42 CFR 485.56 - Condition of participation: Governing body and administration.
Code of Federal Regulations, 2014 CFR
2014-10-01
... behalf of the administrator; and (4) Retains professional and administrative responsibility for all personnel providing facility services. (c) Standard: Group of professional personnel. The facility must have a group of professional personnel associated with the facility that— (1) Develops and periodically...
42 CFR 485.56 - Condition of participation: Governing body and administration.
Code of Federal Regulations, 2012 CFR
2012-10-01
... behalf of the administrator; and (4) Retains professional and administrative responsibility for all personnel providing facility services. (c) Standard: Group of professional personnel. The facility must have a group of professional personnel associated with the facility that— (1) Develops and periodically...
42 CFR 485.56 - Condition of participation: Governing body and administration.
Code of Federal Regulations, 2011 CFR
2011-10-01
... behalf of the administrator; and (4) Retains professional and administrative responsibility for all personnel providing facility services. (c) Standard: Group of professional personnel. The facility must have a group of professional personnel associated with the facility that— (1) Develops and periodically...
42 CFR 485.56 - Condition of participation: Governing body and administration.
Code of Federal Regulations, 2013 CFR
2013-10-01
... behalf of the administrator; and (4) Retains professional and administrative responsibility for all personnel providing facility services. (c) Standard: Group of professional personnel. The facility must have a group of professional personnel associated with the facility that— (1) Develops and periodically...
Buchheit, M; Racinais, S; Bilsborough, J; Hocking, J; Mendez-Villanueva, A; Bourdon, P C; Voss, S; Livingston, S; Christian, R; Périard, J; Cordy, J; Coutts, A J
2013-01-01
Objectives To examine with a parallel group study design the performance and physiological responses to a 14-day off-season ‘live high-train low in the heat’ training camp in elite football players. Methods Seventeen professional Australian Rules Football players participated in outdoor football-specific skills (32±1°C, 11.5 h) and indoor strength (23±1°C, 9.3 h) sessions and slept (12 nights) and cycled indoors (4.3 h) in either normal air (NORM, n=8) or normobaric hypoxia (14±1 h/day, FiO2 15.2–14.3%, corresponding to a simulated altitude of 2500–3000 m, hypoxic (HYP), n=9). They completed the Yo-Yo Intermittent Recovery level 2 (Yo-YoIR2) in temperate conditions (23±1°C, normal air) precamp (Pre) and postcamp (Post). Plasma volume (PV) and haemoglobin mass (Hbmass) were measured at similar times and 4 weeks postcamp (4WPost). Sweat sodium concentration ((Na+)sweat) was measured Pre and Post during a heat-response test (44°C). Results Both groups showed very large improvements in Yo-YoIR2 at Post (+44%; 90% CL 38, 50), with no between-group differences in the changes (−1%; −9, 9). Postcamp, large changes in PV (+5.6%; −1.8, 5.6) and (Na+)sweat (−29%; −37, −19) were observed in both groups, while Hbmass only moderately increased in HYP (+2.6%; 0.5, 4.5). At 4WPost, there was a likely slightly greater increase in Hbmass (+4.6%; 0.0, 9.3) and PV (+6%; −5, 18, unclear) in HYP than in NORM. Conclusions The combination of heat and hypoxic exposure during sleep/training might offer a promising ‘conditioning cocktail’ in team sports. PMID:24282209
Wild, Verina; Carina, Fourie; Frouzakis, Regula; Clarinval, Caroline; Fässler, Margrit; Elger, Bernice; Gächter, Thomas; Leu, Agnes; Spirig, Rebecca; Kleinknecht, Michael; Radovanovic, Dragana; Mouton Dorey, Corine; Burnand, Bernard; Vader, John-Paul; Januel, Jean-Marie; Biller-Andorno, Nikola; The IDoC Group
2015-01-01
The starting point of the interdisciplinary project "Assessing the impact of diagnosis related groups (DRGs) on patient care and professional practice" (IDoC) was the lack of a systematic ethical assessment for the introduction of cost containment measures in healthcare. Our aim was to contribute to the methodological and empirical basis of such an assessment. Five sub-groups conducted separate but related research within the fields of biomedical ethics, law, nursing sciences and health services, applying a number of complementary methodological approaches. The individual research projects were framed within an overall ethical matrix. Workshops and bilateral meetings were held to identify and elaborate joint research themes. Four common, ethically relevant themes emerged in the results of the studies across sub-groups: (1.) the quality and safety of patient care, (2.) the state of professional practice of physicians and nurses, (3.) changes in incentives structure, (4.) vulnerable groups and access to healthcare services. Furthermore, much-needed data for future comparative research has been collected and some early insights into the potential impact of DRGs are outlined. Based on the joint results we developed preliminary recommendations related to conceptual analysis, methodological refinement, monitoring and implementation.
Gokce, Hasan Suat; Piskin, Bulent; Ceyhan, Dogan; Gokce, Sila Mermut; Arisan, Volkan
2010-03-01
The lighting conditions of the environment and visual deficiencies such as red-green color vision deficiency affect the clinical shade matching performance of dental professionals. The purpose of this study was to evaluate the shade matching performance of normal and color vision-deficient dental professionals with standard daylight and tungsten illuminants. Two sets of porcelain disc replicas of 16 shade guide tabs (VITA Lumin) were manufactured to exact L*a*b* values by using a colorimeter. Then these twin porcelain discs (13 mm x 2.4 mm) were mixed up and placed into a color-matching cabinet that standardized the lighting conditions for the observation tests. Normal and red-green color vision-deficient dental professionals were asked to match the 32 porcelain discs using standard artificial daylight D65 (high color temperature) and tungsten filament lamp light (T) (low color temperature) illuminants. The results were analyzed by repeated-measures ANOVA and paired and independent samples t tests for the differences between dental professionals and differences between the illuminants (alpha=.05). Regarding the sum of the correct shade match scores of all observations with both illuminants, the difference between normal vision and red-green color vision-deficient dental professional groups was not statistically significant (F=4.132; P=.054). However, the correct shade match scores of each group were significantly different for each illuminant (P<.005). The correct shade matching scores of normal color vision dental professionals were significantly higher with D65 illuminant (t=7.004; P<.001). Color matching scores of red-green color vision-deficient dental professionals (approximately 5.7 more pairs than with D65) were significantly higher with T illuminant (t=5.977; P<.001). CONCLUSIONS.: Within the limitations of this study, the shade matching performance of dental professionals was affected by color vision deficiency and the color temperature of the illuminant. The color vision-deficient group was notably unsuccessful with the D65 illuminant in shade matching. In contrast, there was a significant increase in the shade matching performance of the color vision-deficient group with T illuminant. The lower color temperature illuminant dramatically decreased the normal color vision groups' correct shade matching score. (c) 2010 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.
Professional aircrews' attitudes toward infectious diseases and aviation medical issues.
Schwartz, Michael D; Macias-Moriarity, Lilia Z; Schelling, Joerg
2012-12-01
Air carrier and professional corporate aircrews provide a unique and highly distinct population in which to examine potential transport and transmission of infectious diseases (ID). This study sought to assess frequency of flying while acutely ill, identify clinical triggers in self-grounding, determine employer support for self-grounding, examine rates of influenza vaccination, and identify unmet needs for current information on ID issues related to extensive travel required of professional aircrews. Anonymous questionnaires were completed by select European mainline, U.S. regional airline, and professional corporate aircrews on ID topics such as flying while ill, flying with ill crewmembers, receipt of influenza vaccination, disinfection, and other aviation medical issues. Data were analyzed and reported as composite and stratified by airline vs. corporate aviation respondents. Aircrews often flew while ill (or with ill crewmembers); 52% flew until fever reached 38 degrees C (100.4 degrees F) and an additional 37% flew up to 38.89 degrees C (102 degrees F). Rate of annual influenza vaccination was quite low for all groups, but especially so for airline crews (21-27%), even given potential occupational exposure risk. Crews also had strongly differing perceptions of employer views on self-grounding, depending upon employment setting. There were sizable disparities between aircrew flying for U.S. regional, European mainline, and large corporate aviation departments with respect to self-grounding when ill and routinely receiving a seasonal influenza vaccination. All study groups reported a pressing need for enhanced anonymous access to current ID and medical information.
Effect of mentoring on professional values in model C clinical nurse leader graduates.
Gazaway, Shena B; Anderson, Lori; Schumacher, Autumn; Alichnie, Chris
2018-04-19
Nursing graduates acquire their nursing values by professional socialization. Mentoring is a crucial support mechanism for these novice nurses, yet little is known about the model C clinical nurse leader graduate and the effects of mentoring. This investigation examined how mentoring affected the development of professional nursing values in the model C clinical nurse leader graduate. A longitudinal design was used to survey model C clinical nurse leader graduates before and after graduation to determine how different types of mentoring relationships influenced professional values. Demographic surveys documented participant characteristics and the Nurses Professional Values Scale - Revised (NPVS-R) assessed professional nursing values. Mean NPVS-R scores increased after graduation for the formally mentored participants, while the NPVS-R scores decreased or remained unchanged for the other mentoring groups. However, no significant difference was found in NPVS-R scores over time (p = .092) or an interaction between the NPVS-R scores and type of mentoring relationships (p = .09). These results suggest that model C clinical nurse leader graduate participants experiencing formal mentoring may develop professional nursing values more than their colleagues. Formal mentoring relationships are powerful and should be used to promote professional values for model C clinical nurse leader graduates. © 2018 John Wiley & Sons Ltd.
Carey, M E; Mandalia, P K; Daly, H; Gray, L J; Hale, R; Martin Stacey, L; Taub, N; Skinner, T C; Stone, M; Heller, S; Khunti, K; Davies, M J
2014-11-01
To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland. The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels. Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.
Sassen, Barbara; Kok, Gerjo; Schepers, Jan; Vanhees, Luc
2014-10-21
Research to assess the effect of interventions to improve the processes of shared decision making and self-management directed at health care professionals is limited. Using the protocol of Intervention Mapping, a Web-based intervention directed at health care professionals was developed to complement and optimize health services in patient-centered care. The objective of the Web-based intervention was to increase health care professionals' intention and encouraging behavior toward patient self-management, following cardiovascular risk management guidelines. A randomized controlled trial was used to assess the effect of a theory-based intervention, using a pre-test and post-test design. The intervention website consisted of a module to help improve professionals' behavior, a module to increase patients' intention and risk-reduction behavior toward cardiovascular risk, and a parallel module with a support system for the health care professionals. Health care professionals (n=69) were recruited online and randomly allocated to the intervention group (n=26) or (waiting list) control group (n=43), and invited their patients to participate. The outcome was improved professional behavior toward health education, and was self-assessed through questionnaires based on the Theory of Planned Behavior. Social-cognitive determinants, intention and behavior were measured pre-intervention and at 1-year follow-up. The module to improve professionals' behavior was used by 45% (19/42) of the health care professionals in the intervention group. The module to support the health professional in encouraging behavior toward patients was used by 48% (20/42). The module to improve patients' risk-reduction behavior was provided to 44% (24/54) of patients. In 1 of every 5 patients, the guideline for cardiovascular risk management was used. The Web-based intervention was poorly used. In the intervention group, no differences in social-cognitive determinants, intention and behavior were found for health care professionals, compared with the control group. We narrowed the intervention group and no significant differences were found in intention and behavior, except for barriers. Results showed a significant overall difference in barriers between the intervention and the control group (F1=4.128, P=.02). The intervention was used by less than half of the participants and did not improve health care professionals' and patients' cardiovascular risk-reduction behavior. The website was not used intensively because of time and organizational constraints. Professionals in the intervention group experienced higher levels of barriers to encouraging patients, than professionals in the control group. No improvements were detected in the processes of shared decision making and patient self-management. Although participant education level was relatively high and the intervention was pre-tested, it is possible that the way the information was presented could be the reason for low participation and high dropout. Further research embedded in professionals' regular consultations with patients is required with specific emphasis on the processes of dissemination and implementation of innovations in patient-centered care. Netherlands Trial Register Number (NTR): NTR2584; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2584 (Archived by WebCite at http://www.webcitation.org/6STirC66r).
Quality of Basic Life Support - A Comparison between Medical Students and Paramedics.
Körber, Maria Isabel; Köhler, Thomas; Weiss, Verena; Pfister, Roman; Michels, Guido
2016-07-01
Poor survival rates after cardiac arrest can partly be explained by poor basic life support skills in medical professionals. This study aimed to assess quality of basic life support in medical students and paramedics. We conducted a prospective observational study with 100 early medical students (group A), 100 late medical students (group B) and 100 paramedics (group C), performing a 20-minute basic life support simulation in teams of two. Average frequency and absolute number of chest compressions per minute (mean (±SD)), chest decompression (millimetres of compression remaining, mean (±SD)), hands-off-time (seconds/minute, mean (±SD)), frequency of switching positions between ventilation and chest compression (per 20 minutes) and rate of sufficient compressions (depth ≥50mm) were assessed as quality parameters of CPR. In groups A, B and C the rates of sufficiently deep chest compressions were 56%, 42% and 52%, respectively, without significant differences. Male gender and real-life CPR experience were significantly associated with deeper chest compression. Frequency and number of chest compressions were within recommended goals in at least 96% of all groups. Remaining chest compressions were 6 mm (±2), 6 mm (±2) and 5 mm (±2) with a significant difference between group A and C (p=0.017). Hands-off times were 6s/min (±1), 5s/min (±1) and 4s/min (±1), which was significantly different across all three groups. Overall, paramedics tended to show better quality of CPR compared to medical students. Though, chest compression depth as an important quality characteristic of CPR was insufficient in almost 50% of participants, even in well trained paramedics. Therefore, we suggest that an effort should be made to find better ways to educate health care professionals in BLS.
[Professional quality of life in workers of the Toledo primary care health area].
Villarín Castro, A; Méndez García, T; Zuzuárregui Gironés, M S; Sánchez Serrano, S; Conejo Ocaña, R
2015-01-01
To determine the professional quality of life in the workers of the Toledo Primary Care Health Area and to analyse its components. Descriptive, cross-sectional study, performed on workers of the Toledo Primary Care Health Area with an online self-administered questionnaire. age, sex, health centre, professional group, seniority, management experience, collaboration in working groups, employment situation, and the PQL-35 professional quality of life questionnaire. A total of 430 completed questionnaires were received (45.3%), of which 68.4% were women. The mean age was 47.7±8.6 years old. Mean seniority was 21.5±9.7 years. PQL-35 results were: perception of management support 4.8±1.5; perception of workload 6.2±1.3; intrinsic motivation 7.9±1.1; job disconnection capacity 6.3±2.6; and professional quality of life 5.2±2.1. Gender differences were found in perception of management support (4.5±1.5 in males vs 4.9±1.5 in females; P=.031) and professional quality of life (4.9±2.0 vs 5.3±2.1; p=.044). Depending on the professional group, differences were found in the perception of workload (6.4±1.1 in physicians, 6.3±1.3 in nurses, 5.9±1.6 in non-sanitary professionals, and 5.3±1.2 in support units professionals; P<.001). Depending on the employment situation, differences were found in the intrinsic motivation (7.8±1.1 in proprietors, 8.3±1.1 in temporary workers, and 8.2±1.1 in substitutes; P=.002). The professional quality of life in the workers of the Toledo Primary Care Health Area is similar to that of other Spanish Health Areas, even in a time of economic crisis. The intrinsic motivation of the professionals is very high, in contrast with their high perception of workload and their low perception of management support. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.
Prevalence of IgE against neuromuscular blocking agents in hairdressers and bakers.
Dong, S; Acouetey, D S; Guéant-Rodriguez, R-M; Zmirou-Navier, D; Rémen, T; Blanca, M; Mertes, P M; Guéant, J-L
2013-11-01
Allergic IgE-mediated reactions to neuromuscular blocking agents (NMBAs) are the main cause of immediate hypersensitivity reactions in anaesthesia; their predominant occurrence in the absence of previous exposure to NMBAs suggests a risk related to environmental exposure. To investigate the prevalence of specific IgE to quaternary ammonium ions in two populations professionally exposed to quaternary ammonium compounds, in the north-eastern France. The study had a retrospective follow-up design whereby apprentices were assessed after their 2-year training period as apprentices. The professionally exposed hairdresser populations (n = 128) were compared with baker/pastry makers (n = 108) and 'non-exposed' matched control subjects (n = 379). We observed a 4.6-fold higher frequency of positive IgE against quaternary ammonium ions in hairdressers (HD), compared with baker/pastry makers (BP) and control (C) groups. The competitive inhibition of quaternary ammonium Sepharose radioimmunoassay (QAS-IgE RIA) with succinylcholine was significantly higher in HD, compared with BP and C groups, with inhibition percentage of 66.2 ± 7.4, 39.7 ± 6.0 and 43.8 ± 9.9, respectively (P < 0.001). The specific IgE against quaternary ammonium ions recognized also two compounds widely used by hairdressers, benzalkonium chloride and polyquaternium-10, in competitive inhibition of IgE RIA. When considering the whole study population, hairdresser professional exposure and total IgE > 100 kU/L were the two significant predictors of IgE-sensitization against quaternary ammonium ions in the multivariate analysis of a model that included age, sex, professional exposure, increased concentration of total IgE (IgE > 100 kU/L) and positive IgE against prevalent allergens (Phadiatop(®) ; P = 0.019 and P = 0.001, respectively). The exposure to hairdressing professional occupational factors increases IgE-sensitization to NMBAs and quaternary ammonium ion compounds used in hairdressing. Besides the pholcodine hypothesis, our study suggests that repetitive exposure to quaternary ammonium compounds used in hairdressing is a risk factor for NMBAs sensitization. © 2013 John Wiley & Sons Ltd.
Professional Wrestling: Can Watching It Bring Out Aggressive and Violent Behaviors in Children?
ERIC Educational Resources Information Center
O'Sullivan, Caroline
This study investigated the effect of viewing professional wrestling programs on first grade boys' violent and aggressive behavior. Interviews were conducted, in focus groups of 4 children, with 16 students who watched wrestling 4-6 hours a week. The children indicated that they enjoyed watching professional wrestling and that after viewing, they…
Dwyer, Tim; Wadey, Veronica; Archibald, Douglas; Kraemer, William; Shantz, Jesse Slade; Townley, John; Ogilvie-Harris, Darrell; Petrera, Massimo; Ferguson, Peter; Nousiainen, Markku
2016-04-01
An entrustable professional activity describes a professional task that postgraduate residents must master during their training. The use of simulation to assess performance of entrustable professional activities requires further investigation. (1) Is simulation-based assessment of resident performance of entrustable professional activities reliable? (2) Is there evidence of important differences between Postgraduate Year (PGY)-1 and PGY-4 residents when performing simulated entrustable professional activities? Three entrustable professional activities were chosen from a list of competencies: management of the patient for total knee arthroplasty (TKA); management of the patient with an intertrochanteric hip fracture; and management of the patient with an ankle fracture. Each assessment of entrustable professional activity was 40 minutes long with three components: preoperative management of a patient (history-taking, examination, image interpretation); performance of a technical procedure on a sawbones model; and postoperative management of a patient (postoperative orders, management of complications). Residents were assessed by six faculty members who used checklists based on a modified Delphi technique, an overall global rating scale as well as a previously validated global rating scale for the technical procedure component of each activity. Nine PGY-1 and nine PGY-4 residents participated in our simulated assessment. We assessed reliability by calculating the internal consistency of the mean global rating for each activity as well as the interrater reliability between the faculty assessment and blinded review of videotaped encounters. We sought evidence of a difference in performance between PGY-1 and PGY-4 residents on the overall global rating scale for each station of each entrustable professional activity. The reliability (Cronbach's α) for the hip fracture activity was 0.88, it was 0.89 for the ankle fracture activity, and it was 0.84 for the TKA activity. A strong correlation was seen between blinded observer video review and faculty scores (mean 0.87 [0.07], p < 0.001). For the hip fracture entrustable professional activity, the PGY-4 group had a higher mean global rating scale than the PGY-1 group for preoperative management (3.56 [0.5] versus 2.33 [0.5], p < 0.001), postoperative management (3.67 [0.5] versus 2.22 [0.7], p < 0.001), and technical procedures (3.11 [0.3] versus 3.67 [0.5], p = 0.015). For the TKA activity, the PGY-4 group scored higher for postoperative management (3.5 [0.8] versus 2.67 [0.5], p = 0.016) and technical procedures (3.22 [0.9] versus 2.22 [0.9], p = 0.04) than the PGY-1 group, but no difference for preoperative management with the numbers available (PGY-4, 3.44 [0.7] versus PGY-1 2.89 [0.8], p = 0.14). For the ankle fracture activity, the PGY-4 group scored higher for postoperative management (3.22 [0.8] versus 2.33 [0.7], p = 0.18) and technical procedures (3.22 [1.2] versus 2.0 [0.7], p = 0.018) than the PGY-1 groups, but no difference for preoperative management with the numbers available (PGY-4, 3.22 [0.8] versus PGY-1, 2.78 [0.7], p = 0.23). The results of our study show that simulated assessment of entrustable professional activities may be used to determine the ability of a resident to perform professional tasks that are critical components of medical training. In this manner, educators can ensure that competent performance of these skills in the simulated setting occurs before actual practice with patients in the clinical setting.
Fear of intimacy with helping professionals and its impact on elderly Chinese.
Lau, Ying; Chow, Aloysius; Chan, Sally; Wang, Wenru
2014-04-01
The present study aimed to investigate the attitudes of Chinese older adults toward seeking help from healthcare professionals, and its impact on their self-care ability and medication adherence. A cross-sectional study using a questionnaire survey was carried out. A convenience sample of 301 older adults was recruited from six health centers in Macao, People's Republic of China. The Chinese versions of Fear of Intimacy with Helping Professionals (C-FIHP), Exercise of Self-care Agency (C-ESCA) and Morisky 4-Item Self-Report Measure of Medication-Taking Behavior (C-MMAS) were used to measure the study variables. Chinese older adults who were married and had comorbidity with arthritis showed significantly negative attitudes toward seeking help form healthcare professional than those who were not married (P < 0.05) and did not have arthritis (P < 0.01). There are significant negative correlations between C-FIHP with C-ESCA (P < 0.01) and C-MMAS-4 (P < 0.01). Regression analysis identified three predicative factors of fear of intimacy with helping professionals: marital status, comorbidity with arthritis and self-care agency, which accounted for 23.9% of variance. The present study suggests that Chinese older adults' fear of intimacy with helping professionals impacts their perceived self-care ability and medication adherence. The three predictive factors identified in the present study might provide useful pointers for healthcare professionals to customize an effective approach to encourage and engage older adults. This might improve the self-care ability and medication adherence of older adults, which will result in a better quality of life and psychosocial well-being. © 2013 Japan Geriatrics Society.
Richards, W; Filipponi, T; Roberts-Burt, V
2014-02-01
The importance of consistent, accurate and unambiguous messages are well documented in oral health promotion literature. Whether the reality of delivering messages in the field fulfils these principle is questionable. This paper explores the perceptions of dental professionals, healthcare professionals and lay community members with regard to key oral health messages in order to highlight any inconsistencies and knowledge gaps between and within groups for disease risk factors. A questionnaire was administered to individuals who belonged to three groups: dental professionals, healthcare professionals and lay community members. The questionnaire established knowledge regarding risk factors for caries, periodontal disease and erosion. Thirty-five (57.4%) of the dental group answered the whole questionnaire correctly, with 22 (27.8%) and 9 (5.1%) of the healthcare and lay community group answering the whole questionnaire correctly, respectively. The question of fluoride levels in children's toothpaste was the main reason for incorrect answers in the dental group. The results of this survey demonstrate a knowledge gradient from dental professionals through to healthcare professionals and then to lay members of the community. The knowledge base observed in the dental group is reflected in the other two groups as would be expected albeit with a significant gap between each group. As expected the dental professionals are generally well informed, but not as well informed as could be expected.
Levine, R S
2014-02-01
The importance of consistent, accurate and unambiguous messages are well documented in oral health promotion literature. Whether the reality of delivering messages in the field fulfils these principle is questionable. This paper explores the perceptions of dental professionals, healthcare professionals and lay community members with regard to key oral health messages in order to highlight any inconsistencies and knowledge gaps between and within groups for disease risk factors. A questionnaire was administered to individuals who belonged to three groups: dental professionals, healthcare professionals and lay community members. The questionnaire established knowledge regarding risk factors for caries, periodontal disease and erosion. Thirty-five (57.4%) of the dental group answered the whole questionnaire correctly, with 22 (27.8%) and 9 (5.1%) of the healthcare and lay community group answering the whole questionnaire correctly, respectively. The question of fluoride levels in children's toothpaste was the main reason for incorrect answers in the dental group. The results of this survey demonstrate a knowledge gradient from dental professionals through to healthcare professionals and then to lay members of the community. The knowledge base observed in the dental group is reflected in the other two groups as would be expected albeit with a significant gap between each group. As expected the dental professionals are generally well informed, but not as well informed as could be expected.
[Use of services and treatment adequacy of major depressive episodes in France].
Briffault, X; Morvan, Y; Rouillon, F; Dardennes, R; Lamboy, B
2010-06-01
Though depressive disorders are major problems of public health, general population data about use of services and treatment adequacy are scarce in France. The literature suggests that the percentage of people suffering from mental disorders who are adequately treated is low. The objective of this study was to estimate the 12-month use of services in the French general population suffering from major depressive episodes (MDE) and levels of treatment adequacy. This analysis was conducted on data from the Health barometer 2005, an epidemiological survey concerning several health topics. Thirty thousand five hundred and fourteen individuals from 12 to 75 years old were interviewed by telephone from October 2004 to February 2005. Depressive disorders were assessed by a standardized tool, the CIDI-SF, according to DSM-IV classification. The mental health questions were answered by 16,883 individuals; i.e. by 60% of individuals aged 15 or older. One year prevalence of MDE was 7.8%. In this group, 58.2% used services in a 12-month period, though only 21% of the service users received adequate treatment. Amongst those who used services, 2/3 consulted health care professionals (i.e. 1/3 of people presenting a MDE). The remaining percentage - 21.4% - of people presenting a MDE used psychotropic drugs without mentioning any use of services for mental health problems. The vast majority of individuals with MDE who used services (34.6% of those with MDE) consulted a professional trained to treat depression (general practitioner, psychiatrist, psychologist and psychotherapist). Only a small proportion (19.9%) of those consulting a professional went to a non-specialist professional as well; and even less (6%) consulted only a non-specialist professional. Amongst trained professionals, most consultations (61%, or 21.1% of the MDE group) concern general practitioners; another 38.4% (13.3% of the MDE group) involved psychiatrists; and 27.8% (9.6% of the MDE group) went to psychologists or psychotherapists. Amongst the psychologists and psychotherapists, most consultations were with psychologists (74.1%). The proportion with adequate treatment differed according to the type of professional. Consulting a general practitioner is associated with the lowest levels of adequate treatment (37.2%, and for general practitioners only, 21.5%). Consulting a psychiatrist is associated with higher proportions of adequate treatment (65.1%, and for consulting a psychiatrist only, 60.7%). Consulting both a general practitioner and a psychiatrist is associated with the highest levels of adequate treatment (79.7%). Antidepressants (ATD) are used far more frequently than psychotherapy (PT): 33.4% of individuals with MDE used ATD, and among the latter, 58.4% had also used anxiolytic drugs (AXL). Finally, 26.9% of the MDE group used AXL, 7.5% without any use of ATD. For PT, 10.8% used PT, and 8.1% used PT and ATD. Improving use of professionals and treatment adequacy are two primary objectives from a public health perspective. Since most adequately treated people used an antidepressant therapy (90%), and only 30% a PT, use of psychotherapeutic approaches might be improved. Moreover, levels of treatment adequacy are very low in people presenting an MDE who did not consult for "mental health reasons". Improving the recognition of symptoms of depression might contribute to better treatment adequacy. Copyright (c) 2009 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.
Sim, Taeyong; Yoo, Hakje; Choi, Ahnryul; Lee, Ki Young; Choi, Mun-Taek; Lee, Soeun; Mun, Joung Hwan
2017-01-01
The aim of this research was to quantify the coordination pattern between thorax and pelvis during a golf swing. The coordination patterns were calculated using vector coding technique, which had been applied to quantify the coordination changes in coupling angle (γ) between two different segments. For this, fifteen professional and fifteen amateur golfers who had no significant history of musculoskeletal injuries. There was no significant difference in coordination patterns between the two groups for rotation motion during backswing (p = 0.333). On the other hand, during the downswing phase, there were significant differences between professional and amateur groups in all motions (flexion/extension: professional [γ] = 187.8°, amateur [γ] = 167.4°; side bending: professional [γ] = 288.4°, amateur [γ] = 245.7°; rotation: professional [γ] = 232.0°, amateur [γ] = 229.5°). These results are expected to be a discriminating measure to assess complex coordination of golfers' trunk movements and preliminary study for interesting comparison by golf skilled levels.
Chan, Kin Sun
2018-01-01
Objectives This study aimed to evaluate the internal consistency, reliability, convergent validity, known-group comparisons, and structural validity of the Chinese version of Fear of Intimacy with Helping Professionals (C–FIS–HP) scale in Macau. Methods A cross-sectional design was used on a sample of 593 older people in 6 health centers. We used Chinese version of Exercise of Self-Care Agency Scale (C-ESCAS) and Morisky 4-item medication adherence scale to evaluate self-care actions and medication adherence. The internal consistency and reliability of C–FIS–HP were analyzed using the Spearman-Brown split-half reliability, Cronbach’s alpha, and test–retest reliability. Convergent validity was tested the construct of C–FIS–HP and self-care actions. Known-group comparisons differentiated predefined groups in an expected direction. Two separated samples were used to test the structural validity. An exploratory factor analysis (EFA) tested the factor structure of C–FISHP using the principal axis factoring. A confirmatory factor analysis (CFA) was further conducted to confirm the factor structure constructed in the prior EFA. Results The C–FIS–HP had a Spearman-Brown split-half coefficient, Cronbach’s alpha, and intraclass correlation coefficient of 0.96, 0.93, and 0.96, respectively. Convergent validity was satisfactory with significantly correlations between the C-FIS-HP and C-ESCAS. C–FIS–HP to differentiate the differences between high-, moderate-, and low- medication adherence groups. EFA demonstrated a two-factor structure among 297 older people. A first-order CFA was performed to confirm the construct dimensionality of C–FIS–HP with satisfactory fit indices (NFI = 0.92; IFI = 0.95; TLI = 0.94; CFI = 0.95 and RMSEA = 0.07) among 296 older people. Conclusions C–FIS–HP is a reliable and valid test for assessing helping relationships in older Chinese people. Health professionals can use C–FIS–HP as a clinical tool to assess the comfort level of patients in a helping relationship, and use this information to develop culturally sensitive therapeutic interventions and treatment plans. Further studies need to be conducted concerning the different psychometric properties, as well as the application of C–FIS–HP in various regions. PMID:29795563
Seeking Professional Help: Etiology Beliefs about Mental Illness across Cultures
ERIC Educational Resources Information Center
Chen, Sylvia Xiaohua; Mak, Winnie W. S.
2008-01-01
In the present study, the authors examined the contributions of cultural beliefs about the etiology of mental illness to the seeking of help from mental health professionals among college students in 4 cultural groups, European Americans, Chinese Americans, Hong Kong Chinese, and Mainland Chinese. Group differences were found in help-seeking…
Visualizing knowledge and attitude factors related to influenza vaccination of physicians.
Antón-Ladislao, Ane; García-Gutiérrez, Susana; Soldevila, Núria; González-Candelas, Fernando; Godoy, Pere; Castilla, Jesús; Mayoral, José María; Astray, Jenaro; Martín, Vicente; Tamames, Sonia; Toledo, Diana; Aguirre, Urko; Domínguez, Angela
2015-02-11
To characterize groups of primary healthcare physicians according to sociodemographic data, years of professional experience and knowledge of and attitudes to influenza, and to evaluate differences between groups with respect to influenza vaccination in the 2011-2012 season. We carried out an anonymous web survey of Spanish primary healthcare physicians in 2012. Information on vaccination, and knowledge of and attitudes to influenza was collected. Multiple correspondence analysis and cluster analysis were used to define groups of physicians. We included 835 physicians and identified three types. Type B were physicians with low professional experience of influenza. Types A and C were physicians with high professional experience with influenza, type A also had a high awareness of influenza and seasonal vaccination. Types A and C were older and more often male than type B (p<0.0001). Knowledge of influenza was greatest in type A and lowest in type B. Awareness of influenza was greatest in type A and lowest in type C. In type A, 71.0% of physicians were vaccinated in the 2011-2012 season, compared with 48.1% and 33.6% from types B and C, respectively (p<0.001). Additional efforts should be made to increase interest and concerns about preventing the transmission of influenza in physicians who do not believe influenza is a severe disease and are not concerned about its transmission. Copyright © 2014 Elsevier Ltd. All rights reserved.
Karadağ, Ayise; Hisar, Filiz; Göçmen Baykara, Zehra; Çalışkan, Nurcan; Karabulut, Hatice; Öztürk, Deniz
2015-01-01
The development of professional attitudes in nursing students is influenced by their learning experiences (knowledge, skills, and attitudes) and instructors' professional behaviors. Instructors can enhance students' professional attitude by organizing the training environment, being a role model, and providing counseling. This study was conducted as a tailoring intervention study over 4 years (2010-2013) examining 73 nursing students (34 intervention, 39 control) to determine the effect of training and counseling on nursing students' professional attitudes. Data were collected utilizing the Introductory Characteristics Form and the Instrument of Professional Attitude for Student Nurses. Intervention group students were provided training and counseling complementing their current education to develop their professional attitudes. Controls proceeded with their current education. Instrument for Professional Attitude for Student Nurses posttest scores of the intervention group were significantly higher than those of control group students. Furthermore, intervention group scores on all subscales other than "competence and continuous education" significantly increased after training. Controls showed no growth in professional attitudes, other than in "contribution to scientific knowledge." The training and counseling program had a positive influence on the professional attitudes of nursing students. Thus, providing tailored training and counseling associated to professionalism throughout the educational process at schools providing nursing training is recommended. Copyright © 2015 Elsevier Inc. All rights reserved.
Creating the Southern Region 4-H Volunteer Advisory Group
ERIC Educational Resources Information Center
Culp, Ken, III; Edwards, Harriett C.; Jordan, Jenny W.
2014-01-01
The SR4-HVAG combines the efforts of states to provide quality educational programming for volunteers and Extension professionals using an advisory group system. An advisory group rather than a council was created because the group provides programmatic input rather than sets policy. The purposes of the SR4-HVAG are to: provide a mechanism for…
Reflective practice as a tool to teach digital professionalism.
Kung, Justin W; Eisenberg, Ronald L; Slanetz, Priscilla J
2012-11-01
Digital professionalism is increasingly being integrated into postgraduate medical education. We developed a small-group, reflective practice-based session incorporating radiology-specific cases to heighten residents' awareness about digital professionalism. Case-based, radiology-specific scenarios were created for a small-group, reflective practice-based session on digital professionalism. Anonymous pre- and postsession surveys evaluating residents' use of social media and their thoughts about the session were administered to the radiology residents. Twenty-five of 38 (66%) residents responded to the presession survey with 40% (10/25) reporting daily social media use; 50% (12/24) witnessing an unprofessional posting on Facebook; and 8% (2/25) posting something unprofessional themselves. Of the 21 residents who attended the session, 13 (62%) responded to the postsession survey. Residents reported that the session added to their understanding of professionalism 3.92, 95% CI (3.57-4.27). As a result of the session, residents stated that they were more aware of protecting patient privacy and confidentiality on social media sites 3.92, 95% CI (3.47-4.37), and would take a more active role in ensuring professional use of social media as it relates to patient care 4.00, 95% CI (3.66-4.34). Residents favorably viewed the reflective case-based session on digital professionalism as a means to be more aware of ways to avoid unprofessional interactions on the internet. Our results suggest that such reflective sessions are an effective method to educate residents on key concepts regarding digital professionalism. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.
Will Natural Resources Professionals Volunteer to Teach Youth?
ERIC Educational Resources Information Center
Smith, Sanford S.; Finley, James C.; San Julian, Gary J.
2010-01-01
A unique approach to volunteer marketing research involved a mail survey with natural resources professionals from across Pennsylvania. Previous work identified this group as a source of potential volunteers for the 4-H youth natural resources program. The results give insights into those most likely to volunteer to teach youth through 4-H…
Jacova, Claudia; McGrenere, Joanna; Lee, Hyunsoo S; Wang, William W; Le Huray, Sarah; Corenblith, Emily F; Brehmer, Matthew; Tang, Charlotte; Hayden, Sherri; Beattie, B Lynn; Hsiung, Ging-Yuek R
2015-01-01
Cognitive Testing on Computer (C-TOC) is a novel computer-based test battery developed to improve both usability and validity in the computerized assessment of cognitive function in older adults. C-TOC's usability was evaluated concurrently with its iterative development to version 4 in subjects with and without cognitive impairment, and health professional advisors representing different ethnocultural groups. C-TOC version 4 was then validated against neuropsychological tests (NPTs), and by comparing performance scores of subjects with normal cognition, Cognitive Impairment Not Dementia (CIND) and Alzheimer disease. C-TOC's language tests were validated in subjects with aphasic disorders. The most important usability issue that emerged from consultations with 27 older adults and with 8 cultural advisors was the test-takers' understanding of the task, particularly executive function tasks. User interface features did not pose significant problems. C-TOC version 4 tests correlated with comparator NPT (r=0.4 to 0.7). C-TOC test scores were normal (n=16)>CIND (n=16)>Alzheimer disease (n=6). All normal/CIND NPT performance differences were detected on C-TOC. Low computer knowledge adversely affected test performance, particularly in CIND. C-TOC detected impairments in aphasic disorders (n=11). In general, C-TOC had good validity in detecting cognitive impairment. Ensuring test-takers' understanding of the tasks, and considering their computer knowledge appear important steps towards C-TOC's implementation.
Ruescas-Escolano, Esther; Orozco-Beltran, Domingo; Gaubert-Tortosa, María; Navarro-Palazón, Ana; Cordero-Fort, Alberto; Navarro-Pérez, Jorge; Carratalá-Munuera, Concepción; Pertusa-Martínez, Salvador; Soler-Bahilo, Enrique; Brotons-Muntó, Francisco; Bort-Cubero, Jose; Núñez-Martínez, Miguel A; Bertomeu-Martínez, Vicente; López-Pineda, Adriana; Gil-Guillén, Vicente F
2014-06-01
Comparison of the results from the EUROASPIRE I to the EUROASPIRE III, in patients with coronary heart disease, shows that the prevalence of uncontrolled risk factors remains high. The aim of the study was to evaluate the effectiveness of a new multifactorial intervention in order to improve health care for chronic coronary heart disease patients in primary care. In this randomized clinical trial with a 1-year follow-up period, we recruited patients with a diagnosis of coronary heart disease (145 for the intervention group and 1461 for the control group). An organizational intervention on the patient-professional relationship (centered on the Chronic Care Model, the Stanford Expert Patient Programme and the Kaiser Permanente model) and formative strategy for professionals were carried out. The main outcomes were smoking control, low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP) and diastolic blood pressure (DBP). A multivariate analysis was performed. The characteristics of patients were: age (68.4±11.8 years), male (71.6%), having diabetes mellitus (51.3%), dyslipidemia (68.5%), arterial hypertension (76.7%), non-smokers (76.1%); LDL-C < 100mg/dL (46.9%); SBP < 140mmHg (64.5%); DBP < 90 (91.2%). The multivariable analysis showed the risk of good control for intervention group to be: smoking, adjusted relative risk (aRR): 15.70 (95% confidence interval [95%CI], 4.2-58.7); P < .001; LDL-C, aRR: 2.98 (95%CI, 1.48-6.02); P < .002; SPB, aRR: 1.97 (95%CI, 1.21-3.23); P < .007, and DBP: aRR: 1.51 (95%CI, 0.65-3.50); P < .342. An intervention based on models for chronic patients focused in primary care and involving patients in medical decision making improves cardiovascular risk factors control (smoking, LDL-C and SBP). Chronic care strategies may be an efficacy tool to help clinicians to involve the patients with a diagnosis of CHD to reach better outcomes. Copyright © 2014 Elsevier España, S.L. All rights reserved.
Vadepally, Ashwant Kumar; Sinha, Ramen
2018-06-01
To investigate the perception of Oral and maxillofacial surgery by healthcare professionals, students and general public. A questionnaire form was created that listed ten clinical situations, and given by hand to 1200 individuals, divided into six groups: group 1, medical professionals; group 2, Specialties of dentistry; group 3, general dentists; group 4, medical students; group 5, dental students; and group 6, general public, each comprising 200 individuals. Respondents were asked to indicate who they would expect to treat them if they had one of the specified conditions listed in the questionnaire. We present the results and current awareness levels of this simple questionnaire. The present study addresses the common issue raised by many authors, 'What surgical education the speciality offers?' especially to medical professionals, medical students and general public to enhance an appropriate referral. Most of the respondents in groups 2, 3 and 5 agreed that specific conditions listed in the questionnaire were within the domain of oral and maxillofacial surgery, but such response was not seen in groups 1, 4 and 6 ( p < 0.001). An overall awareness level of oral and maxillofacial surgery was found to be 50.2%. The onus of creating and improving the awareness and perception of our specialty lies on oral and maxillofacial surgeon. Unified efforts at individual as well as global level will help achieve this goal.
Bhurji, N; Javer, J; Gasevic, D; Khan, N A
2016-01-01
Objectives Optimal control of type 2 diabetes is challenging in many patient populations including in South Asian patients. We systematically reviewed studies on the effect of diabetes management interventions targeted at South Asian patients with type 2 diabetes on glycaemic control. Design Systematic review of MEDLINE, EMBASE and CINAHL databases for randomised controlled trials (RCTs) and pre-post-test studies (January 1990 to February 2014). Studies were stratified by where interventions were conducted (South Asia vs Western countries). Participants Patients originating from Pakistan, Bangladesh or India with type 2 diabetes. Primary outcome Change in glycated haemoglobin (HbA1c). Secondary end points included change in blood pressure, lipid levels, anthropomorphics and knowledge. Results 23 studies (15 RCTs) met criteria for analysis with 7 from Western countries (n=2532) and 16 from South Asia (n=1081). Interventions in Western countries included translated diabetes education, additional clinical care, written materials, visual aids, and bilingual community-based peers and/or health professionals. Interventions conducted in South Asia included yoga, meditation or exercise, community-based peers, health professionals and dietary education (cooking exercises). Among RCTs in India (5 trials; n=390), 4 demonstrated significant reductions in HbA1c in the intervention group compared with usual care (yoga and exercise interventions). Among the 4 RCTs conducted in Europe (n=2161), only 1 study, an education intervention of 113 patients, reported a significant reduction in HbA1c with the intervention. Lipids, blood pressure and knowledge improved in both groups with studies from India more often reporting reductions in body mass index and waist circumference. Conclusions Overall, there was little improvement in HbA1c level in diabetes management interventions targeted at South Asians living in Europe compared with usual care, although other outcomes did improve. The smaller studies in India demonstrated significant improvements in glycaemic and other end points. Novel strategies are needed to improve glycaemic control in South Asians living outside of India. PMID:27098819
IAU Commission 55: Communicating Astronomy with the Public
NASA Astrophysics Data System (ADS)
Fienberg, R. T.; Christensen, L. L.; Russo, P.
2014-01-01
The International Astronomical Union (IAU) has vested considerable responsibility for its public outreach efforts in Commission 55 (C55), Communicating Astronomy with the Public. This article briefly recounts the origin and history of C55 over the past decade, describing how C55 fits into the IAU's recently revised organisational structure and newly implemented Strategic Plan. It also lists C55's current officers, Organising Committee members, Working Groups, and Working Group chairs and explains how IAU members can join C55, inviting other professionals engaged in astronomy-related public outreach to become associates of C55.
Short Duration Heat Acclimation in Australian Football Players
Kelly, Monica; Gastin, Paul B.; Dwyer, Daniel B; Sostaric, Simon; Snow, Rodney J.
2016-01-01
This study examined if five sessions of short duration (27 min), high intensity, interval training (HIIT) in the heat over a nine day period would induce heat acclimation in Australian football (AF) players. Fourteen professional AF players were matched for VO2peak (mL·kg-1·min-1) and randomly allocated into either a heat acclimation (Acc) (n = 7) or Control (Con) group (n = 7). The Acc completed five cycle ergometer HIIT sessions within a nine day period on a cycle ergometer in the heat (38.7 ± 0.5 °C; 34.4 ± 1.3 % RH), whereas Con trained in thermo-neutral conditions (22.3 ± 0.2 °C; 35.8 ± 0. % RH). Four days prior and two days post HIIT participants undertook a 30 min constant load cycling test at 60% V̇O2peak in the heat (37.9 ± 0.1 °C; 28.5 ± 0.7 % RH) during which VO2, blood lactate concentration ([Lac-]), heart rate (HR), rating of perceived exertion (RPE), thermal comfort, core and skin temperatures were measured. Heat acclimation resulted in reduced RPE, thermal comfort and [Lac-] (all p < 0.05) during the submaximal exercise test in the heat. Heart rate was lower (p = 0.007) after HIIT, in both groups. Heat acclimation did not influence any other measured variables. In conclusion, five short duration HIIT sessions in hot dry conditions induced limited heat acclimation responses in AF players during the in-season competition phase. In practice, the heat acclimation protocol can be implemented in a professional team environment; however the physiological adaptations resulting from such a protocol were limited. Key points Some minor heat acclimation adaptations can be induced in professional AF players with five 27 min non-consecutive, short duration HIIT sessions in the heat. The heat acclimation protocol employed in this study was able to be implemented in a professional team sport environment during an actual competitive season. Elevating and maintaining a high core temperature sufficient for heat acclimation likely requires a longer heat training session or some pre-heating prior to exercise. PMID:26957934
Short Duration Heat Acclimation in Australian Football Players.
Kelly, Monica; Gastin, Paul B; Dwyer, Daniel B; Sostaric, Simon; Snow, Rodney J
2016-03-01
This study examined if five sessions of short duration (27 min), high intensity, interval training (HIIT) in the heat over a nine day period would induce heat acclimation in Australian football (AF) players. Fourteen professional AF players were matched for VO2peak (mL·kg(-1)·min(-1)) and randomly allocated into either a heat acclimation (Acc) (n = 7) or Control (Con) group (n = 7). The Acc completed five cycle ergometer HIIT sessions within a nine day period on a cycle ergometer in the heat (38.7 ± 0.5 °C; 34.4 ± 1.3 % RH), whereas Con trained in thermo-neutral conditions (22.3 ± 0.2 °C; 35.8 ± 0. % RH). Four days prior and two days post HIIT participants undertook a 30 min constant load cycling test at 60% V̇O2peak in the heat (37.9 ± 0.1 °C; 28.5 ± 0.7 % RH) during which VO2, blood lactate concentration ([Lac(-)]), heart rate (HR), rating of perceived exertion (RPE), thermal comfort, core and skin temperatures were measured. Heat acclimation resulted in reduced RPE, thermal comfort and [Lac(-)] (all p < 0.05) during the submaximal exercise test in the heat. Heart rate was lower (p = 0.007) after HIIT, in both groups. Heat acclimation did not influence any other measured variables. In conclusion, five short duration HIIT sessions in hot dry conditions induced limited heat acclimation responses in AF players during the in-season competition phase. In practice, the heat acclimation protocol can be implemented in a professional team environment; however the physiological adaptations resulting from such a protocol were limited. Key pointsSome minor heat acclimation adaptations can be induced in professional AF players with five 27 min non-consecutive, short duration HIIT sessions in the heat.The heat acclimation protocol employed in this study was able to be implemented in a professional team sport environment during an actual competitive season.Elevating and maintaining a high core temperature sufficient for heat acclimation likely requires a longer heat training session or some pre-heating prior to exercise.
A study of static, kinetic, and dynamic visual acuity in 102 Japanese professional baseball players
Hoshina, Kohji; Tagami, Yuichi; Mimura, Osamu; Edagawa, Hiroshi; Matsubara, Masao; Nakayama, Teiichi
2013-01-01
Background It seemed that visual functions might have some effects on the performance of baseball players. We measured static, kinetic, and dynamic visual acuity (SVA, KVA, and DVA, respectively) of Japanese professional baseball players to ascertain whether there would be any difference in SVA, KVA, and DVA among player groups stratified according to their performance level. Methods The subjects were 102 male professional baseball players with a mean age of 26 years who were members of a Japanese professional baseball club from 2000 to 2009. They were stratified into three groups according to their performance level: A (players who were on the roster of the top-level team all the time throughout the study period), B (players who were on the roster of the top-level team sometimes but not all the time), and C (players who were never on the roster of the top-level team). They were interviewed for the use of corrective visual aids, and examined for SVA, KVA, and DVA. The measurements of these parameters were compared among groups A, B, and C. We also investigated and analyzed the association of KVA or DVA with player position (pitchers or fielders) and with hand dominance for batting. KVA was compared between the pitchers and the fielders because they each require different playing skills. DVA was compared between the right-handed and the left-handed batters. Results There was no statistically significant difference among groups A, B, and C. There was a statistically significant difference in KVA between the pitchers and the fielders (t-test; P < 0.05) There was no statistically significant difference in DVA between the right-handed and the left-handed batters. Conclusions There was no significant difference in the examined visual functions among player groups with different performance levels. PMID:23569356
42 CFR 414.65 - Payment for telehealth services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... nursing facility care services (not including the Federally-mandated periodic visits under § 483.40(c) and with the limitation of one telehealth nursing facility care service every 30 days), professional... group medical nutrition therapy services, individual and group kidney disease education services...
ERIC Educational Resources Information Center
Popova, I. P.
2011-01-01
Russia's new economy and changes in the technological and employment spheres require the continual retraining of Russian workers and professionals. Research shows that there are benefits of this for individuals and for the society. (Contains 4 tables and 5 notes.) [This article was translated by Kim Braithwaite.
den Herder-van der Eerden, Marlieke; van Wijngaarden, Jeroen; Preston, Nancy; Linge-Dahl, Lisa; Radbruch, Lukas; Van Beek, Karen; Menten, Johan; Busa, Csilla; Csikos, Agnes; Vissers, Kris; van Gurp, Jelle; Hasselaar, Jeroen
2018-01-01
Background: Integrated palliative care aims at improving coordination of palliative care services around patients’ anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. Aim: To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe. Design: Qualitative group interview design. Setting/participants: A total of 19 group interviews were conducted (2 in Belgium, 4 in the Netherlands, 4 in the United Kingdom, 4 in Germany and 5 in Hungary) with 142 healthcare professionals from several integrated palliative care initiatives in five European countries. The majority were nurses (n = 66; 46%) and physicians (n = 50; 35%). Results: The dominant strategy for fostering integrated palliative care is building core teams of palliative care specialists and extended professional networks based on personal relationships, shared norms, values and mutual trust, rather than developing standardised information exchange and referral pathways. Providing integrated palliative care with healthcare professionals in the wider professional community appears difficult, as a shared proactive multidisciplinary palliative care approach is lacking, and healthcare professionals often do not know palliative care professionals or services. Conclusion: Achieving better palliative care integration into regular healthcare and convincing the wider professional community is a difficult task that will take time and effort. Enhancing standardisation of palliative care into education, referral pathways and guidelines and standardised information exchange may be necessary. External authority (policy makers, insurance companies and professional bodies) may be needed to support integrated palliative care practices across settings. PMID:29436279
den Herder-van der Eerden, Marlieke; van Wijngaarden, Jeroen; Payne, Sheila; Preston, Nancy; Linge-Dahl, Lisa; Radbruch, Lukas; Van Beek, Karen; Menten, Johan; Busa, Csilla; Csikos, Agnes; Vissers, Kris; van Gurp, Jelle; Hasselaar, Jeroen
2018-06-01
Integrated palliative care aims at improving coordination of palliative care services around patients' anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe. Qualitative group interview design. A total of 19 group interviews were conducted (2 in Belgium, 4 in the Netherlands, 4 in the United Kingdom, 4 in Germany and 5 in Hungary) with 142 healthcare professionals from several integrated palliative care initiatives in five European countries. The majority were nurses ( n = 66; 46%) and physicians ( n = 50; 35%). The dominant strategy for fostering integrated palliative care is building core teams of palliative care specialists and extended professional networks based on personal relationships, shared norms, values and mutual trust, rather than developing standardised information exchange and referral pathways. Providing integrated palliative care with healthcare professionals in the wider professional community appears difficult, as a shared proactive multidisciplinary palliative care approach is lacking, and healthcare professionals often do not know palliative care professionals or services. Achieving better palliative care integration into regular healthcare and convincing the wider professional community is a difficult task that will take time and effort. Enhancing standardisation of palliative care into education, referral pathways and guidelines and standardised information exchange may be necessary. External authority (policy makers, insurance companies and professional bodies) may be needed to support integrated palliative care practices across settings.
Horseman, Susan V; Hockenhull, Jo; Buller, Henry; Mullan, Siobhan; Barr, Alistair R S; Whay, Helen R
2017-01-01
The equine industry in Great Britain has not been subject to the same pressures as the farming industry to engage with welfare assessment, but this may change as concern about equine welfare increases. Stakeholder attitudes toward welfare assessment may impact the implementation of welfare assessment practices. Focus-group discussions regarding welfare assessment were conducted with 6 equine stakeholder groups: leisure horse owners (caregivers; n = 4), grooms (n = 5), veterinary surgeons (n = 3), welfare scientists (n = 4), welfare charity workers (n = 5), and professional riders (n = 4). Three themes emerged from the discussions: (a) Participants predominantly interpreted welfare assessment as a means of identifying and correcting poor welfare in an immediate way; (b) participants believed that horse welfare varied over time; and (c) attributes of the assessor were viewed as an important consideration for equine welfare assessment. The views of equine industry members give insight into the value welfare assessments may have to the industry and how equine welfare assessment approaches can achieve credibility within the industry and increase the positive impact of welfare assessments on equine welfare.
Astiz, Mariana; Arnal, Nathalie; de Alaniz, María J T; Marra, Carlos Alberto
2011-09-01
The impact of involuntary exposure to pesticides was studied in a group of professional sprayers (S) (25±5 years old) exposed to various agrochemicals for about 10 years. The results were compared with a group of non exposed people (C). S group showed hematological, renal, pancreatic and hepatic biomarkers within the reference values established for the general population, including cholinesterase activity. In spite of that, all the biochemical tests were statistically different compared to C. On the other hand, oxidative stress biomarkers (OSB) such as plasma tocopherol and the total reducing ability of plasma were significantly decreased, while protein carbonyls, thiobarbituric acid-reactive substances, total glutathione and the sum of nitrites and nitrates were increased in the exposed group. Results demonstrated that screening laboratory tests could not be fully sensitive in detecting sub-clinical exposure to pesticides, and also suggest that OSB could be validated and included in health surveillance protocols. Copyright © 2011 Elsevier B.V. All rights reserved.
Dorwie, Florence M; Pacquiao, Dula F
2014-01-01
Describe practices of traditional birth attendants (TBAs) in assisting women in childbirth and the perceptions of TBAs by mothers and health professionals familiar with their work. Qualitative design using focus groups conducted in urban and rural settings in Sierra Leone. Separate audiotaped focus groups conducted for each group of participants lasting between 45 and 90 minutes. Purposive sample of 20 TBAs, 20 mothers, and 10 health professionals who met the following criteria: (a) at least 18 years of age, (b) TBAs currently practicing, (c) mothers who delivered at least one child assisted by a TBA, and (d) health professionals currently practicing in the hospital and familiar with TBA practices. TBAs are valued by mothers, health professionals, and the community because they provide accessible and affordable care to mothers who may otherwise have no access to health services. TBAs need training, supervision, and resources for effective referral of mothers. Systemic problems in the health care system create enormous barriers to effective care for mothers and children independent of TBA practices that contribute to high maternal and infant mortality rates. The study findings have implications on broad public policy in improving maternal and child health in the country.
Sorgaard, Knut W; Ryan, Peter; Dawson, Ian
2010-06-14
Unqualified/non-registered caregivers (N-R Cs) will continue to play important roles in the mental health services. This study compares levels of burnout and sources of stress among qualified and N-R Cs working in acute mental health care. A total of 196 nursing staff --124 qualified staff (mainly nurses) and 72 N-R Cs with a variety of different educational backgrounds--working in acute wards or community mental teams from 5 European countries filled out the Maslach Burnout Inventory (MBI), the Mental Health Professional Scale (MHPSS) and the Psychosocial Work Environment and Stress Questionnaire (PWSQ). (a) The univariate differences were generally small and restricted to a few variables. Only Social relations (N-R Cs being less satisfied) at Work demands (nurses reporting higher demands) were different at the .05 level. (b) The absolute scores both groups was highest on variables that measured feelings of not being able to influence a work situation characterised by great demands and insufficient resources. Routines and educational programs for dealing with stress should be available on a routine basis. (c) Multivariate analyses identified three extreme groups: (i) a small group dominated by unqualified staff with high depersonalization, (ii) a large group that was low on depersonalisation and high on work demands with a majority of qualified staff, and (iii) a small N-R C-dominated group (low depersonalization, low work demands) with high scores on professional self-doubt. In contrast to (ii) the small and N-R C-dominated groups in (i) and (iii) reflected mainly centre-dependent problems. The differences in burnout and sources of stress between the two groups were generally small. With the exception of high work demands the main differences between the two groups appeared to be centre-dependent. High work demands characterized primarily qualified staff. The main implication of the study is that no special measures addressed towards N-R Cs in general with regard to stress and burnout seem necessary. The results also suggest that centre-specific problems may cause more stress among N-R Cs compared to the qualified staff (e.g. professional self-doubt).
Morale and job perception of community mental health professionals in Berlin and London.
Priebe, Stefan; Fakhoury, Walid K H; Hoffmann, Karin; Powell, Richard A
2005-03-01
Morale and job perception of staff in community mental health care may influence feasibility and quality of care, and some research has suggested particularly high burnout of staff in the community. The aims of this study were to: a) assess morale, i. e. team identity, job satisfaction and burnout, in psychiatrists, community psychiatric nurses and social workers in community mental health care in Berlin and London; b) compare findings between the groups and test whether personal characteristics, place of working and professional group predict morale; and c) explore what tasks, obstacles, skills, enjoyable and stressful aspects interviewees perceived as important in their jobs. In all, 189 mental health professionals (a minimum of 30 in each of the six groups) responded to a postal survey and reported activities per week using pre-formed categories. Perception of professional role was assessed on the Team Identity Scale, job satisfaction on the Minnesota Job Satisfaction Scale, and burnout on the Maslach Burnout Inventory. Seven simple open questions were used to elicit the main tasks, skills that staff did and did not feel competent in, aspects that they did and did not enjoy in their job, and obstacles and factors that caused pressure. Answers were subjected to content analysis using a posteriori formed categories. Weekly activities and morale varied between sites and professional groups. Some mean scores for groups in London exceeded the threshold for a burnout syndrome, and are particularly less favourable for social workers. Working in London predicted higher burnout, lower job satisfaction and lower team identity. Being a psychiatrist predicted higher team identity, whilst being a social worker was associated with higher burnout and lower job satisfaction. Male gender predicted lower burnout and higher team identity. However, professional group and site interacted in predicting burnout and job satisfaction. Psychiatrists in London had much more favourable scores than the other two groups, whilst this did not hold true in Berlin. Answers to open questions revealed universal aspects, such as enjoying direct patient contact and disliking bureaucracy, but also various views that were specific to a site or professional group or both. Burnout remains a problem for some, but not all, professional groups in community mental health care, and social workers in London appear to be a group with particularly low morale. Differences between professional groups depend on the location, and it remains unclear to what extent job-related and general factors impact on the morale of mental health professionals. Answers to open questions reveal general as well as specific aspects of the job perception of the professional groups, some of which may be relevant for service development, training and supervision. More conceptual and methodological work and more extensive studies are required to develop a better understanding of how community mental health professionals perceive their job and how morale may be improved.
7 CFR 1773.5 - Qualifications of CPA.
Code of Federal Regulations, 2011 CFR
2011-01-01
... regulations of professional conduct promulgated by the accountancy board of the state in which the borrower is...: (1) Meets the standards for independence contained in the AICPA Code of Professional Conduct in... the accounting and audit practice conducted by an approved peer review program under paragraph (c)(4...
7 CFR 1773.5 - Qualifications of CPA.
Code of Federal Regulations, 2010 CFR
2010-01-01
... regulations of professional conduct promulgated by the accountancy board of the state in which the borrower is...: (1) Meets the standards for independence contained in the AICPA Code of Professional Conduct in... the accounting and audit practice conducted by an approved peer review program under paragraph (c)(4...
7 CFR 1773.5 - Qualifications of CPA.
Code of Federal Regulations, 2013 CFR
2013-01-01
... regulations of professional conduct promulgated by the accountancy board of the state in which the borrower is...: (1) Meets the standards for independence contained in the AICPA Code of Professional Conduct in... the accounting and audit practice conducted by an approved peer review program under paragraph (c)(4...
7 CFR 1773.5 - Qualifications of CPA.
Code of Federal Regulations, 2014 CFR
2014-01-01
... regulations of professional conduct promulgated by the accountancy board of the state in which the borrower is...: (1) Meets the standards for independence contained in the AICPA Code of Professional Conduct in... the accounting and audit practice conducted by an approved peer review program under paragraph (c)(4...
7 CFR 1773.5 - Qualifications of CPA.
Code of Federal Regulations, 2012 CFR
2012-01-01
... regulations of professional conduct promulgated by the accountancy board of the state in which the borrower is...: (1) Meets the standards for independence contained in the AICPA Code of Professional Conduct in... the accounting and audit practice conducted by an approved peer review program under paragraph (c)(4...
Borgerson, Dawn; Dino, Jennifer
2012-01-01
Clinical research professionals are faced with decreased funding and increased workloads; innovative methods of professional development programs are necessary to accommodate these factors. This study evaluated the feasibility, perceived satisfaction, and value of using webinars to educate clinical research professionals on reporting adverse events commonly experienced in pediatric oncology clinical trials. The setting incorporated synchronous web-based educational technology. Constructivist learning provides the theoretical framework for this study. Participants evaluated the professional development program at 2 time points: (a) at the conclusion and (b) 4 to 6 weeks afterward, using survey method. Synchronous webinars were both economical and effective in educating clinical research professionals across institutional sites. Participants reported exceptionally high levels of satisfaction with the accessibility, scope, quality, and interactivity of the professional development program. The vast majority of participants reported that the education would assist with reporting adverse events in pediatric oncology clinical trials and this perception persisted into clinical practice. Although the results of this study were intended to guide future educational efforts of the Children's Oncology Group, they may also apply to other cooperative groups.
de Lasson, Lydia; Just, Eva; Stegeager, Nikolaj; Malling, Bente
2016-06-24
The transition from student to medical doctor is challenging and stressful to many junior doctors. To practice with confidence and professionalism the junior doctors have to develop a strong professional identity. Various suggestions on how to facilitate formation of professional identity have been offered including the possible positive effect of group-coaching courses. The purpose of this study was to explore how group-coaching might facilitate professional identity formation among junior doctors in the transition period. Group-coaching courses comprising three whole-day sessions and five 2 h sessions during a period of 4 months were offered to junior doctors in the first years after graduation. The purpose was to support the participants' professional development, ability to relate to patients, relatives and staff and career development. The coaches in this study had a background as health professionals combined with coaching educations. Data was obtained through observations, open-ended questionnaires and interviews. A generic thematic analysis was applied. Forty-five doctors participated in six coaching groups. The three main themes emerging in the sessions were: Adoption to medical culture, career planning, and work/life-balance. The junior doctors found the coaching intervention highly useful in order to cope with these challenges. Furthermore, the group was a forum where the junior doctors could share thoughts and feelings with colleagues without being afraid that this would endanger their professional career. Many found new ways to respond to everyday challenges mainly through a new awareness of patterns of thinking and feeling. The participants found that the group-coaching course supported their professional identity formation (thinking, feeling and acting as a doctor), adoption to medical culture, career planning and managing a healthy work/life-balance. Further studies in different contexts are recommended as well as studies using other methods to test the results of this qualitative study.
Kaplan Marcusán, Adriana; Riba Singla, Laura; Laye, Mass; Secka, Dodou M; Utzet, Mireia; Le Charles, Marie-Alix
2016-01-01
Background Female genital mutilation/cutting (FGM/C) is a harmful traditional practice that affects two out of three girls in The Gambia, seriously threatening their life and well-being with severe health consequences. By tracking the reference values established in former research conducted between 2009 and 2011, the objectives of this study are to explore trends and to measure and assess changes in knowledge, attitudes, and practices regarding FGM/C among health care professionals (HCPs) in The Gambia. Methods A cross-sectional descriptive study was designed to collect and analyze data from an overall stratified sample consisting of 1,288 HCPs including health professionals and students throughout the six regions of The Gambia. Data were collected by the implementation of a self-administered written knowledge, attitudes, and practices questionnaire between 2012 and 2014. Results The results of this study showed that 76.4% of HCPs are eager to abandon FGM/C, and 71.6% of them regard it as a harmful practice with negative consequences on life and health. HCPs reported more knowledge and favorable attitudes towards FGM/C abandonment, being better able to identify the practice, more aware of its health complications, and more concerned in their essential role as social agents of change. However, 25.4% of HCPs still embraced the continuation of the practice, 24.4% expressed intention of subjecting their own daughters to it, and 10.5% declared to have performed it within their professional praxis. Conclusion Findings confirm progress in knowledge and attitudes regarding FGM/C among HCPs, who are better skilled to understand and manage the consequences. Nevertheless, discrepancies between information, intention, and behavior unveil resistance in practice and proves that FGM/C medicalization is increasing. Thus, there is an urgent need to support HCPs in the integration of FGM/C preventive interventions within the public health system, to address arguments favoring medicalization, and to use data to design appropriate strategies. PMID:27110140
Escalada, Javier; Orozco-Beltran, Domingo; Morillas, Carlos; Alvarez-Guisasola, Fernando; Gomez-Peralta, Fernando; Mata-Cases, Manel; Palomares, Rafael; Iglesias, Rosario; Carratalá-Munuera, Concepción
2016-12-01
To describe the views of healthcare providers about starting insulin in patients with type 2 diabetes and to determine the specific factors that contribute to delay insulin initiation. Two-phases observational descriptive study. In the quantitative phase we conducted a cross-sectional survey of a sample of 380 healthcare professionals (general practitioners (GPs), endocrinologists, internists and nurses). In the qualitative phase, a discussion group reviewed the results of the survey to propose solutions. In poorly controlled patients, 46% of GPs vs. 43.2% of internists and 31.3% of endocrinologists waited 3-6months before starting insulin, and 71.4% of GPs vs. 66.7% of internists vs. 58.8% of endocrinologists need to confirm twice the HbA1c levels. The upper level of basal glucose more frequently considered as good control is 130mg/dL for GPs (35.7%), and 120mg/dL for internists (35.8%) and endocrinologists (37.5%). In patients without comorbidities, 32.5% of endocrinologists vs. 27.2% of internists vs. 17.9% of GPs initiated insulin when HbA1c was >7% while 26.3% of endocrinologists vs. 28.4% of internists vs. 38.4% of GPs initiated insulin when HbA1c was >8%. The interference of the therapy with the patient' social life and the need for time management were the most accepted barriers to initiate insulin. There are significant differences between GPs and endocrinologists regarding the insulin initiation and GPs and internists felt less empowered to manage patients with diabetes. Specific training for professionals and joint work with patients could improve the glycemic control. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
Quantitative analysis of professionally trained versus untrained voices.
Siupsinskiene, Nora
2003-01-01
The aim of this study was to compare healthy trained and untrained voices as well as healthy and dysphonic trained voices in adults using combined voice range profile and aerodynamic tests, to define the normal range limiting values of quantitative voice parameters and to select the most informative quantitative voice parameters for separation between healthy and dysphonic trained voices. Three groups of persons were evaluated. One hundred eighty six healthy volunteers were divided into two groups according to voice training: non-professional speakers group consisted of 106 untrained voices persons (36 males and 70 females) and professional speakers group--of 80 trained voices persons (21 males and 59 females). Clinical group consisted of 103 dysphonic professional speakers (23 males and 80 females) with various voice disorders. Eighteen quantitative voice parameters from combined voice range profile (VRP) test were analyzed: 8 of voice range profile, 8 of speaking voice, overall vocal dysfunction degree and coefficient of sound, and aerodynamic maximum phonation time. Analysis showed that healthy professional speakers demonstrated expanded vocal abilities in comparison to healthy non-professional speakers. Quantitative voice range profile parameters- pitch range, high frequency limit, area of high frequencies and coefficient of sound differed significantly between healthy professional and non-professional voices, and were more informative than speaking voice or aerodynamic parameters in showing the voice training. Logistic stepwise regression revealed that VRP area in high frequencies was sufficient to discriminate between healthy and dysphonic professional speakers for male subjects (overall discrimination accuracy--81.8%) and combination of three quantitative parameters (VRP high frequency limit, maximum voice intensity and slope of speaking curve) for female subjects (overall model discrimination accuracy--75.4%). We concluded that quantitative voice assessment with selected parameters might be useful for evaluation of voice education for healthy professional speakers as well as for detection of vocal dysfunction and evaluation of rehabilitation effect in dysphonic professionals.
Minority and minority-deaf professionals. How many and where are they?
Andrews, J F; Jordan, D L
1993-12-01
A survey of 6,043 professionals in 349 deaf education programs showed that 10.4% are from nonwhite or minority ethnic/cultural backgrounds. Of these minority professionals, 11.7% are deaf. Only 8 minority deaf administrators were found. Chi-square analyses showed that ethnic/cultural background and hearing loss were strongly associated with the type of program where the professionals were employed. More than half of the minority professionals worked in public schools. The District of Columbia, New York, and Maryland lead the country in the number of deaf professionals employed. More than half of all black deaf professionals work in either D.C. or New York. Texas leads the country in numbers of Hispanic professionals employed, and New Mexico has more Hispanic professionals than does California, New York, or Florida.
Nursing professional identity: an infant or one with Alzheimer
Yazdannik, Ahmadreza; Yekta, Zohreh Parsa; Soltani, Aliasghar
2012-01-01
Background: Each group or profession has its own discourse. Discourses create identity, support institutions and reproduce power relationships. Professional identity of Iranian nurses, which has recently had the opportunity to represent itself in social arena, needs investigation. This study aimed to make internal aspect of this identity clear. Materials and Methods: This study was conducted by discourse analysis, using data of 23 semi-structured individual interviews and 4 focus group interviews with nurses and senior nursing students of Tehran and Isfahan University of Medical Sciences, Iran, to evaluate their professional identity. Findings: In professional self-concept, elements like spirituality value and low financial benefits were identified as well as conflicting features of holiness and humility, identity emerging, identity escape, low professional self-confidence and justice seeking, lost professional authority and pride. Conclusions: Nursing professional identity has been formed based on cultural social structure, values and beliefs governing health system. This is a spectrum of a growing and emerging identity to a developed but forgotten identity. Although nursing discourse is subordinate in health system discourse, signs of moving toward professional maturity have emerged. PMID:23833602
Nursing professional identity: an infant or one with Alzheimer.
Yazdannik, Ahmadreza; Yekta, Zohreh Parsa; Soltani, Aliasghar
2012-02-01
Each group or profession has its own discourse. Discourses create identity, support institutions and reproduce power relationships. Professional identity of Iranian nurses, which has recently had the opportunity to represent itself in social arena, needs investigation. This study aimed to make internal aspect of this identity clear. This study was conducted by discourse analysis, using data of 23 semi-structured individual interviews and 4 focus group interviews with nurses and senior nursing students of Tehran and Isfahan University of Medical Sciences, Iran, to evaluate their professional identity. In professional self-concept, elements like spirituality value and low financial benefits were identified as well as conflicting features of holiness and humility, identity emerging, identity escape, low professional self-confidence and justice seeking, lost professional authority and pride. Nursing professional identity has been formed based on cultural social structure, values and beliefs governing health system. This is a spectrum of a growing and emerging identity to a developed but forgotten identity. Although nursing discourse is subordinate in health system discourse, signs of moving toward professional maturity have emerged.
Leblebici, Ihsan Metin; Bozkurt, Suleyman; Eren, Turgut Tunc; Ozemir, Ibrahim Ali; Sagiroglu, Julide; Alimoglu, Orhan
2014-01-01
Our aim is to compare mammographic, demographic and clinicopathological characteristics of patients whose mammographies were classified as subgroups of BI-RADS 4 category (Breast Imaging - Reporting and Data System). In total, 103 patients with mammography (Senographe 600t Senix HF; General Electric, Moulineaux, France) results classified as BI-RADS 4 were included in the study. Demographic data (age, menopause, and family history) were recorded. All data were compared among BI-RADS 4 subgroups. In all, 68.9% (71/103), 7.8% (8/103) and 23.3% (24/103) the patients were in groups BI-RADS 4A, 4B and 4C, respectively. The incidence of malignancy was higher in Groups 4B and 4C than in Group 4A (p<0.05), but similar in Groups 4B and 4C (p>0.05). Mean age was lower in Group 4B than in Groups 4A and 4C (p<0.05). A positive family history was more common in Group 4A than in Group 4B (p=0.025). The frequency of menopausal patients was greater in Groups 4A and 4C than in Group 4B (p=0.021, and 0.003, respectively). The rate of malignancy was higher in Groups 4B, and 4C than in Group 4A. A positive family history was more common in Group 4A than in Group 4C. Groups 4A, and 4C patients tended to be older and were more likely to be menopausal than Group 4B patients.
Li, Jieting; Liu, Yujiao; Ren, Xiuyun; Chang, Le; Yue, Zijie; Shi, Xuexue
2014-09-01
To establish chronic periodontitis model in SD rats, and to investigate the effect of oral intervention on atherosclerosis. Fifty male SD rats were randomly divided into three groups, group A (normal control), group B (atherosclerosis,As) and group C (chronic periodontitis, CP). Group C was further divided into group C1 (natural process), group C2 (simple mechanical treatment), group C3 (systemic antibiotics), group C4-1 (teeth extraction) and group C4-2 (teeth extraction+systemic antibiotics), each group consisted of 7 rats. Every group received oral intervention. Serum interleukin (IL)- 6 levels were detected in five different time points (1, 3, 5, 7, 9 weeks after a successful modeling) by enzyme linked immunosorbent assay. All animals were killed after 24 weeks. Matrix metalloproteinase (MMP)- 2, 9 in the proximal aorta was detected by immuno histochemistry. The levels of serum IL-6 in groups B and C1 increased gradually with time and became significantly higher than that in group A (P < 0.01). Levels of serum IL-6 were increased gradually in each intervention group (C2, C3, C4-1, C4-2) and reached its peak at 5 weeks after modeling [C2:(62.3 ± 14.3) ng/L, C3:(58.2 ± 8.7) ng/L, C4-1:(127.0 ± 29.9) ng/L, C4-2:(120.6 ± 23.1) ng/L]. Compared with group B, group C4- 1 and C4- 2 increased most significantly (P < 0.01). Levels of serum IL- 6 decreased gradually. Eventually, group C2 [(28.6 ± 8.1) ng/L], C3 [(40.8 ± 15.1) ng/L] and C4-2 [(32.7 ± 11.1) ng/L] were significantly lower than group B (P < 0.05), and in group C2 IL- 6 was the lowest. Although levels of serum of IL-6 significantly decreased in group C4-1 [(72.8 ± 16.4) ng/L], but remained the highest. Immunohistochemistry showed that MMP-2, 9 were expressed in group B, C1 and C4-1, and significantly higher than in group A (183.0 ± 2.0, 181.3 ± 2.0), the gray value differences were statistically significant (P < 0.01). Group C4-1 (123.1 ± 2.9, 121.0 ± 3.2) was the strongest, group B (126.4 ± 2.0, 124.8 ± 2.8) and C1 (140.0 ± 2.2, 139.7 ± 3.2) were decreased (P < 0.01). While group C2(169.3 ± 3.4, 169.7 ± 2.3), C3 (149.0 ± 1.7, 145.1 ± 2.5) and C4-2 (157.7 ± 1.2, 155.8 ± 2.7) were significantly lower than group C1 (P < 0.01), and group C2 was close to normal. Periodontitis could increase the risk of atherosclerosis in rats with chronic periodontitis. Periodontal mechanical treatment and teeth extraction may increase the risk of As in the short time. However, the risk would gradually reduce in a long time.
Dual loyalties and the ethical and human rights obligations of occupational health professionals.
London, Leslie
2005-04-01
Underlying most ethical dilemmas in occupational health practice is the problem of Dual Loyalties where health professionals have simultaneous obligations, explicit or implicit, to a third party, usually a private employer. A literature review was undertaken of case studies of workplace occupational health conflicts, international human rights and ethical codes and strategies for managing dual loyalties, complemented by iterative discussions in an international working group convened to address the problem of Dual Loyalties. Violations of the worker-patient's human rights may arise from: (1) the incompatibility of simultaneous obligations; (2) pressure on the professional from the third party; and (3) separation of the health professional's clinical role from that of a social agent. The practitioner's contractual relationship with the third party is often the underlying problem, being far more explicit than their moral obligation to patients, and encouraging a social identification at the expense of a practitioner's professional identity. Because existing ethical guidelines lack specificity on managing Dual Loyalties in occupational health, guidelines that draw on human rights standards have been developed by the working group. These guidelines propose standards for individual professional conduct and complementary institutional mechanisms to address the problem. Copyright (c) 2005 Wiley-Liss, Inc.
Perceptions of Turkish dentists of their professional identity in a market-orientated system.
Ocek, Zeliha Asli; Vatansever, Kevser
2014-01-01
This study explores the perceptions of Turkish dentists of their professional identity and of the effects of market orientation in dentistry. This phenomenological study used a qualitative approach using a group of Turkish dentists, who were selected based on the principle of maximum variation. Four focus groups and 31 in-depth interviews were conducted. Forty-nine dentists were interviewed using a semi-structured form. The data analysis yielded three themes: (a) dentistry as a business; (b) dentistry as a profession; and (c) professional status of dentistry in the health care system and in the community. The participants' statements reflected that the dominance of market mechanisms in dentistry inevitably forces dentists to adopt the characteristics of a business person and prevents them from fulfilling the basic requirements of professionalism. All participants explained that with the transformation of the dental care market, dentists have become a cheap labor force and have lost their professional autonomy. Our study has confirmed previous reports pointing out the conflict between dentistry as a profession and dentistry as a commercial operation. The study also showed that in Turkey, as a country experiencing rapid reform processes, dentists' control over their professional practices and identities has decreased.
Eilers, Stan G; LaPolice, Paula; Mukunyadzi, Perkins; Kapur, Umesh; Wendel Spiczka, Amy; Shah, Ajay; Saleh, Husain; Adeniran, Adebowale; Nunez, Amberly; Balachandran, Indra; Clark, Jennifer J; Lemon, Larry
2014-10-01
Fine-needle aspiration of the thyroid is a common procedure, with an established role in reducing unnecessary thyroid surgery and identifying neoplasms and malignancies. The study evaluated 1558 responses in the American Society for Clinical Pathology (ASCP) Non-GYN Assessment program of aspirates of thyroid neoplasms and malignancies and placed them into the following groups: group A (target or correct interpretation), group B (incorrect interpretation as a benign thyroid nodule), group C (incorrect interpretation malignant aspirate as thyroid neoplasm), and group D (malignant diagnosis with incorrect interpretation). In clinical practice, responses in groups A, C, and D would lead to surgical excision, whereas responses in group B would not. Of a total of 1558 responses, 78.5% of the responses were in group A, 8.5% in group B, 3.75% in group C, and 9.25% in group D. By individual diagnosis, the group rates were 86.5%, 0%, 11%, and 2.5% for anaplastic thyroid carcinoma; 83%, 5.5%, 4.25%, and 7.25% for papillary thyroid carcinoma; 79%, 7%, 6%, and 8% for medullary thyroid carcinoma; 83.5% 6.75%, 0%, and 9.75% for Hürthle cell neoplasm; and 61%, 22%, 0%, and 17% for follicular neoplasm in groups A, B, C, and D respectively. Fine-needle aspiration was effective in diagnosing thyroid neoplasms and malignancies and in separating thyroid nodules into surgical and nonsurgical categories. Data from a large group of cytology professionals showed good performance; however, there is room for improvement, especially in making specific diagnoses. In particular, follicular neoplasm and follicular variant of papillary thyroid carcinoma were challenging diagnoses for participants. © 2014 The Authors. Cancer Cytopathology published by Wiley Periodicals, Inc. on behalf of American Cancer Society.
Guo, Li-juan; Cui, Li-gang; Li, Yu-mei; Liao, Li-ping; Song, Lin
2015-10-01
To investigate the role of high-frequency ultrasound (HFUS) in evaluating in the effectiveness of conservative treatment for professional athletes with patellar tendon enthesiopathy. According to different treatment intensities, 24 professional athletes with patellar tendon enthesiopathy were randomly divided into painless group, slightly-painful group and extremely-painful group. Then changes of the HFUS findings [including ranges of two-dimensional diseases and blood conditions by Color Doppler Flow Imaging (CDFI)] of patellar tendon before and after the treatment were recorded. The results were also compared with conventional clinical treatment evaluations. After two courses of treatment,the percentage of athletes whose pain was resolved or disappeared was 37.5% in painless group, 87.5% in slightly-painful group, and 62.5% in extremely-painful group. The pain score was 4.50 ± 2.07, 4.88 ± 1.13, and 6.13 ± 1.55 in painless group,slightly-painful group,and extremely-painful group, respectively,before treatment and 4.88 ± 2.17, 3.00 ± 1.77,and 5.13 ± 2.36 after treatment. The average pain score remarkably decreased in the slightly-painful group and extremely-painful group,and such difference was statistically significant in the slightly-pain group (P<0.05). The effective rate (defined as thinner patellar,decreased hypoecho area and fewer blood distribution in the lesion) was 38%, 50%, and 62% in the painless group, slightly-painful group,and extremely-painful group, and the rates in the slightly-painful group and extremely-painful group were significantly higher than that in painless group (both P<0.05). HFUS can display the ultrasonographic changes of patellar tendon enthesiopathy after conservative treatments in an objective and quantitative manner. Compared with conventional clinical evaluations, it can more accurately reflect the disease recovery status.
Leadership and professionalism curriculum in the Gross Anatomy course.
