Analysis of Professional and Pre-Accession Characteristics and Junior Naval Officer Performance

DTIC Science & Technology

2018-03-01

REVIEW .............................................5 A. NAVY PERFORMANCE EVALUATION SYSTEM ............................5 B. PROFESSIONAL...17 A. DATA DESCRIPTION ...........................................................................17 B. SUMMARY...STATISTICS ......................................................................24 C. DESCRIPTIVE STATISTICS

Effect of mentoring on professional values in model C clinical nurse leader graduates.

PubMed

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.

Supporting health care professionals to improve the processes of shared decision making and self-management in a web-based intervention: randomized controlled trial.

PubMed

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).

Qualified and Unqualified (N-R C) mental health nursing staff - minor differences in sources of stress and burnout. A European multi-centre study

PubMed Central

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

[Comparative study of burnout in Intensive Care and Emergency Care nursing staff].

PubMed

Ríos Risquez, M I; Godoy Fernández, C; Peñalver Hernández, F; Alonso Tovar, A R; López Alcaraz, F; López Romera, A; Garnés González, S; Salmerón Saura, E; López Real, M D; Ruiz Sánchez, R; Simón Domingo, P; Manzanera Nicolás, J L; Menchón Almagro, M A; Liébanas Bellón, R

2008-01-01

To assess and compare the burnout level between Intensive Care Unit and Emergency Unit, and study its association with the sociodemographic and work characteristics of the professionals surveyed. Cross-sectional, descriptive study. Emplacement. Intensive Care Unit of the university hospital Morales Meseguer, Murcia-Spain. STUDIED SAMPLE: 97 nursing professionals: 55 professionals belong to the Emergency Department, and 42 professionals belong to the Intensive Care Department. Two evaluation tools were used: a sociodemographic and work survey, and the Maslach Burnout Inventory, 1986. Quantitative variables expressed as mean +/- SD compared with the Student's T test and qualitative variables compared with the chi2 test. SPSS 12.0(c). The comparative analysis of the burnout dimensions shows that emotional exhaustion level is significantly higher in the intensive care service than in the emergency one (25.45 +/- 11.15 vs 22.09 +/- 10.99) p < 0.05. The rest of burnout dimensions do not show significant differences between both departments. The masculine gender obtains a higher score in the depersonalization dimension of burnout (10.12 +/- 5.38) than female one (6.7 +/- 5.21) p < 0.01. There is greater vulnerability to emotional exhaustion among the professional group with more than 15 years of work experience (F = 3.592; p = 0.031). The burnout levels are moderate to high among the nursing professionals studied. A total of 5.15% of the sample studied achieves a high score in the three dimensions of the burnout syndrome. The intensive care professionals are the most vulnerable to suffering high levels of emotional exhaustion, and the masculine gender is more susceptible to depersonalization attitudes.

[Professional quality of life in workers of the Toledo primary care health area].

PubMed

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.

Bringing Inquiry Science to K-5 Classrooms

NASA Astrophysics Data System (ADS)

Schachtel, Paula L.; Messina, D. L.; McDermott, L. C.

2006-12-01

As a science coach in the Seattle School District, I am responsible for helping other elementary teachers teach science. For several years, I have been participating in a program that consists of intensive NSF Summer Institutes and an ongoing academic-year Continuation Course. Teachers in this program work through modules in Physics by Inquiry, a research-based curriculum developed by the Physics Education Group at the University of Washington.1 I will discuss how this type of professional development has deepened my understanding of topics in physical science, helped me to teach science by inquiry to my own students, and enabled me to assist my colleagues in implementing inquiry science in their K-5 classrooms. Sponsored by Lillian C. McDermott. 1. A research-based curriculum developed by L.C. McDermott and the Physics Education Group at the University of Washington, Physics by Inquiry, New York, NY, John Wiley & Sons, Inc. (1996.)

Fires. A Joint Publication for U.S. Artillery Professionals. November - December 2010

DTIC Science & Technology

2010-11-01

5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Fires, Building 652, Room 203, McNair...1 sill-www.army.mil/firesbulletin/ • November-December 2010 A Joint Professional Bulletin for U.S. Field and Air Defense Artillerymen November...Publication for U.S. Artillery Professionals . November - December 2010 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S

Short Duration Heat Acclimation in Australian Football Players

PubMed Central

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.

PubMed

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.

Expectations and perceptions of primary healthcare professionals regarding their own continuous education in Catalonia (Spain): a qualitative study.

PubMed

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.

Using the Five Domains Model to Assess the Adverse Impacts of Husbandry, Veterinary, and Equitation Interventions on Horse Welfare

PubMed Central

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

Five-Day Whole-Body Cryostimulation, Blood Inflammatory Markers, and Performance in High-Ranking Professional Tennis Players

PubMed Central

Ziemann, Ewa; Olek, Robert Antoni; Kujach, Sylwester; Grzywacz, Tomasz; Antosiewicz, Jędrzej; Garsztka, Tomasz; Laskowski, Radosław

2012-01-01

Context Tournament season can provoke overreaching syndrome in professional tennis players, which may lead to deteriorated performance. Thus, appropriate recovery methods are crucial for athletes in order to sustain high-level performance and avoid injuries. We hypothesized that whole-body cryostimulation could be applied to support the recovery process. Objective To assess the effects of 5 days of whole-body cryostimulation combined with moderate-intensity training on immunologic, hormonal, and hematologic responses; resting metabolic rate; and tennis performance in a posttournament season. Design Controlled laboratory study. Setting National Olympic Sport Centre. Patients or Other Participants Twelve high-ranking professional tennis players. Intervention(s) Participants followed a moderate-intensity training program. A subgroup was treated with the 5-day whole-body cryostimulation (−120°C) applied twice a day. The control subgroup participated in the training only. Main Outcome Measure(s) Pretreatment and posttreatment blood samples were collected and analyzed for tumor necrosis factor α, interleukin 6, testosterone, cortisol, and creatine kinase. Resting metabolic rate and performance of a tennis drill were also assessed. Results Proinflammatory cytokine (tumor necrosis factor α) decreased and pleiotropic cytokine (interleukin 6) and cortisol increased in the group exposed to cryostimulation. In the same group, greater stroke effectiveness during the tennis drill and faster recovery were observed. Neither the training program nor cryostimulation affected resting metabolic rate. Conclusions Professional tennis players experienced an intensified inflammatory response after the completed tournament season, which may lead to overreaching. Applying whole-body cryostimulation in conjunction with moderate-intensity training was more effective for the recovery process than the training itself. The 5-day exposure to cryostimulation twice a day ameliorated the cytokine profile, resulting in a decrease in tumor necrosis factor α and an increase in interleukin 6. PMID:23182015

5 CFR 319.402 - Scientific and professional positions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS EMPLOYMENT IN SENIOR-LEVEL AND SCIENTIFIC AND PROFESSIONAL POSITIONS Recruitment and Examination § 319.402 Scientific and professional positions. (a) ST positions are filled without competitive... in applicable appropriations acts. (c) ST employees acquire competitive status immediately upon...

5 CFR 319.301 - Qualifications standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Qualifications standards. 319.301 Section... IN SENIOR-LEVEL AND SCIENTIFIC AND PROFESSIONAL POSITIONS Qualifications Requirements § 319.301... in the General Schedule. (c) Standards for scientific and professional positions. (1) Unless the...

5 CFR 319.301 - Qualifications standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Qualifications standards. 319.301 Section... IN SENIOR-LEVEL AND SCIENTIFIC AND PROFESSIONAL POSITIONS Qualifications Requirements § 319.301... in the General Schedule. (c) Standards for scientific and professional positions. (1) Unless the...

Peer-led and professional-led group interventions for people with co-occurring disorders: a qualitative study.

PubMed

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.

Knowledge, attitudes and practices of female genital mutilation/cutting among health care professionals in The Gambia: a multiethnic study.

PubMed

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.

Supported Telemonitoring and Glycemic Control in People with Type 2 Diabetes: The Telescot Diabetes Pragmatic Multicenter Randomized Controlled Trial

PubMed Central

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

Mind the gap! A comparison of oral health knowledge between dental, healthcare professionals and the public.

PubMed

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.

Summary of: Mind the gap! A comparison of oral health knowledge between dental, healthcare professionals and the public.

PubMed

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.

42 CFR Appendix E to Part 5 - Criteria for Designation of Areas Having Shortages of Podiatric Professional(s)

Code of Federal Regulations, 2011 CFR

2011-10-01

... barriers (such as economic or cultural barriers). C. Determination of Degree of Shortage. Designated areas... 42 Public Health 1 2011-10-01 2011-10-01 false Criteria for Designation of Areas Having Shortages... OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS DESIGNATION OF HEALTH PROFESSIONAL(S) SHORTAGE AREAS...

Oral Health Behaviour and Oral Hygiene of Dental Professionals and Laypersons - A Survey Performed in Lower Saxony, Germany.

PubMed

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.

[Local groups as a tool for quality assurance of community health services].

PubMed

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.

5 CFR 319.103 - Scientific and professional positions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... and professional positions. (a) ST positions are established under 5 U.S.C. 3104 to carry out research and development functions that require the services of specially qualified personnel. (b) Research and... Classification.” The guide is available for inspection at the Office of Personnel Management library, 1900 E...

5 CFR 319.103 - Scientific and professional positions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... and professional positions. (a) ST positions are established under 5 U.S.C. 3104 to carry out research and development functions that require the services of specially qualified personnel. (b) Research and... Classification.” The guide is available for inspection at the Office of Personnel Management library, 1900 E...

5 CFR 319.103 - Scientific and professional positions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... and professional positions. (a) ST positions are established under 5 U.S.C. 3104 to carry out research and development functions that require the services of specially qualified personnel. (b) Research and... Classification.” The guide is available for inspection at the Office of Personnel Management library, 1900 E...

5 CFR 319.103 - Scientific and professional positions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... and professional positions. (a) ST positions are established under 5 U.S.C. 3104 to carry out research and development functions that require the services of specially qualified personnel. (b) Research and... Classification.” The guide is available for inspection at the Office of Personnel Management library, 1900 E...

Identifying the predisposing factors, signs and symptoms of overreaching and overtraining in physical education professionals

PubMed Central

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.

Physical examination of arteriovenous fistula: The influence of professional experience in the detection of complications.

PubMed

Sousa, Clemente Neves; Teles, Paulo; Dias, Vanessa Filipa Ferreira; Apóstolo, João Luís Alves; Figueiredo, Maria Henriqueta Jesus Silva; Martins, Maria Manuela

2014-07-01

Vascular access is one of the leading causes of mobilization of financial resources in health systems for people with chronic kidney disease on hemodialysis. Physical examination of the arteriovenous fistula (AVF) has demonstrated its effectiveness in identifying complications. We decided to evaluate the influence of nurses' professional experience in the detection of complications of the AVF (venous stenosis and steal syndrome). The study took place in eight hemodialysis centers between May and September of 2011 in the north of Portugal. Sample was constituted by registered nurses. The nurses involved in the experiment were divided in two groups: those who had more than 5 years of experience and those who had less than 5 years of experience. Ninety-two nurses participated in the study: 34 nurses had less than 5 years of professional experience and 58 had more than 5 years of professional experience. In the practices considered by nurses in the detection of venous stenosis, there were no differences observed between the groups (P > 0.05). In steal syndrome, there were no differences observed between the groups in the practices of the nurses in the detection of this complication of the AVF (P > 0.05). We concluded that professional experience does not influence the detection of venous stenosis and steal syndrome. © 2014 International Society for Hemodialysis.

Effects of continuing professional development on clinical performance

PubMed Central

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

Cognitive and Psychomotor Entrustable Professional Activities: Can Simulators Help Assess Competency in Trainees?

PubMed

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.

Employ Simulation Techniques. Second Edition. Module C-5 of Category C--Instructional Execution. Professional Teacher Education Module Series.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. National Center for Research in Vocational Education.

One of a series of performance-based teacher education learning packages focusing upon specific professional competencies of vocational teachers, this learning module deals with employing simulation techniques. It consists of an introduction and four learning experiences. Covered in the first learning experience are various types of simulation…

Visualizing knowledge and attitude factors related to influenza vaccination of physicians.

PubMed

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.

Leadership and professionalism curriculum in the Gross Anatomy course.

PubMed

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.

