Learner-Controlled Practice Difficulty in the Training of a Complex Task: Cognitive and Motivational Mechanisms

ERIC Educational Resources Information Center

Hughes, Michael G.; Day, Eric Anthony; Wang, Xiaoqian; Schuelke, Matthew J.; Arsenault, Matthew L.; Harkrider, Lauren N.; Cooper, Olivia D.

2013-01-01

An inherent aspect of learner-controlled instructional environments is the ability of learners to affect the degree of difficulty faced during training. However, research has yet to examine how learner-controlled practice difficulty affects learning. Based on the notion of "desirable difficulties" (Bjork, 1994), this study examined the…

Excessive behaviors in clinical practice--A state of the art article.

PubMed

Punzi, Elisabeth H

2016-01-01

This paper concerns difficulties with excessive food intake, sexual activities, romantic relationships, gambling, Internet use, shopping, and exercise-behaviors that might cause considerable suffering. Excessive behaviors are seen as expressions of underlying difficulties that often co-occur with other psychological difficulties, and behaviors may accompany or replace each other. Moreover, they might pass unnoticed in clinical practice. Given the complexity of excessive behaviors, integrated and individualized treatment has been recommended. This paper presents an overview of the terminology concerning excessive behaviors, and the impact of naming is acknowledged. Thereafter, methods for identification and assessment, as well as treatment needs are discussed. Because identification, assessment, and treatment occur in an interaction between client and practitioner, this paper presents a discussion of the need to empower practitioners to identify and assess excessive behaviors and provide an integrated treatment. Moreover, the need to support practitioners' capacity to handle and tolerate the overwhelming suffering and the negative consequences connected to excessive behaviors is discussed. Qualitative studies are suggested in order to understand the meaning of excessive behaviors, treatment needs, and the interaction between client and practitioner.

Enhancing the Student Experiment Experience: Visible Scientific Inquiry Through a Virtual Chemistry Laboratory

NASA Astrophysics Data System (ADS)

Donnelly, Dermot; O'Reilly, John; McGarr, Oliver

2013-08-01

Practical work is often noted as a core reason many students take on science in secondary schools (high schools). However, there are inherent difficulties associated with classroom practical work that militate against scientific inquiry, an approach espoused by many science educators. The use of interactive simulations to facilitate student inquiry has emerged as a complement to practical work. This study presents case studies of four science teachers using a virtual chemistry laboratory (VCL) with their students in an explicitly guided inquiry manner. Research tools included the use of the Inquiry Science Implementation Scale in a `talk-aloud' manner, Reformed Teaching Observation Protocol for video observations, and teacher interviews. The findings suggest key aspects of practical work that hinder teachers in adequately supporting inquiry and highlight where a VCL can overcome many of these difficulties. The findings also indicate considerations in using the VCL in its own right.

Life-cycle costing: Practical considerations

NASA Technical Reports Server (NTRS)

Eisenberger, I.; Lorden, G.

1977-01-01

The history and methodology of life-cycle costing are presented and analyzed, contrasting the potential benefits of the technique with the difficulties of its application. Examples and a short survey of the literature are given.

"Hands on" in bioengineering.

PubMed

Bastos, Teodiano F; Muller, Sandra M T

2010-01-01

Several students of Bioengineering complain about the excess of theoretical classes and the difficulty to assimilate the subject taught. This article presents a strategy to mix theory and practice when teaching, thus motivating students to engage in their studies.

Reflections on providing sport science support for athletes with learning difficulties.

PubMed

Hills, Laura; Utley, Andrea

2010-01-01

To highlight the benefits and the need for sport science support for athletes with learning difficulties, and to reflect on our experience of working with the GB squad for athletes with learning difficulties. A review of key and relevant literature is presented, followed by a discussion of the sport science support provision and the issues that emerged in working with athletes with learning difficulties. Pre- and post- physiological tests along with evaluations of athletes' potential to benefit from sport psychology support were conducted. The aim of these tests was to provide information for the athletes and the coaches on fitness levels, to use this information to plan future training, and to identify how well the performance could be enhanced. A case study is presented for one athlete, who had competed in distance events. The focus is the psychological support that was provided. It is clear that athletes with learning difficulties require the same type of sports science support as their mainstream peers. However, sport scientists will need to consider ways to extend their practice in order to provide the appropriate level of support.

Experience in the Creation of Elite Schools in the Moscow Area

ERIC Educational Resources Information Center

Egorov, O. G.

2005-01-01

One of the chief difficulties of pedagogical science at the present stage has been the growing discrepancy between theory and practice. The former is built basically on an analysis or critique of the Soviet model of the schools, which, in basic outline, persists to this day. In practice, there is an ongoing conflict between the inertia of the…

A systematic literature review of evidence-based clinical practice for rare diseases: what are the perceived and real barriers for improving the evidence and how can they be overcome?

PubMed

Rath, Ana; Salamon, Valérie; Peixoto, Sandra; Hivert, Virginie; Laville, Martine; Segrestin, Berenice; Neugebauer, Edmund A M; Eikermann, Michaela; Bertele, Vittorio; Garattini, Silvio; Wetterslev, Jørn; Banzi, Rita; Jakobsen, Janus C; Djurisic, Snezana; Kubiak, Christine; Demotes-Mainard, Jacques; Gluud, Christian

2017-11-22

Evidence-based clinical practice is challenging in all fields, but poses special barriers in the field of rare diseases. The present paper summarises the main barriers faced by clinical research in rare diseases, and highlights opportunities for improvement. Systematic literature searches without meta-analyses and internal European Clinical Research Infrastructure Network (ECRIN) communications during face-to-face meetings and telephone conferences from 2013 to 2017 within the context of the ECRIN Integrating Activity (ECRIN-IA) project. Barriers specific to rare diseases comprise the difficulty to recruit participants because of rarity, scattering of patients, limited knowledge on natural history of diseases, difficulties to achieve accurate diagnosis and identify patients in health information systems, and difficulties choosing clinically relevant outcomes. Evidence-based clinical practice for rare diseases should start by collecting clinical data in databases and registries; defining measurable patient-centred outcomes; and selecting appropriate study designs adapted to small study populations. Rare diseases constitute one of the most paradigmatic fields in which multi-stakeholder engagement, especially from patients, is needed for success. Clinical research infrastructures and expertise networks offer opportunities for establishing evidence-based clinical practice within rare diseases.

Determinants of HMO success: the case of Complete Health.

PubMed

Widra, L S; Fottler, M D

1992-01-01

The health maintenance organization (HMO) industry has experienced a variety of difficulties and criticisms in recent years. Various hybrid models have been proposed to alleviate these problems. This article presents an in-depth case study of factors associated with the success of one such hybrid: an individual practice association (IPA)-model HMO affiliated with an academic health center. The major success factors identified include the plan design/structure, the strategic orientation/practices, and the stakeholder management orientation practices.

"AmI for health: chronic disease management".

PubMed

Arredondo, M T; Fico, G; Pastor, L

2011-01-01

Several students of Bioengineering complain about the excess of theoretical classes and the difficulty to assimilate the subject taught. This work presents a strategy to mix theory and practice when teaching, thus motivating students to engage in their studies.

Bi-Stability of Movement Coordination as a Function of Skill Level and Task Difficulty

ERIC Educational Resources Information Center

Liu, Yeou-Teh; Mayer-Kress, Gottfried; Newell, Karl M.

2010-01-01

This study investigated whether the level of practice interacts with the initial conditions (here manipulated as preparatory movements) and task difficulty (ball angular velocity and friction) in determining the stability of movement coordination for a roller ball motor task. Practice level and task difficulty were manipulated as two control…

Leaving

ERIC Educational Resources Information Center

Jones, Robyn L.

2011-01-01

Within this article, the author presents a personal story, "Leaving," which highlights the problematic experience of opposing established practice. The tale tells of the difficulty faced by creative agency when confronted by a constraining structural hegemony. Specifically, it draws attention to the professionalization of academic life through a…

Aligning Needs, Expectations, and Learning Outcomes to Sustain Self-Efficacy through Transfer Learning Community Programs

ERIC Educational Resources Information Center

Leptien, Jennifer R.

2015-01-01

This chapter addresses strengths and difficulties encountered in implementing transfer learning community models and how efficacy is supported through transfer learning community programming. Transfer programming best practices and recommendations for program improvements are presented.

Evaluation of nursing practice: process and critique.

PubMed

Braunstein, M S

1998-01-01

This article describes the difficulties in conducting clinical trials to evaluate nursing practice models. Suggestions are offered for strengthening the process. A clinical trial of a nursing practice model based on a synthesis of Aristotelian theory with Rogers' science is described. The rationale for decisions regarding the research procedures used in presented. Methodological limitations of the study design and the specifications of the practice model are examined. It is concluded that clear specification of theoretical relationships within a practice model and clear identification of key intervening variables will enable researchers to better connect the treatment with the outcome.

Linking a Medical User Survey to Management for Library Effectiveness: II, A Checkland Soft Systems Study.

ERIC Educational Resources Information Center

Brember, V. L.

1985-01-01

Presents Checkland's soft systems methodology, discusses it in terms of the systems approach, and illustrates how it was used to relate evidence of user survey to practical problems of library management. Difficulties in using methodology are described and implications for library management and information science research are presented. (8…

Executive Function in Education: From Theory to Practice

ERIC Educational Resources Information Center

Meltzer, Lynn, Ed.

2007-01-01

This uniquely integrative book brings together leading researchers and practitioners from education, neuroscience, and psychology. It presents a theoretical framework for understanding executive function difficulties together with a range of effective approaches to assessment and instruction. Coverage includes executive function processes in…

Feasibility of the adaptive and automatic presentation of tasks (ADAPT) system for rehabilitation of upper extremity function post-stroke.

PubMed

Choi, Younggeun; Gordon, James; Park, Hyeshin; Schweighofer, Nicolas

2011-08-03

Current guidelines for rehabilitation of arm and hand function after stroke recommend that motor training focus on realistic tasks that require reaching and manipulation and engage the patient intensively, actively, and adaptively. Here, we investigated the feasibility of a novel robotic task-practice system, ADAPT, designed in accordance with such guidelines. At each trial, ADAPT selects a functional task according to a training schedule and with difficulty based on previous performance. Once the task is selected, the robot picks up and presents the corresponding tool, simulates the dynamics of the tasks, and the patient interacts with the tool to perform the task. Five participants with chronic stroke with mild to moderate impairments (> 9 months post-stroke; Fugl-Meyer arm score 49.2 ± 5.6) practiced four functional tasks (selected out of six in a pre-test) with ADAPT for about one and half hour and 144 trials in a pseudo-random schedule of 3-trial blocks per task. No adverse events occurred and ADAPT successfully presented the six functional tasks without human intervention for a total of 900 trials. Qualitative analysis of trajectories showed that ADAPT simulated the desired task dynamics adequately, and participants reported good, although not excellent, task fidelity. During training, the adaptive difficulty algorithm progressively increased task difficulty leading towards an optimal challenge point based on performance; difficulty was then continuously adjusted to keep performance around the challenge point. Furthermore, the time to complete all trained tasks decreased significantly from pretest to one-hour post-test. Finally, post-training questionnaires demonstrated positive patient acceptance of ADAPT. ADAPT successfully provided adaptive progressive training for multiple functional tasks based on participant's performance. Our encouraging results establish the feasibility of ADAPT; its efficacy will next be tested in a clinical trial.

[The legal status of medical students during practical training in hospitals (author's transl)].

PubMed

Liebhardt, E; Spann, W; Marx, B

1977-10-21

The most important change in the qualification regulations in force at the present time is the provision for the practical training of medical students, which occurs not only in university hospitals but also in "teaching hospitals" outside the university. The realization of the practical year is problematic according to the actual conditions because of the difficulties and financial investment necessarily associated with it. Furthermore, the legal status of the students during the practical activities differes from that of earlier medical assistants, because according to the present law the legal provisions for employment and social insurance such as the determination of division of labour, working hours and remuneration and also for third party and accident insurance do not apply.

Photonic nonlinearities via quantum Zeno blockade.

PubMed

Sun, Yu-Zhu; Huang, Yu-Ping; Kumar, Prem

2013-05-31

Realizing optical-nonlinear effects at a single-photon level is a highly desirable but also extremely challenging task, because of both fundamental and practical difficulties. We present an avenue to surmounting these difficulties by exploiting quantum Zeno blockade in nonlinear optical systems. Considering specifically a lithium-niobate microresonator, we find that a deterministic phase gate can be realized between single photons with near-unity fidelity. Supported by established techniques for fabricating and operating such devices, our approach can provide an enabling tool for all-optical applications in both classical and quantum domains.

Best Practices in Working with Students with Emotion Dysregulation

ERIC Educational Resources Information Center

Cunningham, Jennifer; Mendez, Linda M. Raffaele; Sundman-Wheat, Ashley N.

2011-01-01

Students with emotion dysregulation have significant difficulty modulating emotional reactions, particularly in response to frustration or challenge. These children can present with a variety of DSM diagnoses in schools, including attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), major depressive disorder (MDD),…

In Pursuit of Authentic School Leadership Practices.

ERIC Educational Resources Information Center

Begley, Paul T.

2001-01-01

Describes authentic leadership and the essential characteristics of values. Discusses concept of values and semantic difficulties related thereto. Uses onion metaphors to illustrate syntax of values terminology and seven arenas of administration. Suggests that discussion and concepts presented in onion illustrations will contribute to school…

Divided attention: an undesirable difficulty in memory retention.

PubMed

Gaspelin, Nicholas; Ruthruff, Eric; Pashler, Harold

2013-10-01

How can we improve memory retention? A large body of research has suggested that difficulty encountered during learning, such as when practice sessions are distributed rather than massed, can enhance later memory performance (see R. A. Bjork & E. L. Bjork, 1992). Here, we investigated whether divided attention during retrieval practice can also constitute a desirable difficulty. Following two initial study phases and one test phase with Swahili-English word pairs (e.g., vuvi-snake), we manipulated whether items were tested again under full or divided attention. Two days later, participants were brought back for a final cued-recall test (e.g., vuvi-?). Across three experiments (combined N = 122), we found no evidence that dividing attention while practicing retrieval enhances memory retention. This finding raises the question of why many types of difficulty during practice do improve long-term retention, but dividing attention does not.

Re-entry Adjustment and Job Embeddedness: The Mediating Role of Professional Identity in Indonesian Returnees.

PubMed

Andrianto, Sonny; Jianhong, Ma; Hommey, Confidence; Damayanti, Devi; Wahyuni, Honey

2018-01-01

The present study examined the relationship between difficulty in re-entry adjustment and job embeddedness, considering the mediating role of sense of professional identity. The online data on demographic characteristics, difficulty on re-entry adjustment, sense of professional identity, and job embeddedness were collected from 178 Indonesian returnees from multiple organizations. The results showed that difficulty in re-entry adjustment was a significant predictor of a sense of professional identity; a sense of professional identity was a significant predictor of job embeddedness. Furthermore, sense of professional identity is an effective mediating variable, bridging the relationship between post-return conditions to the home country and work atmosphere. Finally, the key finding of this study was that sense of professional identity mediated the effect of difficulty in re-entry adjustment on job embeddedness. The theoretical and practical implications, study limitations, and future research needs of our findings are noted.

A Practical Approach to Vocabulary Reinforcement.

ERIC Educational Resources Information Center

Stieglitz, Ezra L.

1983-01-01

Techniques of semantic feature analysis are applied to exploration and reinforcement of vocabulary. Students are presented with categories of familiar items and asked to describe their characteristics. The method can be used to elicit sentences, reinforce existing vocabulary, and begin discussion. Sample exercises for several difficulty levels are…

Treatment of Not-Administered Items on Individually Administered Intelligence Tests

ERIC Educational Resources Information Center

He, Wei; Wolfe, Edward W.

2012-01-01

In administration of individually administered intelligence tests, items are commonly presented in a sequence of increasing difficulty, and test administration is terminated after a predetermined number of incorrect answers. This practice produces stochastically censored data, a form of nonignorable missing data. By manipulating four factors…

Practical Educational Prescriptions for Students in the Mainstream.

ERIC Educational Resources Information Center

Choate, Joyce S., Ed.; Young, Larry S., Ed.

Activity suggestions developed by experienced teachers are presented for mainstreamed students with difficulties in specific instructional areas of reading, mathematics, spelling, writing, and behavior. Activity descriptions are grouped according to instructional area, and are classified as large group, small group, or one to one exercises.…

Difficulties in conducting a randomized controlled trial of health service interventions in intellectual disability: implications for evidence-based practice.

PubMed

Oliver, P C; Piachaud, J; Done, J; Regan, A; Cooray, S; Tyrer, P

2002-05-01

In an era of evidence-based medicine, practice is constantly monitored for quality in accordance with the needs of clinical governance (Oyebode et al. 1999). This is likely to lead to a dramatic change in the treatment of those with intellectual disability (ID), in which evidence for effective intervention is limited for much that happens in ordinary practice. As Fraser (2000, p. 10) has commented, the word that best explains "the transformation of learning disability practice in the past 30 years is 'enlightenment'." This is not enough to satisfy the demands of evidence, and Fraser exhorted us to embrace more research-based practice in a subject that has previously escaped randomized controlled trials (RCTs) of treatment because of ethical concerns over capacity and consent, which constitute a denial of opportunity which "is now at last regarded as disenfranchising". The present paper describes the difficulties encountered in setting up a RCT of a common intervention, i.e. assertive community treatment, and concludes that a fundamental change in attitudes to health service research in ID is needed if proper evaluation is to prosper.

This presentation will discuss how PLOS ONE collaborates with many different scientific communities to help create, share, and preserve the scholarly works produced by their researchers with emphasis on current common difficulties faced by communities, practical solutions, and a broader view of the importance of open data and reproducibility.

NASA Astrophysics Data System (ADS)

Kroffe, K.

2017-12-01

The mission of the Public Library of Science is to accelerate progress in science and medicine by leading a transformation in research communication. Researchers' ability to share their work without restriction is essential, but critical to sharing is open data, transparency in peer review, and an open approach to science assessment. In this session, we will discuss how PLOS ONE collaborates with many different scientific communities to help create, share, and preserve the scholarly works produced by their researchers with emphasis on current common difficulties faced by communities, practical solutions, and a broader view of the importance of open data and reproducibility.

Teaching Analytical Chemistry to Pharmacy Students: A Combined, Iterative Approach

ERIC Educational Resources Information Center

Masania, Jinit; Grootveld, Martin; Wilson, Philippe B.

2018-01-01

Analytical chemistry has often been a difficult subject to teach in a classroom or lecture-based context. Numerous strategies for overcoming the inherently practical-based difficulties have been suggested, each with differing pedagogical theories. Here, we present a combined approach to tackling the problem of teaching analytical chemistry, with…

Five Approaches to Avoid When Managing the Middle School Classroom

ERIC Educational Resources Information Center

Englehart, Joshua M.

2013-01-01

Too often, teachers encountering difficulties with classroom management focus only on the students rather than critically examining the influence of their own approaches on student behavior. Given the particular challenges that middle school students present, certain practices and expectations exacerbate management issues, and a lack of awareness…

Curriculum Development and Discursive Practices: Building a Training Culture around Dual Diagnosis.

ERIC Educational Resources Information Center

Goldsmith, Steve

Dual diagnosis of comorbid substance abuse and mental disorder is currently presenting great difficulties across Australia's health and community service sectors. Historically, mental health professionals have received relatively little formal education or training in substance abuse issues. A new curriculum on dual diagnosis was developed and…

Perls with Gloria Re-reviewed: Gestalt Techniques and Perls's Practices.

ERIC Educational Resources Information Center

Dolliver, Robert H.

1991-01-01

Reviews the filmed interview with Gloria by Perls (1965) which demonstrated some standard Gestalt therapy techniques and presents examples from film. Identifies discrepancies between Perls's description of Gestalt therapeutic processes and his interview behavior. Makes reflections on the inherent difficulties with the concept of the emerging…

Establishing Open and Critical Discourses in the Science Classroom: Reflecting on Initial Difficulties.

ERIC Educational Resources Information Center

Dawson, Vaille M.; Taylor, Peter C.

1998-01-01

Presents a reflective account of a science teacher's endeavors to use the referent of critical constructivism to transform her pedagogical practices. The context of the action research is a Year 10 bioethics unit taught at an independent girls' school. Contains 44 references. (DDR)

What Tension between Fidelity and Cultural Adaptation? A Reaction to Marsiglia and Booth

ERIC Educational Resources Information Center

Sampson, McClain; Torres, Luis R.

2015-01-01

This paper is a reaction to Marsiglia and Booths' paper, "Cultural Adaptation of Interventions in Real Practice Settings." In their paper, Marsiglia and Booth present the difficulty of implementing and replicating evidence-supported treatments, such as randomized clinical trials, among culturally diverse clients. Practitioners working in…

Continuous Professional Learning through School Based Strategic Planning

ERIC Educational Resources Information Center

Tytler, Russell

2007-01-01

There is ample evidence that in many countries school science is in difficulty, with declining student attitudes and uptake of science. This presentation argues that a key to addressing the problem lies in transforming teachers' classroom practice, and that pedagogical innovation is best supported within a school context. Evidence for effective…

The State Role in Promoting Equity.

ERIC Educational Resources Information Center

Richardson, Richard C., Jr.

Information, analysis, and commentary are presented in a report that examines the progress and difficulties that states are having in assuming more of a moral and practical leadership role in achieving equity in higher education among minorities. The report discusses the fundamental dilemma states face in trying to foster greater institutional…

Handbook of Learning Disabilities, Second Edition

ERIC Educational Resources Information Center

Swanson, H. Lee, Ed.; Harris, Karen R., Ed.; Graham, Steve, Ed.

2014-01-01

Widely regarded as the standard reference in the field, this comprehensive handbook presents state-of-the-art knowledge about the nature and classification of learning disabilities (LD), their causes, and how individuals with these difficulties can be identified and helped to succeed. Best practices are described for supporting student performance…

Teaching the Literature Review: A Practical Approach for College Instructors

ERIC Educational Resources Information Center

Cisco, Jonathan

2014-01-01

Instructors across the disciplines require their students to write literature reviews. Although numerous sources describe the literature review process, instructors and students face difficulty when approaching the structure of a literature review. This paper presents a straightforward, efficient approach for teaching students how to write a…

What Is Intensive Instruction and Why Is It Important?

ERIC Educational Resources Information Center

Fuchs, Douglas; Fuchs, Lynn S.; Vaughn, Sharon

2014-01-01

In this article, the authors present two models of intensive instruction for students with and without disabilities who are having difficulties with Response to Intervention (RTI) currently in practice (Tier 1: general instruction that all students receive in mainstream classrooms, and Tier 2: programs often involving small group instruction). The…

To Know Is Not Enough: Research Knowledge and Its Use

ERIC Educational Resources Information Center

Levin, Ben

2013-01-01

This paper is about the relationship between research, policy and practice in education. It outlines reasons for the increased interest in research and its impact and describe some of the difficulties in studying this relationship. A conceptualization of the knowledge mobilization process is presented that identifies three overlapping and…

Repeated retrieval practice and item difficulty: does criterion learning eliminate item difficulty effects?

PubMed

Vaughn, Kalif E; Rawson, Katherine A; Pyc, Mary A

2013-12-01

A wealth of previous research has established that retrieval practice promotes memory, particularly when retrieval is successful. Although successful retrieval promotes memory, it remains unclear whether successful retrieval promotes memory equally well for items of varying difficulty. Will easy items still outperform difficult items on a final test if all items have been correctly recalled equal numbers of times during practice? In two experiments, normatively difficult and easy Lithuanian-English word pairs were learned via test-restudy practice until each item had been correctly recalled a preassigned number of times (from 1 to 11 correct recalls). Despite equating the numbers of successful recalls during practice, performance on a delayed final cued-recall test was lower for difficult than for easy items. Experiment 2 was designed to diagnose whether the disadvantage for difficult items was due to deficits in cue memory, target memory, and/or associative memory. The results revealed a disadvantage for the difficult versus the easy items only on the associative recognition test, with no differences on cue recognition, and even an advantage on target recognition. Although successful retrieval enhanced memory for both difficult and easy items, equating retrieval success during practice did not eliminate normative item difficulty differences.

Brain potentials during mental arithmetic: effects of extensive practice and problem difficulty.

PubMed

Pauli, P; Lutzenberger, W; Rau, H; Birbaumer, N; Rickard, T C; Yaroush, R A; Bourne, L E

1994-07-01

Recent behavioral investigations indicate that the processes underlying mental arithmetic change systematically with practice from deliberate, conscious calculation to automatic, direct retrieval of answers from memory [Bourne, L.E.Jr. and Rickard, T.C., Mental calculation: The development of a cognitive skill, Paper presented at the Interamerican Congress of Psychology, San Jose, Costa Rica, 1991: Psychol. Rev., 95 (1988) 492-527]. Results reviewed by Moscovitch and Winocur [In: The handbook of aging and cognition, Erlbaum, Hillsdale, NJ, 1992, pp. 315-372] suggest that consciously controlled processes are more dependent on frontal lobe function than are automatic processes. It is appropriate, therefore to determine whether transitions in the locus of primary brain activity occur with practice on mental calculation. In this experiment, we examine the relationship between characteristics of event-related brain potentials (ERPs) and mental arithmetic. Single-digit mental multiplication problems varying in difficulty (problem size) were used, and subjects were trained on these problems for four sessions. Problem-size and practice effects were reliably found in behavioral measures (RT). The ERP was characterized by a pronounced late positivity after task presentation followed by a slow wave, and a negativity during response indication. These components responded differentially to the practice and problem-size manipulations. Practice mainly affected topography of the amplitude of positivity and offset latency of slow wave, and problem-size mainly offset latency of slow wave and pre-response negativity. Fronto-central positivity diminished from session to session, and the focus of positivity centered finally at centro-parietal regions.(ABSTRACT TRUNCATED AT 250 WORDS)

Audiologic Management of Older Adults With Hearing Loss and Compromised Cognitive/Psychoacoustic Auditory Processing Capabilities

PubMed Central

Kricos, Patricia B.

2006-01-01

The number and proportion of older adults in the United States population is increasing, and more clinical audiologists will be called upon to deliver hearing care to the approximately 35% to 50% of them who experience hearing difficulties. In recent years, the characteristics and sources of receptive communication difficulties in older individuals have been investigated by hearing scientists, cognitive psychologists, and audiologists. It is becoming increasingly apparent that cognitive compromises and psychoacoustic auditory processing disorders associated with aging may contribute to communication difficulties in this population. This paper presents an overview of best practices, based on our current knowledge base, for clinical management of older individuals with limitations in cognitive or psychoacoustic auditory processing capabilities, or both, that accompany aging. PMID:16528428

Medical students’ perceptions and understanding of their specific learning difficulties

PubMed Central

Abbott, Stephen; Bevere, Grazia; Roberts, Christopher M.

2013-01-01

Objectives The purpose of this study is to explore how medical students with Specific Learning Difficulties perceive and understand their Specific Learning Difficulty and how it has impacted on their experience of medical training. Method A purposive sample of fifteen students from one medical school was interviewed. Framework Analysis was used to identify and organise themes emerging from the data. An interpretation of the data was made capturing the essence of what had been learned. The concept of ‘reframing’ was then used to re-analyse and organise the data. Results Students reported having found ways to cope with their Specific Leaning Difficulty in the past, some of which proved inadequate to deal with the pressures of medical school. Diagnosis was a mixed experience: many felt relieved to understand their difficulties better, but some feared discrimination. Practical support was available in university but not in placement. Students focused on the impact of their Specific Learning Difficulty on their ability to pass undergraduate exams. Most did not contemplate difficulties post-qualification. Conclusions The rigours of the undergraduate medical course may reveal undisclosed Specific Learning Difficulties. Students need help to cope with such challenges, psychologically and practically in both classroom and clinical practice. University services for students with Specific Learning Difficulties should become familiar with the challenges of clinical placements, and ensure that academic staff has access to information about the needs of these students and how these can be met.

The Effect of Self-Regulated and Experimenter-Imposed Practice Schedules on Motor Learning for Tasks of Varying Difficulty

ERIC Educational Resources Information Center

Keetch, Katherine M.; Lee, Timothy D.

2007-01-01

Research suggests that allowing individuals to control their own practice schedule has a positive effect on motor learning. In this experiment we examined the effect of task difficulty and self-regulated practice strategies on motor learning. The task was to move a mouse-operated cursor through pattern arrays that differed in two levels of…

Perceived financial difficulties and maladjustment outcomes in adolescence.

PubMed

Fröjd, Sari; Marttunen, Mauri; Pelkonen, Mirjami; von der Pahlen, Bettina; Kaltiala-Heino, Riittakerttu

2006-10-01

Studies using traditional SES indicators in strictly adolescent populations have usually failed to find class differences in adolescent mental health. The present study aimed to find out whether there is an association between adolescent perceived financial difficulties of the family and adolescent maladjustment, and to explore the possible sex differences in this association. School-based survey on 3278 ninth grade students (15-16 years old) in two economically well developed Finnish cities. One-fifth of the adolescents reported that their family had financial difficulties in the previous 12 months. Perceiving financial difficulties was significantly more common among girls than boys. Perceived financial difficulties were associated with known risk factors of poverty and with depression and harmful drinking patterns in both sexes. Adjusting for parental educational levels, parental unemployment and family structure did not change the significant association with maladjustment outcomes. Additional adjustment with comorbidity, however, levelled out the significance of the association of perceived financial difficulties and harmful drinking patterns in boys. While adolescent perception of financial difficulties is probably associated with the objective financial situation of the family it may also be an indicator of the psychological meaning attached to the situation and should thus be considered a possible risk factor for adolescent maladjustment in clinical practice.

Demographic and Parenting Correlates of Adolescent Sleep Functioning.

PubMed

Zapata Roblyer, Martha I; Grzywacz, Joseph G

2015-11-01

Despite the importance of parenting practices for adolescent adjustment, parenting correlates of adolescent sleep functioning remain understudied. This study delineated patterns of sleep functioning in a sample of ethnically diverse, low-income, adolescents and examined associations among three types of parenting practices (parental involvement, parent-child conflict, and parental control) and adolescent sleep functioning (difficulties initiating sleep and maintaining sleep, and sleep duration). Adolescents ( N = 91, 11-19 years old) self-reported on sleep functioning and parenting practices. Results showed that in the preceding month, 60.5% of adolescents had difficulties initiating sleep and 73.6% had difficulties maintaining sleep. Most adolescents slept 8 or more hours per night, but 30.7% slept less than 8 hours. Latino adolescents slept longer and had fewer difficulties maintaining sleep than non-Latino. High school students had fewer difficulties maintaining sleep than their middle school counterparts; conversely, older adolescents experienced shorter sleep duration than younger ones. Adolescents whose parents had post-secondary education had shorter sleep duration than those whose parents had not graduated from high school. Parental control was correlated with fewer difficulties initiating sleep, whereas parent-child conflict was correlated with more difficulties maintaining sleep. There were no parenting correlates of sleep duration. Latino adolescents had better sleep profiles than non-Latino ones. Regression analyses showed that parental control and parent-child conflict were associated with adolescent sleep functioning across ethnicities. Results suggest that parenting practices, as well as demographic characteristics, are associated with adolescent sleep functioning and should be taken into account in interventions aimed at improving sleep functioning among adolescents.

[Identification of difficulties at the beginning of breastfeeding by means of protocol application].

PubMed

Carvalhaes, Maria Antonieta de Barros Leite; Corrêa, Cláudia Regina Hostin

2003-01-01

To assess a group of mothers/newborns with the necessity of special support at the beginning of breastfeeding by means of protocol application recommended by UNICEF and to verify assisting practices associated with difficulties of breastfeeding.\\par In this descriptive study, the sample comprised 50 mother/newborn pairs randomly selected in a maternity where low risk deliveries are cared by SUS (Brazilian Unified Health System). The breastfeeding observation protocol was used to record the behavior of each pair, including the frequency of negative behavior regarding breastfeeding. Next, each aspect was scored as good, regular or poor. The association between negative scores and particular assisting practices was also investigated. A critical level of p < 0.05 was used.\\par The frequency of pairs presenting evidence of severe problems (poor score) at the beginning of breastfeeding ranged from 2% to 22% according to the aspects assessed. The most frequently observed difficulties were mother and infant's bad positioning during breastfeeding and inappropriate mother/newborn interaction. These problems were significantly more frequent after surgical deliveries (p < 0.05). Milk formula and/or glucose solution was also associated with the worst scores in some breastfeeding aspects. \\par The protocol application to observe and evaluate breastfeeding identified a high prevalence of mothers/newborn pairs with difficulties to begin breastfeeding, especially when the delivery was surgically performed and when the newborn was offered supplementary liquids.

Identification of Infants with Major Cognitive Delay Using Parental Report

ERIC Educational Resources Information Center

Martin, Andrew J.; Darlow, Brian A.; Salt, Alison; Hague, Wendy; Sebastian, Lucille; Mann, Kristy; Tarnow-Mordi, William

2012-01-01

Aim: The collection of data on longer-term neurodevelopmental outcomes within large neonatal randomized controlled trials by trained assessors can greatly increase costs and present many operational difficulties. The aim of this study was to develop a more practical alternative for identifying major cognitive delay in infants at the age of 24…

A Social Work Program's Experience in Teaching about Race in the Curriculum

ERIC Educational Resources Information Center

Phan, Phu; Vugia, Holly; Wright, Paul; Woods, Dianne Rush; Chu, Mayling; Jones, Terry

2009-01-01

Teaching about race, racism, and oppression presents higher education programs with complex challenges. This article reports on the experiences of a new MSW program in designing a gateway "race, gender, and inequality" course. Embracing a theoretical base of culturally competent practice and solutions to the inherent difficulties of discussing…

Communities of Inquiry: Politics, Power and Group Dynamics

ERIC Educational Resources Information Center

Burgh, Gilbert; Yorshansky, Mor

2011-01-01

The notion of a community of inquiry has been treated by many of its proponents as being an exemplar of democracy in action. We argue that the assumptions underlying this view present some practical and theoretical difficulties, particularly in relation to distribution of power among the members of a community of inquiry. We identify two…

Problems in Teaching the Topic of Redox Reactions: Actions and Conceptions of Chemistry Teachers.

ERIC Educational Resources Information Center

De Jong, Onno; And Others

1995-01-01

Presents a case study of problems that can occur when teaching the topic of redox reactions to grade-11 students. Concludes that the teachers' scientific expertise is an important source of difficulties when teaching redox reactions. Discusses implications for improvement of current chemistry classroom practice and content-related teacher…

Developing Pedagogical Tools to Improve Teaching Multiple Models of the Gene in High School

ERIC Educational Resources Information Center

Auckaraaree, Nantaya

2013-01-01

Multiple models of the gene are used to explore genetic phenomena in scientific practices and in the classroom. In genetics curricula, the classical and molecular models are presented in disconnected domains. Research demonstrates that, without explicit connections, students have difficulty developing an understanding of the gene that spans…

Coming down to Earth: Helping Teachers Use 3D Virtual Worlds in Across-Spaces Learning Situations

ERIC Educational Resources Information Center

Muñoz-Cristóbal, Juan A.; Prieto, Luis P.; Asensio-Pérez, Juan I.; Martínez-Monés, Alejandra; Jorrín-Abellán, Iván M.; Dimitriadis, Yannis

2015-01-01

Different approaches have explored how to provide seamless learning across multiple ICT-enabled physical and virtual spaces, including three-dimensional virtual worlds (3DVW). However, these approaches present limitations that may reduce their acceptance in authentic educational practice: The difficulties of authoring and sharing teacher-created…

Decision support for sustainable forestry: enhancing the basic rational model.

Treesearch

H.R. Ekbia; K.M. Reynolds

2007-01-01

Decision-support systems (DSS) have been extensively used in the management of natural resources for nearly two decades. However, practical difficulties with the application of DSS in real-world situations have become increasingly apparent. Complexities of decisionmaking, encountered in the context of ecosystem management, are equally present in sustainable forestry....

Outcomes and Effectiveness of Family Support Services: A Research Review. In Practice Issues.

ERIC Educational Resources Information Center

Statham, June

This report reviews the evidence for the effectiveness of different kinds of family support services, focusing on services in the United Kingdom, particularly for families who are disadvantaged or experiencing particular difficulties in their lives. The report also describes different evaluation methods and presents information on various measures…

Reviewing Evidence-Based Practice for Pupils with Dyslexia and Literacy Difficulties

ERIC Educational Resources Information Center

Griffiths, Yvonne; Stuart, Morag

2013-01-01

There is now a strong evidence base from theory and research providing a "template" to inform practice at Wave 2, guiding the design and implementation of time-limited effective early intervention programmes for pupils identified as "at risk" of reading difficulties following initial literacy instruction (Rose, 2009). In…

Impossible is nothing: 5:3 and 4:3 multi-frequency bimanual coordination.

PubMed

Kovacs, Attila J; Buchanan, John J; Shea, Charles H

2010-03-01

The present findings demonstrate that when participants are provided a Lissajous display with cursor indicating the position of the limbs and a template illustrating the desired movement pattern they can rapidly (10 min) and effectively (continuous relative phase errors and variability ~10 degrees ) tune in a difficult 5:3 bimanual coordination pattern and without additional practice re-tune their responding to an equally difficult 4:3 coordination pattern. The findings indicate the extreme difficulty associated with producing complex polyrhythms in previous experiments has been due to split attention when Lissajous feedback has been provided and inability of the participant to detect and correct coordination errors when only provided vision of the limbs. Effective transfer to the 4:3 polyrhythm without previous practice suggests that the perception-action system's capabilities are extensive. The present findings when viewed in the context of recent experiments using similar protocols suggest that much, but not all, of the difficulty associated with producing a variety of bimanual coordination tasks should be viewed in terms of perceptual constraints imposed by the testing environment.

Managing Body Image Difficulties of Adult Cancer Patients: Lessons from Available Research

PubMed Central

Fingeret, Michelle Cororve; Teo, Irene; Epner, Daniel E.

2013-01-01

Background Body image is a critical psychosocial issue for cancer patients as they often undergo significant changes to appearance and functioning. In this review article, our primary purpose was to identify empirically-supported approaches to treat body image difficulties of adult cancer patients that can be incorporated into high-quality comprehensive cancer care. Methods We provided an overview of theoretical models of body image relevant to cancer patients, and presented findings from published literature on body image and cancer from 2003–2013. We integrated these data with information from the patient-doctor communication literature to delineate a practical approach for assessing and treating body image concerns of adult cancer patients. Results Body image difficulties were found across patients with diverse cancer sites, and were most prevalent in the immediate postoperative and treatment period. Age, body mass index, and specific cancer treatments have been identified as potential risk factors for body image disturbance in cancer patients. Current evidence supports the use of time-limited cognitive-behavioral therapy interventions for addressing these difficulties. Other intervention strategies also show promise but require further study. We identified potential indicators of body image difficulties to alert healthcare professionals when to refer patients for psychosocial care, and proposed a framework for approaching conversations about body image that can be used by the oncologic treatment team. Conclusions Body image issues affect a wide array of cancer patients. Providers can use available evidence combined with information from the healthcare communication literature to develop practical strategies for treating body image concerns of cancer patients. PMID:24895287

Managing body image difficulties of adult cancer patients: lessons from available research.

PubMed

Fingeret, Michelle Cororve; Teo, Irene; Epner, Daniel E

2014-03-01

Body image is a critical psychosocial issue for patients with cancer because they often undergo significant changes to appearance and functioning. The primary purpose of this review article was to identify empirically-supported approaches to treat body image difficulties of adult cancer patients that can be incorporated into high-quality comprehensive cancer care. An overview was provided of theoretical models of body image relevant to cancer patients, and findings were presented from published literature on body image and cancer from 2003 to 2013. These data were integrated with information from the patient-doctor communication literature to delineate a practical approach for assessing and treating body image concerns of adult cancer patients. Body image difficulties were found across patients with diverse cancer sites, and were most prevalent in the immediate postoperative and treatment period. Age, body mass index, and specific cancer treatments have been identified as potential risk factors for body image disturbance in cancer patients. Current evidence supports the use of time-limited cognitive-behavioral therapy interventions for addressing these difficulties. Other intervention strategies also show promise but require further study. Potential indicators of body image difficulties were identified to alert health care professionals when to refer patients for psychosocial care, and a framework was proposed for approaching conversations about body image that can be used by the oncologic treatment team. Body image issues affect a wide array of cancer patients. Providers can use available evidence combined with information from the health care communication literature to develop practical strategies for treating body image concerns of patients with cancer. © 2013 American Cancer Society.

Feasibility of the adaptive and automatic presentation of tasks (ADAPT) system for rehabilitation of upper extremity function post-stroke

PubMed Central

2011-01-01

Background Current guidelines for rehabilitation of arm and hand function after stroke recommend that motor training focus on realistic tasks that require reaching and manipulation and engage the patient intensively, actively, and adaptively. Here, we investigated the feasibility of a novel robotic task-practice system, ADAPT, designed in accordance with such guidelines. At each trial, ADAPT selects a functional task according to a training schedule and with difficulty based on previous performance. Once the task is selected, the robot picks up and presents the corresponding tool, simulates the dynamics of the tasks, and the patient interacts with the tool to perform the task. Methods Five participants with chronic stroke with mild to moderate impairments (> 9 months post-stroke; Fugl-Meyer arm score 49.2 ± 5.6) practiced four functional tasks (selected out of six in a pre-test) with ADAPT for about one and half hour and 144 trials in a pseudo-random schedule of 3-trial blocks per task. Results No adverse events occurred and ADAPT successfully presented the six functional tasks without human intervention for a total of 900 trials. Qualitative analysis of trajectories showed that ADAPT simulated the desired task dynamics adequately, and participants reported good, although not excellent, task fidelity. During training, the adaptive difficulty algorithm progressively increased task difficulty leading towards an optimal challenge point based on performance; difficulty was then continuously adjusted to keep performance around the challenge point. Furthermore, the time to complete all trained tasks decreased significantly from pretest to one-hour post-test. Finally, post-training questionnaires demonstrated positive patient acceptance of ADAPT. Conclusions ADAPT successfully provided adaptive progressive training for multiple functional tasks based on participant's performance. Our encouraging results establish the feasibility of ADAPT; its efficacy will next be tested in a clinical trial. PMID:21813010

Quality assurance of herbal raw materials in supply chain: challenges and opportunities.

PubMed

Govindaraghavan, Suresh

2008-01-01

The herbal medicine industry is presently adopting modern scientific tools to substantiate the guarantee of efficacy that, in the past, rested only on anecdotal evidence derived from traditional knowledge systems. This is particularly true for the processes of identification of herbal raw materials adopting modern tools for phytochemical fingerprinting. The successful adaptation of available technologies and practices depends on an understanding of the phytochemical complexity and variability innate in biological material. It challenges the "mainstream medicinal mindset" that "tend(s) to reject …. therapies for which mechanisms of action do not fit within Newtonian, biochemical orientation" (Dumoff, 2003). The herbal medicinal industry is independently evolving its own rigid quality assurance and control systems using Good Manufacturing Practice (GMP) and Good Laboratory Practice (GLP) guidelines, but it faces unique difficulties. These include lack of Good Agricultural and Collection Practice (GACP), lack of transparency in the raw material supply chain so as to preclude the use of unsafe practices, problems in the authentication of herbal raw materials, and a general lack of understanding of the need to reduce phytochemical variability in these materials. This paper explores these difficulties and outlines strategies to overcome them, but these strategies will require coordinated international government regulations to be fully effective.

Word-finding difficulty: a clinical analysis of the progressive aphasias

PubMed Central

Rohrer, Jonathan D.; Knight, William D.; Warren, Jane E.; Fox, Nick C.; Rossor, Martin N.; Warren, Jason D.

2008-01-01

The patient with word-finding difficulty presents a common and challenging clinical problem. The complaint of ‘word-finding difficulty’ covers a wide range of clinical phenomena and may signify any of a number of distinct pathophysiological processes. Although it occurs in a variety of clinical contexts, word-finding difficulty generally presents a diagnostic conundrum when it occurs as a leading or apparently isolated symptom, most often as the harbinger of degenerative disease: the progressive aphasias. Recent advances in the neurobiology of the focal, language-based dementias have transformed our understanding of these processes and the ways in which they breakdown in different diseases, but translation of this knowledge to the bedside is far from straightforward. Speech and language disturbances in the dementias present unique diagnostic and conceptual problems that are not fully captured by classical models derived from the study of vascular and other acute focal brain lesions. This has led to a reformulation of our understanding of how language is organized in the brain. In this review we seek to provide the clinical neurologist with a practical and theoretical bridge between the patient presenting with word-finding difficulty in the clinic and the evidence of the brain sciences. We delineate key illustrative speech and language syndromes in the degenerative dementias, compare these syndromes with the syndromes of acute brain damage, and indicate how the clinical syndromes relate to emerging neurolinguistic, neuroanatomical and neurobiological insights. We propose a conceptual framework for the analysis of word-finding difficulty, in order both better to define the patient's complaint and its differential diagnosis for the clinician and to identify unresolved issues as a stimulus to future work. PMID:17947337

The effects of autonomous difficulty selection on engagement, motivation, and learning in a motion-controlled video game task.

PubMed

Leiker, Amber M; Bruzi, Alessandro T; Miller, Matthew W; Nelson, Monica; Wegman, Rebecca; Lohse, Keith R

2016-10-01

This experiment investigated the relationship between motivation, engagement, and learning in a video game task. Previous studies have shown increased autonomy during practice leads to superior retention of motor skills, but it is not clear why this benefit occurs. Some studies suggest this benefit arises from increased motivation during practice; others suggest the benefit arises from better information processing. Sixty novice participants were randomly assigned to a self-controlled group, who chose the progression of difficulty during practice, or to a yoked group, who experienced the same difficulty progression but did not have choice. At the end of practice, participants completed surveys measuring intrinsic motivation and engagement. One week later, participants returned for a series of retention tests at three different difficulty levels. RM-ANCOVA (controlling for pre-test) showed that the self-controlled group had improved retention compared to the yoked group, on average, β=46.78, 95% CI=[2.68, 90.87], p=0.04, but this difference was only statistically significant on the moderate difficulty post-test (p=0.004). The self-controlled group also showed greater intrinsic motivation during practice, t(58)=2.61, p=0.01. However, there was no evidence that individual differences in engagement (p=0.20) or motivation (p=0.87) were associated with learning, which was the relationship this experiment was powered to detect. These data are inconsistent with strictly motivational accounts of how autonomy benefits learning, instead suggesting the benefits of autonomy may be mediated through other mechanisms. For instance, within the information processing framework, the learning benefits may emerge from learners appropriately adjusting difficulty to maintain an appropriate level of challenge (i.e., maintaining the relationship between task demands and cognitive resources). Copyright © 2016 Elsevier B.V. All rights reserved.

Religious Observance by Muslim Employees: A Framework for Discussion.

ERIC Educational Resources Information Center

Commission for Racial Equality, London (England).

This paper discusses the relationship between the religious practices of Muslim employees and the requirements of the workplace. It is designed to provide information on the norms of Islam and the difficulties involved in its workplace practice, and to propose suggestions for resolving these difficulties that can form the basis for discussion and…

Assessment and Management of the Communication Difficulties of Children with Cerebral Palsy: A UK Survey of SLT Practice

ERIC Educational Resources Information Center

Watson, Rose Mary; Pennington, Lindsay

2015-01-01

Background: Communication difficulties are common in cerebral palsy (CP) and are frequently associated with motor, intellectual and sensory impairments. Speech and language therapy research comprises single-case experimental design and small group studies, limiting evidence-based intervention and possibly exacerbating variation in practice. Aims:…

Inquiry-based science instruction and performance literacy for students who are deaf or hard of hearing.

PubMed

Wang, Ye

2011-01-01

Deaf and hard of hearing students, who cannot successfully access and utilize information in print, experience various difficulties in conventional science instruction, which heavily relies on lectures and textbooks. The purpose of the present review is threefold. First, an overview of inquiry-based science instruction reform, including the so-ciohistorical forces behind the movement, is presented. Then, the author examines the empirical research on science education for students who are deaf or hard of hearing from the 1970s to the present and identifies and rates inquiry-based practice. After discussing the difficulty of using science texts with deaf and hard of hearing students, the author introduces a conceptual framework that integrates inquiry-based instruction and the construct of performance literacy. She suggests that this integration should enable students who are deaf or hard of hearing to access the general education curriculum.

Branchial Cleft Cyst.

PubMed

Nahata, Vaishali

2016-01-01

Branchial cleft cyst, sinuses, and fistulae are among the most commonly encountered congenital anomalies in pediatric otolaryngic practice. They can present difficulty in diagnosis and surgical management. Here, I report a case of 14-year-old boy who presented with asymptomatic, congenital swelling located just below the jawline in the lateral part of the neck. The lesion was excised surgically. Histopathology showed the cyst lined by squamous as well as columnar ciliated epithelium, which was a characteristic finding of branchial cleft cyst. The aim of presenting this case is its rarity.

[Simulation technologies in anesthesiology, resuscitation and intensive care: state of the problem].

PubMed

Pasechnik, I N; Skobelev, E I; Volkova, N N; Sal'nikov, P S

2014-01-01

The foundation of simulation technologies application in educational process is presented in the article. It is described difficulties during anesthesiologists-resuscitators training and education of physicians of not intensive care specialty in intensive care methods. It was emphasized that new innovative educational stage is formed at present time. It is simulation stage between preclinical and clinical stages. Theoretical foundation and practical evidence of efficiency of simulation training are expressed in detail.

The Challenges of Science Inquiry Teaching for Pre-Service Teachers in Elementary Classrooms: Difficulties on and under the Scene

NASA Astrophysics Data System (ADS)

Yoon, Hye-Gyoung; Joung, Yong Jae; Kim, Mijung

2012-06-01

In the context of the emphasis on inquiry teaching in science education, this study looks into how pre-service elementary teachers understand and practise science inquiry teaching during field experience. By examining inquiry lesson preparation, practice, and reflections of pre-service elementary teachers, we attempt to understand the difficulties they encounter and what could result from those difficulties in their practice. A total of 16 seniors (fourth-year students) in an elementary teacher education program participated in this study. In our findings, we highlight three difficulties `on the lesson' that are related to teaching practices that were missing in the classrooms: (1) developing children's own ideas and curiosity, (2) guiding children in designing valid experiments for their hypotheses, (3) scaffolding children's data interpretation and discussion and another three difficulties `under the lesson' that are related to problems with the pre-service teachers' conceptualization of the task: (4) tension between guided and open inquiry, (5) incomplete understanding of hypothesis, and (6) lack of confidence in science content knowledge. Based on these findings, we discuss how these difficulties are complexly related in the pre-service teachers' understandings and action. Several suggestions for science teacher education for inquiry teaching, especially hypothesis-based inquiry teaching, are then explored.