Pawlina, Wojciech; Hromanik, Michael J; Milanese, Tia R; Dierkhising, Ross; Viggiano, Thomas R; Carmichael, Stephen W
2006-09-01
Today's physicians must demonstrate both professionalism and leadership skills in order to succeed in largely team-based healthcare environments. The purpose of this study was to determine if professionalism attributes, leadership style, and leadership style adaptability are associated with academic performance among first-year students early in their medical curriculum. Students were divided into 4-member dissection groups for the duration of the Gross and Developmental Anatomy course. Leadership responsibility was randomly assigned to a team member on a rotating basis every 5 weeks. After each 5-week block, student performance was measured by written and practical examinations, and each student assessed their leader's or their own professionalism attributes and leadership style using validated survey instruments. Most students demonstrated either a "selling" only (57%) or "participating" only (30%) leadership style with low to moderate leadership adaptability. "Participating" and "delegating" leadership styles have the highest average group written exam scores (89.4%, P <0.008). "Telling" only or "selling" only leaders have the lowest average group exam scores (83.5%, P <0.001). "Selling" and "participating" leaders have significantly lower average group practical exam scores than other styles (81.5%, P <0.007). Positive associations were observed between the written and practical examination scores and the leader's integrity (P = 0.003, P = 0.002) and responsibility (P <0.001, P = 0.037). This study demonstrates that various situational leadership styles and aspects of professionalism are associated with written and practical examination scores in the Gross and Developmental Anatomy course. Furthermore, it demonstrates that first-year medical students are in need of leadership skill development.
2016-04-01
Editor Michael Shoemaker Copy Editor/Circulation Manager Debbie Gonzalez Multimedia Assistant Noelia Gamboa Editing, Design , and Layout The C3 Group ...Schatz Publishing Group CONTENTS | Featured Research A Publication of the Defense Acquisition University April 2016 Vol. 23 No. 2 ISSUE 77 p. 122 The...1998). Examining the relationship between listening effectiveness and leadership emergence: Perceptions, behaviors, and recall. Small Group Research
Lecendreux, Michel; Lavault, Sophie; Lopez, Régis; Inocente, Clara Odilia; Konofal, Eric; Cortese, Samuele; Franco, Patricia; Arnulf, Isabelle; Dauvilliers, Yves
2015-08-01
To evaluate the frequency, severity, and associations of symptoms of attention-deficit/hyperactivity disorder (ADHD) in children with narcolepsy with and without cataplexy. Cross-sectional survey. Four French national reference centers for narcolepsy. One hundred eight consecutively referred children aged younger than 18 y with narcolepsy, with (NwC, n = 86) or without cataplexy (NwoC, n = 22), and 67 healthy controls. The participants, their families, and sleep specialists completed a structured interview and questionnaires about sleep, daytime sleepiness, fatigue, and ADHD symptoms (ADHD-rating scale based upon Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision [DSM-IV-TR] symptoms), and use of psychostimulants for the treatment of narcolepsy (administered in 68.2%). Polysomnographic measures were collected. Clinically significant levels of ADHD symptoms were found in 4.8% of controls compared with 35.3% in patients with NwoC (P < 0.001) and 19.7% in patients with NwC (P < 0.01). Total ADHD scores were 6.4 (95% confidence interval [CI]: 4.5, 9.0) in controls compared with 14.2 (95% CI: 10.6, 18.9; P < 0.001), in patients with NwoC and 12.2 (95% CI: 9.8, 15.3; P < 0.01) in patients with NwC; subscores of inattention and hyperactivity/impulsivity were also significantly higher in both narcolepsy groups compared with controls. No difference was found between the NwC and NwoC groups for any ADHD measure. ADHD symptom severity was associated with increased levels of sleepiness, fatigue, and insomnia. Compared with the 34 untreated patients, the 73 patients treated with psychostimulants (modafinil in 91%) showed a trend toward lower narcolepsy symptoms but not lower ADHD symptoms. Pediatric patients with narcolepsy have high levels of treatment-resistant attention-deficit/hyperactivity disorder (ADHD) symptoms. The optimal treatment for ADHD symptoms in these patients warrants further evaluation in longitudinal intervention studies. © 2015 Associated Professional Sleep Societies, LLC.
[Views of professionals and patients on the introduction of computer science into the consultation].
Roig Buscató, C; Erra Yuste, N; Seguer Toirán, A; Belda Díaz, S; Juncosa Font, S
2005-09-15
To compare the views of professionals and patients on the computerisation of consultations. Cross-sectional. Rural health district in the province of Barcelona, with a population of about 15,000. Consecutive sampling of people seen in the health district and the group of health professionals working in it. Two anonymous self-filled questionnaires with closed questions aimed at health professionals and a sample of patients (accuracy, 0.05; confidence, 95%; prevalence, 50%). The mean age of the 407 patients was 48.4 (SD, 17.2), with 63.6% women. 21 questionnaires were filled in by the professionals (91%), 12 by doctors, and 9 by nurses. Their mean age was 43.9 (SD, 7.5), and 71.4% were women. For common questions, 54.3% of patients were keen on seeing the screen, while professionals calculated this figure at 11%. 5.6% of patients thought computerisation had changed the relationship, whereas 31.6% of professionals did. 12.6% of patients thought it had made the visit longer, whereas 38.1% of the professionals thought it had. 10.6% of patients and 47.4% of professionals thought it had led to loss of confidentiality. The introduction of computers into consultations was accepted well. Professionals were more worried than patients about possible loss of confidentiality, and thought that there had been bigger changes in the doctor-patient relationship and that visits had become longer.
Bechini, Angela; Falla, Abby; Ahmad, Amena; Veldhuijzen, Irene; Boccalini, Sara; Porchia, Barbara; Levi, Miriam
2015-08-19
As part of the EU funded project "HEPscreen", the aim of this study is to identify hepatitis B and C screening and patient management guidelines, to assess the awareness of these among health professionals (HPs) and to explore the availability of hepatitis B/C training programmes for HPs in Germany, Italy, the Netherlands, the UK, Spain and Hungary. A comprehensive literature search through the main scientific databases was performed to retrieve guidelines, following which an online survey was developed and sent to HPs in six areas of health care, including public health, to verify whether HPs are aware of these guidelines, to retrieve additional guidelines and to find out whether specific professional training is available. Twelve national guidelines were identified through the literature search. Of the 268 respondents, 80 % were aware of hepatitis B guidelines and 73 % were aware of hepatitis C guidelines in their country. The national guidelines identified through the literature search were mentioned by 1/3 of HPs in the UK and Germany, 13 % of HPs in the Netherlands, 14 % in Italy and 4 % in Spain. An additional 41 hepatitis B/C related guidance documents were retrieved through the online survey: 15 in the UK, seven in Hungary, six in Italy, five in the Netherlands, four in Germany and four in Spain. Availability of training programmes to improve skills and knowledge in viral hepatitis was most often reported in the Netherlands, with 82 % indicating availability and just 10 % indicating no availability, and least commonly in Italy, with 42 % indicating yes but 40 % indicating no. Availability was also reported by the majority in the UK, Hungary and Spain, while in Germany the majority selected unsure. Results suggest that the scientific databases are not the most important information source of best clinical practice for many HPs. Implementation of best practices requires that guidelines are specifically designed and actively promoted among those who are to follow them. Training can disseminate these best practice recommendations and raise awareness of guidelines. It is therefore encouraging that diverse training about hepatitis B/C is available to the different professional groups.
2010-01-01
Background Unqualified/non-registered caregivers (N-R Cs) will continue to play important roles in the mental health services. This study compares levels of burnout and sources of stress among qualified and N-R Cs working in acute mental health care. Methods A total of 196 nursing staff - 124 qualified staff (mainly nurses) and 72 N-R Cs with a variety of different educational backgrounds - working in acute wards or community mental teams from 5 European countries filled out the Maslach Burnout Inventory (MBI), the Mental Health Professional Scale (MHPSS) and the Psychosocial Work Environment and Stress Questionnaire (PWSQ). Results (a) The univariate differences were generally small and restricted to a few variables. Only Social relations (N-R Cs being less satisfied) at Work demands (nurses reporting higher demands) were different at the .05 level. (b) The absolute scores both groups was highest on variables that measured feelings of not being able to influence a work situation characterised by great demands and insufficient resources. Routines and educational programs for dealing with stress should be available on a routine basis. (c) Multivariate analyses identified three extreme groups: (i) a small group dominated by unqualified staff with high depersonalization, (ii) a large group that was low on depersonalisation and high on work demands with a majority of qualified staff, and (iii) a small N-R C-dominated group (low depersonalization, low work demands) with high scores on professional self-doubt. In contrast to (ii) the small and N-R C-dominated groups in (i) and (iii) reflected mainly centre-dependent problems. Conclusion The differences in burnout and sources of stress between the two groups were generally small. With the exception of high work demands the main differences between the two groups appeared to be centre-dependent. High work demands characterized primarily qualified staff. The main implication of the study is that no special measures addressed towards N-R Cs in general with regard to stress and burnout seem necessary. The results also suggest that centre-specific problems may cause more stress among N-R Cs compared to the qualified staff (e.g. professional self-doubt). PMID:20546587
Relationship between personality traits and vocational choice.
Garcia-Sedeño, Manuel; Navarro, Jose I; Menacho, Inmaculada
2009-10-01
Summary.-The relationship between occupational preferences and personality traits was examined. A randomly chosen sample of 735 students (age range = 17 to 23 years; 50.5% male) in their last year of high school participated in this study. Participants completed Cattell's Sixteen Personality Factor-5 Questionnaire (16PF-5 Questionnaire) and the Kuder-C Professional Tendencies Questionnaire. Initial hierarchical cluster analysis categorized the participants into two groups by Kuder-C vocational factors: one showed a predilection for scientific or technological careers and the other a bias toward the humanities and social sciences. Based on these groupings, differences in 16PF-5 personality traits were analyzed and differences associated with three first-order personality traits (warmth, dominance, and sensitivity), three second-order factors (extraversion, control, and independence), and some areas of professional interest (mechanical, arithmetical artistic, persuasive, and welfare) were identified. The data indicated that there was congruency between personality profiles and vocational interests.
Lown, Beth A; McIntosh, Sharrie; Gaines, Martha E; McGuinn, Kathy; Hatem, David S
2016-03-01
Empathy and compassion provide an important foundation for effective collaboration in health care. Compassion (the recognition of and response to the distress and suffering of others) should be consistently offered by health care professionals to patients, families, staff, and one another. However, compassion without collaboration may result in uncoordinated care, while collaboration without compassion may result in technically correct but depersonalized care that fails to meet the unique emotional and psychosocial needs of all involved. Providing compassionate, collaborative care (CCC) is critical to achieving the "triple aim" of improving patients' health and experiences of care while reducing costs. Yet, values and skills related to CCC (or the "Triple C") are not routinely taught, modeled, and assessed across the continuum of learning and practice. To change this paradigm, an interprofessional group of experts recently recommended approaches and a framework for integrating CCC into health professional education and postgraduate training as well as clinical care. In this Perspective, the authors describe how the Triple C framework can be integrated and enhance existing competency standards to advance CCC across the learning and practice continuum. They also discuss strategies for partnering with patients and families to improve health professional education and health care design and delivery through quality improvement projects. They emphasize that compassion and collaboration are important sources of professional, patient, and family satisfaction as well as critical aspects of professionalism and person-centered, relationship-based high-quality care.
Cooperstein, Robert; Young, Morgan; Lew, Makani
2015-01-01
Objectives: Primary goal: to determine the validity of C1 transverse process (TVP) palpation compared to an imaging reference standard. Methods: Radiopaque markers were affixed to the skin at the putative location of the C1 TVPs in 21 participants receiving APOM radiographs. The radiographic vertical distances from the marker to the C1 TVP, mastoid process, and C2 TVP were evaluated to determine palpatory accuracy. Results: Interexaminer agreement for radiometric analysis was “excellent.” Stringent accuracy (marker placed ±4mm from the most lateral projection of the C1 TVP) = 57.1%; expansive accuracy (marker placed closer to contiguous structures) = 90.5%. Mean Absolute Deviation (MAD) = 4.34 (3.65, 5.03) mm; root-mean-squared error = 5.40mm. Conclusions: Manual palpation of the C1 TVP can be very accurate and likely to direct a manual therapist or other health professional to the intended diagnostic or therapeutic target. This work is relevant to manual therapists, anesthetists, surgeons, and other health professionals. PMID:26136601
Creative Thinking, Professional Artists, and Parkinson's Disease.
Canesi, Margherita; Rusconi, Maria Luisa; Moroni, Federica; Ranghetti, Alessandra; Cereda, Emanuele; Pezzoli, Gianni
2016-01-01
An increase in artistic-like production in Parkinson's disease (PD) has been associated with compulsive and repetitive behaviours after the introduction of dopaminergic treatment (DT). Recent data suggest that it could be due to the emergence of artistic-like skills triggered by DT. In order to evaluate whether artistic production and creative thinking are influenced by DT or linked to artistic-like skills, we characterize creativity features in PD and healthy controls (HC) including professional artists. Three groups of PD out-patients were included consecutively: professional artists (PD-A), patients with (PD-C) and without artistic-like production (PD-NC). Twenty-four gender and age-matched HC were included: professional artists (HC-A) and non-artists (HC-NC). All patients were evaluated by means of a) a battery of neuropsychological tests and a semi-structured interview; b) the Abbreviated Torrance Test for Adults (ATTA) for creative thinking; c) the Minnesota Impulsive Disorders Interview (mMIDI) and a screening for impulse control disorders (ICDs) for compulsive behaviour. ATTA total score was significantly higher in HC-A and PD-A than in the other groups. Although PD-NC showed the lowest ATTA total score the difference vs HC-NC was not significant. ATTA scores were not significantly correlated with DT dosage and duration. mMIDI tests were positive only in PD. There were no differences in ICDs among PD groups. Our results do not support a relationship between DT and the emergence of artistic creativity. We believe that DT may increase the drive to create and that further studies in "on" and "off" medication are needed to clarify this issue.
Wagner, Ida Janelle; Hultman, Charles Scott
2013-05-01
To elucidate the components of professionalism specific to plastic surgery, we surveyed surgeons, anesthesiologists, and fourth-year medical students at a public university. We sought to define the central components of professionalism in plastic surgery, to determine the difference in perception of professionalism by plastic surgeons (PSs), compared to other practitioners (OPs), and to improve education in professionalism by obtaining data on attitudes of professionalism among practitioners. Using SurveyMonkey, we distributed a questionnaire to members of the Departments of Surgery and Anesthesia and fourth-year medical students. The responses of PSs (n = 22) were compared to non-plastic surgeons (OPs, n = 294). Of the 594 participants, 316 completed the survey (response rate, 53%). Participants consisted of 211 (66.8%) medical students, 60 (19%) residents, 5 (1.6%) fellows, 28 (8.9%) attending physicians, 6 (1.9%) nonphysician providers, and 6 (1.9%) administrators. Both PS and OP listed "the development and conformance to a body of ethics" the most important component of professionalism. Most participants thought that professionalism could be taught, and assessed. Plastic surgeons listed "not enough mentors" (63.2%) as the main obstacle to teaching professionalism, whereas OP listed "not a priority in medical school curriculum" (48.2%). Both PS and OP cited substance abuse, fraud, and sexual misconduct as egregious displays of unprofessional behavior. Opinions differed between the groups, regarding aspects of professionalism pertaining to plastic surgery. When asked about "charity raffles" for cosmetic surgery, 72.2% of PS ranked this as a 4 or 5 (with 5 representing the most unprofessional behavior), compared to only 46.7% of OP who assigned this a 4 or 5. For the scenario of a PS deceiving patients, by showing them another surgeon's before and after photographs, 84.2% of PS assigned this a 4 or 5, whereas 71.0% of OP ranked this a 4 or 5. Both groups cited working while impaired with alcohol as the most egregious example of unprofessional behavior. The opinions of PSs mirror those of their colleagues, regarding general components of professionalism. However, PSs are more conservative and cautious than their peers, perhaps due to successful educational efforts in mentoring, training, and maintenance of certification.
Quinn, Margaret M; Henneberger, Paul K; Braun, Barbara; Delclos, George L; Fagan, Kathleen; Huang, Vanthida; Knaack, Jennifer L S; Kusek, Linda; Lee, Soo-Jeong; Le Moual, Nicole; Maher, Kathryn A E; McCrone, Susan H; Mitchell, Amber Hogan; Pechter, Elise; Rosenman, Kenneth; Sehulster, Lynne; Stephens, Alicia C; Wilburn, Susan; Zock, Jan-Paul
2015-05-01
The Cleaning and Disinfecting in Healthcare Working Group of the National Institute for Occupational Safety and Health, National Occupational Research Agenda, is a collaboration of infection prevention and occupational health researchers and practitioners with the objective of providing a more integrated approach to effective environmental surface cleaning and disinfection (C&D) while protecting the respiratory health of health care personnel. The Working Group, comprised of >40 members from 4 countries, reviewed current knowledge and identified knowledge gaps and future needs for research and practice. An integrated framework was developed to guide more comprehensive efforts to minimize harmful C&D exposures without reducing the effectiveness of infection prevention. Gaps in basic knowledge and practice that are barriers to an integrated approach were grouped in 2 broad areas related to the need for improved understanding of the (1) effectiveness of environmental surface C&D to reduce the incidence of infectious diseases and colonization in health care workers and patients and (2) adverse health impacts of C&D on health care workers and patients. Specific needs identified within each area relate to basic knowledge, improved selection and use of products and practices, effective hazard communication and training, and safer alternatives. A more integrated approach can support multidisciplinary teams with the capacity to maximize effective and safe C&D in health care. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.
Khodadadi, Hadi; Pakdel, Roghayeh; Khazaei, Majid; Niazmand, Said; Bavarsad, Kowsar; Hadjzadeh, Mousa Al-Reza
2018-01-01
The present study was performed to evaluate the effects of hydro-alcoholic extract of Portulaca oleracea ( P. oleracea ) seeds and Vitamin C on biochemical and hemodynamic parameters in cardiac tissue of rats with subclinical hyperthyroidism. Forty eight male rats were divided into six groups of 8 and treated for 4 weeks. T4 group received daily injection of levothyroxine sodium (20 μg/kg) and control group was given daily injection of saline. T4-Po groups were given T4 plus 100, 200, and 400 mg/kg of P. oleracea seeds extract in drinking water daily. T4-Vit C group received T4 plus daily injection of Vitamin C (100 mg/kg). At the end of the experiment, body weight, serum free T4 level, left ventricular developed pressure (LVDP), malondialdehyde (MDA) and total thiol levels were measured. Free T4 levels were increased in all groups that were treated with T4. Weight gain was decreased in T4 and T4-Po100 groups compared to control group (p<0.001 and p<0.05). However, body weight was increased in T4-Po (200 and 400) and T4-Vit C groups compared to T4 group. LVDP was increased in T4 group compared to control group but, LVDP was decreased in T4-Po and T4-Vit C groups. Malondialdehyde was decreased in T4-Po groups and T4-Vit C group compared to T4 group. Total thiol groups were increased in T4-Po (200 and 400) and T4-Vit C groups compared to T4 group. The results showed that P. oleracea extract has a protective effect on cardiac dysfunction due to subclinical hyperthyroidism induced by levothyroxine sodium in rats.
CrossTalk: The Journal of Defense Software Engineering. Volume 22, Number 7, Nov/Dec 2009
2009-12-01
an MBA, and is a Certified Corporate Trainer. Booz Allen Hamilton AF PKI SPO 4241 E Piedras DR STE 210 San Antonio,TX 78228 Phone: (210) 925-9129...Certified Secure Software Lifecycle Professional, and a Project Management Professional. General Dynamics C4 Systems AF PKI SPO 4241 E Piedras DR STE 210
John, Holly; Hale, Elizabeth D; Treharne, Gareth J; Carroll, Douglas; Kitas, George D
2009-12-01
Cardiovascular disease (CVD) is the leading cause of death in Britain, and its prevention is a priority. Rheumatoid arthritis (RA) patients have an increased risk of CVD, and management of modifiable classical risk factors requires a programme with patient education at its heart. Before a programme for RA patients is implemented, it is important to explore the perceptions of patients and relevant healthcare professionals and consider how these could influence the subsequent content, timing and delivery of such education. Here, we assess healthcare professionals' perceptions. Qualitative focus group methodology was adopted. Four group meetings of healthcare professionals were held using a semi-structured interview schedule. The focus group transcripts were analysed using interpretative phenomenological analysis. Three superordinate themes emerged: professional determinations about people with RA, including their perceptions about patients' priorities and motivations; communication about CVD risk, including what should be communicated, how, to whom and when; and responsibility for CVD management, referring to patients and the healthcare community. Although healthcare professionals agree that it is important to convey the increased CVD risk to patients with RA, there is concern they may be less proactive in promoting risk management strategies. There was uncertainty about the best time to discuss CVD with RA patients. Maintaining a close relationship between primary and secondary care was thought to be important, with all healthcare professionals 'singing from the same hymn sheet'. These findings can inform the development of novel education material to fulfil a currently unmet clinical need. Copyright (c) 2009 John Wiley & Sons, Ltd.
Social Media in Professional Medicine: New Resident Perceptions and Practices.
Lefebvre, Cedric; Mesner, Jason; Stopyra, Jason; O'Neill, James; Husain, Iltifat; Geer, Carol; Gerancher, Karen; Atkinson, Hal; Harper, Erin; Huang, William; Cline, David M
2016-06-09
For younger generations, unconstrained online social activity is the norm. Little data are available about perceptions among young medical practitioners who enter the professional clinical arena, while the impact of existing social media policy on these perceptions is unclear. The objective of this study was to investigate the existing perceptions about social media and professionalism among new physicians entering in professional clinical practice; and to determine the effects of formal social media instruction and policy on young professionals' ability to navigate case-based scenarios about online behavior in the context of professional medicine. This was a prospective observational study involving the new resident physicians at a large academic medical center. Medical residents from 9 specialties were invited to participate and answer an anonymous questionnaire about social media in clinical medicine. Data were analyzed using SAS 9.4 (Cary, NC), chi-square or Fisher's exact test was used as appropriate, and the correct responses were compared between different groups using the Kruskal-Wallis analysis of variance. Familiarity with current institutional policy was associated with an average of 2.2 more correct responses (P=.01). Instruction on social media use during medical school was related to correct responses for 2 additional questions (P=.03). On dividing the groups into no policy exposure, single policy exposure, or both exposures, the mean differences were found to be statistically significant (3.5, 7.5, and 9.4, respectively) (P=.03). In this study, a number of young physicians demonstrated a casual approach to social media activity in the context of professional medical practice. Several areas of potential educational opportunity and focus were identified: (1) online privacy, (2) maintaining digital professionalism, (3) safeguarding the protected health information of patients, and (4) the impact of existing social media policies. Prior social media instruction and/or familiarity with a social media policy are associated with an improved performance on case-based questions regarding online professionalism. This suggests a correlation between an instruction about online professionalism and more cautious online behavior. Improving the content and delivery of social media policy may assist in preserving institutional priorities, protecting patient information, and safeguarding young professionals from online misadventure.
KNOWLEDGE AND ATTITUDE OF HEALTH CARE WORKERS TOWARD PATIENTS WITH HEPATITIS C INFECTION.
Korkmaz, Pınar; Uyar, Cemile; Ozmen, Ahmet; Toka, Onur
2016-09-01
This study aimed to evaluate the level of knowledge of healthcare workers in Kutahya (a western province of Turkey) about HCV infection and their attitudes toward patients with hepatitis C infection. A total of 335 healthcare workers working in Kutahya Evliya Celebi Research and Training Hospital were included in the study. A questionnaire evaluating demographic characteristics, level of knowledge and attitudes of healthcare workers toward patients with hepatitis C infection was administered to the participants. Thirty-six point four percent of the participants were males. According to the occupations, distributions of the participants were as followings: 54.6% nurse, 25.1% physician, 11.6% trainee nurse, 4.5% intern and 4.2% anesthesia technician. The mean age of healthcare professionals was 30.32±8.10 years. Fifty-eight point eight percent of them experienced percutaneous injury. The mean knowledge score was 18.05±3.01 (from a total of 25). There was a statistically significant relationship between knowledge score and age, working year, occupational group (p<0.001). There was also a significant relationship between total attitude score and gender (p=0.006), age (p=0.002), working year (p=0.021) and occupational group (p<0.001). It was determined that as total knowledge score of the participants increased they exhibited a more positive attitude toward patients with hepatitis C infection (p<0.001). A positive relationship was determined between the level of knowledge of healthcare workers and positive attitudes toward patients with hepatitis C infection. Therefore, increasing the level of knowledge is necessary for more positive attitudes.
Tao, Yimin; Lyu, Ming-Ju Amy; Zhu, Xin-Guang
2016-05-01
C4 photosynthesis evolved independently from C3 photosynthesis in more than 60 lineages. Most of the C4 lineages are clustered together in the order Poales and the order Caryophyllales while many other angiosperm orders do not have C4 species, suggesting the existence of biological pre-conditions in the ancestral C3 species that facilitate the evolution of C4 photosynthesis in these lineages. To explore pre-adaptations for C4 photosynthesis evolution, we classified C4 lineages into the C4-poor and the C4-rich groups based on the percentage of C4 species in different genera and conducted a comprehensive comparison on the transcriptomic changes between the non-C4 species from the C4-poor and the C4-rich groups. Results show that species in the C4-rich group showed higher expression of genes related to oxidoreductase activity, light reaction components, terpene synthesis, secondary cell synthesis, C4 cycle related genes and genes related to nucleotide metabolism and senescence. In contrast, C4-poor group showed up-regulation of a PEP/Pi translocator, genes related to signaling pathway, stress response, defense response and plant hormone metabolism (ethylene and brassinosteroid). The implications of these transcriptomic differences between the C4-rich and C4-poor groups to C4 evolution are discussed.
The influence of social networking web sites on the evaluation of job candidates.
Bohnert, Daniel; Ross, William H
2010-06-01
This study investigated how the content of social networking Web site (SNW) pages influenced others' evaluation of job candidates. Students (N = 148) evaluated the suitability of hypothetical candidates for an entry-level managerial job. A 2 x 4 design was employed: résumés were either marginally qualified or well qualified for the job. SNW printouts reflected (a) an emphasis on drinking alcohol, (b) a family orientation, or (c) a professional orientation; participants in a control group received no Web page information. In addition to a main effect for résumé quality, applicants with either a family-oriented or a professional-oriented SNW were seen as more suitable for the job and more conscientious than applicants with alcohol-oriented SNW pages. They were more likely to be interviewed. If hired, they were also likely to be offered significantly higher starting salaries. Results are discussed in terms of implications for both managers and applicants.
Early microbial succession in redeveloping dental biofilms in periodontal health and disease.
Teles, F R; Teles, R P; Uzel, N G; Song, X Q; Torresyap, G; Socransky, S S; Haffajee, A D
2012-02-01
The development of dental biofilms after professional plaque removal is very rapid. However, it is not clear whether most bacterial species return at similar rates in periodontally healthy and periodontitis subjects or if there are differences in bacterial recolonization between supragingival and subgingival biofilms in periodontal health and disease. Supragingival and subgingival plaque samples were taken separately from 28 teeth in 38 healthy and 17 periodontitis subjects immediately after professional cleaning. Samples were taken again from seven teeth in randomly selected quadrants after 1, 2, 4 and 7 d of no oral hygiene and analyzed using checkerboard DNA-DNA hybridization. The percentage of DNA probe counts were averaged within subjects at each time-point. Ecological succession was determined using a modified moving-window analysis. Succession in supragingival biofilms from subjects with periodontitis and from healthy individuals was similar. At 1 d, Streptococcus mitis and Neisseria mucosa showed increased proportions, followed by Capnocytophaga gingivalis, Eikenella corrodens, Veillonella parvula and Streptococcus oralis at 1-4 d. At 4-7 d, Campylobacter rectus, Campylobacter showae, Prevotella melaninogenica and Prevotella nigrescens became elevated. Subgingival plaque redevelopment was slower and very different from supragingival plaque redevelopment. Increased proportions were first observed for S. mitis, followed by V. parvula and C. gingivalis and, at 7 d, by Capnocytophaga sputigena and P. nigrescens. No significant increase in the proportions of periodontal pathogens was observed in any of the clinical groups or locations. There is a defined order in bacterial species succession in early supragingival and subgingival biofilm redevelopment after professional cleaning. © 2011 John Wiley & Sons A/S.
ERIC Educational Resources Information Center
Gunzenhauser, Nina, Ed.; Caldwell, Bettye M., Ed.
Participants in this pediatric round table met to (l) detrivialize child care; (2) advance the concept of child care as a continuum of services; (3) establish the role of health care professionals in the design and implementation of high quality child care; and (4) develop action guidelines for use by professionals attempting to provide high…
The TSO Logic and G2 Software Product
NASA Technical Reports Server (NTRS)
Davis, Derrick D.
2014-01-01
This internship assignment for spring 2014 was at John F. Kennedy Space Center (KSC), in NASAs Engineering and Technology (NE) group in support of the Control and Data Systems Division (NE-C) within the Systems Hardware Engineering Branch. (NEC-4) The primary focus was in system integration and benchmarking utilizing two separate computer software products. The first half of this 2014 internship is spent in assisting NE-C4s Electronics and Embedded Systems Engineer, Kelvin Ruiz and fellow intern Scott Ditto with the evaluation of a newly piece of software, called G2. Its developed by the Gensym Corporation and introduced to the group as a tool used in monitoring launch environments. All fellow interns and employees of the G2 group have been working together in order to better understand the significance of the G2 application and how KSC can benefit from its capabilities. The second stage of this Spring project is to assist with an ongoing integration of a benchmarking tool, developed by a group of engineers from a Canadian based organization known as TSO Logic. Guided by NE-C4s Computer Engineer, Allen Villorin, NASA 2014 interns put forth great effort in helping to integrate TSOs software into the Spaceport Processing Systems Development Laboratory (SPSDL) for further testing and evaluating. The TSO Logic group claims that their software is designed for, monitoring and reducing energy consumption at in-house server farms and large data centers, allows data centers to control the power state of servers, without impacting availability or performance and without changes to infrastructure and the focus of the assignment is to test this theory. TSOs Aaron Rallo Founder and CEO, and Chris Tivel CTO, both came to KSC to assist with the installation of their software in the SPSDL laboratory. TSOs software is installed onto 24 individual workstations running three different operating systems. The workstations were divided into three groups of 8 with each group having its own operating system. The first group is comprised of Ubuntus Debian -based Linux the second group is windows 7 Professional and the third group ran Red Hat Linux. The highlight of this portion of the assignment is to compose documentation expressing the overall impression of the software and its capabilities.
SeCom - Serious Community 2.0 prevent flooding
NASA Astrophysics Data System (ADS)
Komma, Juergen; Breuer, Roman; Sewilam, Hani; Concia, Francesca; Aliprandi, Bruno; Siegmund, Sabine; Goossens, Jannis
2013-04-01
There is a significant need for raising the awareness and building the capacity of water professionals in different water sectors cross Europe. There is also a need for qualified graduates to implement the EU Flood Risk Directive (FRD). The main aim of this work is to prepare and build the capacity of both groups in flood risk management through identifying synergies, sharing knowledge, and strengthen partnerships between universities and different stakeholders(mainly water professionals). The specific objectives are to develop; a) Development of a dynamic and active tool that allows all target-groups/users to assess their knowledge about flood risk management. b) Development of an innovative, active and problem-based learning methodology for flood risk education and training. c)Development of flood related Vocational Education & Training (VET) modules for water professionals (involving the students to gain practical experience). This will include some modules for undergraduate students on flood risk management and protection.
The Marketability of Army Officers
1992-04-14
1 AD- A 2 4 9 032 U THE MARKETABILITY OF ARMY OFFICERS I DTIC MARK CAMPION MALHAM ELECTSIF. 1 APR2 3 1992 Management Department s C * APPROVED: I I I...DOCUMENTATION PAGE I FonnOp,-v1d ..- C *Mr. q :4ne 30 !’ ~ 4 -:r.Zrr 3 am-**94 ’ a s..P.W -% Gi& .1007 -n :- "-3f W - A :aa 6 .!~ AMCM8 N. 070-0 CM I AGENCY S...CNL? LAhime-ar-pi 2- a : ;EPCT Q A t . RE.CRT -YPE A ?.C) C~r-rS :-C,,f;; 14 April 1992 Professional Report The Marketability of Army Officers 5. AU 7tlcR
Communication resources of managers and business professionals.
Pedrotti, Clarissa Araujo; Behlau, Mara
2017-05-22
To analyze the communication resources reported by managers in the business environment and compare the resources used to those reported by business professionals. 82 professionals volunteered to participate in the research, divided into 50 managers (MP) and 32 business professionals (BP) from industry section in Caxias do Sul and the surrounding region (Brazil). A questionnaire with 4 topics was used: personal data, self-assessment of communicative behavior, self-assessment of communicative resources, and selection of positive and negative resources influencing communication. Regarding communicative behavior, both groups reported normal voice but with significant differences regarding the use of softness in communication, 25% of MP and only 4% of BP. Both groups selected the following main positive resources: knowledge of subject, use of proper vocabulary, and objectivity. The negative resources were, similarly, the lack of subject domain, criticism or prejudgment, and improper vocabulary. Finally, analyzing the degree of influence of each communicative resource, the MP highlighted tone of voice as an important positive resource, while the BP pointed the subject domain. Still, the monotonous voice for MP and nervousness for BP were indicated as the main negative influences. Managers value more communicative resources connected to communicative attitude, such as tone of voice and expression, while business professionals worry about demonstrating security and technical understanding of the subject.
Vitolo, Márcia Regina; Louzada, Maria Laura da Costa; Rauber, Fernanda
2014-12-01
To assess the impact of a child feeding training program for primary care health professionals about breastfeeding and complementary feeding practices. Cluster-randomized field trial conducted in the city of Porto Alegre, (RS), Brazil. Twenty primary health care centers (HCC) were randomized into intervention (n = 9) and control (n = 11) groups. The health professionals (n = 200) at the intervention group centers received training about healthy feeding practices. Pregnant women were enrolled at the study. Up to six months of child's age, home visits were made to obtain variables related to breastfeeding and introduction of foods. 619 children were evaluated: 318 from the intervention group and 301 from the control group. Exclusive breastfeeding prevalence in the first (72.3 versus 59.4%; RR = 1.21; 95%CI 1.08 - 1.38), second (62.6 versus 48.2%; RR = 1.29; 95%CI 1.10 - 1.53), and third months of life (44.0% versus 34.6%; RR = 1.27; 95%CI 1.04 - 1.56) was higher in the intervention group compared to the control group. The prevalence of children who consumed meat four or five times per week was higher in the intervention group than in the control group (36.8 versus 22.6%; RR = 1.62; 95%CI 1.32 - 2.03). The prevalence of children who had consumed soft drinks (34.9 versus 52.5%; RR = 0.66; 95%CI 0.54 - 0.80), chocolate (24.5 versus 36.7% RR = 0.66 95%CI 0.53 - 0.83), petit suisse (68.9 versus 79.7; 95%CI 0.75 - 0.98) and coffee (10.4 versus 20.1%; RR = 0.51; 95%CI 0.31 - 0.85) in their six first months of life was lower in the intervention group. The training of health professionals had a positive impact on infant feeding practices, contributing to the promotion of child health.
The Pilipino Immigrants: A Discussion Guidebook.
ERIC Educational Resources Information Center
Oregon Library Association, Salem.
Filipinos are now the largest Asian group immigrating to the United States. Some of the reasons for the great influx of professionals who have immigrated include: (1) the false picture of the good life in the U.S., (2) the political and economic situation at home, (3) the oversupply of college graduates and professionally trained persons, and (4)…
ERIC Educational Resources Information Center
Hu, Helen; Garimella, Uma
2017-01-01
This proceeding paper will report about a study that investigated how a group of elementary school teachers responded to a professional development training on Science and Technology as demonstrated in their perceived preparedness and comfort with teaching science, and their subsequent implementation with K-4 students. The results from the study…
[Norm study of occupational stress on the professionals in Chengdu and Chongqing area].
Zeng, Fan-Hua; Wang, Zhi-Ming; Wang, Mian-Zhen; Lan, Ya-Jia
2004-12-01
To establish the norm of occupational stress on the professionals in Chengdu and Chongqing area. According to the "Occupation Sorting Canon in the People's Republic of China", the professionals of the above-mentioned area were sorted out and randomly stratified. The normative data were derived from a sample of 2 064 participants. The modified Occupation Stress Inventory Revised Edition (OSI-R) was used to test the targets' occupational stress level (including stressors, strain and coping resources). (1) In these professionals, the sex ratio was about 1:1, average age (36.4 +/- 9.4) years, average length of service (15.9 +/- 10.0) years, 63.07% people were college educated and over 80% married. (2) Descriptive statistics for OSI-R scale scores for the total normative sample, for gender samples and for occupational group samples were modulated. (3) The gender norm showed that there were heavier role overload and stronger occupational strains in males than those in females (P < 0.01). The score of personal resources in the males was not different from that in females (P > 0.05). (4) In terms of different occupations, the scores of occupational role and personal strain among various groups indicated significant differences (P < 0.01). The score of personal resources did not manifest difference (P > 0.05). (5) The major factors influencing OSI-R were sex, occupation and length of service. The norm established can basically represent the occupational stress on professionals in Chengdu and Chongqing area.
Social Media in Professional Medicine: New Resident Perceptions and Practices
2016-01-01
Background For younger generations, unconstrained online social activity is the norm. Little data are available about perceptions among young medical practitioners who enter the professional clinical arena, while the impact of existing social media policy on these perceptions is unclear. Objective The objective of this study was to investigate the existing perceptions about social media and professionalism among new physicians entering in professional clinical practice; and to determine the effects of formal social media instruction and policy on young professionals’ ability to navigate case-based scenarios about online behavior in the context of professional medicine. Methods This was a prospective observational study involving the new resident physicians at a large academic medical center. Medical residents from 9 specialties were invited to participate and answer an anonymous questionnaire about social media in clinical medicine. Data were analyzed using SAS 9.4 (Cary, NC), chi-square or Fisher’s exact test was used as appropriate, and the correct responses were compared between different groups using the Kruskal–Wallis analysis of variance. Results Familiarity with current institutional policy was associated with an average of 2.2 more correct responses (P=.01). Instruction on social media use during medical school was related to correct responses for 2 additional questions (P=.03). On dividing the groups into no policy exposure, single policy exposure, or both exposures, the mean differences were found to be statistically significant (3.5, 7.5, and 9.4, respectively) (P=.03). Conclusions In this study, a number of young physicians demonstrated a casual approach to social media activity in the context of professional medical practice. Several areas of potential educational opportunity and focus were identified: (1) online privacy, (2) maintaining digital professionalism, (3) safeguarding the protected health information of patients, and (4) the impact of existing social media policies. Prior social media instruction and/or familiarity with a social media policy are associated with an improved performance on case-based questions regarding online professionalism. This suggests a correlation between an instruction about online professionalism and more cautious online behavior. Improving the content and delivery of social media policy may assist in preserving institutional priorities, protecting patient information, and safeguarding young professionals from online misadventure. PMID:27283846
Wild, Sarah H.; Hanley, Janet; Lewis, Stephanie C.; McKnight, John A.; Padfield, Paul L.; Parker, Richard A.; Pinnock, Hilary; Sheikh, Aziz; McKinstry, Brian
2016-01-01
Background Self-monitoring of blood glucose among people with type 2 diabetes not treated with insulin does not appear to be effective in improving glycemic control. We investigated whether health professional review of telemetrically transmitted self-monitored glucose results in improved glycemic control in people with poorly controlled type 2 diabetes. Methods and Findings We performed a randomized, parallel, investigator-blind controlled trial with centralized randomization in family practices in four regions of the United Kingdom among 321 people with type 2 diabetes and glycated hemoglobin (HbA1c) >58 mmol/mol. The supported telemonitoring intervention involved self-measurement and transmission to a secure website of twice-weekly morning and evening glucose for review by family practice clinicians who were not blinded to allocation group. The control group received usual care, with at least annual review and more frequent reviews for people with poor glycemic or blood pressure control. HbA1c assessed at 9 mo was the primary outcome. Intention-to-treat analyses were performed. 160 people were randomized to the intervention group and 161 to the usual care group between June 6, 2011, and July 19, 2013. HbA1c data at follow-up were available for 146 people in the intervention group and 139 people in the control group. The mean (SD) HbA1c at follow-up was 63.0 (15.5) mmol/mol in the intervention group and 67.8 (14.7) mmol/mol in the usual care group. For primary analysis, adjusted mean HbA1c was 5.60 mmol/mol / 0.51% lower (95% CI 2.38 to 8.81 mmol/mol/ 95% CI 0.22% to 0.81%, p = 0·0007). For secondary analyses, adjusted mean ambulatory systolic blood pressure was 3.06 mmHg lower (95% CI 0.56–5.56 mmHg, p = 0.017) and mean ambulatory diastolic blood pressure was 2.17 mmHg lower (95% CI 0.62–3.72, p = 0.006) among people in the intervention group when compared with usual care after adjustment for baseline differences and minimization strata. No significant differences were identified between groups in weight, treatment pattern, adherence to medication, or quality of life in secondary analyses. There were few adverse events and these were equally distributed between the intervention and control groups. In secondary analysis, there was a greater number of telephone calls between practice nurses and patients in the intervention compared with control group (rate ratio 7.50 (95% CI 4.45–12.65, p < 0.0001) but no other significant differences between groups in use of health services were identified between groups. Key limitations include potential lack of representativeness of trial participants, inability to blind participants and health professionals, and uncertainty about the mechanism, the duration of the effect, and the optimal length of the intervention. Conclusions Supported telemonitoring resulted in clinically important improvements in control of glycaemia in patients with type 2 diabetes in family practice. Current Controlled Trials, registration number ISRCTN71674628. Trial Registration Current Controlled Trials ISRCTN 71674628 PMID:27458809
The interprofessional team as a small group.
Kane, R A
1975-01-01
Conflicts in interprofessional teamwork may be as much explained by group process considerations as by the interaction of professional roles and statuses. This paper examines the interprofessional team as a small group, using a synthesis of sources from social psychology, social group work, T-group literature, management theory, and health team research. Eight issues are considered in relation to the team as a small group, namely, (a) the individual in the group, (b) team size, (c) group norms, (d) democracy, (e) decision making and conflict resolution, (f) communication and structure, (g) leadership, and (h) group harmony and its relationship to group productivity.
Alvarez, Marc A.; Martinez, Rodolfo A.; Unkefer, Clifford J.
2010-02-16
The present invention is directed to labeled compounds of the formulae ##STR00001## wherein Q is selected from the group consisting of --S(.dbd.O)--, and --S(.dbd.O).sub.2--, Z is selected from the group consisting of 1-naphthyl, substituted 1-naphthyl, 2-naphthyl, substituted 2-naphthyl, and phenyl groups with the structure ##STR00002## wherein R.sub.1, R.sub.2, R.sub.3, R.sub.4 and R.sub.5 are each independently selected from the group consisting of hydrogen, a C.sub.1-C.sub.4 lower alkyl, a halogen, and an amino group selected from the group consisting of NH.sub.2, NHR and NRR' where R and R' are each independently selected from the group consisting of a C.sub.1-C.sub.4 lower alkyl, an aryl, and an alkoxy group, and X is selected from the group consisting of hydrogen, a C.sub.1-C.sub.4 lower alkyl group, and a fully-deuterated C.sub.1-C.sub.4 lower alkyl group.
Strahm, E; Emery, C; Saugy, M; Dvorak, J; Saudan, C
2009-12-01
The determination of the carbon isotope ratio in androgen metabolites has been previously shown to be a reliable, direct method to detect testosterone misuse in the context of antidoping testing. Here, the variability in the 13C/12C ratios in urinary steroids in a widely heterogeneous cohort of professional soccer players residing in different countries (Argentina, Italy, Japan, South Africa, Switzerland and Uganda) is examined. Carbon isotope ratios of selected androgens in urine specimens were determined using gas chromatography/combustion/isotope ratio mass spectrometry (GC-C-IRMS). Urinary steroids in Italian and Swiss populations were found to be enriched in 13C relative to other groups, reflecting higher consumption of C3 plants in these two countries. Importantly, detection criteria based on the difference in the carbon isotope ratio of androsterone and pregnanediol for each population were found to be well below the established threshold value for positive cases. The results obtained with the tested diet groups highlight the importance of adapting the criteria if one wishes to increase the sensitivity of exogenous testosterone detection. In addition, confirmatory tests might be rendered more efficient by combining isotope ratio mass spectrometry with refined interpretation criteria for positivity and subject-based profiling of steroids.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 1 2010-10-01 2010-10-01 false Definitions. 4.2 Section 4.2 Public Health PUBLIC... § 4.2 Definitions. As used in this part: Act means the Public Health Service Act, as amended (42 U.S.C... Director's delegate. Health-sciences professional means any person engaged in: (1) The administration of...
2013-01-01
Background The prevalence of male obesity is increasing, but men are less likely than women to attend existing weight management programmes. We have taken a novel approach to reducing perceived barriers to weight loss for men by using professional football (soccer) clubs to encourage participation in a weight management group programme, gender-sensitised in content and style of delivery. Football Fans in Training (FFIT) provides 12 weeks of weight loss, physical activity and healthy eating advice at top professional football clubs in Scotland. This pilot randomized trial explored the feasibility of using these clubs as a setting for a randomized controlled trial of 12 month weight loss following men’s participation in FFIT. Methods A two-arm pilot trial at two Scottish Premier League football clubs (one large, one smaller), with 103 men (aged 35–65, body mass index (BMI) ≥27 kg/m2) individually randomized to the intervention (n=51, received the pilot programme (p-FFIT) immediately) and waitlist comparison (n=52, received p-FFIT after four months) groups. Feasibility of recruitment, randomization, data collection and retention were assessed. Objective physical measurements (weight, waist circumference, blood pressure, body composition) and questionnaires (self-reported physical activity, diet, alcohol consumption, psychological outcomes) were obtained from both groups by fieldworkers trained to standard protocols at baseline and 12 weeks, and from the intervention group at 6 and 12 months. Qualitative methods elicited men’s experiences of participation in the pilot trial. Results Following a short recruitment period, the recruitment target was achieved at the large, but not smaller, club. Participants’ mean age was 47.1±8.4 years; mean BMI 34.5±5.0 kg/m2. Retention through the trial was good (>80% at 12 weeks and 6 months; >75% at 12 months), and 76% attended at least 80% of available programme delivery sessions. At 12 weeks, the intervention group lost significantly more weight than the comparison group (4.6% c.f. -0.6%, p<.001) and many maintained this to 12 months (intervention group baseline-12 month weight loss: 3.5%, p<.001). There were also improvements in self-reported physical activity and diet, many sustained long term. Conclusions The results demonstrated the feasibility of trial procedures and the potential of FFIT to engage men in sustained weight loss and positive lifestyle change. They supported the conduct of a fully-powered randomized controlled trial. PMID:24171842
Measuring family-centred practices of professionals in early intervention services in Taiwan.
Kang, L-J; Palisano, R J; Simeonsson, R J; Hwang, A-W
2017-09-01
Family-centred practices emphasize professional supports for forming partnerships with families in early intervention. The Measure of Processes of Care for Service Providers (MPOC-SP) measures the perceptions of paediatric service providers in supporting children and families. This study aimed to establish reliability of the Chinese version of the MPOC-SP (C-MPOC-SP) and to examine professional perceptions of family-centred practices in relation to professional discipline and years of experience. A convenience sample of 94 physical therapists, occupational therapists, speech-language pathologists, social workers and early childhood educators completed the C-MPOC-SP. Thirty-seven professionals completed the measure a second time within 2-4 weeks for test-retest reliability. Internal consistency and test-retest reliability were examined by Cronbach's α and intra-class correlation coefficient. Comparisons were made across professional disciplines by multivariate analyses of variance followed by analyses of variance. Relationships between years of experience and ratings of family-centred practices were examined by Pearson's correlation coefficients (r). Cronbach's α for items on each of the four scales of the C-MPOC-SP ranged from 0.80 to 0.92, indicating adequate internal consistency. Intra-class correlation coefficient between the initial and repeat completion of the C-MPOC-SP for each scale ranged from 0.56 to 0.77, indicating adequate to excellent test-retest reliability. Mean ratings for the Communicating Specific Information were significantly higher for physical therapists, occupational therapists and speech-language pathologists than for social workers (P = 0.001). The C-MPOC-SP scores were positively correlated with years of experience for all four scales (r = 0.23-0.38; P < 0.05). This study established adequate internal consistency and adequate to excellent test-retest reliability of the C-MPOC-SP in measuring perceptions of family centeredness of early intervention service providers. Cross-discipline differences were found in communicating specific information about the child. Higher perceptions of family centeredness were associated with more years of experience. The results support the utility of the C-MPOC-SP in professional education and programme evaluation of early intervention services in Taiwan. © 2017 John Wiley & Sons Ltd.
Code of Federal Regulations, 2014 CFR
2014-07-01
... education, in scientific, professional, technical, mechanical, trade, clerical, fiscal, administrative, or... Data Elements for Federal Travel [Accounting & Certification] Group name Data elements Description Accounting Classification Accounting Code Agency accounting code. Non-Federal Source Indicator Per Diem...
Ulutaşdemir, Nilgün; Balsak, Habip; Berhuni, Özlem; Özdemir, Emine; Ataşalan, Esra
2015-11-01
This study was performed to determine the occupational risks and their effects on the work stress of the health professionals working in state hospitals in the Southeast of Turkey. This cross-sectional and descriptive study was composed of 360 health professionals of the Pazarcık, Ergani, and Şehitkamil State Hospitals between December 2014 and January 2015. The data of the study were obtained by performing the survey which was composed of questions related to the socio-demographic characteristics, factors that were thought to affect the occupational risks and job stress, as well as, the questions of the Work Stress Scale. The analyses of the data have been performed using Student's t test and one-way analysis of variance. The working hours, the number of being on-duty, insomnia, and burnout in health professionals were determined to be with the highest mean scores among other stressful risks and hazards. The mean work stress level, which increases the success by creating the group-stimulus effect, was indicated as 2.4 and 2.5 for the health professionals in Pazarcık and Ergani State Hospital, respectively. However, the stress level which poses a threat for the group-health and efficiency was found to be 4.0 for the health professionals of the Şehitkamil State Hospital. As the exposure of the occupational risks increases in the health professionals, the work stress scores also increase (p < 0.05). The occupational risks and work stress of the health professionals in the Şehitkamil State Hospital should be evaluated in terms of occupational health and safety.
Komić, Dubravka; Marušić, Stjepan Ljudevit; Marušić, Ana
2015-01-01
Professional codes of ethics are social contracts among members of a professional group, which aim to instigate, encourage and nurture ethical behaviour and prevent professional misconduct, including research and publication. Despite the existence of codes of ethics, research misconduct remains a serious problem. A survey of codes of ethics from 795 professional organizations from the Illinois Institute of Technology's Codes of Ethics Collection showed that 182 of them (23%) used research integrity and research ethics terminology in their codes, with differences across disciplines: while the terminology was common in professional organizations in social sciences (82%), mental health (71%), sciences (61%), other organizations had no statements (construction trades, fraternal social organizations, real estate) or a few of them (management, media, engineering). A subsample of 158 professional organizations we judged to be directly involved in research significantly more often had statements on research integrity/ethics terminology than the whole sample: an average of 10.4% of organizations with a statement (95% CI = 10.4-23-5%) on any of the 27 research integrity/ethics terms compared to 3.3% (95% CI = 2.1-4.6%), respectively (P<0.001). Overall, 62% of all statements addressing research integrity/ethics concepts used prescriptive language in describing the standard of practice. Professional organizations should define research integrity and research ethics issues in their ethics codes and collaborate within and across disciplines to adequately address responsible conduct of research and meet contemporary needs of their communities.
High fidelity, low cost moulage as a valid simulation tool to improve burns education.
Pywell, M J; Evgeniou, E; Highway, K; Pitt, E; Estela, C M
2016-06-01
Simulation allows the opportunity for repeated practice in controlled, safe conditions. Moulage uses materials such as makeup to simulate clinical presentations. Moulage fidelity can be assessed by face validity (realism) and content validity (appropriateness). The aim of this project is to compare the fidelity of professional moulage to non-professional moulage in the context of a burns management course. Four actors were randomly assigned to a professional make-up artist or a course faculty member for moulage preparation such that two actors were in each group. Participants completed the actor-based burn management scenarios and answered a ten-question Likert-scale questionnaire on face and content validity. Mean scores and a linear mixed effects model were used to compare professional and non-professional moulage. Cronbach's alpha assessed internal consistency. Twenty participants experienced three out of four scenarios and at the end of the course completed a total of 60 questionnaires. Professional moulage had higher average ratings for face (4.30 v 3.80; p=0.11) and content (4.30 v 4.00; p=0.06) validity. Internal consistency of face (α=0.91) and content (α=0.85) validity questions was very good. The fidelity of professionally prepared moulage, as assessed by content validity, was higher than non-professionally prepared moulage. We have shown that using professional techniques and low cost materials we can prepare quality high fidelity moulage simulations. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.
Cherneva, P; Lukanova, R
1994-01-01
The variability of the dust concentration in time and space, as well as the change of worker's place during the working process, define the necessity of introducing personal sampling in the hygiene control practice. However, the laboratory equipment with personal devices is still not sufficient. The aim of this work is to assess the dust exposure of the basic professional groups from the ore- and coal production in Bulgaria by personal sampling in comparative studies of the static ambient sampling used up to now. 63 full-shift investigations of the dust factor were performed on professional groups of miners of the polymetal and coal pits by static ambient devices-[Hygitest production] and personal [from firms "Casella", "Strolein" and "Gilian"] devices, after standardized methods. The results are data processed-by means of logarithmic normal distribution of the relation of the respirable dust concentrations, determined personally and by static ambient sampling. The limits of variation of this correlation are from 0.5 to 4.1 at average geometric value -0.95 and standard geometric deviation-1.8 i.e. both types of sampling are intersubstitutional for the examined groups and sites, as in the underground ores the professional risk of respirable dust is underestimated up to 4 times at static ambient sampling.
Lynch, Elizabeth A; Luker, Julie A; Cadilhac, Dominique A; Fryer, Caroline E; Hillier, Susan L
2017-07-01
To explore the factors perceived to affect rehabilitation assessment and referral practices for patients with stroke. Qualitative study using data from focus groups analysed thematically and then mapped to the Theoretical Domains Framework. Eight acute stroke units in two states of Australia. Health professionals working in acute stroke units. Health professionals at all sites had participated in interventions to improve rehabilitation assessment and referral practices, which included provision of copies of an evidence-based decision-making rehabilitation Assessment Tool and pathway. Eight focus groups were conducted (32 total participants). Reported rehabilitation assessment and referral practices varied markedly between units. Continence and mood were not routinely assessed (4 units), and people with stroke symptoms were not consistently referred to rehabilitation (4 units). Key factors influencing practice were identified and included whether health professionals perceived that use of the Assessment Tool would improve rehabilitation assessment practices (theoretical domain 'social and professional role'); beliefs about outcomes from changing practice such as increased equity for patients or conversely that changing rehabilitation referral patterns would not affect access to rehabilitation ('belief about consequences'); the influence of the unit's relationships with other groups including rehabilitation teams ('social influences' domain) and understanding within the acute stroke unit team of the purpose of changing assessment practices ('knowledge' domain). This study has identified that health professionals' perceived roles, beliefs about consequences from changing practice and relationships with rehabilitation service providers were perceived to influence rehabilitation assessment and referral practices on Australian acute stroke units.
Barriers to Care for Depressed Older People: Perceptions of Aged Care among Medical Professionals
ERIC Educational Resources Information Center
McCabe, Marita P.; Davison, Tanya; Mellor, David; George, Kuruvilla
2009-01-01
The current study evaluated barriers to detection of depression among older people. Focus groups were conducted with 21 professional carers, 4 nurses, 10 general practitioners, and 7 aged care managers. The results demonstrated that care for older people is primarily focused on physical care. Further, staff resources, a lack of continuity of care,…
A Case Study of How Professional Learning Communities Influence Morale and Rigor in the Classroom
ERIC Educational Resources Information Center
McDonough, Jessica S.
2013-01-01
The purpose of this qualitative case study was to explore how professional learning communities influence teacher morale and rigor in the classroom. Participants of the study consisted of six to eight core subject teachers from two 4-A high school campuses in southeast Texas. Two focus group interviews were conducted, one at each school, and…
Exploring the Effects of Classroom Culture on Primary Pre-Service Teachers' Professional Development
ERIC Educational Resources Information Center
Altun, Taner
2013-01-01
This study aims to examine primary student teachers' (PSTs) perceptions about the effects of pre-formed classroom culture on their professional development. In the study, a mixed method approach was used. The study group consisted of 4th year student teachers who attend a primary teacher education program leading to a B.Ed. degree at the Fatih…
Murphy, C L; McLaws, M
2000-04-01
To adopt an evidence-based approach, professionals must be able to access, identify, interpret, and critically appraise best evidence. Critical appraisal requires essential skills, such as computer literacy and an understanding of research principles. These skills also are required for professionals to contribute to evidence. In 1996, members of the Australian Infection Control Association were surveyed to establish a profile including the extent to which they were reading infection control publications, using specific documents for policy and guideline development, developing and undertaking research, publishing research, and using computers. The relationships between demographics, computer use, and research activity were examined. The response rate was 63. 4% (630/993). The study group comprised mostly women (96.1%), and most (66.4%) were older than 40 years of age. Median infection control experience was 4 years (mean, 5.4 years; range, <12 months to 35 years). When developing guidelines and policies (92.7%; 584/630), infection control professionals reviewed State Health Department Infection Control Guidelines and Regulations. Research relating to infection control was undertaken by 21.5% (135/628) of the sample, and 27.6% (37/134) of this group published their research findings. Of the respondents (51.1%; 318/622) who used a computer to undertake infection control tasks, the majority (89.0%) used a personal computer for word processing. Regardless of infection control experience, Australian infection control professionals must be adequately prepared to contribute to, access, appraise, and where appropriate, apply best evidence to their practice. We suggest that computer literacy, an understanding of research principles, and familiarity with infection control literature are three essential skills that infection control professionals must possess and regularly exercise.
Sotiropoulos, Aristomenis; Travlos, Antonios K; Gissis, Ioannis; Souglis, Atnanasios G; Grezios, Apostolos
2009-09-01
The purpose of this study was to evaluate the changes in body fat percentage and aerobic capacity in professional soccer players, after the implementation of a specific 4-week training regimen during the transition period. Fifty-eight professional soccer players of the Greek Premier National Division were separated in experimental (n = 38) and control groups (n = 20). Body composition and maximum oxygen intake were evaluated before and after a 4-week training regimen followed during the transition period. The experimental design used for analyzing weight (kg), percent body fat (%) and VO2 max values (ml x kg(-1) x min(-1)) was a 2 x 2 (Groups x Measures), with Groups as a between-subjects factor and Measures as a within-subjects factor. The level of significance was set at p < or = 0.05 for all analyses. Analyses of variances showed that the experimental and the control groups achieved statistically significant (a) increases from pretest to posttest measures in body weight (0.595 kg and 1.425 kg, respectively) and percent body fat (0.25 and 0.82, respectively), and (b) decreases in VO2 max values from pretest to posttest measures (0.81 and 3.56, respectively). The findings of the study revealed that the players who followed the training regimen compared with the players that did not follow any specific training program gained less weight and body fat and exhibited lower reduction in their VO2 max values.
Consumer involvement in Quality Use of Medicines (QUM) projects - lessons from Australia.
Kirkpatrick, Carl M J; Roughead, Elizabeth E; Monteith, Gregory R; Tett, Susan E
2005-12-01
It is essential that knowledge gained through health services research is collated and made available for evaluation, for policy purposes and to enable collaboration between people working in similar areas (capacity building). The Australian Quality Use of Medicine (QUM) on-line, web-based project database, known as the QUMmap, was designed to meet these needs for a specific sub-section of health services research related to improving the use of medicines. Australia's National Strategy for Quality Use of Medicines identifies the primacy of consumers as a major principle for quality use of medicines, and aims to support consumer led research. The aim of this study was to determine how consumers as a group have been represented in QUM projects in Australia. A secondary aim was to investigate how the projects with consumer involvement fit into Australia's QUM policy framework. Using the web-based QUMmap, all projects which claimed consumer involvement were identified and stratified into four categories, projects undertaken by; (a) consumers for consumers, (b) health professionals for consumers, (c) health professionals for health professionals, and (d) other. Projects in the first two categories were then classified according to the policy 'building blocks' considered necessary to achieve QUM. Of the 143 'consumer' projects identified, the majority stated to be 'for consumers' were either actually by health professionals for health professionals (c) or by health professionals for consumers (b) (47% and 40% respectively). Only 12 projects (9%) were directly undertaken by consumers or consumer groups for consumers (a). The majority of the health professionals for consumers (b) projects were directed at the provision of services and interventions, but were not focusing on the education, training or skill development of consumers. Health services research relating to QUM is active in Australia and the projects are collated and searchable on the web-based interactive QUMmap. Healthcare professionals appear to be dominating nominally 'consumer focussed' research, with less than half of these projects actively involving the consumers or directly benefiting consumers. The QUMmap provides a valuable tool for policy analysis and for provision of future directions through identification of QUM initiatives.
Variations in hospital worker perceptions of safety culture.
Listyowardojo, Tita Alissa; Nap, Raoul E; Johnson, Addie
2012-02-01
To compare the attitudes toward and perceptions of institutional practices that can influence patient safety between all professional groups at a university medical center. A questionnaire measuring nine dimensions of organizational and safety culture was distributed to all hospital workers. Each item was rated on a 1 ('strongly disagree') to 5 ('strongly agree') scale. Professionals (2995), grouped as 'physicians' (16.6%), 'nurses' (40.3%), 'clinical workers' (e.g. psychologists; 21.7%), 'laboratory workers' (e.g. technicians; 11%) and 'non-medical workers' (e.g. managers; 10.4%). One-way analysis of variances (ANOVAs) carried out separately on each dimension with professional group as the independent variable of interest. Differences in ratings of organizational and safety culture were found across professional groups. Physicians and non-medical workers tended to rate the dimensions of organizational and safety culture more positively than did nurses, clinical workers and laboratory workers. For example, physicians gave more positive ratings of 'institutional commitment to safety' than did nurses, clinical workers and laboratory workers (mean = 3.71 vs. 3.62, 3.61 and 3.58, respectively, P < 0.01) and non-medical workers gave more positive ratings than did physicians, nurses, clinical workers and laboratory workers to 'perceptions towards the hospital' (mean = 3.69 vs. 3.39, 3.36, 3.49 and 3.47, respectively, P < 0.001). Interventions to promote safety culture should be tailored to the target group as attitudes and perceptions may differ among groups.
Before the storm: informing and involving stakeholder groups in workplace biomarker monitoring.
Musham, C; Trettin, L; Jablonski, R
1999-01-01
The social, legal and ethical implications of advances in biomarker indentification have been discussed by scholars and environmental researchers, but not by the "everyday" professionals and workers who may eventually make and be affected by decisions about their workplace applications. Through the use of a hypothetical scenario, this study introduced members of various professional and occupational groups to the potential uses of biomarkers research on biological monitoring in the workplace. The purpose was to obtain opinions about how events would proceed based on the scenario, leading to a broad discussion of potential uses and abuses of biomarker-based health monitoring. Six professionally homogeneous focus groups, comprised of 1) company health professionals, 2) third-party payers, 3) attorneys, 4) human resource managers, 5) non-unionized workers, and 6) unionized workers, participated in focus groups presented as "think-tank" discussions in Greenville and Charleston, S.C. Participants were given a fictitious "newspaper article" about the use of biomarker-based monitoring at a chemical plant and were asked to comment on what they thought would happen next. The discussion expanded to a general consideration of biological monitoring and its legal, social and ethical ramifications. Data was analyzed through the "immersion/crystallization" method. Few participants reported any knowledge of biological monitoring prior to the focus group session. Some had initial difficulty understanding the concept and how it differs from other means of measuring environmental risk. Although biological monitoring was previously unknown to many participants, occupational groups were relatively consistent in the issues they raised about its use in the workplace. In all groups, questions about potential discrimination against employees were raised. The general consensus was that the use of biomarker-based monitoring would result in conflict and litigation without regulations to protect employees from discrimination. Although most participants saw potential health benefits resulting from the preventive advantages associated with this technology, their concerns about its misuses were paramount. Perceptions varied as a function of occupation. Non-unionized workers expressed the most concern about discriminatory uses of biological monitoring. Unionized workers, who said they believed the union would support their interests, expressed much less concern. Health professionals (company physicians and nurse practitioners) were most alarmed about the "extra work" a monitoring program would create for them. Human resource managers concentrated on the company's "damage control" efforts. Attorneys emphasized that the reliable use of such tests would establish a causal relationship between exposure and personal injury. The results of this project illustrate that people who are most likely to be affected by biomarker-based biological monitoring in the workplace readily understand and are alarmed by its legal and ethical implications. It is unlikely that this technology will be fully accepted as an environmental risk assessment tool or as a prevention strategy without stringent protection of workers' rights. This study demonstrated the value of focus groups in obtaining opinion data about an environmental risk issue that it not yet well known to the general public.
The demands of professional opera singing on cranio-cervical posture
Skinner, Margot
2009-01-01
Difficulty with singing is a rare but important complication following cervical spine surgery but there is little objective information regarding the cervical and head postural changes taking place during singing. The aim of this study was to identify postural changes in the cranio-cervical region associated with the demands of voice production in professional opera singing. The two Roentgen-cephalograms, one of which are taken whilst performing a specified singing task were taken from 18 professional opera students, 12 females (mean age 20.86 ± 3.07 years) and six males (18.66 ± 1.36 years). A paired t test compared mean cranio-cervical postural and pharyngeal/hyoid variables between the two registrations (P = 0.05). The association between the cranio-cervical postural variables and the pharyngeal/hyoid region in each registration position was examined using Spearman’s rank correlation coefficient. In singing, the position of the atlas with respect to the true vertical (P < 0.001), the axis (P < 0.001) and the C4 vertebra both with respect to the horizontal (P < 0.001), and the axis with respect to the cranium (P < 0.001), were all significantly different to those at rest. Of the cranio-cervical postural variables in the singing registration, the angles measuring positional change of the atlas and C4 relative to the true horizontal were shown be significantly related to an increased pharyngeal airway space at the C3 level (P < 0.01). An appreciation of the requirement for the cervical spine to undergo postural change during professional opera singing has relevance to the potential impact on voice quality in professional opera singers should they undergo cervical spine surgery. PMID:19165506
High Frontier, The Journal for Space & Missile Professionals. Volume 4, Number 4
2008-08-01
46 Next Issue: Space Protection High Frontier Introduction General C . Robert Kehler Commander, Air Force Space Command “ The ... the Air Force and General C . Robert “Bob” Kehler (BS, Education, Pennsylvania State University; MS, Public Administra- tion, University of Oklahoma...depth interview with Dr. F. Robert Naka, former deputy director of the NRO (1969- 1972 ) and former chief scientist of the Air Force (1975-1978
42 CFR 4.6 - Reference, bibliographic, reproduction, and consultation services.
Code of Federal Regulations, 2012 CFR
2012-10-01
... requests from health-sciences professionals for services not reasonably available through local or regional... bibliographic information. (c) Information retrieval system computer tapes. To the extent Library resources...
42 CFR 4.6 - Reference, bibliographic, reproduction, and consultation services.
Code of Federal Regulations, 2013 CFR
2013-10-01
... requests from health-sciences professionals for services not reasonably available through local or regional... bibliographic information. (c) Information retrieval system computer tapes. To the extent Library resources...
42 CFR 4.6 - Reference, bibliographic, reproduction, and consultation services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... requests from health-sciences professionals for services not reasonably available through local or regional... bibliographic information. (c) Information retrieval system computer tapes. To the extent Library resources...
42 CFR 4.6 - Reference, bibliographic, reproduction, and consultation services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... requests from health-sciences professionals for services not reasonably available through local or regional... bibliographic information. (c) Information retrieval system computer tapes. To the extent Library resources...
42 CFR 4.6 - Reference, bibliographic, reproduction, and consultation services.
Code of Federal Regulations, 2014 CFR
2014-10-01
... requests from health-sciences professionals for services not reasonably available through local or regional... bibliographic information. (c) Information retrieval system computer tapes. To the extent Library resources...
12 CFR 211.4 - Permissible activities and investments of foreign branches of member banks.
Code of Federal Regulations, 2014 CFR
2014-01-01
... foreign branches of member banks. 211.4 Section 211.4 Banks and Banking FEDERAL RESERVE SYSTEM BOARD OF... requirements; and (C) Shares of automated electronic-payments networks, professional societies, schools, and...) Investment in subsidiaries. With the Board's prior approval, acquire all of the shares of a company (except...
12 CFR 211.4 - Permissible activities and investments of foreign branches of member banks.
Code of Federal Regulations, 2013 CFR
2013-01-01
... foreign branches of member banks. 211.4 Section 211.4 Banks and Banking FEDERAL RESERVE SYSTEM BOARD OF... requirements; and (C) Shares of automated electronic-payments networks, professional societies, schools, and...) Investment in subsidiaries. With the Board's prior approval, acquire all of the shares of a company (except...
12 CFR 211.4 - Permissible activities and investments of foreign branches of member banks.
Code of Federal Regulations, 2012 CFR
2012-01-01
... foreign branches of member banks. 211.4 Section 211.4 Banks and Banking FEDERAL RESERVE SYSTEM BOARD OF... requirements; and (C) Shares of automated electronic-payments networks, professional societies, schools, and...) Investment in subsidiaries. With the Board's prior approval, acquire all of the shares of a company (except...
5 CFR 575.203 - Eligible categories of employees.
Code of Federal Regulations, 2010 CFR
2010-01-01
... authority); (2) A senior-level or scientific or professional position paid under 5 U.S.C. 5376; (3) A Senior... Enforcement Administration Senior Executive Service position paid under 5 U.S.C. 3151; (4) A position as a law....C. 5311-5317 or a position the rate of pay for which is fixed by law at a rate equal to a rate for...
Bevevino, Adam J; Lehman, Ronald A; Kang, Daniel G; Gwinn, David E; Dmitriev, Anton E
2014-09-01
Human cadaveric biomechanical analysis. To investigate the effect on cervical spine segmental stability that results from a posterior foraminotomy after cervical disc arthroplasty (CDA). Posterior foraminotomy offers the ability to decompress cervical nerves roots while avoiding the need to extend a previous fusion or revise an arthroplasty to a fusion. However, the safety of a foraminotomy in the setting of CDA is unknown. Segmental nondestructive range of motion (ROM) was analyzed in 9 human cadaveric cervical spine specimens. After intact testing, each specimen was sequentially tested according to the following 4 experimental groups: group 1=C5-C6 CDA, group 2=C5-C6 CDA with unilateral C5-C6 foraminotomy, group 3=C5-C6 CDA with bilateral C5-C6 foraminotomy, and group 4=C5-C6 CDA with C5-C6 and C4-C5 bilateral foraminotomy. No differences in ROM were found between the intact, CDA, and foraminotomy specimens at C4-C5 or C6-C7. There was a step-wise increase in C5-C6 axial rotation from the intact state (8°) to group 4 (12°), although the difference did not reach statistical significance. At C5-C6, the degree of lateral bending remained relatively constant. Flexion and extension at C5-C6 was significantly higher in the foraminotomy specimens, groups 2 (18.1°), 3 (18.6°), and 4 (18.2°), compared with the intact state, 11.2°. However, no ROM difference was found within foraminotomy groups (2-4) or between the foraminotomy groups and the CDA group (group 1), 15.3°. Our results indicate that cervical stability is not significantly decreased by the presence, number, or level of posterior foraminotomies in the setting of CDA. The addition of foraminotomies to specimens with a pre-existing CDA resulted in small and insignificant increases in segmental ROM. Therefore, biomechanically, posterior foraminotomy/foraminotomies may be considered a safe and viable option in the setting of recurrent or adjacent level radiculopathy after cervical disc replacement. N/A.
Early microbial succession in re-developing dental biofilms in periodontal health and disease
TELES, F.R.; TELES, R.P.; UZEL, N.G.; SONG, X.Q.; TORRESYAP, G.; SOCRANSKY, S.S.; HAFFAJEE, A.D.
2011-01-01
Objective To determine the order of bacterial species succession in re-developing supra and subgingival biofilms. Methods Supra and subgingival plaque samples were taken separately from 28 teeth in 38 healthy and 17 periodontitis subjects immediately after professional cleaning. Samples were taken again from 7 teeth in randomly selected quadrants after 1, 2, 4 and 7 days of no oral hygiene and analyzed using checkerboard DNA-DNA hybridization. % DNA probe counts were averaged within subjects at each time point. Ecological succession was determined using a modified moving window analysis. Results Succession in supragingival biofilms from periodontitis and health was similar. At 1 day, Streptococcus mitis and Neisseria mucosa showed increased proportions, followed by Capnocytophaga gingivalis, Eikenella corrodens, Veillonella parvula and Streptococcus oralis at 1–4 days. At 4–7 days, Campylobacter rectus, Campylobacter showae, Prevotella melaninogenica and Prevotella nigrescens became elevated. Subgingival plaque redevelopment was slower and very different from supragingival. Increased proportions were first observed for S. mitis, followed by V. parvula and C. gingivalis and, at 7 days by Capnocytophaga sputigena and P. nigrescens. No significant increase in proportions of periodontal pathogens was observed in any of the clinical groups or locations. Conclusions There is a defined order in bacterial species succession in early supra and subgingival biofilm re-development after professional cleaning. PMID:21895662
Compositions for labeling .beta.-amyloid plaques and neurofibrillary tangles
Barrio, Jorge R [Agoura Hills, CA; Petric, Andrej [Ljubljana, SI; Satyamurthy, Nagichettiar [Los Angeles, CA; Small, Gary W [Los Angeles, CA; Cole, Gregory M [Santa Monica, CA; Huang, Sung-Cheng [Sherman Oaks, CA
2008-03-11
Compositions useful for labeling .beta.-amyloid plaques and neurofibrillary tangles are provided. The compositions comprises compounds of formula (I): ##STR00001## wherein R.sub.1 is selected from the group consisting of --C(O)-alkyl, --C(O)-alkylenyl-R.sub.4, --C(O)O-alkyl, --C(O)O-alkylenyl-R.sub.4, --C.dbd.C(CN).sub.2-alkyl, --C.dbd.C(CN).sub.2-alkylenyl-R.sub.4, ##STR00002## wherein R.sub.4 is a radical selected from the group consisting of alkyl, substituted alkyl, aryl and substituted aryl; R.sub.5 is a radical selected from the group consisting of --NH.sub.2, --OH, --SH, --NH-alkyl, --NHR.sub.4, --NH-alkylenyl-R.sub.4, --O-alkyl, --O-alkylenyl-R.sub.4, --S-alkyl, and --S-alkylenyl-R.sub.4; R.sub.6 is a radical selected from the group consisting of --CN, --COOH, --C(O)O-alkyl, --C(O)O-alkylenyl-R.sub.4, --C(O)-alkyl, --C(O)-alkylenyl-R.sub.4, --C(O)-halogen, --C(O)NH-alkyl, --C(O)NH-alkylenyl-R.sub.4 and --C(O)NH.sub.2; R.sub.7 is a radical selected from the group consisting of O, NH, and S; and R.sub.8 is N, O or S; and R.sub.2 is selected from the group consisting of alkyl and alkylenyl-R.sub.10 and R.sub.3 is alkylenyl-R.sub.10, wherein R.sub.10 is selected from the group consisting of --OH, --OTs, halogen, spiperone, spiperone ketal, and spiperone-3-yl, or R.sub.2 and R.sub.3 together form a heterocyclic ring, optionally substituted with at least one radical selected from the group consisting of alkyl, alkoxy, OH, OTs, halogen, alkyl-R.sub.10, carbonyl, spiperone, spiperone ketal and spiperone-3-yl, and further wherein one or more of the hydrogen, halogen or carbon atoms are optionally replaced with a radiolabel.
Methods for labeling .beta.-amyloid plaques and neurofibrillary tangles
Barrio, Jorge R.; Petric, Andrej; Satyamurthy, Nagichettiar; Small, Gary W.; Cole, Gregory M.; Huang, Sung-Cheng
2003-12-09
A method for labeling .beta.-amyloid plaques and neurofibrillary tangles in vivo and in vitro, comprises contacting a compound of formula (I): ##STR1## with mammalian tissue. In formula (I), R.sub.1 is selected from the group consisting of --C(O)-alkyl, --C(O)-alkylenyl-R.sub.4, --C(O)O-alkyl, --C(O)O-alkylenyl-R.sub.4, --C.dbd.C(CN).sub.2 -alkyl, --C.dbd.C(CN).sub.2 -alkylenyl-R.sub.4, ##STR2## R.sub.4 is a radical selected from the group consisting of alkyl, substituted alkyl, aryl and substituted aryl; R.sub.5 is a radical selected from the group consisting of --NH.sub.2, --OH, --SH, --NH-alkyl, --NHR.sub.4, --NH-alkylenyl-R.sub.4, --O-alkyl, --O-alkylenyl-R.sub.4, --S-alkyl, and --S-alkylenyl-R.sub.4 ; R.sub.6 is a radical selected from the group consisting of --CN, --COOH, --C(O)O-alkyl, --C(O)O-alkylenyl-R.sub.4, --C(O)-alkyl, --C(O)-alkylenyl-R.sub.4, --C(O)-halogen, --C(O)NH, --C(O)NH-alkyl, --C(O)NH-alkylenyl-R.sub.4 ; R.sub.7 is a radical selected from the group consisting of O, NH, and S; and R.sub.8 is N, O or S. R.sub.2 and R.sub.3 are each independently selected from the group consisting of alkyl and alkylenyl-R.sub.10, wherein R.sub.10 is selected from the group consisting of --OH, --OTs, halogen, spiperone, spiperone ketal and spiperone-3-yl. Alternatively, R.sub.2 and R.sub.3 together form a heterocyclic ring, optionally substituted with at least one radical selected from the group consisting of alkyl, alkoxy, OH, OTs, halogen, alkylenyl-R.sub.10, carbonyl, spiperone, spiperone ketal and spiperone-3-yl. In the compounds of formula (I), one or more of the hydrogen, halogen or carbon atoms can, optionally, be replaced with a radiolabel.
Methods for labeling .beta.-amyloid plaques and neurofibrillary tangles
Barrio, Jorge R.; Petric, Andrej; Satyamurthy, Nagichettiar; Small, Gary W.; Cole, Gregory M.; Huang, Sung-Cheng
2001-01-01
A method for labeling .beta.-amyloid plaques and neurofibrillary tangles in vivo and in vitro, comprises contacting a compound of formula (I): ##STR1## with mammalian tissue. In formula (I), R.sub.1 is selected from the group consisting of --C(O)-alkyl, --C(O)-alkylenyl-R.sub.4, --C(O)O-alkyl, --C(O)O-alkylenyl-R.sub.4, --C.dbd.C(CN).sub.2 -alkyl, --C.dbd.C(CN).sub.2 -alkylenyl-R.sub.4 , ##STR2## R.sub.4 is a radical selected from the group consisting of alkyl, substituted alkyl, aryl and substituted aryl; R.sub.5, is a radical selected from the group consisting of --NH.sub.2, --OH, --SH, --NH-alkyl, --NHR.sub.4, --NH-alkylenyl-R.sub.4, --O-alkyl, --O-alkylenyl-R.sub.4, --S-alkyl, and --S-alkylenyl-R.sub.4 ; R.sub.6 is a radical selected from the group consisting of --CN, --COOH, --C(O)O-alkyl, --C(O)O-alkylenyl-R.sub.4, --C(O)-alkyl, --C(O)-alkylenyl-R.sub.4, --C(O)-halogen, --C(O)NH , --C(O)NH-alkyl, --C(O)NH-alkylenyl-R.sub.4 ; R.sub.7 is a radical selected from the group consisting of O, NH, and S; and R.sub.8 is N, O or S. R.sub.2 and R.sub.3 are each independently selected from the group consisting of alkyl and alkylenyl-R.sub.10, wherein R.sub.10 is selected from the group consisting of --OH, --OTs, halogen, spiperone, spiperone ketal and spiperone-3-yl. Alternatively, R.sub.2 and R.sub.3 together form a heterocyclic ring, optionally substituted with at least one radical selected from the group consisting of alkyl, alkoxy, OH, OTs, halogen, alkylenyl-R.sub.10, carbonyl, spiperone, spiperone ketal and spiperone-3-yl. In the compounds of formula (I), one or more of the hydrogen, halogen or carbon atoms can, optionally, be replaced with a radiolabel.
Fleming, Michael; Olsen, Dale; Stathes, Hilary; Boteler, Laura; Grossberg, Paul; Pfeifer, Judie; Schiro, Stephanie; Banning, Jane; Skochelak, Susan
2009-01-01
Educating physicians and other health care professionals about the identification and treatment of patients who drink more than recommended limits is an ongoing challenge. An educational randomized controlled trial was conducted to test the ability of a stand-alone training simulation to improve the clinical skills of health care professionals in alcohol screening and intervention. The "virtual reality simulation" combined video, voice recognition, and nonbranching logic to create an interactive environment that allowed trainees to encounter complex social cues and realistic interpersonal exchanges. The simulation included 707 questions and statements and 1207 simulated patient responses. A sample of 102 health care professionals (10 physicians; 30 physician assistants or nurse practitioners; 36 medical students; 26 pharmacy, physican assistant, or nurse practitioner students) were randomly assigned to a no training group (n = 51) or a computer-based virtual reality intervention (n = 51). Professionals in both groups had similar pretest standardized patient alcohol screening skill scores: 53.2 (experimental) vs 54.4 (controls), 52.2 vs 53.7 alcohol brief intervention skills, and 42.9 vs 43.5 alcohol referral skills. After repeated practice with the simulation there were significant increases in the scores of the experimental group at 6 months after randomization compared with the control group for the screening (67.7 vs 58.1; P < .001) and brief intervention (58.3 vs 51.6; P < .04) scenarios. The technology tested in this trial is the first virtual reality simulation to demonstrate an increase in the alcohol screening and brief intervention skills of health care professionals.
Prostanoids and free radicals in Cl4C-induced hepatotoxicity in rats: effect of astilbin.