Professional groups driving change toward patient-centred care: interprofessional working in stroke rehabilitation in Denmark.

PubMed

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.

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.

PubMed

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.

A Study on Contribution of the Basic Training Course to the Professional Development of Probationary Teachers

ERIC Educational Resources Information Center

Yildirim, M. Cevat

2012-01-01

The purpose of this study was to make an evaluation on contribution of the basic training course to the professional development of probationary teachers. The study group consisted of 21 probationary teachers and 5 education supervisors in Sanliurfa province. The data were collected through semi-structured observation, focus group interview and…

Educating for Innovation: Finding Balance in the Army’s Professional Military Education System

DTIC Science & Technology

2016-06-10

Faculty of the U.S. Army Command and General Staff College in partial fulfillment of the requirements for the degree MASTER OF MILITARY ART AND...Balance in the Army’s Professional Military Education System 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ...Paul N. de León, Major 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) U.S

High Frontier: The Journal for Space and Missile Professionals. Volume 7, Number 3, May 2011

DTIC Science & Technology

2011-05-01

The Journal for Space & Missile Professionals. Volume 7, Number 3, May 2011 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Air Force Space Command (AFSPC...Ingols . . . . . . . . . . . . . . 9 Winning in Cyberspace: Air Force Space Command’s Approach to Defending the Air Force Network Ms. Jill Baker

Use of digital media for the education of health professionals in the treatment of childhood asthma.

PubMed

Velasco, Helena F; Cabral, Catiane Z; Pinheiro, Paula P; Azambuja, Rita de Cassia S; Vitola, Luciano S; Costa, Márcia Rosa da; Amantéa, Sérgio L

2015-01-01

Inhalation therapy is the main treatment for asthma and its adequate use has been a factor responsible for disease control; therefore, the aim of the study was to determine whether a digital media tool, which features portability on mobile phones, modifies the assimilation of the inhalation technique. A total of 66 professionals working in the health care area with the pediatric population were selected. They were submitted to a pre-test on their knowledge of inhalation therapy. The professionals were randomized into two groups (A and B). Group A received a media application on their mobile phones showing the steps of inhalation therapy, while group B received the same information in written form only. A post-test was applied after 15 days. The results (pre- and post-) were analyzed by two pediatric pulmonologists. Of the 66 professionals, 87.9% were females. Of a total possible score of ten, the mean score obtained in the pre-test was 5.3 ± 3, and in the second test, 7.5 ± 2 (p<0.000). There were no significant differences when comparing the two groups (p=0.726). The nurses had the lowest mean scores in the initial test (2.3 ± 2); however, they were the group that learned the most with the intervention, showing similar means to those of other groups in the second test (6.1 ± 3). There was significant improvement in knowledge about inhalation therapy in all professional categories using both methods, demonstrating that education, when available to professionals, positively modifies medical practice. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

[The PROPRESE trial: results of a new health care organizational model in primary care for patients with chronic coronary heart disease based on a multifactorial intervention].

PubMed

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.

Knowledge, attitudes and practices of female genital mutilation/cutting among health care professionals in The Gambia: a multiethnic study

PubMed Central

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

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...

5 CFR 334.102 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... research and development center. State as defined in 5 U.S.C. 3371(1) means a State of the United States... college or university, or a technical or junior college; Local government as defined in 5 U.S.C. 3371(2)(A... principal functions, professional advisory, research, educational, or development services, or related...

5 CFR 334.102 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... research and development center. State as defined in 5 U.S.C. 3371(1) means a State of the United States... college or university, or a technical or junior college; Local government as defined in 5 U.S.C. 3371(2)(A... principal functions, professional advisory, research, educational, or development services, or related...

What Surgical Education the Speciality Offers? Perception of Role of Oral and Maxillofacial Surgery by 1200 Healthcare Professionals, Students and the General Public in Hyderabad, India.

PubMed

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.

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.

A study of static, kinetic, and dynamic visual acuity in 102 Japanese professional baseball players

PubMed Central

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...

5 CFR 451.303 - Restrictions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS AWARDS Presidential Rank Awards... (SL) and Scientific-Professional (ST) positions; and (2) The number of senior career employees awarded... appointees to OPM-allocated Senior-Level (SL) and Scientific-Professional (ST) positions. (c) Frequency of...

Maternal anxiety: a 5-year review of an intervention study.

PubMed

Barnett, B; Schaafsma, M F; Guzman, A M; Parker, G B

1991-03-01

Primiparous women were divided into groups according to their post-partum trait anxiety scores. Professional or non-professional support for the first 12 months was offered to two subgroups of high trait anxiety subjects. At the 5-year follow-up the high-anxiety mothers (n = 57) manifested more psychological and social pathology than moderate- and low-anxiety mothers (n = 43), and their children also showed signs of poorer adaptation. There was evidence of improved outcome for mothers in the professional intervention group, but not for their children. Child psychopathology was predicted best by maternal psychosocial variables, and to a lesser extent by child temperament variables. The relation of infant attachment and temperament measures to subsequent psychopathology is discussed.

Assessing the impact of DRGs on patient care and professional practice in Switzerland (IDoC) - a potential model for monitoring and evaluating healthcare reform.

PubMed

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.

The Influence of Supplementary Professional Education on the Position of Workers of Various Social and Professional Groups

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.

Conceptual Representations of Flu and Microbial Illness Held by Students, Teachers, and Medical Professionals

ERIC Educational Resources Information Center

Jones, M. Gail; Rua, Melissa J.

2008-01-01

This study describes 5th, 8th, and 11th-grade students', teachers', and medical professionals' conceptions of flu and microbial illness. Participants constructed a concept map on "flu" and participated in a semi-structured interview. The results showed that these groups of students, teachers and medical professionals held and structured their…

The New Agent: A Qualitative Study to Strategically Adapt New Agent Professional Development

ERIC Educational Resources Information Center

Baker, Lauri M.; Hadley, Gregg

2014-01-01

The qualitative study reported here assessed the needs of agents related to new agent professional development to improve the current model. Agents who participated in new agent professional development within the last 5 years were selected to participate in focus groups to determine concerns and continued needs. Agents enjoyed networking and…

Military Review: The Professional Journal of the U.S. Army. Volume 89, Number 2, March-April 2009

DTIC Science & Technology

2009-04-01

Professional Journal of the U.S. Army. March-April 2009 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT...NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) U.S. Army Combined Arms Center ,Fort Leavenworth,KS...66027 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME( S ) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM( S ) 11. SPONSOR

Validity of palpation of the C1 transverse process: comparison with a radiographic reference standard

PubMed Central

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

Effect of automated ultraviolet C-emitting device on decontamination of hospital rooms with and without real-time observation of terminal room disinfection.

PubMed

Penno, Katie; Jandarov, Roman A; Sopirala, Madhuri M

2017-11-01

We studied the effectiveness of an ultraviolet C (UV-C) emitter in clinical settings and compared it with observed terminal disinfection. We cultured 22 hospital discharge rooms at a tertiary care academic medical center. Phase 1 (unobserved terminal disinfection) included cultures of 11 high-touch environmental surfaces (HTSs) after terminal room disinfection (AD) and after the use of a UV-C-emitting device (AUV). Phase 2 (observed terminal disinfection) included cultures before terminal room disinfection (BD), AD, and AUV. Zero-inflated Poisson regression compared mean colony forming units (CFU) between the groups. Two-sample proportion tests identified significance of the observed differences in proportions of thoroughly cleaned HTSs (CFU < 5). Significant P value was determined using the Bonferroni corrected threshold of α = .05/12 = .004. We obtained 594 samples. Risk of overall contamination was 0.48 times lower in the AUV group than in the AD group (P < .001), with 1.04 log 10 reduction. During phase 1, overall proportion of HTSs with <5 CFUs increased in AUV versus AD by 0.12 (P = .001). During phase 2, it increased in AD versus BD by 0.45 (P < .001), with no significant difference between AD and AUV (P = .02). Use of UV-C with standard cleaning significantly reduced microbial burden and improved the thoroughness of terminal disinfection. We found no further benefit to UV-C use if standard terminal disinfection was observed. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Magnesium Test

MedlinePlus

... For Health Professionals Subscribe Menu Search Global Sites Tests Tests Index Not Listed? Not Listed? 5-HIAA 17- ... BRCA Gene Mutation Testing Breast Cancer Gene Expression Tests C-peptide C-Reactive Protein (CRP) CA 15- ...

Practices of traditional birth attendants in Sierra Leone and perceptions by mothers and health professionals familiar with their care.

PubMed

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.

[Use of Ultrasound in the Follow-up of Professional Athletes Receiving Conservative Treatment of Patellar Tendon Enthesiopathy].

PubMed

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.

Elevation: developing a mentorship model to raise the next generation of plastic surgery professionals.

PubMed

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.

Morale and job perception of community mental health professionals in Berlin and London.

PubMed

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.

Blue Ribbon Committee on Bloodborne Parasitic Diseases.

PubMed

2002-09-01

In summary, the A1 recommendations are related to: developing a network (epidemiologic and demographic aspects); undertaking activities within the network; providing support for parasite research testing; developing new policies, and; preparing a Memorandum to Cabinet for submission by September 1, 2001, for funding from April 2002 over 5 years. The A recommendations deal with sustaining the network and addressing existing needs, including Public and professional education Review of current policies Business plan Development of a contribution program to meet operational needs. The B recommendation(s) will be dealt with by the future Treasury Board submission. The group identified no C recommendations.

Why We Belong - Exploring Membership of Healthcare Professionals in an Intensive Care Virtual Community Via Online Focus Groups: Rationale and Protocol.

PubMed

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.

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...

42 CFR Appendix A to Part 5 - Criteria for Designation of Areas Having Shortages of Primary Medical Care Professional(s)

Code of Federal Regulations, 2013 CFR

2013-10-01

... internees per year to the number of FTE primary care physicians serving the institution is at least 1,000:1... year). (The number of FTE primary care physicians is computed as in part I, section B, paragraph 3... care physicians, as follows: Group 1—Institutions with 500 or more inmates and no physicians. Group 2...

42 CFR Appendix A to Part 5 - Criteria for Designation of Areas Having Shortages of Primary Medical Care Professional(s)

Code of Federal Regulations, 2014 CFR

2014-10-01

... internees per year to the number of FTE primary care physicians serving the institution is at least 1,000:1... year). (The number of FTE primary care physicians is computed as in part I, section B, paragraph 3... care physicians, as follows: Group 1—Institutions with 500 or more inmates and no physicians. Group 2...

42 CFR Appendix A to Part 5 - Criteria for Designation of Areas Having Shortages of Primary Medical Care Professional(s)

Code of Federal Regulations, 2012 CFR

2012-10-01

... internees per year to the number of FTE primary care physicians serving the institution is at least 1,000:1... year). (The number of FTE primary care physicians is computed as in part I, section B, paragraph 3... care physicians, as follows: Group 1—Institutions with 500 or more inmates and no physicians. Group 2...

[Efficacy of motivational interviewing for reducing medication errors in chronic patients over 65 years with polypharmacy: Results of a cluster randomized trial].

PubMed

Pérula de Torres, Luis Angel; Pulido Ortega, Laura; Pérula de Torres, Carlos; González Lama, Jesús; Olaya Caro, Inmaculada; Ruiz Moral, Roger

2014-10-21

To evaluate the effectiveness of an intervention based on motivational interviewing to reduce medication errors in chronic patients over 65 with polypharmacy. Cluster randomized trial that included doctors and nurses of 16 Primary Care centers and chronic patients with polypharmacy over 65 years. The professionals were assigned to the experimental or the control group using stratified randomization. Interventions consisted of training of professionals and revision of patient treatments, application of motivational interviewing in the experimental group and also the usual approach in the control group. The primary endpoint (medication error) was analyzed at individual level, and was estimated with the absolute risk reduction (ARR), relative risk reduction (RRR), number of subjects to treat (NNT) and by multiple logistic regression analysis. Thirty-two professionals were randomized (19 doctors and 13 nurses), 27 of them recruited 154 patients consecutively (13 professionals in the experimental group recruited 70 patients and 14 professionals recruited 84 patients in the control group) and completed 6 months of follow-up. The mean age of patients was 76 years (68.8% women). A decrease in the average of medication errors was observed along the period. The reduction was greater in the experimental than in the control group (F=5.109, P=.035). RRA 29% (95% confidence interval [95% CI] 15.0-43.0%), RRR 0.59 (95% CI:0.31-0.76), and NNT 3.5 (95% CI 2.3-6.8). Motivational interviewing is more efficient than the usual approach to reduce medication errors in patients over 65 with polypharmacy. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Emotional labor and professional practice in sports medicine and science.

