of providing brief, routine follow-up on discharge was influenced by: environmental context and resources; social/professional role and identity; knowledge; beliefs about consequences; and motivation and goals. Using the Theoretical Domains Framework, factors thought to influence the management of mild traumatic brain injury in the emergency department were identified. These factors present theoretically based targets for a future intervention.

Tailoring International Pressure Ulcer Prevention Guidelines for Nigeria: A Knowledge Translation Study Protocol.

PubMed

Ilesanmi, Rose Ekama; Gillespie, Brigid M; Adejumo, Prisca Olabisi; Chaboyer, Wendy

2015-07-28

The 2014 International Pressure Ulcer Prevention (PUP) Clinical Practice Guidelines (CPG) provides the most current evidence based strategies to prevent Pressure Ulcer (PU). The evidence upon which these guidelines have been developed has predominantly been generated from research conducted in developed countries. Some of these guidelines may not be feasible in developing countries due to structural and resource issues; therefore there is a need to adapt these guidelines to the context thus making it culturally acceptable. To present a protocol detailing the tailoring of international PUPCPG into a care bundle for the Nigerian context. Guided by the Knowledge to Action (KTA) framework, a two phased study will be undertaken. In Phase 1, the Delphi technique with stakeholder leaders will be used to review the current PUPCPG, identifying core strategies that are feasible to be adopted in Nigeria. These core strategies will become components of a PUP care bundle. In Phase 2, key stakeholder interviews will be used to identify the barriers, facilitators and potential implementation strategies to promote uptake of the PUP care bundle. A PUP care bundle, with three to eight components is expected to be developed from Phase 1. Implementation strategies to promote adoption of the PUP care bundle into clinical practice in selected Nigerian hospitals, is expected to result from Phase 2. Engagement of key stakeholders and consumers in the project should promote successful implementation and translate into better patient care. Using KTA, a knowledge translation framework, to guide the implementation of PUPCPG will enhance the likelihood of successful adoption in clinical practice. In implementing a PUP care bundle, developing countries face a number of challenges such as the feasibility of its components and the required resources.

Criticising with Foucault: Towards a Guiding Framework for Socio-Political Studies in Mathematics Education

ERIC Educational Resources Information Center

Kollosche, David

2016-01-01

Socio-political studies in mathematics education often touch complex fields of interaction between education, mathematics and the political. In this paper I present a Foucault-based framework for socio-political studies in mathematics education which may guide research in that area. In order to show the potential of such a framework, I discuss the…

Guiding the Design of Lessons by Using the MAPLET Framework: Matching Aims, Processes, Learner Expertise and Technologies

ERIC Educational Resources Information Center

Ifenthaler, Dirk; Gosper, Maree

2014-01-01

This paper introduces the MAPLET framework that was developed to map and link teaching aims, learning processes, learner expertise and technologies. An experimental study with 65 participants is reported to test the effectiveness of the framework as a guide to the design of lessons embedded within larger units of study. The findings indicate the…

Developing Theory to Guide Building Practitioners’ Capacity to Implement Evidence-Based Interventions

PubMed Central

Leeman, Jennifer; Calancie, Larissa; Kegler, Michelle C.; Escoffery, Cam T.; Herrmann, Alison K.; Thatcher, Esther; Hartman, Marieke A.; Fernandez, Maria

2017-01-01

Public health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and other capacity-building strategies can be effective at increasing EBI adoption and implementation. However, little is known about how to design capacity-building strategies or tailor them to differences in capacity required across varying EBIs and practice contexts. To address this need, we conducted a scoping study of frameworks and theories detailing variations in EBIs or practice contexts and how to tailor capacity-building to address those variations. Using an iterative process, we consolidated constructs and propositions across 24 frameworks and developed a beginning theory to describe salient variations in EBIs (complexity and uncertainty) and practice contexts (decision-making structure, general capacity to innovate, resource and values fit with EBI, and unity vs. polarization of stakeholder support). The theory also includes propositions for tailoring capacity-building strategies to address salient variations. To have wide-reaching and lasting impact, the dissemination of EBIs needs to be coupled with strategies that build practitioners’ capacity to adopt and implement a variety of EBIs across diverse practice contexts. PMID:26500080

Benefits and risks of adopting the global code of practice for recreational fisheries

USGS Publications Warehouse

Arlinghaus, Robert; Beard, T. Douglas; Cooke, Steven J.; Cowx, Ian G.

2012-01-01

Recreational fishing constitutes the dominant or sole use of many fish stocks, particularly in freshwater ecosystems in Western industrialized countries. However, despite their social and economic importance, recreational fisheries are generally guided by local or regional norms and standards, with few comprehensive policy and development frameworks existing across jurisdictions. We argue that adoption of a recently developed Global Code of Practice (CoP) for Recreational Fisheries can provide benefits for moving recreational fisheries toward sustainability on a global scale. The CoP is a voluntary document, specifically framed toward recreational fisheries practices and issues, thereby complementing and extending the United Nation's Code of Conduct for Responsible Fisheries by the Food and Agricultural Organization. The CoP for Recreational Fisheries describes the minimum standards of environmentally friendly, ethically appropriate, and—depending on local situations—socially acceptable recreational fishing and its management. Although many, if not all, of the provisions presented in the CoP are already addressed through national fisheries legislation and state-based fisheries management regulations in North America, adopting a common framework for best practices in recreational fisheries across multiple jurisdictions would further promote their long-term viability in the face of interjurisdictional angler movements and some expanding threats to the activity related to shifting sociopolitical norms.

Applying organizational science to health care: a framework for collaborative practice.

PubMed

Dow, Alan W; DiazGranados, Deborah; Mazmanian, Paul E; Retchin, Sheldon M

2013-07-01

Developing interprofessional education (IPE) curricula that improve collaborative practice across professions has proven challenging. A theoretical basis for understanding collaborative practice in health care settings is needed to guide the education and evaluation of health professions trainees and practitioners and support the team-based delivery of care. IPE should incorporate theory-driven, evidence-based methods and build competency toward effective collaboration.In this article, the authors review several concepts from the organizational science literature and propose using these as a framework for understanding how health care teams function. Specifically, they outline the team process model of action and planning phases in collaborative work; discuss leadership and followership, including how locus (a leader's integration into a team's usual work) and formality (a leader's responsibility conferred by the traditional hierarchy) affect team functions; and describe dynamic delegation, an approach to conceptualizing escalation and delegation within health care teams. For each concept, they identify competencies for knowledge, attitudes, and behaviors to aid in the development of innovative curricula to improve collaborative practice. They suggest that gaining an understanding of these principles will prepare health care trainees, whether team leaders or members, to analyze team performance, adapt behaviors that improve collaboration, and create team-based health care delivery processes that lead to improved clinical outcomes.

Developing Theory to Guide Building Practitioners' Capacity to Implement Evidence-Based Interventions.

PubMed

Leeman, Jennifer; Calancie, Larissa; Kegler, Michelle C; Escoffery, Cam T; Herrmann, Alison K; Thatcher, Esther; Hartman, Marieke A; Fernandez, Maria E

2017-02-01

Public health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and other capacity-building strategies can be effective at increasing EBI adoption and implementation. However, little is known about how to design capacity-building strategies or tailor them to differences in capacity required across varying EBIs and practice contexts. To address this need, we conducted a scoping study of frameworks and theories detailing variations in EBIs or practice contexts and how to tailor capacity-building to address those variations. Using an iterative process, we consolidated constructs and propositions across 24 frameworks and developed a beginning theory to describe salient variations in EBIs (complexity and uncertainty) and practice contexts (decision-making structure, general capacity to innovate, resource and values fit with EBI, and unity vs. polarization of stakeholder support). The theory also includes propositions for tailoring capacity-building strategies to address salient variations. To have wide-reaching and lasting impact, the dissemination of EBIs needs to be coupled with strategies that build practitioners' capacity to adopt and implement a variety of EBIs across diverse practice contexts.

Applying Organizational Science to Health Care: A Framework for Collaborative Practice

PubMed Central

Dow, Alan W.; DiazGranados, Deborah; Mazmanian, Paul E.; Retchin, Sheldon M.

2013-01-01

Developing interprofessional education (IPE) curricula that improve collaborative practice across professions has proven challenging. A theoretical basis for understanding collaborative practice in health care settings is needed to guide the education and evaluation of health professions trainees and practitioners and support the team-based delivery of care. IPE should incorporate theory-driven, evidence-based methods and build competency toward effective collaboration. In this article, the authors review several concepts from the organizational science literature and propose using these as a framework for understanding how health care teams function. Specifically, they outline the team process model of action and planning phases in collaborative work; discuss leadership and followership, including how locus (a leader’s integration into a team’s usual work) and formality (a leader’s responsibility conferred by the traditional hierarchy) affect team functions; and describe dynamic delegation, an approach to conceptualizing escalation and delegation within health care teams. For each concept, they identify competencies for knowledge, attitudes, and behaviors to aid in the development of innovative curricula to improve collaborative practice. They suggest that gaining an understanding of these principles will prepare health care trainees, whether team leaders or members, to analyze team performance, adapt behaviors that improve collaboration, and create team-based health care delivery processes that lead to improved clinical outcomes. PMID:23702530

Validity of peer grading using Calibrated Peer Review in a guided-inquiry, conceptual physics course

NASA Astrophysics Data System (ADS)

Price, Edward; Goldberg, Fred; Robinson, Steve; McKean, Michael

2016-12-01

Constructing and evaluating explanations are important science practices, but in large classes it can be difficult to effectively engage students in these practices and provide feedback. Peer review and grading are scalable instructional approaches that address these concerns, but which raise questions about the validity of the peer grading process. Calibrated Peer Review (CPR) is a web-based system that scaffolds peer evaluation through a "calibration" process where students evaluate sample responses and receive feedback on their evaluations before evaluating their peers. Guided by an activity theory framework, we developed, implemented, and evaluated CPR-based tasks in guided-inquiry, conceptual physics courses for future teachers and general education students. The tasks were developed through iterative testing and revision. Effective tasks had specific and directed prompts and evaluation instructions. Using these tasks, over 350 students at three universities constructed explanations or analyzed physical phenomena, and evaluated their peers' work. By independently assessing students' responses, we evaluated the CPR calibration process and compared students' peer reviews with expert evaluations. On the tasks analyzed, peer scores were equivalent to our independent evaluations. On a written explanation item included on the final exam, students in the courses using CPR outperformed students in similar courses using traditional writing assignments without a peer evaluation element. Our research demonstrates that CPR can be an effective way to explicitly include the science practices of constructing and evaluating explanations into large classes without placing a significant burden on the instructor.

Evidence-Based mHealth Chronic Disease Mobile App Intervention Design: Development of a Framework.

PubMed

Wilhide Iii, Calvin C; Peeples, Malinda M; Anthony Kouyaté, Robin C

2016-02-16

Mobile technology offers new capabilities that can help to drive important aspects of chronic disease management at both an individual and population level, including the ability to deliver real-time interventions that can be connected to a health care team. A framework that supports both development and evaluation is needed to understand the aspects of mHealth that work for specific diseases, populations, and in the achievement of specific outcomes in real-world settings. This framework should incorporate design structure and process, which are important to translate clinical and behavioral evidence, user interface, experience design and technical capabilities into scalable, replicable, and evidence-based mobile health (mHealth) solutions to drive outcomes. The purpose of this paper is to discuss the identification and development of an app intervention design framework, and its subsequent refinement through development of various types of mHealth apps for chronic disease. The process of developing the framework was conducted between June 2012 and June 2014. Informed by clinical guidelines, standards of care, clinical practice recommendations, evidence-based research, best practices, and translated by subject matter experts, a framework for mobile app design was developed and the refinement of the framework across seven chronic disease states and three different product types is described. The result was the development of the Chronic Disease mHealth App Intervention Design Framework. This framework allowed for the integration of clinical and behavioral evidence for intervention and feature design. The application to different diseases and implementation models guided the design of mHealth solutions for varying levels of chronic disease management. The framework and its design elements enable replicable product development for mHealth apps and may provide a foundation for the digital health industry to systematically expand mobile health interventions and validate their effectiveness across multiple implementation settings and chronic diseases.