Closa, D; Torres, M; Hotter, G; Bioque, G; León, O S; Gelpí, E; Rósello-Catafau, J
1997-04-01
A beneficial effect of flavonoids in Cl(4)C-induced hepatoxicity in rats has been reported. In this communication we have evaluated the protective effect of astilbin, an active flavonoid isolated from a crude extract of Hymenaea martiana, as well as its action on liver arachidonate metabolism in Cl(4)C-treated rats. The following groups of rats were studied: Group I = controls; Group II = Astilbine-treated animals (40 mg/Kg); Group III = Cl(4)C-treated at 1 ml/kg; Group IV = Astilbine + ClC4 and Group V = Vitamine E (50 mg/Kg) + Cl(4)C-treated animals. Histological findings, superoxide dismutase activity, lipoperoxides and prostanoid profiling studies revealed that the hepatoprotective effect of astilbine was higher than that of vitamin E. Astilbine was capable to restore lipoperoxides and tissue prostanoids to basal values.
Ross, Claire; Dimitrova, Stoyanka; Howard, Louise M; Dewey, Michael; Zimmerman, Cathy; Oram, Siân
2015-08-20
(1) To estimate the proportion of National Health Service (NHS) professionals who have come into contact with trafficked people and (2) to measure NHS professionals' knowledge and confidence to respond to human trafficking. A cross-sectional survey. Face-to-face mandatory child protection and/or vulnerable adults training sessions at 10 secondary healthcare provider organisations in England, and meetings of the UK College of Emergency Medicine. 782/892 (84.4%) NHS professionals participated, including from emergency medicine, maternity, mental health, paediatrics and other clinical disciplines. Self-completed questionnaire developed by an expert panel. Questionnaire asks about prior training and contact with potential victims of trafficking, perceived and actual human trafficking knowledge, confidence in responding to human trafficking, and interest in future human trafficking training. 13% participants reported previous contact with a patient they knew or suspected of having been trafficked; among maternity services professionals this was 20.4%. However, 86.8% (n=679) reported lacking knowledge of what questions to ask to identify potential victims and 78.3% (n=613) reported that they had insufficient training to assist trafficked people. 71% (n=556), 67.5% (n=528) and 53.4% (n=418) lacked confidence in making appropriate referrals for men, women and children, respectively, who had been trafficked. 95.3% (n=746) of respondents were unaware of the scale of human trafficking in the UK, and 76.5% (n=598) were unaware that calling the police could put patients in more danger. Psychometric analysis showed that subscales measuring perceived knowledge, actual knowledge and confidence to respond to human trafficking demonstrated good internal consistency (Cronbach's αs 0.93, 0.63 and 0.64, respectively) and internal correlations. NHS professionals working in secondary care are in contact with potential victims of human trafficking, but lack knowledge and confidence in how to respond appropriately. Training is needed, particularly for maternity staff, on how to identify and respond to victims' needs, including through making safe referrals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Shealy, Craig N; Cobb, Harriet C; Crowley, Susan L; Nelson, Paul; Peterson, Gary
2004-09-01
Is it possible and advisable for the profession of psychology to articulate and endorse a common, generalist, and integrative framework for the education and training of its students? At the Consensus Conference on Combined and Integrated Doctoral Training in Psychology, held at James Madison University in Harrisonburg, VA (USA), May 2 to 4, 2003, participants from across the spectrum of education and training in professional psychology ultimately answered "yes." This article, the first in this special series on the Consensus Conference and Combined-Integrated (C-I) model of doctoral training in professional psychology, essentially provides an overview of the conference rationale, participants, goals, proceedings, and results. Because the other 12 articles in this series all reference the Consensus Conference and C-I model, this overview provides a good starting point for understanding what occurred at the conference, what it means to educate and train from a C-I perspective, and what the potential implications of such a model might be for the profession of psychology.
Reliability of concussion history in former professional football players.
Kerr, Zachary Y; Marshall, Stephen W; Guskiewicz, Kevin M
2012-03-01
The reliability of athletes to recall and self-report a concussion history has never been quantified. This study examined the reliability of the self-report concussion history measure and explored determinants of recall in the number of self-reported concussions in a group of retired professional football players. In 2001, a short questionnaire was administered to a cohort of former professional football players to ascertain the number of self-reported concussions they sustained during their professional playing careers. In 2010, the same instrument was readministered to a subset (n = 899) of the original cohort to assess reliability. Overall reliability was moderate (weighted Cohen κ = 0.48). The majority (62.1%) reported the same number of concussions in both administrations (2001 and 2010); 31.4% reported more concussions in the second administration. Compared with the "same number reported" group, the "greater number reported" group had more deficits in the second administration in their Short Form 36 physical health (composite score combining physical functioning, role physical, bodily pain, general health) and mental health (e.g., composite score combining vitality, social functioning, role emotional) scales. The self-reported concussion history had moderate reliability in former professional football players, on the basis of two administrations of the same instrument, 9 yr apart. However, changes in health status may be differentially associated with recall of concussions.
Strategies for Improving Power in School-Randomized Studies of Professional Development.
Kelcey, Ben; Phelps, Geoffrey
2013-12-01
Group-randomized designs are well suited for studies of professional development because they can accommodate programs that are delivered to intact groups (e.g., schools), the collaborative nature of professional development, and extant teacher/school assignments. Though group designs may be theoretically favorable, prior evidence has suggested that they may be challenging to conduct in professional development studies because well-powered designs will typically require large sample sizes or expect large effect sizes. Using teacher knowledge outcomes in mathematics, we investigated when and the extent to which there is evidence that covariance adjustment on a pretest, teacher certification, or demographic covariates can reduce the sample size necessary to achieve reasonable power. Our analyses drew on multilevel models and outcomes in five different content areas for over 4,000 teachers and 2,000 schools. Using these estimates, we assessed the minimum detectable effect sizes for several school-randomized designs with and without covariance adjustment. The analyses suggested that teachers' knowledge is substantially clustered within schools in each of the five content areas and that covariance adjustment for a pretest or, to a lesser extent, teacher certification, has the potential to transform designs that are unreasonably large for professional development studies into viable studies. © The Author(s) 2014.
Micheel, Christine M; Anderson, Ingrid A; Lee, Patricia; Chen, Sheau-Chiann; Justiss, Katy; Giuse, Nunzia B; Ye, Fei; Kusnoor, Sheila V
2017-01-01
Background Precision medicine has resulted in increasing complexity in the treatment of cancer. Web-based educational materials can help address the needs of oncology health care professionals seeking to understand up-to-date treatment strategies. Objective This study aimed to assess learning styles of oncology health care professionals and to determine whether learning style-tailored educational materials lead to enhanced learning. Methods In all, 21,465 oncology health care professionals were invited by email to participate in the fully automated, parallel group study. Enrollment and follow-up occurred between July 13 and September 7, 2015. Self-enrolled participants took a learning style survey and were assigned to the intervention or control arm using concealed alternating allocation. Participants in the intervention group viewed educational materials consistent with their preferences for learning (reading, listening, and/or watching); participants in the control group viewed educational materials typical of the My Cancer Genome website. Educational materials covered the topic of treatment of metastatic estrogen receptor-positive (ER+) breast cancer using cyclin-dependent kinases 4/6 (CDK4/6) inhibitors. Participant knowledge was assessed immediately before (pretest), immediately after (posttest), and 2 weeks after (follow-up test) review of the educational materials. Study statisticians were blinded to group assignment. Results A total of 751 participants enrolled in the study. Of these, 367 (48.9%) were allocated to the intervention arm and 384 (51.1%) were allocated to the control arm. Of those allocated to the intervention arm, 256 (69.8%) completed all assessments. Of those allocated to the control arm, 296 (77.1%) completed all assessments. An additional 12 participants were deemed ineligible and one withdrew. Of the 552 participants, 438 (79.3%) self-identified as multimodal learners. The intervention arm showed greater improvement in posttest score compared to the control group (0.4 points or 4.0% more improvement on average; P=.004) and a higher follow-up test score than the control group (0.3 points or 3.3% more improvement on average; P=.02). Conclusions Although the study demonstrated more learning with learning style-tailored educational materials, the magnitude of increased learning and the largely multimodal learning styles preferred by the study participants lead us to conclude that future content-creation efforts should focus on multimodal educational materials rather than learning style-tailored content. PMID:28743680
Synthesis of labeled oxalic acid derivatives
Martinez, Rodolfo A.; Unkefer, Clifford J.; Alvarez, Marc A.
2004-06-22
The present invention is directed to labeled compounds, specifically ##STR1## where each C* is selected from the group consisting of a carbon-12, i.e., .sup.12 C, or a carbon-13, i.e., .sup.13 C and at least one C* is .sup.13 C, R.sup.1 is selected from the group of C.sub.1 -C.sub.4 lower alkyl and aryl, and X is selected from the group of --NR.sup.2 R.sup.3 where R.sup.2 and R.sup.3 are each independently selected from the group of C.sub.1 -C.sub.4 lower alkyl, alkoxy and aryl, --SR.sup.4 where R.sup.4 is selected from the group of C.sub.1 -C.sub.4 lower alkyl, alkoxy and aryl, and --OR.sup.5 where R.sup.5 is selected from the group of C.sub.1 -C.sub.4 lower alkyl, alkoxy and aryl with the proviso that when R.sup.1 is methyl then R.sup.5 is other than methyl, when R.sup.1 is ethyl then R.sup.5 is other than ethyl, and when R.sup.1 is benzyl then R.sup.5 is other than benzyl.
Lin, Hsin-Shih; Wang, Ho-Seng; Chiu, Hung-Ta; Cheng, Kuang-You B; Hsu, Ar-Tyan; Huang, Tsang-Hai
2018-06-01
The purpose of the study was to investigate the adaptation process of hindlimb cortical bone subjected to free-fall landing training. Female Wistar rats (7 weeks old) were randomly assigned to four landing (L) groups and four age-matched control (C) groups (n = 12 per group): L1, L2, L4 L8, C1, C2, C4 and C8. Animals in the L1, L2, L4 and L8 groups were respectively subjected to 1, 2, 4 and 8 weeks of free-fall-landing training (40 cm height, 30 times/day and 5 days/week) while the C1, C2, C4 and C8 groups served as age-matched control groups. The tibiae of the L8 group were higher in cortical bone mineral content (BMC) than those in the C8 group (p < 0.05). Except for the higher bone mineralization over bone surface ratio (MS/BS, %) shown in the tibiae of the L1 group (p < 0.05), dynamic histomorphometry in the tibial and femoral cortical bone showed no difference between landing groups and their age-matched control groups. In the femora, the L1 group was lower than the C1 group in cortical bone area (Ct.Ar) and cortical thickness (Ct.Th) (p < 0.05); however, the L4 group was higher than the C4 group in Ct.Ar and Ct.Th (p <0 .05). In the tibiae, the moment of inertia about the antero-posterior axis ( I ap ), Ct.Ar and Ct.Th was significantly higher in the L8 group than in the C8 group (p < 0.05). In biomechanical testing, fracture load (FL) of femora was lower in the L1 group than in the C1 group (p < 0.05). Conversely, yield load (YL), FL and yield load energy (YE) of femora, as well as FL of tibiae were all significantly higher in the L8 group than in the C8 group (p < 0.05). Free-fall landing training may initially compromise bone material. However, over time, the current free-fall landing training induced improvements in biomechanical properties and/or the structure of growing bones.
The Meaning of Natural Environments for Parents and Professionals
ERIC Educational Resources Information Center
Campbell, Philippa H.; Sawyer, L. Brook; Muhlenhaupt, Mary
2009-01-01
A total of 75 individuals participated in 1 of either 5 parent or 4 early intervention therapist focus groups. Groups were held regionally in a large mid-Atlantic state to explore the ways in which each group interpreted the concept of natural environments and to identify any differences in perspectives among parents and therapists. Transcribed…
Komić, Dubravka; Marušić, Stjepan Ljudevit; Marušić, Ana
2015-01-01
Professional codes of ethics are social contracts among members of a professional group, which aim to instigate, encourage and nurture ethical behaviour and prevent professional misconduct, including research and publication. Despite the existence of codes of ethics, research misconduct remains a serious problem. A survey of codes of ethics from 795 professional organizations from the Illinois Institute of Technology’s Codes of Ethics Collection showed that 182 of them (23%) used research integrity and research ethics terminology in their codes, with differences across disciplines: while the terminology was common in professional organizations in social sciences (82%), mental health (71%), sciences (61%), other organizations had no statements (construction trades, fraternal social organizations, real estate) or a few of them (management, media, engineering). A subsample of 158 professional organizations we judged to be directly involved in research significantly more often had statements on research integrity/ethics terminology than the whole sample: an average of 10.4% of organizations with a statement (95% CI = 10.4-23-5%) on any of the 27 research integrity/ethics terms compared to 3.3% (95% CI = 2.1–4.6%), respectively (P<0.001). Overall, 62% of all statements addressing research integrity/ethics concepts used prescriptive language in describing the standard of practice. Professional organizations should define research integrity and research ethics issues in their ethics codes and collaborate within and across disciplines to adequately address responsible conduct of research and meet contemporary needs of their communities. PMID:26192805
Preventive Effects of Eccentric Training on Acute Hamstring Muscle Injury in Professional Baseball
Seagrave, Richard A.; Perez, Luis; McQueeney, Sean; Toby, E. Bruce; Key, Vincent; Nelson, Joshua D.
2014-01-01
Background: Hamstring injuries are the second most common injury causing missed days in professional baseball field players. Recent studies have shown the preventive benefit of eccentric conditioning on the hamstring muscle group in injury prevention. Specifically, Nordic-type exercises have been shown to decrease the incidence of acute hamstring injuries in professional athletes. Purpose: This was a prospective study performed in coordination with a single Major League Baseball (MLB) organization (major and minor league teams) that targeted the effects of Nordic exercises on the incidence of acute hamstring injuries in the professional-level baseball player. Study Design: Prospective cohort study; Level of evidence, 2. Methods: The daily workouts of 283 professional baseball players throughout all levels of a single MLB organization were prospectively recorded. The intervention group participated in the Nordic exercise program and was compared with a randomly selected control group of professional athletes within the organization not participating in the exercise program. The incidence of hamstring injuries in both groups was compared, and the total number of days missed due to injury was compared with the 2 previous seasons. Results: There were 10 hamstring injuries that occurred during the 2012 season among the 283 professional athletes that required removal from play. There were no injuries that occurred in the intervention group (n = 65, 0.00%; P = .0381). The number needed to treat (NNT) to prevent 1 hamstring injury was 11.3. The average repetitions per week of the injured group were assessed at multiple time points (2, 4, 6, and total weeks) prior to injury. There were significantly fewer repetitions per week performed in the injured group at all time points compared with overall average repetitions per week in the noninjured group (P = .0459, .0127, .0164, and .0299, respectively). After beginning the Nordic exercise program, there were 136 total days missed due to a hamstring injury during the 2012 season. This number was less than the 2011 season (273 days missed) and the 2010 season (309 days missed). Conclusion: Study results indicate the initiation of Nordic hamstring exercises may decrease the incidence of acute hamstring injuries and potentially decrease the total number of days missed due to injury in professional baseball players. Clinical Relevance: The financial and competitive interest in professional baseball players is of large importance to the player, team, and fans. Prevention of injuries is as important to all parties involved as the treatment and rehabilitation following an injury. This prospective study shows the initiation of a simple, free exercise can reduce the incidence of hamstring injury in the professional-level baseball player. PMID:26535336
Rolls, Kaye; Hansen, Margaret; Jackson, Debra; Elliott, Doug
2016-06-13
Many current challenges of evidence-based practice are related to ineffective social networks among health care professionals. Opportunities exist for multidisciplinary virtual communities to transcend professional and organizational boundaries and facilitate important knowledge transfer. Although health care professionals have been using the Internet to form virtual communities for many years, little is known regarding "why" they join, as most research has focused on the perspective of "posters," who form a minority of members. Our aim was to develop a comprehensive understanding of why health care professionals belong to a virtual community (VC). A qualitative approach will be used to explore why health care professionals belong to an intensive care practice-based VC, established since 2003. Three asynchronous online focus groups will be convened using a closed secure discussion forum. Participants will be recruited directly by sending emails to the VC and a Google form used to collect consent and participant demographics. Participants will be stratified by their online posting behaviors between September 1, 2012, and August 31, 2014: (1) more than 5 posts, (2) 1-5 posts, or (3) no posts. A question guide will be used to guide participant discussion. A moderation approach based on the principles of focus group method and e-moderation has been developed. The main source of data will be discussion threads, supported by a research diary and field notes. Data analysis will be undertaken using a thematic approach and framed by the Diffusion of Innovation theory. NVivo software will be used to support analyses. At the time of writing, 29 participants agreed to participate (Focus Group 1: n=4; Focus Group 2: n=16; Focus Group 3: n=9) and data collection was complete. This study will contribute to a growing body of research on the use of social media in professional health care settings. Specifically, we hope results will demonstrate an enhancement of health care professionals' social networks and how VCs may improve knowledge distribution and patient care outcomes. Additionally, the study will contribute to research methods development in this area by detailing approaches to understand the effectiveness of online focus groups as a data collection method for qualitative research methods.
Strahm, E; Emery, C; Saugy, M; Dvorak, J; Saudan, C
2009-01-01
Background and objectives: The determination of the carbon isotope ratio in androgen metabolites has been previously shown to be a reliable, direct method to detect testosterone misuse in the context of antidoping testing. Here, the variability in the 13C/12C ratios in urinary steroids in a widely heterogeneous cohort of professional soccer players residing in different countries (Argentina, Italy, Japan, South Africa, Switzerland and Uganda) is examined. Methods: Carbon isotope ratios of selected androgens in urine specimens were determined using gas chromatography/combustion/isotope ratio mass spectrometry (GC-C-IRMS). Results: Urinary steroids in Italian and Swiss populations were found to be enriched in 13C relative to other groups, reflecting higher consumption of C3 plants in these two countries. Importantly, detection criteria based on the difference in the carbon isotope ratio of androsterone and pregnanediol for each population were found to be well below the established threshold value for positive cases. Conclusions: The results obtained with the tested diet groups highlight the importance of adapting the criteria if one wishes to increase the sensitivity of exogenous testosterone detection. In addition, confirmatory tests might be rendered more efficient by combining isotope ratio mass spectrometry with refined interpretation criteria for positivity and subject-based profiling of steroids. PMID:19549614
McGreevy, Paul; Berger, Jeannine; de Brauwere, Nic; Doherty, Orla; Harrison, Anna; Fiedler, Julie; Jones, Claudia; McDonnell, Sue; McLean, Andrew; Nakonechny, Lindsay; Preshaw, Liane; Tzioumis, Vicky; Webster, John; Wolfensohn, Sarah; Yeates, James; Jones, Bidda
2018-01-01
Simple Summary Using an adaptation of the domain-based welfare assessment model, a panel of horse welfare professionals (with professional expertise in psychology, equitation science, veterinary science, education, welfare, equestrian coaching, advocacy, and community engagement) assessed the perceived harms, if any, resulting from 116 interventions that are commonly applied to horses. Scores for Domain 5 (the integrated mental impact) gathered after extensive discussion during a four-day workshop aligned well with overall impact scores assigned by the same panellists individually before the workshop, although some rankings changed after workshop participation. Domain 4 (Behaviour) had the strongest association with Domain 5, whilst Domain 1 (Nutrition) had the weakest association with Domain 5, implying that the panellists considered commonly applied nutritional interventions to have less of a bearing on subjective mental state than commonly applied behavioural restrictions. The workshop defined each intervention, and stated assumptions around each, resulting in a set of exemplar procedures that could be used in future equine welfare assessments. Abstract The aim of this study was to conduct a series of paper-based exercises in order to assess the negative (adverse) welfare impacts, if any, of common interventions on domestic horses across a broad range of different contexts of equine care and training. An international panel (with professional expertise in psychology, equitation science, veterinary science, education, welfare, equestrian coaching, advocacy, and community engagement; n = 16) met over a four-day period to define and assess these interventions, using an adaptation of the domain-based assessment model. The interventions were considered within 14 contexts: C1 Weaning; C2 Diet; C3 Housing; C4 Foundation training; C5 Ill-health and veterinary interventions (chiefly medical); C6 Ill-health and veterinary interventions (chiefly surgical); C7 Elective procedures; C8 Care procedures; C9 Restraint for management procedures; C10 Road transport; C11 Activity—competition; C12 Activity—work; C13 Activity—breeding females; and C14 Activity—breeding males. Scores on a 1–10 scale for Domain 5 (the mental domain) gathered during the workshop were compared with overall impact scores on a 1–10 scale assigned by the same panellists individually before the workshop. The most severe (median and interquartile range, IQR) impacts within each context were identified during the workshop as: C1 abrupt, individual weaning (10 IQR 1); C2 feeding 100% low-energy concentrate (8 IQR 2.5); C3 indoor tie stalls with no social contact (9 IQR 1.5); C4 both (i) dropping horse with ropes (9 IQR 0.5) and forced flexion (9 IQR 0.5); C5 long-term curative medical treatments (8 IQR 3); C6 major deep intracavity surgery (8.5 IQR 1); C7 castration without veterinary supervision (10 IQR 1); C8 both (i) tongue ties (8 IQR 2.5) and (ii) restrictive nosebands (8 IQR 2.5); C9 ear twitch (8 IQR 1); C10 both (i) individual transport (7.00 IQR 1.5) and group transport with unfamiliar companions (7 IQR 1.5); C11 both (i) jumps racing (8 IQR 2.5) and Western performance (8 IQR 1.5); C12 carriage and haulage work (6 IQR 1.5); C13 wet nurse during transition between foals (7.5 IQR 3.75); and C14 teaser horse (7 IQR 8). Associations between pre-workshop and workshop scores were high, but some rankings changed after workshop participation, particularly relating to breeding practices. Domain 1 had the weakest association with Domain 5. The current article discusses the use of the domain-based model in equine welfare assessment, and offers a series of assumptions within each context that future users of the same approach may make when assessing animal welfare under the categories reported here. It also discusses some limitations in the framework that was used to apply the model. PMID:29562654
de Jong, Catharina C; Ros, Wynand Jg; van Leeuwen, Mia; Schrijvers, Guus
2016-11-24
Home-dwelling elderly patients with multimorbidity are at risk of fragmentation of care because of the many different professionals involved and a potentially unclear level of communication. Multidisciplinary communication seems to occur incidentally. Mutual feedback is needed for a professional team to provide consistent care and adequate support to the patient system. eHealth technology can improve outcomes. The aim of this study was to evaluate the use of a tool, Congredi, for electronic communication by professionals for the care of home-dwelling elderly patients. The research group was recruited through general practices and home care organizations. Congredi, a tool designed for multidisciplinary communication, was made available for professionals in primary care. It consists of a care plan and a communication channel (secure emailing). Professionals opened Congredi records for elderly patients who had 2 or more professionals involved. The records were the unit of analysis. Data were gathered from the Congredi system over a period of 42 weeks. An inclusion rate of 21.4% (203/950) was achieved; nearly half of the participants were nurses. During the study, professionals were active in 448 patient records; female professionals were prevalent. In the patient records, 3 types of actions (care activities, emailing, and process activities) were registered. Most activities occurred in the multidisciplinary records (mean 12.2), which had twice the number of activities of monodisciplinary records (6.35), and solo records had a mean of 3.43 activities. Most activities were care activities (mean 9.14), emailing had a mean of 0.89 activities, and process activities had a mean of 0.29. An e-communication tool (Congredi) was usable for improving multidisciplinary communication among professionals. It even seemed to yield results for 40% of the professionals who used the e-care plan on their own. The content of the tool provided an active communication practice, with significant increases observed in the actions that must be shared for the effective coordination of care. ©Catharina C de Jong, Wynand JG Ros, Mia van Leeuwen, Guus Schrijvers. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.11.2016.
Tepsic, Jasna; Vucic, Vesna; Arsic, Aleksandra; Blazencic-Mladenovic, Vera; Mazic, Sanja; Glibetic, Marija
2009-10-01
The effect of intensive long-term physical activity on phospholipid fatty acid (FA) composition has not been studied thoroughly. We determined plasma and erythrocyte phospholipid FA status of professional basketball and football players. Our results showed differences in plasma FA profile not only between sportsmen and sedentary subjects, but also between two groups of sportsmen. Plasma FA profile in basketball players showed significantly higher proportion of n-6 FA (20:3, 20:4, and 22:4) and total polyunsaturated FA (PUFA) than controls, while football players had higher palmitoleic acid (16:1) than basketball players and controls. Total PUFA and 22:4 were also higher in basketball than in football players. Erythrocyte FA profile showed no differences between football players and controls. However, basketball players had higher proportion of 18:0 than controls, higher saturated FA and lower 18:2 than two other groups, and higher 22:4 than football players. These findings suggest that long-term intensive exercise and type of sport influence FA profile.
Randmaa, Maria; Engström, Maria; Swenne, Christine Leo; Mårtensson, Gunilla
2017-08-04
To investigate different professionals' (nurse anaesthetists', anaesthesiologists', and postanaesthesia care unit nurses') descriptions of and reflections on the postoperative handover. A focus group interview study with a descriptive design using qualitative content analysis of transcripts. One anaesthetic clinic at two hospitals in Sweden. Six focus groups with 23 healthcare professionals involved in postoperative handovers. Each group was homogeneous regarding participant profession, resulting in two groups per profession: nurse anaesthetists (n=8), anaesthesiologists (n=7) and postanaesthesia care unit nurses (n=8). Patterns and five categories emerged: (1) having different temporal foci during handover, (2) insecurity when information is transferred from one team to another, (3) striving to ensure quality of the handover, (4) weighing the advantages and disadvantages of the bedside handover and (5) having different perspectives on the transfer of responsibility. The professionals' perceptions of the postoperative handover differed with regard to temporal foci and transfer of responsibility. All professional groups were insecure about having all information needed to ensure the quality of care. They strived to ensure quality of the handover by: focusing on matters that deviated from the normal course of events, aiding memory through structure and written information and cooperating within and between teams. They reported that the bedside handover enhances their control of the patient but also that it could threaten the patient's privacy and that frequent interruptions could be disturbing. The present findings revealed variations in different professionals' views on the postoperative handover. Healthcare interventions are needed to minimise the gap between professionals' perceptions and practices and to achieve a shared understanding of postoperative handover. Furthermore, to ensure high-quality and safe care, stakeholders/decision makers need to pay attention to the environment and infrastructure in postanaesthesia care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Verbal messages strengthen bench press efficacy.
Wise, James B; Posner, Amy E; Walker, Gretchen L
2004-02-01
This study examined the effects of verbal messages on bench press efficacy: the confidence to lift progressively heavier weights for 1 repetition. Thirty-two women who had not bench pressed within the previous 18 months were assigned to 1 of 2 groups and exposed to 2 sources of efficacy information. First, subjects in both groups performed 10 repetitions on a fixed movement, vertical bench press machine and completed the bench press efficacy scale. Next, each group received 1 of 2 possible verbal messages. Both messages included the speaker's strength training qualifications. In addition, one message conveyed specific performance feedback while the other contained more general information. Then efficacy was measured again. Results indicated both messages strengthened efficacy. Strength professionals who work one-on-one with novice women should: (a) make sure lifters are aware of their professional qualifications, (b) provide specific feedback, and (c) profess their beliefs in the lifters' abilities to perform the exercises.
Profiles in coping: responses to sexual harassment across persons, organizations, and cultures.
Cortina, Lilia M; Wasti, S Arzu
2005-01-01
This study explicates the complexity of sexual harassment coping behavior among 4 diverse samples of working women: (a) working-class Hispanic Americans, (b) working-class Anglo Americans, (c) professional Turks, and (d) professional Anglo Americans. K-means cluster analysis revealed 3 common harassment coping profiles: (a) detached, (b) avoidant negotiating, and (c) support seeking. The authors then tested an integrated framework of coping profile determinants, involving social power, stressor severity, social support, and culture. Analysis of variance, chi-square, and discriminant function results identified significant determinants at each of the 4 levels of this ecological model. These findings underscore the importance of focusing on whole patterns of experience--and considering influences at the level of the individual employee and multiple levels of the surrounding context--when studying how women cope with workplace sexual harassment.
Mai, Harry T; Burgmeier, Robert J; Mitchell, Sean M; Hecht, Andrew C; Maroon, Joseph C; Nuber, Gordon W; Hsu, Wellington K
2016-12-01
Retrospective cohort study. The aim of this study was to determine whether the level of a cervical disc herniation (CDH) procedure will uniquely impact performance-based outcomes in elite athletes of the National Football League (NFL). Comparative assessments of postsurgical outcomes in NFL athletes with CDH at different levels are unknown. Further, the surgical decision-making for these types of injuries in professional football athletes remains controversial. NFL players with a CDH injury at a definitive cervical level were identified through a review of publicly available archives. Injuries were divided into upper- (C2-C4) and lower-level (C4-T1) CDH. The impact on player outcomes was determined by comparing return to play statistics and calculating a "Performance Score" for each player on the basis of pertinent statistical data, both before and after surgery. A total of 40 NFL athletes met inclusion criteria. In the upper-level group, 10 of 15 (66.6%) players successfully returned to play an average of 44.6 games over 2.6 years. The lower-level cohort had 18 of 25 (72%) players return to play with an average of 44.1 games over 3.1 years. There was no significant difference in the rate of return to play (P = 0.71). Postsurgical performance scores of the upper and lower-level groups were 1.47 vs. 0.69 respectively, with no significant difference between these groups (P = 0.06). Adjacent segment disease requiring reoperation occurred in 10% of anterior cervical discectomy and fusion patients. In 50% of foraminotomy patients, a subsequent fusion was required. A uniquely high percentage of upper-level disc herniations develop in NFL athletes, and although CDH injuries present career threatening implications, an upper-level CDH does not preclude a player from successfully returning to play at a competitive level. In fact, these athletes showed comparable postsurgical performance to those athletes who underwent CDH procedures at lower cervical levels. 4.
Three Cases of Teachers' Collaborative Design: Perspectives from Those Involved
ERIC Educational Resources Information Center
Preciado-Babb, Armando Paulino; Liljedahl, Peter
2012-01-01
We present the perspectives of teachers and others involved in the collaborative design of teaching and learning artifacts across three cases: (a) an independent group participating in lesson study; (b) teachers participating in professional development programs; and (c) a district initiative for producing numeracy tasks. Among the results we…
Prevention of Intraabdominal Adhesions: An Experimental Study Using Mitomycin-C and 4% Icodextrin.
Urkan, Murat; Özerhan, İsmail Hakkı; Ünlü, Aytekin; Can, Mehmet Fatih; Öztürk, Erkan; Günal, Armağan; Yağcı, Gökhan
2017-01-01
Intraabdominal adhesions remain a significant cause of morbidity and mortality. Moreover, intraabdominal adhesions can develop in more than 50% of abdominal operations. We compared the anti-adhesive effects of two different agents on postoperative adhesion formation in a cecal abrasion model. Experimental animal study. Forty Wistar albino type female rats were anesthetized and underwent laparotomy. Study groups comprised Sham, Control, Mitomycin-C, 4% Icodextrin, and Mitomycin-C +4% Icodextrin groups. Macroscopic and histopathological evaluations of adhesions were performed. The frequencies of moderate and severe adhesions were significantly higher in the control group than the other groups. The mitomycin-C and Mitomycin-C +4% Icodextrin groups were associated with significantly lower adhesion scores compared to the control group and 4% Icodextrin group scores (p=0.002 and p=0.008, respectively). The adhesion scores of the Mitomycin-C group were also significantly lower than those of the 4% Icodextrin group (p=0.008). Despite its potential for bone marrow toxicity, Mitomycin-C seems to effectively prevent adhesions. Further studies that prove an acceptable safety profile relating to this promising anti-adhesive agent are required before moving into clinical trials.
34 CFR 637.2 - Who is eligible to receive a grant?
Code of Federal Regulations, 2011 CFR
2011-07-01
... EDUCATION, DEPARTMENT OF EDUCATION MINORITY SCIENCE AND ENGINEERING IMPROVEMENT PROGRAM General § 637.2 Who... defined in § 637.4; (3) Have a curriculum that includes science or engineering subjects; and (4) Enter... baccalaureate degrees in science and engineering. (c) Nonprofit science-oriented organizations, professional...
34 CFR 637.2 - Who is eligible to receive a grant?
Code of Federal Regulations, 2012 CFR
2012-07-01
... EDUCATION, DEPARTMENT OF EDUCATION MINORITY SCIENCE AND ENGINEERING IMPROVEMENT PROGRAM General § 637.2 Who... defined in § 637.4; (3) Have a curriculum that includes science or engineering subjects; and (4) Enter... baccalaureate degrees in science and engineering. (c) Nonprofit science-oriented organizations, professional...
34 CFR 637.2 - Who is eligible to receive a grant?
Code of Federal Regulations, 2014 CFR
2014-07-01
... EDUCATION, DEPARTMENT OF EDUCATION MINORITY SCIENCE AND ENGINEERING IMPROVEMENT PROGRAM General § 637.2 Who... defined in § 637.4; (3) Have a curriculum that includes science or engineering subjects; and (4) Enter... baccalaureate degrees in science and engineering. (c) Nonprofit science-oriented organizations, professional...
34 CFR 637.2 - Who is eligible to receive a grant?
Code of Federal Regulations, 2010 CFR
2010-07-01
... EDUCATION, DEPARTMENT OF EDUCATION MINORITY SCIENCE AND ENGINEERING IMPROVEMENT PROGRAM General § 637.2 Who... defined in § 637.4; (3) Have a curriculum that includes science or engineering subjects; and (4) Enter... baccalaureate degrees in science and engineering. (c) Nonprofit science-oriented organizations, professional...
34 CFR 637.2 - Who is eligible to receive a grant?
Code of Federal Regulations, 2013 CFR
2013-07-01
... EDUCATION, DEPARTMENT OF EDUCATION MINORITY SCIENCE AND ENGINEERING IMPROVEMENT PROGRAM General § 637.2 Who... defined in § 637.4; (3) Have a curriculum that includes science or engineering subjects; and (4) Enter... baccalaureate degrees in science and engineering. (c) Nonprofit science-oriented organizations, professional...
Childhood fever in well-child clinics: a focus group study among doctors and nurses.
Peetoom, Kirsten K B; Ploum, Luc J L; Smits, Jacqueline J M; Halbach, Nicky S J; Dinant, Geert-Jan; Cals, Jochen W L
2016-07-08
Fever is common in children aged 0-4 years old and often leads to parental worries and in turn, high use of healthcare services. Educating parents may have beneficial effects on their sense of coping and fever management. Most parents receive information when their child is ill but it might be more desirable to educate parents in the setting of well-child clinics prior to their child becoming ill, in order to prepare parents for future illness management. This study aims to explore experiences of well-child clinic professionals when dealing with childhood fever and current practices of fever information provision to identify starting points for future interventions. We held four focus group discussions based on naturalistic enquiry among 22 well-child clinic professionals. Data was analysed using the constant comparative technique. Well-child clinic professionals regularly received questions from parents about childhood fever and felt that parental worries were the major driving factor behind these contacts. These worries were assumed to be driven by: (1) lack of knowledge (2) experiences with fever (3) educational level and size social network (4) inconsistencies in paracetamol administration advice among healthcare professionals. Well-child clinic professionals perceive current information provision as limited and stated a need for improvement. For example, information should be consistent, easy to find and understand. Fever-related questions are common in well-child care and professionals perceive that most of the workload is driven by parental worries. The focus group discussions revealed a desire to optimise the current limited information provision for childhood fever. Future interventions aimed at improving information provision for fever in well-child clinics should consider parental level of knowledge, experience, educational level and social network and inconsistencies among healthcare providers. Future fever information provision should focus on improving fever management and practical skills.
Structures of chloralide, ?-lactic acid chloralide, malic acid chloralide and citric acid chloralide
NASA Astrophysics Data System (ADS)
Koh, L. L.; Huang, H. H.; Chia, L. H. L.; Liang, E. P.
1995-06-01
The crystal and molecular structures of chloralide ( 1), D-lactic acid chloralide ( 2), malic acid chloralide ( 3) and citric acid chloralide ( 4) have been determined by X-ray diffraction methods. Compound 1 crystallizes in the monoclinic space group, {P2 1}/{c}, a = 6.201(2), b = 17.11(2), c = 10.357(6) Å, β = 95.21(4)°, Z = 4; compound 2 in the monoclinic space group P2 1, a = 7.600(4), b = 5.902(4), c = 9.743(6) Å, β = 99.20(5), Z = 2; compound 3 in the monoclinic space group {P2 1}/{c}, a = 16.500(6), b = 5.819(3), c = 10.120(4) Å, β = 91.41(3), Z = 4; compound 4 in the monoclinic space group {P2 1}/{c}, a = 12.041(3), b = 6.1190(10), c = 17.259(4) Å, β = 101.85(2), Z = 4. The five-membered ring systems of all the compounds are slightly twisted out-of-plane, that of compound 4 being the most puckered. The CCl 3 group is trans to the second CCl 3 group in 1, to the CH 3 group in 2 and to the CH 2COOH group in 3. The two CH 2COOH groups in 4 are disposed axially with respect to the ring. Dipole moment and Kerr constant data for D-lactic acid chloralide suggest a structure in solution which is consistent with the X-ray results. The IR spectra of 2, 3 and 4 are discussed in relation to the structures of these compounds.
2013-01-01
Background To evaluate the effectiveness of a new multifactorial intervention to improve health care for chronic ischemic heart disease patients in primary care. The strategy has two components: a) organizational for the patient/professional relationship and b) training for professionals. Methods/design Experimental study. Randomized clinical trial. Follow-up period: one year. Study setting: primary care, multicenter (15 health centers). For the intervention group 15 health centers are selected from those participating in ESCARVAL study. Once the center agreed to participate patients are randomly selected from the total amount of patients with ischemic heart disease registered in the electronic health records. For the control group a random sample of patients with ischemic heart disease is selected from all 72 health centers electronic records. Intervention components: a) Organizational intervention on the patient/professional relationship. Centered on the Chronic Care Model, the Stanford Expert Patient Program and the Kaiser Permanente model: Teamwork, informed and active patient, decision making shared with the patient, recommendations based on clinical guidelines, single electronic medical history per patient that allows the use of indicators for risk monitoring and stratification. b) Formative strategy for professionals: 4 face-to-face training workshops (one every 3 months), monthly update clinical sessions, online tutorial by a cardiologist, availability through the intranet of the action protocol and related documents. Measurements: Blood pressure, blood glucose, HbA1c, lipid profile and smoking. Frequent health care visits. Number of hospitalizations related to vascular disease. Therapeutic compliance. Drug use. Discussion This study aims to evaluate the efficacy of a multifactorial intervention strategy involving patients with ischemic heart disease for the improvement of the degree of control of the cardiovascular risk factors and of the quality of life, number of visits, and number of hospitalizations. Trial registration NCT01826929 PMID:23915267
Scragg, B; Shaikh, S; Shires, G; Stein Hodgins, J; Mercer, C; Robinson, L; Wray, J
2017-08-01
Increasingly patients and clients of health services are using social media to locate information about medical procedures and outcomes. There is increasing pressure for health professionals to engage in on-line spaces to provide clear and accurate information to their patient community. Research suggests there are some anxieties on the part of practitioners to do this. This study aimed to explore the attitudes of the NHS breast screening programme workforce towards engaging in online discussions with clients about breast screening. 78 practitioners, representing a range of professional roles within the NHS Breast Screening Programme, attended one of 4 workshops. We used a Nominal Group Technique to identify and rank responses to the question: "What are the challenges that practitioners face in using SoME as part of their role?" Responses were categorised into themes. Participants were also asked to identify solutions to these challenges. Challenges: We identified two overarching themes: (1) Working within boundaries: which was further categorised into (a) Professional/legal accountability; (b) Information accuracy and (c)Time as a boundary, and (2) Support: further categorised into (a) Employer and (b) Manager. Solutions: These included: training in technical and interactional aspects of on-line communication and a responsibility to better understand employer and professional body SoMe policies. The study participants appeared willing and motivated to engage in SoMe. However, in keeping with the literature from other disciplines, a number of challenges need to be overcome for its use to be adopted more widely by breast screening professionals. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.
Klemenc-Ketis, Zalika; Deilkås, Ellen Tveter; Hofoss, Dag; Bondevik, Gunnar Tschudi
2017-01-01
Purpose To get an overview of health care workers perceptions of patient safety climates and the quality of collaboration in Slovenian out-of-hours health care (OOHC) between professional groups. Materials and methods This was a cross-sectional study carried out in all (60) Slovenian OOHC clinics; 37 (61.7%) agreed to participate with 438 employees. The questionnaire consisted of the Slovenian version of the Safety Attitudes Questionnaire – Ambulatory Version (SAQ-AV). Results The study sample consisted of 175 (70.0%) physicians, nurse practitioners, and practice nurses. Practice nurses reported the highest patient safety climate scores in all dimensions. Total mean (standard deviation) SAQ-AV score was 60.9±15.2. Scores for quality of collaboration between different professional groups were high. The highest mean scores were reported by nurse practitioners on collaboration with practice nurses (4.4±0.6). The lowest mean scores were reported by practice nurses on collaboration with nurse practitioners (3.8±0.9). Conclusion Due to large variations in Slovenian OOHC clinics with regard to how health care workers from different professional backgrounds perceive safety culture, more attention should be devoted to improving the team collaboration in OOHC. A clearer description of professional team roles should be provided. PMID:29184416
Citizen Science in Planetary Sciences: Intersection of Scientific Research and Amateur Networks
NASA Astrophysics Data System (ADS)
Yanamandra-Fisher, Padma A.
2014-11-01
The Pro-Am Collaborative Astronomy (PACA) project evolved from the observational campaign of C/2012 S1 or C/ISON in 2013. Following the success of the professional-amateur astronomer collaboration in scientific research via social media, it is now implemented in other comet observing campaigns. While PACA identifies a consistent collaborative approach to pro-am collaborations, given the volume of data generated for each campaign, new ways of rapid data analysis, mining access and storage are needed. Several interesting results emerged from the synergistic inclusion of both social media and amateur astronomers:(1) the establishment of a network of astronomers and related professionals, that canbe galvanized into action on short notice to support observing campaigns;(2) assist in various science investigations pertinent to the campaign;(3) provide an alert-sounding mechanism should the need arise;(4) immediate outreach and dissemination of results via our media/blogger members;(5) provide a forum for discussions between the imagers and modelers to helpstrategize the observing campaign for maximum benefit.In 2014, two new comet observing campaigns involving pro-am collaborations have been initiated: (1) C/2013 A1 (C/SidingSpring) and (2) 67P/Churyumov-Gerasimenko (CG), target for ESA/Rosetta mission. The evolving need for individual customized observing campaigns has been incorporated into the evolution of PACA portal that currently is focused on comets: from supporting observing campaigns of current comets, legacy data, historical comets; interconnected with social media and a set of shareable documents addressing observational strategies; consistent standards for data; data access, use, and storage, to align with the needs of professional observers. The integration of science, observations by professional and amateur astronomers, and various social media provides a dynamic and evolving collaborative partnership between professional and amateur astronomers. The empowerment of amateur astronomers vis-à-vis their partnerships with the professional scientists creates a new demographic of data scientists, enabling citizen science of the integrated data from both the professional and amateur communities.
The PACA Project: When Amateur Astronomers Become Citizen Scientists
NASA Astrophysics Data System (ADS)
Yanamandra-Fisher, P. A.
2014-12-01
The Pro-Am Collaborative Astronomy (PACA) project evolved from the observational campaign of C/2012 S1 or C/ISON in 2013. Following the success of the professional-amateur astronomer collaboration in scientific research via social media, it is now implemented in other comet observing campaigns. While PACA identifies a consistent collaborative approach to pro-am collaborations, given the volume of data generated for each campaign, new ways of rapid data analysis, mining access and storage are needed. Several interesting results emerged from the synergistic inclusion of both social media and amateur astronomers: (1) the establishment of a network of astronomers and related professionals, that can be galvanized into action on short notice to support observing campaigns; (2) assist in various science investigations pertinent to the campaign; (3) provide an alert-sounding mechanism should the need arise; (4) immediate outreach and dissemination of results via our media/blogger members; (5) provide a forum for discussions between the imagers and modelers to help strategize the observing campaign for maximum benefit. In 2014, two new comet observing campaigns involving pro-am collaborations have been initiated: (1) C/2013 A1 (C/SidingSpring) and (2) 67P/Churyumov-Gerasimenko (CG), target for ESA/Rosetta mission. The evolving need for individual customized observing campaigns has been incorporated into the evolution of PACA portal that currently is focused on comets: from supporting observing campaigns of current comets, legacy data, historical comets; interconnected with social media and a set of shareable documents addressing observational strategies; consistent standards for data; data access, use, and storage, to align with the needs of professional observers. The integration of science, observations by professional and amateur astronomers, and various social media provides a dynamic and evolving collaborative partnership between professional and amateur astronomers. The empowerment of amateur astronomers vis-à-vis their partnerships with the professional scientists creates a new demographic of data scientists, enabling citizen science of the integrated data from both the professional and amateur communities.
Rao, Nisha; Kemper, Kathi J
2016-04-06
Mind-body practices that intentionally generate positive emotion could improve health professionals' well-being and compassion. However, the feasibility and impact of clinician training in these practices is unknown. Data were analyzed from 3 online modules offered to health professionals: (a) Gratitude, (b) Positive Word, and (c) Loving-kindness/Compassion meditation. Pairedttests were used to assess pre- to posttraining changes in gratitude (Gratitude Questionnaire), well-being (World Health Organization Well-Being Index), self-compassion (Neff's Self-Compassion Scale), and confidence in providing compassionate care (Confidence in Providing Calm, Compassionate Care Scale). The 177 enrollees included diverse practitioners (nurses, physicians, social workers, and others). Training was associated with statistically significant improvements in gratitude (38.3 ± 4.6 to 39.5 ± 3.3), well-being (16.4 ± 4.0 to 17.9 ± 4.2), self-compassion (39.5 ± 8.1 to 43.1 ± 7.6), and confidence in providing compassionate care (73.3 ± 16.4 to 80.9 ± 13.8;P< .001 for all comparisons). Brief, online training appeals to diverse health professionals and improves their gratitude, well-being, self-compassion, and confidence in providing compassionate care. © The Author(s) 2016.
Martinez, Rodolfo A [Santa Fe, NM; Unkefer, Clifford J [Los Alamos, NM; Alvarez, Marc A [Santa Fe, NM
2009-09-01
The present invention is directed to labeled compounds, of the formulae ##STR00001## wherein C* is each independently selected from the group consisting of .sup.13C and .sup.12C with the proviso that at least one C* is .sup.13C, each hydrogen of the methylene group can independently be either hydrogen or deuterium, the methyl group includes either zero or three deuterium atoms, Q is from the group of sulfide, sulfinyl, and sulfone, Z is an aryl group from the group of 1-naphthyl, substituted 1-naphthyl, 2-naphthyl, substituted 2-naphthyl, and phenyl groups with the structure ##STR00002## wherein R.sub.1, R.sub.2, R.sub.3, R.sub.4 and R.sub.5 are each independently from the group of hydrogen, a C.sub.1-C.sub.4 lower alkyl, a halogen, and an amino group from the group of NH.sub.2, NHR and NRR' where R and R' are each independently from the group of a C.sub.1-C.sub.4 lower alkyl, a phenyl, and an alkoxy group, and the methyl group can include either zero or three deuterium atoms.
Maroto-Izquierdo, Sergio; García-López, David; de Paz, José A
2017-12-01
The aim of the study was to analyse the effects of 6 week (15 sessions) flywheel resistance training with eccentric-overload (FRTEO) on different functional and anatomical variables in professional handball players. Twenty-nine athletes were recruited and randomly divided into two groups. The experimental group (EXP, n = 15) carried out 15 sessions of FRTEO in the leg-press exercise, with 4 sets of 7 repetitions at a maximum-concentric effort. The control group (CON, n = 14) performed the same number of training sessions including 4 sets of 7 maximum repetitions (7RM) using a weight-stack leg-press machine. The results which were measured included maximal dynamic strength (1RM), muscle power at different submaximal loads (PO), vertical jump height (CMJ and SJ), 20 m sprint time (20 m), T-test time (T-test), and Vastus-Lateralis muscle (VL) thickness. The results of the EXP group showed a substantially better improvement (p < 0.05-0.001) in PO, CMJ, 20 m, T-test and VL, compared to the CON group. Moreover, athletes from the EXP group showed significant improvements concerning all the variables measured: 1RM (ES = 0.72), PO (ES = 0.42 - 0.83), CMJ (ES = 0.61), SJ (ES = 0.54), 20 m (ES = 1.45), T-test (ES = 1.44), and VL (ES = 0.63 - 1.64). Since handball requires repeated short, explosive effort such as accelerations and decelerations during sprints with changes of direction, these results suggest that FRTEO affects functional and anatomical changes in a way which improves performance in well-trained professional handball players.
Ashraf, Hiba; Shah, Nasir; Anwer, Fahad; Akhtar, Hina; Abro, Mairaj Anwar; Khan, Asma
2014-04-01
To assess the level of professional satisfaction amongst family physicians of Pakistan and to identify the factors associated with professional dissatisfaction. The study was part of a larger national survey for "Status of PostgraduateTraining and Continuing Medical Education of Family Physicians in Pakistan" which was a cross-sectional, postal survey of family physicians conducted over 10 months between November 2009 and September 2010. The main outcome variables were professional satisfaction, as well as reasons for professional satisfaction and dissatisfaction. SPSS 17 was used for data analysis. Multivariable logistic regression was used to determine factors associated with professional dissatisfaction. Of the total 1200 survey forms distributed, 288 (24%) were received back. The mean age of the participants was 37 +/- 9 years with a range between 26 and 72 years. Of the total, 226 (78.5%) were males. Overall, 213 (74%) family physicians were satisfied with their profession. The factors significantly associated with professional dissatisfaction included the participants opinion that they were not respected by the public (OR: 11.6, C.I: 1.9-71.5); as well as regretting being a doctor (OR:62.9, C.I: 8.4-469.8). Most of the family physicians had professional satisfaction, but a minority had regrets about being a doctor and were dissatisfied over how their profession affected their family life. Further research may be needed to study work-life balance amongst family physicians of Pakistan.
Vitamin C and E Supplementation Effects in Professional Soccer Players Under Regular Training
Zoppi, Claudio C; Hohl, Rodrigo; Silva, Fernando C; Lazarim, Fernanda L; Neto, Joaquim MF Antunes; Stancanneli, Mirtes; Macedo, Denise V
2006-01-01
Exercise training is known to induce an increase in free radical production potentially leading to enhanced muscle injury. Vitamins C and E are well known antioxidants that may prevent muscle cell damage. The purpose of this study was to determine the effects of these supplemental antioxidant vitamins on markers of oxidative stress, muscle damage and performance of elite soccer players. Ten male young soccer players were divided into two groups. Supplementation group (n = 5) received vitamins C and E supplementation daily during the pre-competitive season (S group), while the placebo group (PL group, n = 5) received a pill containing maltodextrin. Both groups performed the same training load during the three-month pre-season training period. Erythrocyte antioxidant enzymes glutathione reductase, catalase and plasma carbonyl derivatives did not show any significant variation among the experimental groups. Similarly, fitness level markers did not differ among the experimental groups. However, S group demonstrated lower lipid peroxidation and muscle damage levels (p < 0.05) compared to PL group at the final phase of pre-competitive season. In conclusion, our data demonstrated that vitamin C and E supplementation in soccer players may reduce lipid peroxidation and muscle damage during high intensity efforts, but did not enhance performance. PMID:18500971
Kaplan, Adriana; Hechavarría, Suiberto; Bernal, Mariola; Bonhoure, Isabelle
2013-09-16
Female genital mutilation/cutting (FGM/C) is a harmful traditional practice with severe consequences for the health and well-being of girls and women. Health care professionals (HCPs) are therefore expected to be aware of how to identify and manage these consequences in order to ensure that those affected by the practice receive quality health care. Moreover, their integration and legitimacy within the communities allow them to play a key role in the prevention of the practice. Nevertheless, the perception of HCPs on FGM/C has been barely explored in African contexts. This study seeks to contribute to this field of knowledge by examining the knowledge, attitudes, and practices regarding FGM/C among HCPs working in rural settings in The Gambia. A cross-sectional descriptive study was designed through a quantitative methodology, following a multiethnic approach. A pre-tested questionnaire with open and closed-ended questions was created. Forty medical students from the Community-based Medical Programme were trained to administer the questionnaire, face to face, at village health facilities in rural areas of The Gambia. A final sample of 468 HCPs included all nurse cadres and midwives. A significant proportion of Gambian HCPs working in rural areas embraced the continuation of FGM/C (42.5%), intended to subject their own daughters to it (47.2%), and reported having already performed it during their medical practice (7.6%). However, their knowledge, attitudes, and practices were shaped by sex and ethnic identity. Women showed less approval for continuation of FGM/C and higher endorsement of the proposed strategies to prevent it than men. However, it was among ethnic groups that differences were more substantial. HCPs belonging to traditionally practicing groups were more favourable to the perpetuation and medicalisation of FGM/C, suggesting that ethnicity prevails over professional identity. These findings demonstrate an urgent need to build HCP's capacities for FGM/C-related complications, through strategies adapted to their specific characteristics in terms of sex and ethnicity. A culturally and gender sensitive training programme might contribute to social change, promoting the abandonment of FGM/C, avoiding medicalisation, and ensuring accurate management of its health consequences.
Berggren, E; Orrevall, Y; Olin, A Ödlund; Strang, P; Szulkin, R; Törnkvist, L
2016-04-01
Evaluate the effectiveness of a continuing educational intervention on primary health care professionals' familiarity with information important to nutritional care in a palliative phase, their collaboration with other caregivers, and their level of knowledge about important aspects of nutritional care. Observational cohort study. 10 primary health care centers in Stockholm County, Sweden. 140 district nurses/registered nurses and general practitioners/physicians working with home care. 87 professionals participated in the intervention group (IG) and 53 in the control group (CG). The intervention consisted of a web-based program offering factual knowledge; a practical exercise linking existing and new knowledge, abilities, and skills; and a case seminar facilitating reflection. The intervention's effects were measured by a computer-based study-specific questionnaire before and after the intervention, which took approximately 1 month. The CG completed the questionnaire twice (1 month between response occasions). The intervention effects, odds ratios, were estimated by an ordinal logistic regression. In the intra-group analyses, statistically significant changes occurred in the IG's responses to 28 of 32 items and the CG's responses to 4 of 32 items. In the inter-group analyses, statistically significant effects occurred in 20 of 32 statements: all 14 statements that assessed familiarity with important concepts and all 4 statements about collaboration with other caregivers but only 2 of the 14 statements concerning level of knowledge. The intervention effect varied between 2.5 and 12.0. The intervention was effective in increasing familiarity with information important to nutritional care in a palliative phase and collaboration with other caregivers, both of which may create prerequisites for better nutritional care. However, the intervention needs to be revised to better increase the professionals' level of knowledge about important aspects of nutritional care.
Kantsone, Ieva; Lucenko, Irina; Perevoscikovs, Jurijs
2016-01-01
In 1994, the World Health Organization (WHO) declared the goal of eliminating diphtheria within the WHO European Region by the year 2000. However, in 1990 an epidemic emerged within the Russian Federation and spread to other countries, including Latvia, by 1994. We describe national surveillance and immunisation coverage data in Latvia from 1994 to 2014 and present historical data from 1946. We defined a laboratory-confirmed case as a clinical case in which toxin-producing Corynebacterium diphtheriae, C. ulcerans or C. pseudotuberculosis was isolated. From 1994 to 2014, 1,515 cases were reported, giving an average annual incidence of 3.2 cases per 100,000 inhabitants (range 0.1–14.8), with the highest incidence in age groups 5–19 and 40–49 years (4.4 and 4.3/100,000, respectively); 111 deaths were reported, 83.8% cases were laboratory-confirmed. Most cases occurred in unvaccinated adults. To improve disease control a supplementary immunisation campaign for adults was initiated in 1995, and by the end of 1998 national coverage among adults reached 70%, and reached 77% in 2003, but declined to 59% by 2014. Diphtheria remains a problem in Latvia with continued circulation of toxin-producing strains of C. diphtheriae. We recommend to strengthen immunisation to cover adults, as well as the education of health professionals and a serological survey. PMID:27934582
The malleability of developmental trends in neutral and negative memory illusions.
Otgaar, Henry; Howe, Mark L; Brackmann, Nathalie; Smeets, Tom
2016-01-01
Among many legal professionals and memory researchers there exists the assumption that susceptibility to false memory decreases with age. In 4 misinformation experiments, we show that under conditions that focus on the meaning of experiences, children are not always the most susceptible to suggestion-induced false memories. We begin by presenting a short overview of previous developmental false memory studies, the majority of which have found that the susceptibility to misinformation decreases with age. In Experiment 1, 6/7-year-olds, 11/12-year-olds, and adults received a video and were confronted with misinformation about related but nonpresented details. Older children and adults had higher misinformation acceptance rates than younger children. In Experiment 2, we replicated this finding adding a younger child group (4/6-year-olds). In Experiments 3 and 4, we used new material and again found that susceptibility to misinformation increased with age. Together, these experiments show that children's memory accuracy is not necessarily inferior to that of adults.' (c) 2015 APA, all rights reserved).
A combination of dopamine genes predicts success by professional Wall Street traders.
Sapra, Steve; Beavin, Laura E; Zak, Paul J
2012-01-01
What determines success on Wall Street? This study examined if genes affecting dopamine levels of professional traders were associated with their career tenure. Sixty professional Wall Street traders were genotyped and compared to a control group who did not trade stocks. We found that distinct alleles of the dopamine receptor 4 promoter (DRD4P) and catecholamine-O-methyltransferase (COMT) that affect synaptic dopamine were predominant in traders. These alleles are associated with moderate, rather than very high or very low, levels of synaptic dopamine. The activity of these alleles correlated positively with years spent trading stocks on Wall Street. Differences in personality and trading behavior were also correlated with allelic variants. This evidence suggests there may be a genetic basis for the traits that make one a successful trader.
Social Media Impact: Utility of Reflective Approach in the Practice of Surgery.
Mohiuddin, Zia; Shahid, Hassan; Shuaib, Waqas
2015-12-01
Social media is rapidly being incorporated into medical education. We created a small group, reflective practice sessions by integrating specific medical cases to improve awareness about professionalism on social media. Medical scenarios were generated for reflective practice sessions on social media professionalism. Anonymous pre/post-session surveys evaluated residents' use of social media and gathered their opinions on the session. Thirty-eight of 48 (79 %) residents replied to the presession survey with 50 % (19/38) reporting daily digital media use, 76 % (29/38) witnessed unprofessional postings on social media, and 21 % (8/38) posted unprofessional content themselves. Of the 79 % (30/38) residents who attended the session, 74 % (28/38) completed the post-session survey. Residents reported the session added to the longevity of their professional career 4.11, 95 % CI (3.89-4.36). As a result of the session, they were more conscious of using the social media more professionally 3.47, 95 % CI (2.88-3.96) and would be proactive in protecting patient privacy and confidentiality on social media sites 3.96, 95 % CI (3.50-4.37). In summary, reflective practice-based sessions regarding the impact of social media on professionalism in surgery was well favored by the residents. The majority agreed that it had important implications for the longevity of their professional career. Participants reported having an increased awareness to protect patient privacy and utilize social media more professionally.
Effect of age on anthropometric and physical performance measures in professional baseball players.
Mangine, Gerald T; Hoffman, Jay R; Fragala, Maren S; Vazquez, Jose; Krause, Matthew C; Gillett, Javair; Pichardo, Napoleon
2013-02-01
The purpose of this study was to investigate age-related changes in anthropometric and performance variables in professional baseball players. Baseball players (n = 1,157) from several professional baseball organizations were categorized into 7 cohorts based upon age. All adolescent athletes were categorized as age group 1 (AG1), whereas the next 5 groups (AG2-AG6) consisted of players 20-22, 23-25, 26-28, 29-31, and 31-34 years, respectively. The final group (AG7) comprised athletes ≥35 years. All performance assessments were part of the athlete's normal preseason training camp testing routine. Field assessments were used to analyze lower-body power, speed, agility, grip strength, and body composition. The players were heaviest between the ages of 29 and 31 (AG5), and their body mass in that age group was 10.1% (p = 0.004) greater than that of AG1. A 7.0% increase (p = 0.000) in lean body mass occurred between AG1 and AG5. No differences in 10-yd sprint times or agility were seen across any age group or position. A 2.0 seconds (p = 0.001) slower run time for the 300-yd shuttle was seen between AG4 and AG5 for all positions combined. Elevations in grip strength were seen at AG4 compared with AG1 (p = 0.001) and AG2 (p = 0.007) for all positions combined. No other differences were noted. Lower-body power was increased for all positions combined from AG1 to AG3 (p = 0.007). This pattern was similar to that observed in position players, but a 12.4% decrease (p = 0.024) in VJMP was seen between AG7 and AG5 in pitchers. Results of this study indicate that lower-body power is maintained in baseball players until the age of 29-31, whereas speed, agility, and grip strength are maintained in players able to play past the age of 35 years. Age-related differences observed in this study suggest that athletes focus on their strength and conditioning programs to extend the length of their professional careers.
Tippet, Melissa L.; Stofan, John R.; Lacambra, Magie; Horswill, Craig A.
2011-01-01
Abstract Context: Tennis is often played in hot, humid environments, intensifying the thermoregulatory strain placed on the athletes. As a safety measure, some tennis organizations allow for a 10-minute break in play between the second and third sets when environmental conditions are extreme. However, the actual effect of these breaks in reducing core temperature is unknown. Objective: To determine change in core temperature after a 10-minute break in play and assess fluid balance in professional female tennis players during tournament matches in the heat. Design: Cross-sectional study. Setting: A Women's Tennis Association Tour–sanctioned outdoor tournament on hard courts under hot conditions (30.3°C ± 2.3°C). Patients or Other Participants: Seven professional tennis players. Main Outcome Measure(s): Change in core temperature after a 10-minute break in tournament play, fluid intake, and sweat losses during match play. Results: Core temperature was reduced from 38.92°C to 38.67°C (change of −0.25°C ± 0.20°C) when a break was taken (P = .02). Mean sweat rate during match play was 2.0 ± 0.5 L/h. During that time, mean fluid intake was 1.5 ± 0.5 L/h, resulting in a 1.2% ± 1.0% reduction in body mass. Conclusions: Female professional tennis players are subjected to high heat loads during match play in hot environments. However, a 10-minute break in play decreased core temperature in 6 of 7 players by an average of 0.25°C, indicating that the break provides practical benefits in the field. Furthermore, although mean sweat rate in this group of female tennis players was high, most athletes were still able to minimize mass loss to less than 2% of their prematch weight. PMID:21214351
Bijani, Mostafa; Tehranineshat, Banafsheh; Torabizadeh, Camellia
2017-01-01
In order to prove their commitment to the nursing profession, nurses need to base their professional activities on certain acknowledged values. Although a large number of studies have addressed professional values in nursing, only a few studies are available on the identification and comparison of nurses', nursing students', and nursing instructors' understanding of such values. The study aims to compare nurses', nursing students', and nursing instructors' perception of nursing professional values. In this descriptive-comparative study, data were collected using Weis and Schank's Nurses' Professional Values Scale-Revised. The data were analyzed using the SPSS statistical software (v 22). Participants and research context: A total of 299 nurses, 341 nursing students, and 100 nursing instructors from multisite, 20 different wards from 3 university hospitals and associated nursing schools located in the cities of Shiraz, Fasa, and Jahrom in Fars province, participated in 2016. Ethical considerations: The Institutional Review Board of the researchers' primary university has verified that the study complies with research ethics. The total mean scores of the nurses', nursing students', and nursing instructors' perception were found to be 4.23 (0.44), 3.92 (0.50), and 4.34 (0.35), respectively, in the domain of justice-this domain was the subjects' top priority-and 3.40 (0.56), 3.29 (0.49), and 3.55 (0.36), respectively, in the domain of activism-this domain was attached the least importance by the subjects. There were significant differences across the three groups' perception in all of the dimensions of professional values ( p < 0.001). The three study groups' overall mean scores fall within the range of relatively important or important. Several studies show the same results, but there are still controversies in this regard. There is need for plans to increase nurses' awareness of certain professional duties and improve their professional performance in all areas alongside their care duties.
Ball, Lauren E; Leveritt, Michael D
2015-12-01
Nutrition is an important aspect of chronic disease prevention and management by primary health professionals, including GPs, dietitians, practice nurses, diabetes educators and exercise professionals. In order to better understand how to improve the delivery of nutrition care, it is important to have valid and reliable tools to measure self-perceived competence. This study aimed to develop a valid, structured, questionnaire that measures the self-perceived competence of primary health professionals to provide nutrition care to patients with chronic disease. The development of the questionnaire was carried out in four stages (1): preparation of scope and structure, through a literature review and consultation with an expert reference group (2); development of questionnaire items, which were refined through feedback from the reference group and 18 primary health professionals (3); investigation of internal consistency and concurrent validity through a pilot study on 118 primary health professionals (4) and investigation of test-retest reliability through a pilot study on 33 primary health professionals who completed the questionnaire twice, 2-3 weeks apart. Stages 1 and 2 resulted in four constructs and 35 questions in the questionnaire. Stage 3 confirmed internal consistency, with Cronbach's α ranging from 0.88 to 0.98 for each construct and 0.98 for all items combined. Dietitians scored significantly higher than speech pathologists (P < 0.05) in each construct, confirming concurrent validity. Stage 4 confirmed test-retest reliability, with correlation coefficients ranging from 0.89 to 0.94 for each construct and 0.95 for all items combined. The NUTrition COMPetence (NUTCOMP) questionnaire is a valid, reliable and suitable tool that can be used to directly inform professional development and identify opportunities to support safe and effective practice. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
NASA Astrophysics Data System (ADS)
Moriguchi, Tetsuji; Yakeya, Daisuke; Tsuge, Akihiko; Jalli, Venkataprasad
2018-04-01
Three new thiophene condensed fluorescent pyrene derivatives have been synthesized by a two-step process, via. Wittig reaction followed by iodine promoted photocyclization. These molecules have been characterized by 1H NMR and EI-MS. Further, the molecular structures of 4a, 4b and 4c has been confirmed by single crystal X-ray diffraction analysis. The protons located in the fjord and cove-regions of molecules 4b and 4c showed downfield shifts of the protons. Molecule 4a crystallized under monoclinic system with space group P21/c, molecule 4b crystallized under monoclinic system with space group C2/c and the molecule 4c crystalized under triclinic system with space group P-1. Molecules 4a, 4b and 4c showed strong absorption maxima wavelengths at 305, 358 and 330 nm, respectively. The molar extinctinction coefficients (ε) of the compounds 4a, 4b and 4c indicated molecule 4c has better ability to absorb UV light, molecule 4b has better fluorescence intensity than molecule 4a and 4c.
Reading Balint group work through Lacan's theory of the four discourses.
Van Roy, Kaatje; Marché-Paillé, Anne; Geerardyn, Filip; Vanheule, Stijn
2016-02-05
In Balint groups, (para)medical professionals explore difficult interactions with patients by means of case presentations and discussions. As the process of Balint group work is not well understood, this article investigates Balint group meetings by making use of Lacan's theory of the four discourses. Five Balint group case presentations and their subsequent group discussion were studied, resulting in the observation of five crucial aspects of Balint group work. First, Balint group participants brought puzzlement to the group, which is indicative of the structural impossibility Lacan situates at the basis of all discourse (1). As for the group discussion, we emphasize 'hysterization' as a crucial process in Balint group work (2), the supporting role of the discourse of the analyst (3) and the centrality of discourse interactions (4). Finally, the potential transformation of the initial puzzlement is discussed (5). We conclude by putting forth the uniqueness of Balint group work as well as the potential usefulness of our analysis as a framework for Balint group leaders and professionals in charge of continuing medical education. © The Author(s) 2016.
K-9 Traffic Safety Resource Curriculum. Level C. Professional Guide.
ERIC Educational Resources Information Center
Governor's Highway Safety Program Office, Raleigh, NC.
One of four curriculum guides designed to aid teachers of grades K-9 in implementing a balanced, dynamic traffic safety program, this level C guide contains materials for teachers of grades 4-6. Four units in pedestrian, bicycle, school bus, and passenger safety are presented, and minicycle and optional farm vehicle safety units are introduced.…
Hultman, Charles Scott; Halvorson, Eric G; Kaye, Donna; Helgans, Richard; Meyers, Michael O; Rowland, Pamela A; Meyer, Anthony A
2013-03-01
Professionalism is now recognized as a core competency for graduate medical education and maintenance of certification. However, few models exist in plastic surgery that define, teach, and assess professionalism as a competency. The purpose of this project was to evaluate the effectiveness of a professionalism curriculum in an academic plastic surgery practice. We created and conducted a 6-wk, 12-h course for health care professionals in plastic surgery (faculty, residents, nurses, medical students). Teaching methods included didactic lectures, journal club, small group discussions, and book review. Topics included: (1) Professionalism in Our Culture, (2) Leadership Styles, (3) Modeling Professional Behavior, (4) Leading Your Team, (5) Managing Oneself, and (6) Leading While You Work. Using Kirkpatrick methodology to assess perception of the course (level 1 data), learning of the material (level 2 data), effect on behavior (level 3 data), and impact on the organization (level 4 data), we compiled participant questionnaires, scores from pre- and post-tests, and such metrics as incidence of sentinel events (defined as infractions requiring involvement by senior administrators), number of patient complaints reported to Patient Relations, and patient satisfaction (Press Ganey surveys), for the 6 mo before and after the course. Thirty health care professionals participated in a 6-wk course, designed to improve professionalism in plastic surgery. Level 1 data: Although only 56.5% of respondents felt that the course was a "good use of my time," 73.9% agreed that the course "will help me become a better professional" and 82.6% "would recommend the course to others." Level 2 data: Post-test scores increased from 48% to 70% (P < 0.05), and the ability to recall all six competencies increased from 22% to 73% (P < 0.01). Level 3 data: The number of sentinel events in our division decreased from 13 to three. After the course, one resident was placed on probation and resigned, and two other employees left the division after being counseled on issues of professionalism. Interestingly, these participants did very well on the post-test but were not considered to be "team players." Level 4 data: Patient complaints decreased from 14 to eight, and patient satisfaction increased from 85.5% to 90.5%. A focused curriculum in professionalism may improve the knowledge of participants and overall behavior of the group, but may not affect individual attitudes. Nevertheless, efforts toward assessing, teaching, and influencing professionalism in plastic surgery are very valuable and should be pursued by educators to help satisfy Graduate Medical Education/Maintenance of Certification requirements and to improve the performance of the organization. Copyright © 2013. Published by Elsevier Inc.
Roulet Schwab, Delphine; Wangmo, Tenzin
2017-09-01
Older persons' perspectives regarding elder abuse remain little studied. However, definitions of elder abuse and effective prevention strategies require adaptation to the needs and cultures of targeted populations. This study explored the views of older persons and professionals to evaluate their converging and diverging perspectives toward elder abuse and its prevention. The study employed a qualitative approach where six focus groups were held in Western Switzerland (the French-speaking part of the country). Four focus groups with 25 older persons from varying socioeconomic backgrounds, and the other two focus groups were carried out with 16 professionals working in the field of elder abuse prevention. For the focus groups, we used the technique of free associations to begin the discussions and vignette-like statements to explore participants' attitudes toward elder abuse. These were followed by open-ended questions. The transcripts from the focus groups were analyzed thematically and resulted in four main themes: (a) varied associations of the term "abuse," (b) judging elder abuse situations in terms of abuse and severity, (c) self-identification with elder abuse, and (d) prevention of elder abuse. Study findings demonstrated that older persons hold views that are partly different from the views of professionals. Furthermore, perceptions of older persons could be stratified based on the socioeconomic status of the participants. These diverging perspectives reflect the heterogeneity of the senior citizen population and highlight the need for research cognizant of these differences. The results of this study provide strategies for improved targeting of preventive measures, underline the importance of integrating the perspectives of older persons, and reveal the need to expand the commonly accepted definitions of elder abuse so that they better reflect the affected individuals.
Matsuoka, Kempei; Sakamoto, Nobuo; Akanuma, Yasuo; Hotta, Nigishi; Shichiri, Motoaki; Toyota, Takayoshi; Oka, Yoshitomo; Kawamori, Ryuzo; Shigeta, Yukio
2007-09-01
In order to study a long-term effect along with adverse action of epalrestat, an aldose reductase inhibitor, a randomized, prospective study was conducted over the period of 3 years at 112 facilities. Six hundred and three diabetic patients with median motor conduction velocity (MCV)>40 m/s, HbA1c<9% were randomly allocated to epalrestat (50 mg/day p.o. ac, t.i.d.) group (E group: n=289, age: 61+/-9.8 y.o.) and a control group (C group: n=305, age: 61+/-9.1 y.o.). MCV was measured once a year for 3 years. MCV (m/s, M+/-S.D.) on baseline, 1 year and 3 years, was 52.0+/-4.5, 52.2+/-4.9, 52.1+/-4.6 in E group and 53.3+/-4.4, 52.4+/-4.2, 52.0+/-4.6 in C group, respectively. After 3 years, difference from the baseline was significant (p<0.0001, E versus C). Among the subjects with HbA1c<7.0%, C group showed marked deterioration of MCV while in E group, there was no significant deterioration (p<0.001). Although, the subjects with pre-proliferative or proliferative retinopathy, there was no difference between E and C groups for 3 years, in subjects with background retinopathy or without retinopathy, deterioration rate of E group was significantly less than that of C group (p<0.0001). Epalrestat was found to prevent deterioration of MCV especially in well-controlled patients without advanced complications. No remarkable side effects serious enough to discontinue the study was observed.
Code of Federal Regulations, 2012 CFR
2012-10-01
... under their ACO participant TIN as a group practice under the Physician Quality Reporting System Group... participant TIN, on behalf of its ACO supplier/provider participants who are eligible professionals, will... Physician Fee Schedule for that TIN. (4) ACO participant TINs and individual ACO providers/suppliers who are...
Code of Federal Regulations, 2013 CFR
2013-10-01
... under their ACO participant TIN as a group practice under the Physician Quality Reporting System Group... participant TIN, on behalf of its ACO supplier/provider participants who are eligible professionals, will... Physician Fee Schedule for that TIN. (4) ACO participant TINs and individual ACO providers/suppliers who are...
The use of steroids by gym athletes: an attempt to diagnose the problem scale and possible causes.
Gwizdek, Katarzyna; Brzęk, Anna; Bąk-Sosnowska, Monika; Dittfeld, Anna; Knapik, Andrzej; Ziaja, Damian
2017-06-08
Anabolic-androgenic steroids (AAS) are said to be frequently used by both professional and amateur athletes. In addition to having a negative impact on health, steroids defy the concept of fair play. observational study. other - Gyms. The aim of the study was to evaluate the scale of the problem related to using anabolic- androgenic steroids (AAS) by gym athletes and to analyze possible causes. The study involved 435 participants aged between 18-66 (mean age= x=27.49±7.48). Out of them, 61.4% were male and 38.6% were female. The subjects were divided into two groups: Group A included 154 (35.4%) amateur and recreational athletes and group B included 281 (64.6%) professional athletes concerned with fitness, bodybuilding and powerlifting. A survey prepared by the authors was conducted in the study, and it consisted of 23 closed questions about AAS use, body confidence, and exercise dependence. In addition, a stadiometer and a body composition analyzer were utilized to take necessary measurements. Between 1-23% of group A participants admitted to using AAS. For group B, it was between 7-30%. Males were reported to use AAS more frequently than females in both groups. With regard to group A, differences in body confidence and exercise dependence were found between males using and not using AAS. Exercise dependence was reported to be different between group A and group B participants. This was true for both males and females. Also, it was shown that group A and group B females differed in terms of metabolic age, body mass and body composition (fat mass, fat-free mass, muscle mass, and total body water). Most gym athletes do not use AAS. Amateur athletes tend to use AAS more frequently than professional athletes. Factors that contribute to AAS use are: male gender, low body confidence, young age, and long training.
Legal professionals and witness statements from people with a suspected mental health diagnosis.
Reavey, Paula; Wilcock, Rachel; Brown, Steven D; Batty, Richard; Fuller, Serina
2016-01-01
Individuals with mental health problems are considered to be part of a group labeled 'vulnerable' in forensic psychology literature and the legal system more generally. In producing witness statements, there are numerous guidelines in the UK, designed to facilitate the production of reliable and valid accounts by those deemed to be vulnerable witnesses. And yet, it is not entirely clear how mental health impacts on reliability and validity within the judicial system, partly due to the diversity of those who present with mental health difficulties. In this paper, we set out to explore how legal professionals operating in the UK understand the impact of mental distress on the practical production of witness testimonies. Twenty legal professionals, including police officers, judges, magistrates and detectives were involved in a semi-structured interview to examine their knowledge and experience of working with mental health problems, and how they approached and worked with this group. A thematic analysis was conducted on the data and specific themes relevant to the overall research question are presented. These include a) dilemmas and deficiencies in knowledge of mental health, b) the abandonment of diagnosis and c) barriers to knowledge: time restrictions, silence, professional identity and fear. Finally, we explore some of the implications of these barriers, with regard to professional practice. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.
Wilcock, Jane; Strivens, Janet
2015-01-01
Aim To create sustained improvements in medical students' critical thinking skills through short teaching interventions in pharmacology. Method The ability to make professional decisions was assessed by providing year-4 medical students at a UK medical school with a novel medical scenario (antenatal pertussis vaccination). Forty-seven students in the 2012 cohort acted as a pretest group, answering a questionnaire on this novel scenario. To improve professional decision-making skills, 48 students from the 2013 cohort were introduced to three commonly used medications, through tutor-led 40-min teaching interventions, among six small groups using a structured presentation of evidence-based medicine and ethical considerations. Student members then volunteered to peer-teach on a further three medications. After a gap of 8 weeks, this cohort (post-test group) was assessed for professional decision-making skills using the pretest questionnaire, and differences in the 2-year groups analysed. Results Students enjoyed presenting on medications to their peers but had difficulty interpreting studies and discussing ethical dimensions; this was improved by contextualising information via patient scenarios. After 8 weeks, most students did not show enhanced clinical curiosity, a desire to understand evidence, or ethical questioning when presented with a novel medical scenario compared to the previous year group who had not had the intervention. Students expressed a high degree of trust in guidelines and expert tutors and felt that responsibility for their own actions lay with these bodies. Conclusion Short teaching interventions in pharmacology did not lead to sustained improvements in their critical thinking skills in enhancing professional practice. It appears that students require earlier and more frequent exposure to these skills in their medical training.
Wilcock, Jane; Strivens, Janet
2015-01-01
Aim To create sustained improvements in medical students’ critical thinking skills through short teaching interventions in pharmacology. Method The ability to make professional decisions was assessed by providing year-4 medical students at a UK medical school with a novel medical scenario (antenatal pertussis vaccination). Forty-seven students in the 2012 cohort acted as a pretest group, answering a questionnaire on this novel scenario. To improve professional decision-making skills, 48 students from the 2013 cohort were introduced to three commonly used medications, through tutor-led 40-min teaching interventions, among six small groups using a structured presentation of evidence-based medicine and ethical considerations. Student members then volunteered to peer-teach on a further three medications. After a gap of 8 weeks, this cohort (post-test group) was assessed for professional decision-making skills using the pretest questionnaire, and differences in the 2-year groups analysed. Results Students enjoyed presenting on medications to their peers but had difficulty interpreting studies and discussing ethical dimensions; this was improved by contextualising information via patient scenarios. After 8 weeks, most students did not show enhanced clinical curiosity, a desire to understand evidence, or ethical questioning when presented with a novel medical scenario compared to the previous year group who had not had the intervention. Students expressed a high degree of trust in guidelines and expert tutors and felt that responsibility for their own actions lay with these bodies. Conclusion Short teaching interventions in pharmacology did not lead to sustained improvements in their critical thinking skills in enhancing professional practice. It appears that students require earlier and more frequent exposure to these skills in their medical training. PMID:26051556
Wilcock, Jane; Strivens, Janet
2015-01-01
To create sustained improvements in medical students' critical thinking skills through short teaching interventions in pharmacology. The ability to make professional decisions was assessed by providing year-4 medical students at a UK medical school with a novel medical scenario (antenatal pertussis vaccination). Forty-seven students in the 2012 cohort acted as a pretest group, answering a questionnaire on this novel scenario. To improve professional decision-making skills, 48 students from the 2013 cohort were introduced to three commonly used medications, through tutor-led 40-min teaching interventions, among six small groups using a structured presentation of evidence-based medicine and ethical considerations. Student members then volunteered to peer-teach on a further three medications. After a gap of 8 weeks, this cohort (post-test group) was assessed for professional decision-making skills using the pretest questionnaire, and differences in the 2-year groups analysed. Students enjoyed presenting on medications to their peers but had difficulty interpreting studies and discussing ethical dimensions; this was improved by contextualising information via patient scenarios. After 8 weeks, most students did not show enhanced clinical curiosity, a desire to understand evidence, or ethical questioning when presented with a novel medical scenario compared to the previous year group who had not had the intervention. Students expressed a high degree of trust in guidelines and expert tutors and felt that responsibility for their own actions lay with these bodies. Short teaching interventions in pharmacology did not lead to sustained improvements in their critical thinking skills in enhancing professional practice. It appears that students require earlier and more frequent exposure to these skills in their medical training.
Sun, Sheng; Zhang, Yaoshen; Zhang, Qiang; Li, Xin; Wan, Gang; Zhao, Changsong; Cai, Juan; Yuan, Zheng
2014-08-05
To observe the early wound healing of orthopedic surgery in human immunodeficiency virus (HIV) carrier patients treated with optimized auxiliary treatments. During a period of 48 months, according to the inclusion and exclusion criteria plus CD4⁺ T lymphocyte count, the patients scheduled for orthopedic surgery (including HIV positive and negative) were divided into group A (HIV positive, CD4<500/ml) with optimized auxiliary treatments, group B (HIV positive, CD4 ≥ 500/ml) and group C (HIV negative) on prophylactic antibiotic therapy alone. Wound healing of 3 groups were observed postoperatively. The rates of clinical wound infection were compared among 3 groups. A total of 471 cases (n = 79, HIV+; n = 392, HIV-) were selected due to fresh fracture (n = 544, 77.28%), fracture of spine (n = 57, 12.31%), mal-union (n = 13, 2.76%), aseptic necrosis (n = 15, 3.18%) and osteoarthritis (n = 21, 4.46%). During surgery, early open reduction and plate screw internal fixation (group A, n = 23; group B, n = 21; group C, n = 274); pedicle screw internal fixation (group A, n = 5; group B, n = 6; group C, n = 47); total joint replacement (group A, n = 3; group B, n = 4; group C, n = 8); interlocking intramedullary nail fixation (group A, n = 7; group B, n = 4; group C, n = 35) and other operations (group A, n = 3; group B, n = 3; group C, n = 28). For infections, 2 cases (4.88%) were observed in group A, 3 (5.26%) in group B and 26 (6.63%) in group C. The differences were statistically insignificant. Reasonable perioperative adjuvant treatments, including use of antibiotic, nutritional supports, immunomodulators and anti-retroviral drugs, are offered to HIV infected patients undergoing orthopedic surgery. Their risks of postoperative wound infection may be controlled.