My Voice Heard: The Journey of a Young Man with a Cerebral Visual Impairment

ERIC Educational Resources Information Center

Macintyre-Beon, Catriona; Mitchell, Kate; Gallagher, Ian; Cockburn, Debbie; Dutton, Gordon N.; Bowman, Richard

2012-01-01

This longitudinal case study presents John's journey through childhood and adolescence, living with visual difficulties associated with a cerebral visual impairment. It highlights the day-to-day problems that John encountered, giving practical solutions and strategies that have enabled his dream of going to a university to be realized. John and…

From Knowing-About to Knowing-To: Development of Engineering Pedagogical Content Knowledge by Elementary Teachers through Perceived Learning and Implementing Difficulties

ERIC Educational Resources Information Center

Sun, Yan; Strobel, Johannes

2014-01-01

The present study sought to reveal how elementary teachers develop their engineering pedagogical content knowledge (PCK) after leaving professional development programs to practice engineering teaching in real classroom settings. Participants of this study were the elementary teachers who received one-week training of engineering education…

A Central Support System Can Facilitate Implementation and Sustainability of a Classroom-Based Undergraduate Research Experience (CURE) in Genomics

ERIC Educational Resources Information Center

Lopatto, David; Hauser, Charles; Jones, Christopher J.; Paetkau, Don; Chandrasekaran, Vidya; Dunbar, David; MacKinnon, Christy; Stamm, Joyce; Alvarez, Consuelo; Barnard, Daron; Bedard, James E. J.; Bednarski, April E.; Bhalla, Satish; Braverman, John M.; Burg, Martin; Chung, Hui-Min; DeJong, Randall J.; DiAngelo, Justin R.; Du, Chunguang; Eckdahl, Todd T.; Emerson, Julia; Frary, Amy; Frohlich, Donald; Goodman, Anya L.; Gosser, Yuying; Govind, Shubha; Haberman, Adam; Hark, Amy T.; Hoogewerf, Arlene; Johnson, Diana; Kadlec, Lisa; Kaehler, Marian; Key, S. Catherine Silver; Kokan, Nighat P.; Kopp, Olga R.; Kuleck, Gary A.; Lopilato, Jane; Martinez-Cruzado, Juan C.; McNeil, Gerard; Mel, Stephanie; Nagengast, Alexis; Overvoorde, Paul J.; Parrish, Susan; Preuss, Mary L.; Reed, Laura D.; Regisford, E. Gloria; Revie, Dennis; Robic, Srebrenka; Roecklien-Canfield, Jennifer A.; Rosenwald, Anne G.; Rubin, Michael R.; Saville, Kenneth; Schroeder, Stephanie; Sharif, Karim A.; Shaw, Mary; Skuse, Gary; Smith, Christopher D.; Smith, Mary; Smith, Sheryl T.; Spana, Eric P.; Spratt, Mary; Sreenivasan, Aparna; Thompson, Jeffrey S.; Wawersik, Matthew; Wolyniak, Michael J.; Youngblom, James; Zhou, Leming; Buhler, Jeremy; Mardis, Elaine; Leung, Wilson; Shaffer, Christopher D.; Threlfall, Jennifer; Elgin, Sarah C. R.

2014-01-01

In their 2012 report, the President's Council of Advisors on Science and Technology advocated "replacing standard science laboratory courses with discovery-based research courses"--a challenging proposition that presents practical and pedagogical difficulties. In this paper, we describe our collective experiences working with the…

Some observations on precipitation measurement on forested experimental watersheds

Treesearch

Raymond E. Leonard; Kenneth G. Reinhart

1963-01-01

Measurement of precipitation on forested experimental watersheds presents difficulties other than those associated with access to and from the gages in all kinds of weather. For instance, the tree canopy must be cleared above the gage. The accepted practice of keeping an unobstructed sky view of 45" around the gage involves considerable tree cutting. On a level...

Who Is the Real Owner? Or How a Simple Pepsi-Cola Story Can Help Students Build Critical Thinking Skills

ERIC Educational Resources Information Center

Galetcaia, Tatiana; Thiessen, Loreena

2010-01-01

Besides language competence, international students must develop a systematic approach to processing information and follow up with co-construction of the knowledge acquired. Critical thinking is a crucial principle commonly required in North American universities for evaluating academic texts. This practice may present certain difficulties for…

Helping Second Language Literature Learners Overcome E-Learning Difficulties: LET-NET Team Teaching with Online Peer Interaction

ERIC Educational Resources Information Center

Wu, Pin-Hsiang Natalie; Marek, Michael W.

2013-01-01

This study presents and discusses results from an EFL second language literature program in which the instructional design included a team teaching scheme, blended learning practice, and computer-mediated peer-interaction. The team teaching plan used a Mandarin speaking English teacher and a Native English-speaking teacher collaborating and…

Vowels--Sonic Gems of Emotion for Social Communication: Practical Singing Strategies for Non-Musician Teachers with Developmentally Diverse Young Children

ERIC Educational Resources Information Center

Weeks, Kaja

2015-01-01

Communicative and social capacities are known to be of primary developmental importance to all children and often present a particular difficulty for children with neurodevelopmental disorders. A recurring challenge for teachers is achieving effective communication with children who span developmental diversity (e.g. inclusive settings or those…

Patient difficulty using tablet computers to screen in primary care.

PubMed

Hess, Rachel; Santucci, Aimee; McTigue, Kathleen; Fischer, Gary; Kapoor, Wishwa

2008-04-01

Patient-administered computerized questionnaires represent a novel tool to assist primary care physicians in the delivery of preventive health care. The aim of this study was to assess patient-reported ease of use with a self-administered tablet computer-based questionnaire in routine clinical care. All patients seen in a university-based primary care practice were asked to provide routine screening information using a touch-screen tablet computer-based questionnaire. Patients reported difficulty using the tablet computer after completion of their first questionnaire. Ten thousand nine hundred ninety-nine patients completed the questionnaire between January 2004 and January 2006. We calculated rates of reporting difficulty (no difficulty, some difficulty, or a lot of difficulty) using the tablet computers based on patient age, sex, race, educational attainment, marital status, and number of comorbid medical conditions. We constructed multivariable ordered logistic models to identify predictors of increased self-reported difficulty using the computer. The majority of patients (84%) reported no difficulty using the tablet computers to complete the questionnaire, with only 3% reporting a lot of difficulty. Significant predictors of reporting more difficulty included increasing age [odds ratio (OR) 1.05, 95% confidence interval (CI) 1.05-1.05)]; Asian race (OR 2.3, 95% CI 1.8-2.9); African American race (OR 1.4, 95% CI 1.2-1.6); less than a high school education (OR 3.0, 95% CI 2.6-3.4); and the presence of comorbid medical conditions (1-2: OR 1.3, 95% CI 1.2-1.5; > or =3: OR 1.7 95% CI 1.5-2.1). The majority of primary care patients reported no difficulty using a self-administered tablet computer-based questionnaire. While computerized questionnaires present opportunities to collect routine screening information from patients, attention must be paid to vulnerable groups.

Associations between Inadequate Parenting Practices and Behavioral Problems in Children and Adolescents with Attention Deficit Hyperactivity Disorder

PubMed Central

Triguero Veloz Teixeira, Maria Cristina; de Freitas Marino, Regina Luisa; Rodrigues Carreiro, Luiz Renato

2015-01-01

Children and adolescents with ADHD present behaviors such as impulsiveness, inattention, and difficulties with personal organization that represent an overload for parents. Moreover, it also increases their level of stress and leads them to resort to inadequate educational strategies. The present study verifies associations between inadequate parenting practices and behavioral profiles of children and adolescents with ADHD. The sample was composed of 22 children with ADHD (age range 6–16 years) and their mothers. Spearman correlation analyses were made with the scores of Parenting Style Inventory (PSI) and Child Behavior Checklist for ages 6–18 (CBCL/6–18). Results indicate statistically significant associations between behavioral problems and the use of punishment practices and negligence. When assessing a child with ADHD, it is important to verify the predominant types of parenting practices that can influence both immediate interventions and the prognosis of the disorder. PMID:26844292

Spelling errors among children with ADHD symptoms: the role of working memory.

PubMed

Re, Anna Maria; Mirandola, Chiara; Esposito, Stefania Sara; Capodieci, Agnese

2014-09-01

Research has shown that children with attention deficit/hyperactivity disorder (ADHD) may present a series of academic difficulties, including spelling errors. Given that correct spelling is supported by the phonological component of working memory (PWM), the present study examined whether or not the spelling difficulties of children with ADHD are emphasized when children's PWM is overloaded. A group of 19 children with ADHD symptoms (between 8 and 11 years of age), and a group of typically developing children matched for age, schooling, gender, rated intellectual abilities, and socioeconomic status, were administered two dictation texts: one under typical conditions and one under a pre-load condition that required the participants to remember a series of digits while writing. The results confirmed that children with ADHD symptoms have spelling difficulties, produce a higher percentages of errors compared to the control group children, and that these difficulties are enhanced under a higher load of PWM. An analysis of errors showed that this holds true, especially for phonological errors. The increased errors in the PWM condition was not due to a tradeoff between working memory and writing, as children with ADHD also performed more poorly in the PWM task. The theoretical and practical implications are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Practices of Other-Initiated Repair in the Classrooms of Children with Specific Speech and Language Difficulties

ERIC Educational Resources Information Center

Radford, Julie

2010-01-01

Repair practices used by teachers who work with children with specific speech and language difficulties (SSLDs) have hitherto remained largely unexplored. Such classrooms therefore offer a new context for researching repairs and considering how they compare with non-SSLD interactions. Repair trajectories are of interest because they are dialogic…

Identifying Students' Difficulties When Learning Technical Skills via a Wireless Sensor Network

ERIC Educational Resources Information Center

Wang, Jingying; Wen, Ming-Lee; Jou, Min

2016-01-01

Practical training and actual application of acquired knowledge and techniques are crucial for the learning of technical skills. We established a wireless sensor network system (WSNS) based on the 5E learning cycle in a practical learning environment to improve students' reflective abilities and to reduce difficulties for the learning of technical…

Reading and Spelling Difficulties in the ELT Classroom

ERIC Educational Resources Information Center

Gerlach, David

2017-01-01

Learners with reading and/or spelling difficulties (RSD) generally also show severe problems in learning EFL. Taking into consideration several observational and interventional studies, this article illustrates some practical and pragmatic means of identifying RSD, and provides possible solutions when addressing these difficulties in ELT…

[Molecular markers: an important tool in the diagnosis, treatment and epidemiology of invasive aspergillosis].

PubMed

Frías-de León, María Guadalupe; Acosta-Altamirano, Gustavo; Duarte-Escalante, Esperanza; Martínez-Hernández, José Enrique; Martínez-Rivera, María de Los Ángeles; Reyes-Montes, María Del Rocío

2014-01-01

Increase in the incidence of invasive aspergillosis has represented a difficult problem for management of patients with this infection due to its high rate of mortality, limited knowledge concerning its diagnosis, and therapeutic practice. The difficulty in management of patients with aspergillosis initiates with detection of the fungus in the specimens of immunosuppressed patients infected with Aspergillus fumigatus; in addition, difficulty exists in terms of the development of resistance to antifungals as a consequence of their indiscriminate use in prophylactic and therapeutic practice and to ignorance concerning the epidemiological data of aspergillosis. With the aim of resolving these problems, molecular markers is employed at present with specific and accurate results. However, in Mexico, the use of molecular markers has not yet been implemented in the routine of intrahospital laboratories; despite the fact that these molecular markers has been widely referred in the literature, it is necessary for it to validated and standardized to ensure that the results obtained in any laboratory would be reliable and comparable. In the present review, we present an update on the usefulness of molecular markers in accurate identification of A. fumigatus, detection of resistance to antifugal triazoles, and epidemiological studies for establishing the necessary measures for prevention and control of aspergillosis.

[Clinical ethics consultation - an integrative model for practice and reflection].

PubMed

Reiter-Theil, Stella

2008-07-01

Broad evidence exists that health care professionals are facing ethical difficulties in patient care demanding a spectrum of useful ethics support services. Clinical ethics consultation is one of these forms of ethics support being effective in the acute setting. An authentic case is presented as an illustration. We introduce an integrative model covering the activities being characteristic for ethics consultation and going beyond "school"-specific approaches. Finally, we formulate some do's and don'ts of ethics consultation that are considered to be key issues for successful practice.

Obesity Prevention in Early Child Care Settings: A Bistate (Minnesota and Wisconsin) Assessment of Best Practices, Implementation Difficulty, and Barriers

ERIC Educational Resources Information Center

Nanney, Marilyn S.; LaRowe, Tara L.; Davey, Cynthia; Frost, Natasha; Arcan, Chrisa; O'Meara, Joyce

2017-01-01

Background: Long-term evaluation studies reveal that high-quality early care and education (ECE) programs that include a lifestyle component predict later adult health outcomes. The purpose of this article is to characterize the nutrition and physical activity (PA) practices, including implementation difficulty and barriers, of licensed center-…

Teachers' Teaching Practices and Beliefs Regarding Context-Based Tasks and Their Relation with Students' Difficulties in Solving These Tasks

ERIC Educational Resources Information Center

Wijaya, Ariyadi; van den Heuvel-Panhuizen, Marja; Doorman, Michiel

2015-01-01

In this study, we investigated teachers' teaching practices and their underlying beliefs regarding context-based tasks to find a possible explanation for students' difficulties with these tasks. The research started by surveying 27 Junior High School teachers from seven schools in Indonesia through a written questionnaire. Then, to further examine…

Developing Pedagogical Expertise in Modern Language Learning and Specific Learning Difficulties through Collaborative and Open Educational Practices

ERIC Educational Resources Information Center

Gallardo, Matilde; Heiser, Sarah; Arias McLaughlin, Ximena

2017-01-01

This paper analyses teachers' engagement with collaborative and open educational practices to develop their pedagogical expertise in the field of modern language (ML) learning and specific learning difficulties (SpLD). The study analyses the findings of a staff development initiative at the Department of Languages, Open University, UK, in 2013,…

The male reproductive system - An overview of common problems.

PubMed

Wijesinha, Sanjiva; Piterman, Leon; Kirby, Catherine N

2013-05-01

Many male reproductive system problems could be perceived as being embarrassing, which may be one of the reasons that they are often not identified in general practice. This article provides an overview of some common problems affecting the male reproductive system, and outlines current treatment options. Erectile dysfunction, premature ejaculation, loss of libido, testicular cancer and prostate disease may cause embarrassment to the patient and, occasionally, the general practitioner. We describe how patients affected by these conditions may present to general practice, and discuss the reasons why they may not present. We also discuss how GPs can overcome difficulties in identifying and dealing with their male patients suffering from male reproductive system issues.

Teaching Children with Down Syndrome in Inclusive Primary Mathematics Classrooms

ERIC Educational Resources Information Center

Faragher, Rhonda; Stratford, Melanie; Clarke, Barbara

2017-01-01

At the turn of this century, expectations for learning mathematics by students with Down syndrome were low. Research and practice continued to indicate considerable difficulty with number and calculation (Bird & Buckley, 2001). Unfortunately, most authors extrapolated difficulty with number to difficulty with mathematics in general, even…

Pharmacy practice simulations: performance of senior pharmacy students at a University in southern Brazil

PubMed Central

Galato, Dayani; Alano, Graziela M.; Trauthman, Silvana C.; França, Tainã F.

Objective A simulation process known as objective structured clinical examination (OSCE) was applied to assess pharmacy practice performed by senior pharmacy students. Methods A cross-sectional study was conducted based on documentary analysis of performance evaluation records of pharmacy practice simulations that occurred between 2005 and 2009. These simulations were related to the process of self-medication and dispensing, and were performed with the use of patients simulated. The simulations were filmed to facilitate the evaluation process. It presents the OSCE educational experience performed by pharmacy trainees of the University of Southern Santa Catarina and experienced by two evaluators. The student general performance was analyzed, and the criteria for pharmacy practice assessment often identified trainees in difficulty. Results The results of 291 simulations showed that students have an average yield performance of 70.0%. Several difficulties were encountered, such as the lack of information about the selected/prescribed treatment regimen (65.1%); inadequate communication style (21.9%); lack of identification of patients’ needs (7.7%) and inappropriate drug selection for self-medication (5.3%). Conclusions These data show that there is a need for reorientation of clinical pharmacy students because they need to improve their communication skills, and have a deeper knowledge of medicines and health problems in order to properly orient their patients. PMID:24367467

A dynamic model of the human postural control system

NASA Technical Reports Server (NTRS)

Hill, J. C.

1972-01-01

A digital simulation of the pitch axis dynamics of a stick man of figures is described. Difficulties encountered in linearizing the equations of motion are discussed; the conclusion reached is that a completely linear simulation is of such restricted validity that only a nonlinear simulation is of any practical use. Typical simulation results obtained from the full nonlinear model are presented.

Toward a Critical Hermeneutical Approach of Human Rights Education: Universal Ideals, Contextual Realities and Teachers' Difficulties

ERIC Educational Resources Information Center

Zembylas, Michalinos; Charalambous, Panayiota; Charalambous, Constadina; Lesta, Stalo

2017-01-01

The present paper takes the approach of critical hermeneutics in human rights education (HRE) that has been developed theoretically and tries to operationalize it in pedagogical practice. In particular, a group of Greek-Cypriot teachers were trained in a series of workshops on how critical hermeneutical approach (CHA) could be taught in the…

[Not Available].

PubMed

Kordelas, L; Grond-Ginsbach, C

2000-01-01

Kant's discussion of the ethical implications of smallpox inoculation is presented here. In four fragments Kant analyzes the moral legitimacy of endangering other people in medical practice and especially endangering people who are incapable of giving consent. In addition, we re-evaluate the alleged "success story" of the development of smallpox prevention and review the technical and theoretical difficulties of smallpox inoculation at the time of Kant.

Teachers' Beliefs and Practices for Nurturing Creativity in Students: Perspectives from Teachers of Gifted Students in Hong Kong

ERIC Educational Resources Information Center

Chan, Serene; Yuen, Mantak

2015-01-01

The long-term aim of fostering creativity in all students is specifically included in Hong Kong's curriculum guidelines. However, implementation of teaching strategies to achieve this aim has presented difficulties for many teachers. It is likely that teachers with experience in gifted education are in the best position in this respect, because…

Nuclear physics experiments with low cost instrumentation

NASA Astrophysics Data System (ADS)

Oliveira Bastos, Rodrigo; Adelar Boff, Cleber; Melquiades, Fábio Luiz

2016-11-01

One of the difficulties in modern physics teaching is the limited availability of experimental activities. This is particularly true for teaching nuclear physics in high school or college. The activities suggested in the literature generally symbolise real phenomenon, using simulations. It happens because the experimental practices mostly include some kind of expensive radiation detector and an ionising radiation source that requires special care for handling and storage, being subject to a highly bureaucratic regulation in some countries. This study overcomes these difficulties and proposes three nuclear physics experiments using a low-cost ion chamber which construction is explained: the measurement of 222Rn progeny collected from the indoor air; the measurement of the range of alpha particles emitted by the 232Th progeny, present in lantern mantles and in thoriated welding rods, and by the air filter containing 222Rn progeny; and the measurement of 220Rn half-life collected from the emanation of the lantern mantles. This paper presents the experimental procedures and the expected results, indicating that the experiments may provide support for nuclear physics classes. These practices may outreach wide access to either college or high-school didactic laboratories, and the apparatus has the potential for the development of new teaching activities for nuclear physics.

NON-SPECIFIC SYMPTOMS AND SCREENING OF NON-PSYCHOTIC MORBIDITY IN PRIMARY CARE1

PubMed Central

Srinivasan, T.N.; Suresh, T.R.

1990-01-01

SUMMARY Much of the non-psychotic mental morbidity in primary care goes undetected by the primary care health personnel. This is often because of the non-specific somatic nature of the presenting complaints of these patients and the difficulty on the part of the primary care physician to elicit specific emotional symptoms to screen psychiatric problems. This paper describes the development of the 7-item Primary care Psychiatric Questionnaire (PPQ.) which, by requiring to elicit only the non-specific symptoms, could overcome this practical difficulty. This new screening method has been standardised against the Self Report Questionaaire—20-item version which is commonly used in primary care. PMID:21927432

Dentist's distress in the management of chronic pain control: The example of TMD pain in a dental practice-based research network.

PubMed

Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gordan, Valeria V; Gilbert, Gregg H

2018-01-01

We aimed to obtain greater understanding of dentists' distress when they diagnose and treat patients with temporomandibular disorders (TMD), and to explore ways in which TMD can be better treated.We conducted a cross-sectional study based on a questionnaire survey of dentists (n = 148). Dentists were queried using an open-ended questionnaire about distress they experienced when treating patients with TMD. Survey responses were analyzed using mixed methods. Associations between specific dentist and patient characteristics and types of distress were analyzed by one way analysis of variance and residual analysis.One hundred thirteen clinicians responded to the questionnaire, giving a 76% response rate. Thematic analysis identified 6 major themes: difficulty in predicting therapeutic effect and prognosis; difficulty in diagnosis; difficulty in the decision about whether to do occlusal adjustment; difficulty in specifying a cause; difficulty in communicating with patients and mental factors; and health insurance system barriers. Clinicians who reported difficulty in deciding whether to do occlusal adjustment saw significantly more patients who experienced shoulder stiffness and headache (P = .008 and P = .022, respectively). Dentists' knowledge of TMD guidelines was associated with a lower percentage of difficulty in predicting therapeutic effect and prognosis (residual analysis; P = .010).These findings provide important insights into clinician's perception of difficulties with patients experiencing TMD-related pain. Knowledge of the existence of TMD clinical practice guidelines may lower dentist distress, particularly with regard to prognosis. Further studies are needed to decrease dentist's distress and to overcome the evidence-practice gap in TMD treatment. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Practical considerations in Bayesian fusion of point sensors

NASA Astrophysics Data System (ADS)

Johnson, Kevin; Minor, Christian

2012-06-01

Sensor data fusion is and has been a topic of considerable research, but rigorous and quantitative understanding of the benefits of fusing specific types of sensor data remains elusive. Often, sensor fusion is performed on an ad hoc basis with the assumption that overall detection capabilities will improve, only to discover later, after expensive and time consuming laboratory and/or field testing that little advantage was gained. The work presented here will discuss these issues with theoretical and practical considerations in the context of fusing chemical sensors with binary outputs. Results are given for the potential performance gains one could expect with such systems, as well as the practical difficulties involved in implementing an optimal Bayesian fusion strategy with realistic scenarios. Finally, a discussion of the biases that inaccurate statistical estimates introduce into the results and their consequences is presented.

Breast-feeding difficulties experienced by women taking part in a qualitative interview study of postnatal depression.

PubMed

Shakespeare, Judy; Blake, Fiona; Garcia, Jo

2004-09-01

to explore how women experience breast-feeding difficulties. This theme emerged unexpectedly during a study of women's experiences of screening with the Edinburgh postnatal depression scale (EPDS) and subsequent care from primary health-care professionals. qualitative in-depth interview study. postnatal women of 22 general practices within Oxford City Primary Care Group area. 39 postnatal women from a purposeful sample were interviewed at an average of 15 months postnatal. They were chosen from different general practices and with a range of emotional difficulties after birth, judged using EPDS results at eight weeks and eight months postnatal, and whether they received 'listening visits' from health visitors. a qualitative thematic analysis was used, including searches for anticipated and emergent themes. Fifteen women had breast-feeding difficulties. Five themes emerged which explore the difficulties. Firstly, commitment to breast feeding and high expectations of success; secondly, unexpected difficulties; thirdly, seeking professional support for difficulties; fourthly, finding a way to cope; and fifthly, guilt. in this study breast-feeding difficulties were common, caused emotional distress and interactions with professionals could be difficult. Current breast-feeding policy, such as the 'Baby Friendly Initiative', may be a contributing factor. This needs to be explored in a further study.

Practice and Perceived Importance of Advance Care Planning and Difficulties in Providing Palliative Care in Geriatric Health Service Facilities in Japan: A Nationwide Survey.

PubMed

Yokoya, Shoji; Kizawa, Yoshiyuki; Maeno, Takami

2018-03-01

The provision of end-of-life (EOL) care by geriatric health service facilities (GHSFs) in Japan is increasing. Advance care planning (ACP) is one of the most important issues to provide quality EOL care. This study aimed to clarify the practice and perceived importance of ACP and the difficulties in providing palliative care in GHSFs. A self-report questionnaire was mailed to head nurses at 3437 GHSFs nationwide. We asked participants about their practices regarding ACP, their recognition of its importance, and their difficulties in providing palliative care. We also analyzed the relationship between these factors and EOL care education. Among 844 respondents (24.5% response rate), approximately 69% to 81% of head nurses confirmed that GHSF residents and their families understood disease conditions and goals of care. There was a large discrepancy between the actual practice of ACP components and the recognition of their importance (eg, asking residents about existing advance directive [AD; 27.5% practiced it, while 79.6% considered it important]; recommending completion of an AD [18.1% vs 68.4%], and asking for designation of a health-care proxy [30.4% vs 76.8%]). The EOL care education was provided at 517 facilities (61.3%). Head nurses working at EOL care education-providing GHSFs practiced ACP significantly more frequently and had significantly fewer difficulties in providing palliative care. A large discrepancy was found between GHSF nurses' practice of ACP and their recognition of its importance. Providing EOL care education in GHSFs may increase ACP practices and enhance respect for resident's preferences concerning EOL care.

Decreasing barriers for nurse practitioner social entrepreneurship.

PubMed

Sharp, Dayle B; Monsivais, Diane

2014-10-01

To describe difficulties associated with the business-related aspects of practice in role transition of rural nurse practitioners (NPs), and to give practice implications. This focused ethnographic study derived data from semi-structured interviews. Participants provided information about rural NP practice ownership and barriers. The sample consisted of 24 rural NPs living throughout the United States. The majority were 51-60 years of age (45%) and females (93%) who had been in rural practice for 1 to over 20 years. NP social entrepreneurs experience difficulties related to scope of practice, business skills, and role conflict. To decrease barriers for NP clinic ownership and management, NPs need to receive education related to financing a rural practice, legal/regulatory practices, strategic planning, leadership, and clinic management. ©2014 American Association of Nurse Practitioners.

Branchial Cleft Cyst

PubMed Central

Nahata, Vaishali

2016-01-01

Branchial cleft cyst, sinuses, and fistulae are among the most commonly encountered congenital anomalies in pediatric otolaryngic practice. They can present difficulty in diagnosis and surgical management. Here, I report a case of 14-year-old boy who presented with asymptomatic, congenital swelling located just below the jawline in the lateral part of the neck. The lesion was excised surgically. Histopathology showed the cyst lined by squamous as well as columnar ciliated epithelium, which was a characteristic finding of branchial cleft cyst. The aim of presenting this case is its rarity. PMID:27904209

Challenges of Making a Diagnosis in the Outpatient Setting: A Multi-Site Survey of Primary Care Physicians

PubMed Central

Sarkar, Urmimala; Bonacum, Doug; Strull, William; Spitzmueller, Christiane; Jin, Nancy; Lopez, Andrea; Giardina, Traber Davis; Meyer, Ashley N.D.; Singh, Hardeep

2013-01-01

Background Although misdiagnosis in the outpatient setting leads to significant patient harm and wasted resources, it is not well studied. We surveyed primary care physicians (PCPs) about barriers to timely diagnosis in the outpatient setting and assessed their perceptions of diagnostic difficulty. Methods We conducted a survey of general internists and family physicians practicing in an integrated health system across 10 geographically dispersed states in 2005. The survey elicited information on key cognitive failures (such as in clinical knowledge or judgment) for a specific case, and solicited strategies for reducing diagnostic delays. Content analysis was used to categorize cognitive failures and strategies for improvement. We examined the extent and predictors of diagnostic difficulty, defined as reporting >5% patients difficult to diagnose. Results Of 1817 physicians surveyed, 1054 (58%) responded; 848 (80%) respondents primarily practiced in outpatient settings and had an assigned patient panel (inclusion sample). Inadequate knowledge (19.9%) was the most commonly reported cognitive factor. Half reported >5% of their patients were difficult to diagnose; more experienced physicians reported less diagnostic difficulty. In adjusted analyses, problems with information processing (information availability and time to review it) and the referral process, were associated with greater diagnostic difficulty. Strategies for improvement most commonly involved workload issues (panel size, non-visit tasks). Conclusions PCPs report a variety of reasons for diagnostic difficulties in primary care practice. In our study, knowledge gaps appear to be a prominent concern. Interventions that address these gaps as well as practice level issues such as time to process diagnostic information and better subspecialty input may reduce diagnostic difficulties in primary care. PMID:22626738

Policy-to-Practice Context to the Delays and Difficulties in the Acquisition of Speech, Language and Communication in the Early Years

ERIC Educational Resources Information Center

Blackburn, Carolyn; Aubrey, Carol

2016-01-01

The aim was to investigate the policy-to-practice context of delays and difficulties in the acquisition of speech, language and communication (SLC) in children from birth to five in one local authority within the context of Bronfenbrenner's bio-ecological model. Methods included a survey of early years practitioners (64 responses), interviews with…

Quota sampling in internet research: practical issues.

PubMed

Im, Eun-Ok; Chee, Wonshik

2011-07-01

Quota sampling has been suggested as a potentially good method for Internet-based research and has been used by several researchers working with Internet samples. However, very little is known about the issues or concerns in using a quota sampling method in Internet research. The purpose of this article was to present the practical issues using quota sampling in an Internet-based study. During the Internet study, the research team recorded all recruitment issues that arose and made written notes indicating the possible reasons for the problems. In addition, biweekly team discussions were conducted for which written records were kept. Overall, quota sampling was effective in ensuring that an adequate number of midlife women were recruited from the targeted ethnic groups. However, during the study process, we encountered the following practical issues using quota sampling: (1) difficulty reaching out to women in lower socioeconomic classes, (2) difficulty ensuring authenticity of participants' identities, (3) participants giving inconsistent answers for the screening questions versus the Internet survey questions, (4) potential problems with a question on socioeconomic status, (5) resentment toward the research project and/or researchers because of rejection, and (6) a longer time and more expense than anticipated.

Learner Outcomes in Science in South Africa: Role of the Nature of Learner Difficulties with the Language for Learning and Teaching Science

NASA Astrophysics Data System (ADS)

Oyoo, Samuel Ouma

2017-08-01

Paul Leslie Gardner pioneered the study of student difficulties with everyday words presented in the science context (Gardner 1971); several similarly designed studies (e.g. Cassels and Johnstone 1985; Tao in Research in Science Education, 24, 322-330, 1994; Farell and Ventura in Language and Education, 12(4), 243-254, 1998; Childs and O'Farell in Chemistry Education: Research and Practice, 4(3), 233-247, 2003) have since been reported in literature. This article draws from an exploratory study of the difficulties South African High School physical science learners encounter with everyday English words when presented in the science context. The participants (1107 learners and 35 respective physical science teachers) were drawn from 35 public secondary schools in Johannesburg area of South Africa. Data were obtained through a word test to participant learners followed by group interviews but face-to-face interviews with each physical science teacher. This study has revealed that in similar ways as have been reported in each of the studies so far, South African learners also face difficulties with meanings of everyday words presented in a science context. The main source of difficulties encountered was learner inability to distinguish between the meanings of familiar everyday words as used in everyday parlance from the `new' meanings of the same everyday words when used in the science context. Interpretations of learner interview responses revealed that fewer difficulties would have been experienced by learners if science teachers generally explained the context meanings of the words as used during science teaching. The findings suggest that focusing on contextual proficiency more than on general proficiency in the language of learning and teaching (LOLT) during teaching perhaps holds more promise for enhanced learning and achievement in science. Steps necessary to raise teacher awareness of the potential impact of context on meanings of everyday words of the LOLT are discussed. This article stands as an evidence-led discussion of the issues around the language-related difficulties that learners in South Africa may encounter as they learn school science.

The Effective Teacher's Guide to Autism and Communication Difficulties: Practical Strategies, Second Edition. The Effective Teacher's Guides

ERIC Educational Resources Information Center

Farrell, Michael

2011-01-01

In this welcome second edition of "The Effective Teacher's Guide to Autism and Communication Difficulties", best-selling author Michael Farrell addresses how teachers and others can develop provision for students with autism and students that have difficulties with speech, grammar, meaning, use of language and comprehension. Updated and expanded,…

Visual-Perceptual Difficulties and the Impact on Children's Learning: Are Teachers Missing the Page?

ERIC Educational Resources Information Center

Boyle, Christopher; Jindal-Snape, Divya

2012-01-01

This article attempts to bring to the fore of educational practice the importance of considering the visual-perceptual condition of Meares-Irlen syndrome (MIS) when identifying students who have prolonged reading difficulties. Dyslexia is a frequently used term which can be used to label children who have specific difficulties with reading and/or…

[3D planning in maxillofacial surgery].

PubMed

Hoarau, R; Zweifel, D; Lanthemann, E; Zrounba, H; Broome, M

2014-10-01

The development of new technologies such as three-dimensional (3D) planning has changed the everyday practice in maxillofacial surgery. Rapid prototyping associated with the 3D planning has also enabled the creation of patient specific surgical tools, such as cutting guides. As with all new technologies, uses, practicalities, cost effectiveness and especially benefits for the patients have to be carefully evaluated. In this paper, several examples of 3D planning that have been used in our institution are presented. The advantages such as the accuracy of the reconstructive surgery and decreased operating time, as well as the difficulties have also been addressed.

Food pattern and nutritional status of children with cerebral palsy

PubMed Central

Lopes, Patrícia Ayrosa C.; Amancio, Olga Maria S.; Araújo, Roberta Faria C.; Vitalle, Maria Sylvia de S.; Braga, Josefina Aparecida P.

2013-01-01

OBJECTIVES To assess the food intake pattern and the nutritional status of children with cerebral palsy. METHODS Cross-sectional study with 90 children from two to 12.8 years with cerebral palsy in the following forms: hemiplegia, diplegia, and tetraplegia. Nutritional status was assessed by weight, height, and age data. Food intake was verified by the 24-hour recall and food frequency questionnaire. The ability to chew and/or swallowing, intestinal habits, and physical activity were also evaluated. RESULTS For 2-3 year-old age group, the mean energy intake followed the recommended range; in 4-6 year-old age group with hemiplegia and tetraplegia, energy intake was below the recommended limits. All children presented low intake of carbohydrates, adequate intake of proteins and high intake of lipids. The tetraplegia group had a higher prevalence of chewing (41%) and swallowing (12.8%) difficulties compared to 14.5 and 6.6% of children with hemiplegia, respectively. Most children of all groups had a daily intestinal habit. All children presented mild physical activity, while moderate activity was not practiced by any child of the tetraplegia group, which had a significantly lower height/age Z score than those with hemiplegia (-2.14 versus -1.05; p=0.003). CONCLUSIONS The children with cerebral palsy presented inadequate dietary pattern and impaired nutritional status, with special compromise of height. Tetraplegia imposes difficulties regarding chewing/swallowing and moderate physical activity practice. PMID:24142317

Developing learning material of introduction to operation research course based on problem-based learning

NASA Astrophysics Data System (ADS)

Yerizon; Jazwinarti; Yarman

2018-01-01

Students have difficulties experience in the course Introduction to Operational Research (PRO). The purpose of this study is to analyze the requirement of students in the developing lecturing materials PRO based Problem Based Learning which is valid, practice, and effective. Lecture materials are developed based on Plomp’s model. The development process of this device consists of 3 phases: front-end analysis/preliminary research, development/prototype phase and assessment phase. Preliminary analysis was obtained by observation and interview. From the research, it is found that students need the student’s worksheet (LKM) for several reasons: 1) no LKM available, 2) presentation of subject not yet based on real problem, 3) experiencing difficulties from current learning source.

Anaesthetic management of obese parturients: what is the evidence supporting practice guidelines?

PubMed

Eley, V A; van Zundert, A A J; Lipman, J; Callaway, L K

2016-09-01

Increasing rates of obesity in western populations present management difficulties for clinicians caring for obese pregnant women. Various governing bodies have published clinical guidelines for the care of obese parturients. These guidelines refer to two components of anaesthetic care: anaesthetic consultation in the antenatal period for women with a body mass index (BMI) ≥ 40 kg/m 2 and the provision of early epidural analgesia in labour. These recommendations are based on the increased incidence of obstetric complications and the predicted risks and difficulties in providing anaesthetic care. The concept behind early epidural analgesia is logical-site the epidural early, use it for surgical anaesthesia and avoid general anaesthesia if surgery is required. Experts support this recommendation, but there is weak supporting evidence. It is known that the management of labour epidurals in obese women is complicated and that women with extreme obesity require higher rates of general anaesthesia. Anecdotally, anaesthetists view and apply the early epidural recommendation inconsistently and the acceptability of early epidural analgesia to pregnant women is variable. In this topic review, we critically appraise these two practice recommendations. The elements required for effective implementation in multidisciplinary maternity care are considered. We identify gaps in the current literature and suggest areas for future research. While prospective cohort studies addressing epidural extension ('top-up') in obese parturients would help inform practice, audit of local practice may better answer the question "is early epidural analgesia beneficial to obese women in my practice?".

Early Years Centres for Pre-School Children with Primary Language Difficulties: What Do They Cost, and are They Cost-Effective?

ERIC Educational Resources Information Center

Law, J.; Dockrell, J. E.; Castelnuovo, E.; Williams, K.; Seeff, B.; Normand, C.

2006-01-01

Background: High levels of early language difficulties raise practical issues about the efficient and effective means of meeting children's needs. Persistent language difficulties place significant financial pressures on health and education services. This has led to large investment in intervention in the early years; yet, little is known about…

What Is Literacy for Students with Severe Learning Difficulties? Exploring Conventional and Inclusive Literacy

ERIC Educational Resources Information Center

Lacey, Penny; Layton, Lyn; Miller, Carol; Goldbart, Juliet; Lawson, Hazel

2007-01-01

This paper arises from research into inclusive literacy for pupils with severe learning difficulties who do not learn to read and write conventionally. The ultimate aim of the study was to seek out examples of good practice in teaching and learning literacy that includes students with severe learning difficulties and disseminate them as widely as…

[Clarifying the implementation of nursing care systematization].

PubMed

Hermida, Patricia Madalena Vieira

2004-01-01

This study has reviewed the national literature regarding nursing assistance systematization (NAS), with the aim of identifying the difficulties implementing this practice and the factors that interfere with and harm its implementation. The MEDLINE, LILACS, and BDENF databases have been utilized and six studies published in nursing periodicals in the last five years have been surveyed. The results indicate several difficulties implementing the NAS and several factors that interfere negatively with its implementation. Considering the importance of this assistance methodology for valuing professional nursing, it is necessary to reflect on/discuss its practical difficulties so that we can overcome them, making it a pleasurable activity capable of providing nurses with autonomy and providing patients with quality assistance.

Constructing objective tests

NASA Astrophysics Data System (ADS)

Aubrecht, Gordon J.; Aubrecht, Judith D.

1983-07-01

True-false or multiple-choice tests can be useful instruments for evaluating student progress. We examine strategies for planning objective tests which serve to test the material covered in science (physics) courses. We also examine strategies for writing questions for tests within a test blueprint. The statistical basis for judging the quality of test items are discussed. Reliability, difficulty, and discrimination indices are defined and examples presented. Our recommendation are rather easily put into practice.

Dynamic analysis of flexible mechanical systems using LATDYN

NASA Technical Reports Server (NTRS)

Wu, Shih-Chin; Chang, Che-Wei; Housner, Jerrold M.

1989-01-01

A 3-D, finite element based simulation tool for flexible multibody systems is presented. Hinge degrees-of-freedom is built into equations of motion to reduce geometric constraints. The approach avoids the difficulty in selecting deformation modes for flexible components by using assumed mode method. The tool is applied to simulate a practical space structure deployment problem. Results of examples demonstrate the capability of the code and approach.

Bridging In-school and Out-of-school Learning: Formal, Non-Formal, and Informal Education

NASA Astrophysics Data System (ADS)

Eshach, Haim

2007-04-01

The present paper thoroughly examines how one can effectively bridge in-school and out-of-school learning. The first part discusses the difficulty in defining out-of-school learning. It proposes to distinguish three types of learning: formal, informal, and non-formal. The second part raises the question of whether out-of-school learning should be dealt with in the in-school system, in view of the fact that we experience informal learning anyway as well as considering the disadvantages and difficulties teachers are confronted with when planning and carrying out scientific fieldtrips. The voices of the teachers, the students, and the non-formal institution staff are heard to provide insights into the problem. The third part discusses the cognitive and affective aspects of non-formal learning. The fourth part presents some models explaining scientific fieldtrip learning and based on those models, suggests a novel explanation. The fifth part offers some recommendations of how to bridge in and out-of-school learning. The paper closes with some practical ideas as to how one can bring the theory described in the paper into practice. It is hoped that this paper will provide educators with an insight so that they will be able to fully exploit the great potential that scientific field trips may offer.

Facilitators and barriers in expanding scope of practice: findings from a national survey of Irish nurses and midwives.

PubMed

Fealy, Gerard M; Rohde, Daniela; Casey, Mary; Brady, Anne-Marie; Hegarty, Josephine; Kennedy, Catriona; McNamara, Martin; O'Reilly, Pauline; Prizeman, Geraldine

2015-12-01

The aim was to examine current scope of practice among nurses and midwives in Ireland. The objectives were to describe practitioners' self-reported facilitators and barriers to expanding scope of practice and to develop a scope of practice barriers scale. Regulatory authorities permit practice expansion, so long as it falls within accepted parameters of scope of practice. Enduring difficulties in relation to scope of practice include the difficulty of balancing practice restriction with practice expansion. A postal survey design was used to examine registered nurses' and midwives' current scope of practice, including their experiences of facilitators and barriers to expanding practice. A stratified random sample of registered nurses and midwives in Ireland was surveyed using the Scope-QB, a 19-item self-report scope of practice barriers scale. Based on a sample of 1010 respondents, the self-reported perceived barriers to practice expansion included fear of legal consequences, time restrictions and lack of remuneration. Professional satisfaction, patients' needs, organisational support and having access to continuing professional education were perceived as facilitators of practice expansion. Older nurses and midwives as well as nurses and midwives holding more senior promotional grades, such as clinical nurse manager grades, perceived fewer barriers than their younger and more junior counterparts. Nurses and midwives continue to experience difficulties in relation to expanding their practice. Practitioners can operate to optimal scope of practice when practitioner-centred and workplace-based circumstances are optimal. The optimal circumstances for practice expansion exist when the facilitators of practice expansion outweigh the barriers. Given the critical role that nurses and midwives play in modern health services, it is important that they are empowered and enabled to expand their practice and to work to full scope of practice when patient needs and service requirements warrant it. © 2015 John Wiley & Sons Ltd.

Gardner-Diamond syndrome: Difficulties in the management of patients with unexplained medical symptoms

PubMed Central

Meeder, Robert; Bannister, Susan

2006-01-01

The case of an adolescent girl who presented with unexplained bruising is reported. Subsequent investigations failed to elucidate an organic etiology. The diagnosis of Gardner-Diamond syndrome – a syndrome of predictable bruising preceded by pain and warmth at the bruise site, often associated with physical or psychosocial stress – was made. In the present report, the authors use their experience with this rare syndrome to highlight some important ethical and practical considerations with regard to investigation, treatment and communication in illnesses with unexplained medical symptoms. PMID:19030312

The perceptual learning of time-compressed speech: A comparison of training protocols with different levels of difficulty

PubMed Central

Gabay, Yafit; Karni, Avi; Banai, Karen

2017-01-01

Speech perception can improve substantially with practice (perceptual learning) even in adults. Here we compared the effects of four training protocols that differed in whether and how task difficulty was changed during a training session, in terms of the gains attained and the ability to apply (transfer) these gains to previously un-encountered items (tokens) and to different talkers. Participants trained in judging the semantic plausibility of sentences presented as time-compressed speech and were tested on their ability to reproduce, in writing, the target sentences; trail-by-trial feedback was afforded in all training conditions. In two conditions task difficulty (low or high compression) was kept constant throughout the training session, whereas in the other two conditions task difficulty was changed in an adaptive manner (incrementally from easy to difficult, or using a staircase procedure). Compared to a control group (no training), all four protocols resulted in significant post-training improvement in the ability to reproduce the trained sentences accurately. However, training in the constant-high-compression protocol elicited the smallest gains in deciphering and reproducing trained items and in reproducing novel, untrained, items after training. Overall, these results suggest that training procedures that start off with relatively little signal distortion (“easy” items, not far removed from standard speech) may be advantageous compared to conditions wherein severe distortions are presented to participants from the very beginning of the training session. PMID:28545039

Aphasia and Auditory Processing after Stroke through an International Classification of Functioning, Disability and Health Lens

PubMed Central

Purdy, Suzanne C.; Wanigasekara, Iruni; Cañete, Oscar M.; Moore, Celia; McCann, Clare M.

2016-01-01

Aphasia is an acquired language impairment affecting speaking, listening, reading, and writing. Aphasia occurs in about a third of patients who have ischemic stroke and significantly affects functional recovery and return to work. Stroke is more common in older individuals but also occurs in young adults and children. Because people experiencing a stroke are typically aged between 65 and 84 years, hearing loss is common and can potentially interfere with rehabilitation. There is some evidence for increased risk and greater severity of sensorineural hearing loss in the stroke population and hence it has been recommended that all people surviving a stroke should have a hearing test. Auditory processing difficulties have also been reported poststroke. The International Classification of Functioning, Disability and Health (ICF) can be used as a basis for describing the effect of aphasia, hearing loss, and auditory processing difficulties on activities and participation. Effects include reduced participation in activities outside the home such as work and recreation and difficulty engaging in social interaction and communicating needs. A case example of a young man (M) in his 30s who experienced a left-hemisphere ischemic stroke is presented. M has normal hearing sensitivity but has aphasia and auditory processing difficulties based on behavioral and cortical evoked potential measures. His principal goal is to return to work. Although auditory processing difficulties (and hearing loss) are acknowledged in the literature, clinical protocols typically do not specify routine assessment. The literature and the case example presented here suggest a need for further research in this area and a possible change in practice toward more routine assessment of auditory function post-stroke. PMID:27489401

Difficulties, Problems and Countermeasures in Chinese Educational Technology Researches

ERIC Educational Resources Information Center

Chen, Yun-hong; Li, Bing; Xie, Bai-zhi

2007-01-01

The paper discussed the difficulties and problems in experimental researches in educational technology, such as misunderstanding in teachers' concept, disjointedness between theory and practice, inadequate understanding of dialectics in experimental educational technology researches, research project selection and theoretical hypothesis formation…

Recurrent Hydrocoele

PubMed Central

Parks, Kelly; Leung, Lawrence

2013-01-01

Hydrocele is a common cause of scrotal swelling in general practice and is caused by a patent space in the tunica vaginalis. Treatment is often conservative unless the hydrocele grows to a critical size that leads to discomfort or difficulty in walking, in which case drainage is necessary. Depending on the communication of the tunica vaginalis with the peritoneal cavity and other coexistent morbidities, hydrocoele may recur despite repeated drainage posing a problem to management in general practice. We hereby presented a 72-year male with a huge hydrocoele that recurred despite repeated drainage and hernia sac repair, arousing thoughts on this subject and discussions as to the most appropriate management. PMID:24479061

Recruitment strategies for a clinical trial of community-based water therapy for osteoarthritis.

PubMed

Davey, Rachel; Edwards, Sarah Matthes; Cochrane, Tom

2003-04-01

This study compares the efficiency of two methods of recruitment into a randomised controlled trial examining the cost-effectiveness of water therapy for elderly people with lower limb osteoarthritis. The direct cost of recruiting patients via general practice was 27.66 Pounds per patient (1.1 personnel hours/patient). The cost per recruited patient from a local newspaper article was 2.72 Pounds (0.2 personnel hours/patient). The cost differential between the two recruitment methods was largely owing to poor administration practices, difficulties in accessing patient information, and difficulties in contacting patients from the general practice computer database.

Heuristic and algorithmic processing in English, mathematics, and science education.

PubMed

Sharps, Matthew J; Hess, Adam B; Price-Sharps, Jana L; Teh, Jane

2008-01-01

Many college students experience difficulties in basic academic skills. Recent research suggests that much of this difficulty may lie in heuristic competency--the ability to use and successfully manage general cognitive strategies. In the present study, the authors evaluated this possibility. They compared participants' performance on a practice California Basic Educational Skills Test and on a series of questions in the natural sciences with heuristic and algorithmic performance on a series of mathematics and reading comprehension exercises. Heuristic competency in mathematics was associated with better scores in science and mathematics. Verbal and algorithmic skills were associated with better reading comprehension. These results indicate the importance of including heuristic training in educational contexts and highlight the importance of a relatively domain-specific approach to questions of cognition in higher education.

Fostering Cognitive Growth Through Writing.

ERIC Educational Resources Information Center

Sternglass, Marilyn S.

Recent research studies and texts in composition demonstrate the growing belief that students' difficulties with the writing tasks assigned to them are inextricably linked with their difficulties in handling complex cognitive processes. Through appropriate writing activities, students can be provided with practice in the intellectual functions…

Departments: Problems and Alternatives.

ERIC Educational Resources Information Center

Faricy, William H.

This paper deals with the existing inter- and intra-departmental phenomena. Current practices of forming departments and aggregating departments into colleges are investigated and are shown to have inherent difficulties which inhibit the performance of a university. These difficulties are illustrated with empirical data from a representative set…

FEEDING DIFFICULTIES IN PRESCHOOL CHILDREN, PREVIOUS FEEDING PRACTICES, AND NUTRITIONAL STATUS.

PubMed

Maranhão, Hélcio de Sousa; Aguiar, Renata Cunha de; Lira, Débora Teixeira Jales de; Sales, Mônica Úrsula Figuerêdo; Nóbrega, Nathalia Ávila do Nascimento

2018-01-01

To identify the prevalence of feeding difficulties in preschoolers, its association with epidemiological factors and previous eating habits, and repercussion on nutritional status. Cross-sectional study with a questionnaire given to the mothers of 301 children aged 2-6 years enrolled in public and private kindergartens in Natal, Northeast Brazil, conducted in 2014-2015. Feeding difficulty was assessed according to Kerzner's criteria, resulting in the profiles "highly selective intake", "active child with small appetite", "fear of feeding", and "child with psychological disorder or neglected". Association with the following independent variables was analyzed by logistic regression: breastfeeding time, age of cows' milk and complementary feeding introduction, age range, family income, type of school, mothers' profile (responsive or nonresponsive), and body mass index (BMI). Feeding difficulty was found in 37.2% of cases, with predominance of "highly selective intake" (25.4%). It was not associated with infancy feeding practices, family income or type of school. There were no differences between the BMI Z score means for the groups with and without feeding difficulty (1.0±1.5 SD and 1.1±1.4 SD, respectively). The five-to-six age range had more occurrences (OR 1.8; 95%CI 1.1-2.9). Children of responsive mothers were less likely to have feeding difficulties (OR 0.4; 95%CI 0.2-0.8). Feeding difficulties were very frequent. Nutritional status was not impacted by it, and infancy eating habits were not associated with it. Responsive mothers' profile is a protective factor against eating difficulties and reinforces the importance of behavioral factors and mother-child interaction.

Dentist's distress in the management of chronic pain control

PubMed Central

Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gordan, Valeria V.; Gilbert, Gregg H.

2018-01-01

Abstract We aimed to obtain greater understanding of dentists’ distress when they diagnose and treat patients with temporomandibular disorders (TMD), and to explore ways in which TMD can be better treated. We conducted a cross-sectional study based on a questionnaire survey of dentists (n = 148). Dentists were queried using an open-ended questionnaire about distress they experienced when treating patients with TMD. Survey responses were analyzed using mixed methods. Associations between specific dentist and patient characteristics and types of distress were analyzed by one way analysis of variance and residual analysis. One hundred thirteen clinicians responded to the questionnaire, giving a 76% response rate. Thematic analysis identified 6 major themes: difficulty in predicting therapeutic effect and prognosis; difficulty in diagnosis; difficulty in the decision about whether to do occlusal adjustment; difficulty in specifying a cause; difficulty in communicating with patients and mental factors; and health insurance system barriers. Clinicians who reported difficulty in deciding whether to do occlusal adjustment saw significantly more patients who experienced shoulder stiffness and headache (P = .008 and P = .022, respectively). Dentists’ knowledge of TMD guidelines was associated with a lower percentage of difficulty in predicting therapeutic effect and prognosis (residual analysis; P = .010). These findings provide important insights into clinician's perception of difficulties with patients experiencing TMD-related pain. Knowledge of the existence of TMD clinical practice guidelines may lower dentist distress, particularly with regard to prognosis. Further studies are needed to decrease dentist's distress and to overcome the evidence-practice gap in TMD treatment. PMID:29505535

Effects of Fact Retrieval Tutoring on Third-Grade Students with Math Difficulties with and without Reading Difficulties.