Evidence-Based mHealth Chronic Disease Mobile App Intervention Design: Development of a Framework

PubMed Central

Peeples, Malinda M; Anthony Kouyaté, Robin C

2016-01-01

Background Mobile technology offers new capabilities that can help to drive important aspects of chronic disease management at both an individual and population level, including the ability to deliver real-time interventions that can be connected to a health care team. A framework that supports both development and evaluation is needed to understand the aspects of mHealth that work for specific diseases, populations, and in the achievement of specific outcomes in real-world settings. This framework should incorporate design structure and process, which are important to translate clinical and behavioral evidence, user interface, experience design and technical capabilities into scalable, replicable, and evidence-based mobile health (mHealth) solutions to drive outcomes. Objective The purpose of this paper is to discuss the identification and development of an app intervention design framework, and its subsequent refinement through development of various types of mHealth apps for chronic disease. Methods The process of developing the framework was conducted between June 2012 and June 2014. Informed by clinical guidelines, standards of care, clinical practice recommendations, evidence-based research, best practices, and translated by subject matter experts, a framework for mobile app design was developed and the refinement of the framework across seven chronic disease states and three different product types is described. Results The result was the development of the Chronic Disease mHealth App Intervention Design Framework. This framework allowed for the integration of clinical and behavioral evidence for intervention and feature design. The application to different diseases and implementation models guided the design of mHealth solutions for varying levels of chronic disease management. Conclusions The framework and its design elements enable replicable product development for mHealth apps and may provide a foundation for the digital health industry to systematically expand mobile health interventions and validate their effectiveness across multiple implementation settings and chronic diseases. PMID:26883135

P3: a practice focused learning environment

NASA Astrophysics Data System (ADS)

Irving, Paul W.; Obsniuk, Michael J.; Caballero, Marcos D.

2017-09-01

There has been an increased focus on the integration of practices into physics curricula, with a particular emphasis on integrating computation into the undergraduate curriculum of scientists and engineers. In this paper, we present a university-level, introductory physics course for science and engineering majors at Michigan State University called P3 (projects and practices in physics) that is centred around providing introductory physics students with the opportunity to appropriate various science and engineering practices. The P3 design integrates computation with analytical problem solving and is built upon a curriculum foundation of problem-based learning, the principles of constructive alignment and the theoretical framework of community of practice. The design includes an innovative approach to computational physics instruction, instructional scaffolds, and a unique approach to assessment that enables instructors to guide students in the development of the practices of a physicist. We present the very positive student related outcomes of the design gathered via attitudinal and conceptual inventories and research interviews of students’ reflecting on their experiences in the P3 classroom.

Building a Knowledge to Action Program in Stroke Rehabilitation.

PubMed

Janzen, Shannon; McIntyre, Amanda; Richardson, Marina; Britt, Eileen; Teasell, Robert

2016-09-01

The knowledge to action (KTA) process proposed by Graham et al (2006) is a framework to facilitate the development and application of research evidence into clinical practice. The KTA process consists of the knowledge creation cycle and the action cycle. The Evidence Based Review of Stroke Rehabilitation is a foundational part of the knowledge creation cycle and has helped guide the development of best practice recommendations in stroke. The Rehabilitation Knowledge to Action Project is an audit-feedback process for the clinical implementation of best practice guidelines, which follows the action cycle. The objective of this review was to: (1) contextualize the Evidence Based Review of Stroke Rehabilitation and Rehabilitation Knowledge to Action Project within the KTA model and (2) show how this process led to improved evidence-based practice in stroke rehabilitation. Through this process, a single centre was able to change clinical practice and promote a culture that supports the use of evidence-based practices in stroke rehabilitation.

Meanings of Falls and Prevention of Falls According to Rehabilitation Nurses: A Qualitative Descriptive Study.

PubMed

Bok, Amy; Pierce, Linda L; Gies, Cheryl; Steiner, Victoria

2016-01-01

Guided by Friedemann's theoretical framework, this survey explored the meaning of a fall of an institutionalized older adult or fall prevention to rehabilitation registered nurses and whether the experience changed the nurse's practice. Qualitative, descriptive survey. A convenience sample of 742 rehabilitation nurses was asked to describe these experiences and the impact on their practice. Themes discovered related to the meaning of a fall include negative feelings (incongruence) and positive feelings (congruence). Themes related to the meaning of preventing a fall include positive feelings (congruence). Practice change themes emerged from both the experience of a fall and fall prevention. Practice change themes were drawn to Friedemann's (1995) process dimensions. Nurses' experiences and meanings of falls uncovered negative and positive feelings about these falls. New findings of this study were the positive feelings expressed by nurses, when there was no injury or when a fall was prevented. © 2015 Association of Rehabilitation Nurses.

Voyages Guided by the Skies: Ancient Concepts of Exploring and Domesticating Time and Space across Cultures

NASA Astrophysics Data System (ADS)

Rappenglück, Michael A.

2015-05-01

Persistence and change are necessary for the stability and development of both the human individual and the human society, since the beginnings of human history. Man needs a static framework which, related to his self-awareness, defines a topocentric system of perception, evaluation, order, and meaning. He also requires a dynamic impetus, which allows exceeding the limits of special world views, shifting of perspectives and transformations of individual as well as social approaches to life. Travelling especially helped to broaden man's horizon and mind. Across cultures voyages guided by the skies are linked with practical concepts of exploring and domesticating time and space, but also figuratively with the life's journey and with other worlds, being expressed by mythic, ritual and later scientific language.

An eHealth Capabilities Framework for Graduates and Health Professionals: Mixed-Methods Study.

PubMed

Brunner, Melissa; McGregor, Deborah; Keep, Melanie; Janssen, Anna; Spallek, Heiko; Quinn, Deleana; Jones, Aaron; Tseris, Emma; Yeung, Wilson; Togher, Leanne; Solman, Annette; Shaw, Tim

2018-05-15

The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development programs. ©Melissa Brunner, Deborah McGregor, Melanie Keep, Anna Janssen, Heiko Spallek, Deleana Quinn, Aaron Jones, Emma Tseris, Wilson Yeung, Leanne Togher, Annette Solman, Tim Shaw. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 15.05.2018.

Evidence in the learning organization

PubMed Central

Crites, Gerald E; McNamara, Megan C; Akl, Elie A; Richardson, W Scott; Umscheid, Craig A; Nishikawa, James

2009-01-01

Background Organizational leaders in business and medicine have been experiencing a similar dilemma: how to ensure that their organizational members are adopting work innovations in a timely fashion. Organizational leaders in healthcare have attempted to resolve this dilemma by offering specific solutions, such as evidence-based medicine (EBM), but organizations are still not systematically adopting evidence-based practice innovations as rapidly as expected by policy-makers (the knowing-doing gap problem). Some business leaders have adopted a systems-based perspective, called the learning organization (LO), to address a similar dilemma. Three years ago, the Society of General Internal Medicine's Evidence-based Medicine Task Force began an inquiry to integrate the EBM and LO concepts into one model to address the knowing-doing gap problem. Methods During the model development process, the authors searched several databases for relevant LO frameworks and their related concepts by using a broad search strategy. To identify the key LO frameworks and consolidate them into one model, the authors used consensus-based decision-making and a narrative thematic synthesis guided by several qualitative criteria. The authors subjected the model to external, independent review and improved upon its design with this feedback. Results The authors found seven LO frameworks particularly relevant to evidence-based practice innovations in organizations. The authors describe their interpretations of these frameworks for healthcare organizations, the process they used to integrate the LO frameworks with EBM principles, and the resulting Evidence in the Learning Organization (ELO) model. They also provide a health organization scenario to illustrate ELO concepts in application. Conclusion The authors intend, by sharing the LO frameworks and the ELO model, to help organizations identify their capacities to learn and share knowledge about evidence-based practice innovations. The ELO model will need further validation and improvement through its use in organizational settings and applied health services research. PMID:19323819

A Framework to Assess Where and How Children Connect to Nature.

PubMed

Giusti, Matteo; Svane, Ulrika; Raymond, Christopher M; Beery, Thomas H

2017-01-01

The design of the green infrastructure in urban areas largely ignores how people's relation to nature, or human-nature connection (HNC), can be nurtured. One practical reason for this is the lack of a framework to guide the assessment of where people, and more importantly children, experience significant nature situations and establish nature routines. This paper develops such a framework. We employed a mixed-method approach to understand what qualities of nature situations connect children to nature (RQ1), what constitutes children's HNC (RQ2), and how significant nature situations and children's HNC relate to each other over time (RQ3). We first interviewed professionals in the field of connecting children to nature ( N = 26), performed inductive thematic analysis of these interviews, and then further examined the inductive findings by surveying specialists ( N = 275). We identified 16 qualities of significant nature situations (e.g., "awe," "engagement of senses," "involvement of mentors") and 10 abilities that constitute children's HNC (e.g., "feeling comfortable in natural spaces," "feeling attached to natural spaces," "taking care of nature"). We elaborated three principles to answer our research questions: (1) significant nature situations are various and with differing consequences for children's HNC; (2) children's HNC is a complex embodied ability; (3) children's HNC progresses over time through diverse nature routines. Together, these findings form the Assessment framework for Children's Human Nature Situations (ACHUNAS). ACHUNAS is a comprehensive framework that outlines what to quantify or qualify when assessing "child-nature connecting" environments. It guides the assessment of where and how children connect to nature, stimulating both the design of nature-connecting human habitats as well as pedagogical approaches to HNC.

A Framework to Assess Where and How Children Connect to Nature

PubMed Central

Giusti, Matteo; Svane, Ulrika; Raymond, Christopher M.; Beery, Thomas H.

2018-01-01

The design of the green infrastructure in urban areas largely ignores how people's relation to nature, or human-nature connection (HNC), can be nurtured. One practical reason for this is the lack of a framework to guide the assessment of where people, and more importantly children, experience significant nature situations and establish nature routines. This paper develops such a framework. We employed a mixed-method approach to understand what qualities of nature situations connect children to nature (RQ1), what constitutes children's HNC (RQ2), and how significant nature situations and children's HNC relate to each other over time (RQ3). We first interviewed professionals in the field of connecting children to nature (N = 26), performed inductive thematic analysis of these interviews, and then further examined the inductive findings by surveying specialists (N = 275). We identified 16 qualities of significant nature situations (e.g., “awe,” “engagement of senses,” “involvement of mentors”) and 10 abilities that constitute children's HNC (e.g., “feeling comfortable in natural spaces,” “feeling attached to natural spaces,” “taking care of nature”). We elaborated three principles to answer our research questions: (1) significant nature situations are various and with differing consequences for children's HNC; (2) children's HNC is a complex embodied ability; (3) children's HNC progresses over time through diverse nature routines. Together, these findings form the Assessment framework for Children's Human Nature Situations (ACHUNAS). ACHUNAS is a comprehensive framework that outlines what to quantify or qualify when assessing “child-nature connecting” environments. It guides the assessment of where and how children connect to nature, stimulating both the design of nature-connecting human habitats as well as pedagogical approaches to HNC. PMID:29354088

Framework for Nutrition Education: A Guide for Elementary Teachers, Grades K-6. Bulletin 1976, No. 5.

ERIC Educational Resources Information Center

Alabama State Dept. of Education, Montgomery. Div. of Administration and Finance.

The purpose of this guide is to provide a framework on which elementary school teachers (K through 6) can build a nutrition program that can be implemented into the existing curriculum. Founded on the importance of early and sound education for instilling good nutrition habits, the guide is divided into three grade levels: K through 2 (Discovering…

Case study of evaluations that go beyond clinical outcomes to assess quality improvement diabetes programmes using the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE).

PubMed

Paquette-Warren, Jann; Harris, Stewart B; Naqshbandi Hayward, Mariam; Tompkins, Jordan W

2016-10-01

Investments in efforts to reduce the burden of diabetes on patients and health care are critical; however, more evaluation is needed to provide evidence that informs and supports future policies and programmes. The newly developed Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE) incorporates the theoretical concepts needed to facilitate the capture of critical information to guide investments, policy and programmatic decision making. The aim of the study is to assess the applicability and value of DEFINE in comprehensive real-world evaluation. Using a critical and positivist approach, this intrinsic and collective case study retrospectively examines two naturalistic evaluations to demonstrate how DEFINE could be used when conducting real-world comprehensive evaluations in health care settings. The variability between the cases and the evaluation designs are described and aligned to the DEFINE goals, steps and sub-steps. The majority of the theoretical steps of DEFINE were exemplified in both cases, although limited for knowledge translation efforts. Application of DEFINE to evaluate diverse programmes that target various chronic diseases is needed to further test the inclusivity and built-in flexibility of DEFINE and its role in encouraging more comprehensive knowledge translation. This case study shows how DEFINE could be used to structure or guide comprehensive evaluations of programmes and initiatives implemented in health care settings and support scale-up of successful innovations. Future use of the framework will continue to strengthen its value in guiding programme evaluation and informing health policy to reduce the burden of diabetes and other chronic diseases. © 2016 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

How can clinical ethics guide the management of comorbidities in the child with Rett syndrome?