38 CFR 17.603 - Availability of scholarships.
Code of Federal Regulations, 2010 CFR
2010-07-01
... MEDICAL Va Health Professional Scholarship Program § 17.603 Availability of scholarships. Scholarships... students. (Authority: 38 U.S.C. 7612(b)(4) and 7603(b)(1)) [54 FR 28674, July 7, 1989, as amended at 61 FR...
16 CFR 4.9 - The public record.
Code of Federal Regulations, 2010 CFR
2010-01-01
... to § 305.8 of this chapter; (xiii) Annual filings by professional boxing sanctioning organizations as required by the Muhammed Ali Boxing Reform Act, 15 U.S.C. 6301 note, 6307a-6307h; (xiv) Other documents...
Code of Federal Regulations, 2010 CFR
2010-10-01
... UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Administrative Requirements § 456.206... the diagnosis and treatment of mental diseases, and assisted by other professional personnel. (c) The UR committee must be constituted as— (1) A committee of the mental hospital staff; (2) A group...
Modern Learning Methods for HRD: The Clinical Legal Education (CLE) Approach[C
ERIC Educational Resources Information Center
Wootton, Danielle; Stone, Barras Kenneth
2010-01-01
Purpose: The purpose of this paper is to explore how professional skills training in making ethical decisions for redundancy selection, can be utilised though interactive role play, in a virtual learning environment. Design/methodology/approach: A pilot study was undertaken with a group of part time mature students pursuing a professional…
Code of Federal Regulations, 2014 CFR
2014-01-01
... locations. (c) Technical training courses. Agreements for financial assistance to State and local officials, without full-cost recovery to attend training on nuclear material licensing, inspection and emergency..., conferences, workshops, and symposia to assist scientific, professional or educational institutions or groups...
Code of Federal Regulations, 2012 CFR
2012-01-01
... locations. (c) Technical training courses. Agreements for financial assistance to State and local officials, without full-cost recovery to attend training on nuclear material licensing, inspection and emergency..., conferences, workshops, and symposia to assist scientific, professional or educational institutions or groups...
Code of Federal Regulations, 2013 CFR
2013-01-01
... locations. (c) Technical training courses. Agreements for financial assistance to State and local officials, without full-cost recovery to attend training on nuclear material licensing, inspection and emergency..., conferences, workshops, and symposia to assist scientific, professional or educational institutions or groups...
Hansen, Margaret; Jackson, Debra; Elliott, Doug
2016-01-01
Background Many current challenges of evidence-based practice are related to ineffective social networks among health care professionals. Opportunities exist for multidisciplinary virtual communities to transcend professional and organizational boundaries and facilitate important knowledge transfer. Although health care professionals have been using the Internet to form virtual communities for many years, little is known regarding “why” they join, as most research has focused on the perspective of “posters,” who form a minority of members. Objective Our aim was to develop a comprehensive understanding of why health care professionals belong to a virtual community (VC). Methods A qualitative approach will be used to explore why health care professionals belong to an intensive care practice-based VC, established since 2003. Three asynchronous online focus groups will be convened using a closed secure discussion forum. Participants will be recruited directly by sending emails to the VC and a Google form used to collect consent and participant demographics. Participants will be stratified by their online posting behaviors between September 1, 2012, and August 31, 2014: (1) more than 5 posts, (2) 1-5 posts, or (3) no posts. A question guide will be used to guide participant discussion. A moderation approach based on the principles of focus group method and e-moderation has been developed. The main source of data will be discussion threads, supported by a research diary and field notes. Data analysis will be undertaken using a thematic approach and framed by the Diffusion of Innovation theory. NVivo software will be used to support analyses. Results At the time of writing, 29 participants agreed to participate (Focus Group 1: n=4; Focus Group 2: n=16; Focus Group 3: n=9) and data collection was complete. Conclusions This study will contribute to a growing body of research on the use of social media in professional health care settings. Specifically, we hope results will demonstrate an enhancement of health care professionals’ social networks and how VCs may improve knowledge distribution and patient care outcomes. Additionally, the study will contribute to research methods development in this area by detailing approaches to understand the effectiveness of online focus groups as a data collection method for qualitative research methods. PMID:27296929
Philbois, Stella V.; Martins, Jaqueline; Souza, Cesário S.; Sampaio, Rosana F.; Oliveira, Anamaria S.
2016-01-01
BACKGROUND: Several Brazilian studies have addressed the International Classification of Functioning, Disability and Health (ICF), but few have analyzed the knowledge of the health professionals with regards to the ICF. OBJECTIVE: To verify whether the classification of the items in the Brazilian-Portuguese versions of The Shoulder Pain and Disability Index (SPADI) and The Disabilities Arm, Shoulder and Hand (DASH) questionnaires, obtained from health professionals who worked with patients having upper limb injuries, could be related to ICF components as defined by others studies. METHOD: There were 4 participants for the group "professionals with high familiarity of the ICF (PHF)" and 19 for the group of "professionals with some or no familiarity of the ICF (PSNF)". The participants judged whether the items on the two questionnaires belonged to the ICF body function, body structure or activity-participation component, and marked a confidence level for each trial using a numerical scale ranging from zero to 10. The items were classified by the discriminant content validity method using the Student'st-test and the Hochberg correction. The ratings were compared to the literature by the percentage of agreement and Kappa coefficient. RESULTS: The percentage of agreement of the rating from the PSNF and the PHF groups with the literature was equal to or greater than 77%. For the DASH, the agreement of the PSNF and PHF groups with the literature were, respectively, moderate (Kappa=0.46 to 0.48) and substantial (Kappa=0.62 to 0.70). CONCLUSIONS: Health professionals were able to correlate the three components of the ICF for most items on the 2 questionnaires, demonstrating some ease of understanding the ICF components. However, the relation of concept of pain with body function component is not clear for professional and deserves a more attentive approach. PMID:26786076
2013-01-01
Background Healthcare provider spontaneous reporting of suspected adverse events following immunisation (AEFI) is central to monitoring post-licensure vaccine safety, but little is known about how healthcare professionals recognise and report to surveillance systems. The aim of this study was explore the knowledge, experience and attitudes of medical and nursing professionals towards detecting and reporting AEFI. Methods We conducted a qualitative study, using semi-structured, face to face interviews with 13 Paediatric Emergency Department consultants from a tertiary paediatric hospital, 10 General Practitioners, 2 local council immunisation and 4 General Practice nurses, recruited using purposive sampling in Adelaide, South Australia, between December 2010 and September 2011. We identified emergent themes related to previous experience of an AEFI in practice, awareness and experience of AEFI reporting, factors that would facilitate or impede reporting and previous training in vaccine safety. Thematic analysis was used to analyse the data. Results AEFI reporting was infrequent across all groups, despite most participants having reviewed an AEFI. We found confusion about how to report an AEFI and variability, according to the provider group, as to the type of events that would constitute a reportable AEFI. Participants’ interpretation of a “serious” or “unexpected” AEFI varied across the three groups. Common barriers to reporting included time constraints and unsatisfactory reporting processes. Nurses were more likely to have received formal training in vaccine safety and reporting than medical practitioners. Conclusions This study provides an overview of experience and beliefs of three healthcare professional groups in relation to identifying and reporting AEFI. The qualitative assessment reveals differences in experience and awareness of AEFI reporting across the three professional groups. Most participants appreciated the importance of their role in AEFI surveillance and monitoring the ongoing safety of vaccines. Future initiatives to improve education, such as increased training to health care providers, particularly, medical professionals, are required and should be included in both undergraduate curricula and ongoing, professional development. PMID:23945045
Echocardiographic findings in professional hockey players
Fazel, Poorya; Roberts, Brad J.; Brooks, John
2009-01-01
Tissue Doppler imaging was used to evaluate the physiological and morphological response in athletes whose cardiac system must not only adapt to intense cardiovascular demands but also support sudden, transient changes in cardiac output. A total of 45 professional hockey players with a mean age of 24 years underwent a baseline transthoracic echocardiographic protocol after a typical morning workout; 12 healthy age- and gender-matched controls were evaluated as a means of comparison. The athletes in this study possessed larger left ventricular diastolic and systolic dimensions than the control group (5.5 ± 0.4 vs 4.9 ± 0.4 cm and 3.9 ± 0.4 vs 3.3 ± 0.4 cm, P < 0.0001). The increase in athletes' septal and posterior wall thickness was not substantial, nor was there a significant difference in left ventricular ejection fraction. The athletes demonstrated consistently larger left ventricular end-diastolic volume (196 ± 34 vs 136 ± 23 mL, P < 0.001) and end-systolic volume (87 ± 20 vs 57 ± 12 mL, P < 0.0001). They also had lower annular septal and lateral early diastolic and systolic tissue Doppler velocities compared with the control group. Thus, characteristic myocardial changes previously reported in elite athletes were also represented in professional hockey players. The lower left ventricular tissue Doppler velocities was a relatively unique finding and probably a consequence of lower postexertion preload levels compared with controls who were measured at rest. PMID:19633740
Jones, Nancy L.; Peiffer, Ann M.; Lambros, Ann; Guthold, Martin; Johnson, A. Daniel; Tytell, Michael; Ronca, April E.; Eldridge, J. Charles
2013-01-01
A curriculum was designed to shape biomedical graduate students into researchers with a high commitment to professionalism and social responsibility, and to provide students with tools to navigate the complex, rapidly evolving academic and societal environments with a strong ethical commitment. Problem-Based Learning (PBL) pedagogy was chosen because it is active, learner-centered, and focuses on skill and process development. Additionally, the small group format provides a high degree of socialization around professional norms. Two courses were developed. Scientific Professionalism Scientific Integrity addressed discipline-specific and broad professional norms and obligations for the ethical practice of science and responsible conduct of research (RCR). Scientific Professionalism Bioethics and Social Responsibility focused on current ethical and bioethical issues within the scientific profession and implications of research for society. Each small-group session examined case scenarios that included: (1) learning objectives for professional norms and obligations; (2) key ethical issues and philosophies within each topic area; (3) one or more of the RCR instructional areas; and (4) at least one type of moral reflection. Cases went beyond covering overt research misconduct to emphasize professional standards, obligations, and underlying philosophies for the ethical practice of science, competing interests of stakeholders, and oversight of science (internal and external). To our knowledge this was the first use of PBL to teach scientific integrity and ethics. Both faculty and students at Wake Forest endorsed the orientation of professionalism, active learning, and acquiring skills in contrast to a compliance-based approach that emphasizes learning rules and regulations. PMID:20797979
Cognitive and psychosocial function in retired professional hockey players.
Esopenko, Carrie; Chow, Tiffany W; Tartaglia, Maria Carmela; Bacopulos, Agnes; Kumar, Priya; Binns, Malcolm A; Kennedy, James L; Müller, Daniel J; Levine, Brian
2017-06-01
The relationship between repeated concussions and neurodegenerative disease has received significant attention, particularly research in postmortem samples. Our objective was to characterise retired professional ice hockey players' cognitive and psychosocial functioning in relation to concussion exposure and apolipoprotein ε4 status. Alumni athletes (N=33, aged 34-71 years) and an age-matched sample of comparison participants (N=18) were administered measures of cognitive function and questionnaires concerning psychosocial and psychiatric functioning. No significant group differences were found on neuropsychological measures of speeded attention, verbal memory or visuospatial functions, nor were significant differences observed on computerised measures of response speed, inhibitory control and visuospatial problem solving. Reliable group differences in cognitive performance were observed on tests of executive and intellectual function; performance on these measures was associated with concussion exposure. Group differences were observed for cognitive, affective and behavioural impairment on psychosocial questionnaires and psychiatric diagnoses. There was no evidence of differential effects associated with age in the alumni athletes. Possession of an apolipoprotein ε4 allele was associated with increased endorsement of psychiatric complaints, but not with objective cognitive performance. We found only subtle objective cognitive impairment in alumni athletes in the context of high subjective complaints and psychiatric impairment. Apolipoprotein ε4 status related to psychiatric, but not cognitive status. These findings provide benchmarks for the degree of cognitive and behavioural impairment in retired professional athletes and a point of comparison for future neuroimaging and longitudinal studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Characteristics and professional use of voice in street children in Aracaju, Brazil.
Sales, Neuza Josina; Gurgel, Ricardo Queiroz; Gonçalves, Maria Inês Rebelo; Cunha, Edílson; Barreto, Valeria Maria Prado; Todt Neto, João Carlos; D'Avila, Jeferson Sampaio
2010-07-01
The objective of the study was to evaluate voice characteristics of children engaged in street selling, which involves an essentially professional use of voice in this population. A controlled cross-sectional study was carried out. A randomly chosen sample of 200 school children with a history of street selling assisted by public social services and 400 school children without this experience was selected. Seven- to 10-year-old children of both sexes were studied. Both groups were interviewed and given vocal assessment (auditory-perceptual assessment and spectrographic acoustic measures) and otorhinolaryngological evaluation (physical and videonasolaryngoscopic examination). Children with abnormal results in both groups were compared using chi(2) (Chi-squared test). The significance level was established at 5% (P<0.05). Voice problems were detected more frequently in working children (106-53%) than in regular school children (90-22.5%). The control group achieved better school performance as more children in this group attend school regularly than street children, although age-for-grade deficit was similar. The control group had more access to medical visits (80-40%) and treatment with a doctor (34-17%). Language assessment has shown that the control group had more dysphonia (73-37%) and myofunctional orofacial disorders (20-10%). Street children had more normal voice but had more nasal disorders and greater glottal closure than the school control group. Voice disorders were present in both groups, but less frequently in street children. Although subject to inadequate living conditions, street children had better voice quality than the control group. An explanation could be that by adapting their voice professionally for selling goods in the streets, they developed adequate resilience to their difficult living conditions. Copyright (c) 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.
The Adoption of E-Learning across Professional Groups
ERIC Educational Resources Information Center
Gallaher, James; Wentling, Tim L.
2004-01-01
The purpose of the study was to determine the impact of professional group membership on the rate of adoption of e-learning. The sample consisted of Engineering, Finance, Human Resources, Legal, and Marketing professionals from a Fortune 500 manufacturing company. Professional groups were categorized based on Rogers (1995) five categories of…
Altman, Irwin M; Swick, Shannon; Parrot, Devan; Malec, James F
2010-11-01
To evaluate outcomes of home- and community-based postacute brain injury rehabilitation (PABIR). Retrospective analysis of program evaluation data for treatment completers and noncompleters. Home- and community-based PABIR conducted in 7 geographically distinct U.S. cities. Patients (N=489) with traumatic brain injury who completed the prescribed course of rehabilitation (completed-course-of-treatment [CCT] group) compared with 114 who were discharged precipitously before program completion (precipitous-discharge [PD] group). PABIR delivered in home and community settings by certified professional staff on an individualized basis. Mayo-Portland Adaptability Inventory (MPAI-4) completed by means of professional consensus on admission and at discharge; MPAI-4 Participation Index at 3- and 12-month follow-up through telephone contact. Analysis of covariance (CCT vs PD group as between-subjects variable, admission MPAI-4 score as covariate) showed significant differences between groups at discharge on the full MPAI-4 (F=82.25; P<.001), Ability Index (F=50.24; P<.001), Adjustment Index (F=81.20; P<.001), and Participation Index (F=59.48; P<.001). A large portion of the sample was lost to follow-up; however, available data showed that group differences remained statistically significant at follow-up. Results provided evidence of the effectiveness of home- and community-based PABIR and that treatment effects were maintained at follow-up. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Ndubuisi, Chika A; Ohaegbulam, Samuel C; Mezue, Wilfred C
2017-12-01
Leisure sports activities are assumed to be safe. It is however possible that participation in contact sports as leisure activity may also affect the space available for the cervical cord (SAC). The objective of this study is to compare the SAC of asymptomatic young adults involved in active leisure contact sports with matched controls that do not participate in contact sports. This magnetic resonance imaging-based prospective, cross-sectional study involved 204 randomly selected asymptomatic adults, 21-50 years of age. The study included 2 groups: group A (participants in active leisure contact sports) and group B (participants who did not participate in any form of contact sport). The SAC was calculated by subtracting disk-level midsagittal spinal canal dimension from the corresponding level spinal cord dimension. The SAC at C3-4 was 4.5 ± 1.1 mm (group A) and 4.9 ± 1.4 mm (group B) (P = 0.025), at C4-5 was 4.3 ± 1.1 mm (group A) and 4.5 ± 1.2 mm (group B), at C5-6 was 4.6 ± 1.1 mm (group A) and 4.5 ± 1.4 mm (group B), at C6-7 was 5.2 ± 1.3 mm (group A) and 4.9 ± 1.2 mm (group B), at C7-T1 was 5.6 ± 1.3 mm (group A) and 5.6 ± 1.5 mm (group B) (P = 0.004). In men, the SAC at C3-4 was 4.39 ± 0.28 mm (group A) and 4.90 ± 0.30 mm (group B) (P = 0.036) and at C4-5 was 4.16 ± 0.27 mm (group A) and 4.56 ± 0.35 mm (group B). Three-way multivariate analysis of variance revealed significant effect of contact sports (P = 0.005), sex (P = 0.001), and age (P = 0.0001) on the SAC. Combined effect of contact sports participation and age also have significant effects on the SAC (P = 0.035). Participation in leisure contact sports has a small but overall negative effect on the SAC, especially at the upper subaxial cervical spine levels. This effect is most marked after the age of 40 years. Overall, there was no sex difference observed. Copyright © 2017 Elsevier Inc. All rights reserved.
Synthesis of Toll-like receptor 4 in Kupffer cells and its role in alcohol-induced liver disease.
Zuo, Guoqing; Gong, Jianping; Liu, Chang'an; Wu, Chuanxin; Li, Shengwei; Dai, Lili
2003-02-01
To observe the synthesis of Toll-like receptor (TLR) 4 protein and its mRNA expression in Kupffer cells (KCs) and evaluate the role of TLR 4 in liver injury to rats through alcohol-induced liver disease. Twenty-eight Wistar rats were divided into two groups: ethanol-fed (group E) and control (group C). Group E rats were given ethanol at a dose of 5 - 12 g x kg(-1) x d(-1), while group C received dextrose. Animals from both groups were killed at 4 and 8 weeks. The KCs were isolated and synthesis of TLR 4 protein was determined by laser scanning confocal microscopy. TLR 4 mRNA expression in KCs was determined by reverse transcription polymerase chain reaction (RT-PCR) analysis. The levels of endotoxin, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in plasma were determined. Changes in liver pathology were observed. Laser scanning confocal microscopy showed that the intensity of fluorescence of TLR 4 protein in group E was stronger than group C. Ethanol administration led to a significant increase in TLR 4 mRNA expression in group E compared with group C (P < 0.05). The concentrations of plasma endotoxin, TNF-alpha and IL-6 were higher in group E than in group C (P < 0.05). Liver sections from rats in group E demonstrated marked pathological changes. Ethanol administration can lead to the synthesis of TLR 4 protein and its gene expression in KCs, indicating that TLR 4 may play a major role in the development of alcohol-induced liver injury.
Diverse food items are similarly categorized by 8- to 13-year-old children.
Beltran, Alicia; Knight Sepulveda, Karina; Watson, Kathy; Baranowski, Tom; Baranowski, Janice; Islam, Noemi; Missaghian, Mariam
2008-01-01
Assess how 8- to 13-year-old children categorized and labeled food items for possible use as part of a food search strategy in a computerized 24-hour dietary recall. A set of 62 cards with pictures and names of food items from 18 professionally defined food groups was sorted by each child into piles of similar food items. Participants attended the Children's Nutrition Research Center in the summer 2006. 148 8- to 13-year-old children (132 English speaking, 16 primarily Spanish speaking). Sorting of food items into common groupings and their names. Robinson matrices for identification of clusters of food items. Children created on average 11.1 (+/- 4.4) piles with 5.4 (+/- 4.9) cards per pile. Robinson matrix clusters captured 92.4% of the variance in the sorting of food cards. No substantial differences in Robinson clustering were detected across subcategories for each of the demographic characteristics. The label names provided by the children were most frequently categorized as "Taxonomic-Professional" (42.5%), such as meat, fruit, and drinks; or "Script" (26.4%), such as breakfast food, desserts, and snacks. Children categorized food items into similar clusters but used diverse names to label them. These categories may be used to facilitate food search for researchers in a computerized 24-hour dietary recall for children in this age group.
A Combination of Dopamine Genes Predicts Success by Professional Wall Street Traders
Sapra, Steve; Beavin, Laura E.; Zak, Paul J.
2012-01-01
What determines success on Wall Street? This study examined if genes affecting dopamine levels of professional traders were associated with their career tenure. Sixty professional Wall Street traders were genotyped and compared to a control group who did not trade stocks. We found that distinct alleles of the dopamine receptor 4 promoter (DRD4P) and catecholamine-O-methyltransferase (COMT) that affect synaptic dopamine were predominant in traders. These alleles are associated with moderate, rather than very high or very low, levels of synaptic dopamine. The activity of these alleles correlated positively with years spent trading stocks on Wall Street. Differences in personality and trading behavior were also correlated with allelic variants. This evidence suggests there may be a genetic basis for the traits that make one a successful trader. PMID:22292056
García-López, David; de Paz, José A
2017-01-01
Abstract The aim of the study was to analyse the effects of 6 week (15 sessions) flywheel resistance training with eccentric-overload (FRTEO) on different functional and anatomical variables in professional handball players. Twenty-nine athletes were recruited and randomly divided into two groups. The experimental group (EXP, n = 15) carried out 15 sessions of FRTEO in the leg-press exercise, with 4 sets of 7 repetitions at a maximum-concentric effort. The control group (CON, n = 14) performed the same number of training sessions including 4 sets of 7 maximum repetitions (7RM) using a weight-stack leg-press machine. The results which were measured included maximal dynamic strength (1RM), muscle power at different submaximal loads (PO), vertical jump height (CMJ and SJ), 20 m sprint time (20 m), T-test time (T-test), and Vastus-Lateralis muscle (VL) thickness. The results of the EXP group showed a substantially better improvement (p < 0.05-0.001) in PO, CMJ, 20 m, T-test and VL, compared to the CON group. Moreover, athletes from the EXP group showed significant improvements concerning all the variables measured: 1RM (ES = 0.72), PO (ES = 0.42 - 0.83), CMJ (ES = 0.61), SJ (ES = 0.54), 20 m (ES = 1.45), T-test (ES = 1.44), and VL (ES = 0.63 - 1.64). Since handball requires repeated short, explosive effort such as accelerations and decelerations during sprints with changes of direction, these results suggest that FRTEO affects functional and anatomical changes in a way which improves performance in well-trained professional handball players. PMID:29339993
Taiwanese and Sri Lankan students' dimensions and discourses of professionalism.
Monrouxe, Lynn V; Chandratilake, Madawa; Gosselin, Katherine; Rees, Charlotte E; Ho, Ming-Jung
2017-07-01
The definition of medical professionalism poses a challenge to global medical educators. This is especially pronounced in settings where professionalism frameworks developed in the west are transferred into different cultures. Building upon our previous study across Western contexts, we examine Taiwanese and Sri Lankan medical students' conceptualisations of professionalism in terms of what professionalism comprises (i.e. dimensions) and how it is linguistically framed (i.e. discourses). A qualitative group interview study was undertaken comprising 26 group interviews with 135 participants from one Taiwanese (n = 64; Years 4-7) and one Sri Lankan medical school (n = 71; Years 2-5). Through thematic framework analysis we examined the data for explicit dimensions of professionalism. Through discourse analysis we identified how participants constructed professionalism linguistically (discourses). Thirteen common dimensions across Taiwanese and Sri Lankan talk were identified, with the dimensions (contextual, integration and internalised self) being identified only in Sri Lankan data. Professionalism as knowledge and patient-centredness were dominant dimensions in Taiwan; in Sri Lanka, attributes of the individual and rules were dominant dimensions. Participants in both countries used four types of discourses previously identified in the literature. Individual and interpersonal discourses were dominant in Taiwanese talk; the collective discourse was dominant in Sri Lankan talk. Findings were compared with our previous data collected in Western contexts. Despite some overlap in the dimensions and discourses identified across both this and Western studies, Taiwanese and Sri Lankan students' dominant dimensions and discourses were distinct. We therefore encourage global medical educators to look beyond a one-size-fits-all approach to professionalism, and to recognise the significance of context and culture in conceptualisations of professionalism. © 2017 The Authors. Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd.
Martinez, Rodolfo A. , Unkefer; Clifford J. , Alvarez; Marc, A [Santa Fe, NM
2012-06-12
The present invention is directed to the labeled compounds, ##STR00001## wherein C* is each either .sup.13C and .sup.12C where at least one C* is .sup.13C, each hydrogen of the methylene group is hydrogen or deuterium, the methyl group includes either zero or three deuterium atoms, Q is sulfide, sulfinyl, or sulfone, Z is an aryl group such as 1-naphthyl, substituted 1-naphthyl, 2-naphthyl, substituted 2-naphthyl, or a phenyl group ##STR00002## wherein R.sub.1, R.sub.2, R.sub.3, R.sub.4 and R.sub.5 are each independently either hydrogen, a C.sub.1-C.sub.4 lower alkyl, a halogen, and an amino group such as NH.sub.2, NHR and NRR' where R and R' are each independently either a C.sub.1-C.sub.4 lower alkyl, a phenyl, and an alkoxy group, and the methyl group can include either zero or three deuterium atoms. The present invention is also directed to the labeled compounds ##STR00003##
Warner, Morton M.
1977-01-01
In an attempt to find out if the physician perceives the same strengths and weaknesses in today's practice of family medicine as does the consumer, the Lay Advisory Committee of the College's B.C. Chapter initiated a survey of physicians' and consumers' attitudes. This article, the fourth and last in a series, presents some of the results of the survey as they relate to preventive-medicine, professional satisfaction and the rise of consumerism.
Development of the Professional Self-Care Scale.
Dorociak, Katherine E; Rupert, Patricia A; Bryant, Fred B; Zahniser, Evan
2017-04-01
In recent years, there has been an increased emphasis on the importance of self-care for psychologists and other mental health professionals. With the growth of positive psychology and preventive medicine, self-care is an emerging topic, promulgated as a means of avoiding the adverse effects of stress and promoting professional functioning and well-being. However, the research on self-care is limited because of the lack of an empirically based, psychometrically sound measure of this construct. Thus, the purpose of this project was to develop a measure of professional self-care. Professional psychologists were the focus of study, with the goal being to develop a measure that can be used in this population and similar groups of professionals. Based on expert feedback and a preliminary study of 422 licensed psychologists in Illinois, a 5-factor, 21-item scale was created. Factor analysis identified the following self-care factors: Professional Support, Professional Development, Life Balance, Cognitive Awareness, and Daily Balance. Preliminary analyses provided initial support for the validity of the 5 factors. A follow-up study was conducted with a second sample of clinical psychologists. The 5-factor structure provided a good fit to the data with the second sample. Thus, based on factor analysis and validity data, a 5-factor, 21-item Professional Self-Care Scale was established for further study and use in future research. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
An Exploration of Fidelity of Implementation in Drug Abuse Prevention among Five Professional Groups
ERIC Educational Resources Information Center
Dusenbury, Linda; Brannigan, Rosalind; Falco, Mathea; Lake, Antonia
2004-01-01
To explore the extent of awareness among practitioners of the importance of fidelity of implementation and the factors that inhibit or encourage it, interviews were conducted with nine individuals in each of the following groups: 1) researchers who have developed and evaluated prevention curricula; 3) school administrators; 4) teachers; and 5)…
Stenov, Vibeke; Wind, Gitte; Skinner, Timothy; Reventlow, Susanne; Hempler, Nana Folmann
2017-09-18
Healthcare professionals' person-centered communication skills are pivotal for successful group-based diabetes education. However, healthcare professionals are often insufficiently equipped to facilitate person-centeredness and many have never received post-graduate training. Currently, assessing professionals' skills in conducting group-based, person-centered diabetes education primarily focus on experts measuring and coding skills on various scales. However, learner-centered approaches such as adequate self-reflective tools have been shown to emphasize professional autonomy and promote engagement. The aim of this study was to explore the potential of a self-assessment tool to identify healthcare professionals' strengths and areas in need of professional development to aid effective facilitation of group-based, person-centered diabetes education. The study entails of two components: 1) Field observations of five different educational settings including 49 persons with diabetes and 13 healthcare professionals, followed by interviews with 5 healthcare professionals and 28 persons with type 2 diabetes. 2) One professional development workshop involving 14 healthcare professionals. Healthcare professionals were asked to assess their person-centered communication skills using a self-assessment tool based on challenges and skills related to four educator roles: Embracer, Facilitator, Translator, and Initiator. Data were analyzed by hermeneutic analysis. Theories derived from theoretical model 'The Health Education Juggler' and techniques from 'Motivational Interviewing in Groups' were used as a framework to analyze data. Subsequently, the analysis from the field notes and interview transcript were compared with healthcare professionals' self-assessments of strengths and areas in need to effectively facilitate group-based, person-centered diabetes education. Healthcare professionals self-assessed the Translator and the Embracer to be the two most skilled roles whereas the Facilitator and the Initiator were identified to be the most challenged roles. Self-assessments corresponded to observations of professional skills in educational programs and were confirmed in the interviews. Healthcare professionals self-assessed the same professional skills as observed in practice. Thus, a tool to self-assess professional skills in facilitating group-based diabetes education seems to be useful as a starting point to promote self-reflections and identification of healthcare professionals' strengths and areas of need of professional development.
Impact of instructional Approaches to Teaching Elementary Science on Student Achievement
NASA Astrophysics Data System (ADS)
Kensinger, Seth H.
Strengthening our science education in the United States is essential to the future success of our country in the global marketplace. Immersing our elementary students with research-based quality science instruction is a critical component to build a strong foundation and motivate our students to become interested in science. The research for this study pertained to the type of elementary science instruction in correlation to academic achievement and gender. Through this study, the researcher answered the following questions: 1. What is the difference in achievement for elementary students who have been taught using one of the three science instructional approaches analyzed in this study: traditional science instruction, inquiry-based science instruction with little or no professional development and inquiry-based science instruction with high-quality professional development? 2. What is the difference in student achievement between inquiry-based instruction and non-inquiry based (traditional) instruction? 3. What is the difference in student achievement between inquiry with high quality professional development and inquiry with little or no professional development? 4. Do the three instructional approaches have differentiated effects across gender? The student achievement was measured using the 2010 fourth grade Pennsylvania System of School Assessment (PSSA) in Science. Data was collected from 15 elementary schools forming three main groupings of similar schools based on the results from the 2009 third grade PSSA in Mathematics and student and community demographics. In addition, five sub-group triads were formed to further analyze the data and each sub-group was composed of schools with matching demographic data. Each triad contained a school using a traditional approach to teaching science, a school utilizing an inquiry science approach with little or no professional development, and a school incorporating inquiry science instruction with high quality professional development. The five schools which provided its students with inquiry science and high quality professional development were Science Its Elementary (SIE) schools, as provided through a grant from the Pennsylvania Department of Education (PDE). The findings of the study indicated that there is evidence to suggest that elementary science achievement improves significantly when teachers have utilized inquiry instruction after receiving high-quality professional development. Specifically, the analysis of the whole group and the majority of the triad sub-groupings did result in a consistent trend to support science instruction utilizing inquiry with high-quality professional development compared to a traditional approach and an inquiry-based approach with little or no professional development. The gender analysis of this study focused on whether or not girls at the elementary school level would perform better than boys depending upon method of science instruction. The study revealed no relationship between approach to teaching science and achievement level based on gender. The whole group results and sub-group triads produced no significant findings for this part of the data analysis.
Fleisig, Glenn S; Leddon, Charles E; Laughlin, Walter A; Ciccotti, Michael G; Mandelbaum, Bert R; Aune, Kyle T; Escamilla, Rafael F; MacLeod, Toran D; Andrews, James R
2015-05-01
A relatively high number of active professional baseball pitchers have a history of ulnar collateral ligament reconstruction (UCLr) on their throwing elbow. Controversy exists in the literature about whether professional baseball pitchers regain optimal performance after return from UCLr. It has been suggested that pitchers may have different biomechanics after UCLr, but this has not been previously tested. It was hypothesized that, compared with a control group without a history of UCLr, professional pitchers with a history of UCLr would have (1) significantly different throwing elbow and shoulder biomechanics; (2) a shortened stride, insufficient trunk forward tilt, and excessive shoulder horizontal adduction, characteristics associated with "holding back" or being tentative; (3) late shoulder rotation; and (4) improper shoulder abduction and trunk lateral tilt. Controlled laboratory study. A total of 80 active minor league baseball pitchers (and their 8 Major League Baseball organizations) agreed to participate in this study. Participants included 40 pitchers with a history of UCLr and a matched control group of 40 pitchers with no history of elbow or shoulder surgery. Passive ranges of motion were measured for each pitcher's elbows and shoulders, and then 23 reflective markers were attached to his body. The pitcher took as many warm-up pitches as desired and then threw 10 full-effort fastballs for data collection. Ball speed was recorded with a radar gun. The reflective markers were tracked with a 10-camera, 240-Hz automated motion analysis system. Eleven biomechanical parameters were computed for each pitch and then averaged for each participant. Demographic, range of motion, and biomechanical parameters were compared between the UCLr group and the control group by use of Student t tests (significance set at P<.05). All hypotheses were rejected, as there were no differences in pitching biomechanics between the UCLr group and the control group. There were also no differences in passive range of motion between the 2 groups. Compared with a control group, active professional pitchers with a history of UCLr displayed no significant differences in shoulder and elbow passive range of motion and no significant differences in elbow and shoulder biomechanics. Clinical studies have previously shown that 10% to 33% of professional pitchers do not return to their preinjury level; however, the current study showed that those pitchers who successfully return to professional baseball after UCLr pitch with biomechanics similar to that of noninjured professionals. © 2015 The Author(s).
Study on Quality of IUD Services Provided by Trained Professionals at Teaching Institutes.
Prasad, Noopur; Jain, M L; Meena, B S
2018-06-01
Access the completeness in IUD services provided by trained professionals and find out the weak links. Study was conducted on 100 IUD trained professionals of tertiary care hospital and nursing teaching institute. All were given questionnaire that was duly filled by them. Data obtained were analysed. Protocols of case selection, pre-insertion counselling, insertion process and follow-up were assessed. All the four criteria were assessed on score of ten. Study group could not get ten points under any of the set criteria. Average of 53% case selection, 31.4% pre-insertion counselling, 42.5% insertion protocols and 46.1% follow-up counselling criteria were observed by study group. Highest compliance of protocols was seen among postgraduate students. Although IUD training is given to all medical professionals and IUD facility is available up to subcentres but the study shows that completeness in services is still lacking. Ensuring ideal place for IUD insertion, proper case selection, use of specific instruments for insertion and observance of insertion protocols are very vital for the success of IUD.
Peer-support writing group in a community family medicine teaching unit
Al-Imari, Lina; Yang, Jaisy; Pimlott, Nicholas
2016-01-01
Abstract Problem addressed Aspiring physician writers need an environment that promotes self-reflection and can help them improve their skills and confidence in writing. Objective of program To create a peer-support writing group for physicians in the Markham-Stouffville community in Ontario to promote professional development by encouraging self-reflection and fostering the concept of physician as writer. Program description The program, designed based on a literature review and a needs assessment, was conducted in 3 sessions over 6 months. Participants included an emergency physician, 4 family physicians, and 3 residents. Four to 8 participants per session shared their projects with guest physician authors. Eight pieces of written work were brought to the sessions, 3 of which were edited. A mixed quantitative and qualitative evaluation model was used with preprogram and postprogram questionnaires and a focus group. Conclusion This program promoted professional development by increasing participants’ frequency of self-reflection and improving their proficiency in writing. Successful elements of this program include creating a supportive group environment and having a physician-writer expert facilitate the peer-feedback sessions. Similar programs can be useful in postgraduate education or continuing professional development. PMID:27965348
Burns, P
1986-05-01
An acoustical analysis of the speaking and singing voices of two types of professional singers was conducted. The vowels /i/, /a/, and /o/ were spoken and sung ten times each by seven opera and seven country and western singers. Vowel spectra were derived by computer software techniques allowing quantitative assessment of formant structure (F1-F4), relative amplitude of resonance peaks (F1-F4), fundamental frequency, and harmonic high frequency energy. Formant analysis was the most effective parameter differentiating the two groups. Only opera singers lowered their fourth formant creating a wide-band resonance area (approximately 2,800 Hz) corresponding to the well-known "singing formant." Country and western singers revealed similar resonatory voice characteristics for both spoken and sung output. These results implicate faulty vocal technique in country and western singers as a contributory reason for vocal abuse/fatigue.
Symptoms of craniomandibular dysfunction in professional orchestra musicians.
Steinmetz, A; Zeh, A; Delank, K S; Peroz, I
2014-01-01
Up to 80% of professional musicians are affected by playing-related musculoskeletal disorders, but data regarding the frequency of craniomandibular dysfunction (CMD) in professional orchestra musicians is scarce. To evaluate the frequency of CMD and its relation to musculoskeletal pain in various body regions. A questionnaire-based survey approach assessing CMD symptoms and musculoskeletal pain in professional orchestra players was adopted. Relative prevalence rates and prevalence ratios for different instrument groups were estimated. A total of 408 musicians completed the questionnaire (response rate 57%). Playing-related pain in the teeth or jaw was reported by 19-47% of musicians and TMJ pain by 15-34%, depending on the instrument group. Current pain in the face indicating a painful CMD was reported in 6-10% and related symptoms such as teeth grinding in 25-34%, jaw clenching in 33-42% and jaw locking in 11-18% of musicians. Females were 2.4 times (95% confidence intervals (CI) 1.49-3.84) more likely to report having had orofacial pain within the last month. Musicians reporting orofacial pain within the last month were 4.8 times (95% CI: 2.83-8.02) more likely to report pain in the neck and 2.5-3.8 times (P < 0.05) more likely to report pain in other body regions, including shoulders, right wrist, left fingers and the thoracic and lumbar spine. Symptoms suggesting CMD were common in this study of professional orchestra musicians and were associated with pain in the neck, shoulder and hands. There is a need to enhance awareness of CMD to optimize early medical diagnosis and treatment.
Du Mont, Janice; Kosa, Daisy; Macdonald, Sheila; Elliot, Shannon; Yaffe, Mark
2015-01-01
Objective We have undertaken a multi-phase, multi-method program of research to develop, implement, and evaluate a comprehensive hospital-based nurse examiner elder abuse intervention that addresses the complex functional, social, forensic, and medical needs of older women and men. In this study, we determined the importance of possible participating professionals and respective roles and responsibilities within the intervention. Methods Using a modified Delphi methodology, recommended professionals and their associated roles and responsibilities were generated from a systematic scoping review of relevant scholarly and grey literatures. These items were reviewed, new items added for review, and rated/re-rated for their importance to the intervention on a 5-point Likert scale by an expert panel during a one day in-person meeting. Items that did not achieve consensus were subsequently re-rated in an online survey. Analysis Those items that achieved a mean Likert rating of 4+ (rated important to very important), and an interquartile range<1 in the first or second round, and/or for which 80% of ratings were 4+ in the second round were retained for the model elder abuse intervention. Results Twenty-two of 31 recommended professionals and 192 of 229 recommended roles and responsibilities rated were retained for our model elder abuse intervention. Retained professionals were: public guardian and trustee (mean rating = 4.88), geriatrician (4.87), police officer (4.87), GEM (geriatric emergency management) nurse (4.80), GEM social worker (4.78), community health worker (4.76), social worker/counsellor (4.74), family physician in community (4.71), paramedic (4.65), financial worker (4.59), lawyer (4.59), pharmacist (4.59), emergency physician (4.57), geriatric psychiatrist (4.33), occupational therapist (4.29), family physician in hospital (4.28), Crown prosecutor (4.24), neuropsychologist (4.24), bioethicist (4.18), caregiver advocate (4.18), victim support worker (4.18), and respite care worker (4.12). Conclusion A large and diverse group of multidisciplinary, intersectoral collaborators was deemed necessary to address the complex needs of abused older adults, each having important roles and responsibilities to fulfill within a model comprehensive elder abuse intervention. PMID:26630030
Du Mont, Janice; Kosa, Daisy; Macdonald, Sheila; Elliot, Shannon; Yaffe, Mark
2015-01-01
We have undertaken a multi-phase, multi-method program of research to develop, implement, and evaluate a comprehensive hospital-based nurse examiner elder abuse intervention that addresses the complex functional, social, forensic, and medical needs of older women and men. In this study, we determined the importance of possible participating professionals and respective roles and responsibilities within the intervention. Using a modified Delphi methodology, recommended professionals and their associated roles and responsibilities were generated from a systematic scoping review of relevant scholarly and grey literatures. These items were reviewed, new items added for review, and rated/re-rated for their importance to the intervention on a 5-point Likert scale by an expert panel during a one day in-person meeting. Items that did not achieve consensus were subsequently re-rated in an online survey. Those items that achieved a mean Likert rating of 4+ (rated important to very important), and an interquartile range<1 in the first or second round, and/or for which 80% of ratings were 4+ in the second round were retained for the model elder abuse intervention. Twenty-two of 31 recommended professionals and 192 of 229 recommended roles and responsibilities rated were retained for our model elder abuse intervention. Retained professionals were: public guardian and trustee (mean rating = 4.88), geriatrician (4.87), police officer (4.87), GEM (geriatric emergency management) nurse (4.80), GEM social worker (4.78), community health worker (4.76), social worker/counsellor (4.74), family physician in community (4.71), paramedic (4.65), financial worker (4.59), lawyer (4.59), pharmacist (4.59), emergency physician (4.57), geriatric psychiatrist (4.33), occupational therapist (4.29), family physician in hospital (4.28), Crown prosecutor (4.24), neuropsychologist (4.24), bioethicist (4.18), caregiver advocate (4.18), victim support worker (4.18), and respite care worker (4.12). A large and diverse group of multidisciplinary, intersectoral collaborators was deemed necessary to address the complex needs of abused older adults, each having important roles and responsibilities to fulfill within a model comprehensive elder abuse intervention.
2010-01-01
Monitoring of vitamin status of various groups of adult population (by vitamin serum blood level evaluation) during the period since 1987 on 2009 has shown that an authentic improvement of sufficiency with vitamin C takes place. At the present time the deficiency of B group vitamins has been determined much more often than the deficit of vitamins C, A and E. The revealed deficiencies don't depend on a place of residing and a professional accessory and, as a rule, affect not any one vitamin, but have a character of combined insufficiency of B group vitamins and some other vitamins.
[Perception of professionals' quality of life in the Asturias a Health Care Area, Spain].
Alonso Fernández, M; Iglesias Carbajo, A I; Franco Vidal, A
2002-11-15
To report on the perceived quality of life of professionals in the health services sector. Descriptive, cross-sectional study. Directorate of Primary Care of Health Care Area VIII in Asturias, Spain. Two hundred thirty-seven professionals in the health care sector and other sectors. Internal mail was used to send all employees the CV-35 self-administered questionnaire, which measures perceived professional quality of life, understood as the balance between work demands and the capacity to cope with them. The instrument consists of 35 items that evaluate three dimensions: perception of demands, emotional support received from superiors, and intrinsic motivation. Each item was scored on a quantitative scale of 1 to 10. One hundred thirty-five completed questionnaires were received (59.5%). Mean professional quality of life was 5.35 (5.12-5.58); there were no significant differences between age groups, sexes or employment status. Mean score for perceived demands at the workplace was 6.03 (5.89-6.17), and mean score for emotional support received from superiors was 4.78 (4.63-4.97). This support was valued most highly by employees who held a position of responsibility. Mean score for intrinsic motivation was 7.45 (7.34-7.56). Employees in Health Care Area VIII in Asturias perceived their professional quality of life to be moderately good, perceived a moderate degree of support received, and had a high level of intrinsic motivation to cope with high demands at the workplace.
ERIC Educational Resources Information Center
Cowin, Bob
2012-01-01
This report describes agencies (established by government) and organizations (established by others) that dealt exclusively with postsecondary education in British Columbia, Canada and which had at least one professional employee and/or were separate legal entities. Of the fifty groups described since 1960, about two dozen existed in 2012. The…
Parent Partnerships Project for Children's Mental Health Training for Professionals. PHP-c87
ERIC Educational Resources Information Center
PACER Center, 2004
2004-01-01
In the fall of 2003, PACER Center's Parent Partnership Project for Children's Mental Health conducted a survey to better understand what parents and families need from the children?s mental health system in Minnesota. The research team developed a survey questionnaire, a telephone interview, and a focus group session directed at learning what was…
Dal Fabbro, Daniela Reis; de Oliveira, Rebeca Barqueiro; dos Santos, Ingrid Ribeiro; Victor, Elivane da Silva; Aquarone, Rita Lacerda; Andrade, Cristiane Benvenuto; Ribeiro, Vivian Finotti; de Oliveira, Roselaine Coelho; Friedlander, Rosa; Ferreira, Daniela Santos
2017-01-01
Background Stress levels are evident among health professionals. However, there are few studies on sensory-based self-care aimed at stress management, self-esteem and subjective well-being in this group of professionals. Objective To assess the impact of a self-care intervention mediated by the senses on the stress levels, self-esteem and well-being of health professionals in a hospital environment. Methods A total of 93 health professionals participated in an unblinded clinical trial, randomized into four groups: 1) control (no intervention); 2) Monosensory—daily body moisturizing (DBM) with odorless cream; 3) Bisensory—DBM with scented cream; 4) Multisensory—DBM with scented cream associated with audiovisual material. Participants answered specific questionnaires to assess stress, self-esteem and well-being and cortisol samples were collected at baseline, 15 and 30 days following intervention, and at the 30-day follow-up. Results Self-care was characterized as neglected, with most participants reporting inadequate hours of sleep (74%), irregular physical activity (68%), and inadequate nutrition (45%). Compared to the other groups, the Bisensory group had lower stress on all three assessments (p = 0.017; 0.012; 0.036), a life satisfaction 8% higher at follow-up than at baseline (95% CI: 2% to 15%, p = 0.016), a 10% increase in positive affect (95% CI: 2% to 19%, p = 0.011) and a 12% reduction in negative affect (95% CI: 3% to 21% less, p = 0.014) after 30 days. The Multisensory group showed improvement in self-esteem (p = 0.012) and reduced cortisol (p = 0.036) after 30 days of intervention. The control group showed no changes in the variables studied, except for cortisol: an increase at the 15-day evaluation (denoting higher risk for stress, p = 0.009) and a reduction at follow-up (p = 0.028), which was nevertheless within normal levels. Trial registration Clinicaltrials.gov NCT02406755 PMID:28241070
Leão, Eliseth Ribeiro; Dal Fabbro, Daniela Reis; Oliveira, Rebeca Barqueiro de; Santos, Ingrid Ribeiro Dos; Victor, Elivane da Silva; Aquarone, Rita Lacerda; Andrade, Cristiane Benvenuto; Ribeiro, Vivian Finotti; Oliveira, Roselaine Coelho de; Friedlander, Rosa; Ferreira, Daniela Santos
2017-01-01
Stress levels are evident among health professionals. However, there are few studies on sensory-based self-care aimed at stress management, self-esteem and subjective well-being in this group of professionals. To assess the impact of a self-care intervention mediated by the senses on the stress levels, self-esteem and well-being of health professionals in a hospital environment. A total of 93 health professionals participated in an unblinded clinical trial, randomized into four groups: 1) control (no intervention); 2) Monosensory-daily body moisturizing (DBM) with odorless cream; 3) Bisensory-DBM with scented cream; 4) Multisensory-DBM with scented cream associated with audiovisual material. Participants answered specific questionnaires to assess stress, self-esteem and well-being and cortisol samples were collected at baseline, 15 and 30 days following intervention, and at the 30-day follow-up. Self-care was characterized as neglected, with most participants reporting inadequate hours of sleep (74%), irregular physical activity (68%), and inadequate nutrition (45%). Compared to the other groups, the Bisensory group had lower stress on all three assessments (p = 0.017; 0.012; 0.036), a life satisfaction 8% higher at follow-up than at baseline (95% CI: 2% to 15%, p = 0.016), a 10% increase in positive affect (95% CI: 2% to 19%, p = 0.011) and a 12% reduction in negative affect (95% CI: 3% to 21% less, p = 0.014) after 30 days. The Multisensory group showed improvement in self-esteem (p = 0.012) and reduced cortisol (p = 0.036) after 30 days of intervention. The control group showed no changes in the variables studied, except for cortisol: an increase at the 15-day evaluation (denoting higher risk for stress, p = 0.009) and a reduction at follow-up (p = 0.028), which was nevertheless within normal levels. Clinicaltrials.gov NCT02406755.
Effects of continuing professional development on clinical performance
Goulet, François; Hudon, Eveline; Gagnon, Robert; Gauvin, Eliane; Lemire, Francine; Arsenault, Isabelle
2013-01-01
Abstract Objective To evaluate the link between the quantity and quality of continuing professional development (CPD) activities completed by family physicians in Quebec and the quality of their practice. Design Retrospective analysis of data collected during professional inspection visits (PIVs). Setting Quebec. Participants Three groups were created from among Quebec family physicians who had been subject to PIVs (peer evaluation) by the Collège des médecins du Québec between 1998 and 2005. Group 1 was composed of physicians who were members of the College of Family Physicians of Canada, which requires participation in 250 hours of CPD in every 5-year cycle. Group 2 was composed of family physicians who were not members of the College of Family Physicians of Canada but who had declared at least 50 hours a year of CPD on their Collège des médecins du Québec annual notice of assessment for the same period. Group 3 was composed of family physicians who had declared fewer than 10 hours of CPD a year. Main outcome measures During the PIV, the following characteristics were examined: record keeping, quality and number of hours of CPD activities, and quality of professional practice based on 3 components— clinical investigation, accuracy of diagnosis, and appropriateness of treatment plan and follow-up. Results The factors associated with a high quality of practice were privileges in a hospital or local community health centre (institution) and a substantial number of accredited CPD hours (Mainpro-M1, Credit I, or Mainpro-C). The factors associated with a poor quality of practice were advanced age of the physician, absence of privileges in an institution (hospital or local community health centre), and participation in CPD activities that were more informal, such as reading and non-accredited activities (Mainpro-M2). Conclusion This study supports earlier research showing that CPD activities of sufficient quality and quantity are correlated with a high quality of professional practice by family physicians. PMID:23673591
Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-18
... Professional Managers and Aurora Investment Management L.L.C.; Notice of Application April 12, 2013. AGENCY...: Trust for Professional Managers (the ``Trust'') and Aurora Investment Management L.L.C. (the ``Initial... Street, Milwaukee, WI 53202; Scott M. Montpas, Esq., Aurora Investment Management L.L.C., 300 North...
Continuation and Enhancement of the MPOWIR Program
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lozier, Susan
MPOWIR is a community-based program that provides mentoring to physical oceanographers from late graduate school through early careers. The overall goal of MPOWIR is to make mentoring opportunities for junior physical oceanographers universally available and of higher quality by expanding the reach of mentoring opportunities beyond individual home institutions. The aim is to reduce the barriers to career development for all junior scientists in the field, with a particular focus on improving the retention of junior women. Over the past five years MPOWIR has expanded significantly. This funding cycle saw the development and enhancement of MPOWIR’s programs and outreach opportunities.more » MPOWIR’s main programmatic offerings are: mentor groups, a biannual conference, a website and blog, and town hall meetings at national events. Since 2009, MPOWIR has hosted 15 mentor groups, three Pattullo conferences, and created a website that has attracted over 50,000 visitors. MPOWIR’s mentoring groups and Pattullo conferences have reached more than 130 unique participants. Mentor Groups Mentor groups were established in the fall of 2008, and continue to gain momentum after 5 years. Since 2009, 11 groups have formed, with participants mainly, but not exclusively, drawn from Pattullo attendees. To gauge the impact of mentor groups, participants are surveyed approximately annually. Based on an extensive 2011 survey, 100% of mentoring group participants reported that they made progress on their stated scientific, professional, and personal goals. As part of these surveys, participants are asked what they value about their mentoring group, what the benefit of the mentoring group is to their current position, and they are asked questions about the logistics and setup of the groups. Based on the survey conducted in 2012, all participants rated participation in these groups a valuable experience, with particular value placed on feedback on professional development (100% Excellent to Good) and feedback on personal matters (92% Excellent to Good). Pattullo Conferences The centerpiece of the MPOWIR program is the Pattullo Conference, named for June Pattullo, the first woman to receive a Ph.D. in physical oceanography. At each event, the agenda includes research talks, professional development sessions, small group activities, and a question-and-answer session about early-career and retention issues posed by junior scientists to senior researchers. Pattullo Conference participants are surveyed after each conference about their experience. This survey asks participants to rate their opinion on specific topics and invites comments. Combining results from three conferences, 99% of junior participants would recommend the conference to another junior scientist. Of the junior participants, 92% rated the conference as “extremely valuable” overall, with a particular value placed on networking and professional development opportunities. Overall Impact To gain a better perspective on the success of MPOWIR to date, early participants were surveyed in 2013 about their current position, and the impact of MPOWIR on their career path. Individuals were asked to rank the extent to which MPOWIR had impacted various aspects of their professional growth. These aspects included efforts to obtain their current position; exposure to professional development skills; broadening of their professional network; mentoring on work and family balance; performance in current position; and raising awareness of mentoring in career development. Participants overwhelming indicated that MPOWIR had positively impacted all of these aspects. In particular, 95% of respondents expressed that MPOWIR exposed them to useful professional development skills “to a great extent” and 89% consider MPOWIR to have positively impacted their professional network “to a great extent”. Of those surveyed, the majority of participants were 2 years from their Ph.D. at the time of initial involvement. Their current job positions are well distributed over all post-Ph.D. categories: the greatest percentages of positions held are at research institutions (non-academic) or government agencies (29.3%), followed closely by non-faculty research positions at universities (27.6%) and faculty at research universities (22.4%). The remaining positions held (4-year college faculty, profit or not-for-profit company, policy, and graduate students) collectively total 19%. These initial indications point toward mentoring, as offered by MPOWIR, as an effective means for improving retention of women in physical oceanography.« less
Taylor, Catherine A.; Moeller, William; Hamvas, Lauren; Rice, Janet C.
2014-01-01
Parents (n=500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents that sought advice from religious leaders (vs. pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported they were more likely to follow the advice of pediatricians than any other professional; however, Black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents. PMID:23185082
Taylor, Catherine A; Moeller, William; Hamvas, Lauren; Rice, Janet C
2013-02-01
Parents (n = 500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of the parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents who sought advice from religious leaders (vs pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported that they were more likely to follow the advice of pediatricians than any other professional; however, black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents.
Toward a Comprehensive Talent Management Program: Level-I Hospital Commander Preparation
2013-03-01
ethical decision making, personal/professional 21 ethics, bioethics , organizational ethics, individual behavior, group dynamics, conflict...100.00%) Bioethics 16 (51.61%) 10 (32.26%) 4 (12.90%) 1 (3.23%) Org. Ethics 31 (100.0%) Individual Behavior 29 (93.55%) 2 (6.45%) Group Dynamics 27...75.00%) Add. Labor Law 3 (42.86%) 4 (57.14%) Add. Health Law 1 (100.00%) Add. National Dis. 1 (50.00%) 1 (50.00%) Add. Bioethics 2 (100.00
The acute:chonic workload ratio in relation to injury risk in professional soccer.
Malone, Shane; Owen, Adam; Newton, Matt; Mendes, Bruno; Collins, Kieran D; Gabbett, Tim J
2017-06-01
To examine the association between combined sRPE measures and injury risk in elite professional soccer. Observational cohort study. Forty-eight professional soccer players (mean±SD age of 25.3±3.1 yr) from two elite European teams were involved within a one season study. Players completed a test of intermittent-aerobic capacity (Yo-YoIR1) to assess player's injury risk in relation to intermittent aerobic capacity. Weekly workload measures and time loss injuries were recorded during the entire period. Rolling weekly sums and week-to-week changes in workload were measured, allowing for the calculation of the acute:chronic workload ratio, which was calculated by dividing the acute (1-weekly) and chronic (4-weekly) workloads. All derived workload measures were modelled against injury data using logistic regression. Odds ratios (OR) were reported against a reference group. Players who exerted pre-season 1-weekly loads of ≥1500 to ≤2120AU were at significantly higher risk of injury compared to the reference group of ≤1500AU (OR=1.95, p=0.006). Players with increased intermittent-aerobic capacity were better able to tolerate increased 1-weekly absolute changes in training load than players with lower fitness levels (OR=4.52, p=0.011). Players who exerted in-season acute:chronic workload ratios of >1.00 to <1.25 (OR=0.68, p=0.006) were at significantly lower risk of injury compared to the reference group (≤0.85). These findings demonstrate that an acute:chronic workload of between 1.00 and 1.25 is protective for professional soccer players. A higher intermittent-aerobic capacity appears to offer greater injury protection when players are exposed to rapid changes in workload in elite soccer players. Moderate workloads, coupled with moderate-low to moderate-high acute:chronic workload ratios, appear to be protective for professional soccer players. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Adili, F; Kadmon, M; König, S; Walcher, F
2013-10-01
For competency-oriented teaching in surgery a comprehensive medical educational training and professionalization of clinical teachers is essential. The Surgical Working Group for Teaching has therefore set itself the task of developing an appropriate training concept. In the first step the core group took stock of the most relevant educational barriers in the clinical environment. Taking into account these findings a trimodular course was devised that addressed both previous knowledge and different clinical functions of the faculty as well as modern concepts of competency-based academic teaching. The A course is designed for medical teaching of novices with a focus on collation of the medical history, clinical examination and teaching of practical skills. The B course is devised for experienced clinicians and should qualify them for competency-based teaching in complex educational scenarios, such as the operating room or ward rounds, while the C course is directed to a group of persons entrusted with the organization and administration of clinical teaching.
Vavić, Neven; Ignjatović, Ljiljana; Drasković, Biljana; Hrvacević, Rajko; Kovacević, Zoran; Paunić, Zoran
2008-02-01
Cyclosporine (CyA) therapeutic drug monitoring (TDM) through the measurement of drug concentration in blood two hours after the administration (C2), and/or according to the calculated value of the area under the concentration-time curve during the first four hours following administration (AUC(0-4)) shows favourable correlation with clinical manifestations in patients with kidney transplantation (Tx). The aim of this study was to analyze clinical efficiency and usability of TDM CyA through C2 and AUC(0-4) in the group of our kidney transplanted patients during the first 24 months following Tx. The study included 50 patients who had undergone kidney Tx using living donors at the Clinic of Nephrology Military Medical Academy, from 1996 to 2003. The first group (group C2) consisted of 25 patients in whom CyA dose was adjusted according to the target C2 and AUC(0-4) (calculated by the regression formula based on C1, C2 and C3), while the second group (group CO) consisted of 25 "historical" patients in whom the dose of this drug was adjusted according to CO. On the 6th day the average daily dose of CyA in the group C2 was 10.1 +/- 0.8 mg/kg, while in the group CO it was 7.6 +/- 1.6 (p < 0.05). One month following the Tx, daily drug doses were quite similar in the two observed groups (6.2 mg/kg in CO and 6.6 mg/kg in group C2, p = NS). In the group C2, target C2/AUC(0-4) (C2 1700 ng/ml, AUC(0-4) 4400 ng h/ml) on the sixth day was achieved in 36.3%, and on day 14 in 76% of the patients. The target AUC(0-4), in relation with C2, in each observed time interval was reached in the higher number of patients. Maximum CyA concentrations in the group C2 were registered 2 hours following the administration (C2), when compared with the concentrations registered after the first and the third hour (C1 and C3). In relation with C1 and C3, C2 concentration correlated most favorably with AUC(0-4), both on the 6th (r = 0.85) and on the 9th day (r = 0.87). During the first three months following the Tx, in the group CO, 10 episodes (40%) of acute cell rejection (AR) were registered, while in the group C2, two episodes (8%, p = 0.07) were registered; in the observed period covering the first two years, a total of 13 (52%) AR episodes in the group CO and 5 AR episodes (20%) in the group C2 (p = 0.03) were registered. All of five episodes of steroid resistant AR were registered in the group CO. In the group C2, all five patients with AR had lower C2 during AR: the average C2 at the moment of AR was 933.8 ng/ml, and in the patients without rejections was 1364.2 ng/ml (p = 0.008). In the same group, the average C0 at the moment of AR was 263.2 ng/ml, and 240.0 ng/ml (p = 0.486) in the patients without AR. In the C0 group, average C0 concentration at the moment of AR was 227.1 ng/ml, while in the patients without AR it was 227.7 ng/ml (p = 0.95). Totally 68% of the patients showed signs of acute CyA nephrotoxicity during the first year in the group C2, and 52% in the group CO (p = 0.38). In seven patients (28%) of the group C2 and six patients of the group C0 (24%, p = 0.96) in the first two years following Tx, administration of CyA was interrupted due to nephrotoxicity. Overall graft function was good in both groups during the period of two years. One graft was lost in the group CO due to chronic allograft nephropathy. The patients in the group C2 had better early and the same late graft function. Five patients in the group C2 who did not reach the target C2/AUC during the first 30 days, did not have more AR or worse graft function, comparing with the patients who reached the target concentrations. In the patients with CyA TDM through with the C2 and AUC(0-4), AR frequency was considerably lower, and AR episodes had a milder flow than in those with CyA TDM through the CO. The drug concentration in blood two hours after administration (C2) was a good predictor of acute graft rejection, while CO failed to point to the patients with the insufficient drug concentration. Higher drug doses were administered in the group C2 during the first month following Tx, and these patients did not show significantly higher frequency of acute nephrotoxicity and more frequent requirement of the drug use interruption. Graft function in both groups was good during the period of two years. CyA dose determination through C2 and AUC(0-4) is efficient TDM method, relatively simple for use in day to day clinical practice.
A novel immunocompetent murine model for Candida albicans-promoted oral epithelial dysplasia
DWIVEDI, P. P.; MALLYA, S.; DONGARI-BAGTZOGLOU, A.
2009-01-01
Candida albicans is a common opportunistic pathogen found in the oral mucosa. Clinical observations indicate a significant positive association between oral Candida carriage or infection and oral epithelial dysplasia/neoplasia. The aim of this study was to test whether C. albicans is able to promote epithelial dysplasia or carcinoma in a mouse model of infection where a carcinogen (4 Nitroquinoline 1-oxide [4NQO]) was used as initiator of neoplasia. Mice were divided into four groups: group 1 received 4NQO alone; group 2 received 4NQO followed by C. albicans (ATCC 90234); group 3 received vehicle dimethyl sulfoxide (DMSO) followed by C. albicans and group 4 was untreated. Although 4NQO treated mice did not develop oral lesions, mice exposed to both 4NQO and C. albicans developed oral dysplastic lesions 19 weeks after exposure to 4NQO. Mice challenged with C. albicans only developed hyperplastic lesions. The expression of Ki-67 and p16, two cell-cycle associated proteins that are frequently deregulated in oral dysplasia/neoplasia, was also tested in these lesions. Ki-67 and p16 expression increased from normal to hyperplastic to dysplastic mucosa and was highest in the group exposed to both 4NQO and C. albicans. In conclusion, we showed that C. albicans plays a role in the promotion of oral dysplasia in a mouse model of infection when 4NQO was used as initiator of oral neoplasia. PMID:18608888
Botek, Michal; McKune, Andrew J.; Klimešová, Iva
2016-01-01
Abstract This cross-sectional study compared somatic, endurance performance determinants and heart rate variability (HRV) profiles of professional soccer players divided into different age groups: GI (17–19.9 years; n = 23), GII (20–24.9 years; n = 45), GIII (25–29.9 years; n = 30), and GIV (30–39 years; n = 26). Players underwent somatic and HRV assessment and maximal exercise testing. HRV was analyzed by spectral analysis of HRV, and high (HF) and low (LF) frequency power was transformed by a natural logarithm (Ln). Players in GIV (83 ± 7 kg) were heavier (p < 0.05) compared to both GI (73 ± 6 kg), and GII (78 ± 6 kg). Significantly lower maximal oxygen uptake (VO2max, ml•kg-1•min-1) was observed for GIV (56.6 ± 3.8) compared to GI (59.6 ± 3.9), GII (59.4 ± 4.2) and GIV (59.7 ± 4.1). All agegroups, except for GII, demonstrated comparable relative maximal power output (Pmax). For supine HRV, significantly lower Ln HF (ms2) was identified in both GIII (7.1 ± 0.8) and GIV (6.9 ± 1.0) compared to GI (7.9 ± 0.6) and GII (7.7 ± 0.9). In conclusion, soccer players aged >25 years showed negligible differences in Pmax unlike the age group differences demonstrated in VO2max. A shift towards relative sympathetic dominance, particularly due to reduced vagal activity, was apparent after approximately 8 years of competing at the professional level. PMID:28031758
Knöfler, Gerhild; Friedl, Katrin; Fresmann, Sylvia; Mausberg, Rainer F; Haak, Rainer; Ziebolz, Dirk
The aim of this survey-based cross-sectional study was to analyse the oral health behaviour of dental professionals and persons without professional dental knowledge (layperson group) regarding the use and selection of tools for their personal dental hygiene. A total of 356 persons participated in the survey (dental professional group: 160; layperson group: 196). Information regarding dental hygiene habits, such as toothbrush use, toothbrushing habits, and the use of additional dental hygiene tools was determined using a standardised questionnaire. Data were analysed using the chi-squared and Wilcoxon tests, with significance set at p < 0.05. 93% of the dental professional group and 89% of layperson group used manual toothbrushes (p = 0.03). Power toothbrushes were used by 57% of those surveyed in the dental professional group and 37% of those in the layperson group (p < 0.01). In the dental professional group, the duration of toothbrushing was significantly longer and it was performed more often compared to layperson group (p < 0.001). The use of dental floss and interdental brushes in the layperson group (dental floss 38%, interdental brush 5%) was considerably lower than in the dental professional group (dental floss 84%, interdental brush 11%; p < 0.001). The results of the survey on oral health behaviour revealed significant differences between the groups. The acceptance of additional tools for personal dental hygiene was low, such as dental floss and interdental brushes. Given the great importance of these tools for biofilm control, they should be emphasised in motivational measures and instructions regarding oral care performed at home.
Physical activity, sedentary lifestyle, and obesity among Indian dental professionals.
Singh, Abhinav; Purohit, Bharathi
2012-05-01
Regular physical activity is well recognized as an important lifestyle behavior for the development and maintenance of individual and population health and well-being. This study was conducted to evaluate physical activity, sedentary lifestyle, and obesity among Indian dental health professionals. Global Physical Activity Questionnaire was used to assess physical activity among 324 dental health care professionals. Metabolic equivalents (MET) were used to express the intensity of physical activities. Obesity was recorded corresponding to Body Mass Index. Individuals were considered in high risk group to develop obesity if energy expenditure was < 600 MET min/week. Total physical activity measured in mean MET minutes per week was 625.6, 786.3, 296.5, and 296.5 for third year, final year, interns, and faculty, respectively (P ≤ .05). Obesity was observed in 22.4% of third-year students, 16.3% of final-year students, 20.4% of interns, and 40.8% of faculty members (P ≤ .001). The sedentary lifestyle of dental health care professionals is a major threat to the present and future health of the professionals by which the entire community could be prone to an epidemic of chronic disease.
Feng, Zhongxiang; Yang, Miaomiao; Ma, Changxi; Jiang, Kang; Lei, Yewei; Huang, Wenjuan; Huang, Zhipeng; Zhan, Jingjing; Zhou, Muxiong
2017-01-01
The present study examined the types of situations that caused Chinese professional and non-professional drivers to become angry and investigated the differences in driving-elicited anger, considering the influences of type A behavior pattern and trait anger between the two groups. The 20-item revised Driving Anger Scale (DAS) was used to assess a sample of 232 drivers (57% professional, 43% non-professional). The non-professional drivers reported significantly higher levels of anger than the professional drivers on the overall Driving Anger Scale (DAS) and the traffic obstructions and discourtesy subscales. In both groups, the preferred driving speeds were positively related to driving anger. Furthermore, drivers with a type A personality exhibited higher overall driving anger scores and higher anger scores in response to traffic obstructions and slow driving than drivers with a type B personality. Trait anger was significantly related to driving anger in both groups. In the non-professional group, type A behavior patterns (TABPs) and time hurry (TH) were positively correlated with anger evoked by slow driving. In the professional group, TABPs, TH and competitive hostility (CH) were positively related to driving anger, and the TABPs exerted an indirect effect on driving anger by mediating the influence of trait anger. Overall, these findings provide a theoretical basis for implementing targeted interventions for driving anger in both professional and non-professional drivers. PMID:29253004
de Luis, Daniel; Aller, Rocio; Izaola, Olatz; Conde, Rosa; de la Fuente, Beatriz; Gonzalez Sagrado, Manuel
2013-01-01
The C385A polymorphism of FAAH gene (rs324420C>A) has been associated with obesity. We investigate the role of this polymorphism on anthropometric and metabolic responses after an enriched monounsaturated fat hypocaloric diet. A sample of 95 obese individuals was analyzed at baseline and after 3 months of an enriched monounsaturated fat hypocaloric diet. Sixty two patients (65.3%) had the genotype C385C and 33 (34.7%) patients had C385A genotype (30 patients, 31.6%) or A358A (3 patients, 3.2%) (A carriers group). In subjects with C385C genotype, insulin (-1.9±5.3 mUI/l) and HOMA-R (-0.48±0.75 U) decreased. In A carriers subjects, the decreases in weight were 3.7±3.4 kg (decrease in C385C genotype group 4.4±3.6 kg), fat mass 2.7±3.2 kg (decrease in C385C genotype group 3.4±3.2 kg) and waist circumference 3.1±3.4cm (decrease in C385 genotype group 4.4±4.6 cm). These changes were significantly higher in the C385C genotype group than the A carriers subjects. After weight loss, noncarriers of the allele A385 of FAAH had an improvement on insulin and HOMA-R levels with an enriched monounsaturated fat hypocaloric diet. A better response of weight, fat mass and waist circumference was observed in C385 genotype subjects than A carriers participants. Copyright © 2013 Elsevier Inc. All rights reserved.
Zoffmann, V; Vistisen, D; Due-Christensen, M
2015-09-01
To report results from an 18-month randomized controlled trial (RCT) testing the effectiveness of a flexible guided self-determination (GSD) intervention on glycaemic control and psychosocial distress in younger adults with poorly controlled Type 1 diabetes. Between January 2010 and February 2012, we randomly allocated two hundred 18-35-year-olds [mean age 25.7 (5.1) years, 50% men] with Type 1 diabetes for ≥ 1 year [mean duration 13.7 (6.8) years] and HbA1c ≥ 64 mmol/mol (8.0%) to either an immediate GSD (intervention; n = 134) or 18-months delayed GSD group (control; n = 66). Group-based or individual GSD sessions were offered, drawing on reflection sheets and advanced professional communication. The primary outcome was HbA1c (measured at baseline and every three months thereafter) and among secondary outcomes was psychosocial distress (self-reported at baseline and after nine and 18 months). Intention-to-treat analyses included linear regression and repeated measurement analyses. A borderline significant decrease in HbA1c in the intervention group compared with the control group ( - 4 vs - 1 mmol/mol or - 0.4% vs - 0.1%; P = 0.073) was driven by a significantly greater reduction in the GSD women ( - 5 vs + 1 mmol/mol or - 0.5% vs + 0.1%; P = 0.017); parallel decreases were observed in the GSD and control men ( - 3 mmol/mol or - 0.3%; P = 0.955). Significantly greater reduction in the GSD group's psychosocial distress was again driven by differences between the GSD and the control women. The men's improvements were not connected with the intervention. The flexible GSD intervention benefitted younger adult women by significantly improving glycaemic control and decreasing diabetes related distress. No effect was seen among men. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.
Kantsone, Ieva; Lucenko, Irina; Perevoscikovs, Jurijs
2016-12-01
In 1994, the World Health Organization (WHO) declared the goal of eliminating diphtheria within the WHO European Region by the year 2000. However, in 1990 an epidemic emerged within the Russian Federation and spread to other countries, including Latvia, by 1994. We describe national surveillance and immunisation coverage data in Latvia from 1994 to 2014 and present historical data from 1946. We defined a laboratory-confirmed case as a clinical case in which toxin-producing Corynebacterium diphtheriae, C. ulcerans or C. pseudotuberculosis was isolated. From 1994 to 2014, 1,515 cases were reported, giving an average annual incidence of 3.2 cases per 100,000 inhabitants (range 0.1-14.8), with the highest incidence in age groups 5-19 and 40-49 years (4.4 and 4.3/100,000, respectively); 111 deaths were reported, 83.8% cases were laboratory-confirmed. Most cases occurred in unvaccinated adults. To improve disease control a supplementary immunisation campaign for adults was initiated in 1995, and by the end of 1998 national coverage among adults reached 70%, and reached 77% in 2003, but declined to 59% by 2014. Diphtheria remains a problem in Latvia with continued circulation of toxin-producing strains of C. diphtheriae. We recommend to strengthen immunisation to cover adults, as well as the education of health professionals and a serological survey. This article is copyright of The Authors, 2016.
Combination effect naringin and pravastatin in lipid profile and glucose in obese rats.
Raffoul-Orozco, Abdel K; Ávila-González, Ana E; Rodríguez-Razón, Christian M; García-Cobian, Teresa A; Pérez-Guerrero, Edsaul E; García-Iglesias, Trinidad; Rubio-Arellano, Edy David
2018-01-15
The purpose of this study was to compare the effect of naringin 100mg/kg in combination with pravastatin 10mg/kg by gavage for 6weeks compared with monotherapy over lipid profiles, glucose levels and weight in murine model of obesity. The study design was planned with 5 groups of 6 male Wistar Albina rats: Group 1: control with balanced food and vehicle (C-); Group 2: control with Obesity and vehicle (C+); Group 3: Obesity+naringin (N); Group 4: Obesity+pravastatin (P); Group 5: Obesity+pravastatin+naringin (NP). Obesity was developed with a food model. The naringin groups showed a decrease in weight gain and low glucose values compared to the control group (weight NP:311.4 vs C+:348.6; glucose NP: 173.12 vs C+:235.56) (p<0.05); the group with naringin+pravastatin combination showed the total cholesterol (TC), LDL and triglycerides (TGs) to normal levels (TC NP:51.6 vs C+:83.4; LDL NP:9.32 vs C+:32.32; TGs NP:39.4 vs C+:89.4) (p<0.05); but was not statistically significant compared with monotherapy. The combination of naringin and pravastatin did not appear to be better than monotherapy on lipids, but its use could generate euglycemic and antiobesogenic effects, in addition to diminishing the adverse hepatic effects of pravastatin in rats. Copyright © 2017 Elsevier Inc. All rights reserved.
A qualitative study of uptake of free vitamins in England
Jessiman, Tricia; Cameron, Ailsa; Wiggins, Meg; Lucas, Patricia J
2013-01-01
Objective To identify reasons why eligible families are not accessing free ‘Healthy Start’ vitamin supplementation (providing vitamins A, C and D) in England. Design Qualitative study using in-depth interviews. Setting 13 primary care trusts in England. Participants Purposive sample of 15 Healthy Start coordinators, 50 frontline health and children's professionals and 107 parents. Results Vitamin take-up was low across all research sites, reported as below 10% of eligible beneficiaries for free vitamins. Reasons identified by both parents and professionals included (1) poor accessibility of vitamins, (2) low promotion of the scheme by health professionals, (3) a lack of awareness among eligible families, and (4) low motivation among mothers to take vitamins for themselves during pregnancy or for children under 4 years old. Conclusions Low uptake rates can be explained by poor accessibility of vitamins and lack of awareness and motivation to take vitamin supplements among eligible families. Universal provision (at least for pregnant women) and better training for health professionals are identified as potential solutions worthy of further research and evaluation. PMID:23702436
Beyond one-size-fits-all: Tailoring diversity approaches to the representation of social groups.
Apfelbaum, Evan P; Stephens, Nicole M; Reagans, Ray E
2016-10-01
When and why do organizational diversity approaches that highlight the importance of social group differences (vs. equality) help stigmatized groups succeed? We theorize that social group members' numerical representation in an organization, compared with the majority group, influences concerns about their distinctiveness, and consequently, whether diversity approaches are effective. We combine laboratory and field methods to evaluate this theory in a professional setting, in which White women are moderately represented and Black individuals are represented in very small numbers. We expect that focusing on differences (vs. equality) will lead to greater performance and persistence among White women, yet less among Black individuals. First, we demonstrate that Black individuals report greater representation-based concerns than White women (Study 1). Next, we observe that tailoring diversity approaches to these concerns yields greater performance and persistence (Studies 2 and 3). We then manipulate social groups' perceived representation and find that highlighting differences (vs. equality) is more effective when groups' representation is moderate, but less effective when groups' representation is very low (Study 4). Finally, we content-code the diversity statements of 151 major U.S. law firms and find that firms that emphasize differences have lower attrition rates among White women, whereas firms that emphasize equality have lower attrition rates among racial minorities (Study 5). (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Kurakawa, Takuto; Miyamoto, Hiroshi; Kaneyama, Shuichi; Sumi, Masatoshi; Uno, Koki
2016-07-01
It has been reported that the incidence of post-operative segmental nerve palsy, such as C5 palsy, is higher in posterior reconstruction surgery than in conventional laminoplasty. Correction of kyphosis may be related to such a complication. The aim of this study was to elucidate the risk factors of the incidence of post-operative C5 palsy, and the critical range of sagittal realignment in posterior instrumentation surgery. Eighty-eight patients (mean age 64.0 years) were involved. The types of the disease were; 33 spondylosis with kyphosis, 27 rheumatoid arthritis, 17 athetoid cerebral palsy and 11 others. The patients were divided into two groups; Group P: patients with post-operative C5 palsy, and Group NP: patients without C5 palsy. The correction angle of kyphosis, and pre-operative diameter of C4/5 foramen on CT were evaluated between the two groups. Multivariate logistic regression analysis was used to determine the critical range of realignment and the risk factors affecting the incidence of post-operative C5 palsy. Seventeen (19.3 %) of the 88 patients developed C5 palsy. The correction angle of kyphosis in Group P (15.7°) was significantly larger than that in Group NP (4.5°). In Group P, pre-operative diameters of intervertebral foramen at C4/5 (3.2 mm) were significantly smaller than those in Group NP (4.1 mm). The multivariate analysis demonstrated that the risk factors were the correction angle and pre-operative diameter of the C4/5 intervertebral foramen. The logistic regression model showed a correction angle exceeding 20° was critical for developing the palsy when C4/5 foraminal diameter reaches 4.1 mm, and there is a higher risk when the C4/5 foraminal diameter is less than 2.7 mm regardless of any correction. This study has indicated the risk factors of post-operative C5 palsy and the critical range of realignment of the cervical spine after posterior instrumented surgery.
Viana, Ricardo B.; Gentil, Paulo; Lorenço, Vinício S.; Vieira, Carlos A.; Campos, Mário H.; Santos, Douglas A.T.; Silva, Wellington F.; Andrade, Marilia S.; Vancini, Rodrigo L.
2018-01-01
Background It is possible that physical education professionals, especially those who participate in aerobic activities, have predisposing factors, signs and symptoms of overreaching (OVR) and overtraining (OVT) due to a high load and volume of exercise followed by suboptimal recovery time. The present study aimed to identify the predisposing factors, signs and symptoms of OVR and OVT in physical education professionals. Methods A questionnaire consisting of 42 questions (10 questions group) about predisposing factors and signs/symptoms was answered by 132 physical education professionals from both sexes (83 men and 49 women) who were allocated into a resistance training group (RG, n = 74), aerobic training group (AG, n = 20) and resistance and aerobic training group (RAG, n = 38). A mean score was calculated ranging from 1 (completely absent) to 5 (severe) for each question group. A low occurrence of predisposing factors and signs and symptoms of OVR and OVT was considered to be a question group score 4 or lower. Profile of Mood State Questionnaire (POMS) was also applied. Results A mean score of 2.5 ± 0.7, 2.7 ± 0.7 and 2.7 ± 0.8 was found for all question groups for RG, AG and RAG, respectively. Of the total sample, 40.6% trained at least five times/week. The POMS revealed that 67.5% of the RG (n = 50), 80% of the AG (n = 16) and 60.5% of the RAG (n = 23) were classified as having no mood disorders and a standard graphic iceberg was presented. There were no statistical differences (p > 0.05) in the total mood disorders among RG (13.9 ± 24.5), AG (10.3 ± 25.1) and RAG (14.6 ± 27.9) groups. Conclusion Despite the volume of training/body working performed by the physical education professionals surveyed being greater than the recommended to achieve improvements on physical fitness, they did not show predisposing factors, signs or symptoms of OVR and OVT.
Casagrande, Johnny; Zoia, Cesare; Clerici, Giulio; Uccella, Laura; Tabano, Antonio
2016-06-01
A 29-year old midfielder playing professional soccer complains of neck and right shoulder pain without apparent cause. A cervical MR shows disc herniation between C4 and C5 compressing 5th nerve root. The patient undergoes surgical discectomy plus interbody fusion with autologous bone and plate fixation with unicortical screws. No surgical complication is observed and after four weeks of rest, the patient begins a specific rehabilitation program including Tecar Therapy sessions and manual passive physical therapy for six weeks. Two times a week he attends hydrokinesis sessions. After eight weeks the athlete can restart working directly on soccer field and after less than four months he is back on an official competition.