PubMed

Powell, Sarah R; Fuchs, Lynn S; Fuchs, Douglas; Cirino, Paul T; Fletcher, Jack M

2009-01-01

The purpose of this study was to assess the efficacy of fact retrieval tutoring as a function of math difficulty (MD) subtype, that is, whether students have MD alone (MD-only) or have concurrent difficulty with math and reading (MDRD). Third graders (n = 139) at two sites were randomly assigned, blocking by site and MD subtype, to four tutoring conditions: fact retrieval practice, conceptual fact retrieval instruction with practice, procedural computation/estimation instruction, and control (no tutoring). Tutoring occurred for 45 sessions over 15weeks for 15-25 minutes per session. Results provided evidence of an interaction between tutoring condition and MD subtype status for assessment of fact retrieval. For MD-only students, students in both fact retrieval conditions achieved comparably and outperformed MD-only students in the control group as well as those in the procedural computation/estimation instruction group. By contrast, for MDRD students, there were no significant differences among intervention conditions.

Effects of Fact Retrieval Tutoring on Third-Grade Students with Math Difficulties with and without Reading Difficulties

PubMed Central

Powell, Sarah R.; Fuchs, Lynn S.; Fuchs, Douglas; Cirino, Paul T.; Fletcher, Jack M.

2009-01-01

The purpose of this study was to assess the efficacy of fact retrieval tutoring as a function of math difficulty (MD) subtype, that is, whether students have MD alone (MD-only) or have concurrent difficulty with math and reading (MDRD). Third graders (n = 139) at two sites were randomly assigned, blocking by site and MD subtype, to four tutoring conditions: fact retrieval practice, conceptual fact retrieval instruction with practice, procedural computation/estimation instruction, and control (no tutoring). Tutoring occurred for 45 sessions over 15weeks for 15–25 minutes per session. Results provided evidence of an interaction between tutoring condition and MD subtype status for assessment of fact retrieval. For MD-only students, students in both fact retrieval conditions achieved comparably and outperformed MD-only students in the control group as well as those in the procedural computation/estimation instruction group. By contrast, for MDRD students, there were no significant differences among intervention conditions. PMID:19448840

Internationalizing Practical ChE Education: The M.I.T. Practice School in Japan.

ERIC Educational Resources Information Center

O'Connor, Andrea J.; Kandas, Angelo W.; Natori, Yukikazu; Hatton, T. Alan

1999-01-01

Describes the establishment, benefits, and difficulties of an overseas branch of the Massachusetts Institute of Technology's (MIT) chemical engineering Practice School for student internship study at the Mitsubishi Chemical Corporation's Mizushima Plant in Kurashiki, Japan. (WRM)

Preoperative airway assessment - experience gained from a multicentre cluster randomised trial and the Danish Anaesthesia Database.

PubMed

Nørskov, Anders Kehlet

2016-05-01

Difficulties with airway management in relation to general anaesthesia have been a challenge for the anaesthesiologist since the birth of anaesthesia. Massive landmark improvements have been made and general anaesthesia is now regarded as a safe procedure. However, rare, difficult airway management still occurs and it prompts increased risk of morbidity and mortality - especially when not anticipated. Several preoperative risk factors for airway difficulties have been identified, yet none have convincing diagnostic accuracy as stand alone tests. Combining several risk factors increase the predictive value of the test and multivariable risk models have been developed. The Simplified Airway Risk Index (SARI) is a predictive model developed for anticipation of a difficult direct laryngoscopy. However, neither the diagnostic accuracy of the SARI nor of any other model has been tested prospectively and compared with existing practice for airway assessment in a randomised trial setting. The first objective of this thesis was to quantify the proportion of unanticipated difficult intubation and difficult mask ventilation in Denmark. The second objective was to design a cluster randomised trial, using state of the art methodology, in order to test the clinical impact of using the SARI for preoperative airway assessment compared with a clinical judgement based on usual practice for airway assessment. Finally, to test if implementation of the SARI would reduce the proportion of unanticipated difficult intubation compared with usual care for airway assessment. This thesis is based on data from the Danish Anaesthesia Database (DAD). Paper 1 presents an observational cohort study on 188,064 patients who underwent tracheal intubation from 2008 to 2011. Data on the anaesthesiologists' preoperative anticipations of airway difficulties was compared with actual airway management conditions, thus enabling an estimation of the proportion of unanticipated difficulties with intubation and mask ventilation. Papers 2 and 3 outline the methodology and the pre-trial calculations and considerations leading to the DIFFICAIR trial described in Paper 4. The trial was designed to randomise anaesthesia department to either thorough education in, and subsequent use of the SARI for preoperative airway assessment or to continue usual care. Registration of the SARI in DAD was made mandatory in SARI departments and impossible in usual care departments. Conditions regarding anticipation of difficulties and actual airway managements were recorded as for Paper 1. DAD data made it possible to estimate an appropriate sample size, considering the between cluster variation, and to construct a stratification variable based on 2011 baseline values of the primary outcome used in the DIFFICAIR trial. Paper 1 revealed that 1.86% of all patients who were intubated, but not planned for advanced intubation techniques (e.g. video laryngoscopy), were unanticipated difficult to intubate. However, 75 to 93% of all difficult intubations were unanticipated. Furthermore, 94% of all difficult mask ventilations were unanticipated. In Paper 4, 59,514 patients were included in the primary analyses. The proportion of unanticipated difficult intubations was 2.38% (696/29,209) in SARI departments and 2.39% (723/30,305) in usual care departments. The adjusted odds ratio was 1.03 (95% CI: 0.77-1.38), p = 0.84. No significant differences were detected in other adjusted outcome measures and neither a 58% increase in patients anticipated to have intubation difficulties nor an 84% increase in patients scheduled for advanced intubation techniques in SARI departments reached statistical significance, p = 0.29 and p = 0.06 respectively. The papers constituting this thesis demonstrate that at high proportion of airway management difficulties are unanticipated. In a cluster randomised trial it was not possible to reduce the proportion of unanticipated difficult intubation in daily clinical practice by implementing a systematic approach for airway assessment compared with usual care. However, implementation of the SARI may increase the anticipation of intubation difficulties and it may change practice towards advanced intubation techniques. This thesis underlines the continued challenge anaesthesiologists face in predicting airway management related difficulties.

Evidence-Based Practice: a survey regarding behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from São Paulo state

PubMed Central

Silva, Tatiane M.; Costa, Lucíola C. M.; Costa, Leonardo O. P.

2015-01-01

BACKGROUND: Evidence-Based Practice (EBP) has been widely used by health professionals. However, no study in Brazil has investigated the data regarding the knowledge and difficulties related to EBP from a representative sample of physical therapists. OBJECTIVE: To identify behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from the state of São Paulo regarding EBP. METHOD: A customized questionnaire about behavior, knowledge, skills, resources, opinions and perceived barriers regarding EBP was sent by email to a sample of 490 physical therapists registered by the Registration Board of São Paulo, Brazil. Physical therapists who did not respond to the questionnaire were contacted by telephone and/or letter. The data were analyzed descriptively. RESULTS: The final response rate was 64.4% (316/490). Because 60 physical therapists were no longer practicing, 256 answers were analyzed. The physical therapists reported that they routinely read scientific papers (89.5%) as a resource for professional development, followed by continuing education courses (88.3%) and books (86.3%). Approximately 35% of the respondents reported a clear understanding of the implementation of research findings in their practice; approximately 37% reported no difficulties in critically appraising scientific papers; and 67.2% strongly agreed that EBP is important for their practice. The most commonly reported barriers were related to difficulties in obtaining full-text papers (80.1%), using EBP may represent higher cost (80.1%) and the language of publication of the papers (70.3%). CONCLUSION: Physical therapists from São Paulo state believe that they have knowledge and skills to use EBP. Although they have favorable opinions regarding its implementation, they still encounter difficulties in implementing EBP successfully. PMID:26443977

Evidence-Based Practice: a survey regarding behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from São Paulo state.

PubMed

Silva, Tatiane M; Costa, Lucíola C M; Costa, Leonardo O P

2015-01-01

Evidence-Based Practice (EBP) has been widely used by health professionals. However, no study in Brazil has investigated the data regarding the knowledge and difficulties related to EBP from a representative sample of physical therapists. To identify behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from the state of São Paulo regarding EBP. A customized questionnaire about behavior, knowledge, skills, resources, opinions and perceived barriers regarding EBP was sent by email to a sample of 490 physical therapists registered by the Registration Board of São Paulo, Brazil. Physical therapists who did not respond to the questionnaire were contacted by telephone and/or letter. The data were analyzed descriptively. The final response rate was 64.4% (316/490). Because 60 physical therapists were no longer practicing, 256 answers were analyzed. The physical therapists reported that they routinely read scientific papers (89.5%) as a resource for professional development, followed by continuing education courses (88.3%) and books (86.3%). Approximately 35% of the respondents reported a clear understanding of the implementation of research findings in their practice; approximately 37% reported no difficulties in critically appraising scientific papers; and 67.2% strongly agreed that EBP is important for their practice. The most commonly reported barriers were related to difficulties in obtaining full-text papers (80.1%), using EBP may represent higher cost (80.1%) and the language of publication of the papers (70.3%). Physical therapists from São Paulo state believe that they have knowledge and skills to use EBP. Although they have favorable opinions regarding its implementation, they still encounter difficulties in implementing EBP successfully.

Parenting gifted and talented children: what are the key child behaviour and parenting issues?

PubMed

Morawska, Alina; Sanders, Matthew R

2008-09-01

The literature on gifted and talented children is limited. Little is known about the types and nature of difficulties experienced by gifted and talented children, and even less known about parenting issues related to parenting a gifted and talented child. The aim of the present study was to describe children's behavioural and emotional adjustment, and the factors that contribute to children's difficulties, as well as to examine the styles of discipline used by parents of gifted and talented children and their level of confidence in managing specific parenting tasks. A survey of parents of gifted and talented children was conducted, with 211 parents meeting criteria for the study. For a community sample, in general gifted and talented children exhibit no more behavioural difficulties than do other children. But children in this sample seemed to show higher levels of emotional symptoms and peer problems. Children's behavioural and emotional difficulties were best predicted by parenting factors, particularly parental confidence. Parents reported that they were less likely to be permissive with their child, but they tended to use a more authoritarian style of parenting characterized by lecturing and a strong reaction to any problems. There are a number of implications for future research, clinical practice, and the development of parenting interventions for this group of parents.

Microcomputers and Continuing Motivation.

ERIC Educational Resources Information Center

Seymour, Sherrie L.; And Others

1987-01-01

Describes study that investigated the effects of medium of instructional practice, task difficulty, and gender on continuing motivation. Microcomputers and paper and pencil format were compared on tasks at a hard or easy difficulty level with fifth and sixth grade students, and questionnaires were used to determine student attitudes. (Author/LRW)

Failure mode analysis to predict product reliability.

NASA Technical Reports Server (NTRS)

Zemanick, P. P.

1972-01-01

The failure mode analysis (FMA) is described as a design tool to predict and improve product reliability. The objectives of the failure mode analysis are presented as they influence component design, configuration selection, the product test program, the quality assurance plan, and engineering analysis priorities. The detailed mechanics of performing a failure mode analysis are discussed, including one suggested format. Some practical difficulties of implementation are indicated, drawn from experience with preparing FMAs on the nuclear rocket engine program.

Characteristic features of determining the labor input and estimated cost of the development and manufacture of equipment

NASA Technical Reports Server (NTRS)

Kurmanaliyev, T. I.; Breslavets, A. V.

1974-01-01

The difficulties in obtaining exact calculation data for the labor input and estimated cost are noted. The method of calculating the labor cost of the design work using the provisional normative indexes with respect to individual forms of operations is proposed. Values of certain coefficients recommended for use in the practical calculations of the labor input for the development of new scientific equipment for space research are presented.

An introduction to using children's drawings as an assessment tool.

PubMed

Wilson, D; Ratekin, C

1990-03-01

This article is intended to familiarize the ambulatory care provider with possible uses of children's drawings as assessment tools. Drawings can be a useful adjunct in detecting perceptual-motor difficulties and developmental delay, and can provide clues to self-image and family dynamics. Piaget's theory of cognitive development provides a framework to evaluate the child's intellectual development as reflected in drawings. The developmental scales of Koppitz are presented as a practical screening tool. The Koppitz scales include both developmental norms and items that might indicate emotional problems. Observing the child's drawing of the family provides clues to family dynamics. Becoming highly skilled in the evaluation of children's drawings requires a familiarity with neurophysiology, education, psychology, and psychoanalytic and developmental theory, along with intuition and practice. This article presents an introduction to evaluating children's drawings.

Numerical simulation of damage evolution for ductile materials and mechanical properties study

NASA Astrophysics Data System (ADS)

El Amri, A.; Hanafi, I.; Haddou, M. E. Y.; Khamlichi, A.

2015-12-01

This paper presents results of a numerical modelling of ductile fracture and failure of elements made of 5182H111 aluminium alloys subjected to dynamic traction. The analysis was performed using Johnson-Cook model based on ABAQUS software. The modelling difficulty related to prediction of ductile fracture mainly arises because there is a tremendous span of length scales from the structural problem to the micro-mechanics problem governing the material separation process. This study has been used the experimental results to calibrate a simple crack propagation criteria for shell elements of which one has often been used in practical analyses. The performance of the proposed model is in general good and it is believed that the presented results and experimental-numerical calibration procedure can be of use in practical finite-element simulations.

Bedside, classroom and bench: collaborative strategies to generate evidence-based knowledge for nursing practice.

PubMed

Weaver, Charlotte A; Warren, Judith J; Delaney, Connie

2005-12-01

The rise of evidence-base practice (EBP) as a standard for care delivery is rapidly emerging as a global phenomenon that is transcending political, economic and geographic boundaries. Evidence-based nursing (EBN) addresses the growing body of nursing knowledge supported by different levels of evidence for best practices in nursing care. Across all health care, including nursing, we face the challenge of how to most effectively close the gap between what is known and what is practiced. There is extensive literature on the barriers and difficulties of translating research findings into practical application. While the literature refers to this challenge as the "Bench to Bedside" lag, this paper presents three collaborative strategies that aim to minimize this gap. The Bedside strategy proposes to use the data generated from care delivery and captured in the massive data repositories of electronic health record (EHR) systems as empirical evidence that can be analysed to discover and then inform best practice. In the Classroom strategy, we present a description for how evidence-based nursing knowledge is taught in a baccalaureate nursing program. And finally, the Bench strategy describes applied informatics in converting paper-based EBN protocols into the workflow of clinical information systems. Protocols are translated into reference and executable knowledge with the goal of placing the latest scientific knowledge at the fingertips of front line clinicians. In all three strategies, information technology (IT) is presented as the underlying tool that makes this rapid translation of nursing knowledge into practice and education feasible.

Efficient level set methods for constructing wavefronts in three spatial dimensions

NASA Astrophysics Data System (ADS)

Cheng, Li-Tien

2007-10-01

Wavefront construction in geometrical optics has long faced the twin difficulties of dealing with multi-valued forms and resolution of wavefront surfaces. A recent change in viewpoint, however, has demonstrated that working in phase space on bicharacteristic strips using eulerian methods can bypass both difficulties. The level set method for interface dynamics makes a suitable choice for the eulerian method. Unfortunately, in three-dimensional space, the setting of interest for most practical applications, the advantages of this method are largely offset by a new problem: the high dimension of phase space. In this work, we present new types of level set algorithms that remove this obstacle and demonstrate their abilities to accurately construct wavefronts under high resolution. These results propel the level set method forward significantly as a competitive approach in geometrical optics under realistic conditions.

Rethinking Difficulties of Teaching Inquiry-Based Practical Work: Stories from Elementary Pre-Service Teachers

ERIC Educational Resources Information Center

Kim, Mijung; Tan, Aik-Ling

2011-01-01

To alleviate teachers' reluctance toward practical work, there has been much discussion on teachers' pedagogical content knowledge, teaching materials, and failsafe strategies for practical work. Despite these efforts, practical work is still regarded as a challenging task for many elementary science teachers. To understand the complexity of…

State of family medicine practice in Lebanon

PubMed Central

Helou, Mariana; Rizk, Grace Abi

2016-01-01

Background: Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. Materials and Methods: A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. Results: The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Conclusion: Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession. PMID:27453843

State of family medicine practice in Lebanon.

PubMed

Helou, Mariana; Rizk, Grace Abi

2016-01-01

Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession.

Dyspraxia 5-11: A Practical Guide.

ERIC Educational Resources Information Center

Macintyre, Christine

This book attempts to explain dyspraxia, a coordination disorder, and how the condition affects children of primary school age. The first chapter defines dyspraxia and answers common questions concerning what the condition is, difficulties these children experience, reasons for these difficulties, the prevalence of dyspraxia, and ways to help.…

Take the Pencil out of the Process

ERIC Educational Resources Information Center

Broun, Leslie

2009-01-01

In classrooms, it is not unusual to see students who struggle to produce legible print. In actuality, many students have difficulty with the physical printing and writing processes ("handwriting")--difficulty that is significant enough to interfere with their academic performance. Some students grow out of this, and some, with extra practice,…

Using Literature Response Activities To Build Strategic Reading for Students with Reading Difficulties.

ERIC Educational Resources Information Center

Martin, Sarah H.; Martin, Michael A.

2001-01-01

Describes two classroom activities that can be implemented in accordance with the best practices revealed by current research on reading instruction with learning disabled students. Describes what research suggests for promoting comprehension for students with reading difficulties. Describes instructional sequences for two literacy activities,…

Translations among Mathematical Representations: Teacher Beliefs and Practices

ERIC Educational Resources Information Center

Bosse, Michael J.; Adu-Gyamfi, Kwaku; Cheetham, Meredith

2011-01-01

Student ability, teacher expectations, respective degrees of difficulty, and curriculum and instructional practices all work together to provide students experiences leading to differing levels of success in respect to mathematical translations. Herein, we discuss teacher beliefs and instructional practices, investigate why some translations seem…

An exemplar of naturalistic inquiry in general practice research.

PubMed

McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

2017-01-23

Background Before beginning any research project, novice researchers must consider which methodological approach will best address their research questions. The paucity of literature describing a practical application of naturalistic inquiry adds to the difficulty they may experience. Aim To provide a practical example of how naturalistic inquiry was applied to a qualitative study exploring collaboration between registered nurses and general practitioners working in Australian general practice. Discussion Naturalistic inquiry is not without its critics and limitations. However, by applying the axioms and operational characteristics of naturalistic inquiry, the authors captured a detailed 'snapshot' of collaboration in general practice in the time and context that it occurred. Conclusion Using qualitative methods, naturalistic inquiry provides the scope to construct a comprehensive and contextual understanding of a phenomenon. No individual positivist paradigm could provide the level of detail achieved in a naturalistic inquiry. Implications for practice This paper presents a practical example of naturalistic inquiry for the novice researcher. It shows that naturalistic inquiry is appropriate when the researcher seeks a rich and contextual understanding of a phenomenon as it exists in its natural setting.

FEEDING DIFFICULTIES IN PRESCHOOL CHILDREN, PREVIOUS FEEDING PRACTICES, AND NUTRITIONAL STATUS

PubMed Central

Maranhão, Hélcio de Sousa; de Aguiar, Renata Cunha; de Lira, Débora Teixeira Jales; Sales, Mônica Úrsula Figuerêdo; Nóbrega, Nathalia Ávila do Nascimento

2017-01-01

ABSTRACT Objective: To identify the prevalence of feeding difficulties in preschoolers, its association with epidemiological factors and previous eating habits, and repercussion on nutritional status. Methods: Cross-sectional study with a questionnaire given to the mothers of 301 children aged 2-6 years enrolled in public and private kindergartens in Natal, Northeast Brazil, conducted in 2014-2015. Feeding difficulty was assessed according to Kerzner’s criteria, resulting in the profiles “highly selective intake”, “active child with small appetite”, “fear of feeding”, and “child with psychological disorder or neglected”. Association with the following independent variables was analyzed by logistic regression: breastfeeding time, age of cows’ milk and complementary feeding introduction, age range, family income, type of school, mothers’ profile (responsive or nonresponsive), and body mass index (BMI). Results: Feeding difficulty was found in 37.2% of cases, with predominance of “highly selective intake” (25.4%). It was not associated with infancy feeding practices, family income or type of school. There were no differences between the BMI Z score means for the groups with and without feeding difficulty (1.0±1.5 SD and 1.1±1.4 SD, respectively). The five-to-six age range had more occurrences (OR 1.8; 95%CI 1.1-2.9). Children of responsive mothers were less likely to have feeding difficulties (OR 0.4; 95%CI 0.2-0.8). Conclusions: Feeding difficulties were very frequent. Nutritional status was not impacted by it, and infancy eating habits were not associated with it. Responsive mothers’ profile is a protective factor against eating difficulties and reinforces the importance of behavioral factors and mother-child interaction. PMID:29091129

Implementing Practical Based Courses under Open and Distance Learning System: A Study of the Perception of Learners and Counsellors

ERIC Educational Resources Information Center

Basantia, Tapan Kumar

2018-01-01

Implementing practical based courses under Open and Distance Learning (ODL) system is a very difficult and challenging task as the teaching of practical based courses involves intensive practical work. For removing the difficulties and challenges in implementing the practical based courses under ODL system, there is a need to study the existing…

Practice Environments and Job Satisfaction in Patient-Centered Medical Homes

PubMed Central

Alidina, Shehnaz; Rosenthal, Meredith B.; Schneider, Eric C.; Singer, Sara J.; Friedberg, Mark W.

2014-01-01

PURPOSE We undertook a study to evaluate the effects of medical home transformation on job satisfaction in the primary care setting. METHODS We collected primary data from 20 primary care practices participating in medical home pilot projects in Rhode Island and Colorado from 2009 to 2011. We surveyed clinicians and staff about the quality of their practice environments (eg, office chaos, communication, difficulties in providing safe, high-quality care) and job satisfaction at baseline and 30 months, and about stress, burnout, and intention to leave at 30 months. We interviewed practice leaders about the impact of pilot project participation. We assessed longitudinal changes in the practice environment and job satisfaction and, in the final pilot year, examined cross-sectional associations between the practice environment and job satisfaction, stress, burnout, and intention to leave. RESULTS Between baseline and 30 months, job satisfaction improved in Rhode Island (P =.03) but not in Colorado. For both pilot projects, reported difficulties in providing safe, high-quality care decreased (P <.001), but emphasis on quality and the level of office chaos did not change significantly. In cross-sectional analyses, fewer difficulties in providing safe, high-quality care and more open communication were associated with greater job satisfaction. Greater office chaos and an emphasis on electronic information were associated with greater stress and burnout. CONCLUSIONS Medical home transformations that emphasize quality and open communication while minimizing office chaos may offer the best chances of improving job satisfaction. PMID:25024241

Difficulties and practices regarding information provision among Korean and Italian nurses.

PubMed

Ingravallo, F; Kim, K H; Han, Y H; Volta, A; Chiari, P; Taddia, P; Kim, J S

2017-12-01

To investigate nurses' opinions and practices of providing information in a global context through cultural comparison. Providing sufficient information to patients about nursing interventions and plans is essential for patient-centred care. While many countries have specific legislation making information delivery to patients a legal duty of nurses, no such legislation exists in both the Republic of Korea and Italy; nurses' only guidance is the deontological code. This was a cross-sectional survey study involving a convenience sample of 174 Korean nurses and 121 Italian nurses working in internal medicine and surgery at university hospitals. Data were collected using a self-administered questionnaire between February and November 2014. The questionnaire assessed demographic and professional characteristics, and difficulties and practices regarding information provision. Korean and Italian nurses significantly differed in all demographic and professional characteristics. More Korean than Italian participants reported that their role in providing information was well explained within their teams, but both groups reported the same level and type of difficulties in delivering information. Nurses in both countries regularly informed patients about medications and nursing procedures, but provided information about nursing care plans less frequently. Few nurses frequently provided information to relatives instead of patients. Despite cultural, demographic and professional differences between Korean and Italian nurses, their difficulties and practices in information delivery to patient were similar. Hospital managers and policymakers should be aware that nurse-patient communication can be impaired by organizational factors, patient characteristics or the interaction among providers. Educational interventions and strategies are needed to increase information provision to patients about nursing care plans. © 2017 International Council of Nurses.

Parental practices and political violence: the protective role of parental warmth and authority-control in Jewish and Arab Israeli children.

PubMed

Lavi, Iris; Slone, Michelle

2012-10-01

Parental warmth and parental authority-control patterns have been documented as practices with highest significance for children's well-being and development in a variety of life areas. Various forms of these practices have been shown to have a direct positive effect on children and also to protect children from adverse effects of numerous stressors. However, surprisingly, few studies have examined the role of these practices as possible protective factors for children exposed to intractable conflict and political violence. Participants in this study were Jewish (n = 88) and Arab (n = 105) Israeli families, with children aged 7-12.5 (M = 10.73, SD = 0.99). Children completed questionnaires assessing political violence exposure, behavioral, psychological, and social difficulties, and perceived paternal and maternal warmth. Mothers and fathers completed questionnaires assessing parental warmth, parental authority-control, and the child's difficulties. Results showed parental warmth to be a significant moderator of political violence, related to low levels of behavioral and social difficulties of children. Parental authority-control patterns were not protectors from adverse effects of political violence exposure. Maternal authoritarian authority-control showed an effect resembling a risk factor. Differential roles of parental warmth and authority-control, fathers' versus mothers' roles, and ethnic differences are discussed, and practical clinical implications are proposed. © 2012 American Orthopsychiatric Association.

Assessment and management of the communication difficulties of children with cerebral palsy: a UK survey of SLT practice

PubMed Central

Mary Watson, Rose; Pennington, Lindsay

2015-01-01

Background Communication difficulties are common in cerebral palsy (CP) and are frequently associated with motor, intellectual and sensory impairments. Speech and language therapy research comprises single-case experimental design and small group studies, limiting evidence-based intervention and possibly exacerbating variation in practice. Aims To describe the assessment and intervention practices of speech–language therapist (SLTs) in the UK in their management of communication difficulties associated with CP in childhood. Methods & Procedures An online survey of the assessments and interventions employed by UK SLTs working with children and young people with CP was conducted. The survey was publicized via NHS trusts, the Royal College of Speech and Language Therapists (RCSLT) and private practice associations using a variety of social media. The survey was open from 5 December 2011 to 30 January 2012. Outcomes & Results Two hundred and sixty-five UK SLTs who worked with children and young people with CP in England (n = 199), Wales (n = 13), Scotland (n = 36) and Northern Ireland (n = 17) completed the survey. SLTs reported using a wide variety of published, standardized tests, but most commonly reported assessing oromotor function, speech, receptive and expressive language, and communication skills by observation or using assessment schedules they had developed themselves. The most highly prioritized areas for intervention were: dysphagia, alternative and augmentative (AAC)/interaction and receptive language. SLTs reported using a wide variety of techniques to address difficulties in speech, language and communication. Some interventions used have no supporting evidence. Many SLTs felt unable to estimate the hours of therapy per year children and young people with CP and communication disorders received from their service. Conclusions & Implications The assessment and management of communication difficulties associated with CP in childhood varies widely in the UK. Lack of standard assessment practices prevents comparisons across time or services. The adoption of a standard set of agreed clinical measures would enable benchmarking of service provision, permit the development of large-scale research studies using routine clinical data and facilitate the identification of potential participants for research studies in the UK. Some interventions provided lack evidence. Recent systematic reviews could guide intervention, but robust evidence is needed in most areas addressed in clinical practice. PMID:25652139

Assessment and management of the communication difficulties of children with cerebral palsy: a UK survey of SLT practice.

PubMed

Watson, Rose Mary; Pennington, Lindsay

2015-01-01

Communication difficulties are common in cerebral palsy (CP) and are frequently associated with motor, intellectual and sensory impairments. Speech and language therapy research comprises single-case experimental design and small group studies, limiting evidence-based intervention and possibly exacerbating variation in practice. To describe the assessment and intervention practices of speech-language therapist (SLTs) in the UK in their management of communication difficulties associated with CP in childhood. An online survey of the assessments and interventions employed by UK SLTs working with children and young people with CP was conducted. The survey was publicized via NHS trusts, the Royal College of Speech and Language Therapists (RCSLT) and private practice associations using a variety of social media. The survey was open from 5 December 2011 to 30 January 2012. Two hundred and sixty-five UK SLTs who worked with children and young people with CP in England (n = 199), Wales (n = 13), Scotland (n = 36) and Northern Ireland (n = 17) completed the survey. SLTs reported using a wide variety of published, standardized tests, but most commonly reported assessing oromotor function, speech, receptive and expressive language, and communication skills by observation or using assessment schedules they had developed themselves. The most highly prioritized areas for intervention were: dysphagia, alternative and augmentative (AAC)/interaction and receptive language. SLTs reported using a wide variety of techniques to address difficulties in speech, language and communication. Some interventions used have no supporting evidence. Many SLTs felt unable to estimate the hours of therapy per year children and young people with CP and communication disorders received from their service. The assessment and management of communication difficulties associated with CP in childhood varies widely in the UK. Lack of standard assessment practices prevents comparisons across time or services. The adoption of a standard set of agreed clinical measures would enable benchmarking of service provision, permit the development of large-scale research studies using routine clinical data and facilitate the identification of potential participants for research studies in the UK. Some interventions provided lack evidence. Recent systematic reviews could guide intervention, but robust evidence is needed in most areas addressed in clinical practice. © 2015 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

Boredom in psychiatric practice.

PubMed

Morrant, J C

1984-08-01

This paper discusses some of the causes of boredom in psychiatric practice. It also describes how many psychiatric conditions can have boring facets to them, which can lead to difficulties in treatment and "burn-out" in the therapist. Finally, some practical suggestions are given to help avoid and deal with boredom.

The Counseling Center Assessment of Psychological Symptoms (CCAPS): Merging clinical practice, training, and research.

PubMed

Youn, Soo Jeong; Castonguay, Louis G; Xiao, Henry; Janis, Rebecca; McAleavey, Andrew A; Lockard, Allison J; Locke, Benjamin D; Hayes, Jeffrey A

2015-12-01

The goal of this article is to present information about a standardized multidimensional measure of psychological symptoms, the Counseling Center Assessment of Psychological Symptoms (CCAPS; Locke et al., 2011; Locke, McAleavey, et al., 2012; McAleavey, Nordberg, Hayes, et al., 2012), developed to assess difficulties specific to college students' mental health. We provide (a) a brief review and summary of the psychometric and research support for the CCAPS; (b) examples of the use of the CCAPS for various purposes, including clinical, training, policy, and counseling center advocacy; and (c) implications of the integration of routine outcome monitoring and feedback for the future of training, research, and clinical practice. In particular, the article emphasizes how the assimilation of and symbiotic relationship between research and practice can address the scientist-practitioner gap. (c) 2015 APA, all rights reserved).

Application of a low-cost web-based simulation to improve students' practical skills in medical education.

PubMed

Moreno-Ger, Pablo; Torrente, Javier; Bustamante, Julián; Fernández-Galaz, Carmen; Fernández-Manjón, Baltasar; Comas-Rengifo, María Dolores

2010-06-01

Practical sessions in undergraduate medical education are often costly and have to face constraints in terms of available laboratory time and practice materials (e.g. blood samples from animals). This makes it difficult to increase the time each student spends at the laboratory. We consider that it would be possible to improve the effectiveness of the laboratory time by providing the students with computer-based simulations for prior rehearsal. However, this approach still presents issues in terms of development costs and distribution to the students. This study investigates the employment of low-cost simulation to allow medical students to rehearse practical exercises through a web-based e-learning environment. The aim is to maximize the efficiency of laboratory time and resources allocated by letting students become familiarized with the equipment and the procedures before they attend a laboratory session, but without requiring large-scale investment. Moreover, students can access the simulation via the Internet and rehearse at their own pace. We have studied the effects of such a simulation in terms of impact on the laboratory session, learning outcomes and student satisfaction. We created a simulation that covers the steps of a practical exercise in a Physiology course (measuring hematocrit in a blood sample). An experimental group (EG, n=66) played the simulation 1 week before the laboratory session. A control group (CG, n=77) attended the laboratory session without playing the simulation. After the session, all students completed a survey about their perception of the difficulty of the exercise on a scale of 1-10 and the HCT final value that they obtained. The students in the EG also completed a survey about their satisfaction with the experience. After the laboratory session, the perceived difficulty of the procedure was lower on average in the EG compared to the CG (3.52 vs. 4.39, 95% CI: 0.16-1.57, P=.016). There was no significant difference in terms of perceived difficulty using the equipment. The HCT measures reported by the EG group also presented a much lower dispersion, meaning a higher reliability, in determining the HCT value (3.10 vs. 26.94, SD; variances significantly different, P<.001, F: 75.25, Dfd: 68.19 for EG and CG). In the satisfaction test, the majority of the students in the EG reported that the experience was positive or very positive (80.7%) and reported that it had helped them to identify and use the equipment (78%) and to perform the exercise (66%). The simulation was well received by students in the EG, who felt more comfortable during the laboratory session, and it helped them to perform the exercise better, obtaining more accurate results, which indicates more effective training. EG students perceived the procedure as easier to perform, but did not report an improvement in the perceived difficulty in using the equipment. The increased reliability demonstrates that low-cost simulations are a good complement to the laboratory sessions. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Common components of evidence-based parenting programs for preventing maltreatment of school-age children.

PubMed

Temcheff, Caroline E; Letarte, Marie-Josée; Boutin, Stéphanie; Marcil, Katherine

2018-06-01

Child maltreatment can lead to a variety of negative outcomes in childhood including physical and mental health problems that can extend into adulthood. Given the transactional nature of child maltreatment and the difficulties that many maltreating families experience, child protection services typically offer various kinds of programs to maltreated children, their parents, and/or their families. Although the specific difficulties experienced by these families may vary, sub-optimal parenting practices are typically part of the picture and may play a central role in maltreated children's development. Hence, to deal with child maltreatment, programs that focus on parenting practices are essential, and identifying the common components of effective programs is of critical importance. The objectives of the present study were to: 1) describe the components of evidence-based parenting programs aimed at parents who have maltreated their elementary school-aged children or are at-risk for doing so and 2) identify the components that are common to these programs, using the approach proposed by Barth and Liggett-Creel (2014). Fourteen evidence-based parenting programs aimed at parents who had maltreated their elementary school-aged children (ages 6-12) or were at-risk for doing so were identified using both a review of relevant online databases of evidence-based programs (California Evidence-Based Clearinghouse for Child Welfare, Blueprints for Healthy Youth Development, Youth.gov, and the National Registry of Evidence-based Programs and Practices). Common components were identified (operationalized as components present in two thirds of programs) and discussed. The identification of common components of evidence-based programs may help clinicians choose the best intervention methods. Copyright © 2018. Published by Elsevier Ltd.

Operant conditioning-based behavior modification: one approach to treating somatic disorders.

PubMed

LeBow, M D

1975-01-01

The applicability of behavior modification as a process for treating somatic difficulties is examined within the framework of measurement, modification, and evaluation. Illustrations of this process are presented throughout. In particular, the last section of the paper gives an example of a currently operative and multifaceted approach to the problem of obesity. Among the topics considered herein are the use of behavioral contracts that specify ameliorative weight reduction practices and the assessment as well as manipulation of eating speed.

Management of chemical dependence in pregnancy.

PubMed

Christensen, Carl

2008-06-01

Although the percentage of pregnant patients who use illicit drugs is relatively low, the effects can be devastating on both mother and fetus-loss of custody, growth restriction, placental abruption, and death. The practicing obstetrician may be unfamiliar with the various presentations of chemical dependency in pregnancy, including intoxication and withdrawal, and difficulty in making the diagnosis. The obstetrician is in the unique situation of being responsible for the safety of both mother and fetus, which may involve engaging the unwilling patient in treatment.

The theory and applications of ocean wave measuring systems at and below the sea surface, on the land, from aircraft, and from spacecraft

NASA Technical Reports Server (NTRS)

Pierson, W. J.

1976-01-01

Methods for measuring and analyzing ocean waves are described, including those presently in use on spacecraft and planned for SEASAT-A. Potential difficulties with synthetic aperture systems for a spacecraft are described and an alternate design is suggested. The different methods can yield different kinds of spectra and other kinds of imagery. Ways to compare different kinds of data are given. The scientific and practical applications of data from spacecraft are given.

Development of a novel, multilayered presentation format for clinical practice guidelines.

PubMed

Kristiansen, Annette; Brandt, Linn; Alonso-Coello, Pablo; Agoritsas, Thomas; Akl, Elie A; Conboy, Tara; Elbarbary, Mahmoud; Ferwana, Mazen; Medani, Wedad; Murad, Mohammad Hassan; Rigau, David; Rosenbaum, Sarah; Spencer, Frederick A; Treweek, Shaun; Guyatt, Gordon; Vandvik, Per Olav

2015-03-01

Bridging the gap between clinical research and everyday health-care practice requires effective communication strategies. To address current shortcomings in conveying practice recommendations and supporting evidence, we are creating and testing presentation formats for clinical practice guidelines (CPGs). We carried out multiple cycles of brainstorming and sketching, developing a prototype. Physicians participating in the user testing viewed CPG formats linked to clinical scenarios and engaged in semistructured interviews applying a think-aloud method for exploring important aspects of user experience. We developed a multilayered presentation format that allows clinicians to successively view more in-depth information. Starting with the recommendations, clinicians can, on demand, access a rationale and a key information section containing statements on quality of the evidence, balance between desirable and undesirable consequences, values and preferences, and resource considerations. We collected feedback from 27 stakeholders and performed user testing with 47 practicing physicians from six countries. Advisory group feedback and user testing of the first version revealed problems with conceptual understanding of underlying CPG methodology, as well as difficulties with the complexity of the layout and content. Extensive revisions made before the second round of user testing resulted in most participants expressing overall satisfaction with the final presentation format. We have developed an electronic, multilayered, CPG format that enhances the usability of CPGs for frontline clinicians. We have implemented the format in electronic guideline tools that guideline organizations can now use when authoring and publishing their guidelines.

Analysis of potential dynamic concealed factors in the difficulty of lower third molar extraction.

PubMed

Singh, P; Ajmera, D-H; Xiao, S-S; Yang, X-Z; Liu, X; Peng, B

2016-11-01

The purpose of this study was to identify potential concealed variables associated with the difficulty of lower third molar (M3) extractions. To address the research purpose, we implemented a prospective study and enrolled a sample of subjects presenting for M3 removal. Predictor variables were categorized into Group-I and Group-II, based on predetermined criteria. The primary outcome variable was the difficulty of extraction, measured as extraction time. Appropriate univariate and multivariate statistics were computed using ordinal logistic regression. The sample comprised of 1235 subjects with a mean age of 29.49 +/- 8.92 years in Group-I and 26.20 +/- 11.55 years in Group-II subjects. The mean operating time per M3 extraction was 21.24 +/- 12.80 and 20.24 +/- 12.50 minutes for Group-I and Group-II subjects respectively. Three linear parameters including B-M2 height (distance between imaginary point B on the inferior border of mandibular body, and M2), lingual cortical thickness, bone density and one angular parameter including Rc-Cs angle (angle between ramus curvature and curve of spee), in addition to patient's age, profile type, facial type, cant of occlusal plane, and decreased overbite, were found to be statistically associated ( p < or = 0.05) with extraction difficulty under regression models. In conclusion, our study indicates that the difficulty of lower M3 extractions is possibly governed by morphological and biomechanical factors with substantial influence of myofunctional factors. Preoperative evaluation of dynamic concealed factors may not only help in envisaging the difficulty and planning of surgical approach but might also help in better time management in clinical practice.

Developing a general practice library: a collaborative project between a GP and librarian.

PubMed

Pearson, D; Rossall, H

2001-12-01

The authors report on a self-completed questionnaire study from a North Yorkshire based general practice regarding the information needs of its clinicians. The work was carried out with a particular focus on the practice library, and the findings identified that a new approach to maintaining and developing the library was needed. The literature regarding the information needs of primary care clinicians and the role of practice libraries is considered, and compared to those of the clinicians at the practice. Discussion follows on how a collaborative project was set up between the practice and a librarian based at the local NHS Trust library in order to improve the existing practice library. Difficulties encountered and issues unique to the project are explored, including training implications presented by the implementation of electronic resources. Marketing activities implemented are discussed, how the library will operate in its new capacity, and how ongoing support and maintenance of the library will be carried out. It is concluded that although scepticism still exists regarding librarian involvement in practice libraries, collaboration between clinicians and librarians is an effective approach to the successful development and maintenance of a practice library, and recommendations are therefore made for similar collaborative work.

School-Based Assessment of ADHD: Purpose, Alignment with Best Practice Guidelines, and Training

ERIC Educational Resources Information Center

Ogg, Julia; Fefer, Sarah; Sundman-Wheat, Ashley; McMahan, Melanie; Stewart, Tiffany; Chappel, Ashley; Bateman, Lisa

2013-01-01

Youth exhibiting symptoms of attention deficit hyperactivity disorder are frequently referred to school psychologists because of academic, social, and behavioral difficulties that they face. To address these difficulties, evidence-based assessment methods have been outlined for multiple purposes of assessment. The goals of this study were to…

Supporting Children with Communication Difficulties in Inclusive Settings: School-Based Language Intervention.

ERIC Educational Resources Information Center

McCormick, Linda; And Others

Preparing language interventionists and special education teachers to work with colleagues and families on collaborative teams in public school settings, this book provides basic procedures for intervention for all children with language and communication difficulties, with hands-on activities to give students practice in applying the procedures.…

Psycho-Pedagogical Interventions in the Prevention and the Therapy of Learning Difficulties in the Field of Mathematics

ERIC Educational Resources Information Center

Anca, Maria; Hategan, Carolina

2009-01-01

In the given study dyscalculia is approached in the context of learning difficulties, but also in relation with damaged psychic processes and functions. The practical part of the study describes intervention models from the perspective of dyscalculia prevention and therapymaterialized in personalized intervention programs.

Evidence-Based Practice, Response to Intervention, and the Prevention of Reading Difficulties

ERIC Educational Resources Information Center

Justice, Laura M.

2006-01-01

Purpose: This article provides an evidence-based perspective on what school communities can do to lower the prevalence of reading difficulties among their pupils through preventive interventions. It also delineates the roles that speech-language pathologists (SLPs) might play in these interventions. Method: This article is organized to first…

Difficulties in Field-Based Observation among Pre-Service Teachers: Implications to Practice Teaching

ERIC Educational Resources Information Center

Abas, Maripaz C.

2016-01-01

Field-based observation has long been a central part of pre-service teacher education in many countries and is crucial for implementing effective practicum of pre-service teachers. This paper focused on the perspectives of graduating pre-service teachers regarding their difficulties related to administrative support, cooperating teachers, student…

[Spontaneous speech prosody and discourse analysis in schizophrenia and Fronto Temporal Dementia (FTD) patients].

PubMed

Martínez, Angela; Felizzola Donado, Carlos Alberto; Matallana Eslava, Diana Lucía

2015-01-01

Patients with schizophrenia and Frontotemporal Dementia (FTD) in their linguistic variants share some language characteristics such as the lexical access difficulties, disordered speech with disruptions, many pauses, interruptions and reformulations. For the schizophrenia patients it reflects a difficulty of affect expression, while for the FTD patients it reflects a linguistic issue. This study, through an analysis of a series of cases assessed Clinic both in memory and on the Mental Health Unit of HUSI-PUJ (Hospital Universitario San Ignacio), with additional language assessment (analysis speech and acoustic analysis), present distinctive features of the DFT in its linguistic variants and schizophrenia that will guide the specialist in finding early markers of a differential diagnosis. In patients with FTD language variants, in 100% of cases there is a difficulty understanding linguistic structure of complex type; and important speech fluency problems. In patients with schizophrenia, there are significant alterations in the expression of the suprasegmental elements of speech, as well as disruptions in discourse. We present how depth language assessment allows to reassess some of the rules for the speech and prosody analysis of patients with dementia and schizophrenia; we suggest how elements of speech are useful in guiding the diagnosis and correlate functional compromise in everyday psychiatrist's practice. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

[Development and Effects of a Coping Skill Training Program for Caregivers in Feeding Difficulty of Older Adults with Dementia in Long-Term Care Facilities].

PubMed

Hong, Hyun Hwa; Gu, Mee Ock

2018-04-01

We developed and tested the effects of a coping skill training program for caregivers in feeding difficulty among older adults with dementia in long-term care facilities. A non-equivalent control group pretest-posttest design was used. The subjects comprised 34 caregivers (experimental group: 17, control group: 17) and 40 older adults with dementia (experimental group: 20, control group: 20). The developed program was delivered in 4-hour sessions over 6 weeks (including 2 weeks of lectures and lab practice on feeding difficulty coping skills, and 4 weeks of field practice). Data were collected before, immediately after, and 4 weeks after the program (January 3 to April 6, 2016). The data were analyzed using t-test and repeated measures ANOVA using SPSS/WIN 20.0. Compared to their counterparts in the control group, caregivers in the experimental group showed a significantly greater improvement in feeding knowledge and feeding behavior, while older adults with dementia showed greater improvements in feeding difficulty and Body Mass Index. The study findings indicate that this coping skill training program for caregivers in feeding difficulty is an effective intervention for older adults with dementia in long-term care facilities. © 2018 Korean Society of Nursing Science.

Gifted Learners: The Boomerang Kids of Middle School?

ERIC Educational Resources Information Center

Tomlinson, Carol Ann

1994-01-01

A variety of beliefs and practices central to middle schools may cause special difficulties for gifted learners. Such practices often focus on potentially competing goals of student competencies versus student excellence and include such practices as heterogeneous grouping, cooperative learning, and an absence of clearly defined middle school…

[Aims and core contents of basic and post basic courses of nursing management].

PubMed

Saiani, Luisa; Brugnolli, Anna

2006-01-01

The second part of the issue, dedicated to the nursing management offers a discussion on some of the relevant areas of debate for the organization of nursing care. A reflection on the core contents and main aims of basic and post basic (master, advanced level, specialistic degree) nursing courses is proposed in the first contribution. Then a selection of topics is presented, focusing on the main research contributions available in the literature and on the ongoing debate for the following areas: the role of communication at the inter-shift handover and the new model of bedside reporting; the problems and challenges of doctors nurses collaboration in the health care team; the problems and expectations of new nurses joining the health care team and the process of development of practical skills; the hot debate on nursing roles and level of practice and the difficulties in differentiating between elementary, specialist and advanced nursing practice; the new emerging roles: the characteristics and achievements of Nurse Consultant; the new challenges of coordinators of the health care teams with the management of the multigenerational nursing team. For each topic a definition of the problem is presented, an example of relevant study, a critical debate and suggestions for further studies and areas of research. A list of the main journals that deal with nursing management is proposed with comments on the main characteristics of each journal. A study protocol that aims at describing the outcomes of the different styles and models of organization of medical wards on patients and nurses is presented as an example of organizative research; an experience of, and a model for, participation of the nurses to health policy planning is proposed. Nurses were, asked to identify health care problems encountered in their daily practice, their causes and propose solutions at basic and policy level. The session of International Observatory explores the main problems and difficulties of the research on the organization of care, focusing more on opportunities than on the challenges and drawbacks of the available literature.

The difficulties experienced by nurses and healthcare staff involved in the process of breaking bad news.

PubMed

Warnock, Clare; Buchanan, Jean; Tod, Angela Mary

2017-07-01

The aim of this study was to explore the difficulties experienced by nurses and healthcare professionals when engaging in the process of breaking bad news. The challenges faced by staff when breaking bad news have previously been researched in relation to particular settings or participants. This study involved staff from diverse settings and roles to develop broader insights into the range of difficulties experienced in clinical practice. The study used a descriptive survey design involving self-reported written accounts and framework analysis. Data were collected using a structured questionnaire containing a free text section that asked participants to describe a difficult experience they had encountered when involved in the process of breaking bad news. Data were collected from healthcare staff from hospital, community, hospice and care home settings attending training days on breaking bad news between April 2011 and April 2014. Multiple inter-related factors presented challenges to staff engaging in activities associated with breaking bad news. Traditional subjects such as diagnostic and treatment information were described but additional topics were identified such as the impact of illness and care at the end of life. A descriptive framework was developed that summarizes the factors that contribute to creating difficult experiences for staff when breaking bad news. The framework provides insights into the scope of the challenges faced by staff when they engage in the process of breaking bad news. This provides the foundation for developing interventions to support staff that more closely matches their experiences in clinical practice. © 2017 John Wiley & Sons Ltd.

[The advantages of a third party in the “work organization” of head nurses.

PubMed

Dujardin, Pierre-Philippe; Valette, Annick; Reverdy, Thomas; François, Patrice

The organisation of production of care is a task that requires three different levels of competence: operational, structural and learning skills. The organisational requirements (OR) of the Head Nurse (HN) are often centered on the operational level, to the detriment of the other two levels. This difficulty is due to the organisation which presents limited political, cognitive and pragmatic levels of rationality.The aim of this study was to identify the impact of a third party in relation to the organisation and its effect on the HN's OR. An educational device places HN students in the position of a third party to allow them to work on an organisational problem delegated by a HN. The research-intervention followed 17 projects over a period of one year.Intervention by a third party legitimised the problem by recognizing the difficulties in nursing and reconfiguring relations between healthcare professionals in a political dimension. The methods employed by the third party reassured the HN and completed their knowledge, placing particular focus on the importance of methodology and managerial posture. In practice, the third party supported the HN's power to act and coordinate the various members of the team. The third party contributes to the development of the HN's OR and completes certain limits of the HN's rationality. Nevertheless, difficulties still remain in the development of practices outside the medical team, limiting the extension to other services.A unit managerial support, a collective schedule and open spaces of discussion are recommended to bring structure and support to the OR.

The role of parenting in the relationship between childhood eating problems and broader behaviour problems.

PubMed

Blissett, J; Meyer, C; Haycraft, E

2011-09-01

Previous research has established that childhood feeding and eating problems are often related to other behavioural difficulties. Parenting practices have been implicated in both eating behaviour and broader behaviour problems. The aim of this study was to examine whether the relationship between eating and behaviour problems could be explained in part by parenting style and practices. Seventy-seven mothers of 3- to 8-year-old children completed measures of children's eating behaviours, behaviour problems, parenting style and feeding practices. Eating behaviours (food responsiveness, emotional under-eating, fussiness) and behaviour problems (conduct problems, hyperactivity, total difficulties) were significantly correlated, but when parenting style and feeding practices were controlled for, significant associations disappeared. Although the findings are limited because of a relatively low response rate, in non-clinical groups, the perceived commonality between eating and behaviour problems may be explained by parenting. © 2011 Blackwell Publishing Ltd.

Evaluation of a multi-component approach to cognitive-behavioral therapy (CBT) using guided visualizations, cranial electrotherapy stimulation, and vibroacoustic sound.