PubMed

Downs, Jenny; Forbes, David; Johnson, Michael; Leonard, Helen

2016-08-01

Rett syndrome is a rare disorder caused by a mutation in the MECP2 gene. Those affected generally have severe functional impairments, and medical comorbidities such as scoliosis and poor growth are common. There is a paucity of information on the natural history of many rare disorders and an even greater deficit of evidence to guide best practice. The population-based and longitudinal Australian Rett Syndrome Database established in 1993 has supported investigations of the natural history of Rett syndrome and effectiveness of treatments. This paper reviews the disorder Rett syndrome and evidence for the management of scoliosis and poor growth within a clinical ethics framework. Compared with conservative management, we have shown that spinal fusion is associated with reduced mortality and better respiratory health. We have also shown that gastrostomy insertion is associated with subsequent weight gain. Family counselling for both procedures necessarily must include family perspectives and careful clinical attention to their needs and wishes. Vignettes describing family decision-making and experiences are presented to illustrate the principals of beneficence and autonomy in determining the best interests of the child and family. A blend of evidence-based practice with a strong clinical ethics framework has capacity to build existing strengths in families and reduce the negative impacts of disability and in so doing, optimise the health and wellbeing of those with Rett syndrome. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Development of Intervention Materials for Individuals With Limited English Proficiency

PubMed Central

Tu, Shin-Ping; Yip, Mei-Po; Chun, Alan; Choe, John; Bastani, Roshan; Taylor, Vicky

2013-01-01

Background According to recent US census data, 52 million people reported speaking a language other than English at home, and almost 45% of this population reported limited English proficiency (LEP). Colorectal cancer (CRC) ranks among the top 3 most common cancers for several Asian ethnic groups, yet screening remains underutilized by Asian Americans. Objectives This article describes the development of culturally and linguistically appropriate intervention materials for individuals with LEP. We discuss lessons learned from this research and implications for the translation of research into practice. Methods The Health Behavior Framework served as the conceptual model for this study, and qualitative findings guided the development of our intervention materials (a video and pamphlet). To recommend Western preventive behaviors, the research team bridged the gap between Western and Chinese values and beliefs by devoting particular attention to: (1) the target population's sociocul-tural values and health beliefs; and (2) unique linguistic features of the Chinese language. Results Key lessons learned from this study include the importance of: (1) a conceptual framework to guide intervention development; (2) incorporating sociocultural values and health beliefs into the intervention; (3) addressing and capitalizing on complex linguistics issues; (4) using qualitative methodology in cross-cultural research; and (5) contributions from a multicultural and multilingual research team. Other lessons relate to the translation of research findings into practice. We surmise that lessons learned from this study may be pertinent to the promotion of CRC screening among other patient groups with LEP and applicable to additional cancer screening tests. PMID:18725834

Teacher Perspectives of Interdisciplinary Coteaching Relationships in a Clinical Skills Course: A Relational Coordination Theory Analysis.

PubMed

Daniel, Michelle M; Ross, Paula; Stalmeijer, Renée E; de Grave, Willem

2018-01-01

Phenomenon: Interdisciplinary coteaching has become a popular pedagogic model in medical education, yet there is insufficient research to guide effective practices in this context. Coteaching relationships are not always effective, which has the potential to affect the student experience. The purpose of this study was to explore interdisciplinary coteaching relationships between a physician (MD) and social behavioral scientist (SBS) in an undergraduate clinical skills course. We aimed to gain an in-depth understanding of what teachers perceive as influencing the quality of relationships to begin to construct a framework for collaborative teaching in medical education. A qualitative study was conducted consisting of 12 semistructured interviews (6 MD and 6 SBS) and 2 monodisciplinary focus groups. Sampling was purposive and aimed at maximal variation from among 64 possible faculty. The data were analyzed using the constant comparative method to develop a grounded theory. Five major themes resulted from the analysis that outline a framework for interdisciplinary coteaching: respect, shared goals, shared knowledge and understanding, communication, and complementary pairings. Insights: The first 4 themes align with elements of relational coordination theory, an organizational theory of collaborative practice that describes how work roles interact. The complementary pairings extend this theory from work roles to individuals, with unique identities and personal beliefs and values about teaching. Prior studies on coteaching have not provided a clear linkage to theory. The conceptual framework helps suggest future directions for coteaching research and has practical implications for administrative practices and faculty development. These findings contribute to the sparse research in medical education on interdisciplinary coteaching relationships.

Adverse Childhood Experiences among a Community of Resilient Centenarians and Seniors: Implications for a Chronic Disease Prevention Framework.

PubMed

Spencer-Hwang, Rhonda; Torres, Xochitl; Valladares, Johanny; Pasco-Rubio, Marco; Dougherty, Molly; Kim, Wonha

2018-03-11

Research has linked adverse childhood experiences (ACEs) with chronic disease in adults and diminished life span. Adverse biological embedding of ACEs potentially occurs through inflammatory mechanisms; inflammatory marker alterations are identified as candidate biomarkers for mediating health consequences. Lifestyle practices of residents of California's Loma Linda Blue Zone, one of five worldwide longevity hotspots, may provide insight into inflammation remediation and chronic disease prevention. Little research has been done on centenarians' early-life experiences or on ACEs in a longevity community. To interview centenarians and seniors in this region regarding their childhood experiences to inform chronic disease prevention frameworks. Qualitative study of Loma Linda Blue Zone community members. Childhood exposures and practices were assessed using focus groups and semistructured key informant interviews, with open-ended questions on general hardships and ACEs and supplemented with lifestyle and resiliency factor questions. Data were audiorecorded and transcribed. Integrative grounded theory methods guided coding and theming. Exposure to ACEs and practice of resiliency factors. Participants (7 centenarians and 29 seniors) reported exposure to multiple ACEs (domains: Economic deprivation, family dysfunction, and community violence). Community members reported practicing resiliency factors, each with anti-inflammatory properties suggesting mitigation of ACE-related toxic stress. This is one of the first studies of its kind to identify a community of resilient members despite their tremendous burden of ACEs. Embedding the identified resiliency factors into chronic disease prevention frameworks has potential for mitigating systemic inflammation, alleviating chronic disease burden, and promoting a culture of health.

Adverse Childhood Experiences among a Community of Resilient Centenarians and Seniors: Implications for a Chronic Disease Prevention Framework

PubMed Central

Spencer-Hwang, Rhonda; Torres, Xochitl; Valladares, Johanny; Pasco-Rubio, Marco; Dougherty, Molly; Kim, Wonha

2018-01-01

Context Research has linked adverse childhood experiences (ACEs) with chronic disease in adults and diminished life span. Adverse biological embedding of ACEs potentially occurs through inflammatory mechanisms; inflammatory marker alterations are identified as candidate biomarkers for mediating health consequences. Lifestyle practices of residents of California’s Loma Linda Blue Zone, one of five worldwide longevity hotspots, may provide insight into inflammation remediation and chronic disease prevention. Little research has been done on centenarians’ early-life experiences or on ACEs in a longevity community. Objective To interview centenarians and seniors in this region regarding their childhood experiences to inform chronic disease prevention frameworks. Design Qualitative study of Loma Linda Blue Zone community members. Childhood exposures and practices were assessed using focus groups and semistructured key informant interviews, with open-ended questions on general hardships and ACEs and supplemented with lifestyle and resiliency factor questions. Data were audiorecorded and transcribed. Integrative grounded theory methods guided coding and theming. Main Outcome Measures Exposure to ACEs and practice of resiliency factors. Results Participants (7 centenarians and 29 seniors) reported exposure to multiple ACEs (domains: Economic deprivation, family dysfunction, and community violence). Community members reported practicing resiliency factors, each with anti-inflammatory properties suggesting mitigation of ACE-related toxic stress. Conclusion This is one of the first studies of its kind to identify a community of resilient members despite their tremendous burden of ACEs. Embedding the identified resiliency factors into chronic disease prevention frameworks has potential for mitigating systemic inflammation, alleviating chronic disease burden, and promoting a culture of health. PMID:29702049

Striving for safety: communicating and deciding in sociotechnical systems

PubMed Central

Flach, John M.; Carroll, John S.; Dainoff, Marvin J.; Hamilton, W. Ian

2015-01-01

How do communications and decisions impact the safety of sociotechnical systems? This paper frames this question in the context of a dynamic system of nested sub-systems. Communications are related to the construct of observability (i.e. how components integrate information to assess the state with respect to local and global constraints). Decisions are related to the construct of controllability (i.e. how component sub-systems act to meet local and global safety goals). The safety dynamics of sociotechnical systems are evaluated as a function of the coupling between observability and controllability across multiple closed-loop components. Two very different domains (nuclear power and the limited service food industry) provide examples to illustrate how this framework might be applied. While the dynamical systems framework does not offer simple prescriptions for achieving safety, it does provide guides for exploring specific systems to consider the potential fit between organisational structures and work demands, and for generalising across different systems regarding how safety can be managed. Practitioner Summary: While offering no simple prescriptions about how to achieve safety in sociotechnical systems, this paper develops a theoretical framework based on dynamical systems theory as a practical guide for generalising from basic research to work domains and for generalising across alternative work domains to better understand how patterns of communication and decision-making impact system safety. PMID:25761155

Becoming a nurse: "it's just who I am".

PubMed

Flaming, D

2005-12-01

In any research study, researchers situate themselves, either explicitly or implicitly, within a variety of frameworks when studying phenomena. From a research perspective, the study will be more robust if these frameworks and the accompanying assumptions are compatible with each other; otherwise, the project may lack coherence. Ricoeur offers a methodological perspective-that is, an interpretive theory as reflected in mimesis, which is congruent with his ontological theory of self identity (ipse- and idem-identity). To illustrate Ricoeur's frameworks when researching the self identities, I use examples from a research study in which I asked senior nursing students to explore their experience of becoming a nurse. I do not intend for this article to be a comprehensive research report, but I present it as an exemplar of how Ricoeur's ideas can guide other researchers studying self identity. I labelled my study a narrative research project and assumed that becoming a nurse means developing a self identity as a nurse. While self identity is often framed in psychological terms, Ricoeur uses a philosophical perspective when exploring this concept. I conclude the paper by suggesting (a) that Ricoeur can guide any project in which researchers ask participants to describe "becoming" a person with illness, sickness or disease, and (b) that educators of healthcare professional students can improve the educative experience by purposefully considering how a student's ontological self affects that student's practice.

The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework

PubMed Central

2013-01-01

Background The case has been made for more and better theory-informed process evaluations within trials in an effort to facilitate insightful understandings of how interventions work. In this paper, we provide an explanation of implementation processes from one of the first national implementation research randomized controlled trials with embedded process evaluation conducted within acute care, and a proposed extension to the Promoting Action on Research Implementation in Health Services (PARIHS) framework. Methods The PARIHS framework was prospectively applied to guide decisions about intervention design, data collection, and analysis processes in a trial focussed on reducing peri-operative fasting times. In order to capture a holistic picture of implementation processes, the same data were collected across 19 participating hospitals irrespective of allocation to intervention. This paper reports on findings from data collected from a purposive sample of 151 staff and patients pre- and post-intervention. Data were analysed using content analysis within, and then across data sets. Results A robust and uncontested evidence base was a necessary, but not sufficient condition for practice change, in that individual staff and patient responses such as caution influenced decision making. The implementation context was challenging, in which individuals and teams were bounded by professional issues, communication challenges, power and a lack of clarity for the authority and responsibility for practice change. Progress was made in sites where processes were aligned with existing initiatives. Additionally, facilitators reported engaging in many intervention implementation activities, some of which result in practice changes, but not significant improvements to outcomes. Conclusions This study provided an opportunity for reflection on the comprehensiveness of the PARIHS framework. Consistent with the underlying tenant of PARIHS, a multi-faceted and dynamic story of implementation was evident. However, the prominent role that individuals played as part of the interaction between evidence and context is not currently explicit within the framework. We propose that successful implementation of evidence into practice is a planned facilitated process involving an interplay between individuals, evidence, and context to promote evidence-informed practice. This proposal will enhance the potential of the PARIHS framework for explanation, and ensure theoretical development both informs and responds to the evidence base for implementation. Trial registration ISRCTN18046709 - Peri-operative Implementation Study Evaluation (PoISE). PMID:23497438

The safety net medical home initiative: transforming care for vulnerable populations.