PubMed

Hings, R F; Wagstaff, C R D; Thelwell, R C; Gilmore, S; Anderson, V

2018-02-01

The aim of this study was to explore how sport medicine and science practitioners manage their emotions through emotional labor when engaging in professional practice in elite sport. To address the research aim a semistructured interview design was adopted. Specifically, eighteen professional sport medicine and science staff provided interviews. The sample comprised sport and exercise psychologists (n=6), strength and conditioning coaches (n=5), physiotherapists (n=5), one sports doctor and one generic sport scientist. Following a process of thematic analysis, the results were organized into the following overarching themes: (a) factors influencing emotional labor enactment, (b) emotional labor enactment, and (c) professional and personal outcomes. The findings provide a novel contribution to understanding the professional demands faced by practitioners and are discussed in relation to the development of professional competencies and the welfare and performance of sport medics and scientists. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Weight management for overweight and obese men delivered through professional football clubs: a pilot randomized trial

PubMed Central

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

Professional satisfaction of family physicians in Pakistan--results of a cross-sectional postal survey.

PubMed

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.

Chiropractic in North America: toward a strategic plan for professional renewal--outcomes from the 2006 Chiropractic Strategic Planning Conference.

PubMed

Triano, John J; Goertz, Christine; Weeks, John; Murphy, Donald R; Kranz, Karl C; McClelland, George C; Kopansky-Giles, Deborah; Morgan, William; Nelson, Craig F

2010-06-01

This report describes the process, participation, and recommendations of a set of consensus conferences on strategy for professional growth that emphasized elements of public trust and alignment between the chiropractic profession and its stakeholders. In February and August 2006, an invitational group of leaders in the chiropractic profession convened an ad hoc Chiropractic Strategic Planning Conference. Public notice was given and support solicited through the Foundation of Chiropractic Education and Research. A series of international and interdisciplinary speakers gave presentations on the shifting of external social dynamics and medical culture, illuminating opportunities for the profession to extend its privilege and service. A systematic round-robin discussion was followed by group breakout sessions to develop recommendations on priorities for the profession to respond to challenges and opportunities. Recommendations were reviewed by the group as a whole and voted to consensus requiring more than 70% agreement. Participants determined a series of recommendations within 5 key domains for improving health professions practice: education, research, regulation, workplace, and leadership. The action steps proposed by the Strategic Planning Committee are first steps to provide better service to the public while making use of the inherent strengths of the profession. Copyright (c) 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

[Use of services and treatment adequacy of major depressive episodes in France].

PubMed

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.

Continuing professional development for volunteers working in palliative care in a tertiary care cancer institute in India: a cross-sectional observational study of educational needs.

PubMed

Deodhar, Jayita Kedar; Muckaden, Mary Ann

2015-01-01

Training programs for volunteers prior to their working in palliative care are well-established in India. However, few studies report on continuing professional development programs for this group. To conduct a preliminary assessment of educational needs of volunteers working in palliative care for developing a structured formal continuing professional development program for this group. Cross-sectional observational study conducted in the Department of Palliative Medicine of a tertiary care cancer institute in India. Participant volunteers completed a questionnaire, noting previous training, years of experience, and a comprehensive list of topics for inclusion in this program, rated in order of importance according to them. Descriptive statistics for overall data and Chi-square tests for categorical variables for group comparisons were applied using Statistical Package for Social Sciences version 18. Fourteen out of 17 volunteers completed the questionnaire, seven having 5-10-years experience in working in palliative care. A need for continuing professional development program was felt by all participants. Communication skills, more for children and elderly specific issues were given highest priority. Spiritual-existential aspects and self-care were rated lower in importance than psychological, physical, and social aspects in palliative care. More experienced volunteers (>5 years of experience) felt the need for self-care as a topic in the program than those with less (<5-years experience) (P < 0.05). Understanding palliative care volunteers' educational needs is essential for developing a structured formal continuing professional development program and should include self-care as a significant component.

26 CFR 1.414(c)-5 - Certain tax-exempt organizations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... operational goals. A single section 403(b) plan covers professional and staff employees of both the hospital...) INCOME TAX (CONTINUED) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.414(c)-5 Certain... exempt from tax under section 501(a) (an exempt organization) whose employees participate in a plan, the...

Dual loyalties and the ethical and human rights obligations of occupational health professionals.

PubMed

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.

PubMed

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.

Virtual Gaming Simulation in Nursing Education: A Focus Group Study.

PubMed

Verkuyl, Margaret; Hughes, Michelle; Tsui, Joyce; Betts, Lorraine; St-Amant, Oona; Lapum, Jennifer L

2017-05-01

The use of serious gaming in a virtual world is a novel pedagogical approach in nursing education. A virtual gaming simulation was implemented in a health assessment class that focused on mental health and interpersonal violence. The study's purpose was to explore students' experiences of the virtual gaming simulation. Three focus groups were conducted with a convenience sample of 20 first-year nursing students after they completed the virtual gaming simulation. Analysis yielded five themes: (a) Experiential Learning, (b) The Learning Process, (c) Personal Versus Professional, (d) Self-Efficacy, and (e) Knowledge. Virtual gaming simulation can provide experiential learning opportunities that promote engagement and allow learners to acquire and apply new knowledge while practicing skills in a safe and realistic environment. [J Nurs Educ. 2017;56(5):274-280.]. Copyright 2017, SLACK Incorporated.

Effects of angiotensin-II receptor blocker candesartan cilexetil in rats with dilated cardiomyopathy.

PubMed

Shirai, Ken; Watanabe, Kenichi; Ma, Meilei; Wahed, Mir I I; Inoue, Mikio; Saito, Yuki; Suresh, Palaniyandi Selvaraj; Kashimura, Takeshi; Tachikawa, Hitoshi; Kodama, Makoto; Aizawa, Yoshifusa

2005-01-01

We examined effects of an angiotensin-II receptor blockers, candesartan cilexetil, in rats with dilated cardiomyopathy after autoimmune myocarditis. Candesartan cilexetil showed angiotensin-II blocking action in a dose-dependent manner in rats with dilated cardiomyopathy. Twenty-eight days after immunization, surviving Lewis rats were divided into four groups and given candesartan cilexetil at 0.05 mg/kg, 0.5 mg/kg or 5 mg/kg per day (Group-C0.05, n = 15, Group-C0.5, n = 15 and Group-C5, n = 15, respectively) or vehicle alone (Group-V, n = 15). After oral administration for 1 month, the left ventricular end-diastolic pressure and heart weight/body weight ratio were lower in Group-C0.05 (13.3+/-1.1 mmHg and 3.7+/-0.2 g/kg, respectively), in Group-C0.5 (8.0+/-0.9 mmHg and 3.3+/-0.1 g/kg, respectively) and in Group-C5 (5.5+/-1 mmHg and 3.1+/-0.1 g/kg, respectively) than in Group-V (13.5+/-1.0 mmHg and 3.8+/-0.2 g/kg, respectively). The area of myocardial fibrosis was also lower in Group-C0.05 (25+/-3%), in Group-C0.5 (20+/-3%), and in Group-C5 (12+/-1%) than in Group-V (32+/-4%). Furthermore, expressions of transforming growth factor-beta1 and collagen-III mRNA were suppressed in Group-C0.05 (349+/-23% and 395+/-22%, respectively), Group-C0.5 (292+/-81% and 364+/-42%, respectively) and in Group-C5 (204+/-63% and 259+/-33%, respectively) compared with those in Group-V (367+/-26% and 437+/-18%, respectively). These results suggest that candesartan cilexetil can improve the function of inefficient heart.

Tissue electrical properties measured by bioelectrical impedance analysis among healthy and sportsmen population

NASA Astrophysics Data System (ADS)

Kapica, Dominik; Warchulińska, Joanna; Jakubiak, Monika; Teter, Mariusz; Mlak, Radosław; Hałabiś, Magdalena; Wójcik, Waldemar; Małecka-Massalska, Teresa

2015-09-01

Introduction: Bioelectrical impedance analysis (BIA) is a useful tool to asses human body composition and nutrition status; multi-frequency BIA has a higher accuracy than single-frequency BIA. In our study a difference of impedance values (Z) at 5, 100 and 200 kHz and Z200/Z5 index between professional athletes and control group were determined. Methods: In this research 105 people were tested, divided into control group (72 people: 35 males and 37 females) and professional athletes (33 people: 16 males and 17 females). Impedance was measured at three frequency values - 5, 100 and 200 kHz; with received values the Z200/Z5 index was calculated. Results: In most compared subgroups impedance values showed significantly lower values in athletes than in control group (5 kHz - males: p=0.136, females: p=0.001, 100 kHz - males: p=0.039, females: p<0.0001, 200 kHz - males: p=0.047, females: p<0.0001) Z200/Z5 index also showed lower value in athletes than in control group (p=0.016 for males, p<0.0001 for females). Conclusion: Lower values of impedance and Z200/Z5 index indicates a better nutrition status and general health condition of athletes than in control group.

A qualitative exploration of the factors influencing the job satisfaction and career development of physiotherapists in private practice.

PubMed

Davies, J M; Edgar, S; Debenham, J

2016-09-01

The aim of this study was to investigate factors contributing to job satisfaction at different career stages, among private practice physiotherapists in Australia. Qualitative case study design utilising focus groups. Sixteen participants allocated to 3 focus groups: new graduates (n = 6), post graduates (n = 5) and practice owners (n = 5). Focus groups were transcribed verbatim and a thematic analysis was undertaken to determine themes and subthemes from each focus group. The key themes identified within each focus group included the role of peer support and mentoring, professional development, professional relationships, new graduate employment issues and career pathways within private practice. In particular, issues surrounding the new graduate experience in private practice were explored, with all groups noting lack of support and financial pressures were of concern. Findings demonstrated that new graduates are underprepared to work in private practice and modifications to the delivery of peer support, mentoring and professional development is required. Key recommendations include physiotherapy undergraduate program reform to reflect industry requirements in private practice, an increase in private practice clinical placement numbers, as well as streamlining the physiotherapy profession to improve career development pathways. Copyright © 2016 Elsevier Ltd. All rights reserved.

Does Game Participation Impact Cognition and Symptoms in Elite Football Players?

PubMed

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.

Noncommissioned Officer Education and Professional Development Study

DTIC Science & Technology

1971-01-01

34 , _ L -I NOCMISSIO.-iED OFFICER EDUCATION K ND . PROFESSIONAL DEVELOPMENT S T U , P ’-) , !, HEIDQUARTE RS UNITED STATES CONTINENTAL ARMY...I Section C - Assumptions .............. .............. 2 PART II - NONCOMMISSIONED OFFICER EDUCATION SYSTEM . . . 5 Figures 1 - 3...48 Section L - Assignment Patterns ........... 42 Section M - NCOS Attendance. ............ 50 Section N - keneral Educational Development . ..... 52

Professional karate-do and mixed martial arts fighters present with a high prevalence of temporomandibular disorders.

PubMed

Bonotto, Daniel; Namba, Eli Luis; Veiga, Danielle Medeiros; Wandembruck, Fernanda; Mussi, Felipe; Afonso Cunali, Paulo; Ribeiro Rosa, Edvaldo Antonio; Azevedo-Alanis, Luciana Reis

2016-08-01

Facial trauma in sports has been associated with temporomandibular disorders. Because of the intensity and duration of training needed for elite-level competitions, high-performance athletes can have two to five times more traumatic injuries than recreational athletes. This study aimed to investigate the prevalence of temporomandibular disorders in high-performance martial arts fighters and compare it with the prevalence in recreational athletes and non-athletes. The Research Diagnostic Criteria for Temporomandibular Disorders was used to diagnose and classify professional karate-do practitioners (group I; n = 24), amateur karate-do practitioners (group II; n = 17), high-performance mixed martial arts fighters (group III; n = 13), and non-athletes (n = 28). The groups were compared with the chi-square test and tested for the difference between two proportions using a significance level of 5% (P < 0.05). The prevalence of temporomandibular disorders in groups I (54.2%; P = 0.003) and III (61.5%; P = 0.002) was significantly higher than in group IV (14.3%). The prevalence in group II was similar to that in group IV (P > 0.05). A diagnosis of arthralgia from disk displacement was made more frequently in groups I (45.8%; P = 0.013) and III (38.5%; P = 0.012) than in group IV (7.1%). The chronic pain associated with TMD was low intensity and low disability. While there was a high prevalence of temporomandibular disorders in the professional athletes in our study, the prevalence of the condition in recreational athletes was similar to that in individuals who did not practice martial arts. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Why We Belong - Exploring Membership of Healthcare Professionals in an Intensive Care Virtual Community Via Online Focus Groups: Rationale and Protocol

PubMed Central

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

Defense Acquisition Research Journal: Strengthening Cost Consciousness, Professionalism, and Technical Excellence

DTIC Science & Technology

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

Treatment outcomes for professional voice users.