PubMed

Rogers, Donna R B; Ei, Sue; Rogers, Kim R; Cross, Chad L

2007-05-01

This pilot study examines the use of guided visualizations that incorporate both cognitive and behavioral techniques with vibroacoustic therapy and cranial electrotherapy stimulation to form a multi-component therapeutic approach. This multi-component approach to cognitive-behavioral therapy (CBT) was used to treat patients presenting with a range of symptoms including anxiety, depression, and relationship difficulties. Clients completed a pre- and post-session symptom severity scale and CBT skills practice survey. The program consisted of 16 guided visualizations incorporating CBT techniques that were accompanied by vibroacoustic therapy and cranial electrotherapy stimulation. Significant reduction in symptom severity was observed in pre- and post-session scores for anxiety symptoms, relationship difficulties, and depressive symptoms. The majority of the clients (88%) reported use of CBT techniques learned in the guided visualizations at least once per week outside of the sessions.

Extracardiac manifestations of infective endocarditis and their historical descriptions.

PubMed

Silverman, Mark E; Upshaw, Charles B

2007-12-15

In his landmark "Gulstonian Lectures on Malignant Endocarditis," published in 1885, William Osler commented, "Few diseases present greater difficulties in the way of diagnosis than malignant endocarditis, difficulties which in many cases are practically insurmountable." At that time, the fields of microbiology and blood cultures were in their infancy, and the diagnosis was made premortem in just half the patients with the condition. After Osler's report, extracardiac physical findings became essential clues to earlier diagnosis. Today, infective endocarditis is most commonly suggested from the history and often clinched by an echocardiogram and blood cultures. Although prized physical manifestations are much less frequent now, they still do occur and may be an invaluable clue that leads to earlier, more effective treatment. The investigators review these extracardiac findings along with their historical descriptions: splinter hemorrhages, emboli, Osler's nodes, Janeway and Bowman lesions of the eye, Roth spots, petechiae, and clubbing.

The Effect of Tutoring With Nonstandard Equations for Students With Mathematics Difficulty.

PubMed

Powell, Sarah R; Driver, Melissa K; Julian, Tyler E

2015-01-01

Students often misinterpret the equal sign (=) as operational instead of relational. Research indicates misinterpretation of the equal sign occurs because students receive relatively little exposure to equations that promote relational understanding of the equal sign. No study, however, has examined effects of nonstandard equations on the equation solving and equal-sign understanding of students with mathematics difficulty (MD). In the present study, second-grade students with MD (n = 51) were randomly assigned to standard equations tutoring, combined tutoring (standard and nonstandard equations), and no-tutoring control. Combined tutoring students demonstrated greater gains on equation-solving assessments and equal-sign tasks compared to the other two conditions. Standard tutoring students demonstrated improved skill on equation solving over control students, but combined tutoring students' performance gains were significantly larger. Results indicate that exposure to and practice with nonstandard equations positively influence student understanding of the equal sign. © Hammill Institute on Disabilities 2013.

Prison prescribing practice: practitioners' perspectives on why prison is different.

PubMed

Bartlett, A; Dholakia, N; England, R; Hales, H; van Horn, E; McGeorge, T; Moss, B; Ovaisi, S; Tukmachi, E; Patel, S

2014-04-01

The current prison population in England and Wales has multiple, complex healthcare needs, presenting unique challenges to those caring for prisoners. Prison numbers have increased dramatically in the last 10 years. There are now approximately 84,000 prisoners in England and Wales and 120,000 new episodes of imprisonment each year . The authors all contribute to prison healthcare. Below, we discuss a key issue arising from first-hand experience of prisoners' health and social care needs, the prescription of psycho-active drugs by primary and secondary care practitioners. This is a core medical task, but beset with difficulties. These difficulties are not necessarily encountered in other areas of prison healthcare. However, they do illustrate how providing healthcare to prisoners is complex, often lacking a research base and can have pitfalls that are not obvious to the outsider. © 2014 John Wiley & Sons Ltd.

Educational provision for children with specific speech and language difficulties: perspectives of speech and language therapy service managers.

PubMed

Dockrell, Julie E; Lindsay, Geoff; Letchford, Becky; Mackie, Clare

2006-01-01

Children with specific speech and language difficulties (SSLD) pose a challenge to the education system, and to speech and language therapists who support them, as a result of their language needs and associated educational and social-behavioural difficulties. The development of inclusion raises questions regarding appropriate provision, whether the tradition of language units or full inclusion into mainstream schools. To gather the views of speech and language therapy service managers in England and Wales regarding approaches to service delivery, terminology and decision-making for educational provision, and the use of direct and indirect (consultancy) models of intervention. The study reports on a national survey of speech and language therapy (SLT) services in England and Wales (129 respondents, 72.1% response rate) and interviews with 39 SLT service managers. Provision varied by age group with support to children in the mainstream common from pre-school to the end of Key Stage 2 (up to 11 years), and to those in designated specialist provision, common at Key Stages 1/2 (ages 5-11 years), but less prevalent at Key Stages 3/4 (11-16 years). Decision-making regarding provision was influenced by the lack of common terminology, with SSLD and specific language impairment (SLI) the most common, and criteria, including the use of the discrepancy model for defining SSLD. Practice was influenced by the difficulties in distinguishing children with SSLD from those with autistic spectrum disorder, and difficulties translating policies into practice. The implications of the study are discussed with reference to SLT practice, including consultancy models, and the increasingly prevalent policy in local education authorities of inclusion of children with special educational needs.

National Athletic Trainers' Association Position Statement: Management of Asthma in Athletes

PubMed Central

Miller, Michael G; Weiler, John M; Baker, Robert; Collins, James; D'Alonzo, Gilbert

2005-01-01

Objective: To present guidelines for the recognition, prophylaxis, and management of asthma that lead to improvement in the quality of care certified athletic trainers and other heath care providers can offer to athletes with asthma, especially exercise-induced asthma. Background: Many athletes have difficulty breathing during or after athletic events and practices. Although a wide variety of conditions can predispose an athlete to breathing difficulties, the most common cause is undiagnosed or uncontrolled asthma. At least 15% to 25% of athletes may have signs and symptoms suggestive of asthma, including exercise-induced asthma. Athletic trainers are in a unique position to recognize breathing difficulties caused by undiagnosed or uncontrolled asthma, particularly when asthma follows exercise. Once the diagnosis of asthma is made, the athletic trainer should play a pivotal role in supervising therapies to prevent and control asthma symptoms. It is also important for the athletic trainer to recognize when asthma is not the underlying cause for respiratory difficulties, so that the athlete can be evaluated and treated properly. Recommendations: The recommendations contained in this position statement describe a structured approach for the diagnosis and management of asthma in an exercising population. Athletic trainers should be educated to recognize asthma symptoms in order to identify patients who might benefit from better management and should understand the management of asthma, especially exercise-induced asthma, to participate as active members of the asthma care team. PMID:16284647

Human occupational and nonoccupational exposure to fibers.

PubMed Central

Esmen, N A; Erdal, S

1990-01-01

Human exposure to fibers in occupational and nonoccupational environments has been a health concern for nearly a century. In this review, selected results from the literature are presented to highlight the availability, limitations, and interpretive difficulties associated with the past and current human fiber exposure data sets. In the traditionally defined asbestos fibers, large amounts of the data available suffer from the diversity of sample collection and analysis methods. Two simple generalizations suggest that occupational exposures are several orders of magnitude higher than that of environmental exposures; and currently extant data and the current routine measurement practices present significant difficulties in the consistent interpretation of the data with respect to health effects. The data on the human exposures to man-made vitreous fibers are much more complete than the data on asbestos exposure, while exposure data on other man-made fibrous materials are lacking. The human exposure data to many minerals which, at times, exist in fibrous habit, are very scanty, and in view of the biological activity of some of these fibers, this lack may be of significant concern. PMID:2272324

Toward micro-scale spatial modeling of gentrification

NASA Astrophysics Data System (ADS)

O'Sullivan, David

A simple preliminary model of gentrification is presented. The model is based on an irregular cellular automaton architecture drawing on the concept of proximal space, which is well suited to the spatial externalities present in housing markets at the local scale. The rent gap hypothesis on which the model's cell transition rules are based is discussed. The model's transition rules are described in detail. Practical difficulties in configuring and initializing the model are described and its typical behavior reported. Prospects for further development of the model are discussed. The current model structure, while inadequate, is well suited to further elaboration and the incorporation of other interesting and relevant effects.

Early Lactation and Infant Feeding Practices Differ by Maternal Gestational Diabetes History.

PubMed

Oza-Frank, Reena; Moreland, Jennifer J; McNamara, Kelly; Geraghty, Sheela R; Keim, Sarah A

2016-11-01

Detailed data on lactation practices by gestational diabetes mellitus (GDM) history are lacking, precluding potential explanations and targets for interventions to improve lactation intensity and duration and, ultimately, long-term maternal and child health. This study aimed to examine breastfeeding practices through 12 months postpartum by GDM history. Women who delivered a singleton, liveborn infant at The Ohio State University Wexner Medical Center (Columbus, OH), in 2011 completed a postal questionnaire to assess lactation and infant feeding practices and difficulties. Bivariate and multivariate associations between GDM history and lactation and infant feeding practices were examined. The sample included 432 women (62% response rate), including 7.9% who had GDM during the index pregnancy. Women with GDM initiated breastfeeding (at-the-breast or pumping) as often as women without any diabetes but were more likely to report introduction of formula within the first 2 days of life (79.4% vs 53.8%, P < .01; adjusted odds ratio: 3.48; 95% confidence interval, 1.47-8.26). Women with GDM initiated pumping 4 days earlier than women without diabetes ( P < .05), which was confirmed in adjusted analyses. There was no difference in the proportion of women reporting breastfeeding difficulty (odds ratio: 2.08; 95% confidence interval, 0.78-5.52). However, there was a trend toward women with GDM reporting more formula feeding and less at-the-breast feeding as strategies to address difficulty compared with women without diabetes. Additional research is needed to understand why women with GDM engage in different early lactation and infant feeding practices, and how best to promote and sustain breastfeeding among these women.

Behavioral interventions for insomnia: Theory and practice

PubMed Central

Sharma, Mahendra P.; Andrade, Chittaranjan

2012-01-01

Insomnia is a general clinical term that refers to a difficulty in initiating or maintaining sleep. Insomnia is widely prevalent in the general population, especially in the elderly and in those with medical and psychiatric disorders. Hypnotic drug treatments of insomnia are effective but are associated with potential disadvantages. This article presents an overview of behavioral interventions for insomnia. Behavioral interventions for insomnia include relaxation training, stimulus control therapy, sleep restriction therapy, sleep hygiene, paradoxical intention therapy, cognitive restructuring, and other approaches. These are briefly explained. Research indicates that behavioral interventions are efficacious, effective, and likely cost-effective treatments for insomnia that yield reliable, robust, and long-term benefits in adults of all ages. Detailed guidance is provided for the practical management of patients with insomnia. PMID:23372241

A Historical Study to Understand Students' Current Difficulties about RMS Values

ERIC Educational Resources Information Center

Khantine-Langlois, Françoise; Munier, Valérie

2016-01-01

Several studies show that students experience more and more difficulties managing the measurements of electrical values in alternating current and that they have trouble making links between theory and practice. They find it difficult to give meaning to root mean square (RMS; or effective) values, which are not understood as average values and are…

Parental Mediation of the Internet Use of Primary Students: Beliefs, Strategies and Difficulties

ERIC Educational Resources Information Center

Bartau-Rojas, Isabel; Aierbe-Barandiaran, Ana; Oregui-González, Eider

2018-01-01

The use of the Internet by children at an increasingly early age today constitutes a major challenge for families and schools, as well as affecting educational and social policy. This is a qualitative piece of research that analyzes parents' beliefs, everyday practices and the difficulties they face in teaching their children the benefits and…

Educating Children and Young People with Fetal Alcohol Spectrum Disorders: Constructing Personalised Pathways to Learning

ERIC Educational Resources Information Center

Blackburn, Carolyn; Carpenter, Barry; Egerton, Jo

2012-01-01

The range of learning difficulties associated with children and young people who have Fetal Alcohol Spectrum Disorders (FASD) has been highlighted as an emerging but little understood area of Special Educational Needs. This engaging, timely and highly practical book will raise awareness about FASD and its associated difficulties across the entire…

Children Placed at Risk for Learning and Behavioral Difficulties: Implementing a School-Wide System of Early Identification and Intervention.

ERIC Educational Resources Information Center

O'Shaughnessy, Tam E.; Lane, Kathleen L.; Gresham, Frank M.; Beebe-Frankenberger, Margaret E.

2003-01-01

This article describes a school-wide system of early identification and intervention for children recognized as being at risk for learning and behavior difficulties. Suggested guidelines for implementing such a program include: evaluating existing theory, knowledge, and practice; providing ongoing professional development; creating a school-wide…

The Use of Response to Intervention Practices for Behavior: An Examination of the Validity of a Screening Instrument

ERIC Educational Resources Information Center

Muyskens, Paul; Marston, Doug; Reschly, Amy L.

2007-01-01

Behavioral difficulties of school-aged students are typically dealt with in a reactive, rather than preventative manner. This article examines a proactive approach, consistent with the Response-to-Intervention model, using a screening measure designed to identify students at risk for behavior difficulties and targeting these students for early…

Rasch Measurement and Item Banking: Theory and Practice.

ERIC Educational Resources Information Center

Nakamura, Yuji

The Rasch Model is an item response theory, one parameter model developed that states that the probability of a correct response on a test is a function of the difficulty of the item and the ability of the candidate. Item banking is useful for language testing. The Rasch Model provides estimates of item difficulties that are meaningful,…

Exploring the Acceptability of Innovative Technology: A Pilot Study Using LENA with Parents of Young Deaf Children in the UK

ERIC Educational Resources Information Center

Allen, Sarah; Crawford, Paul; Mulla, Imran

2017-01-01

Early intervention is widely recommended for children at risk of difficulties with speech, language and communication. Evidence for effective practice remains limited due in part to inherent difficulties in defining complex interventions and measuring change. The innovative Language Environment Analysis (LENA) system has exciting potential for…

Dyscalculia ? Maths Difficulties. An Analysis of Conflicting Positions at a Time That Calls for Inclusive Practices

ERIC Educational Resources Information Center

Schmidt, Maria Christina Secher

2016-01-01

Using Bourdieu's notion of field, the Scandinavian field of maths pedagogy occurs at a time characterised by increasing inclusion efforts in primary school. Various stakeholders in maths pedagogy are arguing about what should be done about pupils who perform poorly in mathematics and what causes their difficulties. Four analytical positions are…

Monolithic THz Frequency Multipliers

NASA Technical Reports Server (NTRS)

Erickson, N. R.; Narayanan, G.; Grosslein, R. M.; Martin, S.; Mehdi, I.; Smith, P.; Coulomb, M.; DeMartinez, G.

2001-01-01

Frequency multipliers are required as local oscillator sources for frequencies up to 2.7 THz for FIRST and airborne applications. Multipliers at these frequencies have not previously been demonstrated, and the object of this work was to show whether such circuits are really practical. A practical circuit is one which not only performs as well as is required, but also can be replicated in a time that is feasible. As the frequency of circuits is increased, the difficulties in fabrication and assembly increase rapidly. Building all of the circuit on GaAs as a monolithic circuit is highly desirable to minimize the complexity of assembly, but at the highest frequencies, even a complete monolithic circuit is extremely small, and presents serious handling difficulty. This is compounded by the requirement for a very thin substrate. Assembly can become very difficult because of handling problems and critical placement. It is very desirable to make the chip big enough to that it can be seen without magnification, and strong enough that it may be picked up with tweezers. Machined blocks to house the chips present an additional challenge. Blocks with complex features are very expensive, and these also imply very critical assembly of the parts. It would be much better if the features in the block were as simple as possible and non-critical to the function of the chip. In particular, grounding and other electrical interfaces should be done in a manner that is highly reproducible.

Moral mediation in interpreted health care consultations.

PubMed

Seale, Clive; Rivas, Carol; Al-Sarraj, Hela; Webb, Sarah; Kelly, Moira

2013-12-01

This paper reports on the moral work done in routine diabetes review consultations in primary care with nurses. Consultations with fluent English speakers are compared with consultations where an interpreter was present, largely involving patients of Bangladeshi origin. The study setting was Tower Hamlets in London, where type 2 diabetes is particularly common. Existing research has shown some dissatisfaction with diabetes care amongst Bangladeshi patients, and studies of care providers in other locations suggest that they at times experience the care of this group as particularly challenging. Through analysis of video-recorded consultations recorded in 2010-2011 we shed light on possible reasons for these difficulties. The 12 non-English speakers often experienced difficulties in raising issues that concerned them, particularly if their interpreter did not translate their utterance because it was deemed to be unrelated to diabetes. These difficulties were not shared by the 24 fluent English speakers, who also found it easier to convey a positive moral reputation and to excuse behaviour that deviated from recommended self-management practices. Interpreters at times also acted as moral mediators. For example, where a participant in the consultation made statements that appeared to convey a negative moral judgement of an other participant, these would often go untranslated. Probably, neither health care providers nor patients are fully aware of the nature of their communication difficulties. Given this, interpreters possess considerable power to influence matters. Understanding the moral work of consultations is important in explaining the findings of other studies showing difficulties in the provision of diabetes care to people with limited English language skills. Copyright © 2013 Elsevier Ltd. All rights reserved.

Outcome evaluation of the Palliative care Emphasis program on symptom management and Assessment for Continuous Medical Education: nationwide physician education project for primary palliative care in Japan.

PubMed

Yamamoto, Ryo; Kizawa, Yoshiyuki; Nakazawa, Yoko; Ohde, Sachiko; Tetsumi, Sato; Miyashita, Mitsunori

2015-01-01

Palliative care is an essential part of medicine, but most physicians have had no formal opportunity to acquire basic skills in palliative care. In Japan, the Palliative care Emphasis program on symptom management and Assessment for Continuous Medical Education (PEACE) was launched to provide formal primary palliative care education for all physicians engaged in cancer care. This study sought to determine whether PEACE could improve physicians' knowledge of, practices in, and difficulties with palliative care. In 2011, we conducted questionnaire-based surveys before, just after, and 2 months after completion of the PEACE program in physicians participating in the program at each of 15 designated cancer hospitals in Japan. Knowledge was measured using the palliative care knowledge questionnaire for PEACE (PEACE-Q). Practices and difficulties were evaluated using the Palliative Care self-reported Practice Scale (PCPS) and the Palliative Care Difficulties Scale (PCDS), respectively. Among 223 physicians participating in the program, 85 (38%) answered the follow-up survey. Significant improvements were noted on the PEACE-Q compared with baseline immediately after completion of the program, and this progress was maintained at 2 months (21.7 ± 5.56 versus 29.5 ± 2.10 versus 28.7 ± 3.28, respectively; p < 0.0001). Similarly, significant improvements were noted for total scores on both the PCPS and the PCDS at 2 months after completion of the program (62.1 ± 13.9 versus 69.6 ± 9.94 [p < 0.0001] for the PCPS; 44.4 ± 9.96 versus 39.4 ± 10.7 [p < 0.0001] for the PCDS). The PEACE education program improved physicians' knowledge of, practices in, and difficulties with palliative care.

Guided Retrieval Practice of Educational Materials Using Automated Scoring

ERIC Educational Resources Information Center

Grimaldi, Phillip J.; Karpicke, Jeffrey D.

2014-01-01

Retrieval practice is a powerful way to promote long-term retention and meaningful learning. However, students do not frequently practice retrieval on their own, and when they do, they have difficulty evaluating the correctness of their responses and making effective study choices. To address these problems, we have developed a guided retrieval…

The Occupation and Participation Approach to Reading Intervention (OPARI): A Community of Practice Study

ERIC Educational Resources Information Center

Grajo, Lenin C.; Candler, Catherine

2017-01-01

We employed a community of practice to expand the application of the Occupation and Participation Approach to Reading Intervention (OPARI) and build the capacity of practitioners to support children with reading difficulties. Twelve pediatric practitioners participated in a community of practice for 7 months. We used a one…

Relating Theory and Practice in Laboratory Work: A Variation Theoretical Study

ERIC Educational Resources Information Center

Eckerdal, Anna

2015-01-01

Computer programming education has practice-oriented as well as theory-oriented learning goals. Here, lab work plays an important role in students' learning. It is however widely reported that many students face great difficulties in learning theory as well as practice. This paper investigates the important but problematic relation between the…

Mathematics Practice without Feedback: A Desirable Difficulty in a Classroom Setting

ERIC Educational Resources Information Center

Fyfe, Emily R.; Rittle-Johnson, Bethany

2017-01-01

Recent research highlights the potential benefits of practice without feedback on learner's strategy knowledge. However, most prior work has been conducted in one-on-one settings with short retention intervals. We compared the effects of mathematics practice with and without correct-answer feedback on immediate and 1-week delayed performance in a…

Anxiety in children with attention-deficit/hyperactivity disorder.

PubMed

Sciberras, Emma; Lycett, Kate; Efron, Daryl; Mensah, Fiona; Gerner, Bibi; Hiscock, Harriet

2014-05-01

Although anxiety is common in children with attention-deficit/hyperactivity disorder (ADHD), it is unclear how anxiety influences the lives of these children. This study examined the association between anxiety comorbidities and functioning by comparing children with ADHD and no, 1, or ≥2 anxiety comorbidities. Differential associations were examined by current ADHD presentation (subtype). Children with diagnostically confirmed ADHD (N = 392; 5-13 years) were recruited via 21 pediatrician practices across Victoria, Australia. Anxiety was assessed by using the Anxiety Disorders Interview Schedule for Children-IV. Functional measures included parent-reported: quality of life (QoL; Pediatric Quality of Life Inventory 4.0), behavior and peer problems (Strengths and Difficulties Questionnaire), daily functioning (Daily Parent Rating of Evening and Morning Behavior), and school attendance. Teacher-reported behavior and peer problems (Strengths and Difficulties Questionnaire) were also examined. Linear and logistic regression controlled for ADHD severity, medication use, comorbidities, and demographic factors. Children with ≥2 anxiety comorbidities (n = 143; 39%) had poorer QoL (effect size: -0.8) and more difficulties with behavior (effect size: 0.4) and daily functioning (effect size: 0.3) than children without anxiety (n = 132; 36%). Poorer functioning was not observed for children with 1 anxiety comorbidity (n = 95; 26%). Two or more anxiety comorbidities were associated with poorer functioning for children with both ADHD-Inattentive and ADHD-Combined presentation. Children with ADHD demonstrate poorer QoL, daily functioning and behavior when ≥2 anxiety comorbidities are present. Future research should examine whether treating anxiety in children with ADHD improves functional outcomes. Copyright © 2014 by the American Academy of Pediatrics.

Ethical difficulties in clinical practice: experiences of European doctors

PubMed Central

Hurst, S A; Perrier, A; Pegoraro, R; Reiter‐Theil, S; Forde, R; Slowther, A‐M; Garrett‐Mayer, E; Danis, M

2007-01-01

Background Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services. Methods A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK. Results Survey respondents (n = 656, response rate 43%) ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority (17.6%) reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision‐making capacity (94.8%), disagreement among caregivers (81.2%) and limitation of treatment at the end of life (79.3%). The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct (47.5%), someone capable of providing specific advice (41.1%), help in weighing outcomes (36%) and clarification of the issues (35.9%). Few of the types of help expected to be useful varied among countries. Conclusion Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. PMID:17209113

The use of depth interviewing with vulnerable subjects: lessons from a research study of parents with learning difficulties.

PubMed

Booth, T; Booth, W

1994-08-01

This paper explores the practicalities of using the technique of depth interviewing with people who have learning difficulties. The authors set out to provide other researchers with guidance in the use of the life story approach and to demonstrate its utility with this vulnerable and devalued group of informants. They conclude that depth interviewing can provide new knowledge not accessible through other methods of data collection, and offers a way of giving people with learning difficulties a voice in the making of their own history.

Flow experience and the mobilization of attentional resources.

PubMed

de Sampaio Barros, Marcelo Felipe; Araújo-Moreira, Fernando M; Trevelin, Luis Carlos; Radel, Rémi

2018-05-07

The present study attempts to better identify the neurophysiological changes occurring during flow experience and how this can be related to the mobilization of attentional resources. Self-reports of flow (using a flow feelings scale) and attention (using thought probes), autonomic activity (heart rate, heart rate variability, and breathing rate), and cerebral oxygenation (using near-infrared spectroscopy) in two regions of the frontoparietal attention network (right lateral frontal cortex and right inferior parietal lobe) were measured during the practice of two simple video games (Tetris and Pong) played at different difficulty conditions (easy, optimal, hard, or self-selected). Our results indicated that an optimal level of difficulty, compared with an easy or hard level of difficulty led to greater flow feelings and a higher concentration of oxygenated hemoglobin in the regions of the frontoparietal network. The self-selected, named autonomy condition did not lead to more flow feelings than the optimal condition; however, the autonomy condition led to greater sympathetic activity (reduced heart rate variability and greater breathing rate) and higher activation of the frontoparietal regions. Our study suggests that flow feelings are highly connected to the mobilization of attentional resources, and all the more in a condition that promotes individuals' choice and autonomy.

Distinct emotion regulation skills explain psychopathology and problems in social relationships following childhood emotional abuse and neglect.

PubMed

Berzenski, Sara R

2018-03-22

Efforts to differentiate between the developmental sequelae of childhood emotional abuse and childhood emotional neglect are critical to both research and practice efforts. As an oft-identified mechanism of the effects of child maltreatment on later adjustment, emotion dysregulation represents a key potential pathway. The present study explored a higher order factor model of specific emotion regulation skills, and the extent to which these skill sets would indicate distinct developmental pathways from unique emotional maltreatment experiences to multidomain adjustment. A sample of 500 ethnoracially diverse college students reported on their experiences. A two-factor model of emotion regulation skills based on subscales of the Difficulties in Emotion Regulation Scale was revealed. Significant indirect effects of childhood emotional abuse on psychopathology and problems in social relationships were found through response-focused difficulties in emotion regulation, whereas a significant indirect effect of childhood emotional neglect on problems in social relationships was found through antecedent-focused difficulties in emotion regulation. These results are consistent with theoretical models and empirical evidence suggesting differential effects of childhood emotional abuse and emotional neglect, and provide an important indication for developing targeted interventions focusing on specific higher order emotion dysregulation skill clusters.

Project-Based Manufacturing Engineering Practice at Ibaraki University and Its Outcomes

NASA Astrophysics Data System (ADS)

Yamasaki, Kazuhiko; Wang, Dong F.; Maekawa, Katsuhiro

The real world experience of manufacturing processes from an idea stage to a final product must be related to classroom lectures in mechanical engineering curriculum, including design, materials engineering, dynamics and control. Various challenges and difficulties encountered during the manufacturing engineering practice also let students recognize their creativity as well as what kinds of knowledge is missing. Awareness is the start of growth. In line with this principle we have carried out the mechanical engineering practice for 10 years. Some modifications toward “project-based practice” , however, have been made through manufacturing engineers’ real activities. Drawing and specification, process control, cost management, and role-sharing arrangement are stressed during the semester course. The present paper describes how it works and what is left to improve further, such as a refinement of themes and a coaching method for bringing out the hidden talent in students.

The Medical Ethics Curriculum in Medical Schools: Present and Future.

PubMed

Giubilini, Alberto; Milnes, Sharyn; Savulescu, Julian

2016-01-01

In this review article we describe the current scope, methods, and contents of medical ethics education in medical schools in Western English speaking countries (mainly the United Kingdom, the United States, and Australia). We assess the strengths and weaknesses of current medical ethics curricula, and students' levels of satisfaction with different teaching approaches and their reported difficulties in learning medical ethics concepts and applying them in clinical practice. We identify three main challenges for medical ethics education: counteracting the bad effects of the "hidden curriculum," teaching students how to apply ethical knowledge and critical thinking to real cases in clinical practice, and shaping future doctors' right character through ethics education. We suggest ways in which these challenges could be addressed. On the basis of this analysis, we propose practical guidelines for designing, implementing, teaching, and assessing a medical ethics program within a four-year medical course. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

A risk-management approach for effective integration of biomarkers in clinical trials: perspectives of an NCI, NCRI, and EORTC working group.

PubMed

Hall, Jacqueline Anne; Salgado, Roberto; Lively, Tracy; Sweep, Fred; Schuh, Anna

2014-04-01

Clinical cancer research today often includes testing the value of biomarkers to direct treatment and for drug development. However, the practical challenges of integration of molecular information into clinical trial protocols are increasingly appreciated. Inherent difficulties include evidence gaps in available biomarker data, a paucity of robust assay methods, and the design of appropriate studies within the constraints of feasible trial operations, and finite resources. Scalable and proportionate approaches are needed to systematically cope with these challenges. Therefore, we assembled international experts from three clinical trials organisations to identify the common challenges and common solutions. We present a practical risk-assessment framework allowing targeting of scarce resources to crucial issues coupled with a library of useful resources and a simple actionable checklist of recommendations. We hope that these practical methods will be useful for running biomarker-driven trials and ultimately help to develop biomarkers that are ready for integration in routine practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

What makes up good consultations? A qualitative study of GPs' discourses.

PubMed

Van Roy, Kaatje; Vanheule, Stijn; Deveugele, Myriam

2013-05-16

In medical literature, several principles that define 'good consultations' have been outlined. These principles tend to be prescriptive in nature, overlooking the complexity of general practitioners (GPs)' perspectives of everyday practice. Focusing on perspectives might be particularly relevant, since they may affect decisions and actions. Therefore, the present study adopts a bottom-up approach, analyzing GPs' narratives about 'good' and 'bad' consultations. We aimed at describing the range of discourses GPs use in relating on their practice. Semi-structured interviews were conducted with 19 Belgian GPs. By means of a qualitative analysis, the authors mapped patterns in the interview narratives and described the range of different discourses. Four discourses were identified: a biomedically-centered discourse, a communication-focused discourse, a problem-solving discourse and a satisfaction-oriented discourse. Each discourse was further specified in terms of predominant themes, problems the GPs prefer to deal with and inherent difficulties. Although most participants used elements from all four discourses, the majority of the GPs relied on an individual set of predominant discourses and focused on a limited number of themes. This study clearly indicates that there is no uniform way in which GPs perceive clinical practice. Each of the participants used a subtle mix of different criteria to define good and bad medical consultations. Some discourse elements appear to be rooted in medical literature, whereas others are of a more personal nature. By focusing on the limitations of each discourse, this study can shed new light on some of the difficulties GPs encounter in their daily practice: being confronted with specific problems might be an effect of adhering to a specific discourse. The typification of different discourses on consultations may function as a framework to help GPs reflect on how they perceive their practice, and help them manage some of the challenges met in daily practice.

Perceived Difficulty with Physical Tasks, Lifestyle, and Physical Performance in Obese Children

PubMed Central

D'Amico, Osvaldo; Sticco, Maura; Nugnes, Rosa; Mozzillo, Enza; Franzese, Adriana

2014-01-01

We estimated perceived difficulty with physical tasks, lifestyle, and physical performance in 382 children and adolescents (163 obese, 54 overweight, and 165 normal-weight subjects) and the relationship between perceived physical difficulties and sports participation, sedentary behaviors, or physical performance. Perceived difficulty with physical tasks and lifestyle habits was assessed by interview using a structured questionnaire, while physical performance was assessed through the six-minute walking test (6MWT). Obese children had higher perceived difficulty with several activities of daily living, were less engaged in sports, and had lower physical performance than normal-weight or overweight children; on the contrary, they did not differ with regard to time spent in sedentary behaviors. Perceived difficulty in running and hopping negatively predicted sports participation (P < 0.05 and <0.01, resp.), while perceived difficulty in almost all physical activities negatively predicted the 6MWT, independently of BMI (P < 0.01). Our results indicate that perception of task's difficulty level may reflect an actual difficulty in obese children. These findings may have practical implications for approaching physical activity in obese children. Exploring both the perception of a task's difficulty level and physical performance may be useful to design exercise programs that allow safe and successful participation. PMID:25105139

"That Sounds So Cooool": Entanglements of Children, Digital Tools, and Literacy Practices

ERIC Educational Resources Information Center

Toohey, Kelleen; Dagenais, Diane; Fodor, Andreea; Hof, Linda; Nuñez, Omar; Singh, Angelpreet; Schulze, Liz

2015-01-01

Many observers have argued that minority language speakers often have difficulty with school-based literacy and that the poorer school achievement of such learners occurs at least partly as a result of these difficulties. At the same time, many have argued for a recognition of the multiple literacies required for citizens in a 21st century world.…

The Trouble with Maths: A Practical Guide to Helping Learners with Numeracy Difficulties, 2nd Edition

ERIC Educational Resources Information Center

Chinn, Steve

2011-01-01

Now in a second edition, the award-winning "The Trouble with Maths" offers important insights into the often confusing world of numeracy. By looking at learning difficulties in maths from several perspectives, including the language of mathematics, thinking styles and the demands of individual topics, this book offers a complete overview of the…

A Comparison of Father and Mother Report of Child Behaviour on the Strengths and Difficulties Questionnaire

ERIC Educational Resources Information Center

Dave, Shreya; Nazareth, Irwin; Senior, Rob; Sherr, Lorraine

2008-01-01

To date there has been no comparison of father and mother report on the Strengths and Difficulties Questionnaire (SDQ), a standardised measure of child behaviour used widely in the UK in clinical practice and research. The objectives of the study were to investigate differences and agreement between parents on the various SDQ domains of child…

Treating the Whole Person: A Counseling, Psychology and Support Model for Learners with Learning Difficulty and Disabilities

ERIC Educational Resources Information Center

Lee, Larry

2014-01-01

Concerned about traditional practice that attempted to manage the challenging behavior of learners with learning difficulty and disabilities (LLDD) in learning and social environments, I questioned the extent to which they could manage themselves. From 265 students, 15 males, median age of 19, were invited to participate in 12 weekly one-hour…

Trials and Tribulations: Student Approaches and Difficulties with Proposing Mechanisms Using the Electron-Pushing Formalism

ERIC Educational Resources Information Center

Bhattacharyya, Gautam

2014-01-01

The skill of proposing mechanisms of reactions using the electron-pushing formalism (EPF) is not only of value to practicing organic chemists but it is also emphasized to students enrolled in organic chemistry courses at all levels. Several research studies in the past decade have documented the difficulties that undergraduate, and even graduate…

Chinese American Parents’ Acculturation and Enculturation, Bicultural Management Difficulty, Depressive Symptoms, and Parenting

PubMed Central

Kim, Su Yeong; Shen, Yishan; Huang, Xuan; Wang, Yijie; Orozco-Lapray, Diana

2014-01-01

This study examined whether Chinese American parents’ acculturation and enculturation were related to parenting practices (punitive parenting, democratic child participation, and inductive reasoning) indirectly through the mediation of parents’ bicultural management difficulty and parental depressed mood. Data came from a two-wave study of Chinese American families in Northern California. Mothers and fathers were assessed when their children were in early adolescence and then again in middle adolescence (407 mothers and 381 fathers at Wave 1; 308 mothers and 281 fathers at Wave 2). For both waves, we examined cross-sectional models encompassing both direct and indirect links from parental cultural orientations to parenting practices. We also used individual fixed-effects techniques to account for selection bias in testing model relationships at Wave 2. At Wave 1, via bicultural management difficulty and depressive symptoms, American orientation was related to less punitive parenting and more inductive reasoning for both parents, and Chinese orientation was related to more punitive parenting and less inductive reasoning for fathers. The findings indicate that bicultural management difficulty and parental depressed mood are important mechanisms to be considered when studying the relation between Chinese American parents’ acculturation/enculturation and parenting. PMID:25678944

Examining Malaysian Teachers' Online Blogs for Reflective Practices: Towards Teacher Professional Development

ERIC Educational Resources Information Center

Nambiar, R. M. K.; Thang, S. M.

2016-01-01

Blogs are commonly used for online interaction because of their ease of use and access, which allow people to gather in a virtual space to share knowledge, experiences and practices. Teachers can also use blogs as an avenue to think, reflect and respond to views and comments regarding pedagogical practices and difficulties, thereby developing…

Comparison of the Effects of Computer-Based Practice and Conceptual Understanding Interventions on Mathematics Fact Retention and Generalization

ERIC Educational Resources Information Center

Kanive, Rebecca; Nelson, Peter M.; Burns, Matthew K.; Ysseldyke, James

2014-01-01

The authors' purpose was to determine the effects of computer-based practice and conceptual interventions on computational fluency and word-problem solving of fourth- and fifth-grade students with mathematics difficulties. A randomized pretest-posttest control group design found that students assigned to the computer-based practice intervention…

A Case Study of Unfounded Concepts Underpinning Controversial Practices: Lost in "Space Dyslexia"

ERIC Educational Resources Information Center

Stephenson, Jennifer

2009-01-01

Although many are critical of the uptake of unproven practices by teachers and families in their search for treatment for children with reading difficulties, there has been little examination of the specific conditions that persuade teachers and families to adopt such practices. This article traces the emergence and evolution of a particular meme,…

Is there a way for clinical teachers to assist struggling learners? A synthetic review of the literature

PubMed Central

Boileau, Elisabeth; St-Onge, Christina; Audétat, Marie-Claude

2017-01-01

Struggling medical trainees pose a challenge to clinical teachers, since these learners warrant closer supervision that is time-consuming and competes with time spent on patient care. Clinical teachers’ perception that they are ill equipped to address learners’ difficulties efficiently may lead to delays or even lack of remediation for these learners. Because of the paucity of evidence to guide best practices in remediation, the best approach to guide clinical teachers in the field remains to be established. We aimed to present a synthetic review of the empirical evidence and theory that may guide clinical teachers in their daily task of supervising struggling learners, reviewing current knowledge on the challenges and solutions that have been identified and explored. A computerized literature search was performed using Medline, Embase, Education Resources Information Center, and Education Source, after which final articles were selected based on relevance. The literature reviewed provided best evidence for clinical teachers to address learners’ difficulties, which is presented in the order of the four steps inherent to the clinical approach: 1) detecting a problem based on a subjective impression, 2) gathering and documenting objective data, 3) assessing data to make a diagnosis, and 4) planning remediation. A synthesized classification of pedagogical diagnoses is also presented. This review provides an outline of practical recommendations regarding the supervision and management of struggling learners up to the remediation phase. Our findings suggest that future research and faculty development endeavors should aim to operationalize remediation strategies further in response to specific diagnoses, and to make these processes more accessible to clinical teachers in the field. PMID:28176916

Prevention of cardiovascular disease guided by total risk estimations--challenges and opportunities for practical implementation: highlights of a CardioVascular Clinical Trialists (CVCT) Workshop of the ESC Working Group on CardioVascular Pharmacology and Drug Therapy.

PubMed

Zannad, Faiez; Dallongeville, Jean; Macfadyen, Robert J; Ruilope, Luis M; Wilhelmsen, Lars; De Backer, Guy; Graham, Ian; Lorenz, Matthias; Mancia, Giuseppe; Morrow, David A; Reiner, Zeljko; Koenig, Wolfgang

2012-12-01

This paper presents a summary of the potential practical and economic barriers to implementation of primary prevention of cardiovascular disease guided by total cardiovascular risk estimations in the general population. It also reviews various possible solutions to overcome these barriers. The report is based on discussion among experts in the area at a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy that took place in September 2009. It includes a review of the evidence in favour of the "treat-to-target" paradigm, as well as potential difficulties with this approach, including the multiple pathological processes present in high-risk patients that may not be adequately addressed by this strategy. The risk-guided therapy approach requires careful definitions of cardiovascular risk and consideration of clinical endpoints as well as the differences between trial and "real-world" populations. Cost-effectiveness presents another issue in scenarios of finite healthcare resources, as does the difficulty of documenting guideline uptake and effectiveness in the primary care setting, where early modification of risk factors may be more beneficial than later attempts to manage established disease. The key to guideline implementation is to improve the quality of risk assessment and demonstrate the association between risk factors, intervention, and reduced event rates. In the future, this may be made possible by means of automated data entry and various other measures. In conclusion, opportunities exist to increase guideline implementation in the primary care setting, with potential benefits for both the general population and healthcare resources.

Biliary pain--work-up and management in general practice.

PubMed

Crawford, Michael

2013-07-01

Pain arising from the gallbladder and biliary tree is a common clinical presentation. Differentiation from other causes of abdominal pain can sometimes be difficult. This article discusses the work-up, management and after care of patients with biliary pain. The role for surgery for gallstones and gallbladder polyps is described. Difficulties in the diagnosis and management of gallbladder pain are discussed. Intra- and post-operative complications are described, along with their management. The issue of post-operative pain in particular is examined, focusing on the timing of the pain and the relevant investigations.

Burnout in Counseling Practice: Some Potential Professional and Personal Hazards of Becoming a Counselor.

ERIC Educational Resources Information Center

Watkins, C. Edward, Jr.

1983-01-01

Defines the syndrome of burnout and discusses some of the professional and personal hazards that confront the practicing counselor. Examines intrapersonal and interpersonal difficulties which result from burnout. Provides suggestions for dealing with burnout. (Author/RC)

Assessment of Clinical Practices for Crushing Medication in Geriatric Units.

PubMed

Fodil, M; Nghiem, D; Colas, M; Bourry, S; Poisson-Salomon, A-S; Rezigue, H; Trivalle, C

2017-01-01

To assess the modification of the form of medication and evaluate staff observance of good clinical practices. One-day assessment of clinical practices. 17 geriatrics units in the 3 Teaching Hospitals of Paris-Sud (APHP), France. Elderly in-patients with difficulties swallowing capsules and tablets. Assessment of target-patient prescriptions and direct observation of nurses' medical rounds. 155/526 in-patients (29.5%) were unable to swallow tablets or capsules: 98 (40.3%) in long-term care, 46 patients (23.8%) in the rehabilitation unit and 11 (12.2%) in the acute care unit (p = .005). In thirty-nine (27.3%) of the 143 prescriptions studied all tablets were safe to crush and all capsules were safe to open. In 104 cases, at least one medication could not be safely modified, including 26 cases (18.2%) in which none of the prescribed drugs were safe to crush or open. In 48.2% of the 110 medications that were crushed, crushing was forbidden, and presented a potential threat in 12.7% of cases or a reduced efficacy in 8.2% of cases. Crushing methods were rarely appropriate: no specific protective equipment was used (81.8%), crushing equipment was shared between patients without cleaning (95.1%), medications were spilled or lost (69.9%). The method of administration was appropriate (water, jellified water) in 25% of the cases, questionable (soup, coffee, compote, juice, cream) in 55% of the cases and unacceptable (laxative) in 21% of the cases. Management of drug prescriptions in patients with swallowing difficulties is not optimal, and may even have iatrogenic effects. In this study, 12.7% of the modifications of the drug form could have been harmful. Doctors, pharmacists and nurses need to reevaluate their practices.

Later learning stages in procedural memory are impaired in children with Specific Language Impairment.

PubMed

Desmottes, Lise; Meulemans, Thierry; Maillart, Christelle

2016-01-01

According to the Procedural Deficit Hypothesis (PDH), difficulties in the procedural memory system may contribute to the language difficulties encountered by children with Specific Language Impairment (SLI). Most studies investigating the PDH have used the sequence learning paradigm; however these studies have principally focused on initial sequence learning in a single practice session. The present study sought to extend these investigations by assessing the consolidation stage and longer-term retention of implicit sequence-specific knowledge in 42 children with or without SLI. Both groups of children completed a serial reaction time task and were tested 24h and one week after practice. Results showed that children with SLI succeeded as well as children with typical development (TD) in the early acquisition stage of the sequence learning task. However, as training blocks progressed, only TD children improved their sequence knowledge while children with SLI did not appear to evolve any more. Moreover, children with SLI showed a lack of the consolidation gains in sequence knowledge displayed by the TD children. Overall, these results were in line with the predictions of the PDH and suggest that later learning stages in procedural memory are impaired in SLI. Copyright © 2015 Elsevier Ltd. All rights reserved.

Nursing challenges for universal health coverage: a systematic review1

PubMed Central

Schveitzer, Mariana Cabral; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida Maria da Silva

2016-01-01

Objectives to identify nursing challenges for universal health coverage, based on the findings of a systematic review focused on the health workforce' understanding of the role of humanization practices in Primary Health Care. Method systematic review and meta-synthesis, from the following information sources: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS and Proquest, using the keyword Primary Health Care associated, separately, with the following keywords: humanization of assistance, holistic care/health, patient centred care, user embracement, personal autonomy, holism, attitude of health personnel. Results thirty studies between 1999-2011. Primary Health Care work processes are complex and present difficulties for conducting integrative care, especially for nursing, but humanizing practices have showed an important role towards the development of positive work environments, quality of care and people-centered care by promoting access and universal health coverage. Conclusions nursing challenges for universal health coverage are related to education and training, to better working conditions and clear definition of nursing role in primary health care. It is necessary to overcome difficulties such as fragmented concepts of health and care and invest in multidisciplinary teamwork, community empowerment, professional-patient bond, user embracement, soft technologies, to promote quality of life, holistic care and universal health coverage. PMID:27143536

The transfer of theoretical knowledge to clinical practice by nursing students and the difficulties they experience: A qualitative study.

PubMed

Günay, Ulviye; Kılınç, Gülsen

2018-06-01

Nursing education contains both theoretical and practical training processes. Clinical training is the basis of nursing education. The quality of clinical training is closely related to the quality of the clinical learning environment. This study aimed to determine the transfer of theoretical knowledge into clinical practice by nursing students and the difficulties they experience during this process. A qualitative research design was used in the study. The study was conducted in 2015 with 30 nursing students in a university located in the east of Turkey, constituting three focus groups. The questions directed to the students during the focus group interviews were as follows: What do you think about your clinical training? How do you evaluate yourself in the process of putting your theoretical knowledge into clinical practice? What kind of difficulties are you experiencing in clinical practices? The data were interpreted using the method of content analysis. Most of the students reported that theoretical information they received was excessive, their ability to put most of this information into practice was weak, and they lacked courage to touch patients for fear of implementing procedures incorrectly. As a result of the analysis of the data, five main themes were determined: clinical training, guidance and communication, hospital environment and expectations. The results of this study showed that nursing students found their clinical knowledge and skills insufficient and usually failed to transfer their theoretical knowledge into clinical practices. The study observed that nursing students experienced various issues in clinical practices. In order to fix these issues and achieve an effective clinical training environment, collaboration should be achieved among nursing instructors, nurses, nursing school and hospital managements. Additionally, the number of nursing educators should be increased and training programs should be provided regarding effective clinical training methods. Copyright © 2018 Elsevier Ltd. All rights reserved.

Spirituality in nursing practice.

PubMed

Rogers, Melanie; Wattis, John

2015-05-27

Spirituality is an important aspect of holistic care that is frequently overlooked. This is because of difficulties in conceptualising spirituality and confusion about how it should be integrated into nursing care. This article explores what is meant by spirituality and spiritually competent practice. It examines attitudes to spirituality, describes factors that might affect the integration of spirituality into nursing care and offers practical guidance to equip nurses to incorporate spirituality into their practice.

Dangers of neglect: partially embedded ring upon a finger.

PubMed

Kumar, Anand; Edwards, Huw; Lidder, Surjit; Mestha, Prabhakar

2013-05-09

Digital swelling is a common presentation in clinical practice. Patients presenting with swollen fingers to the emergency department will often have rings on their finger, which can be removed using a variety of simple non-operative techniques or by cutting the ring off and thus avoiding any long-term consequences. Very rarely, when there is a delay in presentation of these patients, serious consequences may proceed, including finger ischaemia, infection, tendon attrition or ultimately the need for surgical amputation. We present an unusual case of patient with psychiatric illness who presented late with a ring that had embedded upon the volar aspect of the index finger. The difficulties faced by the emergency care practitioners in such circumstances, the consequences of rings acting as a tourniquet and strategies for removal of rings on swollen fingers are highlighted.

Dyslexia in general practice education: considerations for recognition and support.

PubMed

Shrewsbury, Duncan

2016-07-01

Dyslexia is a common developmental learning difficulty, which persists throughout life. It is highly likely that those working in primary care will know, or even work with someone who has dyslexia. Dyslexia can impact on performance in postgraduate training and exams. The stereotypical characteristics of dyslexia, such as literacy difficulties, are often not obvious in adult learners. Instead, recognition requires a holistic approach to evaluating personal strengths and difficulties, in the context of a supportive relationship. Strategies to support dyslexic learners should consider recommendations made in formal diagnostic reports, and aim to address self-awareness and coping skills.

Mental workload and motor performance dynamics during practice of reaching movements under various levels of task difficulty.

PubMed

Shuggi, Isabelle M; Oh, Hyuk; Shewokis, Patricia A; Gentili, Rodolphe J

2017-09-30

The assessment of mental workload can inform attentional resource allocation during task performance that is essential for understanding the underlying principles of human cognitive-motor behavior. While many studies have focused on mental workload in relation to human performance, a modest body of work has examined it in a motor practice/learning context without considering individual variability. Thus, this work aimed to examine mental workload by employing the NASA TLX as well as the changes in motor performance resulting from the practice of a novel reaching task. Two groups of participants practiced a reaching task at a high and low nominal difficulty during which a group-level analysis assessed the mental workload, motor performance and motor improvement dynamics. A secondary cluster analysis was also conducted to identify specific individual patterns of cognitive-motor responses. Overall, both group- and cluster-level analyses revealed that: (i) all participants improved their performance throughout motor practice, and (ii) an increase in mental workload was associated with a reduction of the quality of motor performance along with a slower rate of motor improvement. The results are discussed in the context of the optimal challenge point framework and in particular it is proposed that under the experimental conditions employed here, functional task difficulty: (i) would possibly depend on an individuals' information processing capabilities, and (ii) could be indexed by the level of mental workload which, when excessively heightened can decrease the quality of performance and more generally result in delayed motor improvements. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Pediatricians' knowledge, attitudes, and practice patterns regarding special education and individualized education programs.

PubMed

Shah, Reshma P; Kunnavakkam, Rangesh; Msall, Michael E

2013-01-01

The medical community has called upon pediatricians to be knowledgeable about an individualized education program (IEP). We sought to: 1) evaluate pediatricians' knowledge and attitudes regarding special education; 2) examine the relationship between perceived responsibilities and practice patterns; and 3) identify barriers that impact pediatricians' ability to provide comprehensive care to children with educational difficulties. Surveys were mailed to a national sample of 1000 randomly selected general pediatricians and pediatric residents from October 2010 to February 2011. The response rate was 47%. Of the knowledge items, respondents answered an average of 59% correctly. The majority of respondents thought pediatricians should be responsible for identifying children who may benefit from special education services and assist families in obtaining services, but less than 50% thought they should assist in the development of an IEP. The majority of pediatricians inquired whether a child is having difficulty at school, but far fewer conducted screening tests or asked parents if they needed assistance obtaining services. Overall, the prevalence of considering a practice a pediatrician's responsibility is significantly higher than examples of such a practice pattern being reported. Financial reimbursement and insufficient training were among the most significant barriers affecting a pediatrician's ability to provide care to children with educational difficulties. In order to provide a comprehensive medical home, pediatricians must be informed about the special education process. This study demonstrates that there are gaps in pediatricians' knowledge and practice patterns regarding special education that must be addressed. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Analysis of difficulties in mathematics learning on students with guardian personality type in problem-solving HOTS geometry test

NASA Astrophysics Data System (ADS)

Karimah, R. K. N.; Kusmayadi, T. A.; Pramudya, I.