PubMed

Sugarman, Jonathan R; Phillips, Kathryn E; Wagner, Edward H; Coleman, Katie; Abrams, Melinda K

2014-11-01

Despite findings that medical homes may reduce or eliminate health care disparities among underserved and minority populations, most previous medical home pilot and demonstration projects have focused on health care delivery systems serving commercially insured patients and Medicare beneficiaries. To develop a replicable approach to support medical home transformation among diverse practices serving vulnerable and underserved populations. Facilitated by a national program team, convening organizations in 5 states provided coaching and learning community support to safety net practices over a 4-year period. To guide transformation, we developed a framework of change concepts aligned with supporting tools including implementation guides, activity checklists, and measurement instruments. Sixty-five health centers, homeless clinics, private practices, residency training centers, and other safety net practices in Colorado, Idaho, Massachusetts, Oregon, and Pennsylvania. We evaluated implementation of the change concepts using the Patient-Centered Medical Home-Assessment, and conducted a survey of participating practices to assess perceptions of the impact of the technical assistance. All practices implemented key features of the medical home model, and nearly half (47.6%) implemented the 33 identified key changes to a substantial degree as evidenced by level A Patient-Centered Medical Home-Assessment scores. Two thirds of practices that achieved substantial implementation did so only after participating in the initiative for >2 years. By the end of the initiative, 83.1% of sites achieved external recognition as medical homes. Despite resource constraints and high-need populations, safety net clinics made considerable progress toward medical home implementation when provided robust, multimodal support over a 4-year period.

Transforming primary care training--patient-centered medical home entrustable professional activities for internal medicine residents.

PubMed

Chang, Anna; Bowen, Judith L; Buranosky, Raquel A; Frankel, Richard M; Ghosh, Nivedita; Rosenblum, Michael J; Thompson, Sara; Green, Michael L

2013-06-01

The U.S. faces a critical gap between residency training and clinical practice that affects the recruitment and preparation of internal medicine residents for primary care careers. The patient-centered medical home (PCMH) represents a new clinical microsystem that is being widely promoted and implemented to improve access, quality, and sustainability in primary care practice. We address two key questions regarding the training of internal medicine residents for practice in PCMHs. First, what are the educational implications of practice transformations to primary care home models? Second, what must we do differently to prepare internal medicine residents for their futures in PCMHs? The 2011 Society of General Internal Medicine (SGIM) PCMH Education Summit established seven work groups to address the following topics: resident workplace competencies, teamwork, continuity of care, assessment, faculty development, 'medical home builder' tools, and policy. The output from the competency work group was foundational for the work of other groups. The work group considered several educational frameworks, including developmental milestones, competencies, and entrustable professional activities (EPAs). The competency work group defined 25 internal medicine resident PCMH EPAs. The 2011 National Committee for Quality Assurance (NCQA) PCMH standards served as an organizing framework for EPAs. The list of PCMH EPAs has the potential to begin to transform the education of internal medicine residents for practice and leadership in the PCMH. It will guide curriculum development, learner assessment, and clinical practice redesign for academic health centers.

A framework for cultural competence in health care organizations.

PubMed

Castillo, Richard J; Guo, Kristina L

2011-01-01

Increased racial and ethnic diversity in the United States brings challenges and opportunities for health care organizations to provide culturally competent services that effectively meet the needs of diverse populations. The need to provide more culturally competent care is essential to reducing and eliminating health disparities among minorities. By removing barriers to cultural competence and placing a stronger emphasis on culture in health care, health care organizations will be better able to address the unique health care needs of minorities. Organizations should assess cultural differences, gain greater cultural knowledge, and provide cultural competence training to deliver high-quality services. This article develops a framework to guide health care organizations as they focus on establishing culturally competent strategies and implementing best practices aimed to improve quality of care and achieve better outcomes for minority populations.

[Technology in nursing care: an analysis from the conceptual framework of Fundamental Nursing].

PubMed

da Silva, Rafael Celestino; Ferreira, Márcia de Assunção

2014-01-01

This is a qualitative, field research, whose purpose was to discuss the use of technologies in the nursing care in intensive therapy, taking as reference the theoretical conceptual framework of Fundamental Nursing. Observation and interviews were conducted with twenty two nurses of an intensive therapy unit, with ethnographic analysis. The technology, from the domain of a technological language, provides conditions so that the fundamentals of the nursing care can be effectively incorporated to the nurse practice. The idea of dehumanization linked to the technology can be explained by the way that the nurse ads sense to the things related to his daily life, which will guide his action. The conclusion is that the technologies help to promote life and to rescue the human.

A Framework for Enhancing the Value of Research for Dissemination and Implementation

PubMed Central

Glasgow, Russell E.; Carpenter, Christopher R.; Grimshaw, Jeremy M.; Rabin, Borsika A.; Fernandez, Maria E.; Brownson, Ross C.

2015-01-01

A comprehensive guide that identifies critical evaluation and reporting elements necessary to move research into practice is needed. We propose a framework that highlights the domains required to enhance the value of dissemination and implementation research for end users. We emphasize the importance of transparent reporting on the planning phase of research in addition to delivery, evaluation, and long-term outcomes. We highlight key topics for which well-established reporting and assessment tools are underused (e.g., cost of intervention, implementation strategy, adoption) and where such tools are inadequate or lacking (e.g., context, sustainability, evolution) within the context of existing reporting guidelines. Consistent evaluation of and reporting on these issues with standardized approaches would enhance the value of research for practitioners and decision-makers. PMID:25393182

Optically stimulated luminescence (OSL) dosimetry in medicine.

PubMed

Yukihara, E G; McKeever, S W S

2008-10-21

This paper reviews fundamental and practical aspects of optically stimulated luminescence (OSL) dosimetry pertaining to applications in medicine, having particularly in mind new researchers and medical physicists interested in gaining familiarity with the field. A basic phenomenological model for OSL is presented and the key processes affecting the outcome of an OSL measurement are discussed. Practical aspects discussed include stimulation modalities (continuous-wave OSL, pulsed OSL and linear modulation OSL), basic experimental setup, available OSL readers, optical fiber systems and basic properties of available OSL dosimeters. Finally, results from the recent literature on applications of OSL in radiotherapy, radiodiagnostics and heavy charged particle dosimetry are discussed in light of the theoretical and practical framework presented in this review. Open questions and future challenges in OSL dosimetry are highlighted as a guide to the research needed to further advance the field.

Development of a behaviour change intervention: a case study on the practical application of theory.

PubMed

Porcheret, Mark; Main, Chris; Croft, Peter; McKinley, Robert; Hassell, Andrew; Dziedzic, Krysia

2014-04-03

Use of theory in implementation of complex interventions is widely recommended. A complex trial intervention, to enhance self-management support for people with osteoarthritis (OA) in primary care, needed to be implemented in the Managing Osteoarthritis in Consultations (MOSAICS) trial. One component of the trial intervention was delivery by general practitioners (GPs) of an enhanced consultation for patients with OA. The aim of our case study is to describe the systematic selection and use of theory to develop a behaviour change intervention to implement GP delivery of the enhanced consultation. The development of the behaviour change intervention was guided by four theoretical models/frameworks: i) an implementation of change model to guide overall approach, ii) the Theoretical Domains Framework (TDF) to identify relevant determinants of change, iii) a model for the selection of behaviour change techniques to address identified determinants of behaviour change, and iv) the principles of adult learning. Methods and measures to evaluate impact of the behaviour change intervention were identified. The behaviour change intervention presented the GPs with a well-defined proposal for change; addressed seven of the TDF domains (e.g., knowledge, skills, motivation and goals); incorporated ten behaviour change techniques (e.g., information provision, skills rehearsal, persuasive communication); and was delivered in workshops that valued the expertise and professional values of GPs. The workshops used a mixture of interactive and didactic sessions, were facilitated by opinion leaders, and utilised 'context-bound communication skills training.' Methods and measures selected to evaluate the behaviour change intervention included: appraisal of satisfaction with workshops, GP report of intention to practise and an assessment of video-recorded consultations of GPs with patients with OA. A stepped approach to the development of a behaviour change intervention, with the utilisation of theoretical frameworks to identify determinants of change matched with behaviour change techniques, has enabled a systematic and theory-driven development of an intervention designed to enhance consultations by GPs for patients with OA. The success of the behaviour change intervention in practice will be evaluated in the context of the MOSAICS trial as a whole, and will inform understanding of practice level and patient outcomes in the trial.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 2: identifying opportunities for disinvestment in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; King, Richard; Ramsey, Wayne; Kelly, Cate; Thiagarajan, Malar

2017-05-05

This is the second in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Rising healthcare costs, continuing advances in health technologies and recognition of ineffective practices and systematic waste are driving disinvestment of health technologies and clinical practices that offer little or no benefit in order to maximise outcomes from existing resources. However there is little information to guide regional health services or individual facilities in how they might approach disinvestment locally. This paper outlines the investigation of potential settings and methods for decision-making about disinvestment in the context of an Australian health service. Methods include a literature review on the concepts and terminology relating to disinvestment, a survey of national and international researchers, and interviews and workshops with local informants. A conceptual framework was drafted and refined with stakeholder feedback. There is a lack of common terminology regarding definitions and concepts related to disinvestment and no guidance for an organisation-wide systematic approach to disinvestment in a local healthcare service. A summary of issues from the literature and respondents highlight the lack of theoretical knowledge and practical experience and provide a guide to the information required to develop future models or methods for disinvestment in the local context. A conceptual framework was developed. Three mechanisms that provide opportunities to introduce disinvestment decisions into health service systems and processes were identified. Presented in order of complexity, time to achieve outcomes and resources required they include 1) Explicit consideration of potential disinvestment in routine decision-making, 2) Proactive decision-making about disinvestment driven by available evidence from published research and local data, and 3) Specific exercises in priority setting and system redesign. This framework identifies potential opportunities to initiate disinvestment activities in a systematic integrated approach that can be applied across a whole organisation using transparent, evidence-based methods. Incorporating considerations for disinvestment into existing decision-making systems and processes might be achieved quickly with minimal cost; however establishment of new systems requires research into appropriate methods and provision of appropriate skills and resources to deliver them.

Biosafety and Biosecurity: A Relative Risk-Based Framework for Safer, More Secure, and Sustainable Laboratory Capacity Building.

PubMed

Dickmann, Petra; Sheeley, Heather; Lightfoot, Nigel

2015-01-01

Laboratory capacity building is characterized by a paradox between endemicity and resources: countries with high endemicity of pathogenic agents often have low and intermittent resources (water, electricity) and capacities (laboratories, trained staff, adequate regulations). Meanwhile, countries with low endemicity of pathogenic agents often have high-containment facilities with costly infrastructure and maintenance governed by regulations. The common practice of exporting high biocontainment facilities and standards is not sustainable and concerns about biosafety and biosecurity require careful consideration. A group at Chatham House developed a draft conceptual framework for safer, more secure, and sustainable laboratory capacity building. The draft generic framework is guided by the phrase "LOCAL - PEOPLE - MAKE SENSE" that represents three major principles: capacity building according to local needs (local) with an emphasis on relationship and trust building (people) and continuous outcome and impact measurement (make sense). This draft generic framework can serve as a blueprint for international policy decision-making on improving biosafety and biosecurity in laboratory capacity building, but requires more testing and detailing development.

End-of-life decision making in the ICU.