PubMed

Wingate, Judith M; Brown, William S; Shrivastav, Rahul; Davenport, Paul; Sapienza, Christine M

2007-07-01

Professional voice users comprise 25% to 35% of the U.S. working population. Their voice problems may interfere with job performance and impact costs for both employers and employees. The purpose of this study was to examine treatment outcomes of two specific rehabilitation programs for a group of professional voice users. Eighteen professional voice users participated in this study; half had complaints of throat pain or vocal fatigue (Dysphonia Group), and half were found to have benign vocal fold lesions (Lesion Group). One group received 5 weeks of expiratory muscle strength training followed by six sessions of traditional voice therapy. Treatment order was reversed for the second group. The study was designed as a repeated measures study with independent variables of treatment order, laryngeal diagnosis (lesion vs non-lesion), gender, and time. Dependent variables included maximum expiratory pressure (MEP), Voice Handicap Index (VHI) score, Vocal Rating Scale (VRS) score, Voice Effort Scale score, phonetogram measures, subglottal pressures, and acoustic and perceptual measures. Results showed significant improvements in MEP, VHI scores, and VRS scores, subglottal pressure for loud intensity, phonetogram area, and dynamic range. No significant difference was found between laryngeal diagnosis groups. A significant difference was not observed for treatment order. It was concluded that the combined treatment was responsible for the improvements observed. The results indicate that a combined modality treatment may be successful in the remediation of vocal problems for professional voice users.

Analysis of Pelvis-Thorax Coordination Patterns of Professional and Amateur Golfers during Golf Swing.

PubMed

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.

Equine Welfare Assessment: Exploration of British Stakeholder Attitudes Using Focus-Group Discussions.

PubMed

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.

[Professionalization of Legal Dental Experts in Germany: Results of Studies on Structured Focus Groups].

PubMed

Brauer, H U; Walther, W; Dick, M

2018-04-01

Legal expert opinions are a crucial instrument of professional self-control in medicine. To give impulses for further development, focus groups were initiated to reflect upon the perspective of legal dental experts. 5 focus group discussions on the topic "Professionalization of legal dental experts" were conducted. A total of 32 experienced legal dental experts participated in the discussions. The results were evaluated by qualitative content analysis. A catalogue of 68 ideas was generated for improvement and divided into 15 categories. Among these were periodic quality circles, interprofessional exchange, supervision of novices and periodic feedback for legal dental experts and dentists. Self-reflection can be included as an instrument for quality improvement of legal dental expert opinions. © Georg Thieme Verlag KG Stuttgart · New York.

Integrating Compassionate, Collaborative Care (the "Triple C") Into Health Professional Education to Advance the Triple Aim of Health Care.

PubMed

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.

Creative Thinking, Professional Artists, and Parkinson's Disease.

PubMed

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.

Cameroonian professional soccer players and risk of atherosclerosis.

PubMed

Nansseu, Jobert Richie; Ama Moor, Vicky Jocelyne; Takam, Ruth Danielle M; Zing-Awona, Bertrand; Azabji-Kenfack, Marcel; Tankeu, Francine; Tchoula, Corinne M; Moukette, Bruno M; Ngogang, Jeanne Y

2017-06-02

Elevated titers of antibodies against oxidized low-density lipoproteins-cholesterol (ox-LDL-Ab) have been reported among professional athletes, paradoxically reflecting an increased risk of developing atherogenic and/or cardiovascular events. This study aimed to determine titers of ox-LDL-Ab in a group of Cameroonian professional soccer players, and evaluate their evolution during part of a competition season as well as the plasmatic antioxidant status to find out if this latter correlates with ox-LDL-Ab . We conducted a descriptive cohort study in 2012 including 18 healthy male soccer players. Three samplings were performed in March (T1), May (T2), and July 2012 (T3) to assess the lipid profile, titers of ox-LDL-Ab, and plasmatic concentrations of four antioxidants: the ferric reducing antioxidant power (FRAP), reduced glutathione (GSH), superoxide dismutase (SOD), and uric acid. Ages ranged from 16 to 28 years with a median (interquartile range) of 19.5 (19-23) years. Total cholesterol, high-density lipoproteins-cholesterol (HDL-C), low-density lipoproteins-cholesterol (LDL-C) and triglycerides varied within normal ranges throughout the three samplings. While total cholesterol and LDL-C titers increased significantly (p = 0.003 and p = 0.006, respectively), triglycerides and HDL-C values varied non-significantly throughout the measurements (p = 0.061 and p = 0.192, respectively). The median ox-LDL-Ab titers were respectively: 653.3 (468.2-838.8) mIU/ml at T1, 777.7 (553.7-1150.7) mIU/ml at T2, and 1037.7 (901.7-1481.5) mIU/ml at T3. Overall, ox-LDL-Ab titers increased significantly from T1 to T3 (p = 0.006). Concomitantly, uric acid and FRAP concentrations decreased significantly (p = 0.001 and p = 0.003, respectively); on the contrary, GSH and SOD values increased, but insignificantly (p = 0.115 and p = 0.110, respectively). There was a positive and significant correlation between ox-LDL-Ab and HDL-C (ρ = 0.519, p = 0.027), and between ox-LDL-Ab and SOD (ρ = 0.504, p = 0.033) at T2. Ox-LDL-Ab values were expected to increase with each new visit (β = 201.1; p = 0.041) and each IU/ml of SOD titers (β = 23.6; p = 0.019). These Cameroonian professional soccer players exhibited high levels of ox-LDL-Ab reflecting elevated levels of oxidatively-modified LDL-C particles with an increment over time, this being insufficiently counterbalanced by the antioxidant defense mechanisms. As a consequence, they may be at increased atherogenic and cardiovascular risks.

Hazardous substances in frequently used professional cleaning products.

PubMed

Gerster, Fabian Melchior; Vernez, David; Wild, Pascal Pierre; Hopf, Nancy Brenna

2014-01-01

A growing number of studies have identified cleaners as a group at risk for adverse health effects of the skin and the respiratory tract. Chemical substances present in cleaning products could be responsible for these effects. Currently, only limited information is available about irritant and health hazardous chemical substances found in cleaning products. We hypothesized that chemical substances present in cleaning products are known health hazardous substances that might be involved in adverse health effects of the skin and the respiratory tract. We performed a systematic review of cleaning products used in the Swiss cleaning sector. We surveyed Swiss professional cleaning companies (n = 1476) to identify the most used products (n = 105) for inclusion. Safety data sheets (SDSs) were reviewed and hazardous substances present in cleaning products were tabulated with current European and global harmonized system hazard labels. Professional cleaning products are mixtures of substances (arithmetic mean 3.5 +/- 2.8), and more than 132 different chemical substances were identified in 105 products. The main groups of chemicals were fragrances, glycol ethers, surfactants, solvents; and to a lesser extent, phosphates, salts, detergents, pH-stabilizers, acids, and bases. Up to 75% of products contained irritant (Xi), 64% harmful (Xn) and 28% corrosive (C) labeled substances. Hazards for eyes (59%) and skin (50%), and hazards by ingestion (60%) were the most reported. Cleaning products potentially give rise to simultaneous exposures to different chemical substances. As professional cleaners represent a large workforce, and cleaning products are widely used, it is a major public health issue to better understand these exposures. The list of substances provided in this study contains important information for future occupational exposure assessment studies.

Hazardous substances in frequently used professional cleaning products

PubMed Central

Gerster, Fabian Melchior; Vernez, David; Wild, Pascal Pierre; Hopf, Nancy Brenna

2014-01-01

Background: A growing number of studies have identified cleaners as a group at risk for adverse health effects of the skin and the respiratory tract. Chemical substances present in cleaning products could be responsible for these effects. Currently, only limited information is available about irritant and health hazardous chemical substances found in cleaning products. We hypothesized that chemical substances present in cleaning products are known health hazardous substances that might be involved in adverse health effects of the skin and the respiratory tract. Methods: We performed a systematic review of cleaning products used in the Swiss cleaning sector. We surveyed Swiss professional cleaning companies (n = 1476) to identify the most used products (n = 105) for inclusion. Safety data sheets (SDSs) were reviewed and hazardous substances present in cleaning products were tabulated with current European and global harmonized system hazard labels. Results: Professional cleaning products are mixtures of substances (arithmetic mean 3.5±2.8), and more than 132 different chemical substances were identified in 105 products. The main groups of chemicals were fragrances, glycol ethers, surfactants, solvents; and to a lesser extent, phosphates, salts, detergents, pH-stabilizers, acids, and bases. Up to 75% of products contained irritant (Xi), 64% harmful (Xn) and 28% corrosive (C) labeled substances. Hazards for eyes (59%) and skin (50%), and hazards by ingestion (60%) were the most reported. Conclusions: Cleaning products potentially give rise to simultaneous exposures to different chemical substances. As professional cleaners represent a large workforce, and cleaning products are widely used, it is a major public health issue to better understand these exposures. The list of substances provided in this study contains important information for future occupational exposure assessment studies. PMID:24804339

'All singing from the same hymn sheet': healthcare professionals' perceptions of developing patient education material about the cardiovascular aspects of rheumatoid arthritis.

PubMed

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.

The Impact of Structured Inter-professional Education on Health Care Professional Students' Perceptions of Collaboration in a Clinical Setting

PubMed Central

Lee, Sam; Lombardo, Samantha; Salama, Mariam; Ellis, Sandi; Kay, Theresa; Davies, Robyn; Landry, Michel D.

2012-01-01

ABSTRACT Purpose: To examine how a structured inter-professional education (IPE) clinical placement influences health care professional (HCP) students' perceptions of inter-professional collaboration (IPC) relative to that of students in a traditional clinical placement. Methods: This study used a mixed-methods design. The Interdisciplinary Education Perception Scale (IEPS) was administered to HCP students (n=36) in two Toronto hospitals before and after a structured 5-week IPE clinical placement to examine changes in their perceptions of IPC. Students in a traditional clinical placement (n=28) were used as a control group. Focus groups were then conducted with seven students who took part in the structured IPE clinical placement. A coding framework was devised a priori, and the qualitative results were used to explain the quantitative findings. Results: There were no statistically significant differences between groups after the structured IPE clinical placement, but the intervention group showed a greater positive trend in total IEPS scores from baseline to follow-up. Qualitative data suggest that students valued the knowledge and skills gained through the structured IPE clinical placement. Conclusions: Findings suggest that structured IPE clinical placements may provide students with valuable collaborative learning opportunities, enhanced respect for other professionals, and insight into the value of IPC in healthcare delivery. More research is needed to explore other factors that influence specific perceptions among physical therapy students. PMID:23450044

How Can the Norwegian Leader Development Program Improve to Better Develop Leaders?

DTIC Science & Technology

2012-12-14

GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) LTC Stig Santiago Bjoernaes 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT...developmental enables individuals to pursue professional and personal goals in a life - 3James Kouzes and...

Understanding Young Children's Behavior: A Guide for Early Childhood Professionals.

ERIC Educational Resources Information Center

Rodd, Jillian

This book seeks to enable professionals who work in group settings with children ages birth to 5 years to develop a flexible and individualized approach to behavior management that is grounded in a full appreciation of a child's developmental stages and limited moral understanding. Young children's behavior is frequently a source of frustration…

Learning about Whole-Class Scaffolding from a Teacher Professional Development Study

ERIC Educational Resources Information Center

Visnovska, Jana; Cobb, Paul

2015-01-01

The importance of teachers developing adaptive instructional practices consistent with metaphor of whole-class scaffolding has been well documented. However, teachers' development of such practices is currently not well understood. We draw on a 5-year professional development (PD) design experiment in which a group of middle school mathematics…

Supporting Children's Mathematical Understanding: Professional Development Focused on Out-of-School Practices

ERIC Educational Resources Information Center

Taylor, Edd V.