2018-04-01

Learning in the current 2013 curriculum is based on contextual issues based on questions that can encourage students to think broadly. HOTS is a real-life based assessment of everyday life, but in practice, the students are having trouble completing the HOTS issue. Learning difficulty is also influenced by personality type Based on the fact that the real difference one can see from a person is behavior. Kersey classifies the personality into 4 types, namely Idealist, Rational, Artisan, and Guardian. The researcher focuses on the type of guardian personality that is the type of personality that does not like the picture. This study aims to describe the difficulty of learning mathematics in students with a type of guardian personality in the completion of Geometry materials especially in solving HOTS. This research type is descriptive qualitative research. Instruments used in this study were the researchers themselves, personality class test sheets, learning difficulty test sheets in the form of HOTS Geometry test, and interview guides. The results showed that students with guardian personality it was found that a total of 3.37 % difficulties of number fact skill, 4.49 % difficulties of arithmetics skill, 37.08 % difficulties of information skill, 31.46% difficulties of language skill, 23.60 % difficulties of visual-spatial skill.

[Tubal sterilization in mentally handicapped women].

PubMed

Barjot, P; Hervé, C

2001-09-22

When performed for contraception purposes, tubular sterilization for mentally handicapped women poses important ethical issues, including patient's rights, body integrity, and the notion of informed consent. French law guarantees the respect and safety of all patients, but in everyday practice, patient's rights must be upheld by family and healthcare workers searching for the most adapted solutions for each individual situation. We present here our proposals for everyday practice. Our conclusions are based on an analysis of the notion of handicap as defined by the WHO and on the observed sexual activities of this type of patient. In this context, informed consent involves a number of subjective factors pointing out the difficulty encountered in providing dear comprehensible information. Finally we discuss the ethical issue of tubular sterilization which many consider to be a masked form of eugenism.

Bring Your Own Device and Nurse Managers' Decision Making.

PubMed

Martinez, Karen; Borycki, Elizabeth; Courtney, Karen L

2017-02-01

The Bring Your Own Device phenomenon is important in the healthcare environment because this trend is changing the workplace in healthcare organizations, such as British Columbia. At present, there is little research that exists in Canada to provide a distinct understanding of the complexities and difficulties unique to this phenomenon within the nursing practice. This study focused on the experiences and perceptions of nurse managers regarding how they make decisions on the use of personal handheld devices in the workplace. Telephone interviews (N = 10) and qualitative descriptive analysis were used. Four major themes emerged: (1) management perspective, (2) opportunities, (3) disadvantages, and (4) solutions. Nurse managers and other executives in healthcare organizations and health information technology departments need to be aware of the practice and organizational implications of the Bring Your Own Device movement.

LEO Spacecraft Charging Guidelines

NASA Technical Reports Server (NTRS)

Hillard, G. B.; Ferguson, D. C.

2002-01-01

Over the past decade, Low Earth Orbiting (LEO) spacecraft have gradually required ever-increasing power levels. As a rule, this has been accomplished through the use of high voltage systems. Recent failures and anomalies on such spacecraft have been traced to various design practices and materials choices related to the high voltage solar arrays. NASA Glenn has studied these anomalies including plasma chamber testing on arrays similar to those that experienced difficulties on orbit. Many others in the community have been involved in a comprehensive effort to understand the problems and to develop practices to avoid them. The NASA Space Environments and Effects program, recognizing the timeliness of this effort, has commissioned and funded a design guidelines document intended to capture the current state of understanding. We present here an overview of this document, which is now nearing completion.

Free-form Airfoil Shape Optimization Under Uncertainty Using Maximum Expected Value and Second-order Second-moment Strategies

NASA Technical Reports Server (NTRS)

Huyse, Luc; Bushnell, Dennis M. (Technical Monitor)

2001-01-01

Free-form shape optimization of airfoils poses unexpected difficulties. Practical experience has indicated that a deterministic optimization for discrete operating conditions can result in dramatically inferior performance when the actual operating conditions are different from the - somewhat arbitrary - design values used for the optimization. Extensions to multi-point optimization have proven unable to adequately remedy this problem of "localized optimization" near the sampled operating conditions. This paper presents an intrinsically statistical approach and demonstrates how the shortcomings of multi-point optimization with respect to "localized optimization" can be overcome. The practical examples also reveal how the relative likelihood of each of the operating conditions is automatically taken into consideration during the optimization process. This is a key advantage over the use of multipoint methods.

Unconscious and Unnoticed Professional Practice within an Outstanding School for Children and Young People with Complex Learning Difficulties and Disabilities

ERIC Educational Resources Information Center

Crombie, Richard; Sullivan, Lesley; Walker, Kate; Warnock, Rebecca

2014-01-01

This article describes a three-year project undertaken at Pear Tree School for children and young people with severe and multiple and profound learning difficulties. Lesley Sullivan, the school's head teacher, believed that much of the value within the work of this outstanding school went unidentified by existing approaches to planning, monitoring…

Perspectives of SENCos and Support Staff in England on Their Roles, Relationships and Capacity to Support Inclusive Practice for Students with Behavioural Emotional and Social Difficulties

ERIC Educational Resources Information Center

Burton, Diana; Goodman, Ruth

2011-01-01

With teachers under pressure to meet curriculum targets, responsibility for including students with behavioural emotional and social difficulties (BESD) in mainstream schools falls heavily on non-teaching staff. In this article, semi-structured interviews were conducted with special educational needs coordinators (SENCos) and support staff in a…

A Community of Practice as an Inclusive Model to Support Children with Social, Emotional and Behavioural Difficulties in School Contexts

ERIC Educational Resources Information Center

Botha, Johan; Kourkoutas, Elias

2016-01-01

Many school children throughout the world who exhibit antisocial or destructive behaviour or have social, emotional and behavioural difficulties (SEBD) do not receive the support they need. As a result, they are caught up in a cycle of vulnerability. Systemic collaborative support is needed to counter this. Although in some cases teachers and…

Reflections on being therapeutic and reflection.

PubMed

Elcock, K

1997-01-01

This article offers a reflective account of an incident that occurred between a nurse tutor and a patient on a cardiology ward. It highlights the importance of interpersonal skills in creating a therapeutic relationship, in particular those of self-awareness, empathy and intuition. The author's difficulties in running reflective practice sessions for pre-registration students are discussed and insights are offered into why these difficulties arose.

School Leavers with Learning Disabilities Moving from Child to Adult Speech and Language Therapy (SLT) Teams: SLTs' Views of Successful and Less Successful Transition Co-Working Practices

ERIC Educational Resources Information Center

McCartney, Elspeth; Muir, Margaret

2017-01-01

School-leaving for pupils with long-term speech, language, swallowing or communication difficulties requires careful management. Speech and language therapists (SLTs) support communication, secure assistive technology and manage swallowing difficulties post-school. UK SLTs are employed by health services, with child SLT teams based in schools.…

A Review of the Empirical Evidence Identifying Effective Interventions and Teaching Practices for Students with Learning Difficulties in Years 4, 5 and 6. Literature Review

ERIC Educational Resources Information Center

Purdie, Nola; Ellis, Louise

2005-01-01

This review has been prepared by the Australian Council for Educational research (ACER) under an Agreement with the Australian Government Department of Education, Science and Training (DEST). It is one component of a project to investigate effective third wave intervention strategies for students and learning difficulties that persist beyond the…

Automated recognition of microcalcification clusters in mammograms

NASA Astrophysics Data System (ADS)

Bankman, Isaac N.; Christens-Barry, William A.; Kim, Dong W.; Weinberg, Irving N.; Gatewood, Olga B.; Brody, William R.

1993-07-01

The widespread and increasing use of mammographic screening for early breast cancer detection is placing a significant strain on clinical radiologists. Large numbers of radiographic films have to be visually interpreted in fine detail to determine the subtle hallmarks of cancer that may be present. We developed an algorithm for detecting microcalcification clusters, the most common and useful signs of early, potentially curable breast cancer. We describe this algorithm, which utilizes contour map representations of digitized mammographic films, and discuss its benefits in overcoming difficulties often encountered in algorithmic approaches to radiographic image processing. We present experimental analyses of mammographic films employing this contour-based algorithm and discuss practical issues relevant to its use in an automated film interpretation instrument.

Segmentation of touching mycobacterium tuberculosis from Ziehl-Neelsen stained sputum smear images

NASA Astrophysics Data System (ADS)

Xu, Chao; Zhou, Dongxiang; Liu, Yunhui

2015-12-01

Touching Mycobacterium tuberculosis objects in the Ziehl-Neelsen stained sputum smear images present different shapes and invisible boundaries in the adhesion areas, which increases the difficulty in objects recognition and counting. In this paper, we present a segmentation method of combining the hierarchy tree analysis with gradient vector flow snake to address this problem. The skeletons of the objects are used for structure analysis based on the hierarchy tree. The gradient vector flow snake is used to estimate the object edge. Experimental results show that the single objects composing the touching objects are successfully segmented by the proposed method. This work will improve the accuracy and practicability of the computer-aided diagnosis of tuberculosis.

Use of technologies in intravenous therapy: contributions to a safer practice.

PubMed

Moreira, Ana Paula Amorim; Escudeiro, Cristina Lavoyer; Christovam, Bárbara Pompeu; Silvino, Zenith Rosa; Carvalho, Márglory Fraga de; Silva, Roberto Carlos Lyra da

2017-01-01

To identify what are the difficulties of the nursing staff in the management of technologies during intravenous therapy (IVT) and discuss the difficulties identified under the perspective of patient's safety. Descriptive study of qualitative approach with data collected by semi-structured interview and analyzed by the Alceste software. The greatest difficulty of cognitive and technical emphasis was the lack of training; and regarding administrative emphasis, the greatest difficulty was the lack of material and human resources. Infusion pumps and their proper use were highlighted as the technological resource that most contributed to patient safety. The lack of training is presented as the greatest difficulty of nursing professionals and permeates safety issues of both patient and professional when using the hard technologies in IVT. Training is essential to the development of techniques, considered nursing tools. Identificar quais são as dificuldades da equipe de Enfermagem no manejo das tecnologias durante a terapia intravenosa (TIV) e discutir as dificuldades identificadas sob a perspectiva da segurança do paciente. abordagem qualitativa, do tipo descritivo com dados coletados por entrevista semiestruturada e analisados pelo programa Alceste. A maior dificuldade de ênfase cognitiva e técnica foi a falta de treinamento; e de ênfase administrativa, foi a falta de recursos materiais e humanos. As bombas de infusão e sua utilização adequada foram destacadas como o recurso tecnológico que mais contribuiu para a segurança do paciente. A falta de treinamento é apresentada como a maior dificuldade dos profissionais de Enfermagem e permeia as questões de segurança do paciente e do profissional ao utilizar as tecnologias duras na TIV. O treinamento é imprescindível para o desenvolvimento das técnicas, consideradas como ferramentas do fazer da Enfermagem.

A historical study to understand students’ current difficulties about RMS values

NASA Astrophysics Data System (ADS)

Khantine-Langlois, Françoise; Munier, Valérie

2016-07-01

Several studies show that students experience more and more difficulties managing the measurements of electrical values in alternating current and that they have trouble making links between theory and practice. They find it difficult to give meaning to root mean square (RMS; or effective) values, which are not understood as average values and are confused with instantaneous values. This shows that students do not clearly differentiate variable and direct currents. In this paper we try, with a historical study and a study of teaching the concept of RMS values, to understand students’ difficulties with this concept. In the first part we present an epistemological analysis of the concept of RMS values, showing that it is multifaceted and can be approached from different points of view. In the second part we analyse the evolution of French secondary school curricula and textbooks from the explicit introduction of variable currents to today, questioning the links between the evolution of the curricula and the evolution of the place of science and technology in our societies. We point out that the evolution of the curricula is linked to the social context and to the connections between science, technology and society, and also to the relationship with mathematics curricula. We show that alternating current is introduced earlier in the curriculum but has gradually lost all phenomenological description. This study allows us to better understand students’ difficulties and to discuss some implications for teaching.

Hearing difficulties, ear-related diagnoses and sickness absence or disability pension--a systematic literature review.

PubMed

Friberg, Emilie; Gustafsson, Klas; Alexanderson, Kristina

2012-09-12

Hearing difficulties is a large public health problem, prognosticated to be the ninth leading burden of disease in 2030, and may also involve large consequences for work capacity. However, research regarding sickness absence and disability pension in relation to hearing difficulties is scarce. The aim was to gain knowledge about hearing difficulties or other ear-related diagnoses and sickness absence and disability pension through conducting a systematic literature review of published studies. Studies presenting empirical data on hearing difficulties or ear-related diagnoses and sick leave or disability pension, published in scientific peer-reviewed journals, were included. Studies were sought for in three ways: in literature databases (Pub-Med, Embase, PsycInfo, SSCI, and Cochrane) through March 2011, through scrutinising lists of references, and through contacts. Identified publications were assessed for relevance and data was extracted from the studies deemed relevant. A total of 18 studies were assessed as relevant and included in this review, regardless of scientific quality. Fourteen studies presented empirical data on hearing difficulties/ear diagnoses and sick leave and six on these conditions and disability pension. Only two studies presented rate ratios or odds ratios regarding associations between hearing difficulties and sick leave, and only two on hearing difficulties and risk of disability pension. Both measures of hearing difficulties and of sick leave varied considerable between the studies. Remarkably few studies on hearing difficulties in relation to sickness absence or disability pension were identified. The results presented in them cannot provide evidence for direction or magnitude of potential associations.

Hearing difficulties, ear-related diagnoses and sickness absence or disability pension - a systematic literature review

PubMed Central

2012-01-01

Background Hearing difficulties is a large public health problem, prognosticated to be the ninth leading burden of disease in 2030, and may also involve large consequences for work capacity. However, research regarding sickness absence and disability pension in relation to hearing difficulties is scarce. The aim was to gain knowledge about hearing difficulties or other ear-related diagnoses and sickness absence and disability pension through conducting a systematic literature review of published studies. Methods Studies presenting empirical data on hearing difficulties or ear-related diagnoses and sick leave or disability pension, published in scientific peer-reviewed journals, were included. Studies were sought for in three ways: in literature databases (Pub-Med, Embase, PsycInfo, SSCI, and Cochrane) through March 2011, through scrutinising lists of references, and through contacts. Identified publications were assessed for relevance and data was extracted from the studies deemed relevant. Results A total of 18 studies were assessed as relevant and included in this review, regardless of scientific quality. Fourteen studies presented empirical data on hearing difficulties/ear diagnoses and sick leave and six on these conditions and disability pension. Only two studies presented rate ratios or odds ratios regarding associations between hearing difficulties and sick leave, and only two on hearing difficulties and risk of disability pension. Both measures of hearing difficulties and of sick leave varied considerable between the studies. Conclusions Remarkably few studies on hearing difficulties in relation to sickness absence or disability pension were identified. The results presented in them cannot provide evidence for direction or magnitude of potential associations. PMID:22966953

Personal Transferable Skills in Higher Education: The Problems of Implementing Good Practice.

ERIC Educational Resources Information Center

Drummond, Ian; Nixon, Iain; Wiltshire, John

1998-01-01

Promotion of effective development of personal transferable skills has had limited success in British higher education. Difficulties inherent in implementing established good practice include institutional inertia, issues of academic freedom, resources, high levels of commitment to a particular discipline, and modularization. (SK)

Authentic Cultural and Linguistic Learning through Practicum in a Nursing Home

ERIC Educational Resources Information Center

Andrew, Martin

2012-01-01

This study investigates the value of community experience for mediating linguistic practice and cultural learning. Learners of English as an Additional Language (EAL), both immigrants and international students, frequently report difficulties in practicing English outside the classroom (Wright, 2006). Grounded in poststructuralist social identity…

Leadership: Who Needs It?

ERIC Educational Resources Information Center

Gronn, Peter

2003-01-01

Critique focuses on the discourse of leadership as a vehicle for representing organizational practice. Identifies a series of conceptual inadequacies, such as difficulties in distinguishing leadership from management. Embedded in each criticism is a claim that, if leadership is to retain its conceptual and practical utility, then it has to be…

Who helps the leaders? Difficulties experienced by cancer support group leaders.

PubMed

Kirsten, Laura; Butow, Phyllis; Price, Melanie; Hobbs, Kim; Sunquist, Kendra

2006-07-01

Cancer support groups are an important source of support for cancer patients, yet little is known about the challenges and training needs of both professionally trained and untrained leaders. The aim of this study was to discover the difficulties experienced and training desired by cancer support group leaders. Twenty-seven leaders of 34 cancer support groups participated in focus groups or individual interviews. Groups were purposively selected as representative of 173 support groups identified in New South Wales which were for adults with cancer and/or their adult carers and were not therapeutic or education-only groups. Difficulties identified included dealing with people's different communication styles and needs; dealing with recurrence, metastases and death; practical issues, including resources, setting the programme and funding security; maintaining personal balance and preventing burn out; establishing group credibility; dealing with group cycles; and leading groups in rural areas. Leaders also identified benefits and rewards from group leadership such as contributing to others' well-being, self-development and insight into others' lives. Non-professionally trained leaders experienced more difficulties, particularly in dealing with group process and practical issues. Difficulties identified were related both to working with a cancer population specifically and to working with groups in general. While some issues were common to both health professionals and non-health professionals, non-health professionals reported greater supportive needs. Clear guidelines, targeted training and development of better methods of support to reduce the stress and burn out experienced by group leaders are needed.

[Students' practice in the construction of knowledge about the phenomenon of drug abuse].

PubMed

dos Santos, Vanessa Oliveira Guimarães; Vargens, Octavio Muniz da Costa

2010-03-01

This is a qualitative descriptive research, carried out with nursing undergraduates from Rio de Janeiro State University, Brazil. The purpose is to discuss students' experiences and their social practice in assisting drugs uses. Data were collected from December 2008 to January, 2009, with the use of focal groups composed by 19 undergraduates from the last three semesters of the course. The project was approved by the Ethics Research Commission. All participants signed the Informed Consent. The results evidenced students' difficulty in facing reality, due to the contrast between theory and practice. Such difficulty came out as a consequence of an inapropriate educational approach. We concluded that the academic institutions should optimize the use of teaching process. Professional formation related to the phenomenon of drug abuse is considered essential as it becomes more and more frequent in nurses' daily routines.

Becoming a nurse faculty leader: facing challenges through reflecting, persevering and relating in new ways.

PubMed

Horton-Deutsch, Sara; Young, Patricia K; Nelson, Kristine A

2010-05-01

The aim of the present study was to explore the experience of becoming a nurse faculty leader. In a recent interpretation of 23 interviews conducted with nurse faculty leaders from across the United States about their experiences of becoming a leader three themes were identified: being thrust into leadership, taking risks and facing challenges. This interpretive phenomenological study further explicates three aspects of how nurse educators faced challenges in becoming and serving as a leader. Facing challenges meant reflecting, persevering through difficulties and learning to relate to others in new ways. Exemplars of participant experiences are provided for concreteness, to assist readers in determining how findings resonate with their own experience and how they can actualize this resonance in their own leadership practice. In the present study, reflecting, persevering through difficulties and learning to relate with others in a new way was how leaders faced challenges. Leadership development opportunities that facilitate self-exploration, caring and thoughtful interactions with others and values clarification serve as the foundation for becoming a nurse faculty leader who is, in turn, able to build leadership capacity in other individuals and organizations.

Burdens and difficulties experienced by caregivers of children and adolescents with schizophrenia-spectrum disorders: a qualitative study.

PubMed

Knock, Jane; Kline, Emily; Schiffman, Jason; Maynard, Ashley; Reeves, Gloria

2011-11-01

The purpose of this qualitative study was to investigate the burdens and difficulties associated with the experience of caring for youth with schizophrenia-spectrum disorders. Ten caregivers participated in a modified version of the Knowledge about Schizophrenia Illness interview. The most common areas of general difficulties reported by caregivers were emotional burdens and the everyday practical demands and sacrifices required in caring for their dependents. RESULTS also suggested high levels of burden for caregivers concerning difficulties with mental health services. Additional work is needed to learn more about the challenges that caregivers of youth with schizophrenia-spectrum disorders are facing, as well as to develop empirically based strategies for helping these caregivers and their dependents. © 2011 Blackwell Publishing Asia Pty Ltd.

Learning from patients: Identifying design features of medicines that cause medication use problems.

PubMed

Notenboom, Kim; Leufkens, Hubert Gm; Vromans, Herman; Bouvy, Marcel L

2017-01-30

Usability is a key factor in ensuring safe and efficacious use of medicines. However, several studies showed that people experience a variety of problems using their medicines. The purpose of this study was to identify design features of oral medicines that cause use problems among older patients in daily practice. A qualitative study with semi-structured interviews on the experiences of older people with the use of their medicines was performed (n=59). Information on practical problems, strategies to overcome these problems and the medicines' design features that caused these problems were collected. The practical problems and management strategies were categorised into 'use difficulties' and 'use errors'. A total of 158 use problems were identified, of which 45 were categorized as use difficulties and 113 as use error. Design features that contributed the most to the occurrence of use difficulties were the dimensions and surface texture of the dosage form (29.6% and 18.5%, respectively). Design features that contributed the most to the occurrence of use errors were the push-through force of blisters (22.1%) and tamper evident packaging (12.1%). These findings will help developers of medicinal products to proactively address potential usability issues with their medicines. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Evidence-based interventions for reading and language difficulties: creating a virtuous circle.

PubMed

Snowling, Margaret J; Hulme, Charles

2011-03-01

BACKGROUND. Children may experience two very different forms of reading problem: decoding difficulties (dyslexia) and reading comprehension difficulties. Decoding difficulties appear to be caused by problems with phonological (speech sound) processing. Reading comprehension difficulties in contrast appear to be caused by problems with 'higher level' language difficulties including problems with semantics (including deficient knowledge of word meanings) and grammar (knowledge of morphology and syntax). AIMS. We review evidence concerning the nature, causes of, and treatments for children's reading difficulties. We argue that any well-founded educational intervention must be based on a sound theory of the causes of a particular form of learning difficulty, which in turn must be based on an understanding of how a given skill is learned by typically developing children. Such theoretically motivated interventions should in turn be evaluated in randomized controlled trials (RCTs) to establish whether they are effective, and for whom. RESULTS. There is now considerable evidence showing that phonologically based interventions are effective in ameliorating children's word level decoding difficulties, and a smaller evidence base showing that reading and oral language (OL) comprehension difficulties can be ameliorated by suitable interventions to boost vocabulary and broader OL skills. CONCLUSIONS. The process of developing theories about the origins of children's educational difficulties and evaluating theoretically motivated treatments in RCTs, produces a 'virtuous circle' whereby theory informs practice, and the evaluation of effective interventions in turn feeds back to inform and refine theories about the nature and causes of children's reading and language difficulties. ©2010 The British Psychological Society.

Adult Attitudes about School Counselor Role.

ERIC Educational Resources Information Center

Yockey, Karen S.

In a time of financial difficulties for schools, few counselors use accountability practices--practices which are necessary in order to justify the expense of school counseling and guidance programs. This descriptive study examines opinions of adults about school counselors. Following a review of literature concerning the role of the counselor, a…

Instruction and Assessment for Struggling Writers Evidence-Based Practices

ERIC Educational Resources Information Center

Troia, Gary A., Ed.

2009-01-01

This book focuses on how to provide effective instruction to K-12 students who find writing challenging, including English language learners and those with learning disabilities or language impairments. Prominent experts illuminate the nature of writing difficulties and offer practical suggestions for building students' skills at the word,…

How to Retain Postgraduate Students in Engineering Programmes: A Practical Perspective

ERIC Educational Resources Information Center

Le, Khoa N.; Tam, Vivian W. Y.

2008-01-01

Six factors for pursuing an engineering postgraduate programme at Griffith University including (i) programme quality; (ii) employment prospects; (iii) practicality; (iv) personal interest; (v) popularity; and (vi) reputation; and 11 factors for not pursuing this engineering programme including (i) employment prospects; (ii) degree of difficulty;…

Thickened Liquids: Practice Patterns of Speech-Language Pathologists

ERIC Educational Resources Information Center

Garcia, Jane Mertz; Chambers, Edgar, IV; Molander, Michelle

2005-01-01

This study surveyed the practice patterns of speech-language pathologists in their use of thickened liquids for patients with swallowing difficulties. A 25-item Internet survey about thickened liquids was posted via an e-mail list to members of the American Speech-Language-Hearing Association Division 13, Swallowing and Swallowing Disorders…

Parents' Talk: Multiple Schemas and Parenting Practice

ERIC Educational Resources Information Center

Sarda, Zoltan G.

2012-01-01

The impetus for this study is derived from the researcher's experience as a teacher and parent educator. In such contexts, parents frequently lament about the difficulties they experience in developing and sustaining "best practices" in raising their children, and the intransigent nature of existing habits. Much schematic cognition…

The Cultivation of Cross-Cultural Communication Competence in Oral English Teaching Practice

ERIC Educational Resources Information Center

Sun, Chunyan

2015-01-01

This paper analyzes the main problems and difficulties in current college English oral English teaching practice, illustrates the relationship between oral English teaching and cross-cultural communication competence. On the one hand, cross-cultural communication plays an essential role in oral English teaching; besides, oral English teaching…

Using Playful Practice to Communicate with Special Children. David Fulton/Nasen

ERIC Educational Resources Information Center

Corke, Margaret

2011-01-01

Playfulness is important; it creates an alternative space where emotional, cognitive and social dimensions can be explored and tested. This highly practical book explores the endless possibilities of using playful, creative and interactive activities to meaningfully engage with children with multiple learning difficulties or autistic spectrum…

Communicating with Families across Cultures: An Investigation of Teacher Perceptions and Practices

ERIC Educational Resources Information Center

Eberly, Jody L.; Joshi, Arti; Konzal, Jean

2007-01-01

Increasing diversity in the student population intensifies the need for and the difficulties of establishing culturally sensitive and meaningful communication between teachers and parents. This study examined the practices of early childhood and elementary teachers concerning culturally sensitive home-school communication. As a second phase of a…

Developmental Perspectives on Reflective Practices of Elementary Science Education Students

ERIC Educational Resources Information Center

Olson, Joanne K.; Finson, Kevin D.

2009-01-01

Instructors of elementary science methods classes have long lamented the significant difficulties their students exhibit when trying to understand the many complexities of teaching science. As noted by some researchers and practicing teachers, preservice teachers often fail to developmentally function at desired levels with respect to…

Dilemmas in the (un)veiling of the diagnosis of Alzheimer's disease: walking an ethical and professional tight rope.

PubMed

Karnieli-Miller, Orit; Werner, Perla; Aharon-Peretz, Judith; Eidelman, Shmuel

2007-08-01

To enhance the understanding and effect of physician's difficulties, attitudes and communication styles on the disclosure of the diagnosis of AD in practice. Qualitative, phenomenological study, combining pre-encounter interviews with physicians, observations of actual encounters of diagnosis disclosure of AD, and post-encounter interviews. There were various ways or tactics to (un)veil the bad news that may be perceived as different ways of dulling the impact and avoiding full and therefore problematic statements. In the actual encounters this was accomplished by keeping encounters short, avoiding elaboration, confirmation of comprehension and explicit terminology and using fractured sentences. The present study's findings highlight the difficulties encountered in breaking the news about AD, in the way it is actually done, and the problems that may arise from this way of un/veiling the news. The main problem is that the reluctance to make a candid disclosure of the diagnosis as was demonstrated in this study may violate basic moral and legal rights and may also deprive patients and caregivers of some of the benefits of early disclosure of diagnosis. There is a need for assisting physicians to cope with their personal difficulties, problems and pitfalls in breaking the news.

Losing Your Gut Feelings. Intuition in Depression

PubMed Central

Remmers, Carina; Michalak, Johannes

2016-01-01

Whereas in basic research, intuition has become a topic of great interest, clinical research and depression research in specific have not applied to the topic of intuition, yet. This is astonishing because a well-known phenomenon during depression is that patients have difficulties to judge and decide. In contrast to healthy individuals who take most daily life decisions intuitively (Kahneman, 2011), depressed individuals seem to have difficulties to come to fast and adaptive decisions. The current article pursues three goals. First, our aim is to establish the hypothesis that intuition is impaired in depression against the background of influential theoretical accounts as well as empirical evidence from basic and clinical research. The second aim of the current paper is to provide explanations for recent findings on the depression-intuition interplay and to present directions for future research that may help to broaden our understanding of decision difficulties in depression. Third, we seek to propose ideas on how therapeutic interventions can support depressed individuals in taking better decisions. Even though our knowledge regarding this topic is still limited, we will tentatively launch the idea that an important first step may be to enhance patients’ access to intuitions. Overall, this paper seeks to introduce the topic of intuition to clinical research on depression and to hereby set the stage for upcoming theory and practice. PMID:27602015

Losing Your Gut Feelings. Intuition in Depression.

PubMed

Remmers, Carina; Michalak, Johannes

2016-01-01

Whereas in basic research, intuition has become a topic of great interest, clinical research and depression research in specific have not applied to the topic of intuition, yet. This is astonishing because a well-known phenomenon during depression is that patients have difficulties to judge and decide. In contrast to healthy individuals who take most daily life decisions intuitively (Kahneman, 2011), depressed individuals seem to have difficulties to come to fast and adaptive decisions. The current article pursues three goals. First, our aim is to establish the hypothesis that intuition is impaired in depression against the background of influential theoretical accounts as well as empirical evidence from basic and clinical research. The second aim of the current paper is to provide explanations for recent findings on the depression-intuition interplay and to present directions for future research that may help to broaden our understanding of decision difficulties in depression. Third, we seek to propose ideas on how therapeutic interventions can support depressed individuals in taking better decisions. Even though our knowledge regarding this topic is still limited, we will tentatively launch the idea that an important first step may be to enhance patients' access to intuitions. Overall, this paper seeks to introduce the topic of intuition to clinical research on depression and to hereby set the stage for upcoming theory and practice.

Comment on the treatment of residual water content in “A consistent set of parametric models for the two-phase flow of immiscible fluids in the subsurface” by L. Luckner et al.

USGS Publications Warehouse

Nimmo, John R.

1991-01-01

Luckner et al. [1989] (hereinafter LVN) present a clear summary and generalization of popular formulations used for convenient representation of porous media fluid flow characteristics, including water content (θ) related to suction (h) and hydraulic conductivity (K) related to θ or h. One essential but problematic element in the LVN models is the concept of residual water content (θr; in LVN, θw,r). Most studies using θr determine its value as a fitted parameter and make the assumption that liquid flow processes are negligible at θ values less than θr. While the LVN paper contributes a valuable discussion of the nature of θr, it leaves several problems unresolved, including fundamental difficulties in associating a definite physical condition with θr, practical inadequacies of the models at low θ values, and difficulties in designating a main wetting curve.

Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation.

PubMed

Van Dam, Nicholas T; van Vugt, Marieke K; Vago, David R; Schmalzl, Laura; Saron, Clifford D; Olendzki, Andrew; Meissner, Ted; Lazar, Sara W; Kerr, Catherine E; Gorchov, Jolie; Fox, Kieran C R; Field, Brent A; Britton, Willoughby B; Brefczynski-Lewis, Julie A; Meyer, David E

2018-01-01

During the past two decades, mindfulness meditation has gone from being a fringe topic of scientific investigation to being an occasional replacement for psychotherapy, tool of corporate well-being, widely implemented educational practice, and "key to building more resilient soldiers." Yet the mindfulness movement and empirical evidence supporting it have not gone without criticism. Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed. Addressing such concerns, the present article discusses the difficulties of defining mindfulness, delineates the proper scope of research into mindfulness practices, and explicates crucial methodological issues for interpreting results from investigations of mindfulness. For doing so, the authors draw on their diverse areas of expertise to review the present state of mindfulness research, comprehensively summarizing what we do and do not know, while providing a prescriptive agenda for contemplative science, with a particular focus on assessment, mindfulness training, possible adverse effects, and intersection with brain imaging. Our goals are to inform interested scientists, the news media, and the public, to minimize harm, curb poor research practices, and staunch the flow of misinformation about the benefits, costs, and future prospects of mindfulness meditation.

Bridging worlds: participatory thinking in Jungian context.

PubMed

Brown, Robin S

2017-04-01

Introducing the 'participatory' paradigm associated with the work of transpersonalists Richard Tarnas and Jorge Ferrer, the author outlines an approach to Jung's archetypal thinking that might offer a more adequate basis in which to ground a non-reductive approach to practice. In order to demonstrate the relevance of this outlook at the present time, the author begins by examining recent debates concerning the nature of 'truth' in the clinical setting. Reflecting on the difficulties analysts face in attempting to maintain professional authority without falling into an implicit authoritarianism, it is argued that any approach to therapy seeking to orient itself towards 'the unconscious' must posit the challenges of pluralism as a central concern for practice. With reference to the relationship between analytical psychology and the psychoanalytic mainstream, attention is drawn to the theoretical problems raised by the relational commitment to constructivist epistemologies, and a consequent tendency towards biological reductionism. Turning to the Jungian literature, similar tensions are observed at play in the present state of analytical psychology. Drawing attention to the process-oriented qualities of Jung's work, it is suggested that the speculative nature of Jung's psychology offers a more adequate basis for contemporary practice than might be assumed. © 2017, The Society of Analytical Psychology.

Incorporating equity considerations in transport infrastructure evaluation: Current practice and a proposed methodology.

PubMed

Thomopoulos, N; Grant-Muller, S; Tight, M R

2009-11-01

Interest has re-emerged on the issue of how to incorporate equity considerations in the appraisal of transport projects and large road infrastructure projects in particular. This paper offers a way forward in addressing some of the theoretical and practical concerns that have presented difficulties to date in incorporating equity concerns in the appraisal of such projects. Initially an overview of current practice within transport regarding the appraisal of equity considerations in Europe is offered based on an extensive literature review. Acknowledging the value of a framework approach, research towards introducing a theoretical framework is then presented. The proposed framework is based on the well established MCA Analytic Hierarchy Process and is also contrasted with the use of a CBA based approach. The framework outlined here offers an additional support tool to decision makers who will be able to differentiate choices based on their views on specific equity principles and equity types. It also holds the potential to become a valuable tool for evaluators as a result of the option to assess predefined equity perspectives of decision makers against both the project objectives and the estimated project impacts. This framework may also be of further value to evaluators outside transport.

To take responsibility or to be an onlooker. Nursing students' experiences of two models of supervision.

PubMed

Hellström-Hyson, Eva; Mårtensson, Gunilla; Kristofferzon, Marja-Leena

2012-01-01

The present study aimed at describing how nursing students engaged in their clinical practice experienced two models of supervision: supervision on student wards and traditional supervision. Supervision for nursing students in clinical practice can be organized in different ways. In the present study, parts of nursing students' clinical practice were carried out on student wards in existing hospital departments. The purpose was to give students the opportunity to assume greater responsibility for their clinical education and to apply the nursing process more independently through peer learning. A descriptive design with a qualitative approach was used. Interviews were carried out with eight nursing students in their final semester of a 3-year degree program in nursing. The data were analyzed using content analysis. Two themes were revealed in the data analysis: When supervised on the student wards, nursing students experienced assuming responsibility and finding one's professional role, while during traditional supervision, they experienced being an onlooker and having difficulties assuming responsibility. Supervision on a student ward was found to give nursing students a feeling of acknowledgment and more opportunities to develop independence, continuity, cooperation and confidence. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

PubMed

Gresz, Miklós

2008-09-07

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

Applied behavior analysis: New directions from the laboratory

PubMed Central

Epling, W. Frank; Pierce, W. David

1983-01-01

Applied behavior analysis began when laboratory based principles were extended to humans inorder to change socially significant behavior. Recent laboratory findings may have applied relevance; however, the majority of basic researchers have not clearly communicated the practical implications of their work. The present paper samples some of the new findings and attempts to demonstrate their applied importance. Schedule-induced behavior which occurs as a by-product of contingencies of reinforcement is discussed. Possible difficulties in treatment and management of induced behaviors are considered. Next, the correlation-based law of effect and the implications of relative reinforcement are explored in terms of applied examples. Relative rate of reinforcement is then extended to the literature dealing with concurrent operants. Concurrent operant models may describe human behavior of applied importance, and several techniques for modification of problem behavior are suggested. As a final concern, the paper discusses several new paradigms. While the practical importance of these models is not clear at the moment, it may be that new practical advantages will soon arise. Thus, it is argued that basic research continues to be of theoretical and practical importance to applied behavior analysis. PMID:22478574

Posttraumatic Stress and Depression in the Nonoffending Caregivers of Sexually Abused Children: Associations with Parenting Practices

PubMed Central

Jobe-Shields, Lisa; Swiecicki, Carole C.; Fritz, Darci R.; Stinnette, Jessica S.; Hanson, Rochelle F.

2016-01-01

Caregiver mental health is a known correlate of parenting practices, and recent research indicated that parental depression following childhood sexual abuse disclosure is associated with concurrent parenting difficulties. The present study extended this line of research by investigating posttraumatic stress symptoms and depression in a sample of caregivers (N=96) of children who experienced sexual abuse recruited from a Children’s Advocacy Center, as well as parenting practices reported by both caregivers and their children (Mean age = 10.79 years, SD = 3.29; 79% female). Twenty four percent of caregivers met criteria for presumptive clinical depression, clinically significant posttraumatic stress, or both. Results indicated elevated caregiver-reported inconsistent parenting in the context of clinically significant distress across symptom groups; children reported particularly elevated inconsistent parenting for caregivers with posttraumatic stress only. Caregiver depression was associated with low self-reported positive parenting and caregiver involvement, in addition to self-reported inconsistencies. Directions for future research are offered to further elucidate the relationships between caregiver mental health and parenting practices following childhood sexual abuse. PMID:26808966

A Patient Record-Filing System for Family Practice

PubMed Central

Levitt, Cheryl

1988-01-01

The efficient storage and easy retrieval of quality records are a central concern of good family practice. Many physicians starting out in practice have difficulty choosing a practical and lasting system for storing their records. Some who have established practices are installing computers in their offices and finding that their filing systems are worn, outdated, and incompatible with computerized systems. This article describes a new filing system installed simultaneously with a new computer system in a family-practice teaching centre. The approach adopted solved all identifiable problems and is applicable in family practices of all sizes.

A medical student in private practice for a 1-month clerkship: a qualitative exploration of the challenges for primary care clinical teachers

PubMed Central

Muller-Juge, Virginie; Pereira Miozzari, Anne Catherine; Rieder, Arabelle; Hasselgård-Rowe, Jennifer; Sommer, Johanna; Audétat, Marie-Claude

2018-01-01

Purpose The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians’ private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva. Methods Data were collected via a focus group using a semistructured interview guide. Participants were asked about their role as a supervisor and their difficulties and positive experiences. The text of the focus group was transcribed and analyzed qualitatively, with a deductive and inductive approach. Results The results show the nature of pressures felt by clinical teachers. First, participants experienced the difficulty of having dual roles: the more familiar one of clinician, and the new challenging one of teacher. Second, they felt compelled to fill the gap between the academic context and the private practice context. Clinical teachers were surprised by the extent of the adaptive load, cognitive load, and even the emotional load involved when supervising a trainee in their clinical practice. The context of this rotation demonstrated its utility and its relevance, because it allowed the students to improve their knowledge about the outpatient setting and to develop their professional autonomy and their maturity by taking on more clinical responsibilities. Conclusion These findings show that future training programs will have to address the needs of clinical teachers as well as bridge the gap between students’ academic training and the skills needed for outpatient care. Professionalizing the role of clinical teachers should contribute to reaching these goals. PMID:29344003

A medical student in private practice for a 1-month clerkship: a qualitative exploration of the challenges for primary care clinical teachers.

PubMed

Muller-Juge, Virginie; Pereira Miozzari, Anne Catherine; Rieder, Arabelle; Hasselgård-Rowe, Jennifer; Sommer, Johanna; Audétat, Marie-Claude

2018-01-01

The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians' private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva. Data were collected via a focus group using a semistructured interview guide. Participants were asked about their role as a supervisor and their difficulties and positive experiences. The text of the focus group was transcribed and analyzed qualitatively, with a deductive and inductive approach. The results show the nature of pressures felt by clinical teachers. First, participants experienced the difficulty of having dual roles: the more familiar one of clinician, and the new challenging one of teacher. Second, they felt compelled to fill the gap between the academic context and the private practice context. Clinical teachers were surprised by the extent of the adaptive load, cognitive load, and even the emotional load involved when supervising a trainee in their clinical practice. The context of this rotation demonstrated its utility and its relevance, because it allowed the students to improve their knowledge about the outpatient setting and to develop their professional autonomy and their maturity by taking on more clinical responsibilities. These findings show that future training programs will have to address the needs of clinical teachers as well as bridge the gap between students' academic training and the skills needed for outpatient care. Professionalizing the role of clinical teachers should contribute to reaching these goals.

Dragons' Den: promoting healthcare research and innovation.

PubMed

Mazhindu, Deborah; Gregory, Siobhan

2015-07-01

The changing health and social care landscape, and, in particular, the financial challenges affecting the NHS, can present difficulties for staff looking for funding to support innovation and new ways of working. One method of competitive tendering that is becoming more accepted as a way of allocating funds, encouraging staff engagement and developing innovation for research is a format based the BBC television series, Dragons' Den. This article describes how Hounslow and Richmond Community Healthcare NHS Trust, London, has developed a 'Dragons' Den initiative' of annual competitive research funding allocation to ensure that some of the most dynamic practice in the trust is captured.

An initially unidentified case of urinary tract infection due to Aerococcus urinae.

PubMed

Meletis, Georgios; Chatzidimitriou, Dimitrios; Tsingerlioti, Fani; Chatzopoulou, Fani; Tzimagiorgis, Georgios

2017-07-01

Aerococcus urinae is a microorganism responsible for urinary tract and blood stream infections which are rarely reported in clinical practice. However, it has been proposed that the infrequency of such reports may be partially due to difficulties related to pathogen identification. We present here a case of an elderly male patient with urinary tract infection where A. urinae was initially not identified by a private microbiology laboratory. Our report highlights the need to consider A. urinae as a causative agent of urinary tract infections because if not identified and properly treated it may lead to endocarditis or septicemia.

Macroscopic quantum states: Measures, fragility, and implementations

NASA Astrophysics Data System (ADS)

Fröwis, Florian; Sekatski, Pavel; Dür, Wolfgang; Gisin, Nicolas; Sangouard, Nicolas

2018-04-01

Large-scale quantum effects have always played an important role in the foundations of quantum theory. With recent experimental progress and the aspiration for quantum enhanced applications, the interest in macroscopic quantum effects has been reinforced. In this review, measures aiming to quantify various aspects of macroscopic quantumness are critically analyzed and discussed. Recent results on the difficulties and prospects to create, maintain, and detect macroscopic quantum states are surveyed. The role of macroscopic quantum states in foundational questions as well as practical applications is outlined. Finally, past and ongoing experimental advances aiming to generate and observe macroscopic quantum states are presented.

Practical problems which women encounter with available contraception in Australia.

PubMed

Weisberg, E

1994-06-01

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

Views on computer program documentation and automation

NASA Technical Reports Server (NTRS)

Grosch, H. R.

1970-01-01

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

The mind: psychoanalytic understanding then and now.

PubMed

Bergmann, Martin S

2008-01-01

The author discusses the evolution of psychoanalytic understanding from Freud's time to the present, citing the influence of various sociocultural changes. He addresses Freud's proper place in history and notes ways in which Freud's contributions cast him as belonging to Romanticism. Freud's shift from the topographic model of the mind to the structural one, and the influence of this on psychoanalysis, is discussed, as well as important developments in the field since Freud. The author focuses particularly on difficulties encountered in psychoanalytic practice today, and he describes what he has termed organizing interpretations as uniquely valuable in the treatment setting.

Policy analysis for prenatal genetic diagnosis.

PubMed

Thompson, M; Milunsky, A

1979-01-01

Consideration of the analytic difficulties faced in estimating the benefits and costs of prenatal genetic diagnosis, coupled with a brief review of existing benefit-cost studies, leads to the conclusion that public subsidy of prenatal testing can yield benefits substantially in excess of costs. The practical obstacles to such programs include the attitudes of prospective parents, a lack of knowledge, monetary barriers, inadequately organized medical resources, and the political issue of abortion. Policy analysis can now nevertheless formulate principles and guide immediate actions to improve present utilization of prenatal testing and to facilitate possible future expansion of these diagnostic techniques.

Motivation in medical education and patient communication. The EGPRN meeting in Zurich, Switzerland, October 2010.

PubMed

Rethans, Jan-Joost; Donner-Banzhoff, Norbert

2011-06-01

The European General Practice Research Network held an international research meeting on 'Motivation in medical education and patient communication' in Zürich, Switzerland, in October 2010. The two authors were keynote speakers, who introduced the theme from different angles and summarized and reflected on individual papers presented at the conference. The theme of the conference underlined the importance of communication in general practice and of motivation in medical education in particular. There were a variety of papers each addressing in its own way the topic of this meeting. We conclude that it is still uncommon to use psychological theories on motivation in research on motivation and patient communication in general practice/family medicine. Motivation and readiness to change are essential concepts in experimental health services research. Research designs increasingly follow the Framework for the Evaluation of Complex Interventions in Health Care as suggested by the British Medical Research Council. However, there are also difficulties related to classical experimental designs that have to be critically discussed.

[Micro and Macro Social Work Practice in the Context of Tuberculosis].

PubMed

Moya, Eva M; Chavez-Baray, Silvia M; Martínez, Omar

2017-07-01

The study of tuberculosis (TB) in the U.S.-Mexico border involves the consideration of three key components, which are complex and interrelated: the difficulty tracking and providing appropriate TB care due to the epidemiological and pathological characteristics of TB; the border itself is a geographical and epidemiological area that interweaves two nations, two cultures, two health systems and different laws; and the need for prevention and treatment approaches to TB that involve comprehensive clinical care and prevention while also taking into consideration stigma, social context and knowledge. This manuscript describes the work of ten studies conducted in Mexico and in the U.S.-Mexico border region from 2006 to 2013. It also provides an understanding of the social and public health implications of TB, the environment and communities, as well as the identification and application of advocacy and social mobilization practices. The work presented provides an understanding of different interventions related to adherence, stigma reduction, person-centered approaches, and effective micro and macro practices in social work.

The meaning of caring in five experienced physical therapists.

PubMed

Greenfield, Bruce H

2006-09-01

Caring has been identified as a desirable indicator of professional behavior in the physical therapy profession and as a necessary value for good patient care. Yet caring is an elusive concept with multiple meanings. The present aim was to describe the nature of caring in the clinical practice of five experienced physical therapists. Purposive sampling was used to recruit five experienced physical therapists. Each physical therapist underwent a series of in-depth, open-ended interviews that were transcribed and coded for themes based on similarities and differences. The analysis resulted in three themes: ethics of caring, risks and conflicts of caring, and learning to care. The data indicated for four of the five participants that caring constituted an ethics of practice or moral orientation. Their moral orientation influenced moral judgment that was integrated throughout their clinical and ethical decision-making practice. The findings stress the difficulty of caring in a managed care health care environment that results in conflicting demands for physical therapists to care for their patients in a system that increasingly values cost control and profit margin. However, the findings also describe the ultimate rewards associated with the practice of an ethics of caring in physical therapy practice.

Challenges to implementation of advance directives of will in hospital practice.

PubMed

Cogo, Silvana Bastos; Lunardi, Valéria Lerch; Quintana, Alberto Manuel; Girardon-Perlini, Nara Marilene Oliveira; Silveira, Rosemary Silva da

2016-01-01

to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context. qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles. the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication. limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients' wishes.

Identifying and Addressing Student Difficulties and Misconceptions: Examples from Physics and from Materials Science and Engineering

ERIC Educational Resources Information Center

Rosenblatt, Rebecca

2012-01-01

Here I present my work identifying and addressing student difficulties with several materials science and physics topics. In the first part of this thesis, I present my work identifying student difficulties and misconceptions about the directional relationships between net force, velocity, and acceleration in one dimension. This is accomplished…

Barriers faced by expanded practice dental hygienists in Oregon.

PubMed

Coplen, Amy E; Bell, Kathryn P

2015-04-01

Oregon allows dental hygienists to provide services without the supervision of a dentist if they hold an expanded practice permit (EPP). This study surveyed practicing and non-practicing EPP holders with the purpose of assessing perceived barriers to practicing independently and better educating students to begin independent practice upon graduation. A survey was developed, approved by the institutional review board and pilot tested with current Expanded Practice Dental Hygienists (EPDHs). A list of EPDHs was obtained from the Oregon State Dental Board, and 181 surveys were mailed in November 2011. The response rate was 39% (n=71). Data from this study indicate a large number of new EPP holders, with 62% (n=41) holding their permit for 3 years or less, but only 41% (n=29) of respondents are actually providing care in a setting requiring an EPP. Responding practicing EPDHs reported barriers including: challenges with insurance reimbursement, lack of knowledge/acceptance, equipment cost/maintenance, difficulty obtaining a collaborative agreement/cooperating facility, advertising and inability to make a living wage. Responding non-practicing EPDHs reported barriers including: currently working in another setting, lack of business knowledge, time, start-up cost, inability to make a living wage, lack of opportunity, reimbursement difficulties and lack of experience. Perceived barriers to practicing independently differ between those practicing utilizing their EPP and those not practicing. Ways to eliminate barriers for both practicing and non-practicing EPDHs should be explored. There is potential to reduce the barriers to independent practice through curricular changes, public health partnerships among EPDHs, and new health care systems that specifically address barriers found through this study. Copyright © 2015 The American Dental Hygienists’ Association.

A confluence of traditions: Examining teacher practice in the merging of secondary science and environmental education

NASA Astrophysics Data System (ADS)

Astrid, Steele

Embedding environmental education within secondary science curriculum presents both philosophical and practical difficulties for teachers. This ethnographic/narrative study, with its methodology grounded in eco-feminism and realism/constructivism, examines the work of six secondary science teachers as they engage in an action research project focused on merging environmental education in their science lessons. Over the course of several months the teachers examine and discuss their views and their professional development related to the project. In the place of definitive conclusions, eight propositions relating the work of secondary science teachers to environmental education, form the basis for a discussion of the implications of the study. The implications are particularly relevant to secondary schools in Ontario, Canada, where the embedding of environmental education in science studies has been mandated.

Narratives by Japanese mothers with chronic mental illness in the Tokyo metropolitan area: their feelings toward their children and perceptions of their children's feelings.

PubMed

Ueno, Rie; Kamibeppu, Kiyoko

2008-07-01

Women with mental illness generally have normal fertility rates. Mothers with mental illness think that their children are important for their lives but also experience difficulties in relating to their children. Therefore, it is important to understand the mothers' perception of what experiences influence them or their parenting practices in relationships with their children. We conducted narrative interviews with 20 Japanese mothers who were being treated for either schizophrenia or mood disorders. The data were analyzed using the Modified Grounded Theory Approach. For the mothers, their feelings toward their children and their perception of their children's feelings toward them or their illness influenced the mothers and their parenting practices. Implications for support are discussed and directions for future research are presented.

Mental health policy developments in Latin America.

PubMed Central

Alarcón, R. D.; Aguilar-Gaxiola, S. A.

2000-01-01

New assessment guidelines for measuring the overall impact of mental health problems in Latin America have served as a catalyst for countries to review their mental health policies. Latin American countries have taken various steps to address long-standing problems such as structural difficulties, scarce financial and human resources, and social, political, and cultural obstacles in the implementation of mental health policies and legislation. These policy developments, however, have had uneven results. Policies must reflect the desire, determination, and commitment of policy-makers to take mental health seriously and look after people's mental health needs. This paper describes the development of mental health policies in Latin American countries, focusing on published data in peer-reviewed journals, and legislative change and its implementation. It presents a brief history of mental health policy developments, and analyzes the basis and practicalities of current practice. PMID:10885167

The classification of normal screening mammograms

NASA Astrophysics Data System (ADS)

Ang, Zoey Z. Y.; Rawashdeh, Mohammad A.; Heard, Robert; Brennan, Patrick C.; Lee, Warwick; Lewis, Sarah J.