PubMed

Siegel, Mark D

2009-03-01

A large proportion of deaths, particularly in the developed world, follows admission to an ICU. Therefore, end-of life decision making is an essential facet of critical care practice. For intensivists, managing death in the critically ill has become a key professional skill. They must be thoroughly familiar with the ethical framework that guides end-of-life decision making. Decisions should generally be made collaboratively by clinicians partnering with patients' families. Treatment choices should be crafted to meet specific, achievable goals. A rational, empathic approach to working with families should encourage appropriate, mutually satisfactory outcomes.

The Value of Physical Examination: A New Conceptual Framework.

PubMed

Zaman, Junaid; Verghese, Abraham; Elder, Andrew

2016-12-01

The physical examination defines medical practice, yet its role is being questioned increasingly, with statistical comparisons of diagnostic accuracy often the sole metric used against newer technologies. We set out to highlight seven ways in which the physical examination has value beyond diagnostic accuracy to reaffirm its place in the core skills of a physician and guide future research, teaching, and curriculum design. We show that this more comprehensive approach to the physical examination of its "utility" beyond that of reaching a diagnosis can be beneficial to both doctor and patient.

Ethics and Reverence for the Discipline of Nursing.

PubMed

Milton, Constance L

2017-01-01

Healthcare disciplines, including nursing, are emerging sciences that contain discipline-specific theories that guide the activities of research, practice, and education. The term nursing science calls forth meaning that has long been accepted and referred to as the extant nursing theories undergirded with philosophy of science. Recent writings dispute the purposes and future usage of nursing theoretical frameworks in the science of nursing. The author of this article proposes new thinking about the importance of reverence and ethical implications for the future of formal inquiry in nursing science.

Defining a risk-informed framework for whole-of-government lessons learned: A Canadian perspective.

PubMed

Friesen, Shaye K; Kelsey, Shelley; Legere, J A Jim

Lessons learned play an important role in emergency management (EM) and organizational agility. Virtually all aspects of EM can derive benefit from a lessons learned program. From major security events to exercises, exploiting and applying lessons learned and "best practices" is critical to organizational resilience and adaptiveness. A robust lessons learned process and methodology provides an evidence base with which to inform decisions, guide plans, strengthen mitigation strategies, and assist in developing tools for operations. The Canadian Safety and Security Program recently supported a project to define a comprehensive framework that would allow public safety and security partners to regularly share event response best practices, and prioritize recommendations originating from after action reviews. This framework consists of several inter-locking elements: a comprehensive literature review/environmental scan of international programs; a survey to collect data from end users and management; the development of a taxonomy for organizing and structuring information; a risk-informed methodology for selecting, prioritizing, and following through on recommendations; and standardized templates and tools for tracking recommendations and ensuring implementation. This article discusses the efforts of the project team, which provided "best practice" advice and analytical support to ensure that a systematic approach to lessons learned was taken by the federal community to improve prevention, preparedness, and response activities. It posits an approach by which one might design a systematic process for information sharing and event response coordination-an approach that will assist federal departments to institutionalize a cross-government lessons learned program.

Development by Design in Colombia: Making Mitigation Decisions Consistent with Conservation Outcomes

PubMed Central

Saenz, Shirley; Walschburger, Tomas; González, Juan Carlos; León, Jorge; McKenney, Bruce; Kiesecker, Joseph

2013-01-01

Mitigation policy and regulatory frameworks are consistent in their strong support for the mitigation hierarchy of: (1) avoiding impacts, (2) minimizing impacts, and then (3) offsetting/compensating for residual impacts. While mitigation frameworks require developers to avoid, minimize and restore biodiversity on-site before considering an offset for residual impacts, there is a lack of quantitative guidance for this decision-making process. What are the criteria for requiring impacts be avoided altogether? Here we examine how conservation planning can guide the application of the mitigation hierarchy to address this issue. In support of the Colombian government's aim to improve siting and mitigation practices for planned development, we examined five pilot projects in landscapes expected to experience significant increases in mining, petroleum and/or infrastructure development. By blending landscape-level conservation planning with application of the mitigation hierarchy, we can proactively identify where proposed development and conservation priorities would be in conflict and where impacts should be avoided. The approach we outline here has been adopted by the Colombian Ministry of Environment and Sustainable Development to guide licensing decisions, avoid piecemeal licensing, and promote mitigation decisions that maintain landscape condition. PMID:24339972

Development by design in Colombia: making mitigation decisions consistent with conservation outcomes.

PubMed

Saenz, Shirley; Walschburger, Tomas; González, Juan Carlos; León, Jorge; McKenney, Bruce; Kiesecker, Joseph

2013-01-01

Mitigation policy and regulatory frameworks are consistent in their strong support for the mitigation hierarchy of: (1) avoiding impacts, (2) minimizing impacts, and then (3) offsetting/compensating for residual impacts. While mitigation frameworks require developers to avoid, minimize and restore biodiversity on-site before considering an offset for residual impacts, there is a lack of quantitative guidance for this decision-making process. What are the criteria for requiring impacts be avoided altogether? Here we examine how conservation planning can guide the application of the mitigation hierarchy to address this issue. In support of the Colombian government's aim to improve siting and mitigation practices for planned development, we examined five pilot projects in landscapes expected to experience significant increases in mining, petroleum and/or infrastructure development. By blending landscape-level conservation planning with application of the mitigation hierarchy, we can proactively identify where proposed development and conservation priorities would be in conflict and where impacts should be avoided. The approach we outline here has been adopted by the Colombian Ministry of Environment and Sustainable Development to guide licensing decisions, avoid piecemeal licensing, and promote mitigation decisions that maintain landscape condition.

GO-guided direct growth of highly oriented metal-organic framework nanosheet membranes for H2/CO2 separation.

PubMed

Li, Yujia; Liu, Haiou; Wang, Huanting; Qiu, Jieshan; Zhang, Xiongfu

2018-05-07

Highly oriented, ultrathin metal-organic framework (MOF) membranes are attractive for practical separation applications, but the scalable preparation of such membranes especially on standard tubular supports remains a huge challenge. Here we report a novel bottom-up strategy for directly growing a highly oriented Zn 2 (bIm) 4 (bIm = benzimidazole) ZIF nanosheet tubular membrane, based on graphene oxide (GO) guided self-conversion of ZnO nanoparticles (NPs). Through our approach, a thin layer of ZnO NPs confined between a substrate and a GO ultrathin layer self-converts into a highly oriented Zn 2 (bIm) 4 nanosheet membrane. The resulting membrane with a thickness of around 200 nm demonstrates excellent H 2 /CO 2 gas separation performance with a H 2 performance of 1.4 × 10 -7 mol m -2 s -1 Pa -1 and an ideal separation selectivity of about 106. The method can be easily scaled up and extended to the synthesis of other types of Zn-based MOF nanosheet membranes. Importantly, our strategy is particularly suitable for the large-scale fabrication of tubular MOF membranes that has not been possible through other methods.

Trajectories of women's abortion-related care: A conceptual framework.

PubMed

Coast, Ernestina; Norris, Alison H; Moore, Ann M; Freeman, Emily

2018-03-01

We present a new conceptual framework for studying trajectories to obtaining abortion-related care. It assembles for the first time all of the known factors influencing a trajectory and encourages readers to consider the ways these macro- and micro-level factors operate in multiple and sometimes conflicting ways. Based on presentation to and feedback from abortion experts (researchers, providers, funders, policymakers and advisors, advocates) (n = 325) between 03/06/2014 and 22/08/2015, and a systematic mapping of peer-reviewed literature (n = 424) published between 01/01/2011 and 30/10/2017, our framework synthesises the factors shaping abortion trajectories, grouped into three domains: abortion-specific experiences, individual contexts, and (inter)national and sub-national contexts. Our framework includes time-dependent processes involved in an individual trajectory, starting with timing of pregnancy awareness. This framework can be used to guide testable hypotheses about enabling and inhibiting influences on care-seeking behaviour and consideration about how abortion trajectories might be influenced by policy or practice. Research based on understanding of trajectories has the potential to improve women's experiences and outcomes of abortion-related care. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Vocational trainees' views and experiences regarding the learning and teaching of communication skills in general practice.

PubMed

Van Nuland, Marc; Thijs, Gabie; Van Royen, Paul; Van den Noortgate, Wim; Goedhuys, Jo

2010-01-01

To explore the views and experiences of general practice (GP) vocational trainees regarding communication skills (CS) and the teaching and learning of these skills. A purposive sample of second and third (final) year GP trainees took part in six focus group (FG) discussions. Transcripts were coded and analysed in accordance with a grounded theory approach by two investigators using Alas-ti software. Finally results were triangulated by means of semi-structured telephone interviews. The analysis led to three thematic clusters: (1) trainees acknowledge the essential importance of communication skills and identified contextual factors influencing the learning and application of these skills; (2) trainees identified preferences for learning and receiving feedback on their communication skills; and (3) trainees perceived that the assessment of communication skills is subjective. These themes are organised into a framework for a better understanding of trainees' communication skills as part of their vocational training. The framework helps in leading to a better understanding of the way in which trainees learn and apply communication skills. The unique context of vocational training should be taken into account when trainees' communication skills are assessed. The teaching and learning should be guided by a learner-centred approach. The framework is valuable for informing curricular reform and future research.

Dentalmaps: Automatic Dental Delineation for Radiotherapy Planning in Head-and-Neck Cancer

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

Thariat, Juliette, E-mail: jthariat@hotmail.com; Ramus, Liliane; INRIA

Purpose: To propose an automatic atlas-based segmentation framework of the dental structures, called Dentalmaps, and to assess its accuracy and relevance to guide dental care in the context of intensity-modulated radiotherapy. Methods and Materials: A multi-atlas-based segmentation, less sensitive to artifacts than previously published head-and-neck segmentation methods, was used. The manual segmentations of a 21-patient database were first deformed onto the query using nonlinear registrations with the training images and then fused to estimate the consensus segmentation of the query. Results: The framework was evaluated with a leave-one-out protocol. The maximum doses estimated using manual contours were considered as groundmore » truth and compared with the maximum doses estimated using automatic contours. The dose estimation error was within 2-Gy accuracy in 75% of cases (with a median of 0.9 Gy), whereas it was within 2-Gy accuracy in 30% of cases only with the visual estimation method without any contour, which is the routine practice procedure. Conclusions: Dose estimates using this framework were more accurate than visual estimates without dental contour. Dentalmaps represents a useful documentation and communication tool between radiation oncologists and dentists in routine practice. Prospective multicenter assessment is underway on patients extrinsic to the database.« less

Social media: A contextual framework to guide research and practice.

PubMed

McFarland, Lynn A; Ployhart, Robert E

2015-11-01

Social media are a broad collection of digital platforms that have radically changed the way people interact and communicate. However, we argue that social media are not simply a technology but actually represent a context that differs in important ways from traditional (e.g., face-to-face) and other digital (e.g., email) ways of interacting and communicating. As a result, social media is a relatively unexamined type of context that may affect the cognition, affect, and behavior of individuals within organizations. We propose a contextual framework that identifies the discrete and ambient stimuli that distinguish social media contexts from digital communication media (e.g., email) and physical (e.g., face-to-face) contexts. We then use this contextual framework to demonstrate how it changes more person-centered theories of organizational behavior (e.g., social exchange, social contagion, and social network theories). These theoretical insights are also used to identify a number of practical implications for individuals and organizations. This study's major contribution is creating a theoretical understanding of social media features so that future research may proceed in a theory-based, rather than platform-based, manner. Overall, we intend for this article to stimulate and broadly shape the direction of research on this ubiquitous, but poorly understood, phenomenon. (c) 2015 APA, all rights reserved).

A Novel Implementation Strategy in Residential Care Settings to Promote EBP: Direct Care Provider Perceptions and Development of a Conceptual Framework.