Gorman, Linda L; McDowell, Joan R S
2018-01-01
Nursing in Egypt faces many challenges and working conditions in health care settings are generally poor. Little is known about the needs of new nurses transitioning in Egypt. The literature focuses on the first year of practice and only a small body of research has explored the transition needs within acute care speciality settings. This paper reports on the important professional needs of new graduate nurses working in an acute cardiac setting in Egypt during the first two years of practice and differences between their perceived most important needs. The total population participated and two group interviews were conducted (n = 5; n = 6) using the nominal group technique. Needs were identified and prioritised using both rankings and ratings to attain consensus. Content analysis was conducted to produce themes and enable cross-group comparison. Rating scores were standardised for comparison within and between groups. Both groups ranked and rated items as important: 1) education, training and continued professional development; 2) professional standards; 3) supportive clinical practice environment; 4) manageable work patterns, and 5) organisational structure. It is important that health care organisations are responsive to these needs to ensure support strategies reflect the priorities of new nurses transitioning in acute care hospitals within Egypt. Copyright © 2017 Elsevier Ltd. All rights reserved.
van Dongen, Jerôme Jean Jacques; Lenzen, Stephanie Anna; van Bokhoven, Marloes Amantia; Daniëls, Ramon; van der Weijden, Trudy; Beurskens, Anna
2016-05-28
The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding interprofessional collaboration related to care plan development in primary care. A qualitative study, including four semi-structured focus group interviews (n = 4). In total, a heterogeneous group of experts (n = 16) and health care professionals (n = 15) participated. Participants discussed viewpoints, barriers, and facilitators regarding interprofessional collaboration related to care plan development. The data were analysed by means of inductive content analysis. The findings show a variety of factors influencing the interprofessional collaboration in developing a care plan. Factors can be divided into 5 key categories: (1) patient-related factors: active role, self-management, goals and wishes, membership of the team; (2) professional-related factors: individual competences, domain thinking, motivation; (3) interpersonal factors: language differences, knowing each other, trust and respect, and motivation; (4) organisational factors: structure, composition, time, shared vision, leadership and administrative support; and (5) external factors: education, culture, hierarchy, domain thinking, law and regulations, finance, technology and ICT. Improving interprofessional collaboration regarding care plan development calls for an integral approach including patient- and professional related factors, interpersonal, organisational, and external factors. Further, the leader of the team seems to play a key role in watching the patient perspective, organising and coordinating interprofessional collaborations, and guiding the team through developments. The results of this study can be used as input for developing tools and interventions targeted at executing and improving interprofessional collaboration related to care plan development.
2013-01-01
Background Female genital mutilation/cutting (FGM/C) is a harmful traditional practice with severe consequences for the health and well-being of girls and women. Health care professionals (HCPs) are therefore expected to be aware of how to identify and manage these consequences in order to ensure that those affected by the practice receive quality health care. Moreover, their integration and legitimacy within the communities allow them to play a key role in the prevention of the practice. Nevertheless, the perception of HCPs on FGM/C has been barely explored in African contexts. This study seeks to contribute to this field of knowledge by examining the knowledge, attitudes, and practices regarding FGM/C among HCPs working in rural settings in The Gambia. Methods A cross-sectional descriptive study was designed through a quantitative methodology, following a multiethnic approach. A pre-tested questionnaire with open and closed-ended questions was created. Forty medical students from the Community-based Medical Programme were trained to administer the questionnaire, face to face, at village health facilities in rural areas of The Gambia. A final sample of 468 HCPs included all nurse cadres and midwives. Results A significant proportion of Gambian HCPs working in rural areas embraced the continuation of FGM/C (42.5%), intended to subject their own daughters to it (47.2%), and reported having already performed it during their medical practice (7.6%). However, their knowledge, attitudes, and practices were shaped by sex and ethnic identity. Women showed less approval for continuation of FGM/C and higher endorsement of the proposed strategies to prevent it than men. However, it was among ethnic groups that differences were more substantial. HCPs belonging to traditionally practicing groups were more favourable to the perpetuation and medicalisation of FGM/C, suggesting that ethnicity prevails over professional identity. Conclusions These findings demonstrate an urgent need to build HCP’s capacities for FGM/C-related complications, through strategies adapted to their specific characteristics in terms of sex and ethnicity. A culturally and gender sensitive training programme might contribute to social change, promoting the abandonment of FGM/C, avoiding medicalisation, and ensuring accurate management of its health consequences. PMID:24040762
Chevannes, Mel
2002-08-01
The main aim of the study was to undertake training needs analysis among a multi-professional group for the purpose of improving care for ethnic minority patients and other service users. Evidence from the literature identifies that some of the explanations advanced for the failure of health professionals to meet the needs of ethnic minorities include lack of understanding of cultural diversities, racism, racial stereotyping, lack of knowledge, exclusivity, and ethnocentrism. While these issues have been addressed in different countries, little work has been carried out to examine these from the perspective of health professionals caring for ethnic minorities. This study is therefore an attempt to find out what health professionals know about caring for patients and other service users from minority ethnic groups and their perception of training needs in this area of work. A pre- and post-training design phase structured the qualitative approach. A purposive sample of individuals working across five health service organizations located in a multi-racial city yielded a multi-professional group of participants. Views of 22 participants were obtained by semi-structured interviews at a pretraining phase. Training needs of health professionals drew on Walklin's (1992) six stages used to structure data collection, data analysis and delivery of training. The post-training phase used questionnaires to evaluate immediate learning that based on a 4-week period of reflection and applied to practice. The questionnaires were complemented by a facilitator-lead focus group. The majority of the participants confirmed that no attention was given in their initial education to the health care needs of minority ethnic groups. Instead, participants engaged in self-initiated learning to improve their knowledge and understanding. The issue of communication was viewed with dissatisfaction and seen as affecting the sufficiency of caring for these patients. All participants rated meeting the needs of ethnic minorities as very important and believed that they had gained a better understanding of the concepts of ethnicity and race and resources available in local communities as a result of the training. They also reported changes in thinking about ethnic minorities and had started to acquire greater confidence to engage with colleagues about different cultural values and practices and the implications of these for caring. While a quarter of the participants had transferred some learning to practice, the majority were not able to bring about any change. This majority response challenged the sustainability of learning about ethnic minorities when training takes place away from the context in which professionals practise. Training embedded in clinical and nonclinical environment where patients and other service users and professionals interact is offered as a major finding.
Code of Federal Regulations, 2014 CFR
2014-07-01
... demonstrable value to the Department of Defense, and consult with professional societies and associations in organizing meetings of the societies and associations that are mutually beneficial. (c) Allow the publication... control of information generated by DoD-funded contracted fundamental research in science, technology, and...
Code of Federal Regulations, 2010 CFR
2010-07-01
... demonstrable value to the Department of Defense, and consult with professional societies and associations in organizing meetings of the societies and associations that are mutually beneficial. (c) Allow the publication... control of information generated by DoD-funded contracted fundamental research in science, technology, and...
Code of Federal Regulations, 2011 CFR
2011-07-01
... demonstrable value to the Department of Defense, and consult with professional societies and associations in organizing meetings of the societies and associations that are mutually beneficial. (c) Allow the publication... control of information generated by DoD-funded contracted fundamental research in science, technology, and...
Code of Federal Regulations, 2013 CFR
2013-07-01
... demonstrable value to the Department of Defense, and consult with professional societies and associations in organizing meetings of the societies and associations that are mutually beneficial. (c) Allow the publication... control of information generated by DoD-funded contracted fundamental research in science, technology, and...
Code of Federal Regulations, 2012 CFR
2012-07-01
... demonstrable value to the Department of Defense, and consult with professional societies and associations in organizing meetings of the societies and associations that are mutually beneficial. (c) Allow the publication... control of information generated by DoD-funded contracted fundamental research in science, technology, and...
Effect of posterior gingival smile on the perception of smile esthetics.
Rodríguez-Martínez, Alicia; Vicente-Hernández, Ascensión; Bravo-González, Luis-Alberto
2014-01-01
To evaluate and compare the influence of posterior gummy smile on the perception of smile esthetics by orthodontists, general-dentists and laypersons. A frontal photograph of a smile with normal gum exposure was chosen and manipulated digitally using Adobe Photoshop C3 to generate three further images with posterior gum exposure of 4, 6 and 8mm. These four images were assessed by the three evaluator groups: orthodontists (n=40), general-dentists (n=40) and laypersons (n=40). Both orthodontists and dentists had at least ten years professional experience and laypersons were aged between 40-50 years. The proportion of men to women was 20:20 in each group. Evaluators awarded a score to the smile esthetics of each image: 1=acceptable, 2=moderately acceptable, 3=unacceptable. Afterwards, each evaluator placed the four images in order of esthetic preference. No significant differences (p>0.05) were detected between the three evaluator groups for the photo without posterior gummy smile. The perception of smile esthetics for a the 4mm posterior gummy smile (median for orthodontists=2, general-dentists= 1, laypersons=1), the 6mm (median for orthodontists=2, general-dentists=1, laypersons=1) and the 8mm (median for orthodontists=3, general-dentists=2, laypersons=2) was significantly different between orthodontists and the other two evaluator groups (p<0.0017). The three evaluator groups coincided in placing the image with the 6mm gum exposure in first place in order of esthetic preference. Posterior gummy smile influences the perception of smile esthetics more negatively among orthodontists than the rest of the groups.
Voice quality change in future professional voice users after 9 months of voice training.
Timmermans, Bernadette; De Bodt, Marc; Wuyts, Floris; Van de Heyning, Paul
2004-01-01
Sixty-eight students of a school for audiovisual communication participated in this study. A part of them, 49 students, received voice training for 9 months (the trained group); 19 subjects received no specific voice training (the untrained group). A multidimensional test battery containing the GRBAS scale, videolaryngostroboscopy, Maximum Phonation Time (MPT), jitter, lowest intensity (IL), highest frequency (FoH), Dysphonia Severity Index (DSI) and Voice Handicap Index (VHI) was applied before and after training to evaluate training outcome. The voice training is made up of technical workshops in small groups (five to eight subjects) and vocal coaching in the ateliers. In the technical workshops, basic skills are trained (posture, breathing technique, articulation and diction), and in the ateliers, the speech and language pathologist assists the subjects in the practice of their voice work. This study revealed a significant amelioration over time for the objective measurements [Dysphonia Severity Index: from 2.3 to 4.5 ( P<0.001)] and the self-evaluation [Voice Handicap Index, from 23 to 18.4 ( P=0.016)] for the trained group only. This outcome favors the systematic introduction of voice training during the schooling of professional voice users.
Lahner, Matthias; Walter, Philipp Alexander; von Schulze Pellengahr, Christoph; Hagen, Marco; von Engelhardt, Lars Victor; Lukas, Carsten
2014-08-01
Femoroacetabular impingement (FAI) represents a novel approach to the mechanical etiology of hip osteoarthritis. The cam-type femoroacetabular impingement deformity occurs frequently in young male athletes. The aim of our study was to evaluate the prevalence of FAI in male semiprofessional soccer players using clinical examination and magnetic resonance imaging (MRI), compared to amateur soccer players. In MRI, the α angle of Nötzli is determined for quantifying FAI. According to power analysis, a total of 22 asymptomatic semiprofessional soccer players with a median of 23.3 years of age (range 18-30 years) and 22 male amateur soccer players with a median of 22.5 years of age (control group, range 18-29 years) underwent an MRI to measure the hip α angle of Nötzli. The α angle of the kicking legs of the semiprofessional group and the amateur group were analyzed. The study group was moreover evaluated by the Hip Outcome Score (HOS) and a clinical hip examination including range of motion (ROM) and impingement tests. In the semiprofessional group, 19 soccer players had a right kicking leg and 1 soccer player had a left kicking leg. 2 soccer players kicked with two feet. In the semi-professional group, the mean value of the α angle of the kicking leg (57.3 ± 8.2°) was significantly higher than in the amateur group (51.7 ± 4.8°, P = 0.008). In the semi-professional group, 15 (62.5 %) of 24 kicking legs had an increased α angle >55°, while 5 (27.3 %) kicking legs of the amateur group had an α angle >55°. Five semi professional soccer players had findings in clinical examination, whereof 4 had an increased α angle >55°. No participant of the amateur group showed pathological results in the clinical examination (P = 0.0484). Overall, semiprofessional soccer players had a higher proportion of an increased α angle than the amateur group. Semiprofessional players have a higher prevalence of an increased α angle in the kicking leg than the amateur group at the same age. The kicking leg is predisposed for FAI.
Analysis of Your Professional Liability Insurance Policy
Sadusk, Joseph F.; Hassard, Howard; Waterson, Rollen
1958-01-01
The most important lessons for the physician to learn in regard to his professional liability insurance coverage are the following: 1. The physician should carefully read his professional liability policy and should secure the educated aid of his attorney and his insurance broker, if they are conversant with this field. 2. He should particularly read the definition of coverage and carefully survey the exclusion clauses which may deny him coverage under certain circumstances. 3. If the physician is in partnership or in a group, he should be certain that he has contingent partnership coverage. 4. The physician should accept coverage only from an insurance carrier of sufficient size and stability that he can be sure his coverage will be guaranteed for “latent liability” claims as the years go along—certainly for his lifetime. 5. The insurance carrier offering the professional liability policy should be prepared to offer coverages up to at least $100,000/$300,000. 6. The physician should be assured that the insurance carrier has claims-handling personnel and legal counsel who are experienced and expert in the professional liability field and who are locally available for service. 7. The physician is best protected by a local or state group program, next best by a national group program, and last, by individual coverage. 8. The physician should look with suspicion on a cancellation clause in which his policy may be summarily cancelled on brief notice. 9. The physician should not buy professional liability insurance on the basis of price alone; adequacy of coverage and service and a good insurance company for his protection should be the deciding factors. PMID:13489519
Leadership competencies for medical education and healthcare professions: population-based study
Çitaku, Fadil; Beran, Tanya; Donnon, Tyrone; Hecker, Kent; Cawthorpe, David
2012-01-01
Objective To identify and empirically investigate the dimensions of leadership in medical education and healthcare professions. Design A population-based design with a focus group and a survey were used to identify the perceived competencies for effective leadership in medical education. Setting The focus group, consisting of five experts from three countries (Austria n=1; Germany n=2; Switzerland n=2), was conducted (all masters of medical education), and the survey was sent to health professionals from medical schools and teaching hospitals in six countries (Austria, Canada, Germany, Switzerland, the UK and the USA). Participants The participants were educators, physicians, nurses and other health professionals who held academic positions in medical education. A total of 229 completed the survey: 135 (59.0%) women (mean age=50.3 years) and 94 (41.0%) men (mean age=51.0 years). Measures A 63-item survey measuring leadership competencies was developed and administered via electronic mail to participants. Results Exploratory principal component analyses yielded five factors accounting for 51.2% of the variance: (1) social responsibility, (2) innovation, (3) self-management, (4) task management and (5) justice orientation. There were significant differences between physicians and other health professionals on some factors (Wilk's λ=0.93, p<0.01). Social responsibility was rated higher by other health professionals (M=71.09) than by physicians (M=67.12), as was innovation (health professionals M=80.83; physicians M=76.20) and justice orientation (health professionals M=21.27; physicians M=20.46). Conclusions The results of the principal component analyses support the theoretical meaningfulness of these factors, their coherence, internal consistency and parsimony in explaining the variance of the data. Although there are some between-group differences, the competencies appear to be stable and coherent. PMID:22457482
2013-01-01
Background Implementation of evidence-based practice (EBP) is regarded as core competence to improve healthcare quality. In the current study, we investigated the EBP of six groups of professionals: physicians, nurses, pharmacists, physical therapists, technicians, and other allied healthcare personnel. Methods A structured questionnaire survey of regional hospitals throughout Taiwan was conducted by post in 2011. Questionnaires were mailed to all healthcare workers of 11 randomly selected hospitals. Linear and logistic regression models were used to examine predictors for implementing EBP. Results In total, 6,160 returned questionnaires, including 645 from physicians, 4,206 from nurses, 430 from pharmacists, 179 from physical therapists, 537 from technicians, and 163 from other allied healthcare professionals, were valid for the analysis. Physicians and pharmacists were more aware of EBP than were the other professional groups (p < 0.001). Positive attitudes toward and beliefs in EBP were significantly lower among nurses than in the other groups (p < 0.001). Physicians had more sufficient knowledge and skills of EBP than did the other professionals (p < 0.001); in addition, they implemented EBP for clinical decision-making more often and perceived fewer personal barriers to EBP (p < 0.001). Multivariate logistic regression analyses showed that EBP implementation was associated with the following characteristics of participants: EBP training, having a faculty position, academic degree, one's profession, and perceptions (beliefs, attitudes, knowledge, skills and barriers). Conclusions This study depicts various levels of EBP implementation among medical, nursing, pharmacological, and allied healthcare personnel. There were significant differences in their implementation of EBP. We observed that certain factors were associated with EBP implementation, including personal backgrounds and perceptions toward EBP. The data suggest that strategies for enhancing EBP implementation should differ for various groups of professionals. PMID:24063756
Camp, Pat G; Reid, W Darlene; Chung, Frank; Kirkham, Ashley; Brooks, Dina; Goodridge, Donna; Marciniuk, Darcy D; Hoens, Alison M
2015-10-01
Exercise is recommended for people with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), yet there is little information to guide safe and effective mobilization and exercise for these patients. The purpose of this study was to develop a clinical decision-making tool to guide health care professionals in the assessment, prescription, monitoring, and progression of mobilization and therapeutic exercise for patients with AECOPD. A 3-round interdisciplinary Delphi panel identified and selected items based on a preselected consensus of 80%. These items were summarized in a paper-based tool titled Mobilization in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD-Mob). Focus groups and questionnaires were subsequently used to conduct a sensibility evaluation of the tool. Nine researchers, 13 clinicians, and 7 individuals with COPD identified and approved 110 parameters for safe and effective exercise in AECOPD. These parameters were grouped into 5 categories: (1) "What to Assess Prior to Mobilization," (2) "When to Consider Not Mobilizing or to Discontinue Mobilization," (3) "What to Monitor During Mobilization for Patient Safety," (4) "How to Progress Mobilization to Enhance Effectiveness," and (5) "What to Confirm Prior to Discharge." The tool was evaluated in 4 focus groups of 18 health care professionals, 90% of whom reported the tool was easy to use, was concise, and would guide a health care professional who is new to the acute care setting and working with patients with AECOPD. The tool was developed based on published evidence and expert opinion, so the applicability of the items to patients in all settings cannot be guaranteed. The Delphi panel consisted of health care professionals from Canada, so items may not be generalizable to other jurisdictions. The AECOPD-Mob provides practical and concise information on safe and effective exercise for the AECOPD population for use by the new graduate or novice acute care practitioner. © 2015 American Physical Therapy Association.
Song, Alice Tung Wan; de Mello, Evandro Sobroza; Alves, Venâncio Avancini Ferreira; Cavalheiro, Norma de Paula; Melo, Carlos Eduardo; Bonazzi, Patricia Rodrigues; Tengan, Fatima Mitiko; Freire, Maristela Pinheiro; Barone, Antonio Alci; D'Albuquerque, Luiz Augusto Carneiro; Abdala, Edson
2015-01-01
Histology is the gold standard for diagnosing acute rejection and hepatitis C recurrence after liver transplantation. However, differential diagnosis between the two can be difficult. We evaluated the role of C4d staining and quantification of hepatitis C virus (HCV) RNA levels in liver tissue. This was a retrospective study of 98 liver biopsy samples divided into four groups by histological diagnosis: acute rejection in patients undergoing liver transplant for hepatitis C (RejHCV+), HCV recurrence in patients undergoing liver transplant for hepatitis C (HCVTx+), acute rejection in patients undergoing liver transplant for reasons other than hepatitis C and chronic hepatitis C not transplanted (HCVTx-). All samples were submitted for immunohistochemical staining for C4d and HCV RNA quantification. Immunoexpression of C4d was observed in the portal vessels and was highest in the HCVTx- group. There was no difference in C4d expression between the RejHCV+ and HCVTx+ groups. However, tissue HCV RNA levels were higher in the HCVTx+ group samples than in the RejHCV+ group samples. Additionally, there was a significant correlation between tissue and serum levels of HCV RNA. The quantification of HCV RNA in liver tissue might prove to be an efficient diagnostic test for the recurrence of HCV infection. PMID:25742264
Ajjan, Ramzi A; Abougila, Kamal; Bellary, Srikanth; Collier, Andrew; Franke, Bernd; Jude, Edward B; Rayman, Gerry; Robinson, Anthony; Singh, Baldev M
2016-05-01
Lowering glucose levels, while avoiding hypoglycaemia, can be challenging in insulin-treated patients with diabetes. We evaluated the role of ambulatory glucose profile in optimising glycaemic control in this population. Insulin-treated patients with type 1 and type 2 diabetes were recruited into a prospective, multicentre, 100-day study and randomised to control (n = 28) or intervention (n = 59) groups. The intervention group used ambulatory glucose profile, generated by continuous glucose monitoring, to assess daily glucose levels, whereas the controls relied on capillary glucose testing. Patients were reviewed at days 30 and 45 by the health care professional to adjust insulin therapy. Comparing first and last 2 weeks of the study, ambulatory glucose profile-monitored type 2 diabetes patients (n = 28) showed increased time in euglycaemia (mean ± standard deviation) by 1.4 ± 3.5 h/day (p = 0.0427) associated with reduction in HbA1c from 77 ± 15 to 67 ± 13 mmol/mol (p = 0.0002) without increased hypoglycaemia. Type 1 diabetes patients (n = 25) showed reduction in hypoglycaemia from 1.4 ± 1.7 to 0.8 ± 0.8 h/day (p = 0.0472) associated with a marginal HbA1c decrease from 75 ± 10 to 72 ± 8 mmol/mol (p = 0.0508). Largely similar findings were observed comparing intervention and control groups at end of study. In conclusion, ambulatory glucose profile helps glycaemic management in insulin-treated diabetes patients by increasing time spent in euglycaemia and decreasing HbA1c in type 2 diabetes patients, while reducing hypoglycaemia in type 1 diabetes patients. © The Author(s) 2016.
Synthesis Of [2h, 13c]M [2h2m 13c], And [2h3,, 13c] Methyl Aryl Sulfones And Sulfoxides
Martinez, Rodolfo A.; Alvarez, Marc A.; Silks, III, Louis A.; Unkefer, Clifford J.; Schmidt, Jurgen G.
2004-07-20
The present invention is directed to labeled compounds, [.sup.2 H.sub.1, .sup.13 C], [.sup.2 H.sub.2, .sup.13 C] and [.sup.2 H.sub.3, .sup.13 C]methyl aryl sulfones and [.sup.2 H.sub.1, .sup.13 C], [.sup.2 H.sub.2, .sup.13 C] and [.sup.2 H.sub.3, .sup.13 C]methyl aryl sulfoxides, wherein the .sup.13 C methyl group attached to the sulfur of the sulfone or sulfoxide includes exactly one, two or three deuterium atoms and the aryl group is selected from the group consisting of 1-naphthyl, substituted 1-naphthyl, 2-naphthyl, substituted 2-naphthyl, and phenyl groups with the structure: ##STR1## wherein R.sub.1, R.sub.2, R.sub.3, R.sub.4 and R.sub.5 are each independently, hydrogen, a C.sub.1 -C.sub.4 lower alkyl, a halogen, an amino group from the group consisting of NH.sub.2, NHR and NRR' where R and R' are each a C.sub.1 -C.sub.4 lower alkyl, a phenyl, or an alkoxy group. The present invention is also directed to processes of preparing methyl aryl sulfones and methyl aryl sulfoxides.
Blood-C.S.F. barriers dysfunction in the chronic organic brain syndrome; a R.I.A. study.
Vardi, Y; Czerniak, P; Rabey, Y; Flechter, S; Boruchowsky, S; Streifler, M
1978-01-01
C.S.F. samples of 35 patients, who suffered from verified chronic, non-tumorous organic brain syndrome, were radioimmunoassayed for T4 and T.S.H., and were compared to C.S.F.-R.I.A. samples from a control group of patients who underwent myelography because of lumbar disc. In addition T4 and T.S.H. plasma levels were evaluated in the O.B.S. patients. C.S.F. T4 and T.S.H. levels were significantly higher in 65% of the O.B.S. group of patients than those of the control group. The average determinations for T4 were: 0.77 muh/100 ml in O.B.S. group as against 0--0.4 micrograms/100 ml in the C.S.F.'s of the control group. P greater than 0,001 T.S.H. C.S.F. levels were 1.33 microU/ml in the O.B.S. group, and 0--0.6 microU/ml in the control group (P greater than 0.005). It is suggested that the elevated R.I.A. values of these hormones in the C.S.F. of the O.B.S. patients reflect a disruption of blood-C.S.F. barriers. Therefore in the organic brain syndrome there seems to exist a pathophysiological dysfunction of brain barriers in addition of the neural damage.
A blended-learning programme regarding professional ethics in physiotherapy students.
Aguilar-Rodríguez, Marta; Marques-Sule, Elena; Serra-Añó, Pilar; Espí-López, Gemma Victoria; Dueñas-Moscardó, Lirios; Pérez-Alenda, Sofía
2018-01-01
In the university context, assessing students' attitude, knowledge and opinions when applying an innovative methodological approach to teach professional ethics becomes fundamental to know if the used approach is enough motivating for students. To assess the effect of a blended-learning model, based on professional ethics and related to clinical practices, on physiotherapy students' attitude, knowledge and opinions towards learning professional ethics. Research design and participants: A simple-blind clinical trial was performed (NLM identifier NCT03241693) (control group, n = 64; experimental group, n = 65). Both groups followed clinical practices for 8 months. Control group performed a public exposition of a clinical case about professional ethics. By contrast, an 8-month blended-learning programme regarding professional ethics was worked out for experimental group. An online syllabus and online activities were elaborated, while face-to-face active participation techniques were performed to discuss ethical issues. Students' attitudes, knowledge and opinions towards learning professional ethics were assessed. Ethical considerations: The study was approved by the University Ethic Committee of Human Research and followed the ethical principles according to the Declaration of Helsinki. After the programme, attitudes and knowledge towards learning professional ethics of experimental group students significantly improved, while no differences were observed in control group. Moreover, opinions reported an adequate extension of themes and temporization, importance of clinical practices and interest of topics. Case study method and role playing were considered as the most helpful techniques. The blended-learning programme proposed, based on professional ethics and related to clinical practices, improves physiotherapy students' attitudes, knowledge and opinions towards learning professional ethics.
Facebook Groups for the Management of Chronic Diseases.
Partridge, Stephanie R; Gallagher, Patrick; Freeman, Becky; Gallagher, Robyn
2018-01-17
The use of Facebook groups by health care researchers and professionals for chronic disease management, namely type 2 diabetes mellitus and coronary heart disease, is in its early stages and challenges are emerging. While Facebook groups offer great potential to deliver health support, research of Facebook groups for chronic disease management remains in its infancy, with robust evidence not yet available. Designing Facebook groups that are acceptable to users, health care researchers as well as health care professionals is a challenge, and there is a poor fit with traditional research and evaluation methods. Key recommendations for future research of Facebook groups for chronic disease management include: (1) iterative content development with input from the target patient population; (2) further understanding of the potential role of group "champions"; (3) ensuring the social media policies of health care institutions allow for real time online communication; and (4) utilizing comprehensive evaluation strategies, including the use of process evaluations. ©Stephanie R Partridge, Patrick Gallagher, Becky Freeman, Robyn Gallagher. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.01.2018.
A mixed-methods study of interprofessional learning of resuscitation skills.
Bradley, Paul; Cooper, Simon; Duncan, Fiona
2009-09-01
This study aimed to identify the effects of interprofessional resuscitation skills teaching on medical and nursing students' attitudes, leadership, team-working and performance skills. Year 2 medical and nursing students learned resuscitation skills in uniprofessional or interprofessional settings, prior to undergoing observational ratings of video-recorded leadership, teamwork and skills performance and subsequent focus group interviews. The Readiness for Interprofessional Learning Scale (RIPLS) was administered pre- and post-intervention and again 3-4 months later. There was no significant difference between interprofessional and uniprofessional teams for leadership, team dynamics or resuscitation tasks performance. Gender, previous interprofessional learning experience, professional background and previous leadership experience had no significant effect. Interview analysis showed broad support for interprofessional education (IPE) matched to clinical reality with perceived benefits for teamwork, communication and improved understanding of roles and perspectives. Concerns included inappropriate role adoption, hierarchy issues, professional identity and the timing of IPE episodes. The RIPLS subscales for professional identity and team-working increased significantly post-intervention for interprofessional groups but returned to pre-test levels by 3-4 months. However, interviews showed interprofessional groups retained a 'residual positivity' towards IPE, more so than uniprofessional groups. An intervention based on common, relevant, shared learning outcomes set in a realistic educational context can work with students who have differing levels of previous IPE and skills training experience. Qualitatively, positive attitudes outlast quantitative changes measured using the RIPLS. Further quantitative and qualitative work is required to examine other domains of learning, the timing of interventions and impact on attitudes towards IPE.
Leveraging Social Media for Pro-Am Collaborations: Support for C/2012 S1 (ISON) Observing Campaign
NASA Astrophysics Data System (ADS)
Yanamandra-Fisher, P. A.
2013-12-01
The interactions of amateur astronomers with professional astronomers have changed significantly in the digital era, from an occasional interaction of exchanging individual images to a sustained collaboration to coordinated global networks of amateur astronomers. Today, amateur astronomers, with sophisticated equipment and software, provide several valuable resources to the professional observers/astronomers: a large source of manpower, or extension of the professional astronomer's group; a vast collection of data that provides both legacy and temporal information and finally, as ambassadors of science, help build bridges between the scientific and public communities. From the professional astronomer/scientist's perspective, given the vast amounts of data acquired through various projects, the natural progression to interactive collaborations between these two communities is tremendously beneficial. The inclusion of the public in this exciting format of interactions between the professional and amateur community is the third component of synergistic science. The concept of Citizen Science, of allowing the public to perform simple visual examination of vast data sets according to a set of guidelines, is now becoming multi-dimensional, corresponding to the experience level of participants in the project. I will highlight a current project that leverages the collaboration between professional and amateur astronomers; and the use of social media to include various components of the public: Comet ISON Observing Campaign (CIOC). From the initial discovery of comet C/2012 S1 (ISON) by Russian amateur astronomers in September 2012, to the present day, amateur astronomers provide valuable resources of global coverage, data, and legacy knowledge to the professional community. The Comet ISON Observing Campaign (CIOC) goals (http://www.isoncampaign.org) are: (i) a detailed characterization of a subset of comets (sun grazers) that are usually difficult to identify and study in the few hours before their demise; and (ii) facilitate collaborations between various investigators for the best science possible. One of the tangible products is the creation of CIOC_ISON, a professional - amateur astronomer collaboration network established on Facebook, with members from the scientific, amateur, science outreach/education, public from around the globe (https://www.facebook.com/groups/cioc.ison) and a Pinterest presence (http://pinterest.com/padmayf/comet-ison/). Members, by invitation or request, provide the details of their equipment, location and observations and post their observations to both share and provide a forum for interactive discussions. Guidelines for observations and their logs are provided and updated as deemed necessary by the scientists for useful data. The long lead time between initial discovery of C/ISON in September 2012 and its perihelion in November 2013 provides a rare opportunity for the scientific and amateur astronomer communities to study a sungrazer comet on its initial (and possibly) only passage through the inner solar system. These collaborations are changing the paradigm of research.
What Experiences in Medical School Trigger Professional Identity Development?
Kay, Denise; Berry, Andrea; Coles, Nicholas A
2018-04-02
Phenomenon: This qualitative inquiry used conceptual change theory as a theoretical lens to illuminate experiences in medical school that trigger professional identity formation. According to conceptual change theory, changes in personal conceptualizations are initiated when cognitive disequilibrium is introduced. We sought to identify the experiences that trigger cognitive disequilibrium and to subsequently describe students' perceptions of self-in-profession prior to the experience; the nature of the experience; and, when applicable, the outcomes of the experience. This article summarizes findings from portions of data collected in a larger qualitative study conducted at a new medical school in the United States that utilizes diverse pedagogies and experiences to develop student knowledge, clinical skills, attitudes, and dispositions. Primary data sources included focus groups and individual interviews with students across the 4 years of the curriculum (audio data). Secondary data included students' comments from course and end-of-year evaluations for the 2013-2017 classes (text data). Data treatment tools available in robust qualitative software, NVivo 10, were utilized to expedite coding of both audio and text data. Content analysis was adopted as the analysis method for both audio and text data. We identified four experiences that triggered cognitive disequilibrium in relationship to students' perceptions of self-in-profession: (a) transition from undergraduate student to medical student, (b) clinical experiences in the preclinical years, (c) exposure to the business of medicine, and (d) exposure to physicians in clinical practice. Insights: We believe these experiences represent vulnerable periods of professional identity formation during medical school. Educators interested in purposefully shaping curriculum to encourage adaptive professional identity development during medical school may find it useful to integrate educational interventions that assist students with navigating the disequilibrium that is introduced during these periods.
Hudek-Knežević, Jasna; Kalebić Maglica, Barbara; Krapić, Nada
2011-01-01
Aim To examine to what extent personality traits (extraversion, agreeableness, conscientiousness, neuroticism, and openness), organizational stress, and attitudes toward work and interactions between personality and either organizational stress or attitudes toward work prospectively predict 3 components of burnout. Methods The study was carried out on 118 hospital nurses. Data were analyzed by a set of hierarchical regression analyses, in which personality traits, measures of organizational stress, and attitudes toward work, as well as interactions between personality and either organizational stress or attitudes toward work were included as predictors, while 3 indices of burnout were measured 4 years later as criteria variables. Results Personality traits proved to be significant but weak prospective predictors of burnout and as a group predicted only reduced professional efficacy (R2 = 0.10), with agreeableness being a single negative predictor. Organizational stress was positive, affective-normative commitment negative predictor, while continuance commitment was not related to any dimension of burnout. We found interactions between neuroticism as well as conscientiousness and organizational stress, measured as role conflict and work overload, on reduced professional efficacy (βNRCWO = -0.30; ßcRCWO = -0.26). We also found interactions between neuroticism and affective normative commitment (β = 0.24) and between openness and continuance commitment on reduced professional efficacy (β = -0.23), as well as interactions between conscientiousness and continuance commitment on exhaustion. Conclusion Although contextual variables were strong prospective predictors and personality traits weak predictors of burnout, the results suggested the importance of the interaction between personality and contextual variables in predicting burnout. PMID:21853549
Purdie-Vaughns, Valerie; Steele, Claude M; Davies, Paul G; Ditlmann, Ruth; Crosby, Jennifer Randall
2008-04-01
This research demonstrates that people at risk of devaluation based on group membership are attuned to cues that signal social identity contingencies--judgments, stereotypes, opportunities, restrictions, and treatments that are tied to one's social identity in a given setting. In 3 experiments, African American professionals were attuned to minority representation and diversity philosophy cues when they were presented as a part of workplace settings. Low minority representation cues coupled with colorblindness (as opposed to valuing diversity) led African American professionals to perceive threatening identity contingencies and to distrust the setting (Experiment 1). The authors then verified that the mechanism mediating the effect of setting cues on trust was identity contingent evaluations (Experiments 2 & 3). The power of social identity contingencies as they relate to underrepresented groups in mainstream institutions is discussed. (c) 2008 APA, all rights reserved.
Wills, Jane; Mahoney, Catherine; Hoyle, Louise; Kelly, Muireann; Atherton, Iain M
2017-01-01
Objective To estimate obesity prevalence among healthcare professionals in England and compare prevalence with those working outside of the health services. Design Cross-sectional study based on data from 5 years (2008–2012) of the nationally representative Health Survey for England. Setting England. Participants 20 103 adults aged 17–65 years indicating they were economically active at the time of survey classified into four occupational groups: nurses (n=422), other healthcare professionals (n=412), unregistered care workers (n=736) and individuals employed in non-health-related occupations (n=18 533). Outcome measure Prevalence of obesity defined as body mass index ≥30.0 with 95% CIs and weighted to reflect the population. Results Obesity prevalence was high across all occupational groups including: among nurses (25.1%, 95% CI 20.9% to 29.4%); other healthcare professionals (14.4%, 95% CI 11.0% to 17.8%); non-health-related occupations (23.5%, 95% CI 22.9% to 24.1%); and unregistered care workers who had the highest prevalence of obesity (31.9%, 95% CI 28.4% to 35.3%). A logistic regression model adjusted for sociodemographic composition and survey year indicated that, compared with nurses, the odds of being obese were significantly lower for other healthcare professionals (adjusted OR (aOR) 0.52, 95% CI 0.37 to 0.75) and higher for unregistered care workers (aOR 1.46, 95% CI 1.11 to 1.93). There was no significant difference in obesity prevalence between nurses and people working in non-health-related occupations (aOR 0.94, 95% CI 0.74 to 1.18). Conclusions High obesity prevalence among nurses and unregistered care workers is concerning as it increases the risks of musculoskeletal conditions and mental health conditions that are the main causes of sickness absence in health services. Further research is required to better understand the reasons for high obesity prevalence among healthcare professionals in England to inform interventions to support individuals to achieve and maintain a healthy weight. PMID:29203505
Neuroblastoma Treatment (PDQ®)—Health Professional Version
Neuroblastoma treatment depends on the assigned risk category (low, intermediate, high, stage 4S). Get detailed information about the genomic/biologic features, presentation, diagnosis/staging, risk groups, prognosis and treatment of newly diagnosed and recurrent neuroblastoma in this summary for clinicians.
Sleep and biological parameters in professional burnout: A psychophysiological characterization
Sauvet, Fabien; Gomez-Merino, Danielle; Boucher, Thierry; Elbaz, Maxime; Delafosse, Jean Yves; Leger, Damien; Chennaoui, Mounir
2018-01-01
Professional burnout syndrome has been described in association with insomnia and metabolic, inflammatory and immune correlates. We investigated the interest of exploring biological parameters and sleep disturbances in relation to burnout symptoms among white-collar workers. Fifty-four participants with burnout were compared to 86 healthy control participants in terms of professional rank level, sleep, job strain (Karasek questionnaire), social support, anxiety and depression (HAD scale). Fasting concentrations of glycaemia, glycosylated hemoglobin (HbA1C), total-cholesterol, triglycerides, C-reactive protein (CRP), thyroid stimulating hormone (TSH), 25-hydroxyvitamin D (25[OH]D), and white blood cell (WBC) counts were assessed. Analysis of variance and a forward Stepwise Multiple Logistic Regression were made to identify predictive factors of burnout. Besides reporting more job strain (in particular job control p = 0.02), higher levels of anxiety (p<0.001), and sleep disorders related to insomnia (OR = 21.5, 95%CI = 8.8–52.3), participants with burnout presented higher levels of HbA1C, glycaemia, CRP, lower levels of 25(OH)D, higher number of leukocytes, neutrophils and monocytes (P<0.001 for all) and higher total-cholesterol (P = 0.01). In particular, when HbA1c is > 3.5%, the prevalence of burnout increases from 16.6% to 60.0% (OR = 4.3, 95%CI = 2.8–6.9). Strong significant positive correlation existed between HbA1C and the two dimensions (emotional exhaustion and depersonalization (r = 0.79 and r = 0.71, p<0.01)) of burnout. Models including job strain, job satisfaction, anxiety and insomnia did not predict burnout (p = 0.30 and p = 0.50). However, when HbA1C levels is included, the prediction of burnout became significant (P = 0.03). Our findings demonstrated the interest of sleep and biological parameters, in particular HbA1C levels, in the characterization of professional burnout. PMID:29385150
Sleep and biological parameters in professional burnout: A psychophysiological characterization.
Metlaine, Arnaud; Sauvet, Fabien; Gomez-Merino, Danielle; Boucher, Thierry; Elbaz, Maxime; Delafosse, Jean Yves; Leger, Damien; Chennaoui, Mounir
2018-01-01
Professional burnout syndrome has been described in association with insomnia and metabolic, inflammatory and immune correlates. We investigated the interest of exploring biological parameters and sleep disturbances in relation to burnout symptoms among white-collar workers. Fifty-four participants with burnout were compared to 86 healthy control participants in terms of professional rank level, sleep, job strain (Karasek questionnaire), social support, anxiety and depression (HAD scale). Fasting concentrations of glycaemia, glycosylated hemoglobin (HbA1C), total-cholesterol, triglycerides, C-reactive protein (CRP), thyroid stimulating hormone (TSH), 25-hydroxyvitamin D (25[OH]D), and white blood cell (WBC) counts were assessed. Analysis of variance and a forward Stepwise Multiple Logistic Regression were made to identify predictive factors of burnout. Besides reporting more job strain (in particular job control p = 0.02), higher levels of anxiety (p<0.001), and sleep disorders related to insomnia (OR = 21.5, 95%CI = 8.8-52.3), participants with burnout presented higher levels of HbA1C, glycaemia, CRP, lower levels of 25(OH)D, higher number of leukocytes, neutrophils and monocytes (P<0.001 for all) and higher total-cholesterol (P = 0.01). In particular, when HbA1c is > 3.5%, the prevalence of burnout increases from 16.6% to 60.0% (OR = 4.3, 95%CI = 2.8-6.9). Strong significant positive correlation existed between HbA1C and the two dimensions (emotional exhaustion and depersonalization (r = 0.79 and r = 0.71, p<0.01)) of burnout. Models including job strain, job satisfaction, anxiety and insomnia did not predict burnout (p = 0.30 and p = 0.50). However, when HbA1C levels is included, the prediction of burnout became significant (P = 0.03). Our findings demonstrated the interest of sleep and biological parameters, in particular HbA1C levels, in the characterization of professional burnout.
Optimal target concentration of remifentanil during cataract surgery with monitored anesthesia care.
Ryu, Jung-Hee; So, Yun-mi; Hwang, Jung-Won; Do, Sang-Hwan
2010-11-01
To determine the effect-site target concentration (C(et)) of remifentanil that provides optimal conditions for patients and operators during cataract surgery during monitored anesthesia care using a target controlled infusion (TCI) of propofol and remifentanil. Prospective, randomized, double-blinded study. Operating room and postoperative recovery area of a university-affiliated hospital. 66 adult, ASA physical status I, II, and III patients undergoing cataract surgery. Group I received C(et) of remifentanil 0.5 ng/mL; Group 2 received C(et) of remifentanil one ng/mL; and Group 3 received C(et) of remifentanil 1.5 ng/mL. After giving TCI propofol (C(et); one μg/mL)-remifentanil, an ophthalmologist administered topical anesthesia. Intraoperative hemodynamics, pain scores, sedation scores, patient satisfaction scores, and operators' satisfaction scores regarding surgical conditions were recorded. No statistical differences in heart rate or mean blood pressure were detected among the three groups during surgery. Pain scores (Group 1: 31.9 ± 17.9 vs. Group 2: 11.8 ± 7.7 and Group 3: 11.8 ± 7.7; P < 0.05) were higher and patient satisfaction scores (Group 1: 4.7 ± 0.8 vs. Group 2: 5.4 ± 0.4 and Group 3: 5.5 ± 0.4; P < 0.05) were lower in Group 1 than Groups 2 and 3. On the other hand, surgeon satisfaction was lowest in Group 3 (Group 3: 2.9 ± 1.3 vs. Group 1: 4.7 ± 0.4 and Group 2: 4.6 ± 0.7; P < 0.05) due to ocular movement. C(et) values of remifentanil and propofol of one ng/mL and one μg/mL, respectively, appear to provide optimal conditions for patients and operators during cataract surgery using monitored anesthesia care with TCI. Copyright © 2010 Elsevier Inc. All rights reserved.
Shin, J H; Bridgewater, B M; Churchill, D G; Parkin, G
2001-10-22
The chiral monodentate phosphine PhP[(C(5)Me(4))(2)] is readily obtained by oxidation of the lithium complex Li(2)[PhP(C(5)Me(4))(2)] with I(2), which couples the two cyclopentadienyl groups to form a five-membered heterocyclic ring. The steric and electronic properties of PhP[(C(5)Me(4))(2)] have been evaluated by X-ray diffraction and IR spectroscopic studies on a variety of derivatives, including Ph[(C(5)Me(4))(2)]PE (E = S, Se), Cp*MCl(4)[P[(C(5)Me(4))(2)]Ph] (M = Mo, Ta), Ir[P[(C(5)Me(4))(2)]Ph](2)(CO)Cl, and CpFe(CO)[PhP[(C(5)Me(4))(2)
Doseyici, S; Mehmetoglu, I; Toker, A; Yerlikaya, F H; Erbay, E
2014-07-01
Obesity is a major health problem. We investigated the effects of forskolin and rolipram in the diet of animals in which obesity had been induced. We used 50 female albino Wistar rats that were assigned randomly into five groups as follows: group 1, control; group 2, high fat diet; group 3, high fat diet + forskolin; group 4, high fat diet + rolipram; and group 5, high fat diet + rolipram + forskolin. The rats were fed for 10 weeks and rolipram and forskolin were administered during last two weeks. The animals were sacrificed and blood samples were obtained. Serum cAMP, cGMP and free fatty acids (FFA) levels were measured using ELISA assays. We also measured weight gain during the 10 week period. cAMP and FFA levels of groups 3, 4 and 5 were significantly higher than those of groups 1 and 2. We found no significant differences in serum cGMP levels among the groups. The weight gain in groups 3, 4 and 5 was significantly less than for group 2. We also found that the weight gain in group 5 was significantly less than in groups 3 and 4. We found that both forskolin and rolipram stimulated lipolysis and inhibited body weight increase by increasing cAMP levels. Also, combination therapy using the two agents may be more effective in preventing diet induced obesity than either agent alone. We found also that these agents did not effect cellular cGMP levels in diet induced obesity.
On Teaching English to Speakers of Other Languages. Series I.
ERIC Educational Resources Information Center
Allen, Virginia French, Ed.
The contents of this volume, a compilation of papers read at the first conference of TESOL (Teachers of English to Speakers of Other Languages), are grouped according to general subject and authors: (1) TESOL as a Professional Field--A.H. Marckwardt, F.J. Colligan, W.F. Marquardt; (2) Reports on Special Programs--J.E. Officer, R.B. Long, M.C.…
2018-01-01
Purpose The purpose of this study was to evaluate the efficacy of the modified plaque score (MPS) for assessing the oral hygiene status of periodontitis patients. Methods A total of 116 patients were included in this study. After evaluation of the Löe and Silness gingival index (GI), Silness and Löe plaque index (PlI), O'Leary plaque control record (PCR), and MPS, patients were randomly assigned to either a conventional tooth brushing instruction (C-TBI) group (n=56) or a professional intraoral tooth brushing instruction (P-TBI) group (n=60). The MPS and clinical parameters were re-evaluated after scaling and a series of root planing. The convergent validity of MPS with the PlI and PCR was assessed. The measurement time for MPS and PCR was compared according to the proficiency of the examiner. Results After root planing, the GI, PlI, PCR, and MPS improved from their respective baseline values in both groups. Three different plaque indices including the MPS, showed significant differences between the C-TBI group and the P-TBI group after root planing. The MPS showed significant concurrence with the PCR and PlI. The mean time for PCR measurement was 2.76±0.71 times longer than that for MPS measurement after 2 weeks of training. Conclusions MPS seems to be a practical plaque scoring system compared with the PlI and PCR. These findings suggest that repetitive plaque control combined with an easily applicable plaque index (MPS) may facilitate more effective oral hygiene education and improved periodontal health. PMID:29535888
Tejiokem, Mathurin Cyrille; Warszawski, Josiane; Ateba Ndongo, Francis; Tetang Ndiang, Suzie; Ndongo, Jean Audrey; Owona, Félicité; Ngoupo, Paul Alain; Tchendjou, Patrice; Kfutwah, Anfumbom; Penda, Ida Calixte; Faye, Albert
2015-10-01
Early diagnosis of HIV is increasingly available for infants in resource-limited settings. We assessed the timing of events until combined antiretroviral therapy (cART) initiation in infants diagnosed before 7 months of age in Cameroon. The ANRS-PediaCAM cohort included HIV-infected infants followed from birth associated with prevention of mother-to-child transmission activities (group 1) or diagnosed for any other reason before 7 months of age (group 2). All infants were offered free cART early after diagnosis. Frequency and factors associated with no or delayed cART initiation, were studied using univariable and multivariable logistic regressions. Between 2007 and 2011, 210 HIV-infected infants (group 1: 69; group 2: 141) were included. Fewer group 1 (14.3%) than group 2 (59.1%) infants were symptomatic (World Health Organization stage 3 or 4). Overall, 5.7% (n = 12) died before receiving any cART. Of the remaining 198 infants, 3.0% (n = 6) were not treated. The median age at initiating cART was 4.1 months [interquartile range (IQR): 3.2-5.6]. The median time until cART initiation after HIV testing was 6.2 weeks (IQR: 4.4-9.4) in group 1 and 5.1 weeks (IQR: 2.9-9.4) in group 2. No or delayed cART, observed for 37.9% (75 of 198) of the infants, was associated with clinical site [adjusted odds ratio (aOR): 4.8; 95% confidence interval: (2.1-11.2)], late diagnosis [aOR: 2.0 (0.9-4.1)], and delayed pretherapeutic biological assessment [aOR: 3.7 (1.4-10.0)]. Although most children included were treated before age 7 months, the initiation of therapy was delayed for more than 1 in 3. The period around HIV diagnosis is critical and should be better managed to reduce delays before cART initiation.
Harland, Nicholas; Drew, Benjamin T
2013-09-01
The purpose of this study was to discover the frequency and type of use of online resources for continuing professional development displayed by physiotherapists in the UK. Therapists' skills, needs and frustrations using these resources were explored. With the relatively recent release and saturated use of the internet the potential presence of a skills gap between therapists at different stages of their career was also investigated. National online survey study. The online survey was carried out using the international online service 'Survey Monkey'. 774 physiotherapists from students to band 8c completed the survey. The online survey was advertised through Frontline, the Interactive Chartered Society of Physiotherapy, Journal of Physiotherapy Pain Association and cascade email through research and other networks. Most physiotherapists reported using the internet for professional purposes daily (40%) or 2 to 4 times a week (37%), with only 8% of respondents using it less than once a week. Overall the results suggest band 6 and 7 physiotherapists had the least skills and most frustrations when using online search engines. History and the nature of rapid technological advancement, specifically of the internet, appears to have created a generational skills gap within the largest group of the physiotherapy workforce band 6 and 7 therapists. Students, band 5 and band 8a therapists appear to most successfully use online resources and the reasons for this are explored. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Feasibility of an International Multiple Sclerosis Rehabilitation Data Repository
Bradford, Elissa Held; Baert, Ilse; Finlayson, Marcia; Feys, Peter
2018-01-01
Abstract Background: Multiple sclerosis (MS) rehabilitation evidence is limited due to methodological factors, which may be addressed by a data repository. We describe the perceived challenges of, motivators for, interest in participating in, and key features of an international MS rehabilitation data repository. Methods: A multimethod sequential investigation was performed with the results of two focus groups, using nominal group technique, and study aims informing the development of an online questionnaire. Percentage agreement and key quotations illustrated questionnaire findings. Subgroup comparisons were made between clinicians and researchers and between participants in North America and Europe. Results: Rehabilitation professionals from 25 countries participated (focus groups: n = 21; questionnaire: n = 166). The top ten challenges (C) and motivators (M) identified by the focus groups were database control/management (C); ethical/legal concerns (C); data quality (C); time, effort, and cost (C); best practice (M); uniformity (C); sustainability (C); deeper analysis (M); collaboration (M); and identifying research needs (M). Percentage agreement with questionnaire statements regarding challenges to, motivators for, interest in, and key features of a successful repository was at least 80%, 85%, 72%, and 83%, respectively, across each group of statements. Questionnaire subgroup analysis revealed a few differences (P < .05), including that clinicians more strongly identified with improving best practice as a motivator. Conclusions: Findings support clinician and researcher interest in and potential for success of an international MS rehabilitation data repository if prioritized challenges and motivators are addressed and key features are included. PMID:29507539
Bradford, Elissa Held; Baert, Ilse; Finlayson, Marcia; Feys, Peter; Wagner, Joanne
2018-01-01
Multiple sclerosis (MS) rehabilitation evidence is limited due to methodological factors, which may be addressed by a data repository. We describe the perceived challenges of, motivators for, interest in participating in, and key features of an international MS rehabilitation data repository. A multimethod sequential investigation was performed with the results of two focus groups, using nominal group technique, and study aims informing the development of an online questionnaire. Percentage agreement and key quotations illustrated questionnaire findings. Subgroup comparisons were made between clinicians and researchers and between participants in North America and Europe. Rehabilitation professionals from 25 countries participated (focus groups: n = 21; questionnaire: n = 166). The top ten challenges (C) and motivators (M) identified by the focus groups were database control/management (C); ethical/legal concerns (C); data quality (C); time, effort, and cost (C); best practice (M); uniformity (C); sustainability (C); deeper analysis (M); collaboration (M); and identifying research needs (M). Percentage agreement with questionnaire statements regarding challenges to, motivators for, interest in, and key features of a successful repository was at least 80%, 85%, 72%, and 83%, respectively, across each group of statements. Questionnaire subgroup analysis revealed a few differences (P < .05), including that clinicians more strongly identified with improving best practice as a motivator. Findings support clinician and researcher interest in and potential for success of an international MS rehabilitation data repository if prioritized challenges and motivators are addressed and key features are included.
Does a Rater's Professional Background Influence Communication Skills Assessment?
Artemiou, Elpida; Hecker, Kent G; Adams, Cindy L; Coe, Jason B
2015-01-01
There is increasing pressure in veterinary education to teach and assess communication skills, with the Objective Structured Clinical Examination (OSCE) being the most common assessment method. Previous research reveals that raters are a large source of variance in OSCEs. This study focused on examining the effect of raters' professional background as a source of variance when assessing students' communication skills. Twenty-three raters were categorized according to their professional background: clinical sciences (n=11), basic sciences (n=4), clinical communication (n=5), or hospital administrator/clinical skills technicians (n=3). Raters from each professional background were assigned to the same station and assessed the same students during two four-station OSCEs. Students were in year 2 of their pre-clinical program. Repeated-measures ANOVA results showed that OSCE scores awarded by the rater groups differed significantly: (F(matched_station_1) [2,91]=6.97, p=.002), (F(matched_station_2) [3,90]=13.95, p=.001), (F(matched_station_3) [3,90]=8.76, p=.001), and ((Fmatched_station_4) [2,91]=30.60, p=.001). A significant time effect between the two OSCEs was calculated for matched stations 1, 2, and 4, indicating improved student performances. Raters with a clinical communication skills background assigned scores that were significantly lower compared to the other rater groups. Analysis of written feedback provided by the clinical sciences raters showed that they were influenced by the students' clinical knowledge of the case and that they did not rely solely on the communication checklist items. This study shows that it is important to consider rater background both in recruitment and training programs for communication skills' assessment.
Ruffolo, Mary C; Kuhn, Mary T; Evans, Mary E
2006-01-01
Building on the respective strengths of parent-led and professional-led groups, a parent-professional team leadership model for group interventions was developed and evaluated for families of youths with emotional and behavioral problems. The model was developed based on feedback from 26 parents in focus group sessions and recommendations from mental health professionals in staff meetings. Evaluations of an implementation of the model in a support, empowerment, and education group intervention (S.E.E. group) have demonstrated the usefulness of this approach in work with families of children with behavioral and emotional problems. This article discusses the challenges of instituting the model in an S.E.E. group. It explores how parents and professionals build the team leadership model and the strengths of this approach in working with parents of youths with serious emotional disturbances.
Giménez-Pérez, Gabriel; Recasens, Assumpta; Simó, Olga; Aguas, Teresa; Suárez, Ana; Vila, Maria; Castells, Ignasi
2016-04-01
To evaluate the health-related use of Web 2.0 tools by patients with type 1 diabetes. Cross-sectional survey assessing views and usage of the Internet, Apps and Web 2.0. Number of participants: 289 (age 42.8±13.5 years; diabetes duration 18.4±12.2 years; 58.7% males; 39% with an upper secondary or higher education level). Web 2.0 usage for health purposes was low with 19.6% and 14% of Web 2.0 members (147; 50.9%) having health-related contacts and posting health comments. Health-related Apps were used by 35.4% of Smartphone owners (161; 55.7%). 75.3% patients would share information online with professionals, preferably through e-mail (78.7%) rather than Facebook (47.7%). 141 (66.5%) of those willing to share information would participate in a professional-moderated Facebook group. Web 2.0 and Apps usage for health purposes is low. The difference between the use of Web 2.0 networks and the willingness to participate in professional-moderated Web 2.0 groups points to the need of a higher implication of health professionals in promoting Web 2.0 technologies if these are to be adopted in a clinical setting. Currently, e-mail is the tool to be considered when aiming to increase online communication with patients with type 1 diabetes. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Carlsen, Benedicte
2003-01-01
Study follows a collaborative support group project between a team of health professionals and a Chronic Fatigue Syndrome patients' group. While advantageous for professionals to decide upon the aim of a joint intervention in dialogue with participants, simply asking participants what their aims are does not guarantee actual agreement. Case study…
Briones-Vozmediano, Erica; Goicolea, Isabel; Ortiz-Barreda, Gaby M; Gil-González, Diana; Vives-Cases, Carmen
2014-04-01
The aim of this study was to explore the experience of service providers in Spain regarding their daily professional encounters with battered immigrant women and their perception of this group's help-seeking process and the eventual abandonment of the same. Twenty-nine in-depth interviews and four focus group discussions were conducted with a total of 43 professionals involved in providing support to battered immigrant women. We interviewed social workers, psychologists, intercultural mediators, judges, lawyers, and public health professionals from Spain. Through qualitative content analysis, four categories emerged: (a) frustration with the victim's decision to abandon the help-seeking process, (b) ambivalent positions regarding differences between immigrant and Spanish women, (c) difficulties in the migratory process that may hinder the help-seeking process, and (d) criticisms regarding the inefficiency of existing resources. The four categories were cross-cut by an overarching theme: helping immigrant women not to abandon the help-seeking process as a chronicle of anticipated failure. The main reasons that emerged for abandoning the help-seeking process involved structural factors such as economic dependence, loss of social support after leaving their country of origin, and limited knowledge about available resources. The professionals perceived their encounters with battered immigrant women to be frustrating and unproductive because they felt that they had few resources to back them up. They felt that despite the existence of public policies targeting intimate partner violence (IPV) and immigration in Spain, the resources dedicated to tackling gender-based violence were insufficient to meet battered immigrant women's needs. Professionals should be trained both in the problem of IPV and in providing support to the immigrant population.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cheng, Chiu Tung; Chan, Man Nin; Wilson, Kevin R.
Oxygenated organic molecules are abundant in atmospheric aerosols and are transformed by oxidation reactions near the aerosol surface by gas-phase oxidants such as hydroxyl (OH) radicals. To gain better insights into how the structure of an organic molecule, particularly in the presence of hydroxyl groups, controls the heterogeneous reaction mechanisms of oxygenated organic compounds, this study investigates the OH-radical initiated oxidation of aqueous tartaric acid (C 4 H 6 O 6 ) droplets using an aerosol flow tube reactor. The molecular composition of the aerosols before and after reaction is characterized by a soft atmospheric pressure ionization source (Direct Analysismore » in Real Time) coupled with a high-resolution mass spectrometer. The aerosol mass spectra reveal that four major reaction products are formed: a single C 4 functionalization product (C 4 H 4 O 6 ) and three C 3 fragmentation products (C 3 H 4 O 4 , C 3 H 2 O 4 , and C 3 H 2 O 5 ). The C 4 functionalization product does not appear to originate from peroxy radical self-reactions but instead forms via an α-hydroxylperoxy radical produced by a hydrogen atom abstraction by OH at the tertiary carbon site. The proximity of a hydroxyl group to peroxy group enhances the unimolecular HO 2 elimination from the α-hydroxylperoxy intermediate. This alcohol-to-ketone conversion yields 2-hydroxy-3-oxosuccinic acid (C 4 H 4 O 6 ), the major reaction product. While in general, C-C bond scission reactions are expected to dominate the chemistry of organic compounds with high average carbon oxidation states (OS C ), our results show that molecular structure can play a larger role in the heterogeneous transformation of tartaric acid (OS C = 1.5). These results are also compared with two structurally related dicarboxylic acids (succinic acid and 2,3-dimethylsuccinic acid) to elucidate how the identity and location of functional groups (methyl and hydroxyl groups) alter heterogeneous reaction mechanisms.« less
van Tulder, Raphael; Laggner, Roberta; Kienbacher, Calvin; Schmid, Bernhard; Zajicek, Andreas; Haidvogel, Jochen; Sebald, Dieter; Laggner, Anton N; Herkner, Harald; Sterz, Fritz; Eisenburger, Philip
2015-04-01
In CPR, sufficient compression depth is essential. The American Heart Association ("at least 5cm", AHA-R) and the European Resuscitation Council ("at least 5cm, but not to exceed 6cm", ERC-R) recommendations differ, and both are hardly achieved. This study aims to investigate the effects of differing target depth instructions on compression depth performances of professional and lay-rescuers. 110 professional-rescuers and 110 lay-rescuers were randomized (1:1, 4 groups) to estimate the AHA-R or ERC-R on a paper sheet (given horizontal axis) using a pencil and to perform chest compressions according to AHA-R or ERC-R on a manikin. Distance estimation and compression depth were the outcome variables. Professional-rescuers estimated the distance according to AHA-R in 19/55 (34.5%) and to ERC-R in 20/55 (36.4%) cases (p=0.84). Professional-rescuers achieved correct compression depth according to AHA-R in 39/55 (70.9%) and to ERC-R in 36/55 (65.4%) cases (p=0.97). Lay-rescuers estimated the distance correctly according to AHA-R in 18/55 (32.7%) and to ERC-R in 20/55 (36.4%) cases (p=0.59). Lay-rescuers yielded correct compression depth according to AHA-R in 39/55 (70.9%) and to ERC-R in 26/55 (47.3%) cases (p=0.02). Professional and lay-rescuers have severe difficulties in correctly estimating distance on a sheet of paper. Professional-rescuers are able to yield AHA-R and ERC-R targets likewise. In lay-rescuers AHA-R was associated with significantly higher success rates. The inability to estimate distance could explain the failure to appropriately perform chest compressions. For teaching lay-rescuers, the AHA-R with no upper limit of compression depth might be preferable. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Micheel, Christine M; Anderson, Ingrid A; Lee, Patricia; Chen, Sheau-Chiann; Justiss, Katy; Giuse, Nunzia B; Ye, Fei; Kusnoor, Sheila V; Levy, Mia A
2017-07-25
Precision medicine has resulted in increasing complexity in the treatment of cancer. Web-based educational materials can help address the needs of oncology health care professionals seeking to understand up-to-date treatment strategies. This study aimed to assess learning styles of oncology health care professionals and to determine whether learning style-tailored educational materials lead to enhanced learning. In all, 21,465 oncology health care professionals were invited by email to participate in the fully automated, parallel group study. Enrollment and follow-up occurred between July 13 and September 7, 2015. Self-enrolled participants took a learning style survey and were assigned to the intervention or control arm using concealed alternating allocation. Participants in the intervention group viewed educational materials consistent with their preferences for learning (reading, listening, and/or watching); participants in the control group viewed educational materials typical of the My Cancer Genome website. Educational materials covered the topic of treatment of metastatic estrogen receptor-positive (ER+) breast cancer using cyclin-dependent kinases 4/6 (CDK4/6) inhibitors. Participant knowledge was assessed immediately before (pretest), immediately after (posttest), and 2 weeks after (follow-up test) review of the educational materials. Study statisticians were blinded to group assignment. A total of 751 participants enrolled in the study. Of these, 367 (48.9%) were allocated to the intervention arm and 384 (51.1%) were allocated to the control arm. Of those allocated to the intervention arm, 256 (69.8%) completed all assessments. Of those allocated to the control arm, 296 (77.1%) completed all assessments. An additional 12 participants were deemed ineligible and one withdrew. Of the 552 participants, 438 (79.3%) self-identified as multimodal learners. The intervention arm showed greater improvement in posttest score compared to the control group (0.4 points or 4.0% more improvement on average; P=.004) and a higher follow-up test score than the control group (0.3 points or 3.3% more improvement on average; P=.02). Although the study demonstrated more learning with learning style-tailored educational materials, the magnitude of increased learning and the largely multimodal learning styles preferred by the study participants lead us to conclude that future content-creation efforts should focus on multimodal educational materials rather than learning style-tailored content. ©Christine M Micheel, Ingrid A Anderson, Patricia Lee, Sheau-Chiann Chen, Katy Justiss, Nunzia B Giuse, Fei Ye, Sheila V Kusnoor, Mia A Levy. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 25.07.2017.
Nair, Swapna; Nair, Ramachandran Unnikrishnan
2017-01-01
Background To study phacoemulsification probe shaft/wound and corneal surface/tip temperatures in vivo during longitudinal, torsional and combined phacoemulsification modes and their relationship to machine parameters. Design This was a prospective study at Chaithanya Eye Hospital and Research Institute, Trivandrum, India (tertiary). Participants Twenty-two eyes of 22 patients were randomized into six groups depending on the grade of nuclear sclerosis (NS) and the type of ultrasound used: Group 1, torsional in NS2; Group 2, torsional in NS3; Group 3, torsional with intermittent longitudinal in NS2; Group 4, torsional with intermittent longitudinal in NS3; Group 5, longitudinal in NS2; Group 6, longitudinal in NS3. Methods Patients underwent phacoemulsification by torsional, longitudinal or combined modalities. A thermal camera was used to measure phaco probe temperatures. Main outcome measures The mean probe shaft and tip temperatures were documented for different ultrasound modalities. Results The mean shaft and tip temperatures were: Group 1, 29.22°C±0.71°C and 28.4°C±0.88°C; Group 2, 32.12°C±0.62°C and 31.88°C±0.84°C; Group 3, 30.25°C±0.71°C and 29.35°C±0.62°C; Group 4, 31.95°C±0.65°C and 32.01°C±1.31°C; Group 5, 23°C and 27.6°C and Group 6, 23°C and 29.68°C, respectively. In all groups using longitudinal ultrasound, the phaco tip surface temperatures were higher than the shaft temperatures, except in Group 3. Shaft temperatures were higher than tip temperatures in cases using torsional phaco, except in Group 4. The mean temperature difference between groups was significant only for shaft temperatures (P=0.001). On thermal imaging, for torsional phaco, the rise in temperature of the probe from shaft to tip was dependent on the amplitude of ultrasound applied (P=0.009). Conclusion The shaft temperatures were higher than over the phaco tip during torsional phacoemulsification. PMID:28184151
Alvarez, Marc A [Santa Fe, NM; Martinez, Rodolfo A [Santa Fe, NM; Unkefer, Clifford J [Los Alamos, NM
2008-01-22
The present invention is directed to labeled compounds of the formulae ##STR00001## wherein Q is selected from the group consisting of --S--, --S(.dbd.O)--, and --S(.dbd.O).sub.2--, Z is selected from the group consisting of 1-naphthyl, substituted 1-naphthyl, 2-naphthyl, substituted 2-naphthyl, and phenyl groups with the structure ##STR00002## wherein R.sub.1, R.sub.2, R.sub.3, R.sub.4 and R.sub.5 are each independently selected from the group consisting of hydrogen, a C.sub.1-C.sub.4 lower alkyl, a halogen, and an amino group selected from the group consisting of NH.sub.2, NHR and NRR' where R and R' are each independently selected from the group consisting of a C.sub.1-C.sub.4 lower alkyl, an aryl, and an alkoxy group, and X is selected from the group consisting of hydrogen, a C.sub.1-C.sub.4 lower alkyl group, and a fully-deuterated C.sub.1-C.sub.4 lower alkyl group. The present invention is also directed to a process of preparing labeled compounds, e.g., process of preparing [.sup.13C]methacrylic acid by reacting a (CH.sub.3CH.sub.2O--.sup.13C(O)--.sup.13CH.sub.2)-- aryl sulfone precursor with .sup.13CHI to form a (CH.sub.3CH.sub.2O--.sup.13C(O)--.sup.13C(.sup.13CH.sub.3).sub.2)-- aryl sulfone intermediate, and, reacting the (CH.sub.3CH.sub.2O--.sup.13C(O)--.sup.13C(.sup.13CH.sub.3).sub.2)-- aryl sulfone intermediate with sodium hydroxide, followed by acid to form [.sup.13C]methacrylic acid. The present invention is further directed to a process of preparing [.sup.2H.sub.8]methyl methacrylate by reacting a (HOOC--C(C.sup.2H.sub.3).sub.2-- aryl sulfinyl intermediate with CD.sub.3I to form a (.sup.2H.sub.3COOC--C(C.sup.2H.sub.3).sub.2)-- aryl sulfinyl intermediate, and heating the(.sup.2H.sub.3COOC--C(C.sup.2H.sub.3).sub.2)-- aryl sulfinyl intermediate at temperatures and for time sufficient to form [.sup.2H.sub.8]methyl methacrylate.
Synthesis Of [2h, 13c] And [2h3, 13c]Methyl Aryl Sulfides
Martinez, Rodolfo A.; Alvarez, Marc A.; Silks, III, Louis A.; Unkefer, Clifford J.
2004-03-30
The present invention is directed to labeled compounds, [.sup.2 H.sub.1, .sup.13 C], [.sup.2 H.sub.2, .sup.13 C] and [.sup.2 H.sub.3, .sup.13 C]methyl aryl sulfides wherein the .sup.13 C methyl group attached to the sulfur of the sulfide includes exactly one, two or three deuterium atoms and the aryl group is selected from the group consisting of 1-naphthyl, substituted 1-naphthyl, 2-naphthyl, substituted 2-naphthyl, and phenyl groups with the structure ##STR1## wherein R.sub.1, R.sub.2, R.sub.3, R.sub.4, and R.sub.5 are each independently, hydrogen, a C.sub.1 -C.sub.4 lower alkyl, a halogen, an amino group from the group consisting of NH.sub.2, NHR and NRR' where R and R' are each a C.sub.1 -C.sub.4 lower alkyl, a phenyl, or an alkoxy group. The present invention is also directed to processes of preparing [.sup.2 H.sub.1, .sup.13 C], [.sup.2 H.sub.2,.sup.13 C] and [.sup.2 H.sub.3, .sup.13 C]methyl aryl sulfides wherein the .sup.13 C methyl group attached to the sulfur of the sulfide includes exactly one, two or three deuterium atoms. The present invention is also directed to the labeled compounds of [.sup.2 H.sub.1, .sup.13 C]methyl iodide and [.sup.2 H.sub.2, .sup.13 C]methyl iodide.
Professional development themes in strength and conditioning coaches.
Tod, David A; Bond, Kath A; Lavallee, David
2012-03-01
The purpose of this study was to explore professional development themes in experienced strength and conditioning coaches. Strength and conditioning coaches (N = 15, mean age = 34.3 years, SD = 5.2 years) with 11.4 (SD = 4.9) years experience working with elite, professional, or talented athletes were interviewed about their professional development. The interviews were transcribed verbatim and content analyzed. Over time, subjects' service-delivery practices became more flexible and client driven. Their role understanding also broadened to include various dimensions, such as the need to consider various stakeholders and the value of good relationships with athletes. The subjects shifted from relying on external justification for professional decision making to their experience-based knowledge. The subjects believed athlete work experience, interactions with senior strength and conditioning coaches and other colleagues, the professional literature, and nonprofessional experiences, such as their own athletic experience and sales or managerial training, were the primary influences on their professional development. Typically, the subjects experienced anxiety about their competence, both early in their careers and when working in new contexts or with new athlete groups, but over time, they developed increased confidence. In addition, the subjects experienced reduced narcissism over time about the control they had over athletes and their competitive results. The current results provide information about the characteristics of effective strength and conditioning coaches, the ways they develop their competencies to help athletes, and the emotions they experience throughout their careers. These results may help strength and conditioning practitioners in planning and optimizing their professional development and effectiveness with athletes.
NASA Astrophysics Data System (ADS)
Minuskin, Sondra
The purpose of this study was to determine the effects of professional development on the knowledge and classroom practices of teachers of science in kindergarten through Grade 5. These teachers, trained to be generalists in the content areas, were strongly prepared in pedagogical practices, reading skills, basic language arts, and mathematics content areas. Science reform has led to more content-specific science standards that were difficult for these unprepared teachers to address without professional development. The researcher implemented a professional development program that used a collaborative model involving 8 teachers in Grade 4. The researcher conducted the professional development, assisted at times by personnel from the New Jersey State Department of Education. The new standards were learned, reinforced, and adopted. The data that were analyzed to determine the effects of the professional development came from a comparison of student achievement of the classes of 2 sets of teachers in Grade 4, one of which was the control set ( n = 8). The other was the experimental set (n = 8). The researcher administered pre- and postintervention content tests to both groups to measure teacher knowledge. In addition, the researcher reviewed lesson plans, conducted observations, and administered surveys to determine whether professional development in science impacted teacher practices in the classroom. This limited study suggested that teacher instruction did not significantly differ after professional development intervention. It also suggested that teacher content knowledge did not significantly increase due to the intervention. The researcher believes that local factors influenced the outcome and recommends a more systemic program that includes the involvement of all stakeholders.
GP and pharmacist inter-professional learning - a grounded theory study.
Cunningham, David E; Ferguson, Julie; Wakeling, Judy; Zlotos, Leon; Power, Ailsa
2016-05-01
Practice Based Small Group Learning (PBSGL) is an established learning resource for primary care clinicians in Scotland and is used by one-third of general practitioners (GPs). Scottish Government and UK professional bodies have called for GPs and pharmacists to work more closely together to improve care. To gain GPs' and pharmacists' perceptions and experiences of learning together in an inter-professional PBSGL pilot. Qualitative research methods involving established GP PBSGL groups in NHS Scotland recruiting one or two pharmacists to join them. A grounded theory method was used. GPs were interviewed in focus groups by a fellow GP, and pharmacists were interviewed individually by two researchers, neither being a GP or a pharmacist. Interviews were audio-recorded, transcribed and analysed using grounded theory methods. Data saturation was achieved and confirmed. Three themes were identified: GPs' and pharmacists' perceptions and experiences of inter-professional learning; Inter-professional relationships and team-working; Group identity and purpose of existing GP groups. Pharmacists were welcomed into GP groups and both professions valued inter-professional PBSGL learning. Participants learned from each other and both professions gained a wider perspective of the NHS and of each others' roles in the organisation. Inter-professional relationships, communication and team-working were strengthened and professionals regarded each other as peers and friends.
Tiku, Vasundhara Razdan; Jiang, Baoming; Kumar, Praveen; Aneja, Satender; Bagga, Arvind; Bhan, Maharaj Kishen; Ray, Pratima
2017-05-30
Group C Rotavirus (RVC) is an enteric pathogen responsible for acute gastroenteritis in children and adults globally. At present there are no surveillance studies on group C Rotaviruses in India and therefore their prevalence in India remains unknown. The present study aimed to evaluate group C rotavirus infection among <5 years old children hospitalized with acute gastroenteritis in New Delhi. A total of 350 fecal specimens were collected during September 2013 to November 2014 from <5 years old diarrheal patients admitted at KSCH hospital, Delhi. The samples found negative for group A rotavirus (N = 180) by Enzyme immunoassay were screened for group C rotavirus by RT-PCR with VP6, VP7 and VP4 gene specific primers. The PCR products were further sequenced (VP6, VP7, VP4) and analyzed to ascertain their origin and G and P genotypes. Six out of 180 (group A rotavirus negative) samples were found positive for group C rotavirus by VP6 gene specific RT-PCR, of which 3 were also found positive for VP7 and VP4 genes. Phylogenetic analysis of VP7 and VP4 genes of these showed them to be G4 and P[2] genotypes. Overall, the nucleotide sequence data (VP6, VP7 and VP4) revealed a close relationship with the human group C rotavirus with no evidence of animal ancestry. Interestingly, the nucleotide sequence analysis of various genes also indicated differences in their origin. While the identity matrix of VP4 gene (n = 3) showed high amino acid sequence identity (97.60 to 98.20%) with Korean strain, the VP6 gene (n = 6) showed maximum identity with Nigerian strain (96.40 to 97.60%) and VP7 gene (n = 3) with Bangladeshi and USA strains. This is true for all analyzed samples. Our study demonstrated the group C rotavirus as the cause of severe diarrhea in young children in Delhi and provides insights on the origin of group C rotavirus genes among the local strains indicating their source of transmission. Our study also highlights the need for a simple and reliable diagnostic test that can be utilized to determine the disease burden due to group C rotavirus in India.
Buder, V; Augustin, M; Schäfer, I; Welsch, G; Catala-Lehnen, P; Herberger, K
2018-05-01
The prevention, early diagnosis and treatment of onychomycosis is of great importance for professional athletes to avoid physical limitations by complications. So far, there is only little data on the prevalence of dermatomycosis in professional athletes. The aim of the study was to detect the prevalence of dermatomycosis in professional football players compared to the general population. The prospective, non-interventional, controlled study on the prevalence of dermatomycosis in professional football players was carried out on football players of a German Bundesliga team compared with a previously studied, equivalently aged German working population. A questionnaire survey, a dermatological check-up and a microbiological detection of pathogens in cases of suspicion were performed. Data of 84 football players (n = 45 in 2013; n = 39 in 2015) were compared to data of n = 8186 male employees between 17 and 35 years of age. In the group of athletes, there were findings of 60.7% onychomycosis, 36.9% of tinea pedis and 17.8% of pityriasis versicolor. In the group of the age-equivalent general German working population the findings were: onychomycosis 3.3%, tinea pedis 3.2%, pityriasis versicolor 1.4%. Our study shows a clearly higher risk for fungal diseases of the skin especially on the feet of professional football players. The results show a necessity for elucidation within prevention and the establishment of an appropriate therapy of dermatomycosis for professional football players.
ERIC Educational Resources Information Center
Cannon, Michael, Ed.
1998-01-01
The four issues of this 1998 publication on gifted and talented students address the themes of: (1) acceleration and grouping, (2) professional development, (3) core content areas, and (4) giftedness: a Texas tradition. Major articles are: "Cooperative Learning, Curriculum Access, and the Challenge of Acceleration" (Ann Robinson);…
Mazerolle, Stephanie M; Myers, Sarah L; Walker, Stacy E; Kirby, Jessica
2018-03-01
Professional commitment, or one's affinity and loyalty to a career, has become a topic of interest in athletic training. The expanding research on the topic, however, has omitted newly credentialed athletic trainers (ATs). For an impressionable group of practitioners, transitioning to clinical practice can be stressful. To explore the professional commitment of newly credentialed ATs in the secondary school setting. Secondary school. Qualitative study. A total of 31 newly credentialed ATs (6 men, 25 women; mean age = 24 ± 3 years) participated. Of these, 17 ATs (4 men, 13 women; mean age = 25 ± 4 years) were employed full time in the secondary school setting, and 14 ATs (2 men, 12 women; mean age = 23.0 ± 2.0 years) were graduate assistant students in the secondary school setting. All participants completed semistructured interviews, which focused on their experiences in the secondary school setting and transitioning into the role and setting. Transcripts were analyzed using the phenomenologic approach. Creditability was established by peer review, member checks, and researcher triangulation. Four main findings related to the professional commitment of newly credentialed ATs in the secondary school setting were identified. Work-life balance, professional relationships formed with the student-athletes, enjoyment gained from working in the secondary school setting, and professional responsibility emerged as factors facilitating commitment. Affective commitment is a primary facilitator of professional commitment. Newly credentialed ATs who enjoy their jobs and have time to engage in nonwork roles are able to maintain a positive professional commitment. Our findings align with the previous literature and help strengthen our understanding that rejuvenation and passion are important to professional commitment.
Fleming, Michael; Olsen, Dale; Stathes, Hilary; Boteler, Laura; Grossberg, Paul; Pfeifer, Judie; Schiro, Stephanie; Banning, Jane; Skochelak, Susan
2009-01-01
Background Educating physicians and other health care professionals to identify and treat patients who drink above recommended limits is an ongoing challenge. Methods An educational Randomized Control Trial (RCT) was conducted to test the ability of a stand alone training simulation to improve the clinical skills of health care professionals in alcohol screening and intervention. The “virtual reality simulation” combines video, voice recognition and non branching logic to create an interactive environment that allows trainees to encounter complex social cues and realistic interpersonal exchanges. The simulation includes 707 questions and statements and 1207 simulated patient responses. Results A sample of 102 health care professionals (10 physicians; 30 physician assistants [PAs] or nurse practitioners [NPs]; 36 medical students; 26 pharmacy, PA or NP students) were randomly assigned to no training (n=51) or a computer based virtual reality intervention (n=51). Subjects in both groups had similar pre-test standardized patient alcohol screening skill scores – 53.2 (experimental) vs. 54.4 (controls), 52.2 vs. 53.7 alcohol brief intervention skills, and 42.9 vs. 43.5 alcohol referral skills. Following repeated practice with the simulation there were significant increases in the scores of the experimental group at 6 months post-randomization compared to the control group for the screening (67.7 vs. 58.1, p<.001) and brief intervention (58.3 vs. 51.6, p<.04) scenarios. Conclusions The technology tested in this trial is the first virtual reality simulation to demonstrate an increase in the alcohol screening and brief intervention skills of health care professionals. PMID:19587253
NASA Astrophysics Data System (ADS)
Wu, Xinhe; Chen, Fengyun; Wang, Xuefei; Yu, Huogen
2018-01-01
Surface modification of g-C3N4 is one of the most effective strategies to boost its photocatalytic H2-evolution performance via promoting the interfacial catalytic reactions. In this study, an in situ one-step hydrothermal method was developed to prepare the oxygen-containing groups-modified g-C3N4 (OG/g-C3N4) by a facile and green hydrothermal treatment of bulk g-C3N4 in pure water without any additives. It was found that the hydrothermal treatment (180 °C) not only could greatly increase the specific surface area (from 2.3 to 69.8 m2 g-1), but also caused the formation of oxygen-containing groups (sbnd OH and Cdbnd O) on the OG/g-C3N4 surface, via the interlayer delamination and intralayer depolymerization of bulk g-C3N4. Photocatalytic experimental results indicated that after hydrothermal treatment, the resultant OG/g-C3N4 samples showed an obviously improved H2-evolution performance. Especially, when the hydrothermal time was 6 h, the resultant OG/g-C3N4(6 h) exhibited the highest photocatalytic activity, which was clearly higher than that of the bulk g-C3N4 by a factor of ca. 7. In addition to the higher specific surface area, the enhanced H2-evolution rate of OG/g-C3N4 photocatalysts can be mainly attributed to the formation of oxygen-containing groups, which possibly works as the effective H2-evolution active sites. Considering the facie and green synthesis method, the present work may provide a new insight for the development of highly efficient photocatalytic materials.
Crystal structures of three 3,4,5-tri-meth-oxy-benzamide-based derivatives.