2016-03-01

Rationale and objectives: To understand how breast screen readers classify the difficulty of normal screening mammograms using common lexicon describing normal appearances. Cases were also assessed on their suitability for a single reader strategy. Materials and Methods: 15 breast readers were asked to interpret a test set of 29 normal screening mammogram cases and classify them by rating the difficulty of the case on a five-point Likert scale, identifying the salient features and assessing their suitability for single reading. Using the False Positive Fractions from a previous study, the 29 cases were classified into 10 "low", 10 "medium" and nine "high" difficulties. Data was analyzed with descriptive statistics. Spearman's correlation was used to test the strength of association between the difficulty of the cases and the readers' recommendation for single reading strategy. Results: The ratings from readers in this study corresponded to the known difficulty level of cases for the 'low' and 'high' difficulty cases. Uniform ductal pattern and density, symmetrical mammographic features and the absence of micro-calcifications were the main reasons associated with 'low' difficulty cases. The 'high' difficulty cases were described as having `dense breasts'. There was a statistically significant negative correlation between the difficulty of the cases and readers' recommendation for single reading (r = -0.475, P = 0.009). Conclusion: The findings demonstrated potential relationships between certain mammographic features and the difficulty for readers to classify mammograms as 'normal'. The standard Australian practice of double reading was deemed more suitable for most cases. There was an inverse moderate association between the difficulty of the cases and the recommendations for single reading.

“I Am a Nice Person When I Do Yoga!!!”

PubMed Central

Ross, Alyson; Bevans, Margaret; Friedmann, Erika; Williams, Laurie; Thomas, Sue

2014-01-01

Purpose To develop a better understanding of how yoga practice affects one’s interpersonal relationships. Design Qualitative. Method Content analysis was used to qualitatively analyze written comments (n = 171) made regarding yoga improving interpersonal relationships in a large cross-sectional survey of yoga practitioners (N = 1,067). Findings Four themes were identified: Yoga practice leads to personal transformation, increases social interaction, provides coping mechanisms to weather relationship losses and difficulties, and leads to spiritual transcendence. Practitioners believed that their interpersonal relationships improved because their attitude and perspective had changed, making them more patient, kind, mindful, and self-aware. They expressed an aspect of community that was both practical (they met new friends) and spiritual (they felt they belonged). They thought they could better weather difficulties such as divorce and death. A number discussed feeling a sense of purpose and that their practice contributed to a greater good. Conclusions There appears to be an aspect of community associated with yoga practice that may be beneficial to one’s social and spiritual health. Yoga could be beneficial for populations at risk for social isolation, such as those who are elderly, bereaved, and depressed, as well as individuals undergoing interpersonal crises. PMID:24166108

An Analysis of Technology Transition Within the Department of Defense

DTIC Science & Technology

2010-06-01

relentless adversaries, it is essential that the DoD performs technology transition in a practical yet expedient manner. Time is a critical factor in...themselves, rather than rely on DOD labs to do so—a practice that brings cost and schedule risk since programs may well find themselves addressing problems...that utilized non-traditional, industry practices to abate the difficulties bringing technologies to a suitable maturation state. Albeit these

The unified acoustic and aerodynamic prediction theory of advanced propellers in the time domain

NASA Technical Reports Server (NTRS)

Farassat, F.

1984-01-01

This paper presents some numerical results for the noise of an advanced supersonic propeller based on a formulation published last year. This formulation was derived to overcome some of the practical numerical difficulties associated with other acoustic formulations. The approach is based on the Ffowcs Williams-Hawkings equation and time domain analysis is used. To illustrate the method of solution, a model problem in three dimensions and based on the Laplace equation is solved. A brief sketch of derivation of the acoustic formula is then given. Another model problem is used to verify validity of the acoustic formulation. A recent singular integral equation for aerodynamic applications derived from the acoustic formula is also presented here.

Stalling of Helicopter Blades

NASA Technical Reports Server (NTRS)

Gustafson, F B; Myers, G C , Jr

1946-01-01

Theoretical studies have predicted that operation of helicopter rotor beyond certain combinations of thrust, forward speed, and rotational speed might be prevented by rapidly increasing stalling of the retreating blade. The same studies also indicate that the efficiency of the rotor will increase until these limits are reached or closely approached, so that it is desirable to design helicopter rotors for operation close to the limits imposed by blade stalling. Inasmuch as the theoretical predictions of blade stalling involve numerous approximations and assumptions, an experimental investigation was needed to determine whether, in actual practice, the stall did occur and spread as predicted and to establish the amount of stalling that could be present without severe vibration or control difficulties being introduced. This report presents the results of such an investigation.

Family Practice: A Proposed Solution to the Problem of Meeting the Medical Needs of the Community

PubMed Central

McAuley, R. G.

1967-01-01

Difficulties in meeting today's community medical needs are outlined, followed by a proposed solution in which the first-contact physician is the trained family physician. The McMaster Family Practice Course is described. The potential research contribution of a Department of Family Medicine is stressed. PMID:6020551

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Enhancing the Student Experiment Experience: Visible Scientific Inquiry through a Virtual Chemistry Laboratory

ERIC Educational Resources Information Center

Donnelly, Dermot; O'Reilly, John; McGarr, Oliver

2013-01-01

Practical work is often noted as a core reason many students take on science in secondary schools (high schools). However, there are inherent difficulties associated with classroom practical work that militate against scientific inquiry, an approach espoused by many science educators. The use of interactive simulations to facilitate student…

Digital Literacies in Higher Education: Exploring Textual and Technological Practice

ERIC Educational Resources Information Center

Lea, Mary R.; Jones, Sylvia

2011-01-01

Concerns are frequently raised about undergraduates being so immersed in web-based technologies in their broader lives that they have difficulties engaging in more conventional study practices, such as academic reading and writing essays. The research reported on here examines this issue through a literacies lens. The project findings illustrate…

Fluency Training. NetNews . Volume 4, Number 5

ERIC Educational Resources Information Center

LDA of Minnesota, 2004

2004-01-01

In the past, researchers believed that reading fluency developed as a result of good word recognition skills; however, it is now believed that fluency must be explicitly taught and practiced orally in order to develop. Readers who are not fluent in reading will be less motivated to practice, have more difficulty learning academic content, and…

Current Practice of Extensive Reading in Asia: Teachers' Perceptions

ERIC Educational Resources Information Center

Chang, Anna C.-S.; Renandya, Willy A.

2017-01-01

This study investigated teachers' perceptions of the practice of extensive reading (ER) in the Asian context. One hundred and nineteen L2 teachers in Asia responded to an online questionnaire that probed into their reasons for implementing ER, the difficulties they encountered, and their perception about the effectiveness of different ways of…

Using Microcomputers To Help Learning Disabled Student with Arithmetic Difficulties.

ERIC Educational Resources Information Center

Brevil, Margarette

The use of microcomputers to help the learning disabled increase their arithmetic skills is examined. The microcomputer should be used to aid the learning disabled student to practice the concepts taught by the teacher. Computer-aided instruction such as drill and practice may help the learning disabled student because it gives immediate feedback…

Word of the Day Improves and Redirects Student Attention while Supporting Vocabulary Development

ERIC Educational Resources Information Center

Vesely, Pamela J.; Gryder, Nancy L.

2009-01-01

To learn and master new concepts, including the acquisition of new vocabulary, students must be able to sustain attention during direct instruction, stay focused throughout the guided practice activity, and successfully complete the independent practice assignments. Yet, difficulty with maintaining attention is a common characteristic for students…

Special Education Teachers' Perceptions and Intentions toward Data Collection

ERIC Educational Resources Information Center

Ruble, Lisa A.; McGrew, John H.; Wong, Wing Hang; Missall, Kristen N.

2018-01-01

Although data-based decision making is an evidence-based practice, many special educators have difficulty applying the practice within daily routines. We applied the theory of planned behavior (TPB) to understand the influences that promote or hinder early childhood special educators' intentions to collect data. We assessed three influences on…

A SAS Interface for Bayesian Analysis with WinBUGS

ERIC Educational Resources Information Center

Zhang, Zhiyong; McArdle, John J.; Wang, Lijuan; Hamagami, Fumiaki

2008-01-01

Bayesian methods are becoming very popular despite some practical difficulties in implementation. To assist in the practical application of Bayesian methods, we show how to implement Bayesian analysis with WinBUGS as part of a standard set of SAS routines. This implementation procedure is first illustrated by fitting a multiple regression model…

Language Choice for Science Education: Policy and Practice

ERIC Educational Resources Information Center

Mifsud, Jordan; Farrugia, Josette

2017-01-01

The Maltese National Minimum Curriculum published in 1999 sought to strengthen bilingualism by reinforcing the practice of teaching and assessing some subjects in English and others in Maltese. It also pointed out that code-switching should only be used in cases of severe pedagogical difficulties. As a new National Curriculum Framework was being…

Putting Teachers First: Leading Change through Design--Initiating and Sustaining Effective Teaching of Mathematics

ERIC Educational Resources Information Center

Proffitt-White, Rob

2017-01-01

The Teachers First initiative is a grass-roots cluster-model approach for bringing together primary and secondary teachers and school principals: to analyse student performance data; design and practice activities and assessment tools; and promote teaching practices that address students' learning difficulties in mathematics. The balance of both…

A Model for Determining Student Plagiarism: Electronic Detection and Academic Judgement

ERIC Educational Resources Information Center

Bretag, Tracey; Mahmud, Saadia

2009-01-01

This paper provides insights based on the authors' own practice as university instructors, researchers and arbitrators of student plagiarism. Recognising the difficulty in defining plagiarism while still acknowledging the practical importance of doing so, the authors find the common element between the various types of plagiarism to be the lack of…

Social and Occupational Integration of Disadvantaged People. Leonardo da Vinci Good Practices Series.

ERIC Educational Resources Information Center

Commission of the European Communities, Brussels (Belgium). Directorate-General for Education and Culture.

This document profiles nine European programs that exemplify good practice in social and occupational integration of disadvantaged people. The programs profiled are as follows: (1) Restaurant Venezia (a CD-ROM program to improve the reading and writing skills of young people in Luxembourg who have learning difficulties); (2) an integrated…

Maternal Dysphoric Mood, Stress, and Parenting Practices in Mothers of Head Start Preschoolers: The Role of Experiential Avoidance

ERIC Educational Resources Information Center

Shea, Sarah E.; Coyne, Lisa W.

2011-01-01

Maternal dysphoria predicts behavioral difficulties in preschool-aged children, and may contribute to negative child outcomes by exacerbating parenting stress. Parenting stress increases the likelihood of maladaptive parenting practices, especially when mothers face multiple contextual stressors. We explored maternal experiential avoidance (EA) as…

Keeping the Best: A Practical Guide to Retaining Key Employees.

ERIC Educational Resources Information Center

Bevan, Stephen; Barber, Linda; Robinson, Dilys

This book, which is intended to assist human resource professionals and line managers in the United Kingdom, is a practical guide to retaining key employees. Discussed in the introduction are the relationship between downsizing and retention, problems that retention difficulties pose for human resource management, and the effects of retention…

Facets of Career Decision-Making Difficulties

ERIC Educational Resources Information Center

Amir, Tami; Gati, Itamar

2006-01-01

The present research investigated the relations among the measured and the expressed career decision-making difficulties in a sample of 299 young adults who intended to apply to college or university. As hypothesised, the correlations between career decision-making difficulties, as measured by the Career Decision-Making Difficulties Questionnaire…

Refugee experiences of general practice in countries of resettlement: a literature review.

PubMed

Cheng, I-Hao; Drillich, Ann; Schattner, Peter

2015-03-01

Refugees and asylum seekers often struggle to use general practice services in resettlement countries. To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement. Literature review using systematic search and narrative data extraction and synthesis methodologies. International, peer-reviewed literature published in English language between 1990 and 2013. Embase, Ovid MEDLINE, PsycINFO, CSA Sociological Abstracts, and CINAHL databases were searched using the terms: refugee, asylum seeker, experience, perception, doctor, physician, and general practitioner. Titles, abstracts and full texts were reviewed and were critically appraised. Narrative themes describing the refugee or asylum seeker's personal experiences of general practice services were identified, coded, and analysed. From 8722 papers, 85 were fully reviewed and 23 included. These represented the experiences of approximately 864 individuals using general practice services across 11 countries. Common narrative themes that emerged were: difficulties accessing general practice services, language barriers, poor doctor-patient relationships, and problems with the cultural acceptability of medical care. The difficulties refugees and asylum seekers experience accessing and using general practice services could be addressed by providing practical support for patients to register, make appointments, and attend services, and through using interpreters. Clinicians should look beyond refugee stereotypes to focus on the needs and expectations of the individual. They should provide clear explanations about unfamiliar clinical processes and treatments while offering timely management. © British Journal of General Practice 2015.

Australasian haematologist referral patterns to palliative care: lack of consensus on when and why.

PubMed

Auret, K; Bulsara, C; Joske, D

2003-12-01

Patients with haematological malignancies are not referred to palliative care services as frequently as those with solid cancers (non-haematological malignancies). The present study surveyed haematologists in Australia and New Zealand. We aimed to record theoretical referral times, identify problems with referral to palliative care and clarify elements used to decide whether a patient was "terminally ill". A questionnaire based on the case-histories of three patients (with acute leukaemia, lymphoma or multiple myeloma) was distributed at the Haematology Society of Australia and New Zealand Congress 2000, Perth, Australia. Each case was divided into stages by transitional points in the illness to include issues or prognostic variables that may stimulate referral to palliative care. Questions were asked about: (i) referral-triggers, (ii) problems previously experienced, (iii) definition of when the patient was "terminally ill", (iv) prognostication difficulties and (v) communication about prognosis. The response rate was 11%, which may represent up to 32% of Australian specialists. Eighty per cent had access to all types of palliative care services and refer for symptom control, regardless of illness stage. Twenty-nine per cent had experienced difficulties in referring. There was a variation as to exactly when referral would occur and when each case was considered "terminally ill". Reasons for early or later referral were explored. Prognostication difficulties were common. In theory there is a willingness to refer to palliative care, however this has yet to be translated to day-to-day practice. This may be due to prognostication difficulties, logistical factors and medical concerns. Models of referral are suggested for further study.

Australian employer usage of the practice of offering reduced working hours to workers close to retirement: Extent and determinants.

PubMed

Taylor, Philip; Earl, Catherine; McLoughlin, Christopher

2016-06-01

This study aimed to determine factors associated with the implementation by employers of the practice of offering reduced working hours for workers nearing retirement. Data came from a survey of 2000 employers of more than 50 employees each (30% response rate). A minority (33%) of employers offered reduced working hours to older workers nearing retirement. Factors associated with offering reduced working hours were: expecting workforce ageing to cause a loss of staff to retirement; being a large employer; being a public/not-for-profit sector employer; not experiencing difficulties recruiting labourers; having a larger proportion of workers aged over 50; experiencing national competition for labour; not experiencing difficulties recruiting machinery operators/drivers; not expecting workforce ageing to increase workplace injuries; and experiencing difficulties with the quality of candidates. A minority of employers were found to offer reduced working hours to those nearing retirement. Factors associated with their propensity to do so included industry sector, size of employer, concerns about labour supply and the effects of workforce ageing. © 2016 AJA Inc.

What Do Romanian Teachers Know about Learning Difficulties

ERIC Educational Resources Information Center

Pop, Cristina Florina; Ciascai, Liliana

2013-01-01

There is a growing concern for students with learning difficulties and teachers are responsible for identifying and helping these students. The present study aims to explore the teachers' knowledge of manifestations, causes and types of learning difficulties, necessary to diagnose, prevent or remedy learning difficulties. The participants involved…

Indicators of Late Emerging Reading-Accuracy Difficulties in Australian Schools

ERIC Educational Resources Information Center

Galletly, Susan A.; Knight, Bruce Allen; Dekkers, John; Galletly, Tracey A.

2009-01-01

Late-emerging reading-accuracy difficulties are those found present in older students not showing reading-accuracy difficulties when tested in earlier years (Leach, Scarborough and Rescorla, 2003). This paper discusses the constructs of reading-accuracy and late-emerging reading-accuracy difficulties. It then discusses data from a cross-sectional…

Factors associated with difficulty achieving initial control with crotalidae polyvalent immune fab antivenom in snakebite patients.

PubMed

Yin, Shan; Kokko, Jamie; Lavonas, Eric; Mlynarchek, Sara; Bogdan, Greg; Schaeffer, Tammi

2011-01-01

The prescribing information for Crotalidae Fab antivenom (FabAV) instructs clinicians to administer FabAV until initial control of the envenomation syndrome is achieved. Risk factors for difficulty achieving initial control are not known. The study aim was to identify factors present before administration of antivenom associated with difficulty achieving initial control. The authors conducted a retrospective study of all patients presenting to any one of 17 centers and receiving FabAV from 2002 to 2004. Demographic and historical information, as well as data about nine specific venom effects, were collected prior to the administration of antivenom. An expert panel used standard criteria to determine if initial control was achieved. The patient group that had difficulty achieving initial control was compared to the group that achieved initial control, and adjusted odds ratios were calculated using stepwise logistic regression. A total of 247 patients were included in the final analysis. The majority of patients were envenomated on the upper extremity and were young males. A total of 203 patients (82.2%) achieved initial control. In univariate analysis, thrombocytopenia, bleeding, neurologic effects, and a severe bite were significantly associated with difficulty achieving initial control. After logistic regression, the presence of neurologic effects and thrombocytopenia remained significantly associated with difficulty achieving initial control. When both factors were present, the patient was 13.8 times more likely to have difficulty achieving initial control. A number of factors were present before the administration of FabAV that were independently associated with difficulty achieving initial control of the envenomation syndrome. Predicting which patients will have difficulty achieving initial control has important ramifications for patient disposition and may provide insight into the mechanisms for lack of antivenom efficacy. © 2010 by the Society for Academic Emergency Medicine.

Essential therapeutics skills required of junior doctors.

PubMed

Baldwin, Mathew J; Abouyannis, Michael; Butt, Tehreem F

2012-12-01

Junior doctors are responsible for the majority of in-hospital prescription errors. Little research has explored their confidence to prescribe, or practical therapeutics related tasks which they are required to perform in day-to-day practice. This survey aimed to explore these areas, gather feedback regarding therapeutics teaching at undergraduate level, and to apply findings to undergraduate training at University of Birmingham. Questionnaire-based survey of all first-year postgraduate doctors (PG1) attending teaching hospitals in the Birmingham and Worcester regions towards the end of the PG1 year. Doctors were asked about difficulties in prescribing, satisfaction with undergraduate training, and how frequently they undertook particular tasks pertaining to therapeutics. Qualitative data on suggestions for improving the curriculum were also collected. Difficulties were commonly encountered with prescribing warfarin, controlled drugs and syringe-driven drugs. Most (87.4 %) had been required to administer intravenous medications. Nearly all had prescribed to 'special groups' such as the elderly (100 %) and patients with renal disease (98.3 %). Thirty-seven percent were not satisfied with their undergraduate therapeutics teaching, and many (56.2 %) recommended making teaching more relevant to clinical practice. Many PG1s expressed difficulties in prescribing potentially dangerous medications. Although better than other UK surveys, significant numbers were not satisfied with undergraduate teaching. The strong opinion was for teaching to become more practical and more relevant. Prescriptions which PG1s are commonly asked to write have been described. Findings have guided improvements to undergraduate teaching and assessment in therapeutics at the University of Birmingham, and may offer guidance to other medical schools.

Patient anxiety and surgical difficulty in impacted lower third molar extractions: a prospective cohort study.

PubMed

Aznar-Arasa, L; Figueiredo, R; Valmaseda-Castellón, E; Gay-Escoda, C

2014-09-01

Encountering patients who are fearful and anxious is common in dental practice and these factors can increase the complexity of dental procedures. A prospective cohort study was performed to assess whether patient anxiety influences the difficulty of impacted lower third molar extraction and to identify other predictive factors of surgical difficulty; 102 extractions done under local anaesthesia were assessed. Several preoperative variables were recorded (demographic, anatomical, and surgical) and patient anxiety was assessed through the use of various questionnaires. Extraction difficulty was measured using the operation time (OT) and a 100-mm visual analogue scale (difficulty VAS) completed by the surgeon. Patients with deep impacted third molars that required bone removal and tooth sectioning showed higher levels of preoperative anxiety. Significant correlations were found between questionnaire scores and the surgical difficulty (OT and difficulty VAS). OT was also related to age, depth of impaction, third molar angulations, proximity of the third molar roots to the mandibular canal, hard and soft tissue coverage, and the need to perform an ostectomy and tooth sectioning. Impacted lower third molar extraction is significantly more difficult in anxious patients. Other demographic, radiological, and surgical factors were also found to be significantly related to the surgical difficulty. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A Telescope at the Solar Gravitational Lens: Problems and Solutions

NASA Technical Reports Server (NTRS)

Landis, Geoffrey A.

2017-01-01

Due to the bending of light by gravity, the gravity of sun forms a lens. In principle, a spacecraft sent to the distance of the solar gravitational focus could be used as a gravitational lens telescope. One example of such a mission would be to use the gravitational lens to image an extrasolar planet around a nearby star. The practical difficulties with this concept are discussed, and some approaches to mitigating these difficulties suggested.

Adapting to conversation with semantic dementia: using enactment as a compensatory strategy in everyday social interaction

PubMed Central

Kindell, Jacqueline; Sage, Karen; Keady, John; Wilkinson, Ray

2014-01-01

Background Studies to date in semantic dementia have examined communication in clinical or experimental settings. There is a paucity of research describing the everyday interactional skills and difficulties seen in this condition. Aims To examine the everyday conversation, at home, of an individual with semantic dementia. Methods & Procedures A 71-year-old man with semantic dementia and his wife were given a video camera and asked to record natural conversation in the home situation with no researcher present. Recordings were also made in the home environment, with the individual with semantic dementia in conversation with a member of the research team. Conversation analysis was used to transcribe and analyse the data. Recurring features were noted to identify conversational patterns. Outcomes & Results Analysis demonstrated a repeated practice by the speaker with semantic dementia of acting out a diversity of scenes (enactment). As such, the speaker regularly used direct reported speech along with paralinguistic features (such as pitch and loudness) and non-vocal communication (such as body posture, pointing and facial expression) as an adaptive strategy to communicate with others in conversation. Conclusions & Implications This case shows that while severe difficulties may be present on neuropsychological assessment, relatively effective communicative strategies may be evident in conversation. A repeated practice of enactment in conversation allowed this individual to act out, or perform what he wanted to say, allowing him to generate a greater level of meaningful communication than his limited vocabulary alone could achieve through describing the events concerned. Such spontaneously acquired adaptive strategies require further attention in both research and clinical settings in semantic dementia and analysis of interaction in this condition, using conversation analysis, may be helpful. PMID:24033649

Why do we pay? A national survey of investigators and IRB chairpersons

PubMed Central

Ripley, Elizabeth; Macrina, Francis; Markowitz, Monika; Gennings, Chris

2011-01-01

The principle that payment to participants should not be undue or coercive is the consensus of international and national guidelines and ethical debates; however, what this means in practice is unclear. This study determined the attitudes and practices of IRB chairpersons and investigators regarding participant payment. One thousand six hundred investigators and 1900 IRB chairpersons received an invitation to participate in a web-based survey. Four hundred and fifty-five investigators (28.3%) and 395 IRB chairpersons (18.6%) responded. The survey was designed to gather considerations that govern payment determination and practical application of these considerations in hypothetical case studies. The survey asked best answer, multiple choice, and open text questions. Short hypothetical case scenarios where presented, and participants were asked to rate factors in the study that might impact payment and then determine their recommended payment. A predictive model was developed for each case to determine factors which affected payment. Although compensation was the primary reason given to justify payment by both investigators and IRB chairpersons, the cases suggested that, in practice, payment is often guided by incentive, as shown by the impact of anticipated difficulty recruiting, inconvenience, and risk in determining payment. Payment models varied by type of study. Ranges for recommended payments by both groups for different types of procedures and studies are presented. PMID:20831420

The Effects of Varying Ratios of Physical and Mental Practice, and Task Difficulty on Performance of a Tonal Pattern

ERIC Educational Resources Information Center

Cahn, Dan

2008-01-01

Sixty undergraduate students who had completed at least one semester of jazz improvisation were assigned to either: (a) physical practice (PP); (b) mental practice (MP); (c) combined 66 percent PP and 33 percent MP (66%PP:33%MP); and (d) combined 33 percent PP and 66 percent MP (33%PP:66%MP) groups. Subjects were to perform a 3-1-7-5 tonal pattern…

Refugee experiences of general practice in countries of resettlement: a literature review

PubMed Central

Cheng, I-Hao; Drillich, Ann; Schattner, Peter

2015-01-01

Background Refugees and asylum seekers often struggle to use general practice services in resettlement countries. Aim To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement. Design and setting Literature review using systematic search and narrative data extraction and synthesis methodologies. International, peer-reviewed literature published in English language between 1990 and 2013. Method Embase, Ovid MEDLINE, PsycINFO, CSA Sociological Abstracts, and CINAHL databases were searched using the terms: refugee, asylum seeker, experience, perception, doctor, physician, and general practitioner. Titles, abstracts and full texts were reviewed and were critically appraised. Narrative themes describing the refugee or asylum seeker’s personal experiences of general practice services were identified, coded, and analysed. Results From 8722 papers, 85 were fully reviewed and 23 included. These represented the experiences of approximately 864 individuals using general practice services across 11 countries. Common narrative themes that emerged were: difficulties accessing general practice services, language barriers, poor doctor–patient relationships, and problems with the cultural acceptability of medical care. Conclusion The difficulties refugees and asylum seekers experience accessing and using general practice services could be addressed by providing practical support for patients to register, make appointments, and attend services, and through using interpreters. Clinicians should look beyond refugee stereotypes to focus on the needs and expectations of the individual. They should provide clear explanations about unfamiliar clinical processes and treatments while offering timely management. PMID:25733438

Online research article discussion board to increase knowledge translation during emergency medicine residency.

PubMed

Stoneking, Lisa R; Grall, Kristi H; Min, Alice A; Panchal, Ashish R

2013-01-01

Many clinicians have difficulties reading current best practice journal articles on a regular basis. Discussion boards are one method of online asynchronous learning that facilitates active learning and participation. We hypothesized that an online repository of best practice articles with a discussion board would increase journal article reading by emergency medicine residents. PARTICIPANTS ANSWERED THREE QUESTIONS WEEKLY ON A DISCUSSION BOARD: What question does this study address? What does this study add to our knowledge? How might this change clinical practice? A survey regarding perceived barriers to participating was then distributed. Most participants completed an article summary once or twice in total (23/32, 71.9%). Only three were involved most weeks (3/32, 9.4%) whereas 5/32 (15.6%) participated monthly. The most common barriers were lack of time (20/32, 62.5%), difficulty logging on (7/32, 21.9%), and forgetting (6/32, 18.8%). Although subjects were provided weekly with an article link, email, and feedback, journal article reading frequency did not increase.

JPRS Report, East Europe.

DTIC Science & Technology

1987-09-23

economic impact . Here, the cooperation of specialists from research institutes is required. c) Practice has shown that not...recording the national economic impact is the determination of the applicability area and the applicability volume. Here, in practice, repeated difficulties...68 68 Dascalescu Speech, by Constantin Dascalescu Olteanu Speech, by Constantin Olteanu Defense Minister’s Order of the Day, by Vasile Milea

Novice Supervisors' Practices and Dilemmatic Space in Supervision of Student Research Projects

ERIC Educational Resources Information Center

Vereijken, Mayke W. C.; van der Rijst, Roeland M.; van Driel, Jan H.; Dekker, Friedo W.

2018-01-01

Growing interest in student research projects in higher education has led to an emphasis on research supervision. We focus in this study on novice supervisors' approaches to research supervision as they explore their practices and experience difficulties supervising medical-students. Teacher noticing was used as a sensitising concept and relations…

Medical Students as Patients: A Pilot Study of Their Health Care Needs, Practices, and Concerns.

ERIC Educational Resources Information Center

Roberts, Laura Weiss; And Others

1996-01-01

Examined the health care needs, practices, insurance status, and concerns of 112 medical students, finding that one-third had informally requested prescriptions or diagnostic tests from medical school faculty and housestaff, and that women more often reported difficulty obtaining health care than men. The majority of students preferred to avoid…

Practice Brief: Assessing Compensatory Strategies and Motivational Factors in High-Achieving Postsecondary Students with Attention Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Schaffer, Gary

2013-01-01

Research speculates that high-achieving college students with attention deficit/hyperactivity disorder (ADHD) may demonstrate a set of compensatory strategies and experience areas of difficulty and motivational factors that differ from the general ADHD populace. This Practice Brief used informal surveys with seven undergraduates with ADHD who had…

Improving the Efficiency of Problem-Solving Practice for Children with Retrieval Difficulties

ERIC Educational Resources Information Center

Hopkins, Sarah; de Villiers, Celeste

2016-01-01

Despite the importance placed on how children come to solve single-digit addition problems, many children count on to solve these problems when they are expected to use accurate retrieval-based strategies. In this study, we assessed if a subitising intervention improved the rate at which problem-solving practice promoted retrieval, using a…

A Well-Started Beginning Elementary Teacher's Beliefs and Practices in Relation to Reform Recommendations about Inquiry-Based Science

ERIC Educational Resources Information Center

Avraamidou, Lucy

2017-01-01

Given reform recommendations emphasizing scientific inquiry and empirical evidence pointing to the difficulties beginning teachers face in enacting inquiry-based science, this study explores a well-started beginning elementary teacher's (Sofia) beliefs about inquiry-based science and related instructional practices. In order to explore Sofia's…

Do the Effects of Computer-Assisted Practice Differ for Children with Reading Disabilities with and without IQ-Achievement Discrepancy?

ERIC Educational Resources Information Center

Jimenez, Juan E.; Ortiz, Maria del Rosario; Rodrigo, Mercedes; Hernandez-Valle, Isabel; Ramirez, Gustavo; Estevez, Adelina; O'Shanahan, Isabel; Trabaue, Maria de la Luz

2003-01-01

A study assessed whether the effects of computer-assisted practice on visual word recognition differed for 73 Spanish children with reading disabilities with or without aptitude-achievement discrepancy. Computer-assisted intervention improved word recognition. However, children with dyslexia had more difficulties than poor readers during…

Developing Successful Collaborative Working Practices for Children with Speech and Language Difficulties: A Pilot Study

ERIC Educational Resources Information Center

Paradice, Ruth; Bailey-Wood, Nicola; Davies, Kate; Solomon, Marion

2007-01-01

The importance of collaborative practice between those who provide services to children with special educational needs is now regarded as essential and is supported strongly by the UK government. However, joint working is often difficult to implement, despite the goodwill of all involved. This paper describes a pilot study aimed at developing…

Instrumentation Methodology for Automobile Crash Testing

DOT National Transportation Integrated Search

1974-08-01

Principal characteristics of existing data acquisition practices and instrumentation methodologies have been reviewed to identify differences which are responsible for difficulties in comparing and interpreting structural crash test data. Recommendat...

Psychosocial and professional characteristics of burnout in Swiss primary care practitioners: a cross-sectional survey.

PubMed

Goehring, Catherine; Bouvier Gallacchi, Martine; Künzi, Beat; Bovier, Patrick

2005-02-19

To measure the prevalence of burnout and explore its professional and psychosocial predictors among Swiss primary care practitioners. A cross-sectional postal survey was conducted to measure burnout, work-related stressors, professional and psychosocial characteristics among a representative sample of primary care practitioners. Answers to the Maslach burnout inventory were used to categorize respondents into moderate and high degree of burnout. 1784 physicians responded to the survey (65% response rate) and 1755 questionnaires could be analysed. 19% of respondents had a high score for emotional exhaustion, 22% had a high score for depersonalisation/cynicism and 16% had a low score for professional accomplishment; 32% had a high score on either the emotional exhaustion or the depersonalisation/cynicism scale (moderate degree of burnout) and 4% had scores in the range of burnout in all three scales (high degree of burnout). Predictors of moderate burnout were male sex, age 45-55 years and excessive perceived stress due to global workload, health-insurance-related work, difficulties to balance professional and private life, changes in the health care system and medical care uncertainty. A high degree of burnout was associated with male sex, practicing in a rural area, and excessive perceived stress due to global workload, patient's expectations, difficulties to balance professional and private life, economic constraints in relation to the practice, medical care uncertainty and difficult relations with non-medical staff at the practice. About one third of Swiss primary care practitioners presented a moderate or a high degree of burnout, which was mainly associated with extrinsic work-related stressors. Medical doctors and politicians in charge of redesigning the health care system should address this phenomenon to maintain an efficient Swiss primary care physician workforce in the future.

The direct support workforce in community supports to individuals with developmental disabilities: issues, implications, and promising practices.

PubMed

Hewitt, Amy; Larson, Sheryl

2007-01-01

Difficulties in finding, keeping, and ensuring the competence of the direct support workforce in community developmental disability services has long been a challenge for individuals, families, providers, and policy makers. Direct support staff recruitment, retention, and competence are widely reported as one of the most significant barriers to the sustainability, growth, and quality of community services for people with developmental disabilities (ANCOR [2001] State of the states report. Alexandria, VA: ANCOR; Colorado Department of Human Services, [2000] Response to Footnote 106 of the FY 2001 appropriations long bill: Capacity of the community services systems for persons with developmental disabilities in Colorado; Hewitt [2000] Dynamics of the workforce crisis. Presentation at the NASDDDS Fall meeting. Alexandria, VA). While long in existence, these challenges are ones of growing concern because the number of people demanding community services is increasing and the population of people from which to recruit workers is declining (Office of the Assistant Secretary for Planning and Evaluation [2006] The supply of direct support professionals serving individuals with intellectual disabilities and other developmental disabilities: Report to Congress. Washington, DC: Office of Disability, Aging and Long-Term Care Policy, ASPE, U.S. Department of Health and Human Services). As the service system moves towards consumer direction, managed care, and more noncategorical service delivery systems, the difficulties of providing for an adequate and well-prepared workforce to support people with developmental disabilities becomes more complex and multifaceted. The solutions to those challenges are also more complex. This article reviews the literature regarding the complexity of the direct support workforce crisis, the effects of this crisis on various stakeholder groups, promising practices designed to address the challenges, and the related practice and policy implications. (c) 2007 Wiley-Liss, Inc.

Fundamental challenges for autism research: the science-practice gap, demarcating autism and the unsuccessful search for the neurobiological basis of autism.

PubMed

Verhoeff, Berend

2015-08-01

One of the central aims of autism research is to identify specific neurodevelopmental mechanisms that cause and explain the visible autistic signs and symptoms. In this short paper, I argue that the persistent search for autism-specific pathophysiologies has two fundamental difficulties. The first regards the growing gap between basic autism science and clinical practice. The second regards the difficulties with demarcating autism as a psychiatric condition. Instead of the unremitting search for the neurobiological basis of autism, I suggest that basic autism research should focus on experiences of impairment and distress, and on how these experiences relate to particular (autistic) behaviors in particular circumstances, regardless of whether we are dealing with an autism diagnosis or not.

Writing Process Products in Intermediate-Grade Children With and Without Language-Based Learning Disabilities.

PubMed

Koutsoftas, Anthony D

2016-12-01

Difficulties with written expression are an important consideration in the assessment and treatment of school-age children. This study evaluated how intermediate-grade children with and without written language difficulties fared on a writing task housed within the Hayes and Berninger (2014) writing process framework. Sixty-four children completed a writing task whereby they planned, wrote, and revised a narrative story across 3 days. Children had extended time to produce an outline, first draft, and final copy of their story. Language transcription approaches were used to obtain measures reflecting writing productivity, complexity, accuracy, and mechanics, in addition to measures of planning and revision. Results indicated that children with writing difficulties produced poorer quality stories compared with their peers yet were not significantly different across all measures. Children with typical development produced longer stories with better spelling accuracy. Writing process measures predicted significant amounts of variance in writing quality across the sample. Writing should be considered as part of language assessment and intervention, whether as the sole language difficulty or alongside difficulties with speaking, listening, or reading in children with language-based learning difficulties. Implications for translation of research to practice and service delivery are provided.

Communication difficulties and strategies used by the nurses and their team in caring for the hearing impaired.

PubMed

Britto, Fernanda da Rocha; Samperiz, Maria Mercedes Fernandez

2010-03-01

To identify communication difficulties faced by the nursing staff and to learn the strategies developed for non-oral communication. This is a descriptive, exploratory, level I study with a quantitative approach. The sample group comprised 37 registered nurses and 63 licensed practical nurses of a private hospital who, after undergoing the ethical-legal procedures, answered a questionnaire to identify difficulties faced and strategies used in the care for hearing-impaired patients. Difficulty in explaining matters of interest to the patient was reported by 66% of professionals; and 32% reported difficulties in understanding patients in their way of communicate. The strategy adopted by 100% of respondents was mimicry, followed by lip reading, used by 94% of respondents; help from a person accompanying the patient was used by 65%, and written communication by 42% of respondents. Only 1% used communication via the Brazilian Sign Language (LIBRAS). The difficulties found and the strategies adopted by the nursing staff in communicating with hearing-impaired patients justify the need to train these professionals to deliver a more humanized care, developing a more inclusive society for those with special needs.

Taking personal responsibility: Nurses' and assistant nurses' experiences of good nursing practice in psychiatric inpatient care.

PubMed

Gabrielsson, Sebastian; Sävenstedt, Stefan; Olsson, Malin

2016-10-01

Therapeutic nurse-patient relationships are considered essential for good nursing practice in psychiatric inpatient care. Previous research suggests that inpatient care fails to fulfil patients' expectations in this regard, and that nurses might experience the reality of inpatient care as an obstruction. The aim of the present study was to explore nurses' and assistant nurses' experiences of good nursing practice in the specific context of psychiatric inpatient care. Qualitative interviews were conducted with 12 skilled, relationship-oriented nurses and assistant nurses in order to explore their experiences with nursing practice related to psychiatric inpatient care. Interviews were transcribed and analysed using an interpretive descriptive approach. Findings describe good nursing practice as a matter of nurses and assistant nurses taking personal responsibility for their actions and for the individual patient as a person. Difficulties in providing dignified nursing care and taking personal responsibility cause them to experience feelings of distress and frustration. Shared values and nursing leadership supports being moral and treating patients with respect, having enough time supports being present and connecting with patients, and working as a part of a competent team with critical daily discussions and diversity supports being confident and building trust. The findings suggest that taking personal responsibility is integral to good nursing practice. If unable to improve poor circumstances, nurses might be forced to promote their own survival by refuting or redefining their responsibility. Nurses need to prioritize being with patients and gain support in shaping their own nursing practice. Nursing leadership should provide moral direction and defend humanistic values. © 2016 Australian College of Mental Health Nurses Inc.

Attitudes of Nigerian physicians toward a National Health Service.

PubMed

Umeh, J C; Freeman, R A; Garner, D D; Blevins, D E

1986-01-01

Despite efforts to improve health services in Nigeria, considerable problems in distribution and access persist. At present, the health care system in Nigeria is organized and financed at the states' level rather than at the national level. A severe maldistribution of resources exists, as does a lack of coordination among states. An alternative system, albeit expensive, is a National Health Service (NHS). The purpose of this research is to quantify physicians' attitudes towards the concept of NHS. Although physicians in Nigeria are mandated to provide government-funded support, a substantial private practice thrives. Accordingly, physicians' attitudes that may be transferred into behavior are a major determinate of a potential NHS' long term success. In summary, Hausa physicians from the north tended to be more favorable to NHS than did others. Also, younger physicians and those who believed Nigeria's present system to be inadequate favored NHS. There was no association between a physician's gender, locus of medical education, and source of support for medication education and attitude. Finally, physicians in private practice and those in urban areas held more negative attitudes. In spite of Nigeria's present difficulties, a NHS may become a viable alternative. At this point, the overall concept is not opposed by physicians.

The effects of concurrent cognitive tasks on postural sway in healthy subjects.

PubMed

Mujdeci, Banu; Turkyilmaz, Didem; Yagcioglu, Suha; Aksoy, Songul

2016-01-01

Keeping balance of the upright stance is a highly practiced daily task for healthy adults and is effectively performed without overt attentional control in most. The purpose of this study was to examine the influence of concurrent cognitive tasks on postural sway in healthy participants. This was a prospective study. 20 healthy volunteer subjects were included. The cognitive and balance tasks were performed separately and then, concurrently. Postural control task consisted of 6 conditions (C) of the Sensory Organization Test. The cognitive task consisted of digit rehearsal task of varying presentation and varying levels of difficulty. A statistically significant difference was noted between dual task and no task for C1, C2, C3 and C4 Sensory Organization Test scores (p<0.05). There was no statistically significant difference between dual task versus non-task for C5, C6 and combined Sensory Organization Test scores (p>0.05). During dual task, increase has been determined in postural sway for C1, C2, C3 and C4 for all presentation modes and difficulty levels of the cognitive tasks. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Auditory evoked potentials in children and adolescents with Down syndrome.

PubMed

Gregory, Letícia; Rosa, Rafael F M; Zen, Paulo R G; Sleifer, Pricila

2018-01-01

Down syndrome, or trisomy 21, is the most common genetic alteration in humans. The syndrome presents with several features, including hearing loss and changes in the central nervous system, which may affect language development in children and lead to school difficulties. The present study aimed to investigate group differences in the central auditory system by long-latency auditory evoked potentials and cognitive potential. An assessment of 23 children and adolescents with Down syndrome was performed, and a control group composed of 43 children and adolescents without genetic and/or neurological changes was used for comparison. All children underwent evaluation with pure tone and vocal audiometry, acoustic immitance measures, long-latency auditory evoked potentials, and cognitive potential. Longer latencies of the waves were found in the Down syndrome group than the control group, without significant differences in amplitude, suggesting that individuals with Down syndrome have difficulty in discrimination and auditory memory. It is, therefore, important to stimulate and monitor these children in order to enable adequate development and improve their life quality. We also emphasize the importance of the application of auditory evoked potentials in clinical practice, in order to contribute to the early diagnosis of hearing alterations and the development of more research in this area. © 2017 Wiley Periodicals, Inc.

Students' Perceptions on an Interprofessional Ward Round Training - A Qualitative Pilot Study.

PubMed

Nikendei, C; Huhn, D; Pittius, G; Trost, Y; Bugaj, T J; Koechel, A; Schultz, J-H

2016-01-01

Ward rounds are an essential activity for interprofessional teams in hospital settings and represent complex tasks requiring not only medical knowledge but also communication skills, clinical technical skills, patient management skills and team-work skills. The present study aimed to analyse final year students', nurses' as well as physiotherapists' views on a simulation-based interprofessional ward round training. In two successive passes a total number of 29 final year students, nursing students and physiotherapy students (16 in the first run, 13 in the second) volunteered to participate in two standardized patient ward round scenarios: (1) patient with myocardial infarction, and (2) patient with poorly controlled diabetes. Views on the interprofessional ward round training were assessed using focus groups. Focus group based feedback contained two main categories (A) ward round training benefits and (B) difficulties. Positive aspects enfolded course preparation, setting of the training, the involvement of the participants during training and the positive learning atmosphere. Difficulties were seen in the flawed atmosphere and realization of ward rounds in the daily clinical setting with respect to inter-professional aspects, and course benefit for the different professional groups. The presented inter-professional ward round training represents a well received and valuable model of interprofessional learning. Further research should assess its effectiveness, processes of interprofessional interplay and transfer into clinical practice.

Standards-Based Wireless Sensor Networking Protocols for Spaceflight Applications

NASA Technical Reports Server (NTRS)

Wagner, Raymond S.

2010-01-01

Wireless sensor networks (WSNs) have the capacity to revolutionize data gathering in both spaceflight and terrestrial applications. WSNs provide a huge advantage over traditional, wired instrumentation since they do not require wiring trunks to connect sensors to a central hub. This allows for easy sensor installation in hard to reach locations, easy expansion of the number of sensors or sensing modalities, and reduction in both system cost and weight. While this technology offers unprecedented flexibility and adaptability, implementing it in practice is not without its difficulties. Recent advances in standards-based WSN protocols for industrial control applications have come a long way to solving many of the challenges facing practical WSN deployments. In this paper, we will overview two of the more promising candidates - WirelessHART from the HART Communication Foundation and ISA100.11a from the International Society of Automation - and present the architecture for a new standards-based sensor node for networking and applications research.

Water supply pipe dimensioning using hydraulic power dissipation

NASA Astrophysics Data System (ADS)

Sreemathy, J. R.; Rashmi, G.; Suribabu, C. R.

2017-07-01

Proper sizing of the pipe component of water distribution networks play an important role in the overall design of the any water supply system. Several approaches have been applied for the design of networks from an economical point of view. Traditional optimization techniques and population based stochastic algorithms are widely used to optimize the networks. But the use of these approaches is mostly found to be limited to the research level due to difficulties in understanding by the practicing engineers, design engineers and consulting firms. More over due to non-availability of commercial software related to the optimal design of water distribution system,it forces the practicing engineers to adopt either trial and error or experience-based design. This paper presents a simple approach based on power dissipation in each pipeline as a parameter to design the network economically, but not to the level of global minimum cost.

The Impact of e-Customer Relationship Marketing in Hotel Industry

NASA Astrophysics Data System (ADS)

Samanta, Irene

The present research investigates the extent to which Greek hotels had developed the electronic customer relationship marketing (E-CRM). The study verifies the practices that frequently appear in relationship marketing process within online operations or whether their Internet presence mainly depends on the basic actions of "supplying information" and "reservations". Also, it investigates the effects of e-CRM system on customer loyalty and satisfaction as well as the impact of relationship marketing practices to customer retention and acquisition. They have understood the importance of using electronic channels instead of traditional ones to implement their marketing strategies. Thus, e-crm system has assisted hotel business to manage more effectively their reservations and serve their customers as fast and as effective as possible. They did not seem to apply many of the relationship marketing strategies to emphasize customer retention and continual satisfaction because of difficulties in staff training.

The Use and Abuse of Diagnostic/Classification Criteria

PubMed Central

June, Rayford R.; Aggarwal, Rohit

2015-01-01

In rheumatic diseases, classification criteria have been developed to identify well-defined homogenous cohorts for clinical research. Although, they are commonly used in clinical practice, their use may not be appropriate for routine diagnostic clinical care. Classification criteria are being revised with improved methodology and further understanding of disease pathophysiology, but still may not encompass all unique clinical situations to be applied for diagnosis of heterogeneous, rare, evolving rheumatic diseases. Diagnostic criteria development is challenging primarily due to difficulty for universal application given significant differences in prevalence of rheumatic diseases based on geographical area and clinic settings. Despite these shortcomings, the clinician can still use classification criteria for understanding the disease as well as a guide for diagnosis with a few caveats. We present the limits of current classification criteria, describe their use and abuse in clinical practice, and how they should be used with caution when applied in clinics. PMID:26096094

On mixed reality environments for minimally invasive therapy guidance: Systems architecture, successes and challenges in their implementation from laboratory to clinic

PubMed Central

Linte, Cristian A.; Davenport, Katherine P.; Cleary, Kevin; Peters, Craig; Vosburgh, Kirby G.; Navab, Nassir; Edwards, Philip “Eddie”; Jannin, Pierre; Peters, Terry M.; Holmes, David R.; Robb, Richard A.

2013-01-01

Mixed reality environments for medical applications have been explored and developed over the past three decades in an effort to enhance the clinician’s view of anatomy and facilitate the performance of minimally invasive procedures. These environments must faithfully represent the real surgical field and require seamless integration of pre- and intra-operative imaging, surgical instrument tracking, and display technology into a common framework centered around and registered to the patient. However, in spite of their reported benefits, few mixed reality environments have been successfully translated into clinical use. Several challenges that contribute to the difficulty in integrating such environments into clinical practice are presented here and discussed in terms of both technical and clinical limitations. This article should raise awareness among both developers and end-users toward facilitating a greater application of such environments in the surgical practice of the future. PMID:23632059

Are Externalizing and Internalizing Difficulties of Young Children with Spelling Impairment Related to Their ADHD Symptoms?

ERIC Educational Resources Information Center

Rietz, Chantal Sabrina; Hasselhorn, Marcus; Labuhn, Andju Sara

2012-01-01

Children with literacy difficulties often suffer from a variety of co-occurring externalizing and internalizing difficulties, as well as comorbid ADHD. Therefore, these externalizing and internalizing problems might be more related to comorbid ADHD, rather than being a correlate of literacy difficulties per se. In the present study, we…

Memory Abilities in Children with Mathematical Difficulties: Comorbid Language Difficulties Matter

ERIC Educational Resources Information Center

Reimann, Giselle; Gut, Janine; Frischknecht, Marie-Claire; Grob, Alexander

2013-01-01

The present study investigated cognitive abilities in children with difficulties in mathematics only (n = 48, M = 8 years and 5 months), combined mathematical and language difficulty (n = 27, M = 8 years and 1 month) and controls (n = 783, M = 7 years and 11 months). Cognitive abilities were measured with seven subtests, tapping visual perception,…

Psychiatry, subjectivity and emotion - deepening the medical model

PubMed Central

Yakeley, Jessica; Hale, Rob; Johnston, James; Kirtchuk, Gabriel; Shoenberg, Peter

2014-01-01

Morale among psychiatrists continues to be seriously challenged in the face of recruitment difficulties, unfilled posts, diagnostic controversies, service reconfigurations and public criticism of psychiatric care, in addition to other difficulties. In this article, we argue that the positivist paradigm that continues to dominate British psychiatry has led to an undervaluing of subjectivity and of the role of emotions within psychiatric training and practice. Reintegrating the subjective perspective and promoting emotional awareness and reflection may go some way towards restoring faith in the psychiatric specialty. PMID:25237517

Sick-listed employees with severe medically unexplained physical symptoms: burden or routine for the occupational health physician? A cross sectional study

PubMed Central

2010-01-01

Background The two primary objectives of this study were to the assess consultation load of occupational health physicians (OHPs), and their difficulties and needs with regard to their sickness certification tasks in sick-listed employees with severe medical unexplained physical symptoms (MUPS). Third objective was to determine which disease-, patient-, doctor- and practice-related factors are associated with the difficulties and needs of the OHPs. Methods In this cross-sectional study, 43 participating OHPs from 5 group practices assessed 489 sick-listed employees with and without severe MUPS. The OHPs filled in a questionnaire about difficulties concerning sickness certification tasks, consultation time, their needs with regard to consultation with or referral to a psychiatrist or psychologist, and communication with GPs. The OHPs also completed a questionnaire about their personal characteristics. Results OHPs only experienced task difficulties in employees with severe MUPS in relation to their communication with the treating physician. This only occured in cases in which the OHP attributed the physical symptoms to somatoform causes. If they attributed the physical symptoms to mental causes, the OHPs reported a need to consultate a psychiatrist about the diagnosis and treatment. Conclusions OHPs experience few difficulties with their sickness certification tasks and consultation load concerning employees with severe MUPS. However, they encounter problems if the diagnostic uncertainties of the treating physician interfere with the return to work process. OHPs have a need for psychiatric expertise whenever they are uncertain about the psychiatric causes of a delayed return to work process. We recommend further training programs for OHPs. They should also have more opportunity for consultation and referral to a psychiatrist, and their communication with treating physicians should be improved. PMID:21059232

[Use of midazolam in hospitalized patients: analysis of medical practice].