PubMed

Slaughter, Susan E; Bampton, Erin; Erin, Daniel F; Ickert, Carla; Jones, C Allyson; Estabrooks, Carole A

2017-06-01

Innovative approaches are required to facilitate the adoption and sustainability of evidence-based care practices. We propose a novel implementation strategy, a peer reminder role, which involves offering a brief formal reminder to peers during structured unit meetings. This study aims to (a) identify healthcare aide (HCA) perceptions of a peer reminder role for HCAs, and (b) develop a conceptual framework for the role based on these perceptions. In 2013, a qualitative focus group study was conducted in five purposively sampled residential care facilities in western Canada. A convenience sample of 24 HCAs agreed to participate in five focus groups. Concurrent with data collection, two researchers coded the transcripts and identified themes by consensus. They jointly determined when saturation was achieved and took steps to optimize the trustworthiness of the findings. Five HCAs from the original focus groups commented on the resulting conceptual framework. HCAs were cautious about accepting a role that might alienate them from their co-workers. They emphasized feeling comfortable with the peer reminder role and identified circumstances that would optimize their comfort including: effective implementation strategies, perceptions of the role, role credibility and a supportive context. These intersecting themes formed a peer reminder conceptual framework. We identified HCAs' perspectives of a new peer reminder role designed specifically for them. Based on their perceptions, a conceptual framework was developed to guide the implementation of a peer reminder role for HCAs. This role may be a strategic implementation strategy to optimize the sustainability of new practices in residential care settings, and the related framework could offer guidance on how to implement this role. © 2017 Sigma Theta Tau International.

North Carolina Social Studies Curriculum 1997.

ERIC Educational Resources Information Center

North Carolina State Dept. of Public Instruction, Raleigh.

This North Carolina curriculum guide provides a social studies framework for grades K-12. Divided into overview, introduction, primary, elementary/middle, and high school sections, the guide outlines a purpose and philosophy, framework goals, rationale for social studies in the curriculum, content overview (for the disciplines of history,…

Services for children with developmental co-ordination disorder: an evaluation against best practice principles.

PubMed

Pentland, Jacqueline; Maciver, Donald; Owen, Christine; Forsyth, Kirsty; Irvine, Linda; Walsh, Mike; Crowe, Miriam

2016-01-01

The National Health Service in Scotland published a best practice framework to support occupational therapists and physiotherapists to deliver effective services for children with developmental co-ordination disorder (DCD); however, adherence is variable. To highlight areas for development, this study compared the care pathway within a paediatric DCD service against the NHS Scotland framework. A partnership of researchers and clinicians based in the United Kingdom conducted a qualitative study with 37 participants (N = 13 interview participants, N = 24 workshop participants). In-depth interviews and/or workshops were used to map the DCD service against the NHS framework. Identified gaps were aligned with four key stages of the care pathway. Qualitative analysis software was used to analyse the data. Core principles to guide future development were identified for each phase of the pathway. These core principles related to the NHS framework and focused on issues such as involving the family, defining clear pathways and enhancing children's participation. Participants identified potential strategies for service improvement such as developing community-based interventions and information provision. Challenges when providing services for children with DCD include confusing service pathways and poor partnership working. It is, therefore, important that clinicians utilise collaborative working strategies that support children's participation. There are numerous challenges related to the implementation of best practice principles into the provision of therapy services for children with developmental coordination disorder (DCD). It is important that AHPs seek ways of engaging parents and educational professionals at all stages of the care pathway in order to ensure optimum service provision for the child. Addressing participation is an important aspect and community-based strategies may be particularly beneficial, both as a preventative activity and as an intervention approach.

Critical Medical Anthropology in Midwifery Research

PubMed Central

Newnham, Elizabeth C.; Pincombe, Jan I.; McKellar, Lois V.

2016-01-01

In this article, we discuss the use of critical medical anthropology (CMA) as a theoretical framework for research in the maternity care setting. With reference to the doctoral research of the first author, we argue for the relevance of using CMA for research into the maternity care setting, particularly as it relates to midwifery. We then give an overview of an existing analytic model within CMA that we adapted for looking specifically at childbirth practices and which was then used in both analyzing the data and structuring the thesis. There is often no clear guide to the analysis or writing up of data in ethnographic research; we therefore offer this Critical analytic model of childbirth practices for other researchers conducting ethnographic research into childbirth or maternity care. PMID:28462347

A practitioner’s guide to interpersonal communication theory: An overview and exploration of selected theories

PubMed Central

Bylund, Carma L.; Peterson, Emily B.; Cameron, Kenzie A.

2011-01-01

Objective To provide a brief overview of selected interpersonal theories and models, and to present examples of their use in healthcare communication research. Results Nine interpersonal communication theories and their application to healthcare communication are discussed. Conclusion As healthcare communication interactions often occur at an interpersonal level, familiarity with theories of interpersonal communication may reinforce existing best practices and lead to the development of novel communication approaches with patients. Practice Implications This article serves as an introductory primer to theories of interpersonal communication that have been or could be applied to healthcare communication research. Understanding key constructs and general formulations of these theories may provide practitioners with additional theoretical frameworks to use when interacting with patients. PMID:22112396

Development of Animal Physiology Practical Guidance Oriented Guided Inquiry for Student of Biology Department

NASA Astrophysics Data System (ADS)

Putra, Z. A. Z.; Sumarmin, R.; Violita, V.

2018-04-01

The guides used for practicing animal physiology need to be revised and adapted to the lecture material. This is because in the subject of Animal Physiology. The guidance of animal physiology practitioners is still conventional with prescription model instructions and is so simple that it is necessary to develop a practical guide that can lead to the development of scientific work. One of which is through practice guided inquiry guided practicum guide. This study aims to describe the process development of the practical guidance and reveal the validity, practicality, and effectiveness Guidance Physiology Animals guided inquiry inferior to the subject of Animal Physiology for students Biology Department State University of Padang. This type of research is development research. This development research uses the Plomp model. Stages performed are problem identification and analysis stage, prototype development and prototyping stage, and assessment phase. Data analysis using descriptive analysis. The instrument of data collection using validation and practical questionnaires, competence and affective field of competence observation and psychomotor and cognitive domain competence test. The result of this research shows that guidance of Inquiry Guided Initiative Guided Physiology with 3.23 valid category, practicality by lecturer with value 3.30 practical category, student with value 3.37 practical criterion. Affective effectiveness test with 93,00% criterion is very effective, psychomotor aspect 89,50% with very effective criteria and cognitive domain with value of 67, pass criterion. The conclusion of this research is Guided Inquiry Student Guided Protoxial Guidance For Students stated valid, practical and effective.

Geriatric Assessment-Guided Care Processes for Older Adults: A Delphi Consensus of Geriatric Oncology Experts.

PubMed

Mohile, Supriya Gupta; Velarde, Carla; Hurria, Arti; Magnuson, Allison; Lowenstein, Lisa; Pandya, Chintan; O'Donovan, Anita; Gorawara-Bhat, Rita; Dale, William

2015-09-01

Structured care processes that provide a framework for how oncologists can incorporate geriatric assessment (GA) into clinical practice could improve outcomes for vulnerable older adults with cancer, a growing population at high risk of toxicity from cancer treatment. We sought to obtain consensus from an expert panel on the use of GA in clinical practice and to develop algorithms of GA-guided care processes. The Delphi technique, a well-recognized structured and reiterative process to reach consensus, was used. Participants were geriatric oncology experts who attended NIH-funded U13 or Cancer and Aging Research Group conferences. Consensus was defined as an interquartile range of 2 or more units, or 66.7% or greater, selecting a utility/helpfulness rating of 7 or greater on a 10-point Likert scale. For nominal data, consensus was defined as agreement among 66.7% or more of the group. From 33 invited, 30 participants completed all 3 rounds. Most experts (75%) used GA in clinical care, and the remainder were involved in geriatric oncology research. The panel met consensus that "all patients aged 75 years or older and those who are younger with age-related health concerns" should undergo GA and that all domains (function, physical performance, comorbidity/polypharmacy, cognition, nutrition, psychological status, and social support) should be included. Consensus was met for how GA could guide nononcologic interventions and cancer treatment decisions. Algorithms for GA-guided care processes were developed. This Delphi investigation of geriatric oncology experts demonstrated that GA should be performed for older patients with cancer to guide care processes. Copyright © 2015 by the National Comprehensive Cancer Network.

Understanding facilitators and barriers to reengineering the clinical research enterprise in community-based practice settings.

PubMed

Kukafka, Rita; Allegrante, John P; Khan, Sharib; Bigger, J Thomas; Johnson, Stephen B

2013-09-01

Solutions are employed to support clinical research trial tasks in community-based practice settings. Using the IT Implementation Framework (ITIF), an integrative framework intended to guide the synthesis of theoretical perspectives for planning multi-level interventions to enhance IT use, we sought to understand the barriers and facilitators to clinical research in community-based practice settings preliminary to implementing new informatics solutions for improving clinical research infrastructure. The studies were conducted in practices within the Columbia University Clinical Trials Network. A mixed-method approach, including surveys, interviews, time-motion studies, and observations was used. The data collected, which incorporates predisposing, enabling, and reinforcing factors in IT use, were analyzed according to each phase of ITIF. Themes identified in the first phase of ITIF were 1) processes and tools to support clinical trial research and 2) clinical research peripheral to patient care processes. Not all of the problems under these themes were found to be amenable to IT solutions. Using the multi-level orientation of the ITIF, we set forth strategies beyond IT solutions that can have an impact on reengineering clinical research tasks in practice-based settings. Developing strategies to target enabling and reinforcing factors, which focus on organizational factors, and the motivation of the practice at large to use IT solutions to integrate clinical research tasks with patient care processes, is most challenging. The ITIF should be used to consider both IT and non-IT solutions concurrently for reengineering of clinical research in community-based practice settings. © 2013.

When is enough evidence enough? - Using systematic decision analysis and value-of-information analysis to determine the need for further evidence.

PubMed

Siebert, Uwe; Rochau, Ursula; Claxton, Karl

2013-01-01

Decision analysis (DA) and value-of-information (VOI) analysis provide a systematic, quantitative methodological framework that explicitly considers the uncertainty surrounding the currently available evidence to guide healthcare decisions. In medical decision making under uncertainty, there are two fundamental questions: 1) What decision should be made now given the best available evidence (and its uncertainty)?; 2) Subsequent to the current decision and given the magnitude of the remaining uncertainty, should we gather further evidence (i.e., perform additional studies), and if yes, which studies should be undertaken (e.g., efficacy, side effects, quality of life, costs), and what sample sizes are needed? Using the currently best available evidence, VoI analysis focuses on the likelihood of making a wrong decision if the new intervention is adopted. The value of performing further studies and gathering additional evidence is based on the extent to which the additional information will reduce this uncertainty. A quantitative framework allows for the valuation of the additional information that is generated by further research, and considers the decision maker's objectives and resource constraints. Claxton et al. summarise: "Value of information analysis can be used to inform a range of policy questions including whether a new technology should be approved based on existing evidence, whether it should be approved but additional research conducted or whether approval should be withheld until the additional evidence becomes available." [Claxton K. Value of information entry in Encyclopaedia of Health Economics, Elsevier, forthcoming 2014.] The purpose of this tutorial is to introduce the framework of systematic VoI analysis to guide further research. In our tutorial article, we explain the theoretical foundations and practical methods of decision analysis and value-of-information analysis. To illustrate, we use a simple case example of a foot ulcer (e.g., with diabetes) as well as key references from the literature, including examples for the use of the decision-analytic VoI framework by health technology assessment agencies to guide further research. These concepts may guide stakeholders involved or interested in how to determine whether or not and, if so, which additional evidence is needed to make decisions. Copyright © 2013. Published by Elsevier GmbH.

An Ethical (Descriptive) Framework for Judgment of Actions and Decisions in the Construction Industry and Engineering-Part I.

PubMed

Alkhatib, Omar J; Abdou, Alaa

2018-04-01

The construction industry is usually characterized as a fragmented system of multiple-organizational entities in which members from different technical backgrounds and moral values join together to develop a particular business or project. The greatest challenge in the construction process for the achievement of a successful practice is the development of an outstanding reputation, which is built on identifying and applying an ethical framework. This framework should reflect a common ethical ground for myriad people involved in this process to survive and compete ethically in today's turbulent construction market. This study establishes a framework for ethical judgment of behavior and actions conducted in the construction process. The framework was primarily developed based on the essential attributes of business management identified in the literature review and subsequently incorporates additional attributes identified to prevent breaches in the construction industry and common ethical values related to professional engineering. The proposed judgment framework is based primarily on the ethical dimension of professional responsibility. The Ethical Judgment Framework consists of descriptive approaches involving technical, professional, administrative, and miscellaneous terms. The framework provides the basis for judging actions as either ethical or unethical. Furthermore, the framework can be implemented as a form of preventive ethics, which would help avoid ethical dilemmas and moral allegations. The framework can be considered a decision-making model to guide actions and improve the ethical reasoning process that would help individuals think through possible implications and consequences of ethical dilemmas in the construction industry.