Gomes, Ligia R; Low, John Nicolson; Oliveira, Catarina; Cagide, Fernando; Borges, Fernanda
2016-05-01
The crystal structures of three benzamide derivatives, viz. N-(6-hy-droxy-hex-yl)-3,4,5-tri-meth-oxy-benzamide, C16H25NO5, (1), N-(6-anilinohex-yl)-3,4,5-tri-meth-oxy-benzamide, C22H30N2O4, (2), and N-(6,6-di-eth-oxy-hex-yl)-3,4,5-tri-meth-oxy-benzamide, C20H33NO6, (3), are described. These compounds differ only in the substituent at the end of the hexyl chain and the nature of these substituents determines the differences in hydrogen bonding between the mol-ecules. In each mol-ecule, the m-meth-oxy substituents are virtually coplanar with the benzyl ring, while the p-meth-oxy substituent is almost perpendicular. The carbonyl O atom of the amide rotamer is trans related with the amidic H atom. In each structure, the benzamide N-H donor group and O acceptor atoms link the mol-ecules into C(4) chains. In 1, a terminal -OH group links the mol-ecules into a C(3) chain and the combined effect of the C(4) and C(3) chains is a ribbon made up of screw related R 2 (2)(17) rings in which the ⋯O-H⋯ chain lies in the centre of the ribbon and the tri-meth-oxy-benzyl groups forms the edges. In 2, the combination of the benzamide C(4) chain and the hydrogen bond formed by the terminal N-H group to an O atom of the 4-meth-oxy group link the mol-ecules into a chain of R 2 (2)(17) rings. In 3, the mol-ecules are linked only by C(4) chains.
Projecting the Demand for Ohio River Basin Waterway Traffic Using Correlation and Regression.
1979-01-01
of basic market conditions and trends. J Table 1: COMMODITY GROUPINGS TO BE UTILIZED FOR PROJECTING OHIO RIVER BASIN WATERWAY TRAFFIC COMMODITY GROUP...Tl-V t : p oMll0 4P o ’I -4C lC41,il0 0 C AL)-0 1 1 01 r iI *1. AC ,ar)a r -4. -1 ’- 1 AC AM M r l 4W .0 .0 U 4)C4 ACAM1 1’ L-10 LO0 0 0 C 4 -4 N c o...J0MC iel CJ4 V .. 4 qN M I:)r"V 41C , r Ai , ’A1,1- ’ k1 14 - oN - AcC 4p p.o N 0U I’-(l) A c OM t ~ ,Q w4 m z0 AC -a 4 . o- 0v - ;’ j0- I 414 4 4- 4
Sabancıogullari, Selma; Dogan, Selma
2015-12-01
The aim of this study was to evaluate the effects of the Professional Identity Development Program on the professional identity, job satisfaction and burnout levels of registered nurses. This study was conducted as a quasi-experimental one with 63 nurses working in a university hospital. Data were gathered using the Personal Information Questionnaire, the Professional Self Concept Inventory, Minnesota Job Satisfaction Inventory and the Maslach Burnout Inventory. The Professional Identity Development Program which consists of ten sessions was implemented to the study group once a week. The Program significantly improved the professional identity of the nurses in the study group compared to that of the control group. During the research period, burnout levels significantly decreased in the study group while those of the control group increased. The programme did not create any significant differences in the job satisfaction levels of the nurses. The programme had a positive impact on the professional identity of the nurses. It is recommended that the programme should be implemented in different hospitals with different samples of nurses, and that its effectiveness should be evaluated. © 2014 Wiley Publishing Asia Pty Ltd.
Turner, Gillian L; Owen, Stephanie; Watson, Paula M
2016-09-01
School entry provides an opportune moment for health professionals to intervene with children who are overweight, yet identification and management of childhood obesity presents challenges in practice. This multi-method qualitative study explored the experiences of 26 school health professionals in addressing childhood obesity at school entry. Methods included semi-structured interviews with service managers (n = 3); focus groups with school nurses (n = 12) and child health practitioners (n = 6); and open-ended questionnaires with school nurses (n = 4) and child health practitioners (n = 1) who were unable to attend the focus groups. A thematic analysis revealed agreement between service managers, school nurses and child health practitioners. Whilst it was felt school health professionals have an important role to play in managing childhood obesity, efforts to address child weight were limited by a lack of capacity, lack of clear protocols, challenges of engaging parents and insufficient training in childhood obesity and related lifestyle issues. School health policymakers need to recognize childhood obesity as a serious public health issue, allocate appropriate resources to nurse training and development and ensure clear pathways are established to ensure consistency of care. © The Author(s) 2015.
Does Game Participation Impact Cognition and Symptoms in Elite Football Players?
Mrazik, Martin; Naidu, Dhiren; Manning, David E; Brooks, Brian L
2016-09-01
To measure neurocognitive functioning in college and professional football players after game participation. Retrospective, cross-sectional cohort design. Ninety-four male university and professional football players. All participants completed Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) testing at baseline, and either at postconcussion (group 1) or postgame (group 2) participation. Results from the 5 ImPACT composite scores (Verbal Memory, Visual Memory, Visual Motor Speed, Reaction Time and Impulse Control) and Total Symptom Score. Repeated-measures analysis of variance demonstrated a significant main effect for time (improvements) in 3 of 5 domains for the postconcussion group, but no improvements in the postgame group. The postconcussion group presented with significantly improved results on 4 of 5 ImPACT domains compared with the postgame group at the follow-up time interval. Participation in a football game with potential cumulative head contacts did not yield increased symptoms or cognitive impairment. However, the absence of improvement in cognitive functioning in noninjured football players, which was found in those players who were returned to play after an injury, may suggest that there is a measureable impact as a result of playing football.
Pallaveshi, Luljeta; Balachandra, Krishna; Subramanian, Priya; Rudnick, Abraham
2014-05-01
This pilot study evaluated the experience of people with co-occurring disorders (mental illness and addiction) in relation to peer-led and professional-led group interventions. The study used a qualitative (phenomenological) approach to evaluate the experience of a convenience sample of 6 individuals with co-occurring disorders who participated in up to 8 sessions each of both peer-led and professional-led group interventions (with a similar rate of attendance in both groups). The semi-structured interview data were coded and thematically analyzed. We found 5 themes within and across the 2 interventions. In both groups, participants experienced a positive environment and personal growth, and learned, albeit different things. They were more comfortable in the peer-led group and acquired more knowledge and skills in the professional-led group. Offering both peer-led and professional-led group interventions to people with co-occurring disorders may be better than offering either alone.
Success attitudes of young ophthalmologists in the first decade of their career.
Chaves, Fernando Rodrigo Pedreira; Arieta, Carlos Eduardo Leite; Nascimento, Maurício Abujamra; Carvalho, Keila Miriam Monteiro de; Lira, Rodrigo Pessoa Cavalcanti
2012-01-01
To describe the main success attitudes of young ophthalmologists in the first decade of their career. This descriptive study comprised subjects selected from a sample of ophthalmologists who were participating in a congress, using a semi-structured questionnaire. The inclusion criteria were as follows: ophthalmologists under the age of 40 years, within 5-10 years from ophthalmology residency conclusion. The subjects were asked about the three main success attitudes in their personal experience during the first years of ophthalmology practice. After the initial results, the 10 most frequently mentioned attitudes were listed and volunteers were again interviewed to choose, within the latter list, the three main attitudes. Forty-eight ophthalmologists were interviewed, 24 (50%) were male; the mean age was 37 years (SD: 2 years, range: 33-40 years) and the mean time from ophthalmology residency conclusion was 8 years (SD: 1 year, range: 5-10 years). The frequency of such mentioned success attitudes were as follows: to invest in professional updating (22.9%), to have a good relationship with patients and professional partners (18.8%), to prioritize individual and family happiness (12.5%), initially to work in an established group (11.1%), to work in public service (9.7%), to have their own business with a homogeneous group (7.6%), to save money (7.6%), to be ready to resume work (4.2%), to get business administration skills (4.2%), and to have professional insurance (0.7%). The three main success attitudes consisted in investing in professional updating (22.9%), maintaining a good relationship with patients and professional partners (18.8%), and prioritizing individual and family happiness (12.5%). Although these results should not be generalized, they are helpful not only for those ophthalmologists at the beginning of a career but also those who want to reflect on what to prioritize in their professional practice.
The Environmental Assessment and Management (TEAM) Guide: Mississippi Supplement
2010-03-01
4 The Environmental Assessment and Management (TEAM) Guide: Mississippi Supplement C on st ru ct io n E n gi...resins manufacturing 10. pulp and paper industry 11. rubber and miscellaneous paper products 12. stone, glass, clay, and concrete products 13...contaminant risk assessment of the material. 4 . The registrant of the by-product must have the certification of a professional engineer licensed in
ERIC Educational Resources Information Center
Ruffolo, Mary C.; Kuhn, Mary T.; Evans, Mary E.
2006-01-01
Building on the respective strengths of parent-led and professional-led groups, a parent-professional team leadership model for group interventions was developed and evaluated for families of youths with emotional and behavioral problems. The model was developed based on feedback from 26 parents in focus group sessions and recommendations from…
Strategies for Improving Power in School-Randomized Studies of Professional Development
ERIC Educational Resources Information Center
Kelcey, Ben; Phelps, Geoffrey
2013-01-01
Objectives: Group-randomized designs are well suited for studies of professional development because they can accommodate programs that are delivered to intact groups (e.g., schools), the collaborative nature of professional development, and extant teacher/school assignments. Though group designs may be theoretically favorable, prior evidence has…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Afrizal,, E-mail: rizalunj04@yahoo.com; Nurdelima,; Umeir
2014-03-24
Chiral Smectic Liquid Crystal (S)-(+)-4-(2-methyl-1-butyloyloxy)phenyl 4-[1-(propenoyloxy) butiloxy] benzoate has been synthesized using method of steglich esterification at room temperature. The mesomorphic behavior of chiral smectic at 55°C that showed schlieren texture in POM analysis. Fixation of structure chiral smectic liquid crystal by means of photopolymerization of monomer (S)-(+)-4-(2-methyl-1-butyloyloxy)phenyl 4-[1-(propenoyloxy) butiloxy] benzoate under UV irradiation which called UV curing techniques. The curing process using UV 3 lamps 100 volt at 60°C for an hour. The product of photopolymerization could be seen by analysis of FTIR spectra both monomer and polymer. FTIR spectra of monomer, two peaks for ester carbonyl and C-Cmore » double bond groups appeared at 1729.09 cm-1and 3123.46 cm{sup −1}. After UV curing process, peak for the carbonyl group at 1729.09 cm{sup −1} decreased and a new peak at 1160.21 cm{sup −1} appeared due to the carbonyl group attached to a C-C bond group and then peak at 3123.46 cm{sup −1} for C-C double bond group was disappeared.« less
Ung, Carolina Oi Lam; Harnett, Joanna; Hu, Hao
2017-08-03
Traditional medicine (TM) and complementary medicine (CM) products have played an increasingly important role in the business of pharmacy for over two decades in a number of countries. With a focus on the quality use of all medicines including complementary medicines, there have been a number of initiatives to encourage the integration of TM/CM products into professional practice. Recent studies report that many of the barriers that prevent such integration remain. To explore the pharmacists' perspective regarding how barriers to the integration of TM/CM products into the professional practice of pharmacy could be resolved. Purposive sampling and snowballing were used to recruit 11 registered pharmacists who had worked in community pharmacy for a minimum of 6 months to participate in one of 3 focus groups. Focus group questions informed by previous studies, explored participants' perspectives on the actions required to support professional services related to TM/CM products. Pharmacists proposed that five key stakeholders (professional pharmacy organizations, universities, government, pharmacy owners, and pharmacists) enact 4 developments that require a collaborative effort ("education and training", "building the evidence base", "developing reliable and accessible information resources", and "workplace support for best practice"). Manufacturers of TM/CM products were not identified by pharmacists as collaborators in these developments. Collectively, the findings from this study support a strategic model to guide the integration of TM/CM products into the professional practice of pharmacy. Copyright © 2017 Elsevier Inc. All rights reserved.
Oxelmark, Lena; Nordahl Amorøe, Torben; Carlzon, Liisa; Rystedt, Hans
2017-01-01
This study explores how interprofessional simulation-based education (IPSE) can contribute to a change in students' understanding of teamwork and professional roles. A series of 1-day training sessions was arranged involving undergraduate nursing and medical students. Scenarios were designed for practicing teamwork principles and interprofessional communication skills by endorsing active participation by all team members. Four focus groups occurred 2-4 weeks after the training. Thematic analysis of the transcribed focus groups was applied, guided by questions on what changes in students' understanding of teamwork and professional roles were identified and how such changes had been achieved. The first question, aiming to identify changes in students' understanding of teamwork, resulted in three categories: realizing and embracing teamwork fundamentals, reconsidering professional roles, and achieving increased confidence. The second question, regarding how participation in IPSE could support the transformation of students' understanding of teamwork and of professional roles, embraced another three categories: feeling confident in the learning environment, embodying experiences, and obtaining an outside perspective. This study showed the potential of IPSE to transform students' understanding of others' professional roles and responsibilities. Students displayed extensive knowledge on fundamental teamwork principles and what these meant in the midst of participating in the scenarios. A critical prerequisite for the development of these new insights was to feel confident in the learning environment. The significance of how the environment was set up calls for further research on the design of IPSE in influencing role understanding and communicative skills in significant ways.
Price, Eboni G; Gozu, Aysegul; Kern, David E; Powe, Neil R; Wand, Gary S; Golden, Sherita; Cooper, Lisa A
2005-01-01
BACKGROUND Ethnic diversity among physicians may be linked to improved access and quality of care for minorities. Academic medical institutions are challenged to increase representation of ethnic minorities among health professionals. OBJECTIVES To explore the perceptions of physician faculty regarding the following: (1) the institution's cultural diversity climate and (2) facilitators and barriers to success and professional satisfaction in academic medicine within this context. DESIGN Qualitative study using focus groups and semi-structured interviews. PARTICIPANTS Nontenured physicians in the tenure track at the Johns Hopkins University School of Medicine. APPROACH Focus groups and interviews were audio-taped, transcribed verbatim, and reviewed for thematic content in a 3-stage independent review/adjudication process. RESULTS Study participants included 29 faculty representing 9 clinical departments, 4 career tracks, and 4 ethnic groups. In defining cultural diversity, faculty noted visible (race/ethnicity, foreign-born status, gender) and invisible (religion, sexual orientation) dimensions. They believe visible dimensions provoke bias and cumulative advantages or disadvantages in the workplace. Minority and foreign-born faculty report ethnicity-based disparities in recruitment and subtle manifestations of bias in the promotion process. Minority and majority faculty agree that ethnic differences in prior educational opportunities lead to disparities in exposure to career options, and qualifications for and subsequent recruitment to training programs and faculty positions. Minority faculty also describe structural barriers (poor retention efforts, lack of mentorship) that hinder their success and professional satisfaction after recruitment. To effectively manage the diversity climate, our faculty recommended 4 strategies for improving the psychological climate and structural diversity of the institution. CONCLUSIONS Soliciting input from faculty provides tangible ideas regarding interventions to improve an institution's diversity climate. PMID:16050848
Price, Eboni G; Gozu, Aysegul; Kern, David E; Powe, Neil R; Wand, Gary S; Golden, Sherita; Cooper, Lisa A
2005-07-01
Ethnic diversity among physicians may be linked to improved access and quality of care for minorities. Academic medical institutions are challenged to increase representation of ethnic minorities among health professionals. To explore the perceptions of physician faculty regarding the following: (1) the institution's cultural diversity climate and (2) facilitators and barriers to success and professional satisfaction in academic medicine within this context. Qualitative study using focus groups and semi-structured interviews. Nontenured physicians in the tenure track at the Johns Hopkins University School of Medicine. Focus groups and interviews were audio-taped, transcribed verbatim, and reviewed for thematic content in a 3-stage independent review/adjudication process. Study participants included 29 faculty representing 9 clinical departments, 4 career tracks, and 4 ethnic groups. In defining cultural diversity, faculty noted visible (race/ethnicity, foreign-born status, gender) and invisible (religion, sexual orientation) dimensions. They believe visible dimensions provoke bias and cumulative advantages or disadvantages in the workplace. Minority and foreign-born faculty report ethnicity-based disparities in recruitment and subtle manifestations of bias in the promotion process. Minority and majority faculty agree that ethnic differences in prior educational opportunities lead to disparities in exposure to career options, and qualifications for and subsequent recruitment to training programs and faculty positions. Minority faculty also describe structural barriers (poor retention efforts, lack of mentorship) that hinder their success and professional satisfaction after recruitment. To effectively manage the diversity climate, our faculty recommended 4 strategies for improving the psychological climate and structural diversity of the institution. Soliciting input from faculty provides tangible ideas regarding interventions to improve an institution's diversity climate.
Critical Care Nurses' Reasons for Poor Attendance at a Continuous Professional Development Program.
Viljoen, Myra; Coetzee, Isabel; Heyns, Tanya
2016-12-01
Society demands competent and safe health care, which obligates professionals to deliver quality patient care using current knowledge and skills. Participation in continuous professional development programs is a way to ensure quality nursing care. Despite the importance of continuous professional development, however, critical care nurse practitioners' attendance rates at these programs is low. To explore critical care nurses' reasons for their unsatisfactory attendance at a continuous professional development program. A nominal group technique was used as a consensus method to involve the critical care nurses and provide them the opportunity to reflect on their experiences and challenges related to the current continuous professional development program for the critical care units. Participants were 14 critical care nurses from 3 critical care units in 1 private hospital. The consensus was that the central theme relating to the unsatisfactory attendance at the continuous professional development program was attitude. In order of importance, the 4 contributing priorities influencing attitude were communication, continuous professional development, time constraints, and financial implications. Attitude relating to attending a continuous professional development program can be changed if critical care nurses are aware of the program's importance and are involved in the planning and implementation of a program that focuses on the nurses' individual learning needs. ©2016 American Association of Critical-Care Nurses.
Rothes, Inês Areal; Henriques, Margarida Rangel
2017-12-01
In a help relation with a suicidal person, the theoretical models of suicidality can be essential to guide the health professional's comprehension of the client/patient. The objectives of this study were to identify health professionals' explanations of suicidal behaviors and to study the effects of professional group, theoretical intervention models, and patient suicide experience in professionals' representations. Two hundred and forty-two health professionals filled out a self-report questionnaire. Exploratory principal components analysis was used. Five explanatory models were identified: psychological suffering, affective cognitive, sociocommunicational, adverse life events, and psychopathological. Results indicated that the psychological suffering and psychopathological models were the most valued by the professionals, while the sociocommunicational was seen as the least likely to explain suicidal behavior. Differences between professional groups were found. We concluded that training and reflection on theoretical models in general and in communicative issues in particular are needed in the education of health professionals.
NASA Astrophysics Data System (ADS)
Rakshit, Subhadeep; Sanyal, Prasanta; Vardhan Gaur, Harsh
2015-04-01
Soil organic carbon, one of the largest reservoirs of carbon, is a heterogeneous mixture of organic compounds with dominant contribution derived from decomposition of plants in various stages. Although general ideas about the processes and mechanisms of soil organic matter (SOM) degradation have been developed, a very few study has linked the SOM with its parent material. In this study we aim to generate reference data set of functional groups from modern vegetation samples (C3 and C4plants) to better understand the degradation dynamics and preferences. The carbon functional groups from modern vegetation samples (eight C3 and nine C4 plants collected from Mohanpur, Nadia, West Bengal, India) were examined by solid state 13C CPMAS NMR spectroscopy. Additionally, isotopic investigations (δ13C) has also been carried out on the modern vegetation samples to understand the relationship of bulk isotopic values to the concentration of functional groups. The major functional groups (alkyl C, O-alkyl C, aromatic C, carbonyl C and aldehyde/ketone) of modern vegetation samples form 16%, 65%, 5%, 14% and 1% respectively in C3 plants. Considerable differences has been observed for C4 plants with average values of alkyl C, O-alkyl C, aromatic C, carbonyl C and aldehyde/ketone are 8%, 83%, 3%, 5% and 1% respectively. The concentration of functional groups from the modern vegetational samples can be considered as reference scale to compare with the 13C NMR data derived from the different soil horizons to understand the SOM degradation dynamics. The δ13CV PDB values of modern vegetation samples plotted against the individual concentration of functional groups shows significant correlation in C4 plants, whereas a lack in correlation has been observed for C3 plants. We assume this difference in relationship of δ13CV PDB values with functional groups of C3 and C4plants can be due to the differences in photosynthesis pathways, the fractionation of CO2 and accumulation of the products during various stages of photosynthesis. A more detailed investigation is warranted to understand the governing mechanism behind this observation.
Homer, L; Launay, E; Joram, N; Jacqueline, C; Jarreau, P-H; Caillon, J; Moyon, T; Branger, B; Potel, G; Roze, J C; Méhats, C; Gras-Leguen, C
2012-03-01
Chorioamnionitis is implicated in the pathophysiology of bronchopulmonary disease, and the associated inflammatory response is responsible for adverse effects on alveolar development. The aim of this work was to analyze the effects of a phosphodiesterase 4 (PDE4)-selective inhibitor, rolipram (a modulator of the inflammatory response), in an experimental model of chorioamnionitis on pulmonary development and on the processes of infection and inflammation. Rabbit mothers were assigned to four groups: 1) saline serum inoculation (controls); 2) Escherichia coli intrauterine inoculation (C+); 3) rolipram infusion (R+); and 4) E. coli inoculation + rolipram infusion (C+R+). High rates of morbility and mortality were noticed in mothers and pups (5 of 13 pregnant rabbits in groups with rolipram). Alveolar development, inflammation, and infection were analyzed in pups at day 0 and day 5. At day 0, in the context of chorioamnionitis, rolipram significantly decreased birth weight (p < 0.01) relative to that of controls (p < 0.05). At day 5, weight normalized in group C+R+ but not in group C+ relative to controls (p < 0.001); moreover, alveolar airspace volume was preserved in group C+R+ but not in group C+ (p < 0.05). Interstitial volume decreased in group C+ versus controls (p < 0.05) but was preserved in group C+R+. Specific alveolar area was not significantly modified by rolipram. No significant difference was found concerning bronchoalveolar lavage cellularity, and all blood cultures remained sterile. In this model of impaired alveologenesis, rolipram significantly preserved specific alveolar density. However, PDE4 inhibition induced antenatal fetal demise and growth retardation.
Brambila-Tapia, Aniel Jessica Leticia; Rios-Gonzalez, Blanca Estela; Lopez-Barragan, Liliana; Saldaña-Cruz, Ana Miriam; Rodriguez-Vazquez, Katya
2016-01-01
The use of complementary and alternative medicine (CAM) has increased in many countries, and this has altered the knowledge, attitudes, and treatment recommendations of health professionals in regard to CAM. Considering Mexican health professionals׳ lack of knowledge of CAM, in this report we surveyed 100 biomedical researchers and Ph.D. students and 107 specialized physicians and residents of a medical specialty in Guadalajara, México (Western Mexico) with a questionnaire to address their attitudes, knowledge, use, and recommendation of CAM. We observed that significantly more researchers had ever used CAM than physicians (83% vs. 69.2%, P = .023) and that only 36.4% of physicians had ever recommended CAM. Female researchers tended to have ever used CAM more than male researchers, but CAM use did not differ between genders in the physician group or by age in either group. Homeopathy, herbal medicine, and massage therapy were the most commonly used CAMs in both the groups. Physicians more frequently recommended homeopathy, massage therapy, and yoga to their patients than other forms of CAM, and physicians had the highest perception of safety and had taken the most courses in homeopathy. All CAMs were perceived to have high efficacy (>60%) in both the groups. The attitude questionnaire reported favorable attitudes toward CAM in both the groups. We observed a high rate of Mexican health professionals that had ever used CAM, and they had mainly used homeopathy, massage therapy, and herbal medicine. However, the recommendation rate of CAM by Mexican physicians was significantly lower than that in other countries, which is probably due to the lack of CAM training in most Mexican medical schools. Copyright © 2016 Elsevier Inc. All rights reserved.
Flentje, Markus; Müßel, Thomas; Henzel, Bettina; Jantzen, Jan-Peter
2016-01-01
Physicians and nursing staff interact as a team on a daily basis in hospital settings. However, both educational paths offer few opportunities to establish contact with the other professional group. Neither professional group can practice its later role with the other group in a "safe" learning environment. Routine interprofessional collaboration is described as being in need of great improvement and carries with it the potential for conflict. To improve interprofessional communication and task management, a simulation-based emergency training session for nursing students and fifth-year medical students was developed at the KRH Klinikum Nordstadt in Hanover, Germany. As a pilot project, the course was held twice in the form of a one-day session with ten nursing and four medical students. Using the example of a patient's fall, course participants were able to observe and actively treat multiple simulated patients. Following each simulation the trainer conducted a comprehensive debriefing. The course was then evaluated using a questionnaire. The evaluation of the team training showed a high level of acceptance among the two participating professional groups. On a scale of 1 (hardly applicable) to 5 (strongly applicable), the course was given a 4 by both professional groups for its relevance to daily work. In the open-ended written responses praise was specifically given for the opportunity to learn how to switch perspectives as a result of the simulation exercises. A common emergency on the hospital ward offers a good opportunity to establish and practice interprofessional team skills. With the knowledge gained about communication and the ability to change viewpoints, participants are able to improve their team skills. Participants demonstrated a high degree of acceptance for the training program.
Douglas, Elliot P.; Langlois, David A.; Benicewicz, Brian C.
1995-01-01
The present invention provides (1) curable bispropargyl-containing monomers represented by the formula: B.sup.1 --A.sup.1.sub.m --R--A.sup.2.sub.n --B.sup.2 wherein R is a radical selected from the group consisting of 1,4-phenylene, 4,4'-biphenyl, 2,6-naphthalene, --C.sub.6 H.sub.4 --CR.sup.2 .dbd.CR.sup.2 --C.sub.6 H.sub.4 -- wherein R.sup.2 is H or CH.sub.3, and the same where said groups contain one or more substituents selected from the group consisting of halo, nitro, lower alkyl, lower alkoxy, fluoroalkyl or fluoroalkoxy, A.sup.1 and A.sup.2 are selected from the group consisting of --C.sub.6 H.sub.4 --C(O)--O-- and --C.sub.6 H.sub.4 --O--C(O)--, m and n are 0 or 1, m+n is 0, 1 or 2, and B.sup.1 and B.sup.2 are --OCH.sub.2 --C.tbd.C--H, (2) thermoset compositions comprised of cured segments derived from monomers represented by the formula: B.sup.1 --A.sup.1.sub.m --R--A.sup.2.sub.n --B.sup.2 as described above, and (3) curable blends of at least two of the monomers.
Kenny, Belinda; Lincoln, Michelle; Balandin, Susan
2010-05-01
To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual narrative transcriptions were analyzed by using the participant's words to develop an ethical story that described and interpreted their responses to dilemmas. Key concepts from individual stories were then coded into group themes to reflect participants' reasoning processes. Five major themes reflected participants' approaches to ethical reasoning: (a) focusing on the well-being of the client, (b) fulfilling professional roles and responsibilities, (c) attending to professional relationships, (d) managing resources, and (e) integrating personal and professional values. SLPs demonstrated a range of ethical reasoning processes: applying bioethical principles, casuistry, and narrative reasoning when managing ethical dilemmas in the workplace. The results indicate that experienced SLPs adopted an integrated approach to ethical reasoning. They supported clients' rights to make health care choices. Bioethical principles, casuistry, and narrative reasoning provided useful frameworks for facilitating health professionals' application of codes of ethics to complex professional practice issues.
Scrum injury risk in English professional rugby union.
Taylor, Aileen E; Kemp, Simon; Trewartha, Grant; Stokes, Keith A
2014-07-01
To assess and evaluate the injury risk associated with the scrum in English professional rugby union in the 2011-2012 season. Prospective, cohort. Players at English Premiership rugby union clubs. Frequency of team scrum-events per match; incidence (injuries per 1000 player-hours; propensity (injuries/1000 events); risk (days absence per 1000 player-hours and days absence per 1000 events). 31% of scrums in competitive matches resulted in collapse. Injury incidence associated with collapsed scrum-events (incidence: 8.6 injuries/1000 scrum-events) was significantly higher than those scrums that did not collapse (incidence: 4.1/1000 scrum-events). The injury risk associated with collapsed scrum supports the continued focus on reducing scrum collapse through changes in, and strict application of, the laws surrounding the scrum. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Chapman, A G; Talebi, A; Yip, P K; Meldrum, B S
2001-07-20
The metabotropic Group III agonist, (1S,3R,4S)-1-aminocyclopentane-1,2,4-tricarboxylic acid (ACPT-1), selective for the mGlu(4alpha) receptor, suppresses sound-induced seizures in DBA/2 mice following its intracerebroventricular (i.c.v.) administration (ED(50) 5.6 [2.9-10.7], nmol i.c.v., 15 min, clonic phase) and in genetically epilepsy-prone (GEP) rats following focal administration into the inferior colliculus (ED(50) 0.08 [0.01-0.50], nmol, 60 min, clonic phase). ACPT-1 also protects against clonic seizures induced in DBA/2 mice by the Group I agonist, (RS)-3,5-dihydroxyphenylglycine (3,5-DHPG) (ED(50) 0.60 [0.29-1.2], nmol i.c.v.) and by the Group III antagonist, (RS)-alpha-methylserine-O-phosphate (MSOP) (ED(50) 49.3 [37.9-64.1], nmol i.c.v.). Another Group III agonist, (RS)-4-phosphonophenyl-glycine (PPG), preferentially activating the mGlu(8) receptor, previously shown to protect against sound-induced seizures in DBA/2 mice and GEP rats, also protects against seizures induced in DBA/2 by 3,5-DHPG (ED(50) 3.7 [2.4-5.7], nmol i.c.v.) and by the Group III antagonist, MSOP (ED(50) 40.2 [21.0-77.0], nmol i.c.v.). At very high doses (500 nmol i.c.v. and above), Group III antagonists have pro-convulsant and convulsant activity. The anticonvulsant protection against sound-induced seizures in DBA/2 mice provided by a fully protective dose (20 nmol, i.c.v.) of the mGlu(4) receptor agonist ACPT-1, is partially reversed by the co-administration of the Group III antagonists, MSOP, (RS)-alpha-methyl-4-phosphonophenylglycine (MPPG) or (S)-2-amino-2-methyl-4-phosphonobutanoic acid (MAP4), in the 20-50 nmol dose range. At doses of 50-200 nmol, MPPG and MAP4 cause further reversal of the ACPT-1 anticonvulsant protection, while the MSOP effect on ACPT-1 protection is abolished at higher doses. In contrast, the anticonvulsant protection against sound-induced seizures in DBA/2 mice provided by a fully protective dose (20 nmol, i.c.v.) of the mGlu(8) receptor agonist PPG, is not significantly affected by the co-administration of the same Group III antagonists, MSOP, MPPG or MAP4. We conclude that activation of either mGlu(4alpha) or mGlu(8) receptors confer anticonvulsant protection in DBA/2 mice. Furthermore, the metabotropic Group III receptor antagonists, MSOP, MPPG, and MAP4 appear to be functionally selective for the mGlu(4) receptor in this system.
Rao, Nisha; Kemper, Kathi J.
2016-01-01
Mind-body practices that intentionally generate positive emotion could improve health professionals’ well-being and compassion. However, the feasibility and impact of clinician training in these practices is unknown. Data were analyzed from 3 online modules offered to health professionals: (a) Gratitude, (b) Positive Word, and (c) Loving-kindness/Compassion meditation. Paired t tests were used to assess pre- to posttraining changes in gratitude (Gratitude Questionnaire), well-being (World Health Organization Well-Being Index), self-compassion (Neff’s Self-Compassion Scale), and confidence in providing compassionate care (Confidence in Providing Calm, Compassionate Care Scale). The 177 enrollees included diverse practitioners (nurses, physicians, social workers, and others). Training was associated with statistically significant improvements in gratitude (38.3 ± 4.6 to 39.5 ± 3.3), well-being (16.4 ± 4.0 to 17.9 ± 4.2), self-compassion (39.5 ± 8.1 to 43.1 ± 7.6), and confidence in providing compassionate care (73.3 ± 16.4 to 80.9 ± 13.8; P < .001 for all comparisons). Brief, online training appeals to diverse health professionals and improves their gratitude, well-being, self-compassion, and confidence in providing compassionate care. PMID:27055823
Effort-Reward Imbalance, Work-Privacy Conflict, and Burnout Among Hospital Employees.
Häusler, Nadine; Bopp, Matthias; Hämmig, Oliver
2018-04-01
Studies investigating the relative importance of effort-reward imbalance and work-privacy conflict for burnout risk between professional groups in the health care sector are rare and analyses by educational attainment within professional groups are lacking. The study population consists of 1422 hospital employees in Switzerland. Multivariate linear regression analyses with standardized coefficients were performed for the overall study population and stratified for professional groups refined for educational attainment. Work-privacy conflict is a strong predictor for burnout and more strongly associated with burnout than effort-reward imbalance in the overall study population and across all professional groups. Effort-reward imbalance only had a minor effect on burnout in tertiary-educated medical professionals. Interventions aiming at increasing the compatibility of work and private life may substantially help to decrease burnout risk of professionals working in a health care setting.
Pharmacokinetics and Metabolism of 4R-Cembranoid.
Vélez-Carrasco, Wanda; Green, Carol E; Catz, Paul; Furimsky, Anna; O'Loughlin, Kathleen; Eterović, Vesna A; Ferchmin, P A
2015-01-01
4R-cembranoid (4R) is a natural cyclic diterpenoid found in tobacco leaves that displays neuroprotective activity. 4R protects against NMDA, paraoxon (POX), and diisopropylfluorophosphate (DFP) damage in rat hippocampal slices and against DFP in rats in vivo. The purpose of this study was to examine the metabolism and pharmacokinetics of 4R as part of its preclinical development as a neuroprotective drug. 10 µM 4R was found to be very stable in plasma for up to 1 hr incubation. 4R metabolism in human microsomes was faster than in the rat. Ten metabolites of 4R were detected in the microsomal samples; 6 dihydroxy and 4 monohydroxy forms of 4R. Male rats received a single dose of 4R at 6 mg/kg i.v., i.m., or s.c. The i.v. group had the highest plasma concentration of 1017 ng/mL. The t1/2 was 36 min and reached the brain within 10 min. The brain peak concentration was 6516 ng/g. The peak plasma concentration in the i.m. group was 163 ng/mL compared to 138 ng/mL in the s.c. group. The t1/2 of 4R after i.m. and s.c. administration was approximately 1.5 hr. The brain peak concentration was 329 ng/g in the i.m. group and 323 ng/g for the s.c. group. The brain to plasma ratio in the i.v. group was 6.4, reached 10 min after dose, whereas in the i.m. and s.c. groups was 2.49 and 2.48, respectively, at 90 min after dose. Our data show that 4R crosses the BBB and concentrates in the brain where it exerts its neuroprotective effect.
Pharmacokinetics and Metabolism of 4R-Cembranoid
Vélez-Carrasco, Wanda; Green, Carol E.; Catz, Paul; Furimsky, Anna; O’Loughlin, Kathleen; Eterović, Vesna A.; Ferchmin, P. A.
2015-01-01
4R-cembranoid (4R) is a natural cyclic diterpenoid found in tobacco leaves that displays neuroprotective activity. 4R protects against NMDA, paraoxon (POX), and diisopropylfluorophosphate (DFP) damage in rat hippocampal slices and against DFP in rats in vivo. The purpose of this study was to examine the metabolism and pharmacokinetics of 4R as part of its preclinical development as a neuroprotective drug. 10 µM 4R was found to be very stable in plasma for up to 1 hr incubation. 4R metabolism in human microsomes was faster than in the rat. Ten metabolites of 4R were detected in the microsomal samples; 6 dihydroxy and 4 monohydroxy forms of 4R. Male rats received a single dose of 4R at 6 mg/kg i.v., i.m., or s.c. The i.v. group had the highest plasma concentration of 1017 ng/mL. The t1/2 was 36 min and reached the brain within 10 min. The brain peak concentration was 6516 ng/g. The peak plasma concentration in the i.m. group was 163 ng/mL compared to 138 ng/mL in the s.c. group. The t1/2 of 4R after i.m. and s.c. administration was approximately 1.5 hr. The brain peak concentration was 329 ng/g in the i.m. group and 323 ng/g for the s.c. group. The brain to plasma ratio in the i.v. group was 6.4, reached 10 min after dose, whereas in the i.m. and s.c. groups was 2.49 and 2.48, respectively, at 90 min after dose. Our data show that 4R crosses the BBB and concentrates in the brain where it exerts its neuroprotective effect. PMID:25811857
Kuchar, Ernest; Ludwikowska, Kamila; Antczak, Adam; Nitsch-Osuch, Aneta
2018-01-01
In Poland, the seasonal influenza vaccination rate is just barely 3% which may be related to the unsatisfactory knowledge of influenza among healthcare professionals, poor recognition of the benefits of influenza immunization and the fear of side effects. To address these issues, we surveyed healthcare professionals through an online questionnaire consisting of 18 closed-ended items. The questionnaire was completed by 495 healthcare professionals, mostly physicians (83%). The results revealed gaps in the knowledge concerning influenza diagnosis, complications, risk groups, and prognostic factors. On average, respondents only answered 4.8 of the 18 questions correctly (27%). Only 10% of respondents passed the threshold of 50% correct answers. The knowledge of contraindications to vaccination far outweighed the knowledge of indications for vaccination. Poor knowledge with a focus on the adverse effects of immunization may be a significant factor responsible for the low vaccination rate in Poland. To increase vaccination rate, healthcare professionals need to be educated about influenza-related risks and benefits of vaccination.
Zurynski, Yvonne; Sureshkumar, Premala; Phu, Amy; Elliott, Elizabeth
2015-12-10
The World Health Organisation (WHO) estimates that 100-140 million girls and women have undergone female genital mutilation or cutting (FGM/C). FGM/C is an ancient cultural practice prevalent in 26 countries in Africa, the Middle East and Asia. With increased immigration, health professionals in high income countries including UK, Europe, North America and Australia care for women and girls with FGM/C. FGM/C is relevant to paediatric practice as it is usually performed in children, however, health professionals' knowledge, clinical practice, and attitudes to FGM/C have not been systematically described. We aimed to conduct a systematic review of the literature to address this gap. The review was conducted according to guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42015015540, http://www.crd.york.ac.uk/PROSPERO/). Articles published in English 2000-2014 which used quantitative methods were reviewed. Of 159 unique articles, 18 met inclusion criteria. The methodological quality was poor - six studies met seven of the eight quality criteria. Study participants included mainly obstetricians, gynaecologists and midwives (15 studies). We found no papers that studied paediatricians specifically, but two papers reported on subgroups of paediatricians within a mixed sample of health professionals. The 18 articles covered 13 different countries: eight from Africa and 10 from high income countries. Most health professionals were aware of the practice of FGM/C, but few correctly identified the four FGM/C categories defined by WHO. Knowledge about FGM/C legislation varied: 25% of professionals in a Sudanese study, 46 % of Belgian labour ward staff and 94 % of health professionals from the UK knew that FGM/C was illegal in their country. Health professionals from high income countries had cared for women or girls with FGM/C. The need to report children with FGM/C, or at risk of FGM/C, to child protection authorities was mentioned by only two studies. Further research is needed to determine health professionals' attitudes, knowledge and practice to support the development of educational materials and policy to raise awareness and to prevent this harmful practice.
A COMPARATIVE ANALYSIS OF THE RESEARCH UTILIZATION PROCESS.
ERIC Educational Resources Information Center
LIPPITT, RONALD; AND OTHERS
A SUGGESTED MODEL FOR ADEQUATE DISSEMINATION OF RESEARCH FINDINGS CONSIDERS FOUR PRIMARY BARRIERS TO EFFECTIVE COMMUNICATION--(1) DIVISION OF PERSONNEL LABOR INTO TASK ROLES, (2) INSTITUTIONAL DISTINCTIONS, (3) DEVELOPMENT OF PROFESSIONAL REFERENCE GROUPS, AND (4) GEOGRAPHICAL DIVISIONS. SUGGESTED SOLUTIONS INCLUDE LINKING SYSTEMS AND ROLES,…
A curricular addition using art to enhance reflection on professional values.
Byars, Lynn A; Stephens, Mark B; Durning, Steven J; Denton, Gerald D
2015-04-01
Art and humanities can enhance undergraduate medical education curricular objectives. Most commonly, art is used to help students learn observational skills, such as medical interviewing and physical diagnosis. Educators concurrently struggle to find ways to meaningfully teach professional values within crowded curricula. This curriculum aimed to combine art and reflection to actively convey tenets of medical professionalism. Internal medicine clerkship at a single institution. Third-year students. Students reviewed an online module describing attributes of medical professionalism before completing a 4-step written exercise stimulated by viewing a work of art and based on a critical incident from their own experiences. A faculty member reviewed the essays and facilitated small group discussion to normalize the students' emotional responses and generalize their observations to others. The curriculum was acceptable to students and enthusiastically received by faculty. Efforts to assess the effects and durability of the exercise on student behavior are ongoing. Artwork can enhance student reflection on professional values. This model efficiently and creatively meets curricular professionalism objectives. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.
ERIC Educational Resources Information Center
KRAMER, LUCY M.
THREE HUNDRED REPRESENTATIVES OF LABOR, MANAGEMENT, EDUCATION, HEALTH ORGANIZATIONS, GOVERNMENT, PROFESSIONAL ASSOCIATIONS, AND OTHER INTERESTED GROUPS ATTENDED A CONFERENCE PLANNED AS A MEDIUM TO DISCUSS ISSUES, EXCHANGE VIEWS, AND SHARE EXPERIENCES IN MATCHING PEOPLE AND JOBS. SPEECHES INCLUDE--(1) "GREETINGS FROM THE DEPARTMENT OF LABOR" BY…
Higgins, Stacy; Bernstein, Lisa; Manning, Kimberly; Schneider, Jason; Kho, Anna; Brownfield, Erica; Branch, William T
2011-01-01
Faculty development is needed that will influence clinical teachers to better enable them to transmit humanistic values to their learners and colleagues. We sought to understand the processes whereby reflective learning influenced professional growth in a convenience sample of young faculty members. We analyzed appreciative inquiry narratives written over 4 years using the constant comparative method to identify major underlying themes and develop hypotheses concerning how reflective learning influenced participants in the faculty development program. Six of the participants and the facilitator were participant observers in the qualitative analysis. Group support, validation, and cohesion led to adoption of common values that informed the professional development of the participants over 4 years of the study. Common values influenced the group members as they progressed in their careers. Faculty development programs that focus on humanism and reflective learning can facilitate the growth of young faculty members by influencing their values and attitudes at crucial phases of their careers.
Inglis, Paul; Bird, Stephen P.
2017-01-01
The objective of the study was to describe the movement demands and running intensities of semi-professional rugby league players during a rugby league 9’s (RL9’s) tournament. Six semi-professional rugby league players competed in a RL9’s tournament over a two-day period comprising of six games. Movement demands and running intensities were recorded using Global Positioning System (GPS) devices providing data on distance and speeds. Data is presented as mean (95% Confidence Intervals) with changes (≥ 75%) likely to exceed the smallest worthwhile change (0.2) considered practically important. Outside backs performed significantly (p < 0.05) more relative VHSR (3.9 m [3.5-4.3] vs 2.4 m [2.1-2.8]) absolute (97.7 m [81.3-114.1] vs 22.6m [15.8-29.3]) and relative (5.0 m·min-1 [4.2-5.9] vs 1.2 m·min-1 [0.8-1.6]) sprint distance than the forwards. Outside backs also performed significantly (p < 0.05) more absolute (97.7 m [81.3-114.1] vs 43.9 m [27.2-60.7]) and relative (5.0 m·min-1 [4.2-5.9] vs 2.3 m·min-1 [1.4-3.2]) sprint distance than the adjustables. Moderate (0.6 – 1.2) to very large (> 2.0) decreases in performance variables were observed over the two days. The biggest magnitude of change over the two days was seen with very large decreases in relative HSR (- 2.10) and sprint (- 2.14) distance. Between playing groups, the outside backs had the biggest decrease in running intensity with a very large (- 2.32) significant (p < 0.05) decrease in VHSR on day 2 (3.3 m·min-1 [2.5 – 4.1]) compared to day 1 (4.9 m·min-1 [4.4 – 5.4]). Running intensities are decreased during an intensified RL9’s tournament in semi-professional rugby league players. The observed decreases in running performances between playing groups are in agreement with previous research and may support the use of individualized player monitoring and recovery management during a RL9’s tournament-style competition. Key points Running intensities are decreased during an intensified rugby league 9’s tournament in semi-professional rugby league players. Forwards and backs performed significantly less high-intensity sprint efforts on day two than day one of the tournament. Appropriate planning and implementation of recovery strategies between games may reduce the potential effects of residual fatigue. PMID:28344447
Study of Effect of Magnesium Sulphate in Management of Acute Organophosphorous Pesticide Poisoning.
Vijayakumar, H N; Kannan, Sudheesh; Tejasvi, C; Duggappa, Devika Rani; Veeranna Gowda, K M; Nethra, S S
2017-01-01
Organophosphorus compound poisoning (OPCP) is a major public health problem in developing countries like India. Atropine and oximes remain the main-stay of management. Magnesium sulfate (MgSO 4 ) has shown benefit in the management of OPCP. This study was designed to assess the effect of MgSO 4 on outcome in OPCP patients admitted to Intensive Care Unit (ICU). Double-blind prospective randomized clinical trial in an ICU of tertiary care institution. One hundred patients (50 in each group) of OPCP, confirmed by history and syndrome of OPCP with low plasma pseudocholinesterase, aged between 18 and 60 years were studied. Magnesium group (Group M) received 4 g of 20% MgSO 4 infusion over 30 min at admission to ICU, control group (Group C) received normal saline placebo in the same manner. Patients were assessed for the need for intubation, requirement of atropine, duration of mechanical ventilation, duration of ICU stay, and its effect on mortality. Chi-square test and Fisher's exact test for categorical data, independent sample t -test, and paired t -test for nominal data. Demographics and basal serum magnesium levels were comparable. Atropine requirement was higher in Group C (74.82 ± 22.39 mg) compared to Group M (53.11 ± 45.83 mg) ( P < 0.001). A total of 33 patients in Group C and 23 patients in Group M required intubation, respectively ( P = 0.043). The mean duration of mechanical ventilation was 4.51 ± 2 days in Group C compared to 4.13 ± 1.6 days in Group M ( P = 0.45). ICU stay was 5.36 ± 2.018 days in Group C compared to 4.54 ± 1.581 days in Group M ( P = 0.026). There was no significant difference in mortality between the groups. Four grams of MgSO 4 given to OPCP patients within 24 h of admission to ICU, decreases atropine requirement, need for intubation, and ICU stay.
[Role expectations of various professional groups in the operating theatre].
Gfrörer, R; Bernard, U; Schaper, C; Bauer, M; Schüpfer, G K
2007-11-01
Clearly defined professional roles have the advantage that team members know what they are expected to do and what their expectations of other professional groups are. For the definition of roles a distinct number of interactions between persons are a prerequisite. In a typical operations room (OR) team members are not constantly involved and are often exchanged. Interactions between personnel are not strong enough to fulfil the designing process of role shaping. In this study the possible substitution of defined roles by a distinct professional culture in an OR was studied. Using a shortened form of the SYMLOG questionnaire, 179 persons working in the ORs of 2 Swiss hospitals were interviewed. The three main professional groups in the OR setting were represented in this cohort: anaesthesia personnel (physicians and nurses), surgeons and operating room technicians and nurses. The SYMLOG questionnaire allows the rating of sympathy, influence and goal orientation of the professional groups. Surgeons and anaesthetists had the strongest influence and higher ratings for goal orientation. In comparison, the influence of members of the nursing profession was less valued. All three professional groups rated themselves higher than in the perception of the other professional groups. It is concluded that in this analysis the role definition was not clear. Optimization is therefore possible which could reduce conflict potential and contribute to a higher productivity.
[Muscular trunk stability in professional and amateur volleyball players].
Miltner, O; Siebert, C; Tschaepe, R; Maus, U; Kieffer, O
2010-03-01
The aim of this study was to analyse the efficiency of muscular activity in the trunk stabilisation of professional volleyball players compared to a group of amateur hobby players. The results were compared amongst the groups as well as with a reference group consisting of asymptomatic individuals. The question to be answered was whether or not professional volleyball players possess a characteristic strength profile in their trunk musculature and if differences exist with regard to the individuals' competitive playing level. In this comparative study 12 professional volleyball players (German Bundesliga) and 18 non-professional volleyball players were analysed with regard to their isometric strength profile in all three planes. The reference group was provided by the Proxomed company, which had previously analysed healthy untrained individuals (n = 1045) of various age groups. A sports-specific profile for the musculature of volleyball players revealed a significant reduction in the flexion and rotation strength as well as a well-developed lateral flexion strength (highly significant when compared to the reference group). With reference to the level played, better strength values in flexion and lateral flexion were found among the professional athletes. Professional volleyball players present with a characteristic trunk musculature strength profile. A detailed analysis of the muscle strength of the spine as part of a sports medicine work-up could prove helpful in preventing injuries and overuse problems in professional and hobby volleyball players.
ERIC Educational Resources Information Center
Peciuliauskiene, Palmira; Barkauskaite, Marija
2011-01-01
This article analyzes the factors determining professional careers of females from different social groups (convict, unemployed and those who achieved successful career). It is decided to classify those factors into two groups: subjective (education and personal qualities); and objective (age and parents' professional career). This article deals…
Synthesis Of Labeled Metabolites
Martinez, Rodolfo A.; Silks, III, Louis A.; Unkefer, Clifford J.; Atcher, Robert
2004-03-23
The present invention is directed to labeled compounds, for example, isotopically enriched mustard gas metabolites including: [1,1',2,2'-.sup.13 C.sub.4 ]ethane, 1,1'-sulfonylbis[2-(methylthio); [1,1',2,2'-.sup.13 C.sub.4 ]ethane, 1-[[2-(methylsulfinyl)ethyl]sulfonyl]-2-(methylthio); [1,1',2,2'-.sup.13 C.sub.4 ]ethane, 1,1'-sulfonylbis[2-(methylsulfinyl)]; and, 2,2'-sulfinylbis([1,2-.sup.13 C.sub.2 ]ethanol of the general formula ##STR1## where Q.sup.1 is selected from the group consisting of sulfide (--S--), sulfone (--S(O)--), sulfoxide (--S(O.sub.2)--) and oxide (--O--), at least one C* is .sup.13 C, X is selected from the group consisting of hydrogen and deuterium, and Z is selected from the group consisting of hydroxide (--OH), and --Q.sup.2 --R where Q.sup.2 is selected from the group consisting of sulfide (--S--), sulfone(--S(O)--), sulfoxide (--S(O.sub.2)--) and oxide (--O--), and R is selected from the group consisting of hydrogen, a C.sub.1 to C.sub.4 lower alkyl, and amino acid moieties, with the proviso that when Z is a hydroxide and Q.sup.1 is a sulfide, then at least one X is deuterium.
Johansson, E; Steffens, J J; Emptage, M; Lindqvist, Y; Schneider, G
2000-05-01
The gene coding for saccharopine reductase (E.C. 1.5.1.10), an enzyme of the alpha-aminoadipic pathway of lysine biosynthesis in the pathogenic fungus Magnaporthe grisea, was cloned and expressed in Escherichia coli. The purified enzyme was crystallized in space groups C2 and C222(1) using ammonium sulfate pH 4.8 or PEG 6000 pH 4. 1 as precipitants. The unit-cell parameters are a = 115.0, b = 56.6, c = 74.3 A, beta = 111.1 degrees for space group C2, and a = 89.3, b = 119.0, c = 195.9 A for space group C222(1). The crystals diffract to resolutions of 2.0 A (C2) and 2.4 A (C222(1)) at synchrotron sources.
Dukić, Lora; Kopčinović, Lara Milevoj; Dorotić, Adrijana; Baršić, Ivana
2016-10-15
Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard - fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline - second edition. Practices related to processing of blood gas samples are not standardized in the Republic of Croatia. Each institution has its own protocol for ordering, collection and analysis of blood gases. Although many laboratories use state of the art analyzers, still many preanalytical procedures remain unchanged. The objective of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) is to standardize the procedures for BGA based on CLSI recommendations. The Working Group for Blood Gas Testing as part of the Committee for the Scientific Professional Development of the CSMBLM prepared a set of recommended protocols for sampling, transport, storage and processing of blood gas samples based on relevant CLSI documents, relevant literature search and on the results of Croatian survey study on practices and policies in acid-base testing. Recommendations are intended for laboratory professionals and all healthcare workers involved in blood gas processing.
Dukić, Lora; Kopčinović, Lara Milevoj; Dorotić, Adrijana; Baršić, Ivana
2016-01-01
Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard – fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline – second edition. Practices related to processing of blood gas samples are not standardized in the Republic of Croatia. Each institution has its own protocol for ordering, collection and analysis of blood gases. Although many laboratories use state of the art analyzers, still many preanalytical procedures remain unchanged. The objective of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) is to standardize the procedures for BGA based on CLSI recommendations. The Working Group for Blood Gas Testing as part of the Committee for the Scientific Professional Development of the CSMBLM prepared a set of recommended protocols for sampling, transport, storage and processing of blood gas samples based on relevant CLSI documents, relevant literature search and on the results of Croatian survey study on practices and policies in acid-base testing. Recommendations are intended for laboratory professionals and all healthcare workers involved in blood gas processing. PMID:27812301
Mundet-Tuduri, Xavier; Crespo, Ramon; Fernandez-Coll, Ma Luisa; Saumell, Montserrat; Millan-Mata, Flor; Cardona, Àngels; Codern-Bové, Núria
2017-11-15
The planning and execution of continuous education in an organization that provides health services is a complex process. The objectives, learning sequences, and implementation strategies should all be oriented to improving the health of the population. The aim of this study was to analyse the expectations and perceptions of continuous educations by primary healthcare professionals (physicians and nurses) and identify aspects that hinder or encourage the process. A qualitative study with 5 focus groups made up of 25 primary healthcare professionals from the Catalan Health Institute, Barcelona (Catalonia, Spain). The focus groups were audio-recorded and the results transcribed. The analysis involved: a) Reading of the data looking for meanings b) Coding of the data by themes and extracting categories c) Reviewing and refining codes and categories d) Reconstruction of the data providing an explanatory framework for the meanings e) Discussion about the interpretations of the findings and f) Discussed with relevant professionals from PHC (physicians and nurses)"Data regarding thematic content were analyzed with the support of Atlasti 5.1 software. The health needs of the population were often at the core of the learning processes but the participants' views did not always spontaneously refer to improvements in these issues. Common themes that could hinder learning and where identified, including contextual aspects such as work constraints (timetables, places being covered during training) and funding policies. New learning strategies to improve the effectiveness of continuous education were proposed such as the exchange of knowledge, the activation of personal commitment to change, and the improvement of organizational aspects. The primary healthcare professionals in our study viewed continuous education as a professional necessity and would like to translate the knowledge acquired to improving the health of the population. Nevertheless, professional, structural, and organizational issues impede the process.
A Controlled-Environment Chamber for Atmospheric Chemistry Studies Using FT-IR Spectroscopy
1990-06-01
necessary and identify by block number) FELD GROUP SUB-GROUP i >Chamber, controlled environment; long-path cell ; 07 04 FT-IR; Hydrazine decay...modification doubles the useable path length of the original multipass cell described by White (Reference 8). The pattern of images formed on the nesting...system is shown in Figure 13. 24 z C C02, Ibm, El4 944 C3 ta) caC E-4- 252 14 $4 41) 41) 0. 0 04 04 4 41) ~0 to 0.0 V-4 (A q14 0~ 1% 4-r4 $4 0 u P416 4 4
34 CFR 656.4 - What types of Centers receive grants?
Code of Federal Regulations, 2013 CFR
2013-07-01
... languages; and (b) Provide training at the— (1) Graduate, professional, and undergraduate levels, as a comprehensive Center; or (2) Undergraduate level only, as an undergraduate Center. (Authority: 20 U.S.C. 1122) ... POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION NATIONAL RESOURCE CENTERS PROGRAM FOR FOREIGN LANGUAGE AND AREA...
34 CFR 656.4 - What types of Centers receive grants?
Code of Federal Regulations, 2012 CFR
2012-07-01
... languages; and (b) Provide training at the— (1) Graduate, professional, and undergraduate levels, as a comprehensive Center; or (2) Undergraduate level only, as an undergraduate Center. (Authority: 20 U.S.C. 1122) ... POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION NATIONAL RESOURCE CENTERS PROGRAM FOR FOREIGN LANGUAGE AND AREA...
34 CFR 656.4 - What types of Centers receive grants?
Code of Federal Regulations, 2011 CFR
2011-07-01
... languages; and (b) Provide training at the— (1) Graduate, professional, and undergraduate levels, as a comprehensive Center; or (2) Undergraduate level only, as an undergraduate Center. (Authority: 20 U.S.C. 1122) ... POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION NATIONAL RESOURCE CENTERS PROGRAM FOR FOREIGN LANGUAGE AND AREA...
34 CFR 656.4 - What types of Centers receive grants?
Code of Federal Regulations, 2014 CFR
2014-07-01
... languages; and (b) Provide training at the— (1) Graduate, professional, and undergraduate levels, as a comprehensive Center; or (2) Undergraduate level only, as an undergraduate Center. (Authority: 20 U.S.C. 1122) ... POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION NATIONAL RESOURCE CENTERS PROGRAM FOR FOREIGN LANGUAGE AND AREA...
O'Hagan, Thomas; Chisolm, Margaret S
2015-01-01
Background As the use of social media (SM) tools becomes increasingly widespread, medical trainees need guidance on applying principles of professionalism to their online behavior. Objective To develop a curriculum to improve knowledge and skills regarding professionalism of SM use by medical students. Methods This project was conducted in 3 phases: (1) a needs assessment was performed via a survey of medical students regarding SM use, rationale for and frequency of use, and concerns; (2) a workshop-format curriculum was designed and piloted for preclinical students to gain foundational knowledge of online professionalism; and (3) a complementary longitudinal SM-based curriculum was designed and piloted for clinical students to promote both medical humanism and professionalism. Results A total of 72 medical students completed the survey (response rate 30%). Among the survey respondents, 71/72 (99%) reported visiting social networking sites, with 55/72 (76%) reporting daily visits. Privacy of personal information (62/72, 86%) and mixing of personal/professional identities (49/72, 68%) were the students’ most commonly endorsed concerns regarding SM use. The workshop-format curriculum was evaluated qualitatively via participant feedback. Of the 120 students who participated in the workshop, 91 completed the post workshop evaluation (response rate 76%), with 56 positive comments and 54 suggestions for improvement. The workshop was experienced by students as enjoyable, thought provoking, informative, and relevant. Suggestions for improvement included adjustments to timing, format, and content of the workshop. The SM-based curriculum was evaluated by a small-scale pilot of 11 students, randomized to the intervention group (participation in faculty-moderated blog) or the control group. Outcomes were assessed quantitatively and qualitatively via personal growth scales, participant feedback, and analysis of blog themes. There was a trend toward improvement in total personal growth scores among those students in the blog group from 3.65 (0.47) to 4.11 (0.31) (mean [SD]) with no change observed for the students in the control group (3.89 [0.11] before and after evaluation). Themes relevant to humanism and professionalism were observed in the blog discussion. Conclusions Most medical students surveyed reported using SM and identified privacy and personal-professional boundaries as areas of concern. The workshop format and SM-based curricula were well-received by students whose formative feedback will inform the refinement and further development of efforts to promote professionalism among medical students. PMID:27731846
Maki, Hideshi; Ryousi, Kazuomi; Nariai, Hiroyuki; Mizuhata, Minoru
2014-08-14
The synthesis and isolation of the sodium salt of cyclo-tri-μ-imidotetraphosphate, i.e. Na4cP4O9(NH)3·H2O, were achieved by the hydrolysis of Na4cP4O8(NH)4·2H2O under very weak acidic conditions, i.e. using 0.2 mol L(-1) propionic acid and the pH-controlled recrystallization procedure. The purity of Na4cP4O9(NH)3·H2O was improved from 2% to 95% by the pH-controlled recrystallization only two times. The first protonation constants of a series of cyclo-μ-imidotetraphosphate anions, i.e. cP4O(12-n)(NH)n(4-) (n = 0, 2, 3, 4), were determined by potentiometric titration and (31)P NMR chemical shift measurements in aqueous solution. Regardless of the paucity of the purity of trans-cP4O10(NH)2(4-) anions, the protonation processes of all anions may be evaluated accurately without any previous purification, because the NMR signals corresponding to cP4O(12-n)(NH)n(4-) (n = 0, 2, 3, 4) anions are well resolved. The logarithmic first protonation constants increase with a "linear" increase in the number of imino groups which constitute the ligand molecules. Macroscopic protonation reactions could be divided into three microscopic protonation processes for -O-PO2-O-, -O-PO2-NH-, and -NH-PO2-NH- groups. The basicity of the -NH-PO2-NH- group is especially high, because the delocalization of H(+) ions by lactam-lactim tautomerism on the whole ring molecule of cP3O6(NH)3 and cP4O8(NH)4 enhances the protonation of these ligands. In addition, also the concurrent change observed in the (31)P NMR chemical shift values of the phosphorus nuclei in the -O-PO2-NH- and -NH-PO2-NH- groups of cP4O9(NH)3(4-) anions suggested the effect of the lactam-lactim tautomerism. The intrinsic (31)P NMR chemical shifts for the central phosphorus nuclei for -O-PO2-O-, -O-PO2-NH-, and -NH-PO2-NH- groups show a good proportional relationship with the number of nitrogen atoms bonded to the central phosphorus atoms. Two types of imino groups with mutually dissimilar chemical environments which are present in the Na4cP4O9(NH)3 molecule, that is -O-PO2-NH-PO2-NH- and -NH-PO2-NH-PO2-NH-, brought about a two-stage pyrolytic elimination of imino groups from the initial stage of combustion over a wide temperature range.
Kuwata, Hitoshi; Okamoto, Saki; Seino, Yusuke; Murotani, Kenta; Tatsuoka, Hisato; Usui, Ryota; Hamamoto, Yoshiyuki; Kurose, Takeshi; Seino, Yutaka; Yabe, Daisuke
2017-11-24
The present study was designed to assess possible relationships between deterioration of the glycated hemoglobin (HbA1c)-lowering effects in dipeptidyl peptidase-4 inhibitor (DPP4i) monotherapy and macronutrient intake among individuals with type 2 diabetes. Type 2 diabetes patients who began and continued DPP4i monotherapy without any prescription change for 1 year were retrospectively stratified into two groups: (i) patients who maintained their HbA1c levels during the 0.5- to 1-year period after DPP4i initiation (group A, ΔHbA1c [1-0.5 year] <0.4%, n = 53); and (ii) those whose HbA1c levels increased [group B, ΔHbA1c (1-0.5 year] ≥0.4%, n = 10). Group B had significantly higher ΔHbA1c (1-0.5 year), Δbodyweight (1-0.5 year) and fat intake, especially of saturated and monounsaturated fats; the carbohydrate and protein intake were similar between groups. Multiple regression analyses showed that fat intake, especially saturated fat intake, was significantly correlated with ΔHbA1c (1-0.5 year). Thus, dietary habits, especially saturated fat intake, might well contribute to deterioration of the HbA1c-lowering effects in DPP4i monotherapy. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
Professionalism in residency training: is there a generation gap?
Borrero, Sonya; McGinnis, Kathleen A; McNeil, Melissa; Frank, Janine; Conigliaro, Rosemarie L
2008-01-01
Teaching and evaluating professionalism is part of the Accreditation Council for Graduate Medical Education's training requirements for postgraduate education. Defining what constitutes professional behavior is the first step in this endeavor. Difficulty in teaching and evaluating professionalism may stem from generational differences between teachers and trainees in their definition of professional behavior. We sought to explore the magnitude of generational differences by asking faculty and residents to evaluate behaviors along a continuum of professionalism. A questionnaire composed of 16 vignettes describing unprofessional behaviors was distributed to a sample of internal medicine trainees and faculty. For each specific behavior described, participants were asked to rate the severity of the infraction on a 4-point scale. Within each group, responses were distributed across severity categories for most vignettes. There were no significant differences in the responses of trainees versus faculty for any of the vignettes except two. There is little consensus for determining the severity of unprofessional behaviors among faculty and trainees at one urban university training program. However, this lack of consensus does not appear to have a generational basis. Attributing difficulties in teaching and assessing professionalism cannot be blamed on differences between the generations.
Polyimides containing pendent trifluoromethyl groups
NASA Technical Reports Server (NTRS)
Havens, S. J.; Hergenrother, P. M.
1993-01-01
Several new polyimides containing trifluoromethyl groups were prepared from the reaction of various aromatic dianhydrides and two new diamines containing trifluoromethyl groups, 4,4'-bis(3-amino-5-trifluoromethylphenoxy)biphenyl and l,4-bis(3-amino-5-trifluoromethylphenoxy)benzene. The diamines were prepared from the aromatic nucleophilic displacement of the disodium salts of 4,4'-biphenol or hydroquinone with 3,5-dinitrobenzotrifluoride followed by hydrogenation of the resultant dinitro compounds. The thermally cured polyimides exhibited glass transition temperatures between 186 and 262 C. By thermogravimetric analysis, the polyimides exhibited 5 percent weight losses at 484-527 C in nitrogen and 452-506 C in air.
Wikaire, Erena; Curtis, Elana; Cormack, Donna; Jiang, Yannan; McMillan, Louise; Loto, Rob; Reid, Papaarangi
2017-05-01
Tertiary institutions internationally aim to increase student diversity, however are struggling to achieve equitable academic outcomes for indigenous and ethnic minority students and detailed exploration of factors that impact on success is required. This study explored the predictive effect of admission variables on academic outcomes for health professional students by ethnic grouping. Kaupapa Māori and Pacific research methodologies were used to conduct a quantitative analysis using data for 2686 health professional students [150 Māori, 257 Pacific, 2279, non-Māori non-Pacific (nMnP)]. The predictive effect of admission variables: school decile; attending school in Auckland; type of admission; bridging programme; and first-year bachelor results on academic outcomes: year 2-4 grade point average (GPA); graduating; graduating in the minimum time; and optimal completion for the three ethnic groupings and the full cohort was explored using multiple regression analyses. After adjusting for admission variables, for every point increase in first year bachelor GPA: year 2-4 GPA increased by an average of 0.46 points for Māori (p = 0.0002, 95% CI 0.22, 0.69), 0.70 points for Pacific (p < 0.0001, CI 0.52, 0.87), and 0.55 points for nMnP (p < 0.0001, CI 0.51, 0.58) students. For the total cohort, ethnic grouping was consistently the most significant predictor of academic outcomes. This study demonstrated clear differences in academic outcomes between both Māori and Pacific students when compared to nMnP students. Some (but not all) of the disparities between ethnic groupings could be explained by controlling for admission variables.
Code of Federal Regulations, 2011 CFR
2011-07-01
...)(4) and 203(c) of the Voting Rights Act of 1965, as Amended Appendix to Part 55 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) IMPLEMENTATION OF THE PROVISIONS OF THE VOTING RIGHTS ACT...)(4) and 203(c) of the Voting Rights Act of 1965, as Amended [Applicable language minority group(s...
MM, Bassiony; A, Yousef; U, Youssef; GM, Salah El-Deen; M, Abdelghani; H, Al-Gohari; E, Fouad; MM, El-Shafaey
2015-01-01
The aim of the study was to estimate the prevalence and associated correlates of major depressive disorder and generalized anxiety disorder in hepatitis C virus patients before and after treatment and to investigate the relationship between major depressive disorder and generalized anxiety disorder and treatment response. A total of 116 consecutive hepatitis C virus patients from hepatitis C virus treatment center in Zagazig city, Egypt, were included in the study and divided into treated group (N = 58) and untreated group (N = 58). All hepatitis C virus patients were screened for major depressive disorder and generalized anxiety disorder using hospital anxiety and depression scale, and those who screened positive were interviewed to confirm the diagnosis of major depressive disorder and generalized anxiety disorder using DSM-IV-TR diagnostic criteria. These measures were done at baseline and after 12 weeks of treatment or observation. At baseline, 3.5% and 12.1% of hepatitis C virus patients (treated group) had major depressive disorder and generalized anxiety disorder, respectively. After 12 weeks of treatment 37.9% of hepatitis C virus patients (treated group) had major depressive disorder and 46.6% had generalized anxiety disorder. There was a significant statistical difference between hospital anxiety and depression scale scores for depression (3.3 ± 2.3 vs. 6.4 ± 3.2, t = 9.6, p = 0.001) and for anxiety (4.6 ± 2.4 vs. 7.3 ± 3.0, t = 10.2, p = 0.001) before and after treatment. There was also significant statistical difference between treated group and untreated group regarding hospital anxiety and depression scale scores after treatment and observation (depression, treated group 6.4 ± 3.2 vs. untreated group 4.0 ± 2.4, t = 3.7, p = 0.001; anxiety, treated group 7.3 ± 3.0 vs. untreated group 4.5 ± 2.3, t = 4.4, p = 0.001). There was no association between major depressive disorder and generalized anxiety disorder and treatment response. Major depressive disorder and generalized anxiety disorder are common in hepatitis C virus patients after treatment with interferon and ribavirin and were not related to treatment response. © The Author(s) 2015.
Survival Pattern of Hodgkin Lymphoma Patients in the Last 25 Years in Lebanon.
Massoud, Marcel; Kerbage, Fouad; Nehme, Joseph; Sakr, Riwa; Rached, Layale; Zeghondy, Jean; Nasr, Fady; Chahine, Georges
2017-07-01
After the emergence of combination chemotherapy in 1960s, survival of patients with Hodgkin lymphoma (HL) has dramatically improved worldwide. We lack studies that document the favorable evolution of survival regarding this disease in Lebanon. To compare the overall survival in HL over 3 different decades in Lebanon. We retrospectively reviewed the charts of 196 patients diagnosed with HL, treated and followed from 1990 to 2015 in our center. Patients were divided into 3 groups according to period of analysis: group A (1990-1999), group B (2000-2009), and group C (2010-2015). We studied the characteristics and survival patterns of patients in each group. The male-to-female sex ratio was 1.06. The median age at diagnosis was 33 years in group A, 30.4 in group B, and 33.12 in group C (P = .6). Results showed variations in the subtypes of the disease according to the following: nodular-sclerosis HL 59.5% in group A, 76.2% in group B, and 85.4% in group C. Mixed cellularity HL 21.6% in group A, 2.4% in group B, and 73.7% in group C (P = .0001). Patients presented with localized disease in 58.6%, 73.7%, and 56.4% in groups A, B, and C, respectively (P = .173). Complete remission was achieved in 76.5% in group A, 85.3% in group B, and 69.5% in group C (P = .007). The survival rate at 5 years in group A was 91%, 94% in group B, and 100% in group C. The survival of patients with HL has dramatically improved over the past 25 years in Lebanon. These results resemble those achieved in Western countries due to the fast adoption of new molecular imaging technologies at diagnosis and follow-up and the rapid approval of new drugs for relapse in the Lebanese market. Copyright © 2017 Elsevier Inc. All rights reserved.
Burau, Viola; Carstensen, Kathrine; Lou, Stina; Kuhlmann, Ellen
2017-09-16
Patient-centred care based on needs has been gaining momentum in health policy and the workforce. This creates new demand for interprofessional teams and redefining roles and tasks of professionals, yet little is known on how to implement new health policies more effectively. Our aim was to analyse the role and capacity of health professions in driving organisational change in interprofessional working and patient-centred care. A case study of the introduction of interprofessional, early discharge teams in stroke rehabilitation in Denmark was conducted with focus on day-to-day coordination of care tasks and the professional groups' interests and strategies. The study included 5 stroke teams and 17 interviews with different health professionals conducted in 2015. Professional groups expressed highly positive professional interest in reorganised stroke rehabilitation concerning patients, professional practice and intersectoral relations; individual professional and collective interprofessional interests strongly coincided. The corresponding strategies were driven by a shared goal of providing needs-based care for patients. Individual professionals worked independently and on behalf of the team. There was also a degree of skills transfer as individual team members screened patients on behalf of other professional groups. The study identified supportive factors and contexts of patient-centred care. This highlights capacity to improve health workforce governance through professional participation, which should be explored more systematically in a wider range of healthcare services.
Hützler, Wilhelm Maximilian; Egert, Ernst; Bolte, Michael
2016-09-01
A path to new synthons for application in crystal engineering is the replacement of a strong hydrogen-bond acceptor, like a C=O group, with a weaker acceptor, like a C=S group, in doubly or triply hydrogen-bonded synthons. For instance, if the C=O group at the 2-position of barbituric acid is changed into a C=S group, 2-thiobarbituric acid is obtained. Each of the compounds comprises two ADA hydrogen-bonding sites (D = donor and A = acceptor). We report the results of cocrystallization experiments of barbituric acid and 2-thiobarbituric acid, respectively, with 2,4-diaminopyrimidine, which contains a complementary DAD hydrogen-bonding site and is therefore capable of forming an ADA/DAD synthon with barbituric acid and 2-thiobarbituric acid. In addition, pure 2,4-diaminopyrimidine was crystallized in order to study its preferred hydrogen-bonding motifs. The experiments yielded one ansolvate of 2,4-diaminopyrimidine (pyrimidine-2,4-diamine, DAPY), C4H6N4, (I), three solvates of DAPY, namely 2,4-diaminopyrimidine-1,4-dioxane (2/1), 2C4H6N4·C4H8O2, (II), 2,4-diaminopyrimidine-N,N-dimethylacetamide (1/1), C4H6N4·C4H9NO, (III), and 2,4-diaminopyrimidine-1-methylpyrrolidin-2-one (1/1), C4H6N4·C5H9NO, (IV), one salt of barbituric acid, viz. 2,4-diaminopyrimidinium barbiturate (barbiturate is 2,4,6-trioxopyrimidin-5-ide), C4H7N4(+)·C4H3N2O3(-), (V), and two solvated salts of 2-thiobarbituric acid, viz. 2,4-diaminopyrimidinium 2-thiobarbiturate-N,N-dimethylformamide (1/2) (2-thiobarbiturate is 4,6-dioxo-2-sulfanylidenepyrimidin-5-ide), C4H7N4(+)·C4H3N2O2S(-)·2C3H7NO, (VI), and 2,4-diaminopyrimidinium 2-thiobarbiturate-N,N-dimethylacetamide (1/2), C4H7N4(+)·C4H3N2O2S(-)·2C4H9NO, (VII). The ADA/DAD synthon was succesfully formed in the salt of barbituric acid, i.e. (V), as well as in the salts of 2-thiobarbituric acid, i.e. (VI) and (VII). In the crystal structures of 2,4-diaminopyrimidine, i.e. (I)-(IV), R2(2)(8) N-H...N hydrogen-bond motifs are preferred and, in two structures, additional R3(2)(8) patterns were observed.
Kurokawa, K; Tanaka, H; Tanaka, S; Abe, S
2001-12-01
Circadian rhythmicity of cysteinyl leukotrienes (LTs) and thromboxane (TX)-A(2) in healthy subjects and nocturnal asthmatic patients remains a subject of controversy. The aim of this study was to investigate the contribution of these mediators to the pathogenesis of nocturnal asthma. We measured peak expiratory flow rate, urinary concentration of LTE(4), 11-dehydro-TXB(2), and creatinine eight times every 3 h in three groups: healthy control subjects (n = 5, group A), nocturnal asthmatic patients (n = 9, group B), and nonnocturnal asthmatic subjects (n = 9, group C). To evaluate the reproducibility of the measurement of urinary LTE(4), we measured urinary LTE(4) in group A for 3 separate days. The urinary LTE(4) concentrations from 3 to 6 AM were significantly (p < 0.05) higher than from 3 to 6 PM in both group A and group B, but not in group C. The mean levels of LTE(4) in group B and group C were significantly higher (p < 0.05) than those in group A. In group B, another small peak was observed from 6 to 9 PM. No significant day-to-day variation was observed in group A. Urinary 11-dehydro-TXB(2) values from 3 to 6 AM were significantly (p < 0.001) higher than those levels from 3 to 6 PM in all groups, and the mean levels in group B and group C were significantly higher than those in group A (p < 0.05). Circadian rhythmicity of urinary LTE(4) with a morning peak was found in healthy control subjects and nocturnal asthmatic subjects, but not in nonnocturnal asthmatic patients. It was suggested that cysteinyl LTs rather than TXA(2) might contribute to the nocturnal worsening of asthma.
Rouillard, Maud; Audiffren, Michel; Albinet, Cédric; Ali Bahri, Mohamed; Garraux, Gaëtan; Collette, Fabienne
2017-03-01
Cognitive reserve (CR) was proposed to explain how individual differences in brain function help to cope with the effects of normal aging and neurodegenerative diseases. Education, professional solicitations, and engagement in leisure and physical activities across the lifetime are considered as major determinants of this reserve. Using multiple linear regression analyses, we tested separately in healthy elderly and Parkinson's disease (PD) populations to what extent cognitive performance in several domains was explained by (a) any of these four environmental lifespan variables; (b) demographic and clinical variables (age, gender, depression score, and, for the PD group, duration of disease and dopaminergic drugs). We also tested for an interaction, if any, between these lifespan variables and brain pathology indexed by global atrophy measured from high-resolution anatomical magnetic resonance imaging. Age was negatively associated with cognitive performance in the PD group. In healthy elderly participants, we observed significant positive associations between cognitive performance and (a) education, (b) leisure activities, and (c) professional solicitation (decisional latitude). Furthermore, participants with greater brain atrophy benefited more from CR. In PD patients, education and professional solicitations contributed to cognitive performance but to a lesser extent than in controls. CR factors modulated the relationship between cognition and brain atrophy only in patients with a slight or moderate brain atrophy. Education is the CR factor that contributed the most to late cognitive functioning in both groups, closely followed by leisure activity in normal aging and professional solicitations in PD. Our results also provide evidence suggesting that the effects of CR does not express similarly in normal aging and PD. From a broader perspective, these results seem to indicate that CR factors the most consistently practiced across lifespan (education and professional solicitation) are those that are the more strongly associated to late cognitive efficiency.
Effect of posterior gingival smile on the perception of smile esthetics
Rodríguez-Martínez, Alicia; Vicente-Hernández, Ascensión
2014-01-01
Objectives: To evaluate and compare the influence of posterior gummy smile on the perception of smile esthetics by orthodontists, general-dentists and laypersons. Study Design: A frontal photograph of a smile with normal gum exposure was chosen and manipulated digitally using Adobe Photoshop C3 to generate three further images with posterior gum exposure of 4, 6 and 8mm. These four images were assessed by the three evaluator groups: orthodontists (n=40), general-dentists (n=40) and laypersons (n=40). Both orthodontists and dentists had at least ten years professional experience and laypersons were aged between 40-50 years. The proportion of men to women was 20:20 in each group. Evaluators awarded a score to the smile esthetics of each image: 1=acceptable, 2=moderately acceptable, 3=unacceptable. Afterwards, each evaluator placed the four images in order of esthetic preference. Results: No significant differences (p>0.05) were detected between the three evaluator groups for the photo without posterior gummy smile. The perception of smile esthetics for a the 4mm posterior gummy smile (median for orthodontists=2, general-dentists= 1, laypersons=1), the 6mm (median for orthodontists=2, general-dentists=1, laypersons=1) and the 8mm (median for orthodontists=3, general-dentists=2, laypersons=2) was significantly different between orthodontists and the other two evaluator groups (p<0.0017). The three evaluator groups coincided in placing the image with the 6mm gum exposure in first place in order of esthetic preference. Conclusions: Posterior gummy smile influences the perception of smile esthetics more negatively among orthodontists than the rest of the groups. Key words:Aesthetics, gummy smile back, orthodontists, dentists, laypersons. PMID:23986015
Canting of the occlusal plane: Perceptions of dental professionals and laypersons
Olivares, Amparo; Jacobo, Carmen; Molina, Sara M.; Rodríguez, Alicia; Bravo, Luis A.
2013-01-01
Objectives: To determine if canting of the occlusal plane influences esthetic evaluation of the smile among orthodontists, dentists and laypersons. Study Design: A frontal photo of a smile with 0º occlusal plane canting in relation to the bipupillary plane was modified using Adobe Photoshop C3 (Adobe Systems Inc, San José, California) to generate two images with occlusal plane inclinations of 2º and 4º. The three images were evaluated esthetically by orthodontists (n=40) general dentists (n=40) and laypersons (n=40). Each image was awarded a score as follows: 1=esthetically acceptable; 2=moderately acceptable; 3=esthetically unacceptable. Evaluators also placed the three images in order in preference. Data were analyzed using the Kruskal-Wallis (p<0.05) and the Mann-Whitney tests, applying the Bonferroni Correction (p<0.016). Results: No significant differences (p> 0.05) were found between the three groups for 0º and 2º cants (median for orthodontists=1; general dentists=1; laypersons=1). Orthodontists (median score=3) made evaluations of the image with 4º occlusal plane that were significantly different from general dentists (median=2) and laypersons (median=2). All three groups put the 0º image in first place in order of esthetic acceptability, the 2º image in second place and the 4º image in third place. Orthodontists placed the 0º image in first place with significantly greater frequency (p<0.016) than laypersons. Conclusions: Occlusal plane canting of 0º and 2º were evaluated as esthetically acceptable by the three groups. The 4º occlusal plane cant was evaluated more negatively by orthodontists than by general dentists and laypersons. All three groups placed the 0º image in first place of esthetic acceptability, 2º in second place and 4º in third. Orthodontists put the 0º image in first place with significantly greater frequency than laypersons. Key words:Canting, perception, smile, orthodontics, dental esthetics. PMID:23524412
Oral, Baha; Guney, Mehmet; Demirin, Hilmi; Ozguner, Meltem; Giray, Seren Gülsen; Take, Gulnur; Mungan, Tamer; Altuntas, Irfan
2006-11-01
We aimed to investigate the effect of subchronic administration of dichlorvos (DDVP) on endometrium and to evaluate ameliorating effects of a combination of Vitamins E and C against DDVP toxicity in the rat. Three groups of rats were used in the experiment. The first group was treated with 4 mg/kg DDVP; the second group was treated with 4 mg/kg body weight DDVP plus Vitamins E and C (DDVP+Vit); the third group was given only corn oil (control). DDVP and DDVP+Vit groups were given DDVP by gavage 5 days a week for 4 weeks at a dose level of 4 mg/kg day by using corn oil as the vechicle. Vitamins E and C were injected at doses of 50 mg/kg i.m. and 20 mg/kg body weight i.p. Histopathological and immunohistochemical examinations for caspase-3 and caspase-9 were accomplished in the endometrium. The level of malondialdehyde (MDA) increased significantly in the DDVP group compared with the control group (p<0.05). MDA significantly decreased in the DDVP+Vit group compared with the DDVP group (p<0.05). Administration of Vitamins E and C along with DDVP significantly reduced the histopathological changes and the extent of apoptosis. In conclusion, subchronic DDVP administration caused endometrial damage and that treatment with a combination of Vitamins E and C reduced endometrial damage caused by DDVP.