PubMed

Giroud, Mathilde; Sellier, Elodie; Laval, Guillemette

2013-09-01

To evaluate the prevalence and the characteristics of use of midazolam among hospitalized patients and to analyze physicians' representation of this medicine. We conducted a retrospective study between 1st May and 22nd May 2011 in Grenoble University Hospital in France. All patients receiving midazolam during the study period were included, excepted if the prescription was performed in intensive care units, operating rooms or in pediatric units. Physicians from the different units were asked about the characteristics of patients receiving midazolam and about their practice concerning the use of midazolam. Forty-four patients were included, 82 % of whom having a cancer. The prevalence of prescription of midazolam was 3.3 % (44/1,323), 2.8 % (37/1,323) for anxiety relieving and 0.8 % (11/1,323) for sedation. The main refractory symptoms that justified the prescription were dyspnea (36.4 %), confusion (29.5 %), pain (27.3 %) and psychological suffering (27.3 %). Twenty-eight physicians were asked about their practice. The main representations of midazolam were the stop of active treatment (46.5 %) and premature cause of death (46.5 %). Practice of sedation is under-estimated by physicians as they have difficulties to differentiate anxiety relieving and sedation and they have difficulties to initiate a sedation. A guideline to help physicians using midazolam could improve practice.

On the prevailing construction waste recycling practices: a South East Queensland study.

PubMed

Tam, Vivian W Y; Kotrayothar, Duangthidar; Loo, Yew-Chaye

2009-03-01

Waste generated from construction and building demolition work constitutes about 68% of all solid waste generated each year in South East Queensland. Consequently, it has created a serious waste management problem. The State Governments of Victoria and New South Wales have been encouraging the use of recycled materials from construction and related waste; they have also promulgated specifications for their use. In Queensland, however, similar regulations are not anticipated in the near future, which explains the lack of funded research conducted in this important arena. This paper presents an evaluation of the prevailing waste recycling practices in Queensland. Nine sites were visited, including two construction sites, three demolition sites, three recycling plants and one landfill in South East Queensland. The difficulties encountered by the recycling programme operators and their associates at these sites are described and the benefits of recycling construction materials are presented. One of the major barriers is that the local councils disallow the use of recycled materials in new construction work. To help rectify these impediments to recycling, recommendations are given to increase the use of recycled construction waste in South East Queensland.

Methodological problems with gamma-ray burst hardness/intensity correlations

NASA Technical Reports Server (NTRS)

Schaefer, Bradley E.

1993-01-01

The hardness and intensity are easily measured quantities for all gamma-ray bursts (GRBs), and so, many past and current studies have sought correlations between them. This Letter presents many serious methodological problems with the practical definitions for both hardness and intensity. These difficulties are such that significant correlations can be easily introduced as artifacts of the reduction procedure. In particular, cosmological models of GRBs cannot be tested with hardness/intensity correlations with current instrumentation and the time evolution of the hardness in a given burst may be correlated with intensity for reasons that are unrelated to intrinsic change in the spectral shape.

On inconsistency in frictional granular systems

NASA Astrophysics Data System (ADS)

Alart, Pierre; Renouf, Mathieu

2018-04-01

Numerical simulation of granular systems is often based on a discrete element method. The nonsmooth contact dynamics approach can be used to solve a broad range of granular problems, especially involving rigid bodies. However, difficulties could be encountered and hamper successful completion of some simulations. The slow convergence of the nonsmooth solver may sometimes be attributed to an ill-conditioned system, but the convergence may also fail. The prime aim of the present study was to identify situations that hamper the consistency of the mathematical problem to solve. Some simple granular systems were investigated in detail while reviewing and applying the related theoretical results. A practical alternative is briefly analyzed and tested.

Cryopyrin-associated periodic syndrome.

PubMed

Posch, Christian; Kaulfersch, Wilhelm; Rappersberger, Klemens

2014-01-01

Cryopyrin-associated periodic syndromes (CAPS) are characterized by apparently unprovoked attacks of fever, rashes, and musculoskeletal and sensorineural inflammation accompanied by high acute-phase reactants. Excessive interleukin-1 (IL-1) signaling appears to be a constant feature in the pathomechanism of the disease, driven by a gain-of-function mutation in the NLRP3 gene. Herein, we present the case of a 9-month-old boy with recurrent nonpruritic rashes and episodes of fever. The difficulties of early diagnosis due to initially mild clinical symptoms and the dramatic response to anti-IL-1 therapy after diagnosis emphasize the practical relevance of considering CAPS as a differential diagnosis in these patients. © 2012 Wiley Periodicals, Inc.

Emergency management of heat exchanger leak on cardiopulmonary bypass with hypothermia.

PubMed

Gukop, P; Tiezzi, A; Mattam, K; Sarsam, M

2015-11-01

Heat exchanger leak on cardiopulmonary bypass is very rare, but serious. The exact incidence is not known. It is an emergency associated with the potential risk of blood contamination, air embolism and haemolysis, difficulty with re-warming, acidosis, subsequent septic shock, multi-organ failure and death. We present a prompt, highly co-ordinated algorithm for the successful management of this important rare complication. There is need for further research to look for safety devices that detect leaks and techniques to reduce bacterial load. It is essential that teams practice oxygenator change-out routines and have a well-established change-out protocol. © The Author(s) 2015.

Effect of fuel density and heating value on ram-jet airplane range

NASA Technical Reports Server (NTRS)

Henneberry, Hugh M

1952-01-01

An analytical investigation of the effects of fuel density and heating value on the cruising range of a ram-jet airplane was made. Results indicate that with present-day knowledge of chemical fuels, neither very high nor very low fuel densities have any advantages for long-range flight. Of the fuels investigated, the borohydrides and metallic boron have the greatest range potential. Aluminum and aluminum hydrocarbon slurries were inferior to pure hydrocarbon fuel and boron-hydrocarbon slurries were superior on a range basis. It was concluded that the practical difficulties associated with the use of liquid hydrogen fuel cannot be justified on a range basis.

The effects of computer-assisted instruction on the mathematics performance and classroom behavior of children with ADHD.

PubMed

Mautone, Jennifer A; DuPaul, George J; Jitendra, Asha K

2005-08-01

The present study examines the effects of computer-assisted instruction (CAI) on the mathematics performance and classroom behavior of three second-through fourth-grade students with ADHD. A controlled case study is used to evaluate the effects of the computer software on participants' mathematics performance and on-task behavior. Participants' mathematics achievement improve and their on-task behavior increase during the CAI sessions relative to independent seatwork conditions. In addition, students and teachers consider CAI to be an acceptable intervention for some students with ADHD who are having difficulty with mathematics. Implications of these results for practice and research are discussed.

Free open access medical education can help rural clinicians deliver 'quality care, out there'.

PubMed

Leeuwenburg, Tim J; Parker, Casey

2015-01-01

Rural clinicians require expertise across a broad range of specialties, presenting difficulty in maintaining currency of knowledge and application of best practice. Free open access medical education is a new paradigm in continuing professional education. Use of the internet and social media allows a globally accessible crowd-sourced adjunct, providing inline (contextual) and offline (asynchronous) content to augment traditional educational principles and the availability of relevant resources for life-long learning. This markedly reduces knowledge translation (the delay from inception of a new idea to bedside implementation) and allows rural clinicians to further expertise by engaging in discussion of cutting edge concepts with peers worldwide.

The Relationship Between Technical Errors and Decision Making Skills in the Junior Resident

PubMed Central

Nathwani, J. N.; Fiers, R.M.; Ray, R.D.; Witt, A.K.; Law, K. E.; DiMarco, S.M.; Pugh, C.M.

2017-01-01

Objective The purpose of this study is to co-evaluate resident technical errors and decision-making capabilities during placement of a subclavian central venous catheter (CVC). We hypothesize that there will be significant correlations between scenario based decision making skills, and technical proficiency in central line insertion. We also predict residents will have problems in anticipating common difficulties and generating solutions associated with line placement. Design Participants were asked to insert a subclavian central line on a simulator. After completion, residents were presented with a real life patient photograph depicting CVC placement and asked to anticipate difficulties and generate solutions. Error rates were analyzed using chi-square tests and a 5% expected error rate. Correlations were sought by comparing technical errors and scenario based decision making. Setting This study was carried out at seven tertiary care centers. Participants Study participants (N=46) consisted of largely first year research residents that could be followed longitudinally. Second year research and clinical residents were not excluded. Results Six checklist errors were committed more often than anticipated. Residents performed an average of 1.9 errors, significantly more than the 1 error, at most, per person expected (t(44)=3.82, p<.001). The most common error was performance of the procedure steps in the wrong order (28.5%, P<.001). Some of the residents (24%) had no errors, 30% committed one error, and 46 % committed more than one error. The number of technical errors committed negatively correlated with the total number of commonly identified difficulties and generated solutions (r(33)= −.429, p=.021, r(33)= −.383, p=.044 respectively). Conclusions Almost half of the surgical residents committed multiple errors while performing subclavian CVC placement. The correlation between technical errors and decision making skills suggests a critical need to train residents in both technique and error management. ACGME Competencies Medical Knowledge, Practice Based Learning and Improvement, Systems Based Practice PMID:27671618

Atypical inter-hemispheric communication correlates with altered motor inhibition during learning of a new bimanual coordination pattern in developmental coordination disorder.

PubMed

Blais, Mélody; Amarantini, David; Albaret, Jean-Michel; Chaix, Yves; Tallet, Jessica

2018-05-01

Impairment of motor learning skills in developmental coordination disorder (DCD) has been reported in several studies. Some hypotheses on neural mechanisms of motor learning deficits in DCD have emerged but, to date, brain-imaging investigations are scarce. The aim of the present study is to assess possible changes in communication between brain areas during practice of a new bimanual coordination task in teenagers with DCD (n = 10) compared to matched controls (n = 10). Accuracy, stability and number of mirror movements were computed as behavioural variables. Neural variables were assessed by electroencephalographic coherence analyses of intra-hemispheric and inter-hemispheric fronto-central electrodes. In both groups, accuracy of the new coordination increased concomitantly with right intra-hemispheric fronto-central coherence. Compared to typically developing teenagers, DCD teenagers presented learning difficulties expressed by less stability, no stabilization of the new coordination and a greater number of mirror movements despite practice. These measures correlated with reduced inter-hemispheric communication, even after practice of the new coordination. For the first time, these findings provide neuro-imaging evidence of a kind of inter-hemispheric 'disconnection' related to altered inhibition of mirror movements during motor learning in DCD. © 2017 John Wiley & Sons Ltd.

Confronting shibboleths of dental education.

PubMed

Masella, Richard S

2005-10-01

Shibboleths are common expressions presented as indisputable truths. When used in educational discussions, they reflect "motherhood and apple pie" viewpoints and tend to bring debate to a halt. Use of shibboleths may precede a desired imposition of "locksteps" in educational programming and are easily perceived as paternalistic by recipients. Nine shibboleths are presented as common beliefs of dental faculty and administrators. Evidence contradicting the veracity of the "obvious truths" is offered. The traditional "splendid isolation" of dentistry contributes to parochialism and belief in false shibboleths. Sound principles of higher and health professions education, student learning, and dental practice apply to dental education as to all health disciplines. Student passivity in dental education is not the best preparation for proficiency in dental practice. The master teacher possesses a repertoire of methodologies specific to meeting defined educational objectives. Active learning experiences bear close resemblances to professional duties and responsibilities and internally motivate future doctors of dental medicine. The difficulty in achieving curricular change leads to curricular entrenchment. Dentistry and dental education should not trade their ethical high ground for the relatively low ethical standards of the business world. Principles of professional ethics should govern relationships between dentists, whether within the dental school workplace or in practice. Suggestions are made on how to confront shibboleths in dental school settings.

Contemporary understanding and management of reflux and constipation in the general population and pregnancy: a consensus meeting.

PubMed

Tytgat, G N; Heading, R C; Müller-Lissner, S; Kamm, M A; Schölmerich, J; Berstad, A; Fried, M; Chaussade, S; Jewell, D; Briggs, A

2003-08-01

Gastro-oesophageal reflux disease (GERD) and constipation have a major impact on public health; however, the wide variety of treatment options presents difficulties for recommending therapy. Lack of definitive guidelines in pharmacy and general practice medicine further exacerbates the decision dilemma. To address these issues, a panel of experts discussed the principles and practice of treating GERD and constipation in the general population and in pregnancy, with the aim of developing respective treatment guidelines. The panel recommended antacids 'on-demand' as the first-line over-the-counter treatment in reflux, and as rescue medication for immediate relief when reflux breaks through with proton pump inhibitors. Calcium/magnesium-based antacids were recommended as the treatment of choice for pregnant women because of their good safety profile. In constipation, current data do not distinguish a hierarchy between polyethylene glycol (PEG)-based laxatives and other first-line treatments, although limitations are associated with stimulant- and bulk-forming laxatives. Where data are available, PEG is superior to lactulose in terms of efficacy. In pregnancy, PEG-based laxatives meet the criteria for the ideal treatment. The experts developed algorithms that present healthcare professionals with clear treatment options and management strategies for GERD and constipation in pharmacy and general practice medicine.

A System Architecture for Efficient Transmission of Massive DNA Sequencing Data.

PubMed

Sağiroğlu, Mahmut Şamİl; Külekcİ, M Oğuzhan

2017-11-01

The DNA sequencing data analysis pipelines require significant computational resources. In that sense, cloud computing infrastructures appear as a natural choice for this processing. However, the first practical difficulty in reaching the cloud computing services is the transmission of the massive DNA sequencing data from where they are produced to where they will be processed. The daily practice here begins with compressing the data in FASTQ file format, and then sending these data via fast data transmission protocols. In this study, we address the weaknesses in that daily practice and present a new system architecture that incorporates the computational resources available on the client side while dynamically adapting itself to the available bandwidth. Our proposal considers the real-life scenarios, where the bandwidth of the connection between the parties may fluctuate, and also the computing power on the client side may be of any size ranging from moderate personal computers to powerful workstations. The proposed architecture aims at utilizing both the communication bandwidth and the computing resources for satisfying the ultimate goal of reaching the results as early as possible. We present a prototype implementation of the proposed architecture, and analyze several real-life cases, which provide useful insights for the sequencing centers, especially on deciding when to use a cloud service and in what conditions.

EHRs in primary care practices: benefits, challenges, and successful strategies.

PubMed

Goetz Goldberg, Debora; Kuzel, Anton J; Feng, Lisa Bo; DeShazo, Jonathan P; Love, Linda E

2012-02-01

To understand the current use of electronic health records (EHRs) in small primary care practices and to explore experiences and perceptions of physicians and staff toward the benefits, challenges, and successful strategies for implementation and meaningful use of advanced EHR functions. Qualitative case study of 6 primary care practices in Virginia. We performed surveys and in-depth interviews with clinicians and administrative staff (N = 38) and observed interpersonal relations and use of EHR functions over a 16-month period. Practices with an established EHR were selected based on a maximum variation of quality activities, location, and ownership. Physicians and staff report increased efficiency in retrieving medical records, storing patient information, coordination of care, and office operations. Costs, lack of knowledge of EHR functions, and problems transforming office operations were barriers reported for meaningful use of EHRs. Major disruption to patient care during upgrades and difficulty utilizing performance tracking and quality functions were also reported. Facilitators for adopting and using advanced EHR functions include team-based care, adequate technical support, communication and training for employees and physicians, alternative strategies for patient care during transition, and development of new processes and work flow procedures. Small practices experience difficulty with implementation and utilization of advanced EHR functions. Federal and state policies should continue to support practices by providing technical assistance and financial incentives, grants, and/or loans. Small practices should consider using regional extension center services and reaching out to colleagues and other healthcare organizations with similar EHR systems for advice and guidance.

Legal Rights of Asbestos Exposure Victims. A Practical Legal Guide for People With Breathing and Other Medical Problems, Possibly Resulting from Exposure to Asbestos.

ERIC Educational Resources Information Center

Silberfeld, Roman M.; Hecht, Richard L.

This practical legal guide for people with breathing and other medical problems, possibly resulting from exposure to asbestos, provides 19 questions and detailed answers about Asbestosis and other diseases resulting from asbestos exposure. Included is information concerning symptoms, difficulty of diagnosis, necessity of a detailed…

A Study of Dynamic Design Dualities in a Web-Supported Community of Practice for Teachers

ERIC Educational Resources Information Center

Baek, Eun-Ok; Barab, Sasha A.

2005-01-01

The concept of a community of practice (CoP) is prevalent in several venues for teachers' professional development, especially in online environments. However, there are few descriptive accounts that effectively represent a CoP in a manner that will be of use to other designers. In order to illuminate potential difficulties which may arise when…

The Challenges of Science Inquiry Teaching for Pre-Service Teachers in Elementary Classrooms: Difficulties on and under the Scene

ERIC Educational Resources Information Center

Yoon, Hye-Gyoung; Joung, Yong Jae; Kim, Mijung

2012-01-01

In the context of the emphasis on inquiry teaching in science education, this study looks into how pre-service elementary teachers understand and practice science inquiry teaching during field experience. By examining inquiry lesson preparation, practice, and reflections of pre-service elementary teachers, we attempt to understand the difficulties…

Critical Issues in the Evaluation of an International Project Dedicated to Technology-Mediated TBLT (PETALL)

ERIC Educational Resources Information Center

Lopes, António

2015-01-01

The CEFR encourages teachers to resort to task-based activities in the language classroom. However, some resistance has been offered to this approach, due to lack of appropriate training and difficulty in meeting some basic practical conditions, as well as in finding resources and examples of good practices, as shown in a survey conducted within…

Implementing quantum logic gates with gradient ascent pulse engineering: principles and practicalities.

PubMed

Rowland, Benjamin; Jones, Jonathan A

2012-10-13

We briefly describe the use of gradient ascent pulse engineering (GRAPE) pulses to implement quantum logic gates in nuclear magnetic resonance quantum computers, and discuss a range of simple extensions to the core technique. We then consider a range of difficulties that can arise in practical implementations of GRAPE sequences, reflecting non-idealities in the experimental systems used.

Therapeutic use of compression stockings for orthostatic hypotension: an assessment of patient and physician perspectives and practices.

PubMed

Quinn, Colin; Deegan, Brian; Cooke, John; Carew, Sheila; Hannigan, Ailish; Dunne, Colum; Lyons, Declan

2015-03-01

Elastic compression stockings (ECS) can be used as a non-pharmacological therapeutic option for older patients with orthostatic hypotension (OH). We aimed to investigate the practices and views of patients and physicians regarding the use of ECS for OH. Two surveys were designed. The first was sent to 90 patients known to have been prescribed ECS for OH. This questionnaire included items related to the frequency of use and issues related to non-compliance. The second was sent to 69 consultant physicians in geriatric medicine. This included items related to prescribing practices and perceived patient compliance. Sixty-seven patients responded (response rate, 74%) and of those 64% were female. Mean age (SD) was 75.1 years (10.5), range 45-91 years. Thirty-three per cent wore ECS daily, whereas 43% never used them. Over half (51%) of the patients reported difficulty in application and 31% reported discomfort. Those aged 75 or older were more likely to report difficulty in application (P=0.003). Forty-eight physicians responded (response rate, 70%). Eighty-nine per cent prescribe ECS for OH. There were significant differences between the frequency of use reported by patients and predicted by physicians (P<0.001), with physicians less likely to predict daily or non-use. Eighty-nine per cent of physicians predicted that difficulty in application was the main reason for non-compliance. Although prescribed frequently, the use of ECS in patients with OH is often limited by issues related to practicality. Physicians correctly predicted the main reasons for non-compliance although underestimated the scale of patient compliance with ECS. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Bridging scales in the evolution of infectious disease life histories: theory.

PubMed

Day, Troy; Alizon, Samuel; Mideo, Nicole

2011-12-01

A significant goal of recent theoretical research on pathogen evolution has been to develop theory that bridges within- and between-host dynamics. The main approach used to date is one that nests within-host models of pathogen replication in models for the between-host spread of infectious diseases. Although this provides an elegant approach, it nevertheless suffers from some practical difficulties. In particular, the information required to satisfactorily model the mechanistic details of the within-host dynamics is not often available. Here, we present a theoretical approach that circumvents these difficulties by quantifying the relevant within-host factors in an empirically tractable way. The approach is closely related to quantitative genetic models for function-valued traits, and it also allows for the prediction of general characteristics of disease life history, including the timing of virulence, transmission, and host recovery. In a companion paper, we illustrate the approach by applying it to data from a model system of malaria. © 2011 The Author(s). Evolution© 2011 The Society for the Study of Evolution.

Defective Number Sense or Impaired Access? Differential Impairments in Different Subgroups of Children With Mathematics Difficulties.

PubMed

Wong, Terry T-Y; Ho, Connie S-H; Tang, Joey

2017-01-01

Developmental dyscalculia (DD) is a specific learning disability in mathematics that affects around 6% of the population. Currently, the core deficit of DD remains unknown. While the number sense deficit hypothesis suggests that the core deficit of DD lies in the inability to represent nonsymbolic numerosity, the access deficit hypothesis suggests that the origin of this disability lies in the inability to associate numbers with the underlying magnitude representation. The present study compared the performance of DDs with their low-achieving (LA) and normally achieving peers in nonsymbolic numerosity processing and number-magnitude mapping over 1 year (from kindergarten to 1st grade). The results demonstrated differential impairments in different subgroups of children with mathematics difficulties. While DDs showed deficits in both nonsymbolic numerosity processing and number-magnitude mapping, LAs showed deficit only in the number-magnitude mapping. Furthermore, the deficit in number-magnitude mapping among the DD group was partially explained by their number sense deficit. The number sense deficit hypothesis is supported. Theoretical and practical implications are discussed. © Hammill Institute on Disabilities 2015.

Determination of NH proton chemical shift anisotropy with 14N-1H heteronuclear decoupling using ultrafast magic angle spinning solid-state NMR

NASA Astrophysics Data System (ADS)

Pandey, Manoj Kumar; Nishiyama, Yusuke

2015-12-01

The extraction of chemical shift anisotropy (CSA) tensors of protons either directly bonded to 14N nuclei (I = 1) or lying in their vicinity using rotor-synchronous recoupling pulse sequence is always fraught with difficulty due to simultaneous recoupling of 14N-1H heteronuclear dipolar couplings and the lack of methods to efficiently decouple these interactions. This difficulty mainly arises from the presence of large 14N quadrupolar interactions in comparison to the rf field that can practically be achieved. In the present work it is demonstrated that the application of on-resonance 14N-1H decoupling with rf field strength ∼30 times weaker than the 14N quadrupolar coupling during 1H CSA recoupling under ultrafast MAS (90 kHz) results in CSA lineshapes that are free from any distortions from recoupled 14N-1H interactions. With the use of extensive numerical simulations we have shown the applicability of our proposed method on a naturally abundant L-Histidine HCl·H2O sample.

Assessing Service Delivery Systems for Assitive Technology in Brazil using HEART Study quality indicators.

PubMed

Maximo, Tulio; Clift, Laurence

2015-01-01

recently in Brazil, there have been investments and improvements in the service delivery system for assistive technology provision. However, there is little documentation of this process, or evidence that users are being involved appropriately. to understand how a ssistive technology service provision currently functions in Belo Horizonte city, Brazil, in order to provide context-specific interventions and recommendations to improve services. Qualitative research design, including visits to key institutions and semi-structured interviews with key stakeholders. Interview questions were divided with two purposes: 1) Exploratory, aiming to understand present service functioning; 2) Evaluative, aiming to assess staff difficulties in applying best existing best practices. Assistive Technology services in Belo Horizonte fall under the 'medical model' definition of service delivery developed by AAATE. It was also found that staff lack training and knowledge support to assess user requirements and involve them during the decision process. Additionally, there is no follow up stage after the device is delivered. The study clearly defines the service provision function and the staff difficulties at Belo Horizonte city, providing information for further studies.

Best practices for budget-based design.

DOT National Transportation Integrated Search

2017-03-01

State Departments of Transportation (State DOTs) encounter difficulties in establishing feasible and : reliable project budget early in the project development. The lack of a systematic process for establishing : baseline budget with the consideratio...

The practical difficulties of commercial flying

NASA Technical Reports Server (NTRS)

Courtney, F T

1924-01-01

This paper relates some of the problems commercial aircraft companies have in attracting larger numbers of paying customers. The author discusses some remedies such as changing the public perception of flying as dangerous.

Item Writer Judgments of Item Difficulty versus Actual Item Difficulty: A Case Study

ERIC Educational Resources Information Center

Sydorenko, Tetyana

2011-01-01

This study investigates how accurate one item writer can be on item difficulty estimates and whether factors affecting item writer judgments correspond to predictors of actual item difficulty. The items were based on conversational dialogs (presented as videos online) that focus on pragmatic functions. Thirty-five 2nd-, 3rd-, and 4th-year learners…

Students' performance in phonological awareness, rapid naming, reading, and writing.

PubMed

Capellini, Simone Aparecida; Lanza, Simone Cristina

2010-01-01

phonological awareness, rapid naming, reading and writing in students with learning difficulties of a municipal public school. to characterize and compare the performance of students from public schools with and without learning difficulties in phonological awareness, rapid naming, reading and writing. participants were 60 students from the 2nd to the 4th grades of municipal public schools divided into 6 groups. Each group was composed by 10 students, being 3 groups of students without learning difficulties and 3 groups with students with learning difficulties. As testing procedure phonological awareness, rapid automatized naming, oral reading and writing under dictation assessments were used. the results highlighted the better performance of students with no learning difficulties. Students with learning difficulties presented a higher ratios considering time/speed in rapid naming tasks and, consequently, lower production in activities of phonological awareness and reading and writing, when compared to students without learning difficulties. students with learning difficulties presented deficits when considering the relationship between naming and automatization skills, and among lexical access, visual discrimination, stimulus frequency use and competition in using less time for code naming, i.e. necessary for the phoneme-grapheme conversion process required in the reading and writing alphabetic system like the Portuguese language.

EFL College Students' Perceptions of the Difficulties in Oral Presentation as a Form of Assessment

ERIC Educational Resources Information Center

Al-Nouh, Nowreyah A.; Abdul-Kareem, Muneera M.; Taqi, Hanan A.

2015-01-01

Oral presentation skills are considered one of the most important proficiencies needed for higher education and future careers. Thus, the present study is interested in eliciting English as a Foreign Language (EFL) college students' perceptions of the difficulties they face in oral presentation as a form of assessment. Participants were 500 female…

The key incident monitoring and management system - history and role in quality improvement.

PubMed

Badrick, Tony; Gay, Stephanie; Mackay, Mark; Sikaris, Ken

2018-01-26

The determination of reliable, practical Quality Indicators (QIs) from presentation of the patient with a pathology request form through to the clinician receiving the report (the Total Testing Process or TTP) is a key step in identifying areas where improvement is necessary in laboratories. The Australasian QIs programme Key Incident Monitoring and Management System (KIMMS) began in 2008. It records incidents (process defects) and episodes (occasions at which incidents may occur) to calculate incident rates. KIMMS also uses the Failure Mode Effects Analysis (FMEA) to assign quantified risk to each incident type. The system defines risk as incident frequency multiplied by both a harm rating (on a 1-10 scale) and detection difficulty score (also a 1-10 scale). Between 2008 and 2016, laboratories participating rose from 22 to 69. Episodes rose from 13.2 to 43.4 million; incidents rose from 114,082 to 756,432. We attribute the rise in incident rate from 0.86% to 1.75% to increased monitoring. Haemolysis shows the highest incidence (22.6% of total incidents) and the highest risk (26.68% of total risk). "Sample is suspected to be from the wrong patient" has the second lowest frequency, but receives the highest harm rating (10/10) and detection difficulty score (10/10), so it is calculated to be the 8th highest risk (2.92%). Similarly, retracted (incorrect) reports QI has the 10th highest frequency (3.9%) but the harm/difficulty calculation confers the second highest risk (11.17%). TTP incident rates are generally low (less than 2% of observed episodes), however, incident risks, their frequencies multiplied by both ratings of harm and discovery difficulty scores, concentrate improvement attention and resources on the monitored incident types most important to manage.

Online interviewing with interpreters in humanitarian contexts

PubMed Central

Chiumento, Anna; Rahman, Atif; Frith, Lucy

2018-01-01

ABSTRACT Purpose: Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Method: Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. Results: A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Conclusions: Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing. PMID:29532739

Online interviewing with interpreters in humanitarian contexts.

PubMed

Chiumento, Anna; Machin, Laura; Rahman, Atif; Frith, Lucy

2018-12-01

Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing.

Practicality of Elementary Statistics Module Based on CTL Completed by Instructions on Using Software R

NASA Astrophysics Data System (ADS)

Delyana, H.; Rismen, S.; Handayani, S.

2018-04-01

This research is a development research using 4-D design model (define, design, develop, and disseminate). The results of the define stage are analyzed for the needs of the following; Syllabus analysis, textbook analysis, student characteristics analysis and literature analysis. The results of textbook analysis obtained the description that of the two textbooks that must be owned by students also still difficulty in understanding it, the form of presentation also has not facilitated students to be independent in learning to find the concept, textbooks are also not equipped with data processing referrals by using software R. The developed module is considered valid by the experts. Further field trials are conducted to determine the practicality and effectiveness. The trial was conducted to the students of Mathematics Education Study Program of STKIP PGRI which was taken randomly which has not taken Basic Statistics Course that is as many as 4 people. Practical aspects of attention are easy, time efficient, easy to interpret, and equivalence. The practical value in each aspect is 3.7; 3.79, 3.7 and 3.78. Based on the results of the test students considered that the module has been very practical use in learning. This means that the module developed can be used by students in Elementary Statistics learning.

Issues in Developing and Evaluating a Culturally Tailored Internet Cancer Support Group

PubMed Central

Im, Eun-Ok; Ji, Xiaopeng; Zhang, Jingwen; Kim, Sangmi; Lee, Yaelim; Chee, Eunice; Chee, Wonshik; Tsai, Hsiu-Min; Nishigaki, Masakazu; Yeo, Seon Ae; Schapira, Marilyn; Mao, Jun James

2016-01-01

The purpose of this paper is to explore practical issues in developing and implementing a culturally tailored Internet Cancer Support Group for a group of ethnic minority cancer patients—Asian American cancer patients. Throughout the research process of the original study testing the Internet cancer support group, research team made written records of practical issues and plausible rationales for the issues. Weekly group discussion among research team members was conducted, and the discussion records were evaluated and analyzed using a content analysis (with individual words as the unit of analysis). The codes from the analysis process were categorized into idea themes, through which the issues were extracted. The issues included those in: (a) difficulties in using multiple languages; (b) collaboration with the IT department and technical challenges (c) difficulties in recruitment; (d) difficulties in retention; (e) optimal timing; and (f) characteristics of the users. Based on the findings, we suggested researchers to plan a workable translation process, check technical needs in advance, use multiple strategies to recruit and retain research participants, plan the right time for data collection, and consider characteristics of the users in the study design. PMID:27379523

The Chiropractic Care of Infants with Breastfeeding Difficulties.

PubMed

Alcantara, Joel; Alcantara, Joey D; Alcantara, Junjoe

2015-01-01

Chiropractors have long advocated on the benefits of breastfeeding and given the realized and potential role of chiropractors in the care of infants with breastfeeding difficulties, we performed this review of the literature on the subject to inform clinical practice. For this article, we searched Pubmed [1966-2013], Manual, Alternative and Natural Therapy Index System (MANTIS) [1964-2013] and Index to Chiropractic Literature [1984-2013] for the relevant literature. The search terms utilized "breastfeeding", "breast feeding", "breastfeeding difficulties", "breastfeeding difficulty", "TMJ dysfunction", "temporomandibular joint", "birth trauma" and "infants", in the appropriate Boolean combinations. We also examined non-peer-reviewed articles as revealed by Index to Chiropractic Literature and secondary analysis of references. Inclusion criteria for review included breastfeeding difficulties regardless of peer-review and written in the English language. A total of 24 articles met our inclusion criteria. These consisted of 8 case reports, 2 case series, and 3 cohort studies. We were also able to identify 6 manuscripts (5 case reports and a case series) that involved breastfeeding difficulties as a secondary complaint. Our findings reveal a theoretical and clinical framework based on the detection of spinal and extraspinal subluxations involving the cervico-cranio-mandibular complex and assessment of the infant while breastfeeding. Chiropractors care of infants with breastfeeding difficulties by addressing spinal and extraspinal subluxations involving the cervico-cranio-mandibular complex. Copyright © 2015 Elsevier Inc. All rights reserved.

The influence of age-related health difficulties and attitudes toward driving on driving self-regulation in the baby boomer and older adult generations.

PubMed

Conlon, Elizabeth G; Rahaley, Nicole; Davis, Jessica

2017-05-01

Our study aimed to determine how age- and disease-related difficulties were associated with attitudes and beliefs about driving self-regulation in men and women in the baby boomer and older generations. Three hundred and ninety-nine men (n=204) and women (n=195) aged between 48 and 91 years participated in a cross-sectional study of Australian drivers. Demographic characteristics and measures of driving confidence, driving difficulty and driving self-regulation; perceptions of visual, physical and cognitive capacity; and attitudes and beliefs about driving were obtained. Driving self-regulation in men and women was explained by different mechanisms. For men, self-report of visual and cognitive difficulties and poor driving confidence predicted driving self-regulation. For women, negative attitudes toward driving mediated the associations found between health-related difficulties and driving self-regulation. Barriers to driving self-regulation were not associated with the driving self-regulatory practices of men or women. Regardless of generation, women reported poorer driving confidence, greater driving difficulty and more driving self-regulation than men. We concluded that age- and disease-related difficulties are related to increasing driving self-regulation in mature men and women. These results indicate that different pathways are needed in models of driving self-regulation for men and women regardless of generational cohort. Copyright © 2017 Elsevier Ltd. All rights reserved.

Undergraduate research in medical education: a descriptive study of students' views.

PubMed

Oliveira, Cristiano C; de Souza, Renata C; Abe, Erika H Sassaki; Silva Móz, Luís E; de Carvalho, Lidia R; Domingues, Maria A C

2014-03-17

Medical students engage in curricular and extracurricular activities, including undergraduate research (UR). The advantages, difficulties and motivations for medical students pursuing research activities during their studies have rarely been addressed. In Brazil, some medical schools have included undergraduate research into their curriculum. The present study aimed to understand the reality of scientific practice among medical students at a well-established Brazilian medical school, analyzing this context from the students' viewpoint. A cross-sectional survey based on a questionnaire applied to students from years one to six enrolled in an established Brazilian medical school that currently has no curricular UR program. The questionnaire was answered by 415 students, 47.2% of whom were involved in research activities, with greater participation in UR in the second half of the course. Independent of student involvement in research activities, time constraints were cited as the main obstacle to participation. Among students not involved in UR, 91.1% said they favored its inclusion in the curriculum, since this would facilitate the development of such activity. This approach could signify an approximation between the axes of teaching and research. Among students who had completed at least one UR project, 87.7% said they would recommend the activity to students entering the course. Even without an undergraduate research program, students of this medical school report strong involvement in research activities, but discussion of the difficulties inherent in its practice is important to future developments.

The views and experiences of female GPs on professional practice and career support.

PubMed

Wedderburn, Clare; Scallan, Samantha; Whittle, Clare; Curtis, Anthony

2013-09-01

National GP demographic data demonstrate an increasing 'feminisation' of the workforce. With female GP specialty trainees continuing to outnumber males, this trend is set to continue. The changing composition of the workforce presents challenges in terms of how best to support the long-term career and educational development needs of this sector of the workforce in an evolving healthcare context. The aim of this work was to capture female GPs' experiences of working in general practice and their expectations concerning their career and educational development. Participants were surveyed and completed a semi-structured questionnaire, which generated qualitative and quantitative data. The sample comprised GP registrars, principals and sessionals. This study has generated an important dataset on working patterns, educational experiences and long-term career intentions of female GPs. Despite increased representation in the GP workforce, female GPs (particularly those with young children) appear less likely to be involved in education and training than their male counterparts, and even less likely to be involved in roles linked to primary care trusts, medico-political issues, hospital service delivery, special clinical interests or deanery education management. younger GPs reported significantly more difficulties in managing their childcare needs than older colleagues. Marital status, number of children and employment status did not moderate the effect of these difficulties. Female GPs reported working more hours with increasing age, but were not necessarily represented in a range of educational and/or training posts as a consequence.

Young people with features of gender dysphoria: Demographics and associated difficulties.

PubMed

Holt, Vicky; Skagerberg, Elin; Dunsford, Michael

2016-01-01

This article presents the findings from a cross-sectional study on demographic variables and associated difficulties in 218 children and adolescents (Mean age = 14 years, SD = 3.08, range = 5-17 years), with features of gender dysphoria, referred to the Gender Identity Development Service (GIDS) in London during a 1-year period (1 January 2012-31 December 2012). Data were extracted from patient files (i.e. referral letters, clinical notes and clinician reports). The most commonly reported associated difficulties were bullying, low mood/depression and self-harming. There was a gender difference on some of the associated difficulties with reports of self-harm being significantly more common in the natal females and autism spectrum conditions being significantly more common in the natal males. The findings also showed that many of the difficulties increased with age. Findings regarding demographic variables, gender dysphoria, sexual orientation and family features are reported, and limitations and implications of the cross-sectional study are discussed. In conclusion, young people with gender dysphoria often present with a wide range of associated difficulties which clinicians need to take into account, and our article highlights the often complex presentations of these young people. © The Author(s) 2014.

Teachers' in-flight thinking in inclusive classrooms.

PubMed

Paterson, David

2007-01-01

This article explores the thinking of five junior high school teachers as they teach students with learning difficulties in inclusive classrooms. Insights into the ways these teachers think about students in these inclusive secondary school contexts were obtained through triangulating data from semistructured interviews, stimulated recall of in-flight thinking, and researcher field notes. Exploration of teachers' in-flight thinking (i.e., the thinking of teachers as they engaged in classroom teaching) revealed a knowledge of individual students that was not related to categorical notions of learning difficulties. This research has implications for the practice of teaching in inclusive settings as well as for teacher preparation. Specifically, it suggests that attention to student differences should be replaced by the development of teachers' knowledge about individual students as a rich source of practical knowledge and the basis for developing effective instructional techniques.

[Residency in family medicine: problems and solutions].

PubMed

Boulé, Richard; Girard, Gilles

2003-04-01

To identify the problems encountered by residents during training and the solutions they proposed. Qualitative study. Family practice program at Sherbrooke University. Sixty-eight residents in the Family practice program between 1999 and 2000. We used the nominal group technique with four groups of participants. Then we held five 3-hour discussion groups to explore difficulties and solutions in depth. Finally, data were validated with a written questionnaire. At least 20% of respondents confirmed 65 difficulties and 61 solutions. Three major themes emerged: the many demands of the residence program, residents' personal experience of the program, and the lack of time for personal life. Publication of these results could help residents develop proactive adaptive strategies to deal with the stress of their training programs. Certain adjustments will be made by the program administration to make it easier for residents to manage their stress.

Synthetic carbohydrate: An aid to nutrition in the future

NASA Technical Reports Server (NTRS)

Berman, G. A. (Editor); Murashige, K. H. (Editor)

1973-01-01

The synthetic production of carbohydrate on a large scale is discussed. Three possible nonagricultural methods of making starch are presented in detail and discussed. The simplest of these, the hydrolysis of cellulose wastes to glucose followed by polymerization to starch, appears a reasonable and economic supplement to agriculture at the present time. The conversion of fossil fuels to starch was found to be not competitive with agriculture at the present time, but tractable enough to allow a reasonable plant design to be made. A reconstruction of the photosynthetic process using isolated enzyme systems proved technically much more difficult than either of the other two processes. Particular difficulties relate to the replacement of expensive energy carrying compounds, separation of similar materials, and processing of large reactant volumes. Problem areas were pinpointed, and technological progress necessary to permit such a system to become practical is described.

The new "Indigenous health" incentive payment: issues and challenges.

PubMed

Couzos, Sophie; Delaney Thiele, Dea

2010-02-01

Paying incentives above the baseline Medicare Benefits Schedule to health services for the additional work required to meet the health needs of Aboriginal people or Torres Strait Islanders might mitigate inequalities of care, but evidence supporting this is lacking. The proposed "Indigenous health" incentive payment to reduce Aboriginal health disadvantage, which is largely aimed at increasing the responsiveness of mainstream general practices, provides an opportunity to examine the assumptions behind this and other recent health reform bids. Contentious implementation issues include: the ineligibility of several Aboriginal community controlled health services (ACCHSs) to receive this payment; determining Aboriginality and the potential for misappropriation of payments; the difficulty accounting for practice population diversity and patient mobility; and concerns about the benefits or otherwise to the Aboriginal community. Evaluation of the measure will present problems: to attribute outcomes, an evaluation must disaggregate outcomes by type of service provider (general practice or ACCHS). If these challenges are not addressed, this initiative may end up merely funding coordination of care for those Aboriginal people and Torres Strait Islanders who are already regular users of the health system.

A co-design process developing heuristics for practitioners providing end of life care for people with dementia.

PubMed

Davies, Nathan; Mathew, Rammya; Wilcock, Jane; Manthorpe, Jill; Sampson, Elizabeth L; Lamahewa, Kethakie; Iliffe, Steve

2016-08-02

The end of life for someone with dementia can present many challenges for practitioners; such as, providing care if there are swallowing difficulties. This study aimed to develop a toolkit of heuristics (rules-of-thumb) to aid practitioners making end-of-life care decisions for people with dementia. An iterative co-design approach was adopted using a literature review and qualitative methods, including; 1) qualitative interviews and focus groups with family carers and 2) focus groups with health and care professionals. Family carers were recruited from a national charity, purposively sampling those with experience of end-of-life care for a person with dementia. Health and care professionals were purposively sampled to include a broad range of expertise including; general practitioners, palliative care specialists, and geriatricians. A co-design group was established consisting of health and social care experts and family carers, to synthesise the findings from the qualitative work and produce a toolkit of heuristics to be tested in practice. Four broad areas were identified as requiring complex decisions at the end of life; 1) eating/swallowing difficulties, 2) agitation/restlessness, 3) ending life-sustaining treatment, and 4) providing "routine care" at the end of life. Each topic became a heuristic consisting of rules arranged into flowcharts. Eating/swallowing difficulties have three rules; ensuring eating/swallowing difficulties do not come as a surprise, considering if the situation is an emergency, and considering 'comfort feeding' only versus time-trialled artificial feeding. Agitation/restlessness encourages a holistic approach, considering the environment, physical causes, and the carer's wellbeing. Ending life-sustaining treatment supports practitioners through a process of considering the benefits of treatment versus quality-of-life and comfort. Finally, a heuristic on providing routine care such as bathing, prompts practitioners to consider adapting the delivery of care, in order to promote comfort and dignity at the end of life. The heuristics are easy to use and remember, offering a novel approach to decision making for dementia end-of-life care. They have the potential to be used alongside existing end-of-life care recommendations, adding more readily available practical assistance. This is the first study to synthesise experience and existing evidence into easy-to-use heuristics for dementia end-of-life care.

Education on electrical phenomena involved in electroporation-based therapies and treatments: a blended learning approach.

PubMed

Čorović, Selma; Mahnič-Kalamiza, Samo; Miklavčič, Damijan

2016-04-07

Electroporation-based applications require multidisciplinary expertise and collaboration of experts with different professional backgrounds in engineering and science. Beginning in 2003, an international scientific workshop and postgraduate course electroporation based technologies and treatments (EBTT) has been organized at the University of Ljubljana to facilitate transfer of knowledge from leading experts to researches, students and newcomers in the field of electroporation. In this paper we present one of the integral parts of EBTT: an e-learning practical work we developed to complement delivery of knowledge via lectures and laboratory work, thus providing a blended learning approach on electrical phenomena involved in electroporation-based therapies and treatments. The learning effect was assessed via a pre- and post e-learning examination test composed of 10 multiple choice questions (i.e. items). The e-learning practical work session and both of the e-learning examination tests were carried out after the live EBTT lectures and other laboratory work. Statistical analysis was performed to compare and evaluate the learning effect measured in two groups of students: (1) electrical engineers and (2) natural scientists (i.e. medical doctors, biologists and chemists) undergoing the e-learning practical work in 2011-2014 academic years. Item analysis was performed to assess the difficulty of each item of the examination test. The results of our study show that the total score on the post examination test significantly improved and the item difficulty in both experimental groups decreased. The natural scientists reached the same level of knowledge (no statistical difference in total post-examination test score) on the post-course test take, as do electrical engineers, although the engineers started with statistically higher total pre-test examination score, as expected. The main objective of this study was to investigate whether the educational content the e-learning practical work presented to the students with different professional backgrounds enhanced their knowledge acquired via lectures during EBTT. We compared the learning effect assessed in two experimental groups undergoing the e-learning practical work: electrical engineers and natural scientists. The same level of knowledge on the post-course examination was reached in both groups. The results indicate that our e-learning platform supported by blended learning approach provides an effective learning tool for populations with mixed professional backgrounds and thus plays an important role in bridging the gap between scientific domains involved in electroporation-based technologies and treatments.

From CBA to Precautionary Appraisal: Practical Responses to Intractable Problems.

PubMed

Stirling, Andrew; Coburn, Josie

2018-01-01

The purpose of this essay is to critically review the design of methods for ethically robust forms of technology appraisal in the regulation of research and innovation in synthetic biology. It will focus, in particular, on the extent to which cost-benefit analysis offers a basis for informing decisions about which technological pathways to pursue and which to discourage. A further goal is to consider what (if anything) the precautionary principle might offer in enabling better decisions. And this, in turn, raises questions about why mention of precaution can excite accusations of unscientific bias or irrational, "anti-innovation" extremism. What does the polarized debate tell us about the politics around synthetic biology? In seeking more rigorous, timely, and practical ways to govern these remarkable new technologies, what might we be missing? The sophistication, diversity, and scope of synthetic biology may seem to make it a rather idiosyncratic area for exploring these general issues. It may seem to be a special case, with the bewildering pace of change amplifying the difficulties. But at root, some of the trickiest issues are just specific instances of familiar and long-standing conundrums in the governance of science and technology. The basic challenge is how to weigh up, for a wide range of potential options, the various pros and cons, as viewed from divergent perspectives, and find a way to justify the best course of action on behalf of society as a whole. This is the central problem addressed by a number of techniques in CBA. On the face of it, synthetic biology seems to present just one more application of these well-established and self-confident prescriptive methods. But there do emerge several obstinate, even prohibitive, difficulties for CBA. Although they are well acknowledged by the scholarly literature on and around this topic, they are often sidelined in practice. Yet all are central to the case for applying the concept of precaution to a field like synthetic biology. This essay will briefly explore multicriteria mapping, an appraisal method for exploring contrasting perspectives on emerging technologies, as one practical way to address them. The essay focuses on MCM, not because it presents any sort of panacea for appraisal, but because it is illustrative of the concrete implications of precaution. Setting out even just one among potentially many practical alternative methods at least refutes the last-ditch argument that CBA is the only operational choice. © 2018 The Hastings Center.

Using the Nudge and Shove Methods to Adjust Item Difficulty Values.

PubMed

Royal, Kenneth D

2015-01-01

In any examination, it is important that a sufficient mix of items with varying degrees of difficulty be present to produce desirable psychometric properties and increase instructors' ability to make appropriate and accurate inferences about what a student knows and/or can do. The purpose of this "teaching tip" is to demonstrate how examination items can be affected by the quality of distractors, and to present a simple method for adjusting items to meet difficulty specifications.

Evaluation of a rule base for decision making in general practice.

PubMed Central

Essex, B; Healy, M

1994-01-01

BACKGROUND. Decision making in general practice relies heavily on judgmental expertise. It should be possible to codify this expertise into rules and principles. AIM. A study was undertaken to evaluate the effectiveness, of rules from a rule base designed to improve students' and trainees' management decisions relating to patients seen in general practice. METHOD. The rule base was developed after studying decisions about and management of thousands of patients seen in one general practice over an eight year period. Vignettes were presented to 93 fourth year medical students and 179 general practitioner trainees. They recorded their perception and management of each case before and after being presented with a selection of relevant rules. Participants also commented on their level of agreement with each of the rules provided with the vignettes. A panel of five independent assessors then rated as good, acceptable or poor, the participants' perception and management of each case before and after seeing the rules. RESULTS. Exposure to a few selected rules of thumb improved the problem perception and management decisions of both undergraduates and trainees. The degree of improvement was not related to previous experience or to the stated level of agreement with the proposed rules. The assessors identified difficulties students and trainees experienced in changing their perceptions and management decisions when the rules suggested options they had not considered. CONCLUSION. The rules developed to improve decision making skills in general practice are effective when used with vignettes. The next phase is to transform the rule base into an expert system to train students and doctors to acquire decision making skills. It could also be used to provide decision support when confronted with difficult management decisions in general practice. PMID:8204334

Experiences obtaining insurance after live kidney donation.

PubMed

Boyarsky, B J; Massie, A B; Alejo, J L; Van Arendonk, K J; Wildonger, S; Garonzik-Wang, J M; Montgomery, R A; Deshpande, N A; Muzaale, A D; Segev, D L

2014-09-01

The impact of kidney donation on the ability to change or initiate health or life insurance following donation is unknown. To quantify this risk, we surveyed 1046 individuals who donated a kidney at our center between 1970 and 2011. Participants were asked whether they changed or initiated health or life insurance after donation, and if they had any difficulty doing so. Among 395 donors who changed or initiated health insurance after donation, 27 (7%) reported difficulty; among those who reported difficulty, 15 were denied altogether, 12 were charged a higher premium and 8 were told they had a preexisting condition because they were kidney donors. Among 186 donors who changed or initiated life insurance after donation, 46 (25%) reported difficulty; among those who reported difficulty, 23 were denied altogether, 27 were charged a higher premium and 17 were told they had a preexisting condition because they were kidney donors. In this single-center study, a high proportion of kidney donors reported difficulty changing or initiating insurance, particularly life insurance. These practices by insurers create unnecessary burden and stress for those choosing to donate and could negatively impact the likelihood of live kidney donation among those considering donation. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

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

PubMed

Beach, Elizabeth F; O'Brien, Ian

2017-06-01

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

Management Documentation: Indicators & Good Practice at Cultural Heritage Places

NASA Astrophysics Data System (ADS)

Eppich, R.; Garcia Grinda, J. L.

2015-08-01

Documentation for cultural heritage places usually refers to describing the physical attributes, surrounding context, condition or environment; most of the time with images, graphics, maps or digital 3D models in their various forms with supporting textural information. Just as important as this type of information is the documentation of managerial attributes. How do managers of cultural heritage places collect information related to financial or economic well-being? How are data collected over time measured, and what are significant indicators for improvement? What quality of indicator is good enough? Good management of cultural heritage places is essential for conservation longevity, preservation of values and enjoyment by the public. But how is management documented? The paper will describe the research methodology, selection and description of attributes or indicators related to good management practice. It will describe the criteria for indicator selection and why they are important, how and when they are collected, by whom, and the difficulties in obtaining this information. As importantly it will describe how this type of documentation directly contributes to improving conservation practice. Good practice summaries will be presented that highlight this type of documentation including Pamplona and Ávila, Spain and Valletta, Malta. Conclusions are drawn with preliminary recommendations for improvement of this important aspect of documentation. Documentation of this nature is not typical and presents a unique challenge to collect, measure and communicate easily. However, it is an essential category that is often ignored yet absolutely essential in order to conserve cultural heritage places.

The Possible Application of Socioeconomic Careers and Path Analysis Concepts to the Study of Factors Relevant to Physicians' Choice of Practice Location.

ERIC Educational Resources Information Center

Grimes, Walter F.