Preservice teachers' use of lesson study in teaching nature of science

NASA Astrophysics Data System (ADS)

McDowell, Amy Virginia

The purpose of this study was to explore preservice teachers' lived experiences in a lesson study focused on teaching and learning nature of science (NOS). The body of knowledge about shifting pre- and in-service novice NOS understandings is substantial. The focus of science education research is now exploring ways to move these informed NOS understandings into classroom practice (Abd-El-Khalick & Lederman, 2000b). The research questions guiding the study were (a) how do preservice teachers' understandings of NOS shift as a result of the lesson study experience?, and (b) how does the reflective practice that occurs in lesson study influence preservice teachers' transition of NOS tenets into classroom practice? The participants in this study represented a sample of graduate preservice teachers, who were part of a middle and secondary science teaching alternative certification program in a southeastern university. In the first summer semester of this certification program, the participants were immersed in reform based science instruction; a section of which included NOS teachings (INTASC, 2002). In the following semester, participants were placed in a practicum setting; where the exploration of the preservice teachers' teaching of NOS was supported through the modified lesson study framework. Data sources included the Views on Nature of Science-Form B (VNOS-b), interviews, and lesson study portfolios. Analysis of NOS understandings was guided by instruments found in literature associated with the VNOS-b (Lederman et al., 2002) and reflection (Ward & McCotter, 2004). Results showed successful transfer of NOS into classroom practice using the modified lesson study framework, with less success in the deepening of participants' NOS understandings. Of particular significance was that results indicated a deepening of NOS pedagogical content knowledge for those participants functioning at higher levels of reflection. The study's results contributes to two knowledge bases. First it provides insight to how lesson study can be used in the United States in alterative teacher preparation programs. Second, it contributes to what is understood about how to support the transition of NOS understandings into classroom practice.

Building workforce capacity for ethical reflection in health promotion: a practitioner's experience.

PubMed

Axford, Annabel; Carter, Drew

2015-12-01

Health promotion does not have a code of ethics, although attempts have been made to assist practitioners in their understanding and application of ethical concepts. This article describes and analyses one such attempt, sustained from 2006 to 2014 in rural South Australia. The attempt comprised capacity-building activities that were informed by principles of organisational change management, especially the principle of creating champions. The article also presents a framework (largely comprising ethical questions) that may help practitioners as a prompt and guide to ethical reflection. The framework was developed to be as accessible as possible in light of the diverse educational backgrounds found in rural settings. Finally, the article highlights some philosophical dimensions to the framework and defends its role, proposing that ethical reflection is integral to good practice and never simply the province of theorists. The article does all this with a view to stimulating discussion on how to increase the frequency and quality of ethical reflection undertaken by health promotion practitioners.

A Framework for Establishing Standard Reference Scale of Texture by Multivariate Statistical Analysis Based on Instrumental Measurement and Sensory Evaluation.

PubMed

Zhi, Ruicong; Zhao, Lei; Xie, Nan; Wang, Houyin; Shi, Bolin; Shi, Jingye

2016-01-13

A framework of establishing standard reference scale (texture) is proposed by multivariate statistical analysis according to instrumental measurement and sensory evaluation. Multivariate statistical analysis is conducted to rapidly select typical reference samples with characteristics of universality, representativeness, stability, substitutability, and traceability. The reasonableness of the framework method is verified by establishing standard reference scale of texture attribute (hardness) with Chinese well-known food. More than 100 food products in 16 categories were tested using instrumental measurement (TPA test), and the result was analyzed with clustering analysis, principal component analysis, relative standard deviation, and analysis of variance. As a result, nine kinds of foods were determined to construct the hardness standard reference scale. The results indicate that the regression coefficient between the estimated sensory value and the instrumentally measured value is significant (R(2) = 0.9765), which fits well with Stevens's theory. The research provides reliable a theoretical basis and practical guide for quantitative standard reference scale establishment on food texture characteristics.

USGEO Common Framework For Earth Observation Data

NASA Astrophysics Data System (ADS)

Walter, J.; de la Beaujardiere, J.; Bristol, S.

2015-12-01

The United States Group on Earth Observations (USGEO) Data Management Working Group (DMWG) is an interagency body established by the White House Office of Science and Technology Policy (OSTP). The primary purpose of this group is to foster interagency cooperation and collaboration for improving the life cycle data management practices and interoperability of federally held earth observation data consistent with White House documents including the National Strategy for Civil Earth Observations, the National Plan for Civil Earth Observations, and the May 2013 Executive Order on Open Data (M-13-13). The members of the USGEO DMWG are working on developing a Common Framework for Earth Observation Data that consists of recommended standards and approaches for realizing these goals as well as improving the discoverability, accessibility, and usability of federally held earth observation data. These recommendations will also guide work being performed under the Big Earth Data Initiative (BEDI). This talk will summarize the Common Framework, the philosophy behind it, and next steps forward.

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

PubMed

Dadich, Ann; Doloswala, Navin

2018-05-10

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

Culture, social networks and HIV vulnerability among men who have sex with men in Indonesia.

PubMed

Fauk, Nelsensius Klau; Merry, Maria Silvia; Sigilipoe, Mitra Andhini; Putra, Sukma; Mwanri, Lillian

2017-01-01

The current study aimed to explore cultural and social network influence on HIV vulnerability among Men who have Sex with Men (MSM) population in Yogyakarta, Indonesia. A qualitative inquiry employing in-depth one-on-one interviews was carried out with 24 MSM participants in July 2015. Data were analysed using a framework analysis and guided by the Social Networks Theory (SNT) as a conceptual framework. Findings indicated that prohibitive cultural perspectives and norms against same-sex marriage made them to conceal their sexual orientation and thus secretively engaging in unprotected sex that increased their predisposition to HIV transmission. The prohibitive cultures were also instrumental in the formation of MSM sexual networks that provided supportive environment for HIV-risky sexual practices among network partners. These findings provide information that can be used to improve HIV/AIDS service practices and policies. However, further studies with large numbers of MSM would be needed to improve the understanding of other HIV vulnerability determinants, the unique needs of MSM, and what and how programs could be conducted to reduce HIV vulnerability among MSM population.

An investigation of the ways in which public health nutrition policy and practices can address climate change.

PubMed

Sulda, Heidi; Coveney, John; Bentley, Michael

2010-03-01

To develop a framework to guide action in the public health nutrition workforce to develop policies and practices addressing factors contributing to climate change. Action/consultative research. Interviews - South Australia, questionnaire - Australia. Interviews - key informants (n 6) were from various government, academic and non-government positions, invited through email. Questionnaire - participants were members of the public health nutrition workforce (n 186), recruited to the study through emails from public health nutrition contacts for each State in Australia (with the exception of South Australia). Support by participants for climate change as a valid role for dietitians and nutritionists was high (78 %). However, climate change was ranked low against other public health nutrition priorities. Support of participants to conduct programmes to address climate change from professional and work organisations was low. The final framework developed included elements of advocacy/lobbying, policy, professional recognition/support, organisational support, knowledge/skills, partnerships and programmes. This research demonstrates a need for public health nutrition to address climate change, which requires support by organisations, policy, improved knowledge and increased professional development opportunities.

Theory and knowledge translation: setting some coordinates.

PubMed

Rycroft-Malone, Jo

2007-01-01

In a healthcare context in which research evidence is not used routinely in practice, there have been increasingly loud calls for the use of theory from investigators working in the field of knowledge translation. Implementation researchers argue that theory should be used to guide the design of testable and practical intervention strategies, and thus, contribute to generalizable knowledge about implementation interventions. The purpose of this commentary is to critique model papers writing by a team of scholars who aimed to disentangle some of the relationships determining research utilization, by scrutinizing an existing conceptual framework that acknowledges, along with other factors, the importance of contextual factors in knowledge translation. These papers are used as a vehicle to explore theory application in knowledge translation research. As theory use and development is in its infancy, some key issues, including different ideological perspectives, factors for and against theory use, ensuring conceptual clarity, selecting coherent overarching frameworks, and choosing appropriately among theories, are considered. Finally, an agenda for theory-informed research is outlined, which highlights the need for scholarly, pluralistic, and collaborative activity if the state of knowledge translation science is to advance.

Differential Susceptibility in Spillover Between Interparental Conflict and Maternal Parenting Practices: Evidence for OXTR and 5-HTT Genes

PubMed Central

Sturge-Apple, Melissa L.; Cicchetti, Dante; Davies, Patrick T.; Suor, Jennifer H.

2012-01-01

Guided by the affective spillover hypothesis and the differential susceptibility to environmental influence frameworks, the present study examined how associations between interparental conflict and mothers’ parenting practices were moderated by serotonin transporter (5-HTT) and oxytocin receptor (OXTR) genes. A sample of 201 mothers and their two-year old child participated in a laboratory-based research assessment. Results supported differential susceptibility hypotheses within spillover frameworks. With respect to OXTR rs53576, mothers with the GG genotype showed greater differential maternal sensitivity across varying levels of interparental conflict. Mothers with one or two copies of the 5-HTTLPR S allele demonstrated differential susceptibility for both sensitive and harsh/punitive caregiving behaviors. Finally, analyses examined whether maternal depressive symptoms and emotional closeness to their child mediated the moderating effects. Findings suggest that maternal emotional closeness with their child indirectly linked OXTR with maternal sensitivity. The results highlight how molecular genetics may explain heterogeneity in spillover models with differential implications for specific parenting behaviors. Implications for clinicians and therapists working with maritally distressed parents are discussed. PMID:22563705

Equity in Science at South African Schools: A pious platitude or an achievable goal?

NASA Astrophysics Data System (ADS)

Dewnarain Ramnarain, Umesh

2011-07-01

The apartheid policies in South Africa had a marked influence on the accessibility and quality of school science experienced by the different race groups. African learners in particular were seriously disadvantaged in this regard. The issues of equity and redress were foremost in transformation of the education system, and the accompanying curriculum reform. This paper reports on equity in terms of equality of outputs and equality of inputs in South African school science, with a particular focus on the implementation of practical science investigations. This was a qualitative case study of two teachers on their implementation of science investigations at two schools, one a township school, previously designated for black children, and the other a former Model C school, previously reserved for white children. My study was guided by the curriculum implementation framework by Rogan and Grayson in trying to understand the practice of these teachers at schools located in contextually diverse communities. The framework helped profile the implementation of science investigations and also enabled me to explore the factors which are able to support or hinder this implementation.

Analysis of Nursing Clinical Decision Support Requests and Strategic Plan in a Large Academic Health System.

PubMed

Whalen, Kimberly; Bavuso, Karen; Bouyer-Ferullo, Sharon; Goldsmith, Denise; Fairbanks, Amanda; Gesner, Emily; Lagor, Charles; Collins, Sarah

2016-01-01

To understand requests for nursing Clinical Decision Support (CDS) interventions at a large integrated health system undergoing vendor-based EHR implementation. In addition, to establish a process to guide both short-term implementation and long-term strategic goals to meet nursing CDS needs. We conducted an environmental scan to understand current state of nursing CDS over three months. The environmental scan consisted of a literature review and an analysis of CDS requests received from across our health system. We identified existing high priority CDS and paper-based tools used in nursing practice at our health system that guide decision-making. A total of 46 nursing CDS requests were received. Fifty-six percent (n=26) were specific to a clinical specialty; 22 percent (n=10) were focused on facilitating clinical consults in the inpatient setting. "Risk Assessments/Risk Reduction/Promotion of Healthy Habits" (n=23) was the most requested High Priority Category received for nursing CDS. A continuum of types of nursing CDS needs emerged using the Data-Information-Knowledge-Wisdom Conceptual Framework: 1) facilitating data capture, 2) meeting information needs, 3) guiding knowledge-based decision making, and 4) exposing analytics for wisdom-based clinical interpretation by the nurse. Identifying and prioritizing paper-based tools that can be modified into electronic CDS is a challenge. CDS strategy is an evolving process that relies on close collaboration and engagement with clinical sites for short-term implementation and should be incorporated into a long-term strategic plan that can be optimized and achieved overtime. The Data-Information-Knowledge-Wisdom Conceptual Framework in conjunction with the High Priority Categories established may be a useful tool to guide a strategic approach for meeting short-term nursing CDS needs and aligning with the organizational strategic plan.