2012-01-01

This study describes the Reflection Connection Cycle professional development designed to support teachers' use and appreciation of students' out-of-school practices related to school mathematics. The year-long program incorporated group lesson design, readings, and video analysis for 14 elementary school (ages 5-12) teachers. Analysis of lesson…

Multidimensional representations: The knowledge domain of germs held by students, teachers and medical professionals

NASA Astrophysics Data System (ADS)

Rua, Melissa Jo

The present study examined the understandings held by 5th, 8th, and 11th-grade students, their teachers and medical professionals about germs. Specifically, this study describes the content and structure of students' and adults' conceptions in the areas of germ contraction, transmission, and treatment of infectious and non-infectious diseases caused by microorganisms. Naturalistic and empirical research methods were used to investigate participants' conceptions. Between and within group similarities were found using data from concept maps on the topic "flu," drawings of germs, a 20 word card sort related to germs and illness, and a semi-structured interview. Concept maps were coded according to techniques by Novak and Gowan (1984). Drawings of germs were coded into four main categories (bacteria, viruses, animal cell, other) and five subcategories (disease, caricature, insect, protozoa, unclassified). Cluster patterns for the card sorts of each group were found using multidimensional scaling techniques. Six coding categories emerged from the interview transcripts: (a) transmission, (b) treatment, (c) effect of weather on illness, (d) immune response, (e) location of germs, and (f) similarities and differences between bacteria and viruses. The findings showed students, teachers and medical professionals have different understandings about bacteria and viruses and the structures of those understandings vary. Gaps or holes in the participants knowledge were found in areas such as: (a) how germs are transmitted, (b) where germs are found, (c) how the body transports and uses medicine, (d) how the immune system functions, (e) the difference between vaccines and non-prescription medicines, (f) differences that exist between bacteria and viruses, and (g) bacterial resistance to medication. The youngest students relied heavily upon personal experiences with germs rather than formal instruction when explaining their conceptions. As a result, the influence of media was evident in the students' understandings and images of microbes. Students also viewed germs as a human problem rather than seeing microorganisms as an independent member of the ecosystem. Teachers' explanations about germs varied in explicitness based on the grade level they taught while medical professionals based their understandings on formal knowledge and tended to use explicit technical language in their explanations of the phenomena.

Comparison of health care professionals' self-assessments of standards of care and patients' opinions on the care they received in hospital: observational study

PubMed Central

Durieux, P; Bissery, A; Dubois, S; Gasquet, I; Coste, J

2004-01-01

Objectives: To compare the views of healthcare professionals and patients regarding compliance with standards of care concerning patient information. Design: Self-rated questionnaire survey. Setting: Nine wards in short stay French hospitals. Participants: 939 patients and 359 healthcare professionals (physicians, nurses, assistants and other professionals). Main outcome measure: Patients' and healthcare professionals' views of compliance with 20 standards of patient care described in the French accreditation manual. Comparison of the rank order of the standards within the two samples. Results: The response rate was 61.5% in the patient group and 85.8% in the healthcare professionals. The rank orders for the 20 items were similar in both groups (Spearman rank order correlation 0.6, p = 0.004). The two items ranked highest by healthcare professionals ("consent request for a surgical procedure" and "the doctors ask the visitors to leave the room before examining a patient") were also the two ranked highest by the patients. Three items were ranked low by both groups: "consent request for students to be present", "health education given to patients", and "possibility to express satisfaction during discharge". Patients were more satisfied with their pain management than were healthcare providers. Professionals were more satisfied with the social services than the patients. Conclusion: There are both similarities and differences between patients' and healthcare professionals' views of care. Accurate assessments of quality performed during the accreditation procedure require that both patients' and professionals' views be taken into account. PMID:15175490

The effect of cervical posterior foraminotomy on segmental range of motion in the setting of total disc arthroplasty.

PubMed

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.

Effect of age on anthropometric and physical performance measures in professional baseball players.

PubMed

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.

Exploring the Influence of Student Focus Groups in Their Professional and Personal Development

NASA Astrophysics Data System (ADS)

Hosseini, S.; Hut, R.

2014-12-01

A scientific career is often more than a 9-to-5 commitment, both in terms of time and passion. An important factor that fuels this passion is engaging with the community on many levels. In the history of education and professional development, there are numerous studies that emphasis the importance of surrounding groups and like-minded peers in one's professional and personal development in a less constrained environment. In our experience, in modern days where students are surrounded with too much information and yet too little clear signal, the idea of mentor and advisor can no longer limit to one or two people. We strongly feel it is imperative to have the opportunity to share expertise on scientific issues, career options, develop presenting and writing skills, participate in professional volunteer activities with alike and advanced colleagues, share future opportunities, and successfully navigating life both inside and outside of graduate school in a relaxed environment. Most of the professional scientific and engineering communities put a lot of effort to create and maintain professional groups in masters and Ph.D. levels but the dynamics within these groups prove it to be very different and it is challenging to maintain both momentum and productivity. Authors of this report would present their experience in creating, running and maintaining various student groups in the discipline of physics, astronomy, planetary science, hydrology, and optical engineering in US, Europe and Middle East. The common factors and differences based on the supportive community, location, and the educational level would be discussed. An outline of potential helpful factors within the academic institutes and professional communities would be presented based on the examination on various successful and unsuccessful experiences.

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.

Identifying the needs of critical and acute cardiac care nurses within the first two years of practice in Egypt using a nominal group technique.

PubMed

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.

Professionalism in Physician Assistant, Physical Therapist, Occupational Therapist, Clinical Psychology, and Biomedical Sciences Students.

PubMed

Noronha, Sandhya; Anderson, Deborah; Lee, Michelle M; Krumdick, Nathaniel D; Irwin, Kent E; Burton-Hess, Judith; Ciancio, Mae; Wallingford, Minetta; Workman, Gloria M

2016-01-01

Interprofessional collaboration for healthcare requires a better understanding of the commonalities and differences in student perceptions of professionalism. 217 students in five programs (PA 71, PT 46, OT 29, CP 12, and BMS 59) completed a 22-item survey (response rate 79.5%). A Likert scale grading from 1 (hardly ever) to 5 (always) was used to assess professional attitudes and behaviors. A mixed-model MANOVA, supplemented with post-hoc analyses, showed significant group by time interactions for 5 items. Sensitivity to differences and diversity of other people increased for BMS students, but decreased for PT students. Timeliness increased for BMS students, but did not change for PA students. Seeking out new learning experiences increased for BMS students, but did not change for PA or PT students. Taking a group leadership role increased for BMS students, decreased for PT students, while PA and OT students showed no change. Volunteering time to serve others decreased for OT and PA students, while BMS and BM students showed no change. It is plausible that these findings emerge from differences in program curricula and specific training objectives. The findings provide initial insight to educators on ways that attitudes and behaviors pertaining to professionalism sometimes vary among students in different health science programs.

The interprofessional team as a small group.

PubMed

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.

Positive impact of child feeding training program for primary care health professionals: a cluster randomized field trial.

PubMed

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.

Single level anterior cervical discectomy and fusion for cervical disc herniation in a professional soccer player.

PubMed

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.

42 CFR Appendix E to Part 5 - Criteria for Designation of Areas Having Shortages of Podiatric Professional(s)

Code of Federal Regulations, 2012 CFR

2012-10-01

... number of FTE podiatrists) will be computed as follows: Podiatrist shortage = adjusted population/28,000... will be assigned to groups, based on the ratio (R) of adjusted population to number of foot care... for the delivery of podiatric services. 2. The area's ratio of population to foot care practitioners...

42 CFR Appendix E to Part 5 - Criteria for Designation of Areas Having Shortages of Podiatric Professional(s)

Code of Federal Regulations, 2014 CFR

2014-10-01

... number of FTE podiatrists) will be computed as follows: Podiatrist shortage = adjusted population / 28... will be assigned to groups, based on the ratio (R) of adjusted population to number of foot care... for the delivery of podiatric services. 2. The area's ratio of population to foot care practitioners...

42 CFR Appendix E to Part 5 - Criteria for Designation of Areas Having Shortages of Podiatric Professional(s)

Code of Federal Regulations, 2013 CFR

2013-10-01

... number of FTE podiatrists) will be computed as follows: Podiatrist shortage = adjusted population / 28... will be assigned to groups, based on the ratio (R) of adjusted population to number of foot care... for the delivery of podiatric services. 2. The area's ratio of population to foot care practitioners...

42 CFR Appendix A to Part 5 - Criteria for Designation of Areas Having Shortages of Primary Medical Care Professional(s)

Code of Federal Regulations, 2010 CFR

2010-10-01

... above.) 2. Determination of Degree of Shortage. Designated correctional institutions will be assigned to... metropolitan areas which display a strong self-identity (as indicated by a homogeneous socioeconomic or... population for the differing health service requirements of various age-sex population groups will be...

21 CFR 343.80 - Professional labeling.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., randomized, multi-center, placebo-controlled trials of predominantly male post-MI subjects and one randomized... group on the aspirin molecule. This acetyl group is responsible for the inactivation of cyclo-oxygenase... event rate was reduced to 5 percent from the 10 percent rate in the placebo group. Chronic Stable Angina...

21 CFR 343.80 - Professional labeling.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., randomized, multi-center, placebo-controlled trials of predominantly male post-MI subjects and one randomized... group on the aspirin molecule. This acetyl group is responsible for the inactivation of cyclo-oxygenase... event rate was reduced to 5 percent from the 10 percent rate in the placebo group. Chronic Stable Angina...

21 CFR 343.80 - Professional labeling.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., randomized, multi-center, placebo-controlled trials of predominantly male post-MI subjects and one randomized... group on the aspirin molecule. This acetyl group is responsible for the inactivation of cyclo-oxygenase... event rate was reduced to 5 percent from the 10 percent rate in the placebo group. Chronic Stable Angina...

21 CFR 343.80 - Professional labeling.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., randomized, multi-center, placebo-controlled trials of predominantly male post-MI subjects and one randomized... group on the aspirin molecule. This acetyl group is responsible for the inactivation of cyclo-oxygenase... event rate was reduced to 5 percent from the 10 percent rate in the placebo group. Chronic Stable Angina...

21 CFR 343.80 - Professional labeling.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., randomized, multi-center, placebo-controlled trials of predominantly male post-MI subjects and one randomized... group on the aspirin molecule. This acetyl group is responsible for the inactivation of cyclo-oxygenase... event rate was reduced to 5 percent from the 10 percent rate in the placebo group. Chronic Stable Angina...

Detection of testosterone administration based on the carbon isotope ratio profiling of endogenous steroids: international reference populations of professional soccer players.

PubMed

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.

Evaluating factors that affect the shade-matching ability of dentists, dental staff members and laypeople.

PubMed

Capa, Nuray; Malkondu, Ozlem; Kazazoglu, Ender; Calikkocaoglu, Senih

2010-01-01

The authors conducted a study to evaluate the influence of dentists' and nondentists' experience, age, sex, eye color and use of eyeglasses or contact lenses on tooth shade-matching ability. The authors included 120 participants in this study conducted in Istanbul (periodontists, oral and maxillofacial surgeons, orthodontists, endodontists, pediatric dentists, prosthodontists, restorative dentists, general dentists in private practice, dental technicians, dental assistants, dental assistant students and laypeople). The authors assigned participants to one of three groups: group 1 was composed of prosthodontists, restorative dentists and dental technicians; group 2 consisted of other dental specialists and general dentists; and group 3 included dental assistants, dental assistant students and laypeople. The authors asked participants to match the shades of three artificial maxillary right central incisors (Vitapan acrylic teeth [shades 2L1.5, 1M2, 2R1.5], Vita Zahnfabrik, Bad Säckingen, Germany) by using a shade guide system (Vita Toothguide 3D-Master, Vita Zahnfabrik). They calculated shade matching for the three color components (value, hue, chroma) and analyzed the results by using a chi(2) test. The rate of success in matching the shade for IM2 was 53.3 percent for participants in group 1, 30 percent for participants in group 2 and 20 percent for participants in group 3 (P = .017). However, there were no significant differences between the three groups for shades 2L1.5 and 2R1.5. Professional experience (P = .003) and age (P = .027) were associated with shade-matching success for tooth shade 2L1.5 only. The results showed no statistically significant differences with respect to sex, eye color or use of eyeglasses or contact lenses. Dental care professionals who routinely performed restorative procedures matched the shades better than did participants in other groups. Professional experience was associated positively with the outcome, while sex, eye color and use of eyeglasses or contact lenses did not have any effect on shade-matching results. To improve shade-matching skills, clinicians should participate in hands-on courses, continuing education classes and other training programs.