In response to the current shortage of rural physicians and the difficulties encountered in studying this problem, this paper attempts to apply a specific multivariate technique (path analysis) and the socioeconomic careers model of Featherman and others to the study of the physician's choice of practice location. The socioeconomic careers model…

Erickson's Model of Psychosocial Development with Autistic Children and Connections to Evidence-Based Practices for No Child Left Behind

ERIC Educational Resources Information Center

Stephens, Lauren M.; Dieppa, Melissa; LeBlanc, Patrice

2006-01-01

The purpose of this paper is to provide information about the social difficulties of students with Autism. A review of Erikson's Theory supports why developing social skills is important. No Child Left Behind evidence-based practices are suggested to assist these students. A literature review was conducted on these topics using key words to…

Measuring Ultraviolet Radiation Underwater: A Practical Application of the Beer-Lambert-Bouguer Law for High School Physics

ERIC Educational Resources Information Center

Schouten, Peter; Parisi, Alfio; Downs, Nathan

2009-01-01

The measurement of solar UV under water is not a simple process. In the underwater environment the difficulty of obtaining useable data is greatly amplified due to the optically complicated and at times unpredictable nature of water itself. The following practical exercise designed for use in the Year 11 and Year 12 Physics classroom aims to…

Comparative Analysis of the Approaches Used By Prospective Music Teachers in Turkey in Practicing the Piano Works of Contemporary Turkish Composers

ERIC Educational Resources Information Center

Sönmezöz, Feyza

2015-01-01

This study determined the levels of recognizing piano works of contemporary Turkish composers, the importance of practicing these works and difficulty in playing these works by the prospective music teachers in the Departments of Music Education in Turkey. Furthermore, this study performed a comparative analysis on the opinions of the prospective…

"Good Practice" School Advisors in Greek Education: The Difficulty in Linking Collaborative Networks, Communities of Practice and Quality Culture

ERIC Educational Resources Information Center

Stamelos, Georgios; Bartzakli, Marianna

2013-01-01

Quality in education is considered to be a central aim as far as the formation and the implementation of educational policy worldwide is concerned. The basic prerequisite for it, though, is quality culture. Collaborative networks between school advisors and primary school teachers are examined to reveal how they can affect the formation of…

Flexible Transcription Testing

ERIC Educational Resources Information Center

Carr-Smith, Norma

1976-01-01

Flexible structure in a San Francisco State University shorthand course is described as a way to provide motivation for students. Topics discussed are transcription testing plan, method of evaluation, practice tests, increasing difficulty of tests, and classroom results. (TA)

The relative importance of relational and scientific characteristics of psychotherapy: Perceptions of community members vs. therapists.

PubMed

Farrell, Nicholas R; Deacon, Brett J

2016-03-01

Although client preferences are an integral component of evidence-based practice in psychology (American Psychological Association, 2006), relatively little research has examined what potential mental health consumers value in the psychotherapy they may receive. The present study was conducted to examine community members' preferences for the scientific and relational aspects of psychotherapy for different types of presenting problems, and how accurately therapists perceive these preferences. Community members (n = 200) were surveyed about the importance of scientific (e.g., demonstrated efficacy in clinical trials) and relational (e.g., therapist empathy) characteristics of psychotherapy both for anxiety disorders (e.g., obsessive-compulsive disorder) and disorder-nonspecific issues (e.g., relationship difficulties). Therapists (n = 199) completed the same survey and responded how they expected the average mental health consumer would. Results showed that although community members valued relational characteristics significantly more than scientific characteristics, the gap between these two was large for disorder-nonspecific issues (d = 1.24) but small for anxiety disorders (d = .27). Community members rated scientific credibility as important across problem types. Therapists significantly underestimated the importance of scientific characteristics to community members, particularly in the treatment of disorder-nonspecific issues (d = .74). Therapists who valued research less in their own practice were more likely to underestimate the importance of scientific credibility to community members. The implications of the present findings for understanding the nature of client preferences in evidence-based psychological practice are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Validating office-based screening for psychosocial strengths and difficulties among youths in foster care.

PubMed

Jee, Sandra H; Szilagyi, Moira; Conn, Anne-Marie; Nilsen, Wendy; Toth, Sheree; Baldwin, Constance D; Szilagyi, Peter G

2011-05-01

To assess the effectiveness of social-emotional screening in the primary care setting for youths in foster care. The setting was a primary care practice for all youth in home-based foster care in 1 county. Subjects were youths, aged 11 to 17 years, and their foster parents; both completed a Strengths and Difficulties Questionnaire at well-child visits. The Strengths and Difficulties Questionnaire is a previously validated 25-item tool that has 5 domains: emotional symptoms; conduct problems; hyperactivity/inattention; peer problems; and prosocial behaviors and an overall total difficulties score. We first compared youth versus parent Strengths and Difficulties Questionnaire scores and then assessed the accuracy of these Strengths and Difficulties Questionnaire scores by comparing them in a subsample of youths (n = 50) with results of home-based structured clinical interviews using the Children's Interview for Psychiatric Syndromes. Of 138 subjects with both youth and parent reports, 78% had prosocial behaviors (strengths), and 70% had 1 or more social-emotional problems. Parents reported significantly more conduct problems (38% vs 16%; P < .0001) and total difficulties (30% vs 16%; P = .002) than did youth. The Strengths and Difficulties Questionnaire had better agreement with the Children's Interview for Psychiatric Syndromes (n = 50) for any Strengths and Difficulties Questionnaire-identified problem for combined youth and foster-parent reports (93%), compared with youth report alone (54%) or parent report alone (71%). Although most youths in foster care have social-emotional problems, most have strengths as well. Youth and foster-parent perspectives on these problems differ. Systematic social-emotional screening in primary care that includes both youth and parent reports can identify youths who may benefit from services.

Advanced nursing practice.

PubMed

Carroll, Mark

Mark Carroll examines the concept of advanced nursing practice and highlights a number of the difficulties in assessing and defining different levels of practice. Some of the differences and similarities between advanced practice in the US and UK are compared and contrasted. Issues of élitism and the lack of correlation between the needs of the healthcare system and professional self-interest prevent the advancement of specialist roles in the UK. The continuing focus of local trusts on the medicalisation of roles to meet the demands of the healthcare system appears to ignore the need for nursing to expand from within the profession.

[How can institutional structures make clinical research in France more operational?].

PubMed

Funck-Brentano, C; Brouard, R

The laws regulating the practice of clinical research in France, in particular the law of 20 December 1988, the so-called Huriet's law, constitute a major advance for medical progress. However, their implementation by administrative offices generates practical difficulties which impair the development of applied research in human beings. Beyond the laws themselves, it appears that our institutions are unprepared to optimize the conduct of such research. This round table sought to list the existing problems and to propose constructive solutions or objectives to be reached to optimize clinical research in France, with a view to improving French participation in international collaborative programmes, notably European ones. Evaluation of projects and practices, financial support and accounting, and some aspects of existing laws have been identified as the major sources of our difficulties. Harmonization and clarification of our procedures as well as improvement of training should be our primary objectives to achieve a higher level of medical, scientific, financial and administrative quality in the conduct of clinical research. Creation of a referential Web site, designed and updated by a central public organization, is an imperative step towards reaching these objectives.

A Five-Year Evaluation of Examination Structure in a Cardiovascular Pharmacotherapy Course

PubMed Central

Kolar, Claire; Janke, Kristin K.

2015-01-01

Objective. To evaluate the composition and effectiveness as an assessment tool of a criterion-referenced examination comprised of clinical cases tied to practice decisions, to examine the effect of varying audience response system (ARS) questions on student examination preparation, and to articulate guidelines for structuring examinations to maximize evaluation of student learning. Design. Multiple-choice items developed over 5 years were evaluated using Bloom’s Taxonomy classification, point biserial correlation, item difficulty, and grade distribution. In addition, examination items were classified into categories based on similarity to items used in ARS preparation. Assessment. As the number of items directly tied to clinical practice rose, Bloom’s Taxonomy level and item difficulty also rose. In examination years where Bloom’s levels were high but preparation was minimal, average grade distribution was lower compared with years in which student preparation was higher. Conclusion. Criterion-referenced examinations can benefit from systematic evaluation of their composition and effectiveness as assessment tools. Calculated design and delivery of classroom preparation is an asset in improving examination performance on rigorous, practice-relevant examinations. PMID:27168611

Involving users with learning difficulties in health improvement: lessons from inclusive learning disability research.

PubMed

Walmsley, Jan

2004-03-01

In this paper the author considers the lessons to be drawn from what is termed "inclusive" learning disability research for user involvement around health improvement. Inclusive learning disability research refers to research where people with learning difficulties (intellectual disability) are involved as active participants, as opposed to passive subjects. There is by now a considerable body of such research, developed over the past 25 years. From the review, the author draws attention to areas which can inform practice in involvement of users in a way that adds value.

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

PubMed

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

2011-01-01

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

[The application and development of artificial intelligence in medical diagnosis systems].

PubMed

Chen, Zhencheng; Jiang, Yong; Xu, Mingyu; Wang, Hongyan; Jiang, Dazong

2002-09-01

This paper has reviewed the development of artificial intelligence in medical practice and medical diagnostic expert systems, and has summarized the application of artificial neural network. It explains that a source of difficulty in medical diagnostic system is the co-existence of multiple diseases--the potentially inter-related diseases. However, the difficulty of image expert systems is inherent in high-level vision. And it increases the complexity of expert system in medical image. At last, the prospect for the development of artificial intelligence in medical image expert systems is made.

HOPE: Help fOr People with money, employment, benefit or housing problems: study protocol for a randomised controlled trial.

PubMed

Barnes, M C; Haase, A M; Bard, A M; Donovan, J L; Davies, R; Dursley, S; Potokar, J; Kapur, N; Hawton, K; O'Connor, R C; Hollingworth, W; Metcalfe, C; Gunnell, D

2017-01-01

Self-harm and suicide increase in times of economic recession. Factors including job loss, austerity measures, financial difficulties and house repossession contribute to the risk. Vulnerable individuals commonly experience difficulties in navigating the benefits system and in accessing the available sources of welfare and debt advice, and this contributes to their distress. Our aim is to determine the feasibility and acceptability of a brief psychosocial intervention (the "HOPE" service) for people presenting to hospital emergency departments (ED) following self-harm or in acute distress because of financial, employment, or welfare (benefit) difficulties. A pilot study including randomisation will be employed to determine whether it is possible to undertake a full-scale trial. Twenty people presenting to the ED who have self-harmed, have suicidal thoughts and depression and/or are in crisis and where financial, employment or benefit problems are cited as contributory factors will be asked to consent to random allocation to the intervention or control arm on a 2:1 basis. People who require secondary mental health follow-up will be excluded. Those randomised to the intervention arm will receive up to six sessions with a mental health worker who will provide practical help with financial and other problems. The mental health worker will use the motivational interviewing method in their interactions with participants. Control participants will receive one session signposting them to existing relevant support organisations. Participants will be followed up after 3 months. Participants and the mental health workers will take part in qualitative interviews to enable refinement of the intervention. The acceptability of outcome measures including the PHQ-9, GAD-7, repeat self-harm, EQ5D-5L and questions about debt, employment and welfare benefits will be explored. This study will assess whether a full-scale randomised trial of this novel intervention to prevent self-harm among those distressed because of financial difficulties is feasible, including the acceptability of randomisation, potential rate of recruitment and the acceptability of outcome measures. ISRCTN58531248.

Effects on Text Simplification: Evaluation of Splitting up Noun Phrases

PubMed Central

Leroy, Gondy; Kauchak, David; Hogue, Alan

2016-01-01

To help increase health literacy, we are developing a text simplification tool that creates more accessible patient education materials. Tool development is guided by data-driven feature analysis comparing simple and difficult text. In the present study, we focus on the common advice to split long noun phrases. Our previous corpus analysis showed that easier texts contained shorter noun phrases. Subsequently, we conduct a user study to measure the difficulty of sentences containing noun phrases of different lengths (2-gram, 3-gram and 4-gram), conditions (split or not) and, to simulate unknown terms, use of pseudowords (present or not). We gathered 35 evaluations for 30 sentences in each condition (3×2×2 conditions) on Amazon’s Mechanical Turk (N=12,600). We conducted a three-way ANOVA for perceived and actual difficulty. Splitting noun phrases had a positive effect on perceived difficulty but a negative effect on actual difficulty. The presence of pseudowords increased perceived and actual difficulty. Without pseudowords, longer noun phrase led to increased perceived and actual difficulty. A follow-up study using the phrases (N = 1,350) showed that measuring awkwardness may indicate when to split noun phrases. We conclude that splitting noun phrases benefits perceived difficulty, but hurts actual difficulty when the phrasing becomes less natural. PMID:27043754

Laparoscopic diagnosis of endometriosis.

PubMed

Wood, Carl; Kuhn, Raphael; Tsaltas, Jim

2002-08-01

To consider and explain the possibility of difficulties in diagnosis of endometriosis at previous laparoscopy Retrospective patient record review. The Endometriosis Care Centre of Australia and the private practices of authors. Two hundred and fifteen patients with clinical evidence of endometriosis examined laparoscopically between March 1999 and May 2001. Confirmation of endometriosis by histological biopsy. Endometriosis was confirmed in 168 of the 215 women. Of these women 38 had a previous negative laparoscopy within 12 months of the current laparoscopy. It is possible that in some of the patients, who previously had a negative laparoscopy, endometriosis was not recognised. Possible reasons for difficulty in diagnosis have been identified and techniques to improve diagnosis suggested. This retrospective study was performed to consider and explain the possibility of difficulties in diagnosis of endometriosis at previous laparoscopy.

The Construction of Emotional and Behavioural Difficulties

ERIC Educational Resources Information Center

Jones, Raya A.

2003-01-01

This paper presents a critique of the educational model of emotional and behavioural difficulties in British education. In the wake of strong criticisms of the so-called medical model of maladjustment (pre-1980s), educational policies have defined the "disturbing" pupil as having emotional and behavioural difficulties, and have more…

Attention Functioning among Adolescents with Multiple Learning, Attentional, Behavioral, and Emotional Difficulties

ERIC Educational Resources Information Center

Shalev, Lilach; Kolodny, Tamar; Shalev, Nir; Mevorach, Carmel

2016-01-01

Attention-deficit/hyperactivity disorder (ADHD) is characterized by high levels of inattention, hyperactivity, and impulsivity; however, these symptoms can result from a variety of reasons. To obtain a comprehensive understanding of the various difficulties of individuals with ADHD, especially when co-occurrence difficulties are present, it is…

Classification of Students with Reading Comprehension Difficulties: The Roles of Motivation, Affect, and Psychopathology

ERIC Educational Resources Information Center

Sideridis, Georgios D.; Mouzaki, Angeliki; Simos, Panagiotis; Protopapas, Athanassios

2006-01-01

Attempts to evaluate the cognitive-motivational profiles of students with reading comprehension difficulties have been scarce. The purpose of the present study was twofold: (a) to assess the discriminatory validity of cognitive, motivational, affective, and psychopathological variables for identification of students with reading difficulties, and…

Sources of Difficulty in L2 Scope Judgments

ERIC Educational Resources Information Center

Chung, Eun Seon

2013-01-01

Second language (L2) learners have been found to experience difficulty in tasks that require the integration of discourse-pragmatic properties with syntactic and semantic properties (Sorace and Serratrice, 2009; Tsimpli and Sorace, 2006; Valenzuela, 2006). The present article investigates the sources of L2 difficulty in a phenomenon where multiple…

Research Reports.

ERIC Educational Resources Information Center

Shore, Sue; And Others

1993-01-01

Includes "Positively Different: Guidance for Developing Inclusive Adult Literacy, Language and Numeracy Curricula" (Shore et al.); "Difficulties of Applied Practice Experienced by Recently Graduated Tertiary Nursing Students in Their First Six Months of Employment in a Major Public Hospital" (Bates); and "Development of…

[The tinnitus questionnaire. A standard instrument for grading the degree of tinnitus. Results of a multicenter study with the tinnitus questionnaire].

PubMed

Goebel, G; Hiller, W

1994-03-01

The clinical examination of patients with severe and chronic tinnitus must include associated psychological disturbances. The present paper describes traditional diagnostic methods of ENT practice as well as the Tinnitus Questionnaire (TQ) which has been evaluated in a number of studies. This instrument differentiates between emotional and cognitive distress, auditory perceptual difficulties and self-experienced intrusiveness produced by the tinnitus. The results of a German multicenter study are presented which show that the TQ can be used to demonstrate differences of tinnitus distress under different clinical conditions (e.g., ENT clinic vs psychosomatic clinic and in- vs out-patient care). The TQ can be employed for comparative studies in different tinnitus-related institutions and for the evaluation of the relative effects of different treatment approaches.

"I intend to donate but ...": non-donors' views of blood donation in the UK.

PubMed

McVittie, Chris; Harris, Lisa; Tiliopoulos, Niko

2006-02-01

Although only 6% of the eligible United Kingdom population regularly donate blood, reasons for low donation rates remain poorly understood. In a grounded theory investigation, blood donors (n = 23) and non-donors (n = 27) completed a questionnaire that included 15 open-ended items. Semi-structured interviews were conducted with sub-samples of donors (n = 5) and non-donors (n = 7). Analysis of open-ended responses and interview transcripts identified five themes. Three themes, namely pro-social views, helping behaviour and awareness had similar relevance for donors and non-donors. Two themes, anxiety and practical difficulties, were used by non-donors to account for non-donation despite intentions to donate. Although non-donors' anxieties may be difficult to overcome, perceived practical difficulties provide scope for intervention. The removal of perceived barriers to donation offers one way of increasing donation rates.

Peripheral Nerve Blocks Causing Increased Risk for Fall and Difficulty in Ambulation for the Hip and Knee Joint Replacement Patient.

PubMed

Crumley Aybar, Bonnie L; Gillespie, Michael J; Gipson, Sean F; Mullaney, Caitlin E; Tommasino-Storz, Melissa

2016-12-01

A systematic review of the literature was completed by the Evidence-Based Practice Group for the Patient population, Intervention/Issue, Comparison Intervention, Outcomes, Timing (PICOT) question: "Does the use of a peripheral nerve block increase the risk for falls and difficulty ambulation in patients after lower extremity surgery through postoperative day 2?" A search of multiple databases using specified key terms resulted in 258 articles for total knee arthroplasty or total hip arthroplasty. These were reduced to 13 with exclusion criteria and became primary evidence. Numbers Needed to Harm and Numbers Needed to Treat (NNT) were calculated. Numbers Needed to Harm supported the PICOT question. Further research of postoperative falls and nursing interventions to reduce or prevent falls is suggested before creation of a Clinical Practice Guideline. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

PubMed Central

Boulé, Richard; Girard, Gilles

2003-01-01

OBJECTIVE: To identify the problems encountered by residents during training and the solutions they proposed. DESIGN: Qualitative study. SETTING: Family practice program at Sherbrooke University. PARTICIPANTS: Sixty-eight residents in the Family practice program between 1999 and 2000. METHOD: We used the nominal group technique with four groups of participants. Then we held five 3-hour discussion groups to explore difficulties and solutions in depth. Finally, data were validated with a written questionnaire. MAIN FINDINGS: At least 20% of respondents confirmed 65 difficulties and 61 solutions. Three major themes emerged: the many demands of the residence program, residents' personal experience of the program, and the lack of time for personal life. CONCLUSION: Publication of these results could help residents develop proactive adaptive strategies to deal with the stress of their training programs. Certain adjustments will be made by the program administration to make it easier for residents to manage their stress. PMID:12729243

Ethics Regulation in Social Computing Research: Examining the Role of Institutional Review Boards.

PubMed

Vitak, Jessica; Proferes, Nicholas; Shilton, Katie; Ashktorab, Zahra

2017-12-01

The parallel rise of pervasive data collection platforms and computational methods for collecting, analyzing, and drawing inferences from large quantities of user data has advanced social computing research, investigating digital traces to understand mediated behaviors of individuals, groups, and societies. At the same time, methods employed to access these data have raised questions about ethical research practices. This article provides insights into U.S. institutional review boards' (IRBs) attitudes and practices regulating social computing research. Through descriptive and inferential analysis of survey data from staff at 59 IRBs at research universities, we examine how IRBs evaluate the growing variety of studies using pervasive digital data. Findings unpack the difficulties IRB staff face evaluating increasingly technical research proposals while highlighting the belief in their ability to surmount these difficulties. They also indicate a lack of consensus among IRB staff about what should be reviewed and a willingness to work closely with researchers.

Theoretical and practical issues in the definition of health: insights from Aboriginal Australia.

PubMed

Boddington, Paula; Räisänen, Ulla

2009-02-01

This paper discusses attempts to define health within a public policy arena and practical and conceptual difficulties that arise. An Australian Aboriginal definition of health is examined. Although there are certain difficulties of translation, this definition is prominent in current Australian health policy and discourse about health. The definition can be seen as broadly holistic in comparison to other holistic definitions such as that of the World Health Organization. The nature of this holism and its grounding within the context of Aboriginal Australia is discussed. In particular, its implications for the phenomenon of medicalization, which may be associated with a holistic notion of health, is critically explored, as is the link of notions of health to culture and the question of the possibility of a universal definition of health. The question of to what extent a definition of health is inspirational or operational is also raised.

Parenting by anxious mothers: effects of disorder subtype, context and child characteristics.

PubMed

Murray, Lynne; Lau, Pui Yi; Arteche, Adriane; Creswell, Cathy; Russ, Stephanie; Zoppa, Letizia Della; Muggeo, Michela; Stein, Alan; Cooper, Peter

2012-02-01

There has been increasing research interest in parenting by anxious adults; however, little is known about anxiety-subtype effects, or effects of the context in which parenting is assessed. Two groups of anxious mothers, social phobia (N = 50), generalised anxiety disorder (N = 38), and nonanxious controls (N = 62) were assessed with their 4.9-year-old children in three tasks: two presented threat specifically relevant to each maternal disorder, namely, a social threat task where the child had to give a speech, and a nonsocial threat task where the child had to explore potentially scary objects; the third was a nonthreat task (playing with play dough). Seven parenting dimensions were scored. Effects on parenting of maternal anxiety subgroup and task, and their interactions, were examined, as were effects of earlier child behavioural inhibition and currently manifest anxiety. There were no parenting differences between maternal groups in the nonthreat play-dough task; parenting difficulties in the two anxious groups were principally evident in the disorder-specific challenge. Parenting differences between nonanxious and anxious mothers occurred independently of child characteristics. There was little evidence for particular forms of parenting difficulty being unique to maternal disorder. Anxious mothers' parenting difficulties emerge when occurring under challenge, especially when this is disorder-specific. These effects should be considered in research and clinical practice. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

Memory and communication support in dementia: research-based strategies for caregivers.

PubMed

Smith, Erin R; Broughton, Megan; Baker, Rosemary; Pachana, Nancy A; Angwin, Anthony J; Humphreys, Michael S; Mitchell, Leander; Byrne, Gerard J; Copland, David A; Gallois, Cindy; Hegney, Desley; Chenery, Helen J

2011-03-01

Difficulties with memory and communication are prominent and distressing features of dementia which impact on the person with dementia and contribute to caregiver stress and burden. There is a need to provide caregivers with strategies to support and maximize memory and communication abilities in people with dementia. In this project, a team of clinicians, researchers and educators in neuropsychology, psychogeriatrics, nursing and speech pathology translated research-based knowledge from these fields into a program of practical strategies for everyday use by family and professional caregivers. From the available research evidence, the project team identified compensatory or facilitative strategies to assist with common areas of difficulty, and structured these under the mnemonics RECAPS (for memory) and MESSAGE (for communication). This information was adapted for presentation in a DVD-based education program in accordance with known characteristics of effective caregiver education. The resultant DVD comprises (1) information on the nature and importance of memory and communication in everyday life; (2) explanations of common patterns of difficulty and preserved ability in memory and communication across the stages of dementia; (3) acted vignettes demonstrating the strategies, based on authentic samples of speech in dementia; and (4) scenarios to prompt the viewer to consider the benefits of using the strategies. Using a knowledge-translation framework, information and strategies can be provided to family and professional caregivers to help them optimize residual memory and communication in people with dementia. Future development of the materials, incorporating consumer feedback, will focus on methods for enabling wider dissemination.

[I want to breastfeed my baby: Unvealing the experiences of women who lived process difficulties in their breastfeeding].

PubMed

Lucchini Raies, Camila; Márquez Doren, Francisca; Rivera Martínez, María Soledad

2017-01-01

Breastfeeding is the most beneficial feeding practice for infants. However, it is not always the first choice for mothers and their encouragement and support from health professionals is variable. To understand the experience of mothers who had difficulties with their breastfeeding process. A phenomenological study was conducted in a University Health center. Twelve breastfeeding women were included. Data collection technique was in depth interviews, taped recorded with participants’ consent. Phenomenological analysis of data followed Streubert´s method. The rigor of the study was guarded by criteria for qualitative research and the research process. Ethical aspects were sheltered through the informed consent process, confidentiality and methodological rigor. The experience of living difficulties in the breastfeeding process is revealed in five comprehensive categories: recognizing the difficulties with breastfeeding; emotional impact when unable to breastfeed; motivation to overcome the difficulty and ask for help; support for breastfeeding recovery; and transition process from stress and anxiety to peace, gratification and empowerment. The understanding of this experience is qualitative evidence that contributes to a comprehensive understanding of the situation of each mother and child, allowing to improve support care interventions in health.

Practical difficulties in the diagnosis of transient non-ketotic hyperglycinaemia.

PubMed

Lang, T F; Parr, J R; Matthews, E E; Gray, R G F; Bonham, J R; Kay, J D S

2008-02-01

Making a diagnosis of transient non-ketotic hyperglycinaemia (tNKH) can be difficult. We report an infant who presented in the neonatal period with symptoms of NKH. Metabolic studies performed on day 2 of life showed raised cerebrospinal fluid (CSF) and plasma glycine, and a CSF:plasma glycine ratio consistent with NKH; however, a liver biopsy performed on day 5 revealed normal liver glycine cleavage system activity. Subsequently, the child's clinical condition improved in the absence of any therapeutic medication. Clinical assessment and developmental follow-up at 5 months, 1 year, and 2 years were age-appropriate. Guidance for the investigation and management of future suspected cases of tNKH is discussed.

Burnout in Female Faculty Members.

PubMed

Cassidy-Vu, Lisa; Beck, Keli; Moore, Justin B

2017-04-01

Despite approximately equal numbers of male and female medical school graduates, women are entering academic medicine at a lower rate than their male colleagues. Of those who do assume a faculty position, female faculty members report higher levels of burnout, often attributable to gender-specific difficulties in clinical expectations and maintenance of work-life balance. Many of these struggles are attributable to issues that are amenable to supportive policies, but these policies are inconsistent in their availability and practice. This commentary presents evidence for inconsistencies in the day-to-day experience of female faculty members, and proposes solutions for the mitigation of the challenges experienced more often by female faculty members with the goal of diversifying and strengthening academic medicine.

Burnout in Female Faculty Members

PubMed Central

Cassidy-Vu, Lisa; Beck, Keli; Moore, Justin B.

2016-01-01

Despite approximately equal numbers of male and female medical school graduates, women are entering academic medicine at a lower rate than their male colleagues. Of those who do assume a faculty position, female faculty members report higher levels of burnout, often attributable to gender-specific difficulties in clinical expectations and maintenance of work-life balance. Many of these struggles are attributable to issues that are amenable to supportive policies, but these policies are inconsistent in their availability and practice. This commentary presents evidence for inconsistencies in the day-to-day experience of female faculty members, and proposes solutions for the mitigation of the challenges experienced more often by female faculty members with the goal of diversifying and strengthening academic medicine. PMID:27650035

The Role of Social Work for Foreign Residents in an Epidemic: The MERS Crisis in the Republic of Korea.

PubMed

Park, Hong-Jae; Lee, Bong Joo

2016-01-01

This article explores the experiences of foreign residents during the period of the Middle East Respiratory Syndrome (MERS) outbreak in (South) Korea and discusses from a social work perspective the implications of their experiences and their needs. Data were obtained from interviews with 22 foreigners who either live and work or study in Korea. The data were then interpreted using a thematic analysis approach in a multilingual research context. The findings from the study show that foreign residents experienced a wide range of social and psychoemotional difficulties during the MERS health threat. Implications for social work practice in an epidemic emergency are presented.

Development and initial validation of the internalization of Asian American stereotypes scale.

PubMed

Shen, Frances C; Wang, Yu-Wei; Swanson, Jane L

2011-07-01

This research consists of four studies on the initial reliability and validity of the Internalization of Asian American Stereotypes Scale (IAASS), a self-report instrument that measures the degree Asian Americans have internalized racial stereotypes about their own group. The results from the exploratory and confirmatory factor analyses support a stable four-factor structure of the IAASS: Difficulties with English Language Communication, Pursuit of Prestigious Careers, Emotional Reservation, and Expected Academic Success. Evidence for concurrent and discriminant validity is presented. High internal-consistency and test-retest reliability estimates are reported. A discussion of how this scale can contribute to research and practice regarding internalized stereotyping among Asian Americans is provided.

A quick guide to ethical theory in healthcare: solving ethical dilemmas in nutrition support situations.

PubMed

Ferrie, Suzie

2006-04-01

Ethical dilemmas can be challenging for the nutrition support clinician who is accustomed to evidence-based practice. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle's virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, nonmaleficence, and justice). Adopting a step-by-step approach can simplify the process of resolving ethical problems.

Text-based CAPTCHAs over the years

NASA Astrophysics Data System (ADS)

Chow, Y. W.; Susilo, W.

2017-11-01

The notion of CAPTCHAs has been around for more than two decades. Since its introduction, CAPTCHAs have now become a ubiquitous part of the Internet. Over the years, research on various aspects of CAPTCHAs has evolved and different design principles have emerged. This article discusses text-based CAPTCHAs in terms of their fundamental requirements, namely, security and usability. Practicality necessitates that humans must be able to correctly solve CAPTCHA challenges, while at the same time automated computer programs should have difficulty solving the challenges. This article also presents alternative paradigms to text-based CAPTCHA design that have been examined in previous work. With the advances in techniques to defeat CAPTCHAs, the future of auto- mated Turing tests is an open question.

Numeracy and Communication with Patients: They Are Counting on Us

PubMed Central

Paasche-Orlow, Michael K.; Remillard, Janine T.; Bennett, Ian M.; Ben-Joseph, Elana Pearl; Batista, Rosanna M.; Hyde, James; Rudd, Rima E.

2008-01-01

Patient-centered interactive communication between physicians and patients is recommended to improve the quality of medical care. Numerical concepts are important components of such exchanges and include arithmetic and use of percentages, as well as higher level tasks like estimation, probability, problem-solving, and risk assessment - the basis of preventive medicine. Difficulty with numerical concepts may impede communication. The current evidence on prevalence, measurement, and outcomes related to numeracy is presented, along with a summary of best practices for communication of numerical information. This information is integrated into a hierarchical model of mathematical concepts and skills, which can guide clinicians toward numerical communication that is easier to use with patients. PMID:18830764

Upper-Division Students' Difficulties with Ampere's Law

ERIC Educational Resources Information Center

Wallace, Colin S.; Chasteen, Stephanie V.

2010-01-01

This study presents and interprets some conceptual difficulties junior-level physics students experience with Ampere's law. We present both quantitative data, based on students' written responses to conceptual questions, and qualitative data, based on interviews of students solving Ampere's law problems. We find that some students struggle to…

Exploring Australian speech-language pathologists' use and perceptions ofnon-speech oral motor exercises.

PubMed

Rumbach, Anna F; Rose, Tanya A; Cheah, Mynn

2018-01-29

To explore Australian speech-language pathologists' use of non-speech oral motor exercises, and rationales for using/not using non-speech oral motor exercises in clinical practice. A total of 124 speech-language pathologists practising in Australia, working with paediatric and/or adult clients with speech sound difficulties, completed an online survey. The majority of speech-language pathologists reported that they did not use non-speech oral motor exercises when working with paediatric or adult clients with speech sound difficulties. However, more than half of the speech-language pathologists working with adult clients who have dysarthria reported using non-speech oral motor exercises with this population. The most frequently reported rationale for using non-speech oral motor exercises in speech sound difficulty management was to improve awareness/placement of articulators. The majority of speech-language pathologists agreed there is no clear clinical or research evidence base to support non-speech oral motor exercise use with clients who have speech sound difficulties. This study provides an overview of Australian speech-language pathologists' reported use and perceptions of non-speech oral motor exercises' applicability and efficacy in treating paediatric and adult clients who have speech sound difficulties. The research findings provide speech-language pathologists with insight into how and why non-speech oral motor exercises are currently used, and adds to the knowledge base regarding Australian speech-language pathology practice of non-speech oral motor exercises in the treatment of speech sound difficulties. Implications for Rehabilitation Non-speech oral motor exercises refer to oral motor activities which do not involve speech, but involve the manipulation or stimulation of oral structures including the lips, tongue, jaw, and soft palate. Non-speech oral motor exercises are intended to improve the function (e.g., movement, strength) of oral structures. The majority of speech-language pathologists agreed there is no clear clinical or research evidence base to support non-speech oral motor exercise use with clients who have speech sound disorders. Non-speech oral motor exercise use was most frequently reported in the treatment of dysarthria. Non-speech oral motor exercise use when targeting speech sound disorders is not widely endorsed in the literature.

Development of SMOG-Cro readability formula for healthcare communication and patient education.

PubMed

Brangan, Sanja

2015-03-01

Effective communication shows a positive impact on patient satisfaction, compliance and medical outcomes, at the same time reducing the healthcare costs. Written information for patients needs to correspond to health literacy levels of the intended audiences. Readability formulas correlate well with the reading and comprehension tests but are considered an easier and quicker method to estimate a text difficulty. SMOG readability formula designed for English language needs to be modified if used for texts in other languages. The aim of this study was to develop a readability formula based on SMOG, that could be used to estimate text difficulty of written materials for patients in Croatian language. Contras- tive analysis of English and Croatian language covering a corpus of almost 100,000 running words showed clear linguis- tic differences in the number of polysyllabic words. The new formula, named SMOG-Cro, is presented as an equation: SMOG-Cro = 2 + √4+ syllables, with the score showing the number of years of education a person needs to be able to understand a piece of writing. The presented methodology could help in the development of readability formulas for other languages. We hope the results of this study are soon put into practice for more effective healthcare communication and patient education, and for development of a health literacy assessment tool in Croatian language.

Collection of biological samples in forensic toxicology.

PubMed

Dinis-Oliveira, R J; Carvalho, F; Duarte, J A; Remião, F; Marques, A; Santos, A; Magalhães, T

2010-09-01

Forensic toxicology is the study and practice of the application of toxicology to the purposes of the law. The relevance of any finding is determined, in the first instance, by the nature and integrity of the specimen(s) submitted for analysis. This means that there are several specific challenges to select and collect specimens for ante-mortem and post-mortem toxicology investigation. Post-mortem specimens may be numerous and can endow some special difficulties compared to clinical specimens, namely those resulting from autolytic and putrefactive changes. Storage stability is also an important issue to be considered during the pre-analytic phase, since its consideration should facilitate the assessment of sample quality and the analytical result obtained from that sample. The knowledge on degradation mechanisms and methods to increase storage stability may enable the forensic toxicologist to circumvent possible difficulties. Therefore, advantages and limitations of specimen preservation procedures are thoroughfully discussed in this review. Presently, harmonized protocols for sampling in suspected intoxications would have obvious utility. In the present article an overview is given on sampling procedures for routinely collected specimens as well as on alternative specimens that may provide additional information on the route and timing of exposure to a specific xenobiotic. Last, but not least, a discussion on possible bias that can influence the interpretation of toxicological results is provided. This comprehensive review article is intented as a significant help for forensic toxicologists to accomplish their frequently overwhelming mission.

Supporting Teachers in Making Innovative Changes in the Use of Computer-Aided Practical Work to Support Concept Development in Physics Education

ERIC Educational Resources Information Center

Barton, Roy

2005-01-01

There continues to be a gulf between what have been identified from the literature as the potential benefits of using computer-aided practical work and the difficulties of realizing them as reported by practising teachers, even from those who are committed to the use of Information and Communication Technology (ICT). This article reports on a…

Development of Principles for Multimodal Displays in Army Human-Robot Operations

DTIC Science & Technology

2010-06-01

Research Laboratory ATTN: RDRL- HRM -D Aberdeen Proving Ground, MD 21005-5425 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT...the practical limitations of various cognitive resource channels for HRI tasks. 2.1.2 Purpose Now that MRT and the common workload manipulations...with more mission targets. • Workload conditions were not counter-balanced for practice effects. 7 Increasing task difficulty generally

After-hours access to primary care practices linked with lower emergency department use and less unmet medical need.

PubMed

O'Malley, Ann S

2013-01-01

One goal of the Affordable Care Act is to improve patients' access to primary care and the coordination of that care. An important ingredient in achieving that goal is ensuring that patients have access to their primary care practice outside of regular business hours. This analysis of the 2010 Health Tracking Household Survey found that among people with a usual source of primary care, 40.2 percent reported that their practice offered extended hours, such as at night or on weekends. The analysis also found that one in five people who attempted after-hours contact with their primary care provider reported it was "very difficult" or "somewhat difficult" to reach a clinician. Those who reported less difficulty contacting a clinician after hours had significantly fewer emergency department visits (30.4 percent compared to 37.7 percent) and lower rates of unmet medical need (6.1 percent compared to 13.7 percent) than people who experienced more difficulty. The findings provide a valuable baseline on after-hours access, especially as patient-centered medical homes and accountable care organizations expand. Increasing support to primary care practices to offer or coordinate after-hours care may help reduce rates of emergency department use and unmet medical need.

The impact of an evolving profession on the frequency and perceived difficulty of ethical encounters among physical therapists in the clinic.

PubMed

Berg-Poppe, Patti; MacCabe, Angela; Karges, Joy

2018-05-14

Ethical decision making is situated within dynamic contexts specific to practice standards and environments, contemporary policy, and responsive educational systems. Reflecting on an evolving profession lends insight into the role of ethical codes of conduct. The purpose of this study was to gather information about the frequency and perceived difficulty physical therapists (PTs) experience with common ethical situations within contemporary clinical practice. PTs within the United States were invited to participate in an online questionnaire replicating a 1980 study. Subjects were 336 PTs from a variety of practice environments. Just 1 item was reported as moderately/extremely difficult by contemporary respondents, compared to 16 items in the 1980 study. The number of items meeting moderate/high encounter frequency was similar between the two groups (2015 = 16/19; 1980 = 15/19). While today's PTs report that they encounter ethical situations at a frequency similar to PTs in 1980, these same PTs report these ethical challenges as minimally difficult when compared to PTs responding to the 1980 survey. It is proposed that a move toward autonomous practice, the elevation of the entry level professional degree, and changing health care policy and environments have been influential in shaping these changes over time.

A survey of visual function in an Austrian population of school-age children with reading and writing difficulties.

PubMed

Dusek, Wolfgang; Pierscionek, Barbara K; McClelland, Julie F

2010-05-25

To describe and compare visual function measures of two groups of school age children (6-14 years of age) attending a specialist eyecare practice in Austria; one group referred to the practice from educational assessment centres diagnosed with reading and writing difficulties and the other, a clinical age-matched control group. Retrospective clinical data from one group of subjects with reading difficulties (n = 825) and a clinical control group of subjects (n = 328) were examined.Statistical analysis was performed to determine whether any differences existed between visual function measures from each group (refractive error, visual acuity, binocular status, accommodative function and reading speed and accuracy). Statistical analysis using one way ANOVA demonstrated no differences between the two groups in terms of refractive error and the size or direction of heterophoria at distance (p > 0.05). Using predominately one way ANOVA and chi-square analyses, those subjects in the referred group were statistically more likely to have poorer distance visual acuity, an exophoric deviation at near, a lower amplitude of accommodation, reduced accommodative facility, reduced vergence facility, a reduced near point of convergence, a lower AC/A ratio and a slower reading speed than those in the clinical control group (p < 0.05). This study highlights the high proportions of visual function anomalies in a group of children with reading difficulties in an Austrian population. It confirms the importance of a full assessment of binocular visual status in order to detect and remedy these deficits in order to prevent the visual problems continuing to impact upon educational development.

The Utility of the Family Empowerment Scale With Custodial Grandmothers

PubMed Central

Hayslip, Bert; Smith, Gregory C.; Montoro-Rodriguez, Julian; Streider, Frederick H.; Merchant, William

2016-01-01

The Family Empowerment Scale (FES) was developed specifically to assess empowerment in families with emotional disorders. Its relevance to custodial grandfamilies is reflected in the difficulties in grandchildren's social, emotional, and behavioral functioning, wherein such difficulties may be explained via either reactions to changes in their family structure or in their responses to the newly formed family unit. Utilizing 27 items derived from the 34-item version of the FES, which had represented differential levels of empowerment (family, service system, community) as indexed by one's attitudes, knowledge, and behavior, we explored the factor structure, internal consistency, construct, and convergent validity of the FES with grandparent caregivers. Three-hundred forty-three (M age = 58.45, SD = 8.22, n Caucasian = 152, n African American = 149, n Hispanic = 38) custodial grandmothers caring for grandchildren between ages 4 and 12 years completed the 27 FES items and various measures of their psychological well-being, grandchild psychological difficulties, emotional support, and parenting practices. Factor analysis revealed three factors that differed slightly from the originally proposed FES subscales: Parental Self-Efficacy/Self-Confidence, Service Activism, and Service Knowledge. Each of the factors was internally consistent, and derived factor scores were moderately interrelated, speaking to the question of convergent validity. The construct validity of these three factors was evidenced by meaningful patterns of statistically significant correlations with grandmothers’ psychological well-being, grandchild psychological difficulties, emotional support, and parenting practices. These factor scores were independent of grandmother age, health, and education. These findings suggest the newly identified FES factors to be valuable in understanding empowerment among grandmother caregivers. PMID:26452627

The Utility of the Family Empowerment Scale With Custodial Grandmothers.

PubMed

Hayslip, Bert; Smith, Gregory C; Montoro-Rodriguez, Julian; Streider, Frederick H; Merchant, William

2017-03-01

The Family Empowerment Scale (FES) was developed specifically to assess empowerment in families with emotional disorders. Its relevance to custodial grandfamilies is reflected in the difficulties in grandchildren's social, emotional, and behavioral functioning, wherein such difficulties may be explained via either reactions to changes in their family structure or in their responses to the newly formed family unit. Utilizing 27 items derived from the 34-item version of the FES, which had represented differential levels of empowerment (family, service system, community) as indexed by one's attitudes, knowledge, and behavior, we explored the factor structure, internal consistency, construct, and convergent validity of the FES with grandparent caregivers. Three-hundred forty-three ( M age = 58.45, SD = 8.22, n Caucasian = 152, n African American = 149, n Hispanic = 38) custodial grandmothers caring for grandchildren between ages 4 and 12 years completed the 27 FES items and various measures of their psychological well-being, grandchild psychological difficulties, emotional support, and parenting practices. Factor analysis revealed three factors that differed slightly from the originally proposed FES subscales: Parental Self-Efficacy/Self-Confidence, Service Activism, and Service Knowledge. Each of the factors was internally consistent, and derived factor scores were moderately interrelated, speaking to the question of convergent validity. The construct validity of these three factors was evidenced by meaningful patterns of statistically significant correlations with grandmothers' psychological well-being, grandchild psychological difficulties, emotional support, and parenting practices. These factor scores were independent of grandmother age, health, and education. These findings suggest the newly identified FES factors to be valuable in understanding empowerment among grandmother caregivers.

Knowledge, attitudes and practices regarding head lice infestations in rural Nigeria.

PubMed

Heukelbach, Jorg; Ugbomoiko, Uade Samuel

2011-09-14

Head lice infestations are common in sub-Saharan Africa, but knowledge, attitudes and practices have never been studied in this region. This population-based study was conducted in a small rural community (population = 590) in Kwara State, Central Nigeria. Inhabitants of the community were interviewed regarding head lice infestations, using a pre-tested structured questionnaire, and examined regarding the presence of active pediculosis. Of the 496 participants included, 367 (74.0%) had experienced head lice infestations, but only 26 (11.1%) of the individuals older than 15 years knew the correct mode of transmission. Of 142 individuals with active pediculosis, only 1 (0.7%) felt ashamed. Treatment was most commonly done by grooming (46.3%), followed by combing (27.2%). Only 4.6% used pediculicides, and 21.8% did not apply any treatment. Opinions about difficulties in controlling head lice were asked in three groups: biological, technical and social. In the first group, the most common difficulty noted was detecting head lice (52.1%), followed by possible resistance that would lengthen the time of infestation (38.9%). Technical constraints included concerns on the safety and effectiveness of products (48.7%) and difficulties in obtaining treatment (46.2%). Social contraints included difficulty in treating children (24.4%), lack of knowledge (23.5%), and the social behavior of children (22.2%). Head lice were not perceived as an important disease in a rural Nigerian community, and feelings about the infestation were mostly indifferent. Despite its common occurrence, knowledge on head lice was limited.  

Temporal attention is involved in the enhancement of attentional capture with task difficulty: an event-related brain potential study.

PubMed

Sugimoto, Fumie; Kimura, Motohiro; Takeda, Yuji; Katayama, Jun'ichi

2017-08-16

In a three-stimulus oddball task, the amplitude of P3a elicited by deviant stimuli increases with an increase in the difficulty of discriminating between standard and target stimuli (i.e. task-difficulty effect on P3a), indicating that attentional capture by deviant stimuli is enhanced with an increase in task difficulty. This enhancement of attentional capture may be explained in terms of the modulation of modality-nonspecific temporal attention; that is, the participant's attention directed to the predicted timing of stimulus presentation is stronger when the task difficulty increases, which results in enhanced attentional capture. The present study examined this possibility with a modified three-stimulus oddball task consisting of a visual standard, a visual target, and four types of deviant stimuli defined by a combination of two modalities (visual and auditory) and two presentation timings (predicted and unpredicted). We expected that if the modulation of temporal attention is involved in enhanced attentional capture, then the task-difficulty effect on P3a should be reduced for unpredicted compared with predicted deviant stimuli irrespective of their modality; this is because the influence of temporal attention should be markedly weaker for unpredicted compared with predicted deviant stimuli. The results showed that the task-difficulty effect on P3a was significantly reduced for unpredicted compared with predicted deviant stimuli in both the visual and the auditory modalities. This result suggests that the modulation of modality-nonspecific temporal attention induced by the increase in task difficulty is at least partly involved in the enhancement of attentional capture by deviant stimuli.

The Social, Emotional and Behavioural Difficulties of Primary School Children with Poor Attendance Records

ERIC Educational Resources Information Center

Carroll, H. C. M.

2013-01-01

Two complementary studies of poor and better attenders are presented. To measure emotional and behavioural difficulties (EBD) different teacher-completed rating scales were employed, and to determine social difficulties, the studies used sociometry and some items from the scales. One study had a longitudinal design. It revealed that, after…

Career Decision-Making Difficulties and Help-Seeking among Israeli Young Adults

ERIC Educational Resources Information Center

Vertsberger, Dana; Gati, Itamar

2016-01-01

The present research focused on the various types of support young adults consider using when making career decisions and located factors that affect their intentions to seek help. Career decision-making difficulties (assessed by the Career Decision-making Difficulties Questionnaire), self-reported intentions to seek help, and career decision…

A Cognitive View of Reading Comprehension: Implications for Reading Difficulties

ERIC Educational Resources Information Center

Kendeou, Panayiota; Broek, Paul; Helder, Anne; Karlsson, Josefine

2014-01-01

Our aim in the present paper is to discuss a "cognitive view" of reading comprehension, with particular attention to research findings that have the potential to improve our understanding of difficulties in reading comprehension. We provide an overview of how specific sources of difficulties in inference making, executive functions, and…

Learning Difficulties: A Portuguese Perspective of a Universal Issue

ERIC Educational Resources Information Center

Martins, Ana Paula Loucao; Correia, Luis de Miranda; Hallahan, Daniel P.

2012-01-01

In this article we present findings of a study that was conducted with the purpose of deepening the knowledge about the field of learning difficulties in Portugal. Therefore, within these findings we will discuss across several cultural boundaries, themes related with the existence of learning difficulties as a construct, the terminology, the…

Use of WIRIS Quizzes in an Online Calculus Course

ERIC Educational Resources Information Center

Calm, Remei; Masià, Ramon; Olivé, Carme; Parés, Núria; Pozo, Francesc; Ripoll, Jordi; Sancho-Vinuesa, Teresa

2017-01-01

Calculus courses often present a large number of difficulties to undergraduate students of scientific studies, especially in engineering degrees. These difficulties are sometimes related to teaching and assessment strategies. In this paper, a teaching innovation experience is presented within the framework of the Universitat Oberta de Catalunya.…

The social development of children with severe learning difficulties: a case study of an inclusive education initiative between two primary schools in Oxfordshire, UK.

PubMed

Dew-Hughes, D; Blandford, S

1999-08-01

This case study of primary age children in two linked Oxfordshire schools investigated the contribution of staff attitudes and practices to inequalities in education, and contrasted the socialisation of children with similar learning difficulties in different educational placements. Participant observation of a group of children and carers in a special school suggested areas of more rigorous inquiry. Structured observations compared this group with a matched sample of children with similar learning difficulties in a mainstream setting. Staff on both sites were invited to comment on findings arising from analysed data in order to identify attitudes and policies which might account for the observed differences in practice. The study was engendered by experience of differences arising from educational placement. The theoretical stance arose through reviewing previous work, predominantly the debate on inclusive education, and the wider issues of human rights and equal opportunities embedded in the social development of people with disabilities. The theoretical framework underpinning this study is established in some depth. The project was designed to investigate issues of the wider social perspective, by conducting a micro-study of one model of educational inclusion whose outcomes have direct relevance to those issues.

Using Reflective Practice to Facilitate Conversations and Transform Instructional Practice for Middle School Science Teachers

NASA Astrophysics Data System (ADS)

Higdon, Robbie L.

The process of teaching, especially inquiry, is complex and requires extended time for developing one's instructional practice (Loucks-Horsley, Stiles, Mundry, Love, & Hewson, 2010). The implementation of a continued cycle of self-reflection can engage teachers in analyzing their prior experiences and understandings about their instructional practice to promote the accommodation of new concepts and transform their practice. However, many teachers have difficulty engaging in the cognitive dissonance needed to identify those problems and promote their own growth without support. As one's professional practice becomes more repetitive and routine, it is difficult for the practitioner to recognize opportunities in which to contemplate one's habitual actions (Schon, 1983). In this multi-case study, two middle school science teachers who were engaged within a sustained professional development initiative participated in a series of one-on-one reflective dialogues regarding the decisions they made about the utilization of inquiry-based instruction. In addition, these teachers were asked to reflect upon the criteria used to determine how and when to implement these inquiry-based practices. These reflective dialogue sessions provided the opportunity to observe teacher conceptions and stimulate teacher cognitive dissonance about instructional practice. Qualitative analysis of data collected from these reflective dialogues along with informal and formal classroom observations of instructional practice uncovered diverse perceptions regarding the implementation of inquiry-based methods into present teaching practice. The use of reflective dialogue within the existing structure of the professional development initiative allowed for the facilitators of the professional development initiative to tailor ongoing support and their effective implementation of inquiry-based instruction. Additional research is needed to investigate the impact of reflective dialogue in achieving accommodation of new concepts leading to lasting conceptual change about inquiry-based instruction.

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

PubMed

Smith, Kirsten V; Thew, Graham R

2017-09-01

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