Self-guided field trips for students of environments

NASA Astrophysics Data System (ADS)

Moore, G.; Kerr, Roger; Hadgraft, Roger

2011-05-01

In many learning institutions around the world, there is a trend towards larger classes, more flexible learning pathways and reduced teaching resources. Experiential learning is often used in the form of site visits or field trips for students studying engineering, natural resource management, geography and similar disciplines. Providing opportunities for students to undertake field trips without the traditional support mechanism is one of the more challenging issues for subject designers. How can large cohorts of students gain practical exposure to various aspects of the natural or built environment? Although this is typically done using traditional site visits and fieldwork with a high staff/student ratio, the goal has been to use action research to design and develop resources to enable small groups (three or four) to make self-guided visits to sites close to campus. Multimedia resources to examine and interpret aspects of the site that relate to their on-campus learning guide the students. One critical issue in the success of these activities has been proper risk assessment and control procedures. The outcome of this research is a framework to provide a safe, active learning experience by way of self-guided field trips that is suitable for implementation with large classes.

Science: Grade 7. Interim Guide.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg.

This guide is one of a set of 10 science guides, each covering a separate grade in Manitoba, together covering kindergarten through grade 9. The guides have been designed to provide a framework for building scientific concepts and developing the learning of process skills. They replace an earlier set of guides dated 1979. Each guide is essentially…

Science: Grade 6. Interim Guide.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg.

This guide is one of a set of 10 science guides, each covering a separate grade in Manitoba, together covering kindergarten through grade 9. The guides have been designed to provide a framework for building scientific concepts and developing the learning of process skills. They replace an earlier set of guides dated 1979. Each guide is essentially…

Science: Grade 8. Interim Guide.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg.

This guide is one of a set of 10 science guides, each covering a separate grade in Manitoba, together covering kindergarten through grade 9. The guides have been designed to provide a framework for building scientific concepts and developing the learning of process skills. They replace an earlier set of guides dated 1979. Each guide is essentially…

Science: Grade 2. Interim Guide.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg.

This guide is one of a set of 10 science guides, each covering a separate grade in Manitoba, together covering kindergarten through grade 9. The guides have been designed to provide a framework for building scientific concepts and developing the learning of process skills. They replace an earlier set of guides dated 1979. Each guide is essentially…

Science: Grade 1. Interim Guide.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg.

This guide is one of a set of 10 science guides, each covering a separate grade in Manitoba, together covering kindergarten through grade 9. The guides have been designed to provide a framework for building scientific concepts and developing the learning of process skills. They replace an earlier set of guides dated 1979. Each guide is essentially…

Science: Kindergarten. Interim Guide.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg.

This guide is one of a set of 10 science guides, each covering a separate grade in Manitoba, together covering kindergarten through grade 9. The guides have been designed to provide a framework for building scientific concepts and developing the learning of process skills. They replace an earlier set of guides dated 1979. Each guide is essentially…

Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care.

PubMed

Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

2012-10-01

Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ± 24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ± 7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1.

Using a knowledge translation framework to implement asthma clinical practice guidelines in primary care

PubMed Central

Licskai, Christopher; Sands, Todd; Ong, Michael; Paolatto, Lisa; Nicoletti, Ivan

2012-01-01

Quality problem International guidelines establish evidence-based standards for asthma care; however, recommendations are often not implemented and many patients do not meet control targets. Initial assessment Regional pilot data demonstrated a knowledge-to-practice gap. Choice of solutions We engineered health system change in a multi-step approach described by the Canadian Institutes of Health Research knowledge translation framework. Implementation Knowledge translation occurred at multiple levels: patient, practice and local health system. A regional administrative infrastructure and inter-disciplinary care teams were developed. The key project deliverable was a guideline-based interdisciplinary asthma management program. Six community organizations, 33 primary care physicians and 519 patients participated. The program operating cost was $290/patient. Evaluation Six guideline-based care elements were implemented, including spirometry measurement, asthma controller therapy, a written self-management action plan and general asthma education, including the inhaler device technique, role of medications and environmental control strategies in 93, 95, 86, 100, 97 and 87% of patients, respectively. Of the total patients 66% were adults, 61% were female, the mean age was 35.7 (SD = ±24.2) years. At baseline 42% had two or more symptoms beyond acceptable limits vs. 17% (P< 0.001) post-intervention; 71% reported urgent/emergent healthcare visits at baseline (2.94 visits/year) vs. 45% (1.45 visits/year) (P< 0.001); 39% reported absenteeism (5.0 days/year) vs. 19% (3.0 days/year) (P< 0.001). The mean follow-up interval was 22 (SD = ±7) months. Lessons learned A knowledge-translation framework can guide multi-level organizational change, facilitate asthma guideline implementation, and improve health outcomes in community primary care practices. Program costs are similar to those of diabetes programs. Program savings offset costs in a ratio of 2.1:1 PMID:22893665

Who uses nursing theory? A univariate descriptive analysis of five years' research articles.

PubMed

Bond, A Elaine; Eshah, Nidal Farid; Bani-Khaled, Mohammed; Hamad, Atef Omar; Habashneh, Samira; Kataua', Hussein; al-Jarrah, Imad; Abu Kamal, Andaleeb; Hamdan, Falastine Rafic; Maabreh, Roqia

2011-06-01

Since the early 1950s, nursing leaders have worked diligently to build the Scientific Discipline of Nursing, integrating Theory, Research and Practice. Recently, the role of theory has again come into question, with some scientists claiming nurses are not using theory to guide their research, with which to improve practice. The purposes of this descriptive study were to determine: (i) Were nursing scientists' research articles in leading nursing journals based on theory? (ii) If so, were the theories nursing theories or borrowed theories? (iii) Were the theories integrated into the studies, or were they used as organizing frameworks? Research articles from seven top ISI journals were analysed, excluding regularly featured columns, meta-analyses, secondary analysis, case studies and literature reviews. The authors used King's dynamic Interacting system and Goal Attainment Theory as an organizing framework. They developed consensus on how to identify the integration of theory, searching the Title, Abstract, Aims, Methods, Discussion and Conclusion sections of each research article, whether quantitative or qualitative. Of 2857 articles published in the seven journals from 2002 to, and including, 2006, 2184 (76%) were research articles. Of the 837 (38%) authors who used theories, 460 (55%) used nursing theories, 377 (45%) used other theories: 776 (93%) of those who used theory integrated it into their studies, including qualitative studies, while 51 (7%) reported they used theory as an organizing framework for their studies. Closer analysis revealed theory principles were implicitly implied, even in research reports that did not explicitly report theory usage. Increasing numbers of nursing research articles (though not percentagewise) continue to be guided by theory, and not always by nursing theory. Newer nursing research methods may not explicitly state the use of nursing theory, though it is implicitly implied. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

A new framing approach in guideline development to manage different sources of knowledge.

PubMed

Lukersmith, Sue; Hopman, Katherine; Vine, Kristina; Krahe, Lee; McColl, Alexander

2017-02-01

Contemporary guideline methodology struggles to consider context and information from different sources of knowledge besides quantitative research. Return to work programmes involve multiple components and stakeholders. If the guideline is to be relevant and practical for a complex intervention such as return to work, it is essential to use broad sources of knowledge. This paper reports on a new method in guideline development to manage different sources of knowledge. The method used framing for the return-to-work guidance within the Clinical Practice Guidelines for the Management of Rotator Cuff Syndrome in the Workplace. The development involved was a multi-disciplinary working party of experts including consumers. The researchers considered a broad range of research, expert (practice and experience) knowledge, the individual's and workplace contexts, and used framing with the International Classification of Functioning, Disability and Health. Following a systematic database search on four clinical questions, there were seven stages of knowledge management to extract, unpack, map and pack information to the ICF domains framework. Companion graded recommendations were developed. The results include practical examples, user and consumer guides, flow charts and six graded or consensus recommendations on best practice for return to work intervention. Our findings suggest using framing in guideline methodology with internationally accepted frames such as the ICF is a reliable and transparent framework to manage different sources of knowledge. Future research might examine other examples and methods for managing complexity and using different sources of knowledge in guideline development. © 2016 John Wiley & Sons, Ltd.

A theoretical framework for antigay aggression: Review of established and hypothesized effects within the context of the general aggression model⋆

PubMed Central

Parrott, Dominic J.

2008-01-01

Theory and research on antigay aggression has identified different motives that facilitate aggression based on sexual orientation. However, the individual and situational determinants of antigay aggression associated with these motivations have yet to be organized within a single theoretical framework. This limits researchers’ ability to organize existing knowledge, link that knowledge with related aggression theory, and guide the application of new findings. To address these limitations, this article argues for the use of an existing conceptual framework to guide thinking and generate new research in this area of study. Contemporary theories of antigay aggression, and empirical support for these theories, are reviewed and interpreted within the unifying framework of the general aggression model [Anderson, C.A. & Bushman, B.J. (2002). Human aggression. Annual Review of Psychology, 53, 27–51.]. It is concluded that this conceptual framework will facilitate investigation of individual and situational risk factors that may contribute to antigay aggression and guide development of individual-level intervention. PMID:18355952

Co-Operative Advances in Behavioral Health and Performance Research and Operations

NASA Technical Reports Server (NTRS)

VanderArk, Stephen T.; Leveton, Lauren B.

2011-01-01

In organizations that engage in both operations and applied research, with operational needs guiding research questions and research informing improved operations, the ideal goal is a synergy of ideas and information. In reality, this ideal synergy is often lacking. Real-time operational needs driving day-to-day decisions, lack of communication, lag time in getting research advances plugged into operations can cause both areas to suffer from this gap between operations and research. At Johnson Space Center, the Behavior Health and Performance group (BHP) strives to bridge this gap by following a Human Research Program framework: Expectations of future operational needs identify the knowledge gaps; the gaps in turn guide research leading to a product that is transitioned into operations. Thus, the direction those of us in research take is in direct response to current and future needs of operations. Likewise, those of us in operations actively seek knowledge that is supported by evidence-based research. We make an ongoing effort to communicate across the research and operations gap by working closely with each other and making a conscious effort to keep each other informed. The objective of the proposed panel discussion is to demonstrate through the following presentations the results of a successful collaboration between research and operations and to provide ASMA members with more practical knowledge and strategies for building these bridges to serve our field of practice well. The panel will consist of six presenters from BHP operations, internal BHP research, and external research instigated by BHP who together represent the entire BHP Research Transition to Operations Framework

Reasoning and Data Representation in a Health and Lifestyle Support System.

PubMed

Hanke, Sten; Kreiner, Karl; Kropf, Johannes; Scase, Marc; Gossy, Christian

2017-01-01

Case-based reasoning and data interpretation is an artificial intelligence approach that capitalizes on past experience to solve current problems and this can be used as a method for practical intelligent systems. Case-based data reasoning is able to provide decision support for experts and clinicians in health systems as well as lifestyle systems. In this project we were focusing on developing a solution for healthy ageing considering daily activities, nutrition as well as cognitive activities. The data analysis of the reasoner followed state of the art guidelines from clinical practice. Guidelines provide a general framework to guide clinicians, and require consequent background knowledge to become operational, which is precisely the kind of information recorded in practice cases; cases complement guidelines very well and helps to interpret them. It is expected that the interest in case-based reasoning systems in the health.

Definitional ceremonies: narrative practices for psychologists to inform interdisciplinary teams' understanding of children's spirituality in pediatric settings.

PubMed

Moore, Kelsey; Talwar, Victoria; Moxley-Haegert, Linda

2015-03-01

In pediatric settings, parents and children often seek spiritual and religious support from their healthcare provider, as they try to find meaning in their illness. Narrative practices, such as definitional ceremonies, can provide a unique framework for psychologists to explore children's spirituality and its role in the midst of illness. In addition, definitional ceremonies can be used as a means for psychologists to inform interdisciplinary teams' understanding of children's spirituality and its relevance in pediatric treatment settings. In this article, our objectives are to (a) provide a brief overview of the literature on children's spirituality, (b) review some of the literature on childhood cancer patients' spirituality, (c) highlight the importance of whole-person care for diverse pediatric patients, and (d) introduce definitional ceremonies as appropriate narrative practices that psychologists can use to both guide their therapy and inform interdisciplinary teams' understanding of children's spirituality. © The Author(s) 2015.