Harvey, E L; Glenny, A; Kirk, S F; Summerbell, C D
2001-01-01
Obesity is increasing throughout the industrialised world. If left unchecked it will have major implications for both population health and costs to health services. To assess whether health professionals' management or the organisation of care for overweight and obese people could be improved. We searched the specialised registers of the Cochrane Effective Practice and Organisation of Care Group (April 2000), the Cochrane Depression, Anxiety and Neurosis Group (August 1997), the Cochrane Diabetes Group (August 1997), the Cochrane Controlled Trials Register (September 1997), MEDLINE to April 2000, EMBASE to February 2000, Cinahl (1982 to February 2000), PsycLit (1974 to May 2000), Sigle (1980 to April 2000), Sociofile (1974 to October 1997), Dissertation Abstracts (1861 to January 1998), Conference Papers Index (1973 to January 1998), Resource Database in Continuing Medical Education. We also hand searched seven key journals and contacted experts in the field. Randomised trials, controlled before-and-after studies and interrupted time series analyses of providers' management of obesity or the organisation of care to improve provider practice or patient outcomes. We addressed three a priori comparisons and a fourth post hoc comparison. 1. Interventions aimed at improving health professionals' management or the delivery of health care for overweight/obese patients are more effective than usual care. 2. Interventions aimed at redressing negative attitudes and related practices towards overweight/obese patients are more effective than usual care. 3. Organisational interventions designed to change the structure of services for overweight/obese people are more effective than educational or behavioural interventions for health professionals. 4. Comparisons of different organisational interventions. Two reviewers independently extracted data and assessed study quality. Eighteen studies were included involving more than 447 providers and 4104 patients. Six studies were identified for comparison 1. Five were professional-oriented interventions (the use of reminders and training) and the sixth was a study of professional and organisational interventions of shared care. No studies were identified for comparisons 2 or 3. Twelve studies were identified for post hoc comparison 4. These compared either the deliverer of weight loss interventions or the setting of interventions. The included studies were heterogeneous and of generally poor quality. At present, decisions about improving provision of services must be based on the evidence of patient interventions and good clinical judgement. Further research is needed to identify cost effective strategies for improving the management of obesity.
Scanlan, Aaron T; Tucker, Patrick S; Dascombe, Ben J; Berkelmans, Daniel M; Hiskens, Matthew I; Dalbo, Vincent J
2015-11-01
Examination of activity demands and stoppage durations across game periods provides useful insight concerning fatigue, tactical strategies, and playing pace in team sports such as basketball. Therefore, the aims of this study were to quantify and compare game activity fluctuations across quarters in professional and semiprofessional basketball players. Video-based time-motion analyses were conducted across multiple games. Frequencies, total durations (in seconds), total distances (in meters), and mean velocities (in meters per second) were calculated for low-intensity movement (≤3 m·s), high-intensity movement (>3 m·s), shuffling, and dribbling activity. Frequencies were determined for jumping and upper-body activity; stoppage durations were also calculated. Separate repeated-measures analysis of variance and Cohen's d were used to identify significant differences and quantify the effect sizes between game quarters for all outcome measures, respectively. Pearson correlation analyses were performed to determine the relationship between stoppage duration and all activity measures. The results showed significantly (p ≤ 0.05) reduced dribbling (3.09 ± 0.03 m·s vs. 2.81 ± 0.01 m·s) and total (2.22 ± 0.04 m·s vs. 2.09 ± 0.03 m·s) activity velocities during the third compared with the first quarter in professional players. Furthermore, effect size analyses showed greater decreases in high-intensity (professional: d = 1.7-5.4; semiprofessional: d = 0.3-1.7), shuffling (professional: d = 2.3-3.2; semiprofessional: d = 1.4-2.1), and total (professional: d = 1.0-4.9; semiprofessional: d = 0.3-0.8) activity and increases in dribbling (professional: d = 1.4-4.7; semiprofessional: d = 2.5-2.8) with game progression in professional players. In semiprofessional players, stoppage duration was significantly (p ≤ 0.05) related to various low-intensity (R = 0.64-0.72), high-intensity (R = 0.65-0.72), and total (R = 0.63-0.73) activity measures. Although not directly measured, the observed game activity fluctuations were likely because of a combination of physiological (e.g., muscle glycogen depletion, dehydration), tactical (e.g., ball control, game pace), and game-related (e.g., time-outs, player fouls) factors. Basketball coaches can use the provided data to (a) develop more precise training plans and management strategies, (b) elevate semiprofessional player performance closer to the professional level, and (c) incorporate tactical strategies to maximize the benefits of stoppages.
Ryu, Seung-Hyun; Park, Jong-Hyung; Choi, Soo-Young; Jeon, Hee-Yeon; Park, Jin-Il; Kim, Jun-Young; Ham, Seung-Hoon; Choi, Yang-Kyu
2016-07-28
The main objective of this study was to investigate whether Lactobacillus rhamnosus GG (LGG) ameliorated the effects of Citrobactor rodentium infection in Toll-like receptor 2 (TLR2) knockout (KO) and TLR4 KO mice, as well as in wild-type C57BL/6 (B6) mice. TLR2 KO, TLR4 KO, and B6 mice were divided into three groups per each strain. Each group had an uninfected control group (n = 5), C. rodentium-infected group (n = 8), and LGG-pretreated C. rodentium-infected group (n = 8). The survival rate of B6 mice infected with C. rodentium was higher when pretreated with LGG. Pretreatment with LGG ameliorated C. rodentium-induced mucosal hyperplasia in B6 and TLR4 KO mice. However, in C-rodentium-infected TLR2 KO mice, mucosal hyperplasia persisted, regardless of pretreatment with LGG. In addition, LGG-pretreated B6 and TLR4 KO mice showed a decrease in spleen weight and downregulation of tumor necrosis factor alpha, interferon gamma, and monocyte chemotactic protein 1 mRNA expression compared with the non-pretreated group. In contrast, such changes were not observed in TLR2 KO mice, regardless of pretreatment with LGG. From the above results, we conclude that pretreatment with LGG ameliorates C. rodentium-induced colitis in B6 and TLR4 KO mice, but not in TLR2 KO mice. Therefore, LGG protects mice from C. rodentium-induced colitis in a TLR2-dependent manner.
Efficient, environmentally acceptable method for waterproofing insulation material
NASA Technical Reports Server (NTRS)
Blohowiak, Kay Y. (Inventor); Krienke, Kenneth A. (Inventor); Olli, Larry K. (Inventor); Newquist, Charles W. (Inventor)
2000-01-01
A process of waterproofing alumina-rich or silica-rich fibrous thermal insulation material, the process including the steps of: (a) providing an alumina-rich or a silica-rich fibrous material; (b) providing a waterproofing solution including: (1) a carrier solvent selected from the group consisting of aliphatic alcohols having from 1C to 6C, water, and mixtures thereof; and (2) an alkoxysilane defined by the formula R.sub.4-x -Si-(O-R').sub.x where x is 1-3 and R is selected from the group consisting of alkyl groups having from 1C to 10C, hydrogen, or fluorocarbon groups having from 1F to 15F; and where O-R' is an alkoxy group having from 1C to 5C, or a mixture of alkoxysilanes defined by the above formula R.sub.4-x -Si-(O-R').sub.x ; and optionally (3) modifiers including acids, such as acetic acid or nitric acid, or bases, such as ammonium hydroxide, RNH.sub.2, R.sub.2 NH, or R.sub.3 N, or MOH, where R is selected from the group consisting of alkyl groups having from 1C to 10C or hydrogen, and where M=Na, Li, or K; (c) contacting the fibrous material with the waterproofing solution for a sufficient amount of time to waterproof the fibrous material; and (d) curing the coated fibrous material to render it sufficiently waterproof. A chemical solution for waterproofing alumina-rich or silica-rich fibrous thermal insulation materials, the solution including: (a) a carrier solvent selected from the group consisting of aliphatic alcohols having from 1C to 6C, water, and mixtures thereof; and (b) an alkoxysilane defined by the formula R.sub.4-x -Si-(O-R').sub.x where x is 1-3 and R is selected from the group consisting of alkyl groups having from 1C to 10C, hydrogen, or fluorocarbon groups having from 1F to 15F; and where O-R' is an alkoxy group having from 1C to 5C, or a mixture of alkoxysilanes defined by the above formula R.sub.4-x -Si-(O-R').sub.x ; and optionally (c) modifiers including acids, such as acetic acid or nitric acid, or bases, such as ammonium hydroxide, RNH.sub.2, R.sub.2 NH, or R.sub.3 N, or MOH, where R is selected from the group consisting of alkyl groups having from 1C to 10C or hydrogen, and where M=Na, Li, or K.
Li, Xin; Luo, Shu-jing; Zhang, Kai; Yang, Hui-xia
2012-10-01
To establish and assess the high-birth-weight offspring model of the diabetic rat induced by stueptozotocin, and the long-term metabolic impact of maternal hyperglycemia of those offsprings. Streptozotocin (STZ, 25 mg/kg) was given to Wistar rats (G group, n = 14) once intraperitoneally to induce maternal hyperglycemia model (blood glucose between 10 - 20 mmol/L), and there still had a number of rats defined as severe hyperglycemia model group (SG group, n = 5). The Control group (C group, n = 7) were given the same volume citrate buffer solution. The body weight and blood glucose were recorded, and the lavaging glucose tolerance test (LGTT) was performed by a glucose meter in the gestation. The offsprings were corresponding allocated into 2 groups, and the birth weight were recorded. All the offsprings were observated body weight, blood glucose blood pressure (male rats only), and so on. (1) The blood glucose of G group (16.8 ± 5.4 mmol/L) and SG group (20.5 ± 5.6 mmol/L) were increased significantly as compared with C group (7.0 ± 1.4 mmol/L) 5 days after the model was established (P < 0.01); and the average blood glucose of G group (16.6 ± 3.4 mmol/L) and SG group (23.8 ± 1.5 mmol/L) increased too as comparede with C group (5.8 ± 1.1 mmol/L), the difference was significance according to statistics (P < 0.01). (2) According to the LGTT result, which operationed on generation day 4 and day 10, the blood glucose of every time point of G group were increased significantly as compared with C group (P < 0.01). (3) The male and female birth weight of G group was remarkably higher than the C group and the SG group (P < 0.05), and the blood glucose of SG/G/C group was (6.5 ± 1.2) mmol/L, (4.1 ± 0.8) mmol/L, (4.1 ± 0.8) mmol/L respectively, according to the statistics results, the difference between SG group and G/C group respectively both remarkable (P < 0.05). (4) The body weight, Lee's index, fat weight, and the fat weight of mass ratio in C group mother rats after lactation presented dressed compared with the SG group (P < 0.05), and so as to the G group compared with the SG group (P < 0.05). (5) In the female offsprings of G group, the birth weight was remarkably increased compared with the C group (P < 0.05); the body weight of the female offsprings presented an increased trend compared with the C group since the 12 weeks, but had no statistical significance; there were significant differences of body weight between G group and C group since 15 weeks (P < 0.05), and the trend kept up until 26 weeks; in the male offsprings of G group, the body weight on birth day and 4 weeks had a marked rise compared with the C group (P < 0.05); and from then on, the body weight of the male offsprings presented an increased trend compared with the C group, but had no statistical significance until 26 weeks (P > 0.05). (6) In G group, the blood glucose on 30 min and 60 min of LGTT in female offsprings were increased than the C group since 20 weeks (P < 0.05); the blood glucose of LGTT (30 min) still had a marked rise until 24 weeks (P < 0.05); in G group, the blood glucose on 30 min of LGTT in male offsprings was remarkably increased than the C group since 16 weeks (P < 0.05) ; the blood glucose of LGTT (30 min) still had a marked rise until 24 weeks (P < 0.05). (7) The blood pressure of male offsprings in G group had a marked rise on 12 weeks compared with the C group (P < 0.05); from then on the blood pressure of G group kept up a rise trend until 26 weeks, but had no statistical significance (P > 0.05). The diabetic high-birth-weight rat model could be duplicated with STZ (25 mg/kg) once intrapertoneally on the first day of gestation, which were observed some evidently metabolic changes in weight, glucose tolerance and blood pressure. These results could represent an forward step in the clinical study of human gestational diabetes mellitus and their macrosomia babies, which may suffer some metabolic disease in their later life.
Interactions between COL5A1 Gene and Risk of the Anterior Cruciate Ligament Rupture.
Lulińska-Kuklik, Ewelina; Rahim, Masouda; Domańska-Senderowska, Daria; Ficek, Krzysztof; Michałowska-Sawczyn, Monika; Moska, Waldemar; Kaczmarczyk, Mariusz; Brzeziański, Michał; Brzeziańska-Lasota, Ewa; Cięszczyk, Paweł; September, Alison V
2018-06-01
Collagen alpha-1(V) chain, encoded by the COL5A1 gene, plays a crucial role in abundant fibrillar collagens supporting many tissues in the body containing type I collagen and appears to regulate the association between heterotypic fibers composed of both type I and type V collagen occurring among others in muscles, tendons and ligaments. Taking this fact into consideration we decided to examine the association between COL5A1 rs12722 and rs13946 polymorphisms, individually and as inferred haplotypes, with anterior cruciate ligament rupture risk (ACLR) in professional soccer players. A total of 134 male professional soccer players with surgically diagnosed primary anterior cruciate ligament ruptures and 211 apparently healthy male professional soccer players, who were without any self-reported history of ligament or tendon injury, were included in the study. Both the cases and the healthy controls were recruited from the same soccer teams, of a similar age category, and had a comparable level of exposure to anterior cruciate ligament injury. Genomic DNA was extracted from oral epithelial cells using GenElute Mammalian Genomic DNA MiniprepKit. All samples were genotyped for the rs12722 and rs13946 polymorphisms using a Rotor-Gene realtime polymerase chain reaction. Statistically significant differences in the genotype frequencies for the COL5A1 rs13946 polymorphisms in dominant modes of inheritance occurred (p = 0.039). Statistically significant differences were documented only in the dominant model under the representation tendency of the C-C haplotype in the ACLR group compared to controls (p = 0.038). Our results suggest that variation in the COL5A1 gene may be one of the non-modifiable factors associated with the ACL injury in professional soccer players. The C-C rs12722-rs13946 haplotype provides a protective effect against the ACL tear.
ERIC Educational Resources Information Center
Hadar, Linor L.; Brody, David L.
2013-01-01
This study explores the interaction between transformative processes in which a group of teacher educators became a professional development community (PDC) and the individual progress of these instructors through the professional development course on the topic of thinking education. Twelve teacher educators who participated in one of three…
Widger, Kimberley; Tourangeau, Ann E; Steele, Rose; Streiner, David L
2015-01-01
The field of pediatric palliative care is hindered by the lack of a well-defined, reliable, and valid method for measuring the quality of end-of-life care. The study purpose was to develop and test an instrument to measure mothers' perspectives on the quality of care received before, at the time of, and following a child's death. In Phase 1, key components of quality end-of-life care for children were synthesized through a comprehensive review of research literature. These key components were validated in Phase 2 and then extended through focus groups with bereaved parents. In Phase 3, items were developed to assess structures, processes, and outcomes of quality end-of-life care then tested for content and face validity with health professionals. Cognitive testing was conducted through interviews with bereaved parents. In Phase 4, bereaved mothers were recruited through 10 children's hospitals/hospices in Canada to complete the instrument, and psychometric testing was conducted. Following review of 67 manuscripts and 3 focus groups with 10 parents, 141 items were initially developed. The overall content validity index for these items was 0.84 as rated by 7 health professionals. Based on feedback from health professionals and cognitive testing with 6 parents, a 144-item instrument was finalized for further testing. In Phase 4, 128 mothers completed the instrument, 31 of whom completed it twice. Test-retest reliability, internal consistency, and construct validity were demonstrated for six subscales: Connect With Families, Involve Parents, Share Information With Parents, Share Information Among Health Professionals, Support Parents, and Provide Care at Death. Additional items with content validity were grouped in four domains: Support the Child, Support Siblings, Provide Bereavement Follow-up, and Structures of Care. Forty-eight items were deleted through psychometric testing, leaving a 95-item instrument. There is good initial evidence for the reliability and validity of this new quality of end-of-life care instrument as a mechanism for evaluative feedback to health professionals, health systems, and policy makers to improve children's end-of-life care.
Klossner, Joanne
2008-01-01
Professional socialization during formal educational preparation can help students learn professional roles and can lead to improved organizational socialization as students emerge as members of the occupation's culture. Professional socialization research in athletic training is limited. To present the role of legitimation and how it influences the professional socialization of second-year athletic training students. Modified constructivist grounded theory and case study methods were used for this qualitative study. An accredited undergraduate athletic training education program. Twelve second-year students were selected purposively. The primary sample group (n = 4) was selected according to theoretical sampling guidelines. The remaining students made up the cohort sample (n = 8). Theoretically relevant data were gathered from 14 clinical instructors to clarify emergent student data. Data collection included document examination, observations, and interviews during 1 academic semester. Data were collected and analyzed through constant comparative analysis. Data triangulation, member checking, and peer-review strategies were used to ensure trustworthiness. Legitimation from various socializing agents initiated professional socialization. Students viewed trust and team membership as rewards for role fulfillment. My findings are consistent with the socialization literature that shows how learning a social or professional role, using rewards to facilitate role performance, and building trusting relationships with socializing agents are important aspects of legitimation and, ultimately, professional socialization.
Developing professionalism: dental students' perspective.
Ashar, Abid; Ahmad, Amina
2014-12-01
To explore the undergraduate dental students' insight of their professionalism development through Focus Group Discussions (FGD). Constructivist approach using qualitative phenomenological design. Fatima Memorial Hospital, College of Dentistry, Lahore, from April to June 2011. Four FGDs of 1st year (8 students), 2nd year (6 students), 3rd year (6 students) and 4th year (6 students) enrolled in Bachelor of Dental Surgery (BDS) program were conducted to explore how they have developed various elements of professionalism namely altruism, accountability, excellence, duty and service, honor and integrity, and respect for all; and how professionalism can be further developed in them. The FGDs were audio taped, transcribed and analyzed through thematic analysis. Triangulation of themes and trends were done through content analysis by relating to their respective frequency of quotes. Data verification was done through audit by second author. Role models and social responsibility were the main reasons in the students' professionalism development thus far with personal virtues and reasons; religion; and punishment and reward contributing to a lesser degree. Training contributed least but was deemed most in furthering professionalism. Excessive workload (quota) and uncongenial educational environment were considered detrimental to the cause. Formal planning and implementation of professionalism curriculum; selection of students with appropriate attributes; control of hidden curriculum, including effective role models, good educational and working environments will foster professionalism among dental students maximally.
Jackson, John K; Hussainy, Safeera Y; Kirkpatrick, Carl M J
2017-08-01
Objective The aim of the present study was to describe an environmental framework for pharmacists in primary care in Australia and determine the major factors within that environment that have the greatest bearing on their capacity to implement patient-focused models of professional practice. Methods A draft framework for pharmacists' practice was developed by allocating structures, systems and related factors known to the researchers or identified from the literature as existing within pharmacists' internal, operational and external environments to one of five domains: Social, Technological, Economic, Environmental or Political [STEEP]. Focus groups of pharmacists used an adapted nominal group technique to assess the draft and add factors where necessary. Where applicable, factors were consolidated into groups to establish a revised framework. The three major factors or groups in each domain were identified. The results were compared with the enabling factors described in the profession's vision statement. Results Seventy-eight individual factors were ultimately identified, with 86% able to be grouped. The three dominant groups in each of the five domains that had a bearing on the implementation of professional models of practice were as follows: (1) Social: the education of pharmacists, their beliefs and the capacity of the pharmacist workforce; (2) Technological: current and future practice models, technology and workplace structures; (3) Economic: funding of services, the viability of practice and operation of the Pharmaceutical Benefits Scheme; (4) Environmental: attitudes and expectations of stakeholders, including consumers, health system reform and external competition; and (5) Political: regulation of practice, representation of the profession and policies affecting practice. Conclusions The three dominant groups of factors in each of the five STEEP environmental domains, which have a bearing on pharmacists' capacity to implement patient-focused models of practice, correlate well with the enabling factors identified in the profession's vision statement, with the addition of three factors in the Environmental domain of stakeholder attitudes, health system reform and external competition. What is known about the topic? The extensive range of patient-focused professional programs developed for application by pharmacists in primary care in Australia has yet to be widely implemented. What does this paper add? Factors both within and beyond the pharmacists' immediate practice environment that have a bearing on the uptake of professional programs have been identified and prioritised using a structured thematic approach. What are the implications for practitioners? The results demonstrate the need for a multifactorial approach to the implementation of professional models of practice in this setting.
Leo, Francisco Miguel; González-Ponce, Inmaculada; Sánchez-Oliva, David; Pulido, Juan José; García-Calvo, Tomás
2015-01-01
This investigation presents two studies with the goal of adapting and validating a short version of the Group Environment Questionnaire in the Spanish sport context with professional players. Study 1 used a sample of 377 male soccer players aged between 18 and 39 years ( M = 24.51, SD = 3.73), in a preliminary study using exploratory factor analysis. Study 2 used a sample of 604 professional male and female athletes, ages between 15 and 38 years ( M = 24.34, SD = 4.03). The data analyzed were collected at three moments of the season. For each measurement, we developed seven first- and second-order structures that were analyzed with confirmatory factor analysis. Study 1 indicated appropriate factorial validity (> .60) and internal consistency (> .70), with only Item 3 presenting a low factor loading (.11), so its drafting was modified in the next study. Study 2 revealed that the Spanish version of the GEQ has high levels of internal consistency (> .70) and acceptable fit index values in its original four first-order factor structure in all three measurements ( χ²/df = 4.39, CFI = .95, IFI = .95, RMSEA = .07, SRMR = .04, AIC = 271.09). Discriminant validity (from r = .45 to r = .72) and concurrent validity (from r = .21 to r = .60) also presented appropriate values. Lastly, we conducted analysis of invariance, confirming that the models established in the different measurements were invariant. The short 12-item adaptation of the GEQ to Spanish is a valid and reliable instrument to measure team cohesion in professional male and female soccer players.
EFFECT OF DIFFERENT PROPHYLAXIS METHODS ON SOUND AND DEMINERALIZED ENAMEL
Honório, Heitor Marques; Rios, Daniela; Abdo, Ruy César Camargo; Machado, Maria Aparecida de Andrade Moreira
2006-01-01
Considering the importance of professional plaque control for caries prevention, this study comprised an in vitro evaluation of wear by two prophylaxis methods (sodium bicarbonate jet – Profident and pumice and brush) on sound bovine enamel and with artificial carious lesions. Sixty enamel fragments were employed (4x4mm), which were divided into 4 groups: GI – 15 sound blocks treated with pumice and brush; GII – 15 sound blocks treated with Profident; GIII – 15 demineralized blocks treated with pumice and brush, and GIV – 15 demineralized blocks treated with Profident. In the fragments of Groups III and IV, artificial carious lesions were simulated by immersion in 0.05M acetic acid solution 50% saturated with bovine enamel powder at 37oC for 16h. The specimens were submitted to the prophylactic treatments for 10 seconds. Wear analysis was performed by profilometer and revealed the following results: 0.91μm – GI; 0.42μm – GII; 1.6μm – GIII, and 0.94μm – GIV. The two-way ANOVA and Tukey's test (p<0.05) revealed significant difference between all groups. Scanning electron microscopy images were employed to illustrate the wear pattern, with observation of larger alteration on the demineralized enamel surface (GIII; GIV), round-shaped wear on GI and GIII and blasted aspect on GII and GIV. The study indicated that the demineralized enamel presented more wear than the sound enamel, and the brush led to larger wear when compared to Profident. PMID:19089042
Fan, Guoxin; Guan, Xiaofei; Sun, Qi; Hu, Annan; Zhu, Yanjie; Gu, Guangfei; Zhang, Hailong; He, Shisheng
2015-01-01
Percutaneous transforaminal endoscopic discectomy (PTED) usually requires numerous punctures under X-ray fluoroscopy. Repeated puncture will lead to more radiation exposure and reduce the beginners' confidence. This cadaver study aimed to investigate the efficacy of HE's Lumbar Location (HELLO) system in puncture reduction of PTED. Cadaver study. Comparative groups. HELLO system consists of self-made surface locator and puncture locator. One senior surgeon conducted the puncture procedure of PTED on the left side of 20 cadavers at L4/L5 and L5/S1 level with the assistance of HELLO system (Group A). Additionally, the senior surgeon conducted the puncture procedure of PTED on the right side of the cadavers at L4/L5 and L5/S1 level with traditional methods (Group B). On the other hand, an inexperienced surgeon conducted the puncture procedure of PTED on the left side of the cadavers at L4/L5 and L5/S1 level with the assistance of our HELLO system (Group C). At L4/L5 level, there was significant difference in puncture times between Group A and Group B (P<0.001), but no significant difference was observed between Group A and Group C (P = 0.811). Similarly at L5/S1 level, there was significant difference in puncture times between Group A and Group B (P<0.001), but no significant difference was observed between Group A and Group C (P = 0.981). At L4/L5 level, there was significant difference in fluoroscopy time between Group A and Group B (P<0.001), but no significant difference was observed between Group A and Group C (P = 0.290). Similarly at L5/S1 level, there was significant difference in fluoroscopy time between Group A and Group B (P<0.001), but no significant difference was observed between Group A and Group C (P = 0.523). As for radiation exposure, HELLO system reduced 39%-45% radiation dosage when comparing Group A and Group B, but there was no significant difference in radiation exposure between Group A and Group C whatever at L4/L5 level or L5/S1 level (P>0.05). There was no difference in location time between Group A and Group B or Group A and Group C either at L4/L5 level or L5/S1 level (P>0.05). Small-sample preclinical study. HELLO system was effective in reducing puncture times, fluoroscopy time and radiation exposure, as well as the difficulty of learning PTED. (2015-RES-127).
Parslow, Roxanne M; Shaw, Alison; Haywood, Kirstie L; Crawley, Esther
2017-02-01
Paediatric Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) is relatively common and disabling. Improving treatment requires the development of Patient Reported Outcome Measures (PROMs) that enable clinicians and researchers to collect patient-centred evidence on outcomes. Health professionals are well placed to provide clinical insight into the condition, its treatment and possible outcomes. This study aimed to understand the perspectives of specialist paediatric CFS/ME health professionals and identify outcomes that are clinically important. Focus groups and interviews were held with 15 health professionals involved in the care of children with CFS/ME from the four largest specialist paediatric CFS/ME services in the NHS in England. A range of clinical disciplines were included and experience in paediatric CFS/ME ranged from 2 months to 25 years. Ten participants (67%) were female. Focus groups and interviews were recorded, transcribed verbatim and data were analysed using thematic analysis. All health professionals identified the impact of CFS/ME across multiple aspects of health. Health professionals described four areas used to assess the severity of the illness and outcome in children: 1) symptoms; 2) physical function; 3) participation (school, activities and social life); and 4) emotional wellbeing. They also described the complexity of the condition, contextual factors and considerations for treatment to help children to cope with the condition. Clinically important outcomes in paediatric CFS/ME involve a range of aspects of health. Health professionals consider increases in physical function yet maintaining school functioning and participation more widely as important outcomes from treatment. The results are similar to those described by children in a recent study and will be combined to develop a new child-specific PROM that has strong clinical utility and patient relevance.
Turner, David A; Fleming, Geoffrey M; Winkler, Margaret; Lee, K Jane; Hamilton, Melinda F; Hornik, Christoph P; Petrillo-Albarano, Toni; Mason, Katherine; Mink, Richard
2015-01-01
Communication and professionalism are often challenging to teach, and the impact of the use of a given approach is not known. We undertook this investigation to establish pediatric critical care medicine (PCCM) trainee perception of education in professionalism and communication and to compare their responses from those obtained from PCCM fellowship program directors. The Education in Pediatric Intensive Care (E.P.I.C.) Investigators used the modified Delphi technique to develop a survey examining teaching of professionalism and communication. After piloting, the survey was sent to all 283 PCCM fellows in training in the United States. Survey response rate was 47% (133 of 283). Despite high rates of teaching overall, deficiencies were noted in all areas of communication and professionalism assessed. The largest areas of deficiency included not being specifically taught how to communicate: as a member of a nonclinical group (reported in 24%), across a broad range of socioeconomic and cultural backgrounds (19%) or how to provide consultation outside of the intensive care unit (17%). Only 50% of fellows rated education in communication as "very good/excellent." However, most felt confident in their communication abilities. For professionalism, fellows reported not being taught accountability (12%), how to conduct a peer review (12%), and how to handle potential conflict between personal beliefs, circumstances, and professional values (10%). Fifty-seven percent of fellows felt that their professionalism education was "very good/excellent," but nearly all expressed confidence in these skills. Compared with program directors, fellows reported more deficiencies in both communication and professionalism. There are numerous components of communication and professionalism that PCCM fellows perceive as not being specifically taught. Despite these deficiencies, fellow confidence remains high. Substantial opportunities exist to improve teaching in these areas. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Kadowaki, Takashi; Inagaki, Nobuya; Kondo, Kazuoki; Nishimura, Kenichi; Kaneko, Genki; Maruyama, Nobuko; Nakanishi, Nobuhiro; Gouda, Maki; Iijima, Hiroaki
2017-01-01
Dipeptidyl peptidase‐4 (DPP‐4) inhibitors and sodium glucose co‐transporter 2 (SGLT2) inhibitors are frequently used in combination for the treatment of type 2 diabetes mellitus (T2DM). We examined the efficacy and safety of teneligliptin (a DPP‐4 inhibitor) added to canagliflozin (an SGLT2 inhibitor) monotherapy in Japanese patients with poorly controlled T2DM as part of the development of a fixed‐dose combination of teneligliptin and canagliflozin. Japanese patients treated with canagliflozin (100 mg) for ≥12 weeks were randomized to receive add‐on teneligliptin (20 mg; C + T group) or placebo (C + P group) for 24 weeks. The primary endpoint was change in glycated haemoglobin (HbA1c) from baseline to Week 24. The between‐group differences in reductions from baseline to Week 24 were significantly greater in the C + T group for HbA1c (−0.94%; P < .001). The incidence of adverse events was similar in both groups (55.8% and 49.4% in the C + T and C + P groups, respectively). No episodes of hypoglycaemia were reported. Teneligliptin added to ongoing canagliflozin monotherapy improved glycaemic control and was well tolerated in Japanese patients with inadequately controlled T2DM. PMID:28786530
Luo, Haoxuan; Chen, Yan; Sun, Baoguo; Xiang, Ting; Zhang, Shijun
2017-01-01
Spleen-deficiency syndrome (SDS) in Traditional Chinese Medicine (TCM) played pivotal roles on the development of hepatocellular carcinoma (HCC). This study was performed to establish and evaluate HCC model in mice with SDS in TCM. A total of 90 C57BL/6 mice were randomized in six groups (n=15 for each group): A, Control group; B, SDS group; C, orthotopic HCC (OHCC) group; D, OHCC based on SDS (SDS-OHCC) group; E, Drug-induced HCC (DHCC) group; F, DHCC based on SDS (SDS-DHCC) group. The SDS model were established by subcutaneous injection of reserpine, followed by the OHCC or DHCC model establishment. The SDS scores, tumor formation rate and survival time were recorded and calculated, as well as the histochemical stain was performed. The SDS scores of mice in Group B, D, F were 17.57±4.86 (P<0.05 vs. Group A), 18.13±4.53 (P<0.05 vs. Group A and C) and 23.32±4.94 (P<0.05 vs. Group A and E) respectively. The tumor formation rate of mice in Group C, D, E and F were 73.33%, 100%, 60% and 80% respectively. The survival time of mice in Group C, D, E and F were 26.42±5.27, 17.33±4.76 (P<0.05 vs. Group C), 35.77±6.12 and 22.61±5.05 (P<0.05 vs. Group E) respectively. The SDS-oriented HCC mice models were simple and easily-operated models for further studies on SDS oriented tumor. Meanwhile, SDS was a pivotal factor for low outcome of hepatic tumor. Abbreviations: HCC, Hepatocellular carcinoma; OHCC, Orthotopic hepatocellular carcinoma; DHCC, Drug-induced hepatocellular carcinoma; SDS, Spleen-deficiency syndrome; TCM, Traditional Chinese Medicine; SPF, Specific pathogen-free; DEN, Diethylnitrosamine; CCl4, Carbon tetrachloride; HE, Hematoxylin-eosin; IACUC, Institutional Animal Care and Use Committee.
Cross-cultural differences in the management of children and adolescents with diabetes.
Greene, A C; Tripaldi, M; Chiarelli, F; McKiernan, P; Morris, A; Newton, R; Greene, S
2002-01-01
Glycaemic control deteriorates frequently in adolescents with diabetes. There is a considerable body of work on the effect of psychological aspects of management in this age group, but few randomized controlled trials of the effect of specific behavioural therapy and lifestyle modification on the improvement of glycaemic control. Of recent interest have been the observations from the Hvidøre Study Group on cross-cultural differences in glycaemic control. The average glycosylated haemoglobin in 22 centres, across 18 countries, varied in young people, with HbA1c levels ranging from 7.6 to 10.2%. No obvious differences in management were identified in this survey that could account for the disparities in glycaemic control. Data from the Scottish Study Group demonstrated similar variation in average glycaemic control in centres across a single culture. Using the qualitative methodology of anthropological research, some specific factors were identified that appear to influence young people's response to diabetes management and strategies employed by health professionals in their advice and care of the diabetes, particularly in relation to intensive insulin regimens. The main cultural factors influencing glycaemic control appear to be communication, reciprocal support between young people and professional heart carers and family structure within an individualistic, as against an egalitarian, society. Shared beliefs about teenage risk behaviour together with the medicalization of adolescence within medical culture also appears to be highly influential. The aim of this educational discussion group was to explore how a variety of health care professionals from distinctive cultures approach diabetes care delivery in this age group. The specific success and difficulties in different cultures in managing the young person with diabetes were investigated. Also discussed was how qualitative research methodology may generate further research in this area. Copyright 2002 S. Karger AG, Basel
Intrauterine Growth Restricted Rats Exercised at Pregnancy: Maternal-Fetal Repercussions.
Corvino, S B; Netto, A O; Sinzato, Y K; Campos, K E; Calderon, I M P; Rudge, M V C; Volpato, G T; Zambrano, E; Damasceno, D C
2015-08-01
To evaluate the effect of swimming in pregnant rats born with intrauterine growth restriction (IUGR) and their offspring, IUGR rats were obtained using the streptozotocin-induced severe diabetic (SD) rats. In this study, the nondiabetic parental generation presented 10 rats and diabetic parental generation presented 116 rats. Of these, the mated nondiabetic female rats were 10 and the number of diabetic rats was 45. In relation to term pregnancy, there were 10 animals in the nondiabetic group and 15 rats in the diabetic group. In the offspring of SD rats (IUGR group), 43 females were classified as small for pregnancy age, 19 rats were classified as appropriate for pregnancy age, and 0 female was classified as large for pregnancy age. The nondiabetic and SD pregnant rats generated offspring with appropriate (control [C]) and small (IUGR) weight for pregnancy age, respectively. At adult life, the C group was maintained as nonexercised C group and IUGR rats were distributed into 2 subgroups, namely, nonexercised (IUGR) and exercised (IUGRex). The rate of mated rats in the IUGR group was reduced compared to the C group. During pregnancy, the IUGR rats presented hyperinsulinemia, impaired reproductive outcomes, decreased body weight, hypertriglyceridemia, and hyperlactacidemia. The IUGRex presented reduced insulin and triglyceride levels. Thus, swimming improved lipid metabolism and increased insulin sensitivity. However, the offspring showed retarded growth, reinforcing the need to stimulate the exercise practice in women under supervision with different professional expertise to promote appropriate gestational conditions and improve perinatal outcomes. © The Author(s) 2015.
He, Axiang; Xie, Dong; Qu, Bo; Cai, Xiaomin; Kong, Qin; Yang, Lili; Chen, Xiongsheng; Jia, Lianshun
2018-01-31
Cervical radiculopathy is a common disease that affects millions of people. Patients usually are managed by conservative therapy and surgical treatments. To compare the clinical outcomes between cervical disc arthroplasty (CDA) and conservative management for patients with single level cervical radiculopathy at C5/6. Seventy-two patients with cervical radiculopathy that only affect C5/6 joints were included and thirty-two of them received CDA surgery, and forty patients were treated with conservative management. All the patients were followed up around 4 years. Cervical curvature, cervical range of motion (CROM), horizontal displacement of cervical spine, and intervertebral gap were measured by radiological examination. All the patients have comparable disease severity based on pre-surgical radiological assessments. At the 4-year follow-up examination, patients with CDA surgery had less CROM at C5/6 level, while greater CROM at C4/5 level, than control group. Similarly, the horizontal displacement in CDA group decreased at C5/6 vertebrae, and increased at C4/5 level at the 4-year follow-up examination. The intervertebral gaps of patients in CDA group were larger than control group at one-year and last follow-up examination. CDA surgery stabilized C5/6 vertebrae and increased the CROM and horizontal displacement of upper adjacent C4/5 vertebrae. Copyright © 2018. Published by Elsevier Ltd.
Fuertes Goñi, Maria Carmen; Elizalde, L; De Andrés, M R; García Castellano, P; Urmeneta, S; Uribe, J M; Bustince, P
2010-01-01
To describe utilisation of health care services and motives for consultation in Primary Care in the native and the immigrant population, and compare this with the perception of primary care professionals. Data was collected on health care activity during the year 2006 for all people registered (N=86,966) in the 6 basic health care zones with the highest proportion of immigrants (14.4%) and on the following variables: country of origin, age, sex, year of inscription in the public health service. The health card and OMI-AP programme databases were used. A qualitative methodology of focus groups and in-depth interviews was employed. Seventy-two point four percent of immigrants requested care from the primary care professionals in 2006, of whom 50% proceeded from Ecuador and 70% were between 25 and 44 years old. Eighty-two percent of the natives made consultations and required more referrals to specialised care than the immigrants of the same age group. The most frequent consultation with natives and with immigrants was "acute respiratory infections" (7 to 23% according to age group). The second most frequent with immigrants was "administrative problems". The consultations with immigrants were not related to preventive aspects such as smoking and there were more consultations (p>0.001) for gynaeco-obstetric episodes (10.7%) and those related to work (19%) or psychosomatic problems (8.5%). The perception of the primary care professionals was that the immigrants carry out more consultations than the natives and generate a certain "disorder" in the clinic. Immigrants use healthcare services less than the native population. Nonetheless, this fact is not perceived in this way by the primary care professionals. Fewer preventive activities are carried out with immigrants, who suffer from more labour and psychosomatic problems.
Survivorship Care for Older Adults with Cancer: U13 Conference Report
Guerard, Emily J.; Nightingale, Ginah; Bellizzi, Keith; Burhenn, Peggy; Rosko, Ashley; Artz, Andrew S.; Korc-Grodzicki, Beatriz; Canin, Beverly; Dale, William; Ferrell, Betty
2016-01-01
Older adult cancer survivors currently account for almost 60% of all cancer survivors. The number of older cancer survivors will continue to increase as the population ages and as patients’ live longer after a cancer diagnosis. As part of cancer center accreditation, the American College of Surgeons Commission on Cancer® (CoC) has placed great importance on survivorship care planning. While the CoC has set standards for general survivorship care, there is sparse evidence on how to best care for older adult cancer survivors. Concern exists among the medical community that survivorship care plans could increase paperwork without improving outcomes. Given the diverse and unique needs of older adult cancer survivors, the inter-professional team provides a structure and process for survivorship care built around the particular needs of older adults. The Cancer and Aging Research Group (CARG), in partnership with the NIA/NCI, held a U13 conference in May 2015 in part to discuss survivorship care for older adults with cancer. This report discusses four themes that emerged from one section of the conference: (1) survivorship care is a process that continually evolves to meet the needs of older adults; (2) older adult cancer survivors have unique needs and care plans should be tailored to meet these needs; (3) the inter-professional team is ideally suited to structure survivorship care of older adults; (4) patient advocacy must be encouraged throughout the cancer care continuum. As evidence based survivorship practices develop, the unique needs of older adults need to be given substantial attention. PMID:27424802
Cheng, Chiu Tung; Chan, Man Nin; Wilson, Kevin R.
2016-07-09
Oxygenated organic molecules are abundant in atmospheric aerosols and are transformed by oxidation reactions near the aerosol surface by gas-phase oxidants such as hydroxyl (OH) radicals. To gain better insights into how the structure of an organic molecule, particularly in the presence of hydroxyl groups, controls the heterogeneous reaction mechanisms of oxygenated organic compounds, this paper investigates the OH-radical initiated oxidation of aqueous tartaric acid (C 4H 6O 6) droplets using an aerosol flow tube reactor. The molecular composition of the aerosols before and after reaction is characterized by a soft atmospheric pressure ionization source (Direct Analysis in Real Time)more » coupled with a high-resolution mass spectrometer. The aerosol mass spectra reveal that four major reaction products are formed: a single C 4 functionalization product (C 4H 4O 6) and three C 3 fragmentation products (C 3H 4O 4, C 3H 2O 4, and C 3H 2O 5). The C 4 functionalization product does not appear to originate from peroxy radical self-reactions but instead forms via an α-hydroxylperoxy radical produced by a hydrogen atom abstraction by OH at the tertiary carbon site. The proximity of a hydroxyl group to peroxy group enhances the unimolecular HO 2 elimination from the α-hydroxylperoxy intermediate. This alcohol-to-ketone conversion yields 2-hydroxy-3-oxosuccinic acid (C 4H 4O 6), the major reaction product. While in general, C–C bond scission reactions are expected to dominate the chemistry of organic compounds with high average carbon oxidation states (OS C), our results show that molecular structure can play a larger role in the heterogeneous transformation of tartaric acid (OS C = 1.5). Finally, these results are also compared with two structurally related dicarboxylic acids (succinic acid and 2,3-dimethylsuccinic acid) to elucidate how the identity and location of functional groups (methyl and hydroxyl groups) alter heterogeneous reaction mechanisms.« less
Urbańska, Katarzyna; Żelazko, Aleksandra; Domagalska, Joanna; Nowak, Przemysław
Fast progress in a lot of economic sectors has greatly contributed to a growing role of road transportation systems, including freight transport and passenger transport. The job of professional drivers is regarded as extremely hard and dangerous, it is associated with high risk of health loss and even life loss. This profession is also associated with mental burden, the main cause of the absence at work and alarming number of road accidents. The aim of study was to compare exposure to stress, check the level of stress and ways to cope with stress in 2 groups of drivers (N = 187). The study was carried out among public transport drivers and freight transport drivers. The authors' own questionnaire and 2 psychological tests: Perceived Stress Scale (PSS-10) and Posttraumatic Growth Inventory and Inventory to Measure Coping Strategies with Stress (Mini-COPE) were used as the study tools. The level of stress is high in both groups, mostly due to a similar type of work. Both groups practice similar ways to cope with stress, but active ways predominate. The work of a professional driver is considered as extremely stressful. The level of stress among professional drivers should be under continuous control. Employers should introduce preventive programs and educate employees about some professional ways to cope with stress. Med Pr 2016;67(4):455-466. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Extending inter-professional learning through the use of a multi-disciplinary Wiki.
Stephens, Melanie; Robinson, Leslie; McGrath, Denis
2013-11-01
This paper reports our experiences of a student learning activity which employed a Wiki for student radiographers and nurses to build on an inter-professional learning event. The aim of the Wiki was to facilitate inter-professional learning for students who, having met face-to-face once for a classroom based activity, would not be timetabled to meet again. It was designed to allow students from differing disciplines to: construct knowledge together, learn from and about one another, and collaboratively produce a textual learning resource. 150 nursing and radiography undergraduates were provided with a PBL trigger related to the acute presentation of stroke. The students met once (5 mixed-discipline groups) to discuss the role of the professions and the outcomes for the trigger scenario. Further learning was enabled through the provision of a Wiki for each group. At week 4, all Wikis were made visible for group peer assessment. Wiki editing skills were provided by student 'Wiki champions', who cascaded training to their peers. We report and reflect on the students' evaluations of both the Wiki as process and outcome and discuss the value of Wikis for inter-professional learning. Findings show that, in addition to being an enjoyable and flexible learning experience, the Wiki satisfied its intended aims. There was a variation in the level and quality of student participation the causes of which are discussed. Ground rules for effective Wiki use are proposed. Copyright © 2013 Elsevier Ltd. All rights reserved.
Zahner, V; Rabinovitch, L; Cavados, C F; Momen, H
1994-04-01
Sixty strains of Bacillus sphaericus, including 31 insect pathogens were studied by multilocus enzyme electrophoresis and were classified into 44 zymovars (electrophoretic types). Among the entomopathogenic strains, 11 belong to the same zymovar (Z59) indicating a widespread frequent genotype. Bands of enzyme activity were not detected among the strains for the loci GPI (E.C.5.3.1.9), G6P (E.C.1.1.1.49), 6PG (E.C.1.1.1.44) and ME (E.C.1.1.1.40). The enzymatic loci NP (E.C.2.4.2.1) and ACON (E.C.4.2.1.3) were monomorphic while the other enzymes, MDH (E.C.1.1.1.37), LeDH (E.C.1.4.1.9), ADH (E.C.1.4.1.1), EST (E.C.3.1.1.1), PEP-2 (E.C.3.4.11.1), PEP-3 (E.C.3.4.11) and PEP-D (E.C. 3.4.13.9) were polymorphic. The genetic variation in the non-insect pathogenic group seemed to be greater than in the entomopathogenic group. This latter group appears to be distinct from other strains of these species. All insect pathogens were recovered in the same phenetic cluster and a diagnostic allele is reported for the identification of entomopathogenic strains.
Jackson, Hope T; Young, Monica T; Rodriguez, H Alejandro; Wright, Andrew S
2018-06-01
Facebook is a popular online social networking platform increasingly used for professional collaboration. Literature regarding use of Facebook for surgeon professional development and education is limited. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has established a Facebook group dedicated to discussion of surgery of the esophagus, stomach, and small intestine-the "SAGES Foregut Surgery Masters Program." The aim of this study is to examine how this forum is used for professional development, education, and quality improvement. Member and post statistics were obtained from https://grytics.com , a Facebook group analytics service. All posts added to the Foregut forum since its creation in April 2015 through December 2016 were reviewed and categorized for content and topic. Posts were reviewed for potential identifiable protected health information. As of December 2016, there were 649 total members in the group. There have been a total of 411 posts and 4116 comments with a median of 10.1 comments/post (range 0-72). Posts were categorized as operative technique (64%), patient management (52%), continuing education (10%), networking (10%), or other (6%). Video and/or photos were included in 53% of posts with 4% of posts depicting radiologic studies and 13% with intraoperative photos or videos. An additional 40 posts included links to other pages, such as YouTube, journal articles, or the SAGES website. One post (0.2%) contained identifiable protected health information and was deleted once recognized by the moderators of the group. Social media is a unique, real-time platform where surgeons can learn, discuss, and collaborate towards the goal of optimal treatment of surgical disease. Active online surgical communities such as the SAGES Foregut Surgery Masters Program have the potential to enhance communication between surgeons and are a potential innovative adjunct to traditional methods of continuing surgical education. Surgical societies should adopt and promote professional and responsible use of social media.
Crystal structures of three 3,4,5-trimethoxybenzamide-based derivatives
Gomes, Ligia R.; Low, John Nicolson; Oliveira, Catarina; Cagide, Fernando; Borges, Fernanda
2016-01-01
The crystal structures of three benzamide derivatives, viz. N-(6-hydroxyhexyl)-3,4,5-trimethoxybenzamide, C16H25NO5, (1), N-(6-anilinohexyl)-3,4,5-trimethoxybenzamide, C22H30N2O4, (2), and N-(6,6-diethoxyhexyl)-3,4,5-trimethoxybenzamide, C20H33NO6, (3), are described. These compounds differ only in the substituent at the end of the hexyl chain and the nature of these substituents determines the differences in hydrogen bonding between the molecules. In each molecule, the m-methoxy substituents are virtually coplanar with the benzyl ring, while the p-methoxy substituent is almost perpendicular. The carbonyl O atom of the amide rotamer is trans related with the amidic H atom. In each structure, the benzamide N—H donor group and O acceptor atoms link the molecules into C(4) chains. In 1, a terminal –OH group links the molecules into a C(3) chain and the combined effect of the C(4) and C(3) chains is a ribbon made up of screw related R 2 2(17) rings in which the ⋯O—H⋯ chain lies in the centre of the ribbon and the trimethoxybenzyl groups forms the edges. In 2, the combination of the benzamide C(4) chain and the hydrogen bond formed by the terminal N—H group to an O atom of the 4-methoxy group link the molecules into a chain of R 2 2(17) rings. In 3, the molecules are linked only by C(4) chains. PMID:27308017
Structure of complexes of uranyl succinate with carbamide and dimethylurea
NASA Astrophysics Data System (ADS)
Serezhkina, L. B.; Grigor'ev, M. S.; Seliverstova, N. V.; Serezhkin, V. N.
2017-09-01
Three new succinate-containing complexes of uranyl with carbamide ( Urea) and N,N'-dimethylurea ( s-Dmur) are synthesized and studied by IR spectroscopy and X-ray diffraction. Structures of the same type, [UO2( Urea)4(H2O)][(UO2)2(C4H4O4)3] · 3H2O and [UO2( Urea)4(H2O)][(UO2)2(C4H4O4)3] · 2 Urea contain two sorts of uranium-containing complex groups, namely, mononuclear [UO2( Urea)4(H2O)]2+ cations and two-dimensional [(UO2)2(C4H4O4)3]2- anions described by crystal-chemical formulas AM 5 1 and A 2 Q 3 02, respectively ( A = UO2 2+, M 1 = Urea or H2O, Q 02 = C4H4O4 2-), and differ only in the nature of noncoordinated molecules—water and carbamide. The main structural groups of the [(UO2)2(C4H4O4)2( s-Dmur)3] crystals are [(UO2)2(C4H4O4)2( s-Dmur)3] chains belonging to the A 2 Q 2 02 M 3 1 ( A = UO2 2+, Q 02 = C4H4O4 2-, M 1 = s-Dmur) crystal-chemical group. Specific features of intermolecular interactions in the crystal structures are revealed using the Voronoi-Dirichlet method of molecular polyhedra.
Joshi-Khadke, Suchita; Khadke, V. V.; Patel, S. J.; Borse, Y. M.; Kelkar, K. V.; Dighe, J. P.; Subhedar, R. D.
2015-01-01
Background: Intrathecal neostigmine and magnesium sulfate (MgSO4) produce substantial antinociception, potentiate analgesia of bupivacaine without neurotoxicity. Aims: The aim was to investigate the effect of neostigmine and MgSO4 on characteristics of spinal anesthesia (SA), hemodynamic stability and postoperative analgesia when added to 0.5% hyperbaric bupivacaine for SA. Subjects and Methods: In this prospective, randomized, double-blind study 75 American Society of Anesthesiologist status I and II adult females posted for major gynecological surgery were assigned to one of the three groups (n = 25). Group N received Neostigmine 25 μg, Group M received MgSO4 50 mg, Group C received 0.5 ml saline as an adjuvant to 17.5 mg hyperbaric bupivacaine. Onset, duration of block, heart rate, mean arterial pressure, postoperative analgesia, analgesic requirement, and adverse effects were recorded. Data expressed as mean (standard deviation) or number (%). P <0.05 were statistically significant. Results: The three groups were comparable in characteristics of SA. The mean duration of analgesia was significantly longer in Group N (5.1 h) followed by Group M (4.2 h) and Group C (3.8 h) (P = 0.0134). Analgesic requirement was significantly less in Group N followed by Group M and Group C (P = 0.00232). The pain score was significantly less in Group M (P < 0.05). The incidence of hypotension and vasopressor requirement was lowest (48%) in Group N than in Group M (64%) and Group C 84% (P = 0.0276). The incidence of bradycardia and atropine requirement was the lowest in Group M (P = 0.0354). Sedation was observed in 56% patients in Group M compared to 20% in Group N and 8% in Group C (P = 0.0004). Conclusion: Intrathecal Neostigmine and MgSo4 does not affect characteristics of SA. Postoperative analgesia of neostigmine was better than MgSO4. Neostigmine provides some protection against hypotension of SA whereas MgSO4 protects against bradycardia. PMID:25886423
Yin, Xiaojuan; Meng, Fanping; wang, Yan; Xie, Lu; Kong, Xiangyong; Feng, Zhichun
2013-01-01
Objective: To determine whether the SP-B deficiency and gene mutations in exon 4 is associated with neonatal RDS in China Han ethnic population. Methods: The study population consisted of 40 neonates with RDS and 40 neonates with other diseases as control in China Han ethnic population. We Compared SP-B expression in lung tissue and bronchoalveolar lavage fluid with immunoblotting, and analyzed mutations in the SP-B gene with polymerase chain reaction (PCR) and gene sequencing. Results: In RDS group, low mature Surfactant protein B was found in both lung tissue and bronchoalveolar lavage fluid in 8 neonates. In control group, only 4 neonates with low mature Surfactant protein B in both lung tissue and bronchoalveolar lavage fluid. In RDS group, 20 neonates were found to have mutations in exon 4, 12 homozygous mutations with C/C genotype and 8 heterozygous mutations with C/T genotype in surfactant protein B gene+1580 polymorphism. There were 8 cases mutations in control group, 1 in C/C and 7 in C/T genotype. The frequency of homozygotes with C/C genotype was 0.3 and frequency of heterozygotes with C/T genotype was 0.02 in RDS group. In control group, frequency of homozygotes with C/C genotype was 0.025 and frequency of heterozygote with C/T genotype was 0.175. Conclusion: Low mature Surfactant protein B is associated with the pathogenesis of neonatal respiratory distress syndrome (RDS) in China Han ethnic population. Mutations in exon 4 of the surfactant protein B gene demonstrate an association between homozygous mutations with C/C genotype in SP-B gene and neonatal RDS. PMID:23330012
Randomized, Controlled Trial of CBT Training for PTSD Providers
2016-10-01
implement and evaluate a cost effective, web based self-paced training program to provide skills-oriented continuing education for mental health...professionals. The objective is to learn whether novel, internet-based training methods, with or without web -centered supervision, may provide an...condition: a) Web -based training plus web -centered supervision; b) Web - based training alone; and c) Training-as-usual control group. An equal number of
ERIC Educational Resources Information Center
National Multicultural Inst., Washington, DC.
This is primarily a collection of abstracts for training workshops for professionals in the field of multicultural education. The abstracts are: (1) "An Exploration of the Unspoken: A Group Relations Approach to Multicultural Dialogue" (Zachary G. Green); (2) "Exploring Our Cultural Assumptions" (Daniel Rivera); (3)…
Perfectionism and burnout in women professional golfers.
Kang, Kyoung D; Hannon, James C; Harveson, Andrew; Lee, Jea W; Nam, Jea J; Han, Doug H
2016-09-01
Perfectionism and burnout have been thought to affect performance in sports. The aim of current study was to analyze differences between members of the Korean Ladies Professional Association (KLPGA) and non-KLPGA golfers as they relate to perfectionism, burnout and commitment as well as analyze the relationship between the same psychological factors and golf score during a 3-day professional golf tournament. Participants were 245 LPGA athletes and 233 non-LPGA athletes, all of whom were members of the Korean Golf Association. Participants were assessed using Multidimensional Perfectionism Scale, Athletes Burnout Questionnaires, Expansion of Sports Commitment Model and State-Trait Anxiety Inventory-Y. Perfectionism (t=48.47, P<0.001) and burnout (t=3.5, P=0.01) scores in the KLPGA group were lower than those observed in the non-KLPGA group (Mann-Whitney U Test). Sport devaluation of burnout (t=3.84, P<0.001) was also lower in the KLPGA group than the non-KLPGA group (Mann-Whitney U Test). Perfectionism, burnout, and psychological factors were also found to be associated with golf scores during a 3-day professional golf tournament. There were significant differences in score change patterns from the first 9-holes of round 1 (R1) to the last 9-holes of R1 (F=10.92, P=0.003), as well as from the first 9-holes of R3 to the last 9-holes of R3 (F=4.47, P=0.04) between the LPGA top 10 group and LPGA non-top 10 group (repeated measures ANOVA). First 9-hole scores of R1 were positively correlated with total perfectionism (r=0.58, P=0.001), total burnout (r=0.50, P=0.008), and state anxiety (r=0.50, P=0.0049) (spearman correlation). Findings suggest that golfers seeking to attain high levels of performance must consider the importance of the mental aspect of the game of golf, and find ways to minimize stress and perfectionist strivings.
Chemoenzymatic synthesis of C-4'-spiro-oxetanoribonucleosides.
Sharma, Vivek K; Kumar, Manish; Sharma, Deepti; Olsen, Carl E; Prasad, Ashok K
2014-09-19
Novozyme-435-mediated diastereoselective deacylation of one of the two diastereotopic acyloxymethyl groups in 5-O-acyl-4-C-acyloxymethyl-3-O-benzyl-1,2-O-isopropylidene-α-D-ribofuranose has been achieved in quantitative yield. The exclusive selectivity of the lipase for the 5-O-acyl over the 4-C-acyloxymethyl group in the substrate was confirmed by chemical transformation of enzymatically monodeacetylated compound to 1,2-O-isopropylidene-C-4-spiro-oxetanoribofuranose. Further, the selective biocatalytic deacylation methodology has been utilized for the efficient synthesis of C-4'-spiro-oxetanoribonucleosides of uracil (U) and thymine (T) in 37 and 45% overall yields, respectively.
4-[(E)-(2,4-Difluoro-phen-yl)(hydroxy-imino)meth-yl]piperidinium picrate.
Jasinski, Jerry P; Butcher, Ray J; Yathirajan, H S; Mallesha, L; Mohana, K N
2009-09-05
The title compound, C(12)H(15)F(2)N(2)O(+)·C(6)H(2)N(3)O(7) (-), a picrate salt of 4-[(E)-(2,4-difluoro-phen-yl)(hydroxy-imino)meth-yl]piper-idine, crystallizes with two independent mol-ecules in a cation-anion pair in the asymmetric unit. In the cation, a methyl group is tris-ubstituted by hydroxy-imino, piperidin-4-yl and 2,4-difluoro-phenyl groups, the latter of which contains an F atom disordered over two positions in the ring [occupancy ratio 0.631 (4):0.369 (4)]. The mean plane of the hydr-oxy group is in a synclinical conformation nearly orthogonal [N-C-C-C = 72.44 (19)°] to the mean plane of the piperidine ring, which adopts a slightly distorted chair conformation. The dihedral angle between the mean plane of the 2,4-difluoro-phenyl and piperidin-4-yl groups is 60.2 (3)°. In the picrate anion, the mean planes of the two o-NO(2) and single p-NO(2) groups adopt twist angles of 5.7 (2), 25.3 (7) and 8.3 (6)°, respectively, with the attached planar benzene ring. The dihedral angle between the mean planes of the benzene ring in the picrate anion and those in the hydroxy-imino, piperidin-4-yl and 2,4-difluoro-phenyl groups in the cation are 84.9 (7), 78.9 (4) and 65.1 (1)°, respectively. Extensive hydrogen-bond inter-actions occur between the cation-anion pair, which help to establish the crystal packing in the unit cell. This includes dual three-center hydrogen bonds with the piperidin-4-yl group, the phenolate and o-NO(2) O atoms of the picrate anion at different positions in the unit cell, which form separate N-H⋯(O,O) bifurcated inter-molecular hydrogen-bond inter-actions. Also, the hydr-oxy group forms a separate hydrogen bond with a nearby piperidin-4-yl N atom, thus providing two groups of hydrogen bonds, which form an infinite two-dimensional network along (011).
ERIC Educational Resources Information Center
Carroll, D.
2005-01-01
This article reports on a year-long study of collaborative professional learning in a mentor teacher study group connected to a large university teacher education program. It introduces a theoretical framework for considering the nature of interactive talk and its relationship to professional learning. Using examples of study group discourse, it…
Virtual Learning Environment in Continuing Education for Nursing in Oncology: an Experimental Study.
das Graças Silva Matsubara, Maria; De Domenico, Edvane Birelo Lopes
2016-12-01
Nurses working in oncology require continuing education and nowadays distance education is a possibility. To compare learning outcomes of the professionals participating in classroom learning versus distance learning; describing the sociodemographic characteristics and digital fluency of participants; comparing learning outcomes with independent variables; assessing the adequacy of educational practices in Virtual Environment Moodle Learning through the constructivist online learning environment survey. An experimental, randomized controlled study; conducted at the A C Camargo Cancer Center, located in São Paulo, SP, Brazil. The study included 97 nurses, with average training of 1 to 2 years. A control group (n = 44) had face to face training and the experiment group (n = 53) had training by distance learning, both with identical program content. The dependent variable was the result of learning, measured by applying a pre-assessment questionnaire and post-intervention for both groups. The sociodemographic and digital fluency data were uniform among the groups. The performance of both groups was statistically significant (p 0.005), and the control group had a greater advantage (40.4 %). Distance education has proven to be an effective alternative for training nurses, especially when they have more complex knowledge, more experience in the area and institutional time. Distance Education may be a possibility for the training of nurses for work in oncology. The association of age, training time and the institution, and the experience in Oncology interfered in the performance of both groups.
Akpinar, Yeliz Yelen; Baykan, Zeynep; Naçar, Melis; Gün, Iskender; Çetinkaya, Fevziye
2011-01-01
The awareness of health professionals about breast cancer prevention is of vital importance, since their beliefs and behaviors may have a major impact on other women. The aim of this study was to investigate the knowledge, and attitudes regarding risk factors for breast cancer as well as screening such as breast self-examination, clinical breast examination and mammography among different groups of female health professionals. In this cross- sectional study, 444 female health professionals in various health centers located in Corum Province, Turkey, were interviewed using a self-administered questionnaire. The mean age was 33.1 ± 6.1 and most were married (81.3%). The rate of feeling under risk regarding breast cancer among female health personnel was 31.3%. The majority (98.4 %) perceived breast self-examination as a beneficial method for the early detection of breast cancer. Although 81.3 % of the participants stated that they did breast self examination, only 27.3 % reported doing so on a regular basis (performed monthly or once per menstrual cycle). The most common reason for not doing breast self-examination was the belief that it was not necessary (45.8 %). Of the entire group, the rate of having a mammography was 10.1% and the rate of clinical breast examination was 24.8%. Health professionals are a direct source of medical information to the public. The use of breast self-examination and mammography was found lower than expected when considering the fact that participants were health care professionals.
Dolmans, Diana Hjm; Luijk, Scheltus J; Wolfhagen, Ineke Hap; Scherpbier, Albert Jja
2006-02-01
We investigated the influence of harsh grading by tutors on tutor performance rating by students. A total of 187 tutors assessed students' professional behaviour in tutorial groups. Students rated tutor performance after receiving their grades for professional behaviour. In addition, students were asked to indicate whether they perceived their professional behaviour grades as too positive, adequate or too negative. This was considered to reflect tutors' harshness of grading. Students also rated the quality of the feedback they received from tutors with respect to their grades. Professional behaviour grades that students perceived as too negative, adequate or too positive were associated with tutor performance ratings of 7.4 (SD = 0.9, scale 1-10, n = 33), 7.7 (SD = 0.9, scale 1-10, n = 95) and 7.5 (SD = 0.8, scale 1-10, n = 59), respectively. Harshness of grading did not influence tutor performance ratings significantly. Tutor ratings were predicted more effectively by the quality of the feedback tutors provided on grades than by the harshness of grading. Tutor performance ratings were not related significantly to harshness of grading. Two explanations can be given: (1) tutor performance ratings were based on rating by groups of students and (2) the percentage of tutors who rated students' professional behaviour as unsatisfactory was low. The strong relationship between tutor performance ratings and the adequacy of the feedback given by tutors suggests that the tutor performance ratings collected in this study are a valid measure of the quality of their teaching, although, for a full picture of teaching quality, more measures will be needed.
Hamel, Aimee V.; Sims, Tai L.; Klassen, Dan; Havey, Thomas; Gaugler, Joseph E.
2017-01-01
Reminiscence interventions are potentially effective in improving well-being of persons with memory loss (PWMLs) and may also enhance relationships with family and professional caregivers. Using a parallel convergent mixed-methods design, the feasibility of “Memory Matters” (MM), a mobile device application developed to promote reminiscence, was evaluated. Eighteen PWMLs and eight family members were enrolled from a long-term care facility and asked to use MM for 4 weeks. Participants were observed using MM at enrollment and 2 weeks and completed 1-month interviews. Six staff participants also completed a system review checklist and/or focus group at 1 month. Three qualitative domains were identified: (a) context of use, (b) barriers to use, and (c) MM influences on outcomes. Participants reported real-time social engagement, ease of use, and other benefits. However, PWMLs were unlikely to overcome barriers without assistance. Empirical data indicated that family and staff perceived MM favorably. Participants agreed that MM could provide stimulating, reminiscence-based activity. PMID:26870986
Using Indigenous Australian drama to break cultural barriers in healthcare relationships.
Matharu, K
2009-06-01
Since colonisation, the marginalisation of Indigenous Australians has adversely affected their language, culture and health. Mainstream society has failed to address social differences and establish culturally-appropriate health programmes for these groups. This paper extracts important humanistic themes within the context of health from four Indigenous Australian plays written during a period of social unrest in response to past oppression: (1) The dreamers, by Jack David; (2) Murras, by Eva Johnson; (3) Coordah, by Richard Walley; and (4) The keepers, by Bob Maza. These plays will be analysed to (a) illuminate human suffering from an indigenous perspective, based upon social and cultural planes of analysis; (b) understand the socio-cultural basis of poor health; and (c) instruct healthcare professionals that health is a social construct that can be interpreted as the product of select plays that are not solely based upon an illness narrative.
10 CFR Appendix A to Part 4 - Federal Financial Assistance to Which This Part Applies 1
Code of Federal Regulations, 2012 CFR
2012-01-01
... recovery, in meetings, conferences, workshops, and symposia to assist scientific, professional or educational institutions or groups. (e) Research Support. Agreements for the financial support of basic and applied scientific research and for the exchange of scientific information. [29 FR 19277, Dec. 31, 1964...
10 CFR Appendix A to Part 4 - Federal Financial Assistance to Which This Part Applies 1
Code of Federal Regulations, 2013 CFR
2013-01-01
... recovery, in meetings, conferences, workshops, and symposia to assist scientific, professional or educational institutions or groups. (e) Research Support. Agreements for the financial support of basic and applied scientific research and for the exchange of scientific information. [29 FR 19277, Dec. 31, 1964...
American Indian Doctors Today. Volume Two.
ERIC Educational Resources Information Center
Beiswenger, James N., Ed.
The Indians Into Medicine Program presents an additional 44 brief biographies of American Indian health professionals (7 women and 37 men) from 29 different tribal groups, to acquaint young Indian people with potential careers in health professions (4 of the biographies appeared in Volume One). The biographical sketches contain information on:…
10 CFR Appendix A to Part 4 - Federal Financial Assistance to Which This Part Applies 1
Code of Federal Regulations, 2011 CFR
2011-01-01
... recovery, in meetings, conferences, workshops, and symposia to assist scientific, professional or educational institutions or groups. (e) Research Support. Agreements for the financial support of basic and applied scientific research and for the exchange of scientific information. [29 FR 19277, Dec. 31, 1964...
10 CFR Appendix A to Part 4 - Federal Financial Assistance to Which This Part Applies 1
Code of Federal Regulations, 2010 CFR
2010-01-01
... recovery, in meetings, conferences, workshops, and symposia to assist scientific, professional or educational institutions or groups. (e) Research Support. Agreements for the financial support of basic and applied scientific research and for the exchange of scientific information. [29 FR 19277, Dec. 31, 1964...
Gifted Education Communicator, 2001.
ERIC Educational Resources Information Center
Gosfield, Margaret, Ed.
2001-01-01
Four issues of this periodical of the California Association for the Gifted focus on: (1) issues in gifted education; (2) professional development; (3) history and social science for gifted learners; and (4) equity and excellence. Among major articles are the following: "Profoundly Gifted Guilt" (James R. Delisle); "Grouping the Gifted: Myths and…
MacNeill, Heather; Telner, Deanna; Sparaggis-Agaliotis, Alexandra; Hanna, Elizabeth
2014-01-01
Computer-supported collaborative learning (CSCL) may facilitate continuing interprofessional education while overcoming barriers of time and place for busy health care professionals. The purpose of this study was to understand the experiences, advantages, and challenges of group versus individual online learning. Fifteen multidisciplinary health professionals participated in a 12-week online course on either diabetes or traumatic brain injury. This consisted of background e-modules and a longitudinal build-a-case exercise, done either individually or as a group. Focus group sessions exploring participants' experiences after course completion and at 4 months were conducted, transcribed, and analyzed for recurring themes. Participant reflection homework and video-recorded group sessions were used for triangulation of results. Individual learners appreciated the flexibility and control, but experienced decreased motivation. Group learners appreciated the immediate feedback from their co-learners and felt social pressure to come to the weekly sessions prepared but expressed challenges in determining group goal-setting for the session. Both groups felt they learned about interprofessional roles; however, group learners described a richer learning experience and understanding of interprofessional roles through the online collaboration exercise. The intense resources necessary for interprofessional CSCL, including time, faculty development, and technological issues, are described. CSCL is a valuable educational strategy in online learning. While individual online learning may be better suited for short and simple educational interventions such as knowledge acquisition, CSCL seems to allow for richer and deeper learning in complex and interprofessional educational experiences. However, strategies, resources, and faculty development required to enhance CSCL need to be addressed carefully. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.
Klytta, C; Wilz, G
2007-02-01
Because the effectiveness of self-help groups (SHGs) has not been proven yet and also since multi-focus reviews on SHGs are rare, the present article offers an overview of the current state of research. Possible reasons for the conflicting results in the literature are also investigated. An extensive literature search was done to review studies which used longitudinal design and control groups to measure the effectiveness of SHGs and so-called "support groups". Positive effects in comparison to the control groups were proven in four out of seven of the studies. In the remaining three studies the outcomes between the groups were the same. Considering the naturalistic designs of the studies, these results clearly indicate that SHGs are indeed effective. An insufficient consideration of the heterogeneity of the groups is held responsible for the difficulties associated with previous research on the topic, especially as far as the differentiation between SHGs and professionally led groups is concerned. The definition excludes professional leadership but, in fact, professional involvement in SHGs up to their leadership is the rule. The following suggestions have been derived from this literature analysis: uniform classifications for SHGs and professionally-led support groups should be established in order to make it possible to provide a clear distinction between these types of groups as well as to indicate the extent of professional involvement in them. A plea is made for a generally stronger consideration of organisational differences in the research of SHGs.
Hanif, Farina M; Laeeq, S Muddasir; Luck, Nasir Hassan; Aziz, Tahir; Abbas, Zaigham; Mubarak, Muhammed
2017-02-01
The clinical effects of hepatitis C virus infection acquired after transplant have not been thoroughly studied. We aimed to study hepatitis C virus-related morbidity and mortality with de novo hepatitis C virus infection after renal transplant. Data from mortality files were retrospectively collected from January 2011 to January 2015. Patients were divided into 2 groups: hepatitis C virus positive (group A) and hepatitis C virus negative (group B). Eighty-one patients were included, with median duration of survival of 39 months after transplant. In group A (32 patients), 78.1% of patients were males, with mean age of 36.83 ± 9.15 years. The mean survival duration was better in group A than in group B (67.59 ± 67.1 vs 58.10 ± 59.6 mo; P = .58). Acute cellular rejection was 25% in group A versus 20.4% in group B, whereas chronic allograft nephropathy was 20.4% for group A versus 18.4% for group B. Hepatitis C virus-related death was observed in 7 patients (21.9%). Infection was the main cause of death, with 40.6% of patients in group A versus 53% of patients in group B. On multivariate analyses, better patient survival was associated with greater interval of acquiring HCV after transplant (P = .038). HCV infection acquired after renal transplant is not associated with increased HCV-related mortality, and prognosis is related to the time interval of acquiring infection after transplant.
Aktaş, Şerife; Uçak, Sema; Kurt, Fatma; Taşdemir, Mehmet; Kutlu, Orkide; Eker, Pınar
2018-01-01
To evaluate protein C, protein S level in patients with diabetes mellitus receiving statin and ACE inhibitor/ARB therapy. 95 patients were included in the study and divided into four groups depending on the use of statin and ACE inhibitor/ARB therapy. Group 1 comprised of patients receiving statin therapy (n = 15), Group 2 comprised of patients receiving ACE inhibitor/ARB therapy (n = 31), Group 3 comprised of patients receiving statin and ACE inhibitor/ARB therapy (n = 23), and Group 4 comprised of patients who did not receive either statin or ACE inhibitor/ARB therapy (n = 26). These four groups were compared with respect to protein C, protein S, fibrinogen, D-dimer, INR, and aPTT levels. There were statistically significant differences with respect to protein C levels. Group 1 and group 2 had higher protein C levels compared with group 4. (p < .01). Similarly, Group 3 had higher protein C levels compared with group 4. (p < .01). There was no significant difference between the groups with respect to protein S, INR, aPTT, and D-dimer levels. Diabetic patients receiving statin or ACE inhibitor/ARB therapy had higher protein C levels. Use of statin and ACE inhibitor/ARB therapy in diabetic patients decrease hypercoagulability and therefore could reduce the occurrence of cardiovascular events. Copyright © 2017 Elsevier B.V. All rights reserved.
Soler-Gonzalez, Jorge; San-Martín, Montserrat; Delgado-Bolton, Roberto; Vivanco, Luis
2017-01-01
Human connections are key to the promotion of health and prevention of illness; moreover, illness can cause deterioration of human connections. Healthcare professional-patient relationships are key to ensuring the preservation of adequate human connections. It is important for healthcare professionals to develop their ability to foster satisfactory human connections because: (i) they represent social support for patients; and (ii) they prevent work-related stress. In this study we assessed the relationship between absence (loneliness) and presence (empathy) of human connections with the occupational well-being of healthcare professionals. The Scale of Collateral Effects, which measures somatization, exhaustion, and work alienation; the Jefferson Scale of Empathy; and the Social and Emotional Loneliness Scale for Adults, were mailed to 628 healthcare professionals working in Spanish public healthcare institutions. The following explanatory variables were used to evaluate work well-being: (a) empathy, as a professional competence; (b) loneliness, age, and family burden, as psychological indicators; and (c) professional experience, work dedication, and salary, as work indicators. Comparison, correlation, and regression analyses were performed to measure the relationships among these variables and occupational well-being. Of 628 surveys mailed, 433 (69% response rate) were returned fully completed. Adequate reliability was confirmed for all instruments. The entire sample was divided into four groups, based on the combined variable, "occupation by sex." Comparative analyses demonstrated differences among "occupation by sex" groups in collateral effects ( p = 0.03) and empathy ( p = 0.04), but not loneliness ( p = 0.84). Inverse associations between empathy and collateral effects were confirmed for somatization ( r = -0.16; p < 0.001), exhaustion ( r = -0.14; p = 0.003), and work alienation ( r = -0.16; p < 0.001). Furthermore, loneliness was positively associated with collateral effects ( r = 0.22; p < 0.001). Neither family burden, nor work dedication to clinics or management activities were associated with the three collateral effects measured. These findings support an important role for empathy in the prevention of work stress in healthcare professionals. They also confirm that loneliness, as a multidimensional and domain specific experience, is detrimental to occupational well-being.
Di Lorenzo, G; Pacor, M L; Vignola, A M; Profita, M; Esposito-Pellitteri, M; Biasi, D; Corrocher, R; Caruso, C
2002-12-01
The recovery of mediator metabolites from urine has the potential to provide a rapid, safe, and easily available index of release of mediators. We aimed to determine urinary metabolites of both histamine and leukotrienes (LTs) in patients affected by chronic urticaria (CU). Twenty patients with CU were studied. They were selected on the basis of double-blind placebo-controlled challenge (DBPC) with acetyl salicylic acid (ASA) and food additives. Ten patients (group B) were negative to both challenges. Ten patients (group C) presented urticaria and/or the appearance of angioedema during or 24 h after challenge, with reactions to ASA (five patients) or food additives (five patients). We recruited 15 healthy volunteers as controls (group A). During a second challenge, groups B and C were challenged double-blind with a single dose of ASA, or a specific food additive, or placebo. The healthy group was challenged only with a placebo (talc capsule). Patients in groups B and C were challenged twice: with placebo (as groups B1 and C1) and with ASA (groups B2 and C2) or food additives (C2). Four samples of urine were collected; one during the night before the specific or sham challenge (baseline), and three at 2, 6 and 24 h after the challenge. Urinary methylhistamine (N-MH) and LTE4 were analyzed and normalized for urinary creatinine. For urinary N-MH at baseline, there was a significant difference only between group A and groups B1, B2, C1 and C2 (A vs. B1, P < 0.0001; A vs. B2, P < 0.0001; A vs. C1, P < 0.0001; A vs. C2, P < 0.0001). We detected a significant variation in urinary methylhistamine excretion only in group C2 after 2 h, 6 h and 24 h (P < 0.0001). However, no variations were observed in N-MH excretion rate in the other groups (A, B1, C1) after challenge with placebo, and in B2 after challenge with ASA 20 mg. For urinary LTE4 at baseline no differences were found between the mean values for the different groups. After specific challenge, only C2 patients showed significantly increased excretion rates of urinary LTE4 compared with the other groups challenged with placebo (A, B1, C1), or ASA (B2) (P < 0.0001). No significant correlation was seen between urinary LTE4 and methylhistamine excretion rate in any patients. Our results show that urinary excretion of N-MH and LTE4 is different for CU patients without ASA or food hypersensitivity, compared to those with CU with ASA or food additive hypersensitivity after specific challenge.
Kyle, Richard G; Wills, Jane; Mahoney, Catherine; Hoyle, Louise; Kelly, Muireann; Atherton, Iain M
2017-12-04
To estimate obesity prevalence among healthcare professionals in England and compare prevalence with those working outside of the health services. Cross-sectional study based on data from 5 years (2008-2012) of the nationally representative Health Survey for England. England. 20 103 adults aged 17-65 years indicating they were economically active at the time of survey classified into four occupational groups: nurses (n=422), other healthcare professionals (n=412), unregistered care workers (n=736) and individuals employed in non-health-related occupations (n=18 533). Prevalence of obesity defined as body mass index ≥30.0 with 95% CIs and weighted to reflect the population. Obesity prevalence was high across all occupational groups including: among nurses (25.1%, 95% CI 20.9% to 29.4%); other healthcare professionals (14.4%, 95% CI 11.0% to 17.8%); non-health-related occupations (23.5%, 95% CI 22.9% to 24.1%); and unregistered care workers who had the highest prevalence of obesity (31.9%, 95% CI 28.4% to 35.3%). A logistic regression model adjusted for sociodemographic composition and survey year indicated that, compared with nurses, the odds of being obese were significantly lower for other healthcare professionals (adjusted OR (aOR) 0.52, 95% CI 0.37 to 0.75) and higher for unregistered care workers (aOR 1.46, 95% CI 1.11 to 1.93). There was no significant difference in obesity prevalence between nurses and people working in non-health-related occupations (aOR 0.94, 95% CI 0.74 to 1.18). High obesity prevalence among nurses and unregistered care workers is concerning as it increases the risks of musculoskeletal conditions and mental health conditions that are the main causes of sickness absence in health services. Further research is required to better understand the reasons for high obesity prevalence among healthcare professionals in England to inform interventions to support individuals to achieve and maintain a healthy weight. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Röding, K
1999-08-01
The first 9 weeks of the dental undergraduate education at the Karolinska Institutet comprises a transition course, designed to introduce students to university studies leading to professional qualifications in patient-related health sciences. 1 week has been set aside for the theme Man and Society, highlighting the importance of the human sciences for the development of behavioural skills necessary for achieving professionalism and a holistic patient concept. Some essential ethical questions are addressed: intercultural communication, empathy, professional demeanour and the development of professional competence, and group dynamics. In this context, more specific subjects are considered, such as the emergence of the multicultural society and its implications for health services, interpersonal skills and patient communication in the health and medical fields. There are several reasons for including this theme, which forms the basis for the ethical and communicative strands throughout the entire curriculum. As 30-40% of freshmen dental students are of non-Swedish origin, it is essential to include cultural awareness seminars. Another reason is that within the EU, cultural and communicative skills are recognised proficiencies for health professionals; it is also acknowledged that effective delivery of health care may be impeded by misunderstandings in communication and conflict in ethical beliefs. Group discussions are scheduled during the week in order to allow the students to discuss their own experiences related to the theme. The students are also given a written assignment in relation to one of the seminars; the report is assessed as a part of the examination. The week is concluded by a plenum discussion summarising the group discussions. To date, 4 course evaluations, with a response rate of 92.5%, show that 97.3% of the students were positive to the theme as a whole or to specific seminars held during the week, especially intercultural communication, ethics and empathy. The students also believe that the theme is of great importance for dental health professionals.
Hultman, Charles S; Connolly, Annamarie; Halvorson, Eric G; Rowland, Pamela; Meyers, Michael O; Mayer, David C; Drake, Amelia F; Sheldon, George F; Meyer, Anthony A
2012-10-01
Few educational programs exist for medical students that address professionalism in surgery, even though this core competency is required for graduate medical education and maintenance of board certification. Lapses in professional behavior occur commonly in surgical disciplines, with a negative effect on the operative team and patient care. Therefore, education regarding professionalism should begin early in the surgeon's formative process, to improve behavior. The goal of this project was to enhance the attitudes and knowledge of medical students regarding professionalism, to help them understand the role of professionalism in a surgical practice. We implemented a 4-h seminar, spread out as 1-h sessions over the course of their month-long rotation, for 4th-year medical students serving as acting interns (AIs) in General Surgery, a surgical subspecialty, Obstetrics/Gynecology, or Anesthesia. Teaching methods included lecture, small group discussion, case studies, and journal club. Topics included Cognitive/Ethical Basis of Professionalism, Behavioral/Social Components of Professionalism, Managing Yourself, and Leading While You Work. We assessed attitudes about professionalism with a pre-course survey and tracked effect on learning and behavior with a post-course questionnaire. We asked AIs to rate the egregiousness of 30 scenarios involving potential lapses in professionalism. A total of 104 AIs (mean age, 26.5 y; male to female ratio, 1.6:1) participated in our course on professionalism in surgery. Up to 17.8% of the AIs had an alternate career before coming to medical school. Distribution of intended careers was: General Surgery, 27.4%; surgical subspecialties, 46.6%; Obstetrics/Gynecology, 13.7%; and Anesthesia, 12.3%. Acting interns ranked professionalism as the third most important of the six core competencies, after clinical skills and medical knowledge, but only slightly ahead of communication. Most AIs believed that professionalism could be taught and learned, and that the largest obstacle was not enough time in the curriculum. The most effective reported teaching methods were mentoring and modeling; lecture and journal club were the effective. Regarding attitudes toward professionalism, the most egregious examples of misconduct were substance abuse, illegal billing, boundary issues, sexual harassment, and lying about patient data, whereas the least egregious examples were receiving textbooks or honoraria from drug companies, advertising, self-prescribing for family members, and exceeding work-hour restrictions. The most important attributes of the professional were integrity and honesty, whereas the least valued were autonomy and altruism. The AIs reported that the course significantly improved their ability to define professionalism, identify attributes of the professional, understand the importance of professionalism, and integrate these concepts into practice (all P < 0.01). Although medical students interested in surgery may already have well-formed attitudes and sophisticated knowledge about professionalism, this core competency can still be taught to and learned by trainees pursuing a surgical career. Copyright © 2012. Published by Elsevier Inc.