Comparing School Lunch and Canteen Foods Consumption of Children in Kayseri, Turkey

PubMed Central

Ongan, Dilek; Inanc, Neriman; Cicek, Betül

2014-01-01

Objective: School Nutrition Programs (SNPs) may have positive effects on children’s food choices through high nutritional quality meals. This cross-sectional & descriptive study was conducted to determine nutritional quality of school lunch and to compare lunch consumption of students who participated in SNP and who did not, at the first governmental school serving school lunch in Kayseri, Turkey. Methods: One hundred and sixteen students aged 9-14 years were divided into two groups after being matched according to gender, age, grade; 58 participants (school lunch group; SL-G) and 58 nonparticipants (school canteen group; SC-G) were recruited. Energy-nutrient content of 5-day school lunch was determined by recipes. Socio-demographic data and lunch consumption on 5 consecutive weekdays with weighed left overs were obtained. Lunch energy-nutrient intakes and anthropometric measurements were compared. Results: School lunch was adequate for vitamins (E & C), fibre, iron, inadequate for energy, carbohydrate, folate, calcium. Contribution of fat (36.6±6.8%) and saturated fat (12.2±3.5%) to energy and sodium content was high (1001 mg) in school lunch. SL-G consumed significantly higher protein, vitamin C, thiamine, vitamin B6, potassium, magnesium, iron, zinc (p<0.001 for each) than SC-G. Energy (p<0.001), carbohydrate (p<0.001), fat (p<0.05), vitamin E (p<0.001) intakes of SC-G were significantly higher than SL-G. Body weights, height, body mass index of groups were similar. Conclusions: Foodservice at school should be revised with collaboration of school management, catering firm, dietetic professionals. Policy should focus on reducing fat, saturated fat, sodium content and meeting energy-nutrient requirements of school aged children. PMID:24948977

Mental health and behaviour of students of public health and their correlation with social support: a cross-sectional study

PubMed Central

2011-01-01

Background Future public health professionals are especially important among students partly because their credibility in light of their professional messages and activities will be tested daily by their clients; and partly because health professionals' own lifestyle habits influence their attitudes and professional activities. A better understanding of public health students' health and its determinants is necessary for improving counselling services and tailoring them to demand. Our aim was to survey public health students' health status and behaviour with a focus on mental health. Methods A cross-sectional study was carried out among public health students at 1-5-years (N = 194) with a self-administered questionnaire that included standardized items on demographic data, mental wellbeing characterized by sense of coherence (SoC) and psychological morbidity, as well as health behaviour and social support. Correlations between social support and the variables for mental health, health status and health behaviour were characterized by pairwise correlation. Results The response rate was 75% and represented students by study year, sex and age in the Faculty. Nearly half of the students were non-smokers, more than one quarter smoked daily. Almost one-fifth of the students suffered from notable psychological distress. The proportion of these students decreased from year 1 to 5. The mean score for SoC was 60.1 and showed an increasing trend during the academic years. 29% of the students lacked social support from their student peers. Significant positive correlation was revealed between social support and variables for mental health. Psychological distress was greater among female public health students than in the same age female group of the general population; whereas the lack of social support was a more prevalent problem among male students. Conclusions Health status and behaviour of public health students is similar to their non-students peers except for their worse mental health. Future public health professionals should be better prepared for coping with the challenges they face during their studies. Universities must facilitate this process by providing helping services targeted at those with highest risk, and developing training to improve coping skills. Social support is also a potentially amenable determinant of mental health during higher education. PMID:22087581

Effect of yoga on musculoskeletal discomfort and motor functions in professional computer users.

PubMed

Telles, Shirley; Dash, Manoj; Naveen, K V

2009-01-01

The self-rated musculoskeletal discomfort, hand grip strength, tapping speed, and low back and hamstring flexibility (based on a sit and reach task) were assessed in 291 professional computer users. They were then randomized as Yoga (YG; n=146) and Wait-list control (WL; n=145) groups. Follow-up assessments for both groups were after 60 days during which the YG group practiced yoga for 60 minutes daily, for 5 days in a week. The WL group spent the same time in their usual recreational activities. At the end of 60 days, the YG group (n=62) showed a significant decrease in the frequency, intensity and degree of interference due to musculoskeletal discomfort, an increase in bilateral hand grip strength, the right hand tapping speed, and low back and hamstring flexibility (repeated measures ANOVA and post hoc analysis with Bonferroni adjustment). In contrast, the WL group (n=56) showed an increase in musculoskeletal discomfort and a decrease in left hand tapping speed. The results suggest that yoga practice is a useful addition to the routine of professional computer users.

Sleep and biological parameters in professional burnout: A psychophysiological characterization

PubMed Central

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.

PubMed

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.

Increasing capacity to deliver diabetes self-management education: results of the DESMOND lay educator non-randomized controlled equivalence trial.

PubMed

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.

Attitudes towards insulin initiation in type 2 diabetes patients among healthcare providers: A survey research.

PubMed

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.

Improving management of type 2 diabetes in South Asian patients: a systematic review of intervention studies

PubMed Central

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

28 CFR 16.80 - Exemption of Office of Professional Responsibility System-limited access.

Code of Federal Regulations, 2012 CFR

2012-07-01

... pursuant to 5 U.S.C. 552a(j)(2), (k)(1), (k)(2), and (k)(5). (b) Exemptions from the particular subsections... accounting would enable the subject of an investigation to gain information concerning the existence, nature....S.C. 552a(j)(2), (k)(1), and (k)(2). To the extent that information in a record pertaining to an...

28 CFR 16.80 - Exemption of Office of Professional Responsibility System-limited access.

Code of Federal Regulations, 2013 CFR

2013-07-01

... pursuant to 5 U.S.C. 552a(j)(2), (k)(1), (k)(2), and (k)(5). (b) Exemptions from the particular subsections... accounting would enable the subject of an investigation to gain information concerning the existence, nature....S.C. 552a(j)(2), (k)(1), and (k)(2). To the extent that information in a record pertaining to an...

28 CFR 16.80 - Exemption of Office of Professional Responsibility System-limited access.

Code of Federal Regulations, 2011 CFR

2011-07-01

... pursuant to 5 U.S.C. 552a(j)(2), (k)(1), (k)(2), and (k)(5). (b) Exemptions from the particular subsections... accounting would enable the subject of an investigation to gain information concerning the existence, nature....S.C. 552a(j)(2), (k)(1), and (k)(2). To the extent that information in a record pertaining to an...

28 CFR 16.80 - Exemption of Office of Professional Responsibility System-limited access.

Code of Federal Regulations, 2014 CFR

2014-07-01

... pursuant to 5 U.S.C. 552a(j)(2), (k)(1), (k)(2), and (k)(5). (b) Exemptions from the particular subsections... accounting would enable the subject of an investigation to gain information concerning the existence, nature....S.C. 552a(j)(2), (k)(1), and (k)(2). To the extent that information in a record pertaining to an...

28 CFR 16.80 - Exemption of Office of Professional Responsibility System-limited access.

Code of Federal Regulations, 2010 CFR

2010-07-01

... pursuant to 5 U.S.C. 552a(j)(2), (k)(1), (k)(2), and (k)(5). (b) Exemptions from the particular subsections... accounting would enable the subject of an investigation to gain information concerning the existence, nature....S.C. 552a(j)(2), (k)(1), and (k)(2). To the extent that information in a record pertaining to an...

41 CFR Appendix C to Chapter 301 - Standard Data Elements for Federal Travel [Traveler Identification

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...

5 CFR 534.506 - Conversion provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Conversion provisions. 534.506 Section... OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.506 Conversion provisions. (a) This section covers initial conversion to the pay system under 5 U.S.C. 5376 as of the...

5 CFR 534.506 - Conversion provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Conversion provisions. 534.506 Section... OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.506 Conversion provisions. (a) This section covers initial conversion to the pay system under 5 U.S.C. 5376 as of the...

'It's quite hard to grasp the enormity of it': perceived needs of people upon diagnosis of rheumatoid arthritis.

PubMed

Radford, S; Carr, M; Hehir, M; Davis, B; Robertson, L; Cockshott, Z; Tipler, S; Hewlett, S

2008-09-01

The diagnosis of rheumatoid arthritis (RA) brings rapid pharmacological and multidisciplinary team interventions to address inflammatory processes and symptom management. However, people may also need support on the journey to self-management. The aim of this study was to explore what professional support patients feel they receive upon diagnosis, and what support they feel would be most helpful. Two focus groups comprised patients with at least five years'; disease duration (n = 7), and patients more recently diagnosed (5-18 months, n = 5). The latter had attended at least two appointments in a rheumatology nurse specialist clinic during the previous year, aimed at providing support upon diagnosis. Transcripts were subjected to thematic analysis to identify common issues regarding support needs, which were then grouped into themes. Interviewing and analysis was performed by researchers not involved in clinical care. Four overarching themes emerged. 'Information' was needed about the symptoms of RA, its management and personal outcome, while 'Support' related to emotional needs ('It's quite hard to grasp the enormity of it'). Information and Support overlapped, in that patients wanted someone to talk to, and to be listened to. These two themes were underpinned by issues of service delivery: 'Choice' (patient or professional to talk to, groups, one-to-one) and 'Involvement' (holistic care, partnership), which overlapped in terms of the opportunity to decide when and which interventions to access. People with RA report not only informational, but also emotional support needs at diagnosis. The potential for delivering emotional support to patients around the time of diagnosis warrants further exploration. (c) 2008 John Wiley & Sons, Ltd.

Professional quality of life normative benchmarks.

PubMed

De La Rosa, Gabriel M; Webb-Murphy, Jennifer A; Fesperman, Susan F; Johnston, Scott L

2018-03-01

Those responsible for the care of trauma survivors can experience both beneficial and detrimental consequences resulting from their professional demands. Research has demonstrated that among professional caregivers, compassion satisfaction (CS), burnout (BO), and compassion fatigue (CF) are important factors contributing to professional quality of life. The current research aims to provide normative information regarding the factors contributing to professional quality of life among those who interact with survivors of trauma. The Professional Quality of Life (ProQOL) Scale is a widely used measure of CS, BO, and CF. The most recent iteration of the ProQOL manual provides normative data to assist in the interpretation of scores. However, a review of the literature reporting raw scores on the ProQOL suggests that mean scores and cutoff scores for the 25th and 75th percentiles may be misleading. A review of 30 studies (total sample size of 5,612) was conducted and normative values are presented. The mean (standard deviation) level of CS, CF, and BO were 37.7 (6.5), 16.7 (5.7), and 22.8 (5.4), respectively. Values gathered from the literature review tend to align well with one another and suggest that within a given sample, CS scores tend to be higher than BO scores, and BO scores tend to be slightly higher than CF scores. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Effects of Sesame (Sesamum indicum L.) Supplementation on Creatine Kinase, Lactate Dehydrogenase, Oxidative Stress Markers, and Aerobic Capacity in Semi-Professional Soccer Players

PubMed Central

Barbosa, Carlos V. da Silva; Silva, Alexandre S.; de Oliveira, Caio V. C.; Massa, Nayara M. L.; de Sousa, Yasmim R. F.; da Costa, Whyara K. A.; Silva, Ayice C.; Delatorre, Plínio; Carvalho, Rhayane; Braga, Valdir de Andrade; Magnani, Marciane

2017-01-01

Nutritional intervention with antioxidants rich foods has been considered a strategy to minimize the effects of overtraining in athletes. This experimental, randomized, and placebo-controlled study evaluated the effects of consumption of sesame (Sesamum indicum L.) on muscle damage markers, oxidative stress, systemic inflammation, and aerobic performance in male semi-professional soccer players. Twenty athletes were randomly assigned to groups that received 40 g (two tablespoons) per day of sesame or a placebo during 28 days of regular training (exposed to routine training that includes loads of heavy training in the final half of the season). Before and after intervention, creatine kinase (CK), lactate dehydrogenase (LDH), malondialdehyde (MDA), superoxide dismutase (SOD), C-reactive protein (hs-CRP), and aerobic capacity were evaluated. Before intervention, a physiologic imbalance was noted in both groups related to CK and LDH levels. Sesame intake caused a reduction of CK (19%, p < 0.05), LDH (37%, p < 0.05), MDA (55%, p < 0.05) and hs-CRP (53%, p < 0.05) and increased SOD (14%, p < 0.05), vitamin A (25%, p < 0.05), and vitamin E (65%, p < 0.05) in the experimental group. These phenomena were accompanied by increased aerobic capacity (17%, p < 0.05). The placebo group showed an increase in CK (5%, p < 0.05) and no significant change in LDH, SOD or vitamin A. MDA levels decreased (21%, p < 0.05) and vitamin E increased (14%, p < 0.05) in the placebo group, but to a much lesser extent than in the experimental group. These results show that sesame consumption may reduce muscle damage and oxidative stress while improving the aerobic capacity in soccer players. PMID:28408889

Ophthalmology on social networking sites: an observational study of Facebook, Twitter, and LinkedIn.

PubMed

Micieli, Jonathan A; Tsui, Edmund

2015-01-01

The use of social media in ophthalmology remains largely unknown. Our aim was to evaluate the extent and involvement of ophthalmology journals, professional associations, trade publications, and patient advocacy and fundraising groups on social networking sites. An archived list of 107 ophthalmology journals from SCImago, trade publications, professional ophthalmology associations, and patient advocacy organizations were searched for their presence on Facebook, Twitter, and LinkedIn. Activity and popularity of each account was quantified by using the number of "likes" on Facebook, the number of followers on Twitter, and members on LinkedIn. Of the 107 journals ranked by SCImago, 21.5% were present on Facebook and 18.7% were present on Twitter. Journal of Community Eye Health was the most popular on Facebook and JAMA Ophthalmology was most popular on Twitter. Among the 133 members of the International Council of Ophthalmology, 17.3% were present on Facebook, 12.8% were present on Twitter, and 7.5% were present on LinkedIn. The most popular on Facebook was the International Council of Ophthalmology, and the American Academy of Ophthalmology was most popular on Twitter and LinkedIn. Patient advocacy organizations were more popular on all sites compared with journals, professional association, and trade publications. Among the top ten most popular pages in each category, patient advocacy groups were most active followed by trade publications, professional associations, and journals. Patient advocacy groups lead the way in social networking followed by professional organizations and journals. Although some journals use social media, most have yet to engage its full potential and maximize the number of potential interested individuals.

Comparison of Different Analgesia Drug Regimens for Pain Control During Extracorporeal Shock Wave Lithotripsy for Renal Stones: A Randomized Control Study

PubMed Central

Butt, Amna; Ayaz Khan, Mohammad; Khan, Ijaz; Saqib, Imad-ud-din; Hussain, Tariq; Akhter, Saeed

2017-01-01

Introduction With the increased use of extracorporeal shock wave lithotripsy (ESWL), the management of urolithiasis has become much convenient for the patients and the health care professionals alike. However, associated with the procedure is the common complaint of pain. No agreed upon pain management strategy has yet been developed for the procedure. We compared the effect of different analgesia drug regiments for pain control. Methodology A randomised controlled trial was carried out in Shifa International Hospital from between July 2015 to January 2016. A total of 135 patients were divided into three groups; group A received 30 g lidocaine 2% gel applied locally on corresponding lumber area 30 minutes before the procedure, group B received oral naproxen sodium 550 mg 45 minutes before the procedure, and group C received both oral naproxen and lidocaine gel. Patients were supplemented with intravenous nalbuphine during the procedure. The pain was assessed with 0-10 visual analogue scale. Both pre-procedure and post-procedure pain score was measured. Results Among 135 patients, 105 (77.8%) were male and 29 (21.5%) were female with mean age of 38.7 ± 1.31 years. There was no difference of mean pain score or need for supplemental intravenous nalbuphine between groups B and C but there was significantly decreased mean pain score and need for supplemental intravenous nalbuphine in groups B and C in comparison with group A. Conclusion The use of oral naproxen sodium with or without the addition of lidocaine gel during ESWL is a promising option for pain management during the procedure with significant improvement in comparison with lidocaine gel alone. PMID:28560121

Professional aircrews' attitudes toward infectious diseases and aviation medical issues.

PubMed

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.

Life habits of school-aged children with specific language impairment as perceived by their parents and by school professionals.

PubMed

Croteau, Claire; McMahon-Morin, Paméla; Morin, Claudia; Jutras, Benoît; Trudeau, Natacha; Le Dorze, Guylaine

2015-01-01

Describe social participation of a group of children with specific language impairment. 26 parents of children with specific language impairment (SLI) aged from 5 to 13 years and 11 school professionals participated in the study. Data collection was performed with the adapted version for children aged from 5 to 13 years old of the Assessment of Life Habits (Fougeyrollas et al., 2001). The questionnaire encompasses 196 life habits, grouped in 12 dimensions: nutrition, fitness, personal care, communication, housing, mobility, responsibilities, interpersonal relationships, community life, education, work and recreation (Fougeyrollas, 2010). According to their parents and school professionals, children in this study carried out without difficulty life habits related to housing and mobility. However, they experienced difficulty with life habits related to interpersonal relationships, recreation and responsibilities, in addition to communication and education. Children with SLI are perceived by their parents and school professionals as having reduced social participation in many aspects of their daily life. Social participation should be considered as a major outcome when offering services in school to these children. This study proposes specific ways to help children with SLI. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Consumer involvement in Quality Use of Medicines (QUM) projects - lessons from Australia.

PubMed

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.

Sometimes you can't make it on your own: the impact of a professionalism curriculum on the attitudes, knowledge, and behaviors of an academic plastic surgery practice.

PubMed

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.

Variations in hospital worker perceptions of safety culture.

PubMed

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.

Effective, Sustained Inquiry-Based Instruction Promotes Higher Science Proficiency Among All Groups: A 5-Year Analysis

NASA Astrophysics Data System (ADS)

Marshall, Jeff C.; Alston, Daniel M.

2014-11-01

Student's performance in science classrooms has continued to languish throughout the USA. Even though proficiency rates on national tests such as National Assessment of Educational Progress are higher for Caucasian students than African-Americans and Hispanics, all groups lack achieving desired proficiency rates. Further, the Next Generation Science Standards detail a new higher benchmark for all students. This study analyzes a professional development (PD) project, entitled Inquiry in Motion, designed to (a) facilitate teacher transformation toward greater quantity and quality of inquiry-based instruction, (b) improve student achievement in science practices and science concepts, and (c) begin to narrow the achievement gap among various groups. This 5-year PD study included 11 schools, 74 middle school teachers, and 9,981 students from diverse, high minority populations. Findings from the quasi-experimental study show statistically significant gains for all student groups (aggregate, males, females, Caucasians, African-Americans, and Hispanics) on all three science Measure of Academic Progress tests (composite, science practices, and science concepts) when compared to students of non-participating teachers. In addition to an increase in overall performance for all groups, a narrowing of the achievement gap of minority students relative to Caucasian students was seen. When combined with other studies, this study affirms that, when facilitated effectively, inquiry-based instruction may benefit all students, for all demographic groups measured.

Before the storm: informing and involving stakeholder groups in workplace biomarker monitoring.

PubMed

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.

22 CFR 228.40 - Local procurement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... transaction does not exceed $5,000. (c) Professional services contracts estimated not to exceed the local... available locally: (1) Utilities, including fuel for heating and cooking, waste disposal and trash...

Success attitudes of young ophthalmologists in the first decade of their career.

PubMed

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.

[Antitumor effect of capsaicin on colorectal carcinoma xenograft in nude mice].

PubMed

Zhu, Li-li; Hu, Wan-le; Zhang, Lin-jun; Yu, Zhi-gao; Huang, Chong-jie; Jiang, Ming-zhe; Teng, Ming-xing; Liu, Jian-lu; Liu, Chang-bao

2013-04-01

To evaluate the effect of capsaicin on nude mice xenografted with colorectal carcinoma cells, and to explore its mechanism of action. A nude mouse model of colorectal cancer was established by subcutaneous inoculation of human colorectal carcinoma HT-29 cells. Terminal deoxynucleotidyl transferase-mediated nicked labeling assay (TUNEL) was undertaken to detect the cell proliferation and apoptosis in the xenograft tissue in nude mice. Immunohistochemical (IHC) staining and Western blot were used to detect the expression of HSP27, Cyt-C and active caspase-3. The tumor growth of the groups C10 and C20 was significantly slower than that of the group NS. The integrated optical density (IOD) of both the group C5 (2532.14 ± 578.11) and group C10 (6364.03 ± 1137.98) was significantly higher than that of the group NS (760.12 ± 238.05), (P < 0.05). The integrated optical density (IOD) of the group C20 was (15743.96 ± 1855.95), significantly higher than that of the groups C10, C5 and NS (all were P < 0.01). Immunohistochemistry showed that the cytoplasmic expression of HSP27 was strongly positive in the group NS, and significantly reduced with the increasing dose of capsaicin in the treated groups. The expression of active caspase-3 and Cyt-C in the group NS was weakly positive, and was significantly increased with the increasing dose of capsaicin in the groups C5 and C10 (P < 0.05), and the expression of active caspase-3 and Cyt-C of the group C20 was significantly higher than that of the groups C5, C10 and NS (P < 0.01). Western blot analysis showed that both the expressions of HSP27 of the group C5 (0.73 ± 0.05) and the group C10 (0.41 ± 0.03) were significantly lower than that of the group NS (P < 0.05). The expression of HSP27 of the group C20 (0.22 ± 0.06) was significantly lower than that of the groups C5, C10 and NS (P < 0.01). The expressions of active-caspase-3 and Cyt-C in the group C5 were (2.57 ± 0.34) and (2.03 ± 0.38), significantly higher than those of the group NS (P < 0.05). The expressions of active-caspase-3 and Cyt-C in the group C10 were (4.23 ± 0.45) and (3.13 ± 0.44), also significantly higher than those of the group NS (P < 0.05). The expressions of active-caspase-3 and Cyt-C in the group C20 were (5.78 ± 0.48) and (4.92 ± 0.52), significantly higher than those of the group C5, C10 and NS (P < 0.01). TUNEL analysis showed that there was a significant difference of cell apoptosis in comparison of each two groups. The higher dose of capsaicin was used, the more apoptosis was observed. Capsaicin can significantly inhibit the tumor growth and induce cell apoptosis in the colorectal carcinoma xenograft in nude mice. Its mechanism of action is possibly related with the down-regulation of HSP27 expression and up-regulation of expression of active caspase-3 and Cyt-C in the colorectal carcinoma xenograft in nude mice.

[Perception of professionals' quality of life in the Asturias a Health Care Area, Spain].

PubMed

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.

Developing physical activity counselling in primary care through participatory action approach.

PubMed

Aittasalo, Minna; Kukkonen-Harjula, Katriina; Toropainen, Erja; Rinne, Marjo; Tokola, Kari; Vasankari, Tommi

2016-10-04

Many adults are insufficiently physically active for health. Counselling is the main method to promote physical activity (PA) in primary care but often implemented inadequately. The aim of this study was to increase health professionals' i) know-how about health-related PA and PA counselling, ii) implementation and quality of PA counselling, iii) familiarity with and use of Physical Activity Prescription (PAP), iv) internal and external collaboration and v) use of electronic patient record system in PA counselling. Four Finnish health centres participated. Each nominated a working group for reaching the goals through a 6-month development work, which was supported with monthly tutorials by the research group. The outcome evaluation of the development work included 19 variables, which reflected the five goals and were assessed before (baseline) and after the development work (follow-up). Variable-specific differences in proportions (%) and their 95 % confidence intervals (CI) between the time points indicated change. The measures were questionnaires to the health professionals (N = 75 at baseline and N = 80 at follow-up) and patients (N = 441 and N = 431), professionals' record sheets on patient visits (N = 1008 and N = 1000), and telephone interviews to external partners (N = 48 and N = 28). The process was evaluated with the extent the working group members participated in the development work and with the implementation of development actions. Assessment was based on meeting minutes of tutorials and working group meetings. Health professionals' familiarity with PAP (questionnaire, change 39 %-points; 95 % CI 26.5 to 52.5) and use of PAP (questionnaire, 32 %-points; 95 % CI 18.9 to 45.1 and record sheet, 4 %-points; 95 % CI 2.7 to 5.3) increased. A greater proportion of professionals had agreed in their working unit on using PAP (questionnaire, 32 %-points; 95 % CI 20.3 to 43.7) and used PAP as a referral to other health professionals (record sheet, 1 %-point; 95 % CI 0.3 to 1.7). Also the know-how of PA and PA counselling showed improvement but not statistically significantly. The working group members participated unevenly in the development work and had difficulties in allocating time for the work. This was seen in limited number of actions implemented. The study was able to achieve some improvements in the familiarity with and use of PAP and to lesser extent in the know-how of health-related PA and PA counselling. To observe changes in other goals, which targeted more at organisational, inter-professional and multi-sectorial level, may have required more long-term actions.