[Local groups as a tool for quality assurance of community health services].
Mjell, J; Hjortdahl, P
2001-05-30
The aim of this study was to assess the use of local interprofessional or audit groups as a tool of quality enhancement. Fifty-six doctors, physiotherapists and nurses attended nine local interprofessional groups. The aim was to improve the quality of each professional's practice and to improve communication between the professions. The groups had a total of 62 meetings with each professional attending on average 5.7 meetings. All groups initiated quality enhancement projects. Initially the groups were very active and showed great initiative, but there were few final results. However, many groups reported improved communication and cooperation between the participating professionals. The experience from this project may be summarised as follows: The professionals within one and the same group should have more or less the same background and specialty. We recommend caution with organising interprofessional groups unless their participants work in the same practice. Interprofessional groups should spend adequate time for the members to get to know each other, and they should be guided by an experienced leader.
Mao-to Prolongs the Survival of and Reduces TNF-α Expression in Mice with Viral Myocarditis
Shijie, Zhu; Moriya, Junji; Yamakawa, Jun’ichi; Chen, Rui; Takahashi, Takashi; Sumino, Hiroyuki; Nakahashi, Takeshi; Iwai, Kunimitsu; Morimoto, Shigeto; Yamaguchi, Nobuo
2010-01-01
Goal of this study was to evaluate effects of Mao-to on development of myocarditis induced by encephalomyocarditis (EMC) virus in mice. Mice were randomly divided into five groups. Group N included uninfected controls (n = 18), while group A, B and C underwent intraperitoneal injection of EMC virus. Group A was administered oral saline from day 0 to day 4. Group B was administered oral Mao-to (500 mg−1 kg−1 day−1) from day 0 to day 4. Group C was administered Mao-to from day 2 to day 6. Group D was administered Mao-to from day 5 to day 10. Treated mice were followed for survival rates during 2 weeks after infection. Body weight (BW) and organ weights including heart (HW), lungs, thymus and spleen were examined on days 4, 6 and 14. Survival rate of group C (36.4%) was significantly improved compared with group A, B or D (0% of each, P < 0.05). HW and HW/BW ratio in group C was significantly (P < 0.05) lower than those in group A, B or D. Viral titers of hearts were significantly different among groups A, B and C. Cardiac expression in tumor necrosis factor-α (TNF-α) was significantly reduced in group C in comparison with group A, B or D on day 6 by immunohistochemical study. Administration of Mao-to starting on day 2 improves mortality resulting from viral myocarditis in mice with reduced expression of cardiac TNF-α. These findings suggest that timing of Mao-to is crucial for preventing cardiac damage in mice with viral myocarditis. PMID:20671770
Measuring professional identity formation early in medical school.
Kalet, Adina; Buckvar-Keltz, Lynn; Harnik, Victoria; Monson, Verna; Hubbard, Steven; Crowe, Ruth; Song, Hyuksoon S; Yingling, Sandra
2017-03-01
To assess the feasibility and utility of measuring baseline professional identity formation (PIF) in a theory-based professionalism curriculum for early medical students. All 132 entering students completed the professional identity essay (PIE) and the defining issues test (DIT2). Students received score reports with individualized narrative feedback and wrote a structured reflection after a large-group session in which the PIF construct was reviewed. Analysis of PIEs resulted in assignment of a full or transitional PIF stage (1-5). The DIT2 score reflects the proportion of the time students used universal ethical principles to justify a response to 6 moral dilemma cases. Students' reflections were content analyzed. PIF scores were distributed across stage 2/3, stage 3, stage 3/4, and stage 4. No student scores were in stages 1, 2, 4/5, or 5. The mean DIT2 score was 53% (range 9.7?76.5%); the correlation between PIF stage and DIT score was ρ = 0.18 (p = 0.03). Students who took an analytic approach to the data and demonstrated both awareness that they are novices and anticipation of continued PIF tended to respond more positively to the feedback. These PIF scores distributed similarly to novice students in other professions. Developmental-theory based PIF and moral reasoning measures are related. Students reflected on these measures in meaningful ways suggesting utility of measuring PIF scores in medical education.
Al-Gizawiy, Mona M; P Rudé, Elaine
2004-07-01
To compare carprofen to butorphanol, with regard to postsurgical analgesic effects, duration of analgesia, and adverse side effects. Blinded, randomized clinical study. Seventy-one cats, 0.5-5 years of age, weighing 3.24 +/- 0.61 kg, undergoing ovariohysterectomy (OHE). Cats were premedicated with subcutaneous atropine (0.04 mg kg(-1)), acepromazine (0.02 mg kg(-1)), and ketamine (5 mg kg(-1)). Anesthesia was induced with ketamine (5 mg kg(-1)) and diazepam (0.25 mg kg(-1)) given intravenously, and maintained with isoflurane. There were three treatment groups: group C (4 mg kg(-1) carprofen SC at induction), group B (0.4 mg kg(-1) butorphanol SC at end of surgery), and group S (0.08 mL kg(-1) of sterile saline SC at induction and end of surgery). Behavioral data were collected using a composite pain scale (CPS), prior to surgery (baseline) and 1, 2, 3, 4, 8, 12, 16, 20, and 24 hours post-surgery. Interaction scores were analyzed separately. Cats with CPS scores >12 received rescue analgesia (meperidine, 4 mg kg(-1), intramuscular). Sixty cats completed the study. The CPS scores did not differ significantly between groups C and B at any time period. CPS scores for groups B and C were significantly increased for 12 hours post-surgery, and in group S for 20 hours. Both group C and B CPS scores were significantly lower than group S in this 20-hour postoperative period, except at 4 hours (B and C) and at 3 and 8 hours (B alone). Interaction scores for group C returned to preoperative baseline 4 hours after surgery, while both groups B and S remained increased for at least 24 hours post-surgery. Nine cats required meperidine. In this study, carprofen provided better postsurgical analgesia than butorphanol. Clinical relevance Neither drug completely abolished pain, however preoperative carprofen provided better pain control compared with postoperative butorphanol in the 24-hour period following OHE surgery in cats.
The Other Quiet Professionals: Lessons for Future Cyber Forces from the Evolution of Special Forces
2014-01-01
Special Forces, Rangers, civil affairs, and psychological operations units—under the new command. Furthermore, the army provided Special Forces with...and 10th Special Forces (Airborne) groups; the 4th Psychological Operations Group, 96th Civil Affairs Battalion; the 75th Ranger Regiment; the 160th...and reserve psychological operations and civil affairs units. Similarly, the Navy sought to withhold U.S. Naval Special Warfare forces, arguing that
2005-04-29
many personnel had little knowledge or understanding of their wartime units and jobs and met for the very first time when they arrived at the...this handbook useful in teaching an undergraduate introduction to public policy and for executive education groups" (Bardach, 1996, Foreword,). The...FY04 Budget ($M) (includes $76.8 GWOT) D...cM F F A 47% Percent Residency wf, 9.. Ft . TX Ci 0 Programs of Army Total El P-.TX GPk * ft C.- Cb, X PROFIS
Ito, Tsukasa; Yoshiguchi, Kazumi; Ariesyady, Herto Dwi; Okabe, Satoshi
2011-12-01
Major acetate-utilizing bacterial and archaeal populations in methanogenic anaerobic digester sludge were identified and quantified by radioisotope- and stable-isotope-based functional analyses, microautoradiography-fluorescence in situ hybridization (MAR-FISH) and stable-isotope probing of 16S rRNA (RNA-SIP) that can directly link 16S rRNA phylogeny with in situ metabolic function. First, MAR-FISH with (14)C-acetate indicated the significant utilization of acetate by only two major groups, unidentified bacterial cells and Methanosaeta-like filamentous archaeal cells, in the digester sludge. To identify the acetate-utilizing unidentified bacteria, RNA-SIP was conducted with (13)C(6)-glucose and (13)C(3)-propionate as sole carbon source, which were followed by phylogenetic analysis of 16S rRNA. We found that bacteria belonging to Synergistes group 4 were commonly detected in both 16S rRNA clone libraries derived from the sludge incubated with (13)C-glucose and (13)C-propionate. To confirm that this bacterial group can utilize acetate, specific FISH probe targeting for Synergistes group 4 was newly designed and applied to the sludge incubated with (14)C-acetate for MAR-FISH. The MAR-FISH result showed that bacteria belonging to Synergistes group 4 significantly took up acetate and their active population size was comparable to that of Methanosaeta in this sludge. In addition, as bacteria belonging to Synergistes group 4 had high K(m) for acetate and maximum utilization rate, they are more competitive for acetate over Methanosaeta at high acetate concentrations (2.5-10 mM). To our knowledge, it is the first time to report the acetate-utilizing activity of uncultured bacteria belonging to Synergistes group 4 and its competitive significance to acetoclastic methanogen, Methanosaeta.
Ito, Tsukasa; Yoshiguchi, Kazumi; Ariesyady, Herto Dwi; Okabe, Satoshi
2011-01-01
Major acetate-utilizing bacterial and archaeal populations in methanogenic anaerobic digester sludge were identified and quantified by radioisotope- and stable-isotope-based functional analyses, microautoradiography-fluorescence in situ hybridization (MAR-FISH) and stable-isotope probing of 16S rRNA (RNA-SIP) that can directly link 16S rRNA phylogeny with in situ metabolic function. First, MAR-FISH with 14C-acetate indicated the significant utilization of acetate by only two major groups, unidentified bacterial cells and Methanosaeta-like filamentous archaeal cells, in the digester sludge. To identify the acetate-utilizing unidentified bacteria, RNA-SIP was conducted with 13C6-glucose and 13C3-propionate as sole carbon source, which were followed by phylogenetic analysis of 16S rRNA. We found that bacteria belonging to Synergistes group 4 were commonly detected in both 16S rRNA clone libraries derived from the sludge incubated with 13C-glucose and 13C-propionate. To confirm that this bacterial group can utilize acetate, specific FISH probe targeting for Synergistes group 4 was newly designed and applied to the sludge incubated with 14C-acetate for MAR-FISH. The MAR-FISH result showed that bacteria belonging to Synergistes group 4 significantly took up acetate and their active population size was comparable to that of Methanosaeta in this sludge. In addition, as bacteria belonging to Synergistes group 4 had high Km for acetate and maximum utilization rate, they are more competitive for acetate over Methanosaeta at high acetate concentrations (2.5–10 m). To our knowledge, it is the first time to report the acetate-utilizing activity of uncultured bacteria belonging to Synergistes group 4 and its competitive significance to acetoclastic methanogen, Methanosaeta. PMID:21562600
Kushiyama, Akifumi; Kikuchi, Takako; Tanaka, Kentaro; Tahara, Tazu; Takao, Toshiko; Onishi, Yukiko; Yoshida, Yoko; Kawazu, Shoji; Iwamoto, Yasuhiko
2016-06-10
To investigate whether active glucagon-like peptide-1 (GLP-1) is a prediction Factor of Effect of sitagliptin on patients with type 2 diabetes mellitus (GLP-1 FEST:UMIN000010645). Seventy-six patients with type 2 diabetes, who had insufficient glycemic control [Hemoglobin A1c (HbA1c) ≥ 7%] in spite of treatment with metformin and/or sulfonylurea, were included in the investigation. Patients were divided into three groups by tertiles of fasting plasma active GLP-1 level, before the administration of 50 mg sitagliptin. At baseline, body mass index, serum UA, insulin and HOMA-IR were higher in the high active GLP-1 group than in the other two groups. The high active GLP-1 group did not show any decline of HbA1c (7.6% ± 1.4% to 7.5% ± 1.5%), whereas the middle and low groups indicated significant decline of HbA1c (7.4 ± 0.7 to 6.8 ± 0.6 and 7.4 ± 1.2 to 6.9 ± 1.3, respectively) during six months. Only the low and middle groups showed a significant increment of active GLP-1, C-peptide level, a decreased log and proinsulin/insulin ratio after administration. In logistic analysis, the low or middle group is a significant explanatory variable for an HbA1c decrease of ≥ 0.5%, and its odds ratio is 4.5 (1.40-17.6) (P = 0.01) against the high active GLP-1 group. This remains independent when adjusted for HbA1c level before administration, patients' medical history, medications, insulin secretion and insulin resistance. Plasma fasting active GLP-1 is an independent predictive marker for the efficacy of dipeptidyl peptidase 4 inhibitor sitagliptin.
Does the longus colli have an effect on cervical vertigo?
Liu, Xiao-Ming; Pan, Fu-Min; Yong, Zhi-Yao; Ba, Zhao-yu; Wang, Shan-Jin; Liu, Zheng; Zhao, Wei-dong; Wu, De-Sheng
2017-01-01
Abstract The aim of the study was to evaluate the role of the longus colli muscles in cervical vertigo. We retrospectively analyzed 116 adult patients who underwent anterior cervical discectomy and fusion (ACDF) during 2014 in our department. Patients were assigned to the vertigo group or the nonvertigo group. Demographic data were recorded. Inner distance and cross-sectional area (CSA) of longus colli were measured using coronal magnetic resonance imaging (MRI). The vertigo group (n = 44) and the nonvertigo group (n = 72) were similar in demographic data. Mean preoperative Japanese Orthopaedic Association (JOA) score was higher in the vertigo group than in the nonvertigo group (P = 0.037), but no difference postoperatively. Mean JOA scores increased significantly postoperatively in both groups (P = 0.002 and P = 0.001). The mean vertigo score decreased significantly from pre- to postoperatively in the vertigo group (P = 0.023). The mean preoperative Cobb angle was significantly smaller in the vertigo group than in the nonvertigo group (P <0.001), but no significant difference postoperatively. After ACDF, the mean Cobb angle increased significantly in the vertigo group (P <0.001). The instability rates of C3/4 and C4/5 were significantly higher in the vertigo group (P <0.001 and P <0.001). The inner distance of longus colli was significantly shorter (P = 0.032 and P = 0.026) and CSA significantly smaller (P = 0.041 and P = 0.035), at C3/4 and C4/5 in the vertigo group than in the nonvertigo group. Mean Miyazaki scores were significantly higher in the vertigo group at C3/4 and C4/5 (P = 0.044 and P = 0.037). Moreover, a shorter inner distance and smaller CSA were related to a higher Miyazaki score. Inner distance and cross-sectional area (CSA) of longus colli are associated closely with cervical vertigo. Shorter inner distance and smaller CSA of the longus colli muscles might be risk factors for cervical vertigo. ACDF provided a good resolution of cervical vertigo. PMID:28328822
Does the longus colli have an effect on cervical vertigo?: A retrospective study of 116 patients.
Liu, Xiao-Ming; Pan, Fu-Min; Yong, Zhi-Yao; Ba, Zhao-Yu; Wang, Shan-Jin; Liu, Zheng; Zhao, Wei-Dong; Wu, De-Sheng
2017-03-01
The aim of the study was to evaluate the role of the longus colli muscles in cervical vertigo.We retrospectively analyzed 116 adult patients who underwent anterior cervical discectomy and fusion (ACDF) during 2014 in our department. Patients were assigned to the vertigo group or the nonvertigo group. Demographic data were recorded. Inner distance and cross-sectional area (CSA) of longus colli were measured using coronal magnetic resonance imaging (MRI).The vertigo group (n = 44) and the nonvertigo group (n = 72) were similar in demographic data. Mean preoperative Japanese Orthopaedic Association (JOA) score was higher in the vertigo group than in the nonvertigo group (P = 0.037), but no difference postoperatively. Mean JOA scores increased significantly postoperatively in both groups (P = 0.002 and P = 0.001). The mean vertigo score decreased significantly from pre- to postoperatively in the vertigo group (P = 0.023). The mean preoperative Cobb angle was significantly smaller in the vertigo group than in the nonvertigo group (P <0.001), but no significant difference postoperatively. After ACDF, the mean Cobb angle increased significantly in the vertigo group (P <0.001). The instability rates of C3/4 and C4/5 were significantly higher in the vertigo group (P <0.001 and P <0.001). The inner distance of longus colli was significantly shorter (P = 0.032 and P = 0.026) and CSA significantly smaller (P = 0.041 and P = 0.035), at C3/4 and C4/5 in the vertigo group than in the nonvertigo group. Mean Miyazaki scores were significantly higher in the vertigo group at C3/4 and C4/5 (P = 0.044 and P = 0.037). Moreover, a shorter inner distance and smaller CSA were related to a higher Miyazaki score.Inner distance and cross-sectional area (CSA) of longus colli are associated closely with cervical vertigo. Shorter inner distance and smaller CSA of the longus colli muscles might be risk factors for cervical vertigo. ACDF provided a good resolution of cervical vertigo.
Context-Based Pedagogy: A Framework From Experience.
Kantar, Lina D
2016-07-01
Attempts to transform teaching practice are inadvertently subjected to several hurdles, mostly attributed to the lack of a guiding framework. This study aimed at unraveling the conceptual underpinnings of the context-based pedagogy, being perceived the pedagogy that prepares professionals for future practice. Through focus group interviews, data were collected from 16 nursing students who had case studies as the main instructional format in three major courses. The participants were divided into three focus groups, and interview questions were based on three educational parameters: the learning environment, instructional format, and instructional process. Initial findings revealed an array of classroom activities that characterize each parameter. An in-depth analysis of these activities converged on four concepts: (a) dynamic learning environment, (b) realism, (c) thinking dispositions, and (d) professional formation. These concepts improvise a beginning framework for educators and curriculum leaders that can be used to integrate cases in the curriculum and to facilitate the contextualization of knowledge. [J Nurs Educ. 2016;55(7):391-395.]. Copyright 2016, SLACK Incorporated.
Treatment response assessment with (R)-[11CPAQ PET in the MMTV-PyMT mouse model of breast cancer.
Tegnebratt, T; Lu, L; Eksborg, S; Chireh, A; Damberg, P; Nikkhou-Aski, S; Foukakis, T; Rundqvist, H; Holmin, S; Kuiper, R V; Samen, E
2018-04-03
The goal of the study was to assess the potential of the vascular endothelial growth factor receptor (VEGFR)-2-targeting carbon-11 labeled (R)-N-(4-bromo-2-fluorophenyl)-6-methoxy-7-((1-methyl-3-piperidinyl)methoxy)-4-quinazolineamine ((R)-[ 11 C]PAQ) as a positron emission tomography (PET) imaging biomarker for evaluation of the efficacy of anticancer drugs in preclinical models. MMTV-PyMT mice were treated with vehicle alone (VEH), murine anti-VEGFA antibody (B20-4.1.1), and paclitaxel (PTX) in combination or as single agents. The treatment response was measured with (R)-[ 11 C]PAQ PET as standardized uptake value (SUV) mean , SUV max relative changes at the baseline (day 0) and follow-up (day 4) time points, and magnetic resonance imaging (MRI)-derived PyMT mammary tumor volume (TV) changes. Expression of Ki67, VEGFR-2, and CD31 in tumor tissue was determined by immunohistochemistry (IHC). Non-parametric statistical tests were used to evaluate the relation between (R)-[ 11 C]PAQ radiotracer uptake and therapy response biomarkers. The (R)-[ 11 C]PAQ SUV max in tumors was significantly reduced after 4 days in the B20-4.1.1/PTX combinational and B20-4.1.1 monotherapy groups (p < 0.0005 and p < 0.003, respectively). No significant change was observed in the PTX monotherapy group. There was a significant difference in the SUV max change between the VEH group and B20-4.1.1/PTX combinational group, as well as between the VEH group and the B20-4.1.1 monotherapy group (p < 0.05). MRI revealed significant decreases in TV in the B20-4.1.1/PTX treatment group (p < 0.005) but not the other therapy groups. A positive trend was observed between the (R)-[ 11 C]PAQ SUV max change and TV reduction in the B20-4.1.1/PTX group. Statistical testing showed a significant difference in the blood vessel density between the B20-4.1.1/PTX combinational group and the VEH group (p < 0.05) but no significant difference in the Ki67 positive signal between treatment groups. The results of this study are promising. However, additional studies are necessary before (R)-[ 11 C]PAQ can be approved as a predictive radiotracer for cancer therapy response.
Guidelines for psychological practice with older adults.
2014-01-01
The "Guidelines for Psychological Practice With Older Adults" are intended to assist psychologists in evaluating their own readiness for working with older adults and in seeking and using appropriate education and training to increase their knowledge, skills, and experience relevant to this area of practice. The specific goals of these professional practice guidelines are to provide practitioners with (a) a frame of reference for engaging in clinical work with older adults and (b) basic information and further references in the areas of attitudes, general aspects of aging, clinical issues, assessment, intervention, consultation, professional issues, and continuing education and training relative to work with this group. The guidelines recognize and appreciate that there are numerous methods and pathways whereby psychologists may gain expertise and/or seek training in working with older adults. This document is designed to offer recommendations on those areas of awareness, knowledge, and clinical skills considered as applicable to this work, rather than prescribing specific training methods to be followed. The guidelines also recognize that some psychologists will specialize in the provision of services to older adults and may therefore seek more extensive training consistent with practicing within the formally recognized specialty of Professional Geropsychology (APA, 2010c). PsycINFO Database Record (c) 2014 APA, all rights reserved.
MouseNet database: digital management of a large-scale mutagenesis project.
Pargent, W; Heffner, S; Schäble, K F; Soewarto, D; Fuchs, H; Hrabé de Angelis, M
2000-07-01
The Munich ENU Mouse Mutagenesis Screen is a large-scale mutant production, phenotyping, and mapping project. It encompasses two animal breeding facilities and a number of screening groups located in the general area of Munich. A central database is required to manage and process the immense amount of data generated by the mutagenesis project. This database, which we named MouseNet(c), runs on a Sybase platform and will finally store and process all data from the entire project. In addition, the system comprises a portfolio of functions needed to support the workflow management of the core facility and the screening groups. MouseNet(c) will make all of the data available to the participating screening groups, and later to the international scientific community. MouseNet(c) will consist of three major software components:* Animal Management System (AMS)* Sample Tracking System (STS)* Result Documentation System (RDS)MouseNet(c) provides the following major advantages:* being accessible from different client platforms via the Internet* being a full-featured multi-user system (including access restriction and data locking mechanisms)* relying on a professional RDBMS (relational database management system) which runs on a UNIX server platform* supplying workflow functions and a variety of plausibility checks.
Diet Replenishment for Ad-libitum–fed Mice Housed in Social Groups is Compatible with Shelf Life
Huerkamp, Michael J; Dowdy, Minida R
2008-01-01
Regulatory guidelines and best practices in the care of research animals allow diets milled for laboratory animals to be used within 180 d of formulation but otherwise permit latitude and professional judgment in how and when feed is offered. As such, practices at some research institutions allow for the replenishment (‘topping up’) of fresh chow over that existing in the cage food hopper, rather than complete replacement of the diet on a regular basis. To determine the depletion rate of a pelleted diet as fed from a conventional overhead food hopper, the consumption of full hoppers of food was measured for breeding pairs of mice in production and gender-specific groups of weanlings and juvenile mice kept in ventilated cages at 71.9 ± 0.2 °F (approximately 22.6 °C) and 40% ± 5% relative humidity. Breeding pairs of mice depleted 97% of a 250-g ration within 44 d of offering and consumed diet at a rate of 4.7 ± 0.5 g per mouse daily. Gender-grouped weanling and juvenile mice housed 5 to 6 per cage exhausted more than 99% of a 500-g ration of diet in 24 d and consumed chow at a rate of 3.4 ± 0.3 g per animal daily. These findings suggest that breeding pairs and groups of mice kept 5 to 6 per cage deplete feed at such a rate that diets can be fed by using replenishment provided diet is offered within 5 mo of the milling date. PMID:18459713
Systematic review of peer education intervention programmes among individuals with type 2 diabetes.
Gatlin, Tricia K; Serafica, Reimund; Johnson, Michael
2017-12-01
To systematically review published randomised controlled trials of peer education interventions among adults with type 2 diabetes. Systematic reviews have shown mixed results for peer support interventions to improve diabetes self-management. Given the effectiveness of diabetes education by healthcare professionals, peer education interventions may be a useful alternative approach. This review addressed that gap. Systematic review. A systematic search of published randomised controlled trials between 2006-2016 was conducted using the keywords diabetes, type 2 diabetes, randomised controlled trials, self-management, peer education and peer support. The methodological quality of each study was assessed using the Jadad scale. Seven studies were included in the final review, and the Jadad scores ranged from 8-10 of a possible 13 points. There was no consistent design, setting, or outcome measurement among the studies. There were two types of peer education interventions compared to traditional diabetes education: face-to-face or a combination of face-to-face and telephone/texting. The most common clinical outcome measure was HbA1c. Two of six studies showed statistically significant improvement in HbA1c between intervention and control groups. An increase in diabetes knowledge was also statistically significant in two of five studies. Peer education could be successful in improving clinical outcomes. No evidence was found indicating that healthcare provider education was superior in regard to clinical knowledge or behavioural or psychological outcome measures than peer education. HbA1c was statistically significantly lower in some peer education groups compared to control groups. There is evidence that peer education can be useful in achieving positive clinical outcomes such as decreasing HbA1c levels and increasing diabetes knowledge. A certified diabetes educator or a trained healthcare professional should not be overlooked though when using peer educators. © 2017 John Wiley & Sons Ltd.
Alaunyte, Ieva; Perry, John L; Aubrey, Tony
2015-01-01
Adequate nutrient intake is important to support training and to optimise performance of elite athletes. Nutritional knowledge has been shown to play an important role in adopting optimal nutrition practices. The aim of the present study was to investigate the relationship between the level of nutritional knowledge and dietary habits in elite English rugby league players using the eatwell plate food categories. General nutritional knowledge questionnaires were collected during the Super League competitive season in the first team squad of 21 professional Rugby league players (mean age 25 ± 5 yrs, BMI 27 ± 2.4 kg/m2, experience in game 6 ± 4 yrs). According to their nutritional knowledge scores, the players were assigned to either good or poor nutritional knowledge group (n = 11, n = 10, respectively). Their dietary habits were assessment using a food frequency questionnaire. The findings revealed that nutritional knowledge was adequate (mean 72.82%) in this group of athletes with the highest scores in dietary advice section (85.71%), followed by food groups (71.24%) and food choice (69.52%). The majority of athletes were not aware of current carbohydrate recommendations. This translated into their dietary habits as many starchy and fibrous foods were consumed only occasionally by poor nutritional knowledge group. In terms of their eating habits, the good nutritional knowledge group consumed significantly more fruit and vegetables, and starchy foods (p <.05). Nutritional knowledge was positively correlated to fruit and vegetables consumption (rs = .52, p <.05) but not to any other eatwell plate categories. The study identified adequate general nutritional knowledge in professional rugby league players with the exception of recommendation for starchy and fibrous foods. Players who scored higher in nutritional knowledge test were more likely to consume more fruits, vegetables and carbohydrate-rich foods.
Cuesta-Briand, Beatriz; Auret, Kirsten; Johnson, Paula; Playford, Denese
2014-04-12
The importance of professional behaviour has been emphasized in medical school curricula. However, the lack of consensus on what constitutes professionalism poses a challenge to medical educators, who often resort to a negative model of assessment based on the identification of unacceptable behaviour. This paper presents results from a study exploring medical students' views on professionalism, and reports on students' constructs of the 'good' and the 'professional' doctor. Data for this qualitative study were collected through focus groups conducted with medical students from one Western Australian university over a period of four years. Students were recruited through unit coordinators and invited to participate in a focus group. De-identified socio-demographic data were obtained through a brief questionnaire. Focus groups were audio-recorded, transcribed and subjected to inductive thematic analysis. A total of 49 medical students took part in 13 focus groups. Differences between students' understandings of the 'good' and 'professional' doctor were observed. Being competent, a good communicator and a good teacher were the main characteristics of the 'good' doctor. Professionalism was strongly associated with the adoption of a professional persona; following a code of practice and professional guidelines, and treating others with respect were also associated with the 'professional' doctor. Students felt more connected to the notion of the 'good' doctor, and perceived professionalism as an external and imposed construct. When both constructs were seen as acting in opposition, students tended to forgo professionalism in favour of becoming a 'good' doctor.Results suggest that the teaching of professionalism should incorporate more formal reflection on the complexities of medical practice, allowing students and educators to openly explore and articulate any perceived tensions between what is formally taught and what is being observed in clinical practice.
Timen, Aura; Hulscher, Marlies E J L; Rust, Laura; van Steenbergen, Jim E; Akkermans, Reinier P; Grol, Richard P T M; van der Meer, Jos W M
2010-11-01
Communicable disease crises can endanger the health care system and often require special guidelines. Understanding reasons for nonadherence to crisis guidelines is needed to improve crisis management. We identified and measured barriers and conditions for optimal adherence as perceived by 4 categories of health care professionals. In-depth interviews were performed (n = 26) to develop a questionnaire for a cross-sectional survey of microbiologists (100% response), infection preventionists (74% response), public health physicians (96% response), and public health nurses (82% response). The groups were asked to appraise barriers encountered during 4 outbreaks (severe acute respiratory syndrome [SARS], Clostridium difficile ribotype 027, rubella, and avian influenza) according to a 5-point Likert scale. When at least 33% of the participants responded "strongly agree," "agree," or "rather agree than disagree," a barrier was defined as "often experienced." The common ("generic") barriers were included in a univariate and multivariate model. Barriers specific to the various groups were studied as well. Crisis guidelines were found to have 4 generic barriers to adherence: (1) lack of imperative or precise wording, (2) lack of easily identifiable instructions specific to each profession, (3) lack of concrete performance targets, and (4) lack of timely and adequate guidance on personal protective equipment and other safety measures. The cross-sectional study also yielded profession-specific sets of often-experienced barriers. To improve adherence to crisis guidelines, the generic barriers should be addressed when developing guidelines, irrespective of the infectious agent. Profession-specific barriers require profession-specific strategies to change attitudes, ensure organizational facilities, and provide an adequate setting for crisis management. Copyright © 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-13
...Trader.com Web site. Exchange Customer Firm MM Professional BATS $0.[36]50 $0.55 $0.55 $0.[48]50 BOX 0.06... Exchange Act of 1934 (``Act''),\\1\\ and Rule 19b-4 thereunder,\\2\\ notice is hereby given that on January 3... proposed rule change from interested persons. \\1\\ 15 U.S.C. 78s(b)(1). \\2\\ 17 CFR 240.19b-4. I. Self...
Ibrahim, Muhamad Alif Bin; Chow, Chengzi; Poh, Bee Fong; Ang, Brenda; Chow, Angela
2018-03-01
Good hand hygiene (HH) prevents health care-associated infections. We compared psychosocial and organizational factors associated with HH compliance and perceived need for improvement among physicians, nurses, and allied health professionals (AHPs). We conducted a mixed-methods study in a 1,600-bed adult tertiary-care hospital in Singapore. Seven focus group discussions were conducted and data were analyzed using thematic analysis. The subsequent cross-sectional survey involved 1,064 staff members. Principal components analysis was performed to derive the latent factor structure that was applied in multivariable analyses. All staff members acknowledged that HH was an integral part of their work, but were noncompliant due to competing priorities. Physicians were forgetful but appreciated reminders. Nurses were intrinsically motivated for HH. After adjusting for gender, staff category, seniority, and dermatitis history, having positive knowledge-attitudes-behaviors (odds ratio [OR], 1.44; 95% confidence interval [CI], 1.23-1.69), personal motivators-enablers (OR, 1.60; 95% CI, 1.38-1.86), and emotional motivators (OR, 1.62; 95% CI 1.40-1.88) were positively associated with good HH compliance. Women (OR, 3.91; 95% CI, 1.37-11.11), seniors (OR, 2.88; 95% CI, 1.08-7.68), nurses (OR, 4.05; 95% CI, 1.51-10.87), and staff with personal motivators-enablers for HH (OR, 1.60; 95% CI, 1.08-2.37) were more likely to perceive a need for improvement. Factors influencing self-reported HH differed between health care professional groups. Group-specific interventions are needed to improve compliance. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Bond, Stuart Evan; Crowther, Shelley P; Adhikari, Suman; Chubaty, Adriana J; Yu, Ping; Borchard, Jay P; Boutlis, Craig Steven; Yeo, Wilfred Winston; Miyakis, Spiros
2018-02-26
Internet-based learning for health professional education is increasing. It offers advantages over traditional learning approaches, as it enables learning to be completed at a time convenient to the user and improves access where facilities are geographically disparate. We developed and implemented the Vancomycin Interactive (VI) e-learning tool to improve knowledge on the clinical use of the antibiotic vancomycin, which is commonly used for treatment of infections caused by methicillin-resistant Staphylococcus aureus (MRSA). The aims of this study were to evaluate the effect of the VI e-learning tool on (1) survey knowledge scores and (2) clinical use of vancomycin among health professionals. We conducted a comparative pre-post intervention study across the 14 hospitals of two health districts in New South Wales, Australia. A knowledge survey was completed by nurses, doctors, and pharmacists before and after release of a Web-based e-learning tool. Survey scores were compared with those obtained following traditional education in the form of an email intervention. Survey questions related to dosing, administration, and monitoring of vancomycin. Outcome measures were survey knowledge scores among the three health professional groups, vancomycin plasma trough levels, and vancomycin approvals recorded on a computerized clinical decision support system. Survey response rates were low at 26.87% (577/2147) preintervention and 8.24% (177/2147) postintervention. The VI was associated with an increase in knowledge scores (maximum score=5) among nurses (median 2, IQR 1-2 to median 2, IQR 1-3; P<.001), but not among other professional groups. The comparator email intervention was associated with an increase in knowledge scores among doctors (median 3, IQR 2-4 to median 4, IQR 2-4; P=.04). Participants who referred to Web-based resources while completing the e-learning tool achieved higher overall scores than those who did not (P<.001). The e-learning tool was not shown to be significantly more effective than the comparator email in the clinical use of vancomycin, as measured by plasma levels within the therapeutic range. The e-learning tool was associated with improved knowledge scores among nurses, whereas the comparator email was associated with improved scores among doctors. This implies that different strategies may be required for optimizing the effectiveness of education among different health professional groups. Low survey response rates limited conclusions regarding the tool's effectiveness. Improvements to design and evaluation methodology may increase the likelihood of a demonstrable effect from e-learning tools in the future. ©Stuart Evan Bond, Shelley P Crowther, Suman Adhikari, Adriana J Chubaty, Ping Yu, Jay P Borchard, Craig Steven Boutlis, Wilfred Winston Yeo, Spiros Miyakis. Originally published in JMIR Medical Education (http://mededu.jmir.org), 26.02.2018.
Gehrke, Sergio Alexandre; Bettach, Raphaél; Taschieri, Silvio; Boukhris, Gilles; Corbella, Stefano; Del Fabbro, Massimo
2015-08-01
The study aims to test the hypothesis of no differences in temperature variation by using a single bur for implant site preparation as compared with conventional drilling sequence using multiple burs with incremental diameter. Synthetic blocks of bone (type I density) were used for drilling procedures. Group 1 and Group 2 - drilling with three consecutive burs for a 4.1 mm cylindrical implant and for a 4.3 mm conical implant, respectively; Group 3 - drilling with a single bur for a 4.2 mm conical implant. For each group, 20 drilling procedures were performed without irrigation and 20 with external irrigation. The temperature in the cortical bone during osteotomy for implant site preparation was measured through a thermocouple. The mean temperatures and standard deviations for the drilling without irrigation were: 25.5 ± 1.24°C for Group 1; 28.1 ± 1.76°C for Group 2; 26.5 ± 1.79°C for Group 3. Considering the drilling with irrigation, the mean values and standard deviations were: 20.4 ± 1.17°C for Group 1; 22.2 ± 1.38°C for Group 2; 20.2 ± 0.83°C for Group 3. Groups 1 and 3 yielded similar results, while Group 2 displayed significantly higher temperature increase than the other two groups. The single bur drilling protocol did not produce greater bone heating than the conventional protocol and may be considered a safe procedure. © 2013 Wiley Periodicals, Inc.
Lehocká, Hana; Závacká, Ivona; Vavrošová, Jana; Janout, Vladimír
2017-03-01
The aim of this study is to analyze the genotoxic risks in the Moravian-Silesian Region in the Czech Republic and assess the significance of genotoxic factors in the etiology of cancer by bringing together the Registry of Occupational Exposure to Genotoxic Factors and the Cancer Registry and compare the rate of detected cancer in persons exposed to genotoxic factors via their work in the Moravian-Silesian Region with the occurrence of cancer in the population of the Czech Republic. The results show: (a) For the monitored group (748 person) for the period 1996-2008, according to gender, was no statistically significant difference in the incidence of oncological diseases compared to the population of the Czech Republic. (b) But statistically significant difference was found in the cases of oncological diseases in groups according to % AB.C. using the Cytogenetic analysis of human peripheral lymphocytes (CAPL). The highest incidence was in the group with a higher incidence of % AB.C. High values of % AB.C. may predict the development of oncological diseases.
Andrews, Michael C; Itsiopoulos, Catherine
2016-02-01
Athletes require sufficient nutrition knowledge and skills to enable appropriate selection and consumption of food and fluids to meet their health, body composition, and performance needs. This article reports the nutrition knowledge and dietary habits of male football (soccer) players in Australia. Players age 18 years and older were recruited from 1 A-League club (professional) and 4 National Premier League clubs (semiprofessional). No significant difference in general nutrition knowledge (GNK; 54.1% ± 13.4%; 56.8% ± 11.7%; M ± SD), t(71) = -0.91, p = .37, or sports nutrition knowledge (SNK; 56.9% ± 15.5%; 61.3% ± 15.9%), t(71) = -1.16, p = .25) were noted between professional (n = 29) and semiprofessional (n = 44) players. In general, players lacked knowledge in regard to food sources and types of fat. Although nutrition knowledge varied widely among players (24.6-82.8% correct responses), those who had recently studied nutrition answered significantly more items correctly than those who reported no recent formal nutrition education (62.6% ± 11.9%; 54.0% ± 11.4%), t(67) = 2.88, p = .005). Analysis of 3-day estimated food diaries revealed both professionals (n = 10) and semiprofessionals (n = 31) consumed on average less carbohydrate (3.5 ± 0.8 gC/kg; 3.9 ± 1.8 gC/kg) per day than football-specific recommendations (FIFA Medical and Assessment Research Centre [F-MARC]: 5-10 gC/kg). There was a moderate, positive correlation between SNK and carbohydrate intake (n = 41, ρ = 0.32, p = .04), indicating that players who exhibited greater SNK had higher carbohydrate intakes. On the basis of these findings, male football players in Australia would benefit from nutrition education targeting carbohydrate and fat in an attempt to improve nutrition knowledge and dietary practices.
NASA Astrophysics Data System (ADS)
Fernandes, Geraldo W. Rocha; Rodrigues, António M.; Ferreira, Carlos Alberto
2018-03-01
This article aims to characterise the research on science teachers' professional development programs that support the use of Information and Communication Technologies (ICTs) and the main trends concerning the theoretical frameworks (theoretical foundation, literature review or background) that underpin these studies. Through a systematic review of the literature, 76 articles were found and divided into two axes on training science teachers and the use of digital technologies with their categories. The first axis (characterisation of articles) presents the category key features that characterise the articles selected (major subjects, training and actions for the professional development and major ICT tools and digital resources). The second axis (trends of theoretical frameworks) has three categories organised in theoretical frameworks that emphasise the following: (a) the digital technologies, (b) prospects of curricular renewal and (c) cognitive processes. It also characterised a group of articles with theoretical frameworks that contain multiple elements without deepening them or that even lack a theoretical framework that supports the studies. In this review, we found that many professional development programs for teachers still use inadequate strategies for bringing about change in teacher practices. New professional development proposals are emerging with the objective of minimising such difficulties and this analysis could be a helpful tool to restructure those proposals.
Mendes, Alvaro; Paneque, Milena; Sousa, Liliana
2012-10-01
This article examines genetics healthcare professionals' opinions about a multifamily psychoeducational programme for hereditary cancer susceptibility families, implemented at a Portuguese genetics service. Their views on how a family-oriented approach is envisioned to be incorporated in Portuguese genetic counselling services are also reported. Six focus groups and three individual interviews were undertaken comprising 30 professionals working in the provision of genetic counselling and genetic counsellor trainees. Participants were given a page-summary describing the intervention and asked to comment the strengths and limitations of the multifamily intervention. All interviews were fully transcribed and analysed using the constant comparison method. The qualitative analysis generated data comprising four thematic categories in relation to the professionals' views: (a) usefulness of the programme; (b) programme's methodological and practical obstacles; (c) genetics services constraints; and (d) suggestions for improving the programme and further family-oriented interventions. We reflect on the reported views examining the intervention, and on how current constraints of genetic services limit the provision of psychosocial support for cancer susceptibility families. The implications of these findings regarding the purpose of genetic counselling are discussed. Results may sensitise stakeholders and policy makers for the need to deliver family-based services in cancer genetic counselling, with adequate planning and collaborative involvement of different professionals.
Ismail, Rasha S. A.; El-Megeid, Ashraf A. A.; Abdel-Moemin, Aly R.
2009-01-01
The aim of the present investigation was to study the effects of olive oil (OO), corn oil (CO), and flaxseed oil (FO), with or without supplementation of vitamins E and C, on food intake, body weight gain %, liver weight to body weight %, total lipids, liver functions, and liver histology in male rats intoxicated with carbon tetrachloride (CCl4). Forty-two rats were divided into two main groups. The first main group was fed on basal diet (BD) as a negative control group (NC). The second main group received subcutaneous injections of CCl4 in paraffin oil (50% v/v 2ml/kg) twice a week to induce chronic damage in the liver. The group was then divided into six subgroups, three of which were fed on 4% unsupplemented oils (CO, FO, and OO) as positive control for the three oils used. The rest of the groups were fed on 4% of the same oils supplemented with vitamins E and C. The results of the flaxseed oil rat group indicate that supplementing vitamin E and C led to a significant reduction in the mean values of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and liver alanine amino transferase enzyme (ALT). Moreover, it caused an increase of the mean value of high-density lipoprotein cholesterol (HDL-C) as compared to the negative control group (NC). The olive oil group supplemented with the same vitamins showed a significant decrease in the mean value of serum TC and significant (P<0.05) increase in the mean value of serum HDL-C as compared to NC. The results of the corn oil group supplemented with vitamins showed a significant increase in the mean value of serum HDL-C as compared to the negative control group. The histology results confirmed that the group hepatically injured with CCl4 treatment and fed on supplemented FO or OO showed apparently normal hepatocytes. Conclusion: The most effective treatment was observed with oils supplemented with vitamins E and C. Hierarchically FO achieved the best results compared to other additives, followed by OO and finally CO showing the least effective treatment among the observed groups. PMID:19675745
Ismail, Rasha S A; El-Megeid, Ashraf A A; Abdel-Moemin, Aly R
2009-06-30
The aim of the present investigation was to study the effects of olive oil (OO), corn oil (CO), and flaxseed oil (FO), with or without supplementation of vitamins E and C, on food intake, body weight gain %, liver weight to body weight %, total lipids, liver functions, and liver histology in male rats intoxicated with carbon tetrachloride (CCl(4)). Forty-two rats were divided into two main groups. The first main group was fed on basal diet (BD) as a negative control group (NC). The second main group received subcutaneous injections of CCl(4) in paraffin oil (50% v/v 2 ml/kg) twice a week to induce chronic damage in the liver. The group was then divided into six subgroups, three of which were fed on 4% unsupplemented oils (CO, FO, and OO) as positive control for the three oils used. The rest of the groups were fed on 4% of the same oils supplemented with vitamins E and C. The results of the flaxseed oil rat group indicate that supplementing vitamin E and C led to a significant reduction in the mean values of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and liver alanine amino transferase enzyme (ALT). Moreover, it caused an increase of the mean value of high-density lipoprotein cholesterol (HDL-C) as compared to the negative control group (NC). The olive oil group supplemented with the same vitamins showed a significant decrease in the mean value of serum TC and significant (P<0.05) increase in the mean value of serum HDL-C as compared to NC. The results of the corn oil group supplemented with vitamins showed a significant increase in the mean value of serum HDL-C as compared to the negative control group. The histology results confirmed that the group hepatically injured with CCl(4) treatment and fed on supplemented FO or OO showed apparently normal hepatocytes. The most effective treatment was observed with oils supplemented with vitamins E and C. Hierarchically FO achieved the best results compared to other additives, followed by OO and finally CO showing the least effective treatment among the observed groups.
Design of Computer-Related Workstations in Relation to Job Functions and Productivity.
1984-12-01
I nadequat e Neut ra I Adequat e Mana,’,ement 36.6% 17. 3 46.2 C Compiter Prog. 45.1 25.3 29.7 Syst ems Analyst 44.6 20.0 35.4 FPmctional Analyst...2~ der md prJgrvTm~r C S 4 0 6 I 0 I S I S g tS * Ar . ± " S . l _ - ---- ,E- , ! ---- - -.-- _EA E L 2 . ... .. __., ____ I - / 1: - i - - " I...there ;ire lrina van :ibl -e; which .0 tect fati I I ty desi gn and l ayout. In a professional * oputr-rlatd ’vi ronimInt , sat i stact 110 with
Thakare, Kaustubh S; Deo, Vikas; Bhongade, Manohar L
2010-01-01
Several studies suggested an association between periodontal disease and cardiovascular disease (CVD). C- reactive protein is elevated in periodontitis patients and has been found to be a predictor of increased risk for cardiovascular disease. Since, CRP is known to play a role in pathogenesis of atherosclerosis, the present study was undertaken to evaluate the serum levels of CRP in periodontitis patients with or without atherosclerosis. A total of 45 patients, 15 chronic periodontitis patients with atherosclerosis (Group A), 15 chronic periodontitis patients with no history of any systemic disease (Group B), and 15 clinically healthy individuals with no history of periodontal or systemic disease (Group C) within age range of 30 to 55 years were selected for the study. PI, PBI, PPD, CAL and radiographic marginal alveolar bone level were assessed in all the three groups. CRP levels were assessed with 'Turbi-latex' kit using turbidimetric analysis. The mean CAL recorded was 4.9mm in group A, 4.6mm in group B and 1.9 mm in group C. The mean radiographic marginal bone level was 45 to 50% in group A, 45 to 50% in group B and 90 to 95% in group C. Mean serum C-reactive protein level was significantly higher in group A (8.9 mg/l), as compared to group B (4.9 mg/l) as well as group C (0.9 mg/l). Within the limits of this study it was concluded that periodontitis may add to the inflammatory burden of the individual and may result in increased risk of atherosclerosis based on serum C-reactive protein concentrations.
Who helps the leaders? Difficulties experienced by cancer support group leaders.
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.
Ramírez-Farías, Carlett; Madrigal-Santillán, Eduardo; Gutiérrez-Salinas, José; Rodríguez-Sánchez, Nidia; Martínez-Cruz, Maricela; Valle-Jones, Ilse; Gramlich-Martínez, Ingrid; Hernández-Ceruelos, Alejandra; Morales-Gonzaléz, José A
2008-02-14
To investigate the effects of vitamins (A, C and E) on liver injury induced by ethanol administration during liver regeneration in rats. Male Wistar rats subjected to 70% partial hepatectomy were divided into five groups (groups 1-5). During the experiment, animals of Group 1 drank only water. The other four groups (2-5) drank 30 mL of ethanol/L of water. Group 3 additionally received vitamin A, those of group 4 vitamin C and those of group 5 received vitamin E. Subsequently serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin and bilirubin were measured colorimetrically. Lipid peroxidation (thiobarbituric-acid reactive substances, TBARS) both in plasma and liver was measured, as well as liver mass gain assessment and total DNA. Compared with sham group, serum AST and ALT increased significantly under ethanol treatment (43% and 93%, respectively, with P < 0.05). Vitamin C and vitamin E treatment attenuated the ethanol-induced increases in ALT and AST activity. Ethanol treatment also decreased serum albumin concentration compared to sham group (3.1 +/- 0.4 g/dL vs 4.5 +/- 0.2 g/dL; P < 0.05). During liver regeneration vitamins C and E significantly ameliorated liver injury for ethanol administration in hepatic lipid peroxidation (4.92 nmol/mg and 4.25 nmol/mg vs 14.78 nmol/mg, respectively, with P < 0.05). In association with hepatic injury, ethanol administration caused a significant increase in both hepatic and plasma lipid peroxidation. Vitamins (C and E) treatment attenuated hepatic and plasma lipid peroxidation. Vitamins C and E protect against liver injury and dysfunction, attenuate lipid peroxidation, and thus appear to be significantly more effective than vitamin A against ethanol-mediated toxic effects during liver regeneration.
Legal Professionals' Knowledge of Eyewitness Testimony in China: A Cross-Sectional Survey
Jiang, Lina; Luo, Dahua
2016-01-01
Purpose To examine legal professionals’ knowledge of a wide range of factors that affect eyewitness accuracy in China. Methods A total of 812 participants, including 210 judges, 244 prosecutors, 202 police officers, and 156 defense attorneys, were asked to respond to 12 statements about eyewitness testimony and 3 basic demographic questions (i.e., gender, age, and prior experience). Results Although the judges and the defense attorneys had a somewhat higher number of correct responses than the other two groups, all groups showed limited knowledge of eyewitness testimony. In addition, the participants’ responses to only four items (i.e., weapon focus, attitude and expectations, child suggestibility, and the impact of stress) were roughly unanimous within the four legal professional groups. Legal professionals’ gender showed no significant correlations with their knowledge of eyewitness testimony. Prior experiences were significantly and negatively correlated with the item on the knowledge of forgetting curve among judges but positively correlated with two items (i.e., attitudes and exposure time) among defense attorneys and with 4 statements (i.e., the knowledge of attitudes and expectations, impact of stress, child witness accuracy, and exposure time) among prosecutors. Conclusions The findings suggest that knowledge of the factors that influence eyewitness accuracy must be more effectively communicated to legal professionals in the future. PMID:26828933
Thompson, A; Madan, N; Hesselink, J R; Weinstein, G; Munoz del Rio, A; Haughton, V
2016-04-01
The cause of syringomyelia in patients with Chiari I remains uncertain. Cervical spine anatomy modifies CSF velocities, flow patterns, and pressure gradients, which may affect the spinal cord. We tested the hypothesis that cervical spinal anatomy differs between Chiari I patients with and without syringomyelia. We identified consecutive patients with Chiari I at 3 institutions and divided them into groups with and without syringomyelia. Five readers measured anteroposterior cervical spinal diameters, tonsillar herniation, and syrinx dimensions on cervical MR images. Taper ratios for C1-C7, C1-C4, and C4-C7 spinal segments were calculated by linear least squares fitting to the appropriate spinal canal diameters. Mean taper ratios and tonsillar herniation for groups were compared and tested for statistical significance with a Kruskal-Wallis test. Inter- and intrareader agreement and correlations in the data were measured. One hundred fifty patients were included, of which 49 had syringomyelia. C1-C7 taper ratios were smaller and C4-C7 taper ratios greater for patients with syringomyelia than for those without it. C1-C4 taper ratios did not differ significantly between groups. Patients with syringomyelia had, on average, greater tonsillar herniation than those without a syrinx. However, C4-C7 taper ratios were steeper, for all degrees of tonsil herniation, in patients with syringomyelia. Differences among readers did not exceed differences among patient groups. The tapering of the lower cervical spine may contribute to the development of syringomyelia in patients with Chiari I. © 2016 by American Journal of Neuroradiology.
Seven Liberal Outcomes of Professional Study.
ERIC Educational Resources Information Center
Stark, Joan S.
A group of faculty members and accrediting representatives was assembled to explore ways to better integrate liberal and professional study during the undergraduate years. The group based its discussions on educational outcomes previously identified by the project directors as important for all college-educated professionals. The project involved…
2014-01-01
Background Inter-professional learning has been promoted as the solution to many clinical management issues. One such issue is the correct use of asthma inhaler devices. Up to 80% of people with asthma use their inhaler device incorrectly. The implications of this are poor asthma control and quality of life. Correct inhaler technique can be taught, however these educational instructions need to be repeated if correct technique is to be maintained. It is important to maximise the opportunities to deliver this education in primary care. In light of this, it is important to explore how health care providers, in particular pharmacists and general medical practitioners, can work together in delivering inhaler technique education to patients, over time. Therefore, there is a need to develop and evaluate effective inter-professional education, which will address the need to educate patients in the correct use of their inhalers as well as equip health care professionals with skills to engage in collaborative relationships with each other. Methods This mixed methods study involves the development and evaluation of three modules of continuing education, Model 1, Model 2 and Model 3. A fourth group, Model 4, acting as a control. Model 1 consists of face-to-face continuing professional education on asthma inhaler technique, aimed at pharmacists, general medical practitioners and their practice nurses. Model 2 is an electronic online continuing education module based on Model 1 principles. Model 3 is also based on asthma inhaler technique education but employs a learning intervention targeting health care professional relationships and is based on sociocultural theory. This study took the form of a parallel group, repeated measure design. Following the completion of continuing professional education, health care professionals recruited people with asthma and followed them up for 6 months. During this period, inhaler device technique training was delivered and data on patient inhaler technique, clinical and humanistic outcomes were collected. Outcomes related to professional collaborative relationships were also measured. Discussion Challenges presented included the requirement of significant financial resources for development of study materials and limited availability of validated tools to measure health care professional collaboration over time. PMID:24708800
Bosnic-Anticevich, Sinthia Z; Stuart, Meg; Mackson, Judith; Cvetkovski, Biljana; Sainsbury, Erica; Armour, Carol; Mavritsakis, Sofia; Mendrela, Gosia; Travers-Mason, Pippa; Williamson, Margaret
2014-04-07
Inter-professional learning has been promoted as the solution to many clinical management issues. One such issue is the correct use of asthma inhaler devices. Up to 80% of people with asthma use their inhaler device incorrectly. The implications of this are poor asthma control and quality of life. Correct inhaler technique can be taught, however these educational instructions need to be repeated if correct technique is to be maintained. It is important to maximise the opportunities to deliver this education in primary care. In light of this, it is important to explore how health care providers, in particular pharmacists and general medical practitioners, can work together in delivering inhaler technique education to patients, over time. Therefore, there is a need to develop and evaluate effective inter-professional education, which will address the need to educate patients in the correct use of their inhalers as well as equip health care professionals with skills to engage in collaborative relationships with each other. This mixed methods study involves the development and evaluation of three modules of continuing education, Model 1, Model 2 and Model 3. A fourth group, Model 4, acting as a control.Model 1 consists of face-to-face continuing professional education on asthma inhaler technique, aimed at pharmacists, general medical practitioners and their practice nurses.Model 2 is an electronic online continuing education module based on Model 1 principles.Model 3 is also based on asthma inhaler technique education but employs a learning intervention targeting health care professional relationships and is based on sociocultural theory.This study took the form of a parallel group, repeated measure design. Following the completion of continuing professional education, health care professionals recruited people with asthma and followed them up for 6 months. During this period, inhaler device technique training was delivered and data on patient inhaler technique, clinical and humanistic outcomes were collected. Outcomes related to professional collaborative relationships were also measured. Challenges presented included the requirement of significant financial resources for development of study materials and limited availability of validated tools to measure health care professional collaboration over time.
De Vriendt, Patricia; Cornelis, Elise; Desmet, Valerie; Vanbosseghem, Ruben; Van de Velde, Dominique
2018-01-01
Professionals in dementia-care ought to be able to work within a Bio-Psycho-Social model. The objectives were to examine whether dementia-care is delivered in a Bio-Psycho-Social way, to explore the influencing factors and to evaluate the factorial validity of the 'Bio-Psycho-Social-Dementia-Care scale'. 413 healthcare-professionals completed the 'Bio-Psycho-Social-Dementia-Care scale'. Differences between groups (settings, professions, years of experience) were calculated with a student's t-test and one-way ANOVA. The facture structure of the scale was evaluated using a confirmatory factor analysis. The factor-analysis confirmed the 5 subscale-structure (1) networking, (2) using the client's expertise, (3) assessment and reporting, (4) professional knowledge and skills and (5) using the environment. (No significant differences were found between professionals in residential care and community care for the subscales 'networking' and 'using the client's expertise'. Professionals in residential care score higher than community care for 'assessment and reporting' (p<0,05) and 'professional knowledge and skills' (p<0,01) but lower for 'using the environment' (p<0,001). The juniors score higher for 'professional knowledge' compared to seniors (p<0,01) and the seniors score better for 'professional experience' (p<0,01). The Cure and Care disciplines and the Therapy disciplines had higher values in 'assessment and reporting' compared to the Social Support disciplines (p<0,001 and p<0.001). The Therapy disciplines scored higher in 'using professional knowledge and skills' compared to the Social Support group (p 0.021) and the Cure and Care disciplines (p<0,001). The Social Support disciplines scored higher in 'using the environment' compared to the Therapy disciplines (p<0.001) and the Cure and care disciplines (p<0.001). The Bio-Psycho-Social-Dementia-scale is a valid tool and offers opportunities not only to rate, but also to improve Bio-Psycho-Social functioning in dementia-care: increase interdisciplinary collaboration, facilitate assessment, combine the strengths of the different professions and install a heterogeneous team with regard to age and experience.
Dancing with the Muses: dissociation and flow.
Thomson, Paula; Jaque, S Victoria
2012-01-01
This study investigated dissociative psychological processes and flow (dispositional and state) in a group of professional and pre-professional dancers (n=74). In this study, high scores for global (Mdn=4.14) and autotelic (Mdn=4.50) flow suggest that dancing was inherently integrating and rewarding, although 17.6% of the dancers were identified as possibly having clinical levels of dissociation (Dissociative Experiences Scale-Taxon cutoff score≥20). The results of the multivariate analysis of variance indicated that subjects with high levels of dissociation had significantly lower levels of global flow (p<.05). Stepwise linear regression analyses demonstrated that dispositional flow negatively predicted the dissociative constructs of depersonalization and taxon (p<.05) but did not significantly predict the variance in absorption/imagination (p>.05). As hypothesized, dissociation and flow seem to operate as different mental processes.
Health education with older adults: action research with primary care professionals.
Mendonça, Francielle Toniolo Nicodemos Furtado de; Santos, Álvaro da Silva; Buso, Ana Luisa Zanardo; Malaquias, Bruna Stephanie Sousa
2017-01-01
To assess the development and implementation of permanent education action. Quantitative-qualitative research based on action research in three phases (diagnosis of reality, implementation of activity and evaluation), performed with health professionals and managers of basic health units. The evaluation was on the perception of changes immediately following the activity and after 120 days. In the first phase, 110 professionals took part, 36.4% of whom indicated the existence of groups for older adults at work. In the second phase, 98 professionals participated, pointing out interferences of the group in the life of older adults, items of importance and facilitation in forming groups and developing reality-based activities. The third phase showed, in the quantitative analysis, positive impact of the training, and in the qualitative analysis, reassessment of groups, greater knowledge and confidence in managing groups and increased respect for older adults. Permanent education opens pathways for the construction of differentiated care for older adults based on respect and health promotion. Avaliar o desenvolvimento e implementação de uma ação de educação permanente. Pesquisa quantitativo-qualitativa baseada na pesquisa-ação em 3 fases (diagnóstico da realidade, implementação de atividade e avaliação), realizada com profissionais de saúde e gerentes de unidades básicas. A avaliação se deu pela percepção de mudanças imediatamente à atividade e após 120 dias. Na 1ª fase, participaram 110 profissionais, dos quais 36,4% apontaram a existência de grupos para idosos no trabalho. Na 2ª fase, participaram 98 profissionais, que apontaram interferências do grupo na vida do idoso, itens de importância e facilitação para construção de grupos e atividade baseada na realidade. A 3ª fase mostrou, na análise quantitativa, impacto positivo do treinamento; e, na qualitativa, releitura dos grupos e manejo com mais conhecimento, segurança e respeito ao idoso. A educação permanente abre caminhos para a construção da atenção diferenciada aos idosos pautada no respeito e na promoção da saúde.
A comparison of the survival of F+RNA and F+DNA coliphages in lake water microcosms.
Long, Sharon C; Sobsey, Mark D
2004-03-01
The survival of seven F+RNA phages (MS2 Group I ATCC type strain, two Group I environmental isolates, a Group II environmental isolate, a Group III environmental isolate, and two Group IV environmental isolates) and six F+DNA phages (M13, fd, f1, and ZJ/2 ATCC type strains, and two environmental isolates) were examined in microcosms using a surface drinking water source. Phages were spiked into replicate aliquots of a source water at about 20,000 pfu/ml. Replicate spikes were incubated at 4 and 20 degrees C and monitored for 110 days. At 4 degrees C, Groups I and II F+ RNA phages were detectable through 110 days, with reductions of about 1 and 3 log10, respectively. The Group III F+RNA phage demonstrated 5 log10 reduction after 3 weeks, and the Group IV F+RNA phages were reduced to detection limits (5 log10 reduction) within 10 days. Of the F+DNA phages, all four type strains were detectable with about 2.5 log10 reduction after 110 days at 4 degrees C. The F+DNA environmental isolates were detectable with about a 4 log10 reduction after 110 days at 4 degrees C. All phages demonstrated faster decay at 20 degrees C. These results suggest that differences in F+ phage survival may influence their prevalence in environmental waters and the ability to attribute their prevalence to specific human and animal sources of faecal contamination.
Koukouli, Sofia; Pattakou-Parasyri, Vassiliki; Kalaitzaki, Argyroula E
2014-04-01
This study investigates the anxiety people feel about aging and the psychometric properties of the Anxiety about Aging Scale (AAS) in Greek samples. The AAS was administered in 3 groups: 147 primary health care professionals, 74 Nursing and Social Work students, and 99 community residents. A confirmatory factor analysis reproduced the 4 factors underlying the Greek-translated AAS, with acceptable reliabilities for the 3 samples. Multivariate analysis of variance showed that students expressed significantly more anxiety about aging (higher overall AAS score), more "Fear of old people," "Psychological concerns," and "Concerns about physical appearance," and less "Fear of losses," compared with professionals and community residents. Women reported the highest concerns about physical appearance compared with men. Students and professionals having experience with dementia showed lower and higher overall AAS scores, respectively, compared with those who had no such experience. The younger professionals without experience and the less educated ones with experience expressed higher overall anxiety about aging than the older professionals and the less educated both without experience. Our findings suggest the importance of implementing appropriate educational interventions and ongoing training tailored to assuage students' and professionals' anxiety about their own aging and lessen their agist attitudes toward old people.
Use of Oral Chroma™ in the assessment of volatile sulfur compounds in patients with fixed protheses.
Sinjari, B; Murmura, G; Caputi, S; Ricci, L; Varvara, G; Scarano, A
2013-01-01
Prosthetic rehabilitation improves the patient's quality of life and oral health. The purpose of the present study was to assess the production of volatile sulfur compounds (VSCs) using Oral Chroma in patients wearing provisional and permanent fixed prosthesis, who were treated or not, with supportive non-surgical periodontal therapy. A total of 10 healthy patients not affected by periodontal disease and who needed the restoration of at least two edentulous single sites were included in the present study. Registrations of VSCs were carried out with a Gas Chromatograph OralChroma™ (Oral Chroma™, Abimedical, Abilit Corp., Osaka, Japan) one month after placement of the provisional restoration (group 1) and one month after placement of the final restoration (group 3). After each measurement, professional oral hygiene was carried out both on patients with provisional (group 2) and permanent prostheses (group 4) and VSC values were registered. The results showed that there were no statistical significant differences in the VSC quantity between groups with temporary or permanent prostheses. Meanwhile, statistically significant differences were found in VCS values between groups before and after the professional health care session (p less than 0.05). Also it was observed that dimethyl sulphide (CH3)2S was present in all the study groups. The present preliminary study suggests that OralChroma™ produce a comprehensive assessment of VSC in the clinical diagnosis of halitosis and that professional oral hygiene seems to influence VSC production. However, further clinical long-term studies with a larger sample size are necessary for a better understanding of halitosis manifestation in patients wearing provisional and permanent fixed prosthesis.
Valades, David; Palao, José M; Femia, Pedro; Ureña, Aurelio
2017-07-25
The purpose of this study was to assess the effect of incorporating specific upper-body plyometric training for the spike into the competitive season of a women's professional volleyball team. A professional team from the Spanish first division participated in the study. An A-B-A' quasi-experimental design with experimental and control groups was used. The independent variable was the upper-body plyometric training for eight weeks during the competitive season. The dependent variables were the spiked ball's speed (Km/h); the player's body weight (Kg), BMI (Kg/m2), and muscle percentage in arms (%); 1 repetition maximum (1RM) in the bench press (Kg); 1RM in the pullover (Kg); and overhead medicine ball throws of 1, 2, 3, 4, and 5 kg (m). Inter-player and inter-group statistical analyses of the results were carried out (Wilcoxon test and linear regression model). The experimental group significantly improved their spike speed 3.8% from phase A to phase B, and they maintained this improvement after the retention phase. No improvements were found in the control group. The experimental group presented a significant improvement from phase A to phase B in dominant arm muscle area (+10.8%), 1RM for the bench press (+8.41%), 1RM for the pullover (+14.75%), and overhead medicine ball throws with 1 kg (+7.19%), 2 kg (+7.69%), and 3 kg (+5.26%). The control group did not present differences in these variables. Data showed the plyometric exercises that were tested could be used by performance-level volleyball teams to improve spike speed. The experimental group increased their upper-body maximal strength, their power application, and spike speed.
Academia, advocacy, and industry: a collaborative method for clinical research advancement.
Vanzo, Rena J; Lortz, Amanda; Calhoun, Amy R U L; Carey, John C
2014-07-01
Professionals who work in academia, advocacy, and industry often carry out mutually exclusive activities related to research and clinical care. However, there are several examples of collaboration among such professionals that ultimately allows for improved scientific and clinical understanding. This commentary recounts our particular experience (a collaboration between geneticists at the Universities of Minnesota and Utah, the 4p- Support Group, and Lineagen, Inc) and reviews other similar projects. We formally propose this collaborative method as a conduit for future clinical research programs. Specifically, we encourage academicians, directors of family/advocacy/support groups, and members of industry to establish partnerships and document their experiences. The medical community as a whole will benefit from such partnerships and, specifically, families will teach us lessons that could never be learned in a laboratory or textbook. © 2014 Wiley Periodicals, Inc.
NASA Astrophysics Data System (ADS)
Sisk-Hilton, Stephanie Lee
This study examines the two way relationship between an inquiry-based professional development model and teacher enactors. The two year study follows a group of teachers enacting the emergent Supporting Knowledge Integration for Inquiry Practice (SKIIP) professional development model. This study seeks to: (a) identify activity structures in the model that interact with teachers' underlying assumptions regarding professional development and inquiry learning; (b) explain key decision points during implementation in terms of these underlying assumptions; and (c) examine the impact of key activity structures on individual teachers' stated belief structures regarding inquiry learning. Linn's knowledge integration framework facilitates description and analysis of teacher development. Three sets of tensions emerge as themes that describe and constrain participants' interaction with and learning through the model. These are: learning from the group vs. learning on one's own; choosing and evaluating evidence based on impressions vs. specific criteria; and acquiring new knowledge vs. maintaining feelings of autonomy and efficacy. In each of these tensions, existing group goals and operating assumptions initially fell at one end of the tension, while the professional development goals and forms fell at the other. Changes to the model occurred as participants reacted to and negotiated these points of tension. As the group engaged in and modified the SKIIP model, they had repeated opportunities to articulate goals and to make connections between goals and model activity structures. Over time, decisions to modify the model took into consideration an increasingly complex set of underlying assumptions and goals. Teachers identified and sought to balance these tensions. This led to more complex and nuanced decision making, which reflected growing capacity to consider multiple goals in choosing activity structures to enact. The study identifies key activity structures that scaffolded this process for teachers, and which ultimately promoted knowledge integration at both the group and individual levels. This study is an "extreme case" which examines implementation of the SKIIP model under very favorable conditions. Lessons learned regarding appropriate levels of model responsiveness, likely areas of conflict between model form and teacher underlying assumptions, and activity structures that scaffold knowledge integration provide a starting point for future, larger scale implementation.
The Chinese Communist Armed Forces.
1974-01-01
tepriorcosn \\ MAR 1 3 1981 C ~) AIR UNIVERSITY -4 MAXWELL AIR FORCE BASE, ALABAMA I z AU-I I "-- ’The Chinese Communist Armed Forces. Kenneth R. Whiting...AO-A096 28 DEPARTMENT OF STATE WASHINGTON DC OFFICE OF EXTERNAL--ETC F/6 S/ THE CH INESE C OMMUNIST ARMED FORCES. (U) vsif k.1974 K R WHITING FAR...1974 Directorate of Documentary Research Air University Institute for Professional Development Maxwell Air Force Base, Alabama "/" I;-) K II AIR
Which subgroups of fire fighters are more prone to work-related diminished health requirements?
Plat, Marie-Christine J; Frings-Dresen, Monique H W; Sluiter, Judith K
2012-10-01
To determine whether certain subgroups of fire fighters are prone to work-related diminished health requirements. The health requirements for fire-fighting were tested in a workers' health surveillance (WHS) setting. These health requirements included psychological, physical and sense-related components as well as cardiovascular risk factors. The odds ratio (OR) and 95% confidence interval (95% CI) for the presence of the diminished health requirements were calculated for the subgroups of gender, professionalism and age. The prevalence of diminished psychological requirements was equivalent among the subgroups, and no significant high-risk group was identified. As compared to men fire fighters, women fire fighters were more likely to have diminished physical requirements (OR 28.5; 95% CI 12.1-66.9) and less likely to have cardiovascular risk factors (OR 0.3; 0.1-0.5). As compared to volunteer fire fighters, professionals were less likely to have diminished physical requirements (OR 0.5; 0.3-0.9), but professionals had a higher prevalence of cardiovascular risk factors with an odds ratio of 1.9 (1.1-3.2). As compared to the youngest fire fighters, the oldest fire fighters were more likely to have diminished sense-related requirements (OR 7.1; 3.4-15.2); a similar comparison could be made between oldest and middle-aged fire fighters (OR 5.1; 2.5-10.5). In addition, the oldest fire fighters were more likely to have cardiovascular risk factors when compared to the youngest (OR 4.4; 1.7-11.1) and to the middle-aged fire fighters (OR 3.1; 1.2-7.9). Subgroups (gender, professionalism and age) of fire fighters are prone to at least one specific work-related diminished health requirement. Therefore, parts of the WHS could be applied with more attention to these high-risk groups.
Rossaro, Lorenzo; Tran, Thu P; Ransibrahmanakul, Kanat; Rainwater, Julie A; Csik, Genell; Cole, Stacey L; Prosser, Colette C; Nesbitt, Thomas S
2007-06-01
This study compared the impact of multipoint videoconferencing (VC) versus standard lecturing (ST) on primary care providers' (MDs, NPs/PAs, and RNs) education regarding hepatitis C virus (HCV). The hypothesis was that the educational impact of teaching through telemedicine is comparable to the traditional method. The aim was to provide participants clinically relevant information and knowledge about the natural history, diagnosis, and management of HCV. Improved knowledge was scored from a 10-item quiz administered before and after the educational intervention. Comparison of the pretest knowledge scores within provider groups showed no statistically significant difference in baseline knowledge for the ST versus VC method. However, for all practitioners combined, the VC group scored significantly lower on the pretest than the ST group (p < 0.05). All three types of learners improved their knowledge scores following intervention. On average, MDs and NP/PAs correctly answered two to 3.5 more questions in the posttest. RNs showed the greatest improvements, correctly answering an average of four to five more questions following intervention. Improvement in knowledge scores between the two methods was statistically significant in favor of VC for the MDs (VC = 3.56 +/- 1.92 vs. ST = 2.13 +/- 1.89, p < 0.001) and all groups combined (VC 4.37 +/- 1.92 vs ST 3.06 +/- 1.89, p < 0.001). The results of this study indicate that VC is equivalent, if not better, than standard continuing medical education (CME). VC can potentially improve clinician education regarding the history, diagnosis, and management of HCV, thereby making a substantial impact on the clinical course of patients with this condition. In addition, VC has the potential to eliminate the financial and geographic barriers to professional education for rural practitioners.
Reese, C; Bengel, J; Mittag, O
2014-07-01
Psychologists from rehabilitation centres were surveyed about their current job situation. Following areas were included: (a) professional self-perception, (b) occupational resources and stress, (c) job satisfaction. A nationwide survey of psychologists of all rehabilitation centres in Germany was conducted. Overall, 1,461 rehabilitation centres of all specialties were contacted in writing, of which 623 psychologists participated in the survey. Some of the results can be compared with reference data from previous surveys. The professional self-perception has hardly changed over the last 10 years. Counselling and psychotherapy in one-to-one sessions and group interventions still play an essential role. Overall, job satisfaction and resources are high. General job satisfaction can be best predicted by career opportunities and opportunities for qualification. The results of the study indicate which resources should be strengthened in order to enhance job satisfaction of psychologists in medical rehabilitation. Particular thought should be given to improving career opportunities for psychologists in rehabilitation centres. © Georg Thieme Verlag KG Stuttgart · New York.
Achieving professional success in US government, academia, and industry: an EMGS commentary.
Poirier, Miriam C; Schwartz, Jeffrey L; Aardema, Marilyn J
2014-08-01
One of the goals of the EMGS is to help members achieve professional success in the fields they have trained in. Today, there is greater competition for jobs in genetic toxicology, genomics, and basic research than ever before. In addition, job security and the ability to advance in one's career is challenging, regardless of whether one works in a regulatory, academic, or industry environment. At the EMGS Annual Meeting in Monterey, CA (September, 2013), the Women in EMGS Special Interest Group held a workshop to discuss strategies for achieving professional success. Presentations were given by three speakers, each representing a different employment environment: Government (Miriam C. Poirier), Academia (Jeffrey L. Schwartz), and Industry (Marilyn J. Aardema). Although some differences in factors or traits affecting success in the three employment sectors were noted by each of the speakers, common factors considered important for advancement included networking, seeking out mentors, and developing exceptional communication skills. © 2014 Wiley Periodicals, Inc.
Mizukami, Taketomo; Orihashi, Kazumasa; Herlambang, Bagus; Takahashi, Shinya; Hamaishi, Makoto; Okada, Kenji; Sueda, Taijiro
2010-12-01
Delayed paraplegia after operation on the thoracoabdominal aorta is considered to be related to vulnerability of motor neurons to ischemia. Previous studies have demonstrated the relationship between neuronal vulnerability and endoplasmic reticulum (ER) stress after transient ischemia in the spinal cord. The aim of this study was to investigate whether sodium 4-phenylbutyrate (PBA), a chemical chaperone that reduces the load of mutant or unfolded proteins retained in the ER during cellular stress, can protect against ischemic spinal cord damage. Spinal cord ischemia was induced in rabbits by direct aortic cross-clamping (below the renal artery and above the bifurcation) for 15 minutes at normothermia. Group A (n = 6) was a sham operation control group. In group B (n = 6) and group C (n = 6), vehicle or 15 mg/kg/h of sodium 4-PBA was infused intravenously, respectively, from 30 minutes before the induction of ischemia until 30 minutes after reperfusion. Neurologic function was assessed at 8 hours, and 2 and 7 days after reperfusion with a Tarlov score. Histologic changes were studied with hematoxylin-eosin staining. Immunohistochemistry analysis for ER stress-related molecules, including caspase12 and GRP78 were examined. The mean Tarlov scores were 4.0 in every group at 8 hours, but were 4.0, 2.5, and 3.9 at 2 days; and 4.0, 0.7, and 4.0 at 7 days in groups A, B, and C, respectively. The numbers of intact motor neurons at 7 days after reperfusion were 47.4, 21.5, and 44.9 in groups A, B, and C, respectively. There was no significant difference in terms of viable neurons between groups A and C. Caspase12 and GRP78 immunoreactivities were induced in motor neurons in group B, whereas they were not observed in groups A and C. Reduction in ER stress-induced spinal cord injury was achieved by the administration of 4-PBA. 4-PBA may be a strong candidate for use as a therapeutic agent in the treatment of ischemic spinal cord injury. Copyright © 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Dunleavy, Kim; Chevan, Julia; Sander, Antoinette P; Gasherebuka, Jean Damascene; Mann, Monika
2018-06-01
Continuing professional development is an important component of capacity building in low resource countries. The purpose of this case study is to describe the use of a contextual instructional framework to guide the processes and instructional design choices for a series of continuing professional development courses for physiotherapists in Rwanda. Four phases of the project are described: (1) program proposal, needs assessment and planning, (2) organization of the program and instructional design, (3) instructional delivery and (4) evaluation. Contextual facilitating factors and needs informed choices in each phase. The model resulted in delivery of continuing professional development to the majority of physiotherapists in Rwanda (n = 168, 0.48 rural/0.52 urban) with participants reporting improvement in skills and perceived benefit for their patients. Environmental and healthcare system factors resulted in offering the courses in rural and urban areas. Content was developed and delivered in partnership with Rwandan coinstructors. Based on the domestic needs identified in early courses, the program included advocacy and leadership activities, in addition to practical and clinical instruction. The contextual factors (environment, healthcare service organization, need for rehabilitation and status and history of the physiotherapy profession) were essential for project and instructional choices. Facilitating factors included the established professional degree and association, continuing professional development requirements, a core group of active professionals and an existing foundation from other projects. The processes and contextual considerations may be useful in countries with established professional-level education but without established postentry-level training. Implications for Rehabilitation Organizations planning continuing professional development programs may benefit from considering the context surrounding training when planning, designing and developing instruction. The surrounding context including the environment, the organization of healthcare services, the population defined need for rehabilitation, and the domestic status and history of the physiotherapy profession, is important for physiotherapy projects in countries with lower resources. Facilitating factors in low resource countries such as an established professional degree and association, continuing professional development requirements, a core group of active professionals and an existing foundation from other projects impact the success of projects. Methods that may be useful for relevance, dissemination and consistency include involvement of in-country leaders and instructors and attendance in multiple courses with consistent themes. Rehabilitation professionals in low resource countries may benefit from continuing professional development courses that emphasize practical skills, and clinical reasoning, accompanied by clinical mentoring and directed coaching that encourages knowledge transfer to the clinical setting. Active learning approaches and multiple progressive courses provide opportunities to develop peer support through professional communities of practice.
P Safadi, Marco Aurelio; Martinon-Torres, Federico; Weckx, Lily Yin; Moreira, Edson Duarte; da Fonseca Lima, Eduardo Jorge; Mensi, Ilhem; Calabresi, Marco; Toneatto, Daniela
2017-04-11
After implementation of routine infant MenC vaccination, MenB remains a serious cause of meningococcal disease, yet to be targeted by vaccination programs in several countries. This study (NCT01339923) investigated the immunogenicity and safety of MenC CRM-conjugated vaccine (MenC-CRM) concomitantly administered with MenB vaccine (4CMenB). Infants (N=251) were randomised 1:1 to receive 4CMenB and MenC-CRM (Group 1) or MenC-CRM alone (Group 2) at 3 and 5months (M3, M5) and a booster at 12months of age (M12), and pneumococcal vaccine at M3, M5, M7, M12. Antibody responses to meningococcal vaccines were measured at M3, M6, M12, and M13. Non-inferiority of MenC-CRM response in Group 1 vs Group 2 was demonstrated at M6 and M13, if the lower limit of the 95% confidence interval (LL95%CI) of the difference in percentage of infants with hSBA titres ≥1:8 was >-10%. Sufficiency of MenB response was achieved if LL95%CI of the percentage of infants with hSBA titres ≥1:4 against fHbp, NadA and PorA strains was ≥70% at M6 or ≥75% at M13. Adverse events (AEs) were collected for 7days post-vaccination, and serious AEs (SAEs) and medically attended AEs throughout the study. Non-inferiority of MenC response in Group 1 vs Group 2 (LL95%CI -6.4% [M6]; -5.2% [M13]) and sufficiency of MenB response in Group 1 (LL95%CI 92%, 90%, 89% [M6]; 97%, 92%, 93% [M13] against fHbp, NadA, PorA, respectively) were demonstrated. Higher rates of mild to moderate solicited AEs were reported in Group 1. Unsolicited AEs and SAEs incidences were similar across groups. Concomitant administration of MenC-CRM and 4CMenB in infants was immunogenic, resulting in non-inferior responses against MenC compared to MenC-CRM alone and demonstration of sufficient immune response to MenB, after primary and booster vaccination. Reactogenicity was higher for concomitant vaccines administration, but no safety concerns were identified. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
NASA Astrophysics Data System (ADS)
Wang, Shi; Ding, Xue-Hua; Li, Yong-Hua; Huang, Wei
2015-07-01
A series of supramolecular salts have been obtained by the self-assembly of 4-fluorobenzylamine and halide ions or metal chloride with 18-crown-6 as the host in the hydrochloric acid medium, i.e. (C7H9FN)+ṡX- (X = Cl-, 1; Br-, 2), [(C7H9FN)2ṡ(18-crown-6)2]2+ṡ(MCl4)2- (M = Mn, 3; Co, 5; Zn, 7; Cd, 8), [(C7H9FN)ṡ(18-crown-6)]+ṡ(FeCl4)- (4) and [(C7H9FN)ṡ(18-crown-6)]+ṡ1/2(CuCl4)2- (6). Structural analyses indicate that 1-2 crystallize in the triclinic space group P-1, 4 in orthorhombic space group Pnma and 3, 5, 6-8 in the monoclinic space group P21/c or C2/c. In these compounds, extensive intermolecular interactions have been utilized for the self-assembly of diverse supramolecular architectures, ranging from strong N-H⋯X (X = O, Cl, Br) hydrogen bonds to weak C-H⋯Y (Y = F, Cl, π) interactions. N-H⋯Cl/Br hydrogen bonds offer the major driving force in the crystal packing of salts 1-2 while N-H⋯O hydrogen bonds are found in salts 3-8.