[Views of professionals and patients on the introduction of computer science into the consultation].

PubMed

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.

Virtual reality skills training for health care professionals in alcohol screening and brief intervention.

PubMed

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.

Ethical attitudes on human cloning among professionals in Taiwan and the policy implications for regulation.

PubMed

Yang, Che-Ming; Chung, Chun-Chih; Lu, Meei-Shiow; Lin, Chiou-Fen; Chen, Jiun-Shyan

2005-01-01

This research focused on understanding the attitudes toward human cloning in Taiwan among professionals in healthcare, law, and religion. The study was conducted utilizing a structured questionnaire. 220 healthcare professionals from two regional hospitals located in Taipei, 351 religious professionals in the northern Taiwan and 711 legal professionals were selected by to receive questionnaires. The valid response rate is 42.1% The questions were generated by an expert panel and represented major arguments in the human cloning debate. There were a total of six Likert scaled questions in the questionnaire. The responses were coded from 1 to 5 with 1 representing strong opposition to human cloning, 3 representing a neutral attitude; and 5 representing a strong favorable attitude toward human cloning. Healthcare professionals had the highest overall average score of 2.14 and the religious professionals had the lowest average at 1.58. All three categories of respondents' attitude toward cloning ranged from mild opposition to strong opposition to human cloning. The religious professionals were more strongly opposed to cloning. Age, education, and religion significantly influenced attitudes toward cloning. Professionals between fifty-one and sixty years old, those with less education, and Roman Catholic professionals were more strongly opposed to cloning. Religious professionals were more strongly opposed to human cloning than professionals in healthcare or law. Younger professionals as an age group demonstrated less opposition to human cloning. Regulation of human cloning will be influenced by professionals in healthcare, law, and religion, and the regulatory environment chosen now will play a pivotal role in influencing the acceptance of human cloning in the future.

Outcomes of microfracture in professional basketball players.

PubMed

Cerynik, Douglas L; Lewullis, Gabriel E; Joves, Brian C; Palmer, Michael P; Tom, James A

2009-09-01

Surgical treatment for chondral defects of the knee in competitive running and jumping athletes remains controversial. This study evaluated the performance outcomes of professional basketball players in the National Basketball Association (NBA) who underwent microfracture. Data from 24 professional basketball players from 1997 to 2006 was obtained and analyzed. NBA player efficiency ratings (PER) were calculated for two seasons before and after injury. A control group of 24 players was used for comparison. Study group and control group demographics including age, NBA experience, and minutes per game demonstrated no statistical difference. Mean time to return to an NBA game was 30.0 weeks from the time of surgery. The first season after returning to competition PER and minutes per game decreased by 3.5 (P < 0.01) and 4.9 min (P < 0.05), respectively. The 17 players who continued to play two or more seasons after surgery, the average reduction in their PER and minutes per game was 2.7 (P > 0.05) and 3.0 min (P < 0.26), respectively. A multivariant comparison versus controls demonstrated that power rating during the 2 years after surgery decreased by 3.1 (P < 0.01); while minutes per game decreased by 5.2 (P < 0.001). Twenty-one percent (n = 5 of 24) of the players treated with microfracture did not return to competition in an NBA game. On return to competition player performance and minutes per game are diminished.

Flexible guided self-determination intervention for younger adults with poorly controlled Type 1 diabetes, decreased HbA1c and psychosocial distress in women but not in men: a real-life RCT.

PubMed

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.

An analysis of the meanings of pre-eclampsia for pregnant and postpartum women and health professionals in Rio Grande do Norte, Brazil.

PubMed

de Azevedo, Daniela Vasconcelos; de Araújo, Ana C P F; Clara Costa, Iris C

2011-12-01

To understand the meanings of pre-eclampsia for pregnant and postpartum women and health-care professionals. a word-association test and semi-structured interviews. A maternity hospital located in Natal, Rio Grande do Norte, Brazil that serves pregnant and postpartum women considered to be at high risk. 51 Pregnant women, 10 postpartum women and 87 health-care professionals completed a word-association test; 18 pregnant women, two postpartum women and 20 health-care professionals for the interviews. Thematic categories based on the word-association test and the interviews were created to help the data analysis. χ(2) test was used to compare the categories raised by both groups in the word-association test to determine the association between the frequencies of these categories. The meanings of pre-eclampsia to pregnant and postpartum women were fear, risk, care and lack of information. To the health-care professionals, the meanings were care, fear, risk, high blood pressure, oedema and proteinuria. The frequencies of the categories 'fear', 'care' and 'risk' were statistically different (χ(2) = 31.84, 14.5, 38.19, respectively; df = 2, p < 0.001) between the group of pregnant and postpartum women and the group of health-care professionals. For the first group, the most significant meanings were fear and risk, compared with care for the second group. The analysis of the interviews confirmed and deepened the results of the word-association test, and also demonstrated that the pregnant and postpartum women had no information about pre-eclampsia. There is a gap between how women and health professionals view their experiences of pre-eclampsia. A warm welcome to the health-care facility, with clear explanations about the disease and the procedures to be performed during the visits and hospitalisation would be important aspects for the physical and mental well-being of pregnant and postpartum women. Copyright © 2010 Elsevier Ltd. All rights reserved.

High Levels of Soluble C5b-9 Complex in Dialysis Fluid May Predict Poor Prognosis in Peritonitis in Peritoneal Dialysis Patients.

PubMed

Mizuno, Masashi; Suzuki, Yasuhiro; Higashide, Keiko; Sei, Yumi; Iguchi, Daiki; Sakata, Fumiko; Horie, Masanobu; Maruyama, Shoichi; Matsuo, Seiichi; Morgan, B Paul; Ito, Yasuhiko

2017-01-01

We searched for indicators to predict the prognosis of infectious peritonitis by measuring levels of complement proteins and activation products in peritoneal dialysis (PD) fluid (PDF) of patients at early stages of peritonitis. We retrospectively analyzed the relationship between the levels of sC5b-9, C3 and C4 in PDF and the subsequent clinical prognosis. We measured levels of sC5b-9, C3 and C4 in PDF on days 1, 2 and 5 post-onset of peritonitis in 104 episodes of infectious peritonitis in PD patients from 2008 and retrospectively compared levels with clinical outcomes. Further analysis for the presence of causative microorganisms or to demonstrate bacterial culture negative peritonitis was performed and correlated with change of levels of sC5b-9 in PDF. When PD patients with peritonitis were divided into groups that either failed to recover from peritonitis and were finally withdrawn from PD (group 1; n = 25) or recovered (group 2; n = 79), levels of sC5b-9, C3 and C4 in PDF were significantly higher in group 1 patients compared to those in group 2 on day5. Analysis of microorganisms showed significantly higher sC5b-9 levels in PDF of peritonitis cases caused by culture negative peritonitis in group 1 compared with group 2 when we analyzed for individual microorganisms. Of note, on day5, the sC5b-9 levels in PDF were similarly high in peritonitis caused by fungi or other organisms. Our results suggested that levels of complement markers in PDF, especially sC5b-9, have potential as surrogate markers to predict prognosis of PD-related peritonitis.

Diet Replenishment for Ad-libitum–fed Mice Housed in Social Groups is Compatible with Shelf Life

PubMed Central

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

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…

Detection of testosterone administration based on the carbon isotope ratio profiling of endogenous steroids: international reference populations of professional soccer players

PubMed Central

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

Using the Five Domains Model to Assess the Adverse Impacts of Husbandry, Veterinary, and Equitation Interventions on Horse Welfare.

PubMed

McGreevy, Paul; Berger, Jeannine; de Brauwere, Nic; Doherty, Orla; Harrison, Anna; Fiedler, Julie; Jones, Claudia; McDonnell, Sue; McLean, Andrew; Nakonechny, Lindsay; Nicol, Christine; Preshaw, Liane; Thomson, Peter; Tzioumis, Vicky; Webster, John; Wolfensohn, Sarah; Yeates, James; Jones, Bidda

2018-03-18

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.

Use of ISDN video-phones for clients receiving palliative and antenatal home care.

PubMed

Miyazaki, Masako; Stuart, Michelle; Liu, Lili; Tell, Sharon; Stewart, Marianne

2003-01-01

We examined the use of ISDN video-phones by health professionals and two types of home care clients: those receiving palliative care and those receiving antenatal care. In the palliative care group, there were four female clients and 15 health professionals; these clients on average had the video-phones at home for six weeks and made 12.5 calls per week. The antenatal care group consisted of six female clients and eight female registered nurses; these clients on average also had the video-phones at home for six weeks and made 12.5 calls per week. Exit interviews were conducted with three clients and eight staff in the palliative care group, and with six clients and three staff in the antenatal care group. Palliative care clients and their families commented that the visual feature of the phone enhanced the care that they received. In the antenatal group, the video-phone was used mainly for booking appointments and arranging home visits. In general, the technology was well received by clients and care providers.

Sick-leave and help seeking among rescue workers after the terror attacks in Norway, 2011.

PubMed

Gjerland, Astrid; Pedersen, May Janne Botha; Ekeberg, Øivind; Skogstad, Laila

2015-12-01

Several studies have addressed psychological problems after terror attacks, especially among victims. Fewer have addressed possible health consequences among rescue workers involved with terror attacks. This study's aim was to investigate the levels of sick-leave and psychological help seeking among rescue workers involved in the terror attacks in Norway on July 22, 2011, and to identify associations between sick-leave and background-, exposure- and work-related variables. This cross-sectional study included five groups of professional rescue personnel and one group of unaffiliated volunteers. The questionnaire was distributed approximately 10 months after the terror attacks, with a response rate of 61.3 % (N = 1790). A total of 9.7 % of participants self-reported sick-leave. The rate varied from 2.4 % among police officers to 14.5 % among unaffiliated volunteers, p < .001. There were 0.0-1.2 % of the professionals who were on sick-leave for more than 2 weeks and 5.5 % among the unaffiliated volunteers. More unaffiliated volunteers (42.6 %) and psychosocial personnel (16.3 %) consulted a psychologist or psychiatrist compared to other groups (3-9 %), p < .001. General healthcare providers (OR 6.1), psychosocial personnel (OR 6.3) and unaffiliated volunteers (OR 5.7) were associated with sick-leave, together with unwanted stress reactions (OR 1.6) and starting work on July 22 (OR 1.6). A small minority of professional rescue workers reported sick-leave for more than 2 weeks, and few had sought psychological help. Unaffiliated volunteers reported more stress symptoms, longer sick-leave duration and more psychological help seeking. This group may benefit from more support.

Comparative study of the femoroacetabular impingement (FAI) prevalence in male semiprofessional and amateur soccer players.

PubMed

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.

Ophthalmology on social networking sites: an observational study of Facebook, Twitter, and LinkedIn

PubMed Central

Micieli, Jonathan A; Tsui, Edmund

2015-01-01

Background The use of social media in ophthalmology remains largely unknown. Our aim was to evaluate the extent and involvement of ophthalmology journals, professional associations, trade publications, and patient advocacy and fundraising groups on social networking sites. Methods An archived list of 107 ophthalmology journals from SCImago, trade publications, professional ophthalmology associations, and patient advocacy organizations were searched for their presence on Facebook, Twitter, and LinkedIn. Activity and popularity of each account was quantified by using the number of “likes” on Facebook, the number of followers on Twitter, and members on LinkedIn. Results Of the 107 journals ranked by SCImago, 21.5% were present on Facebook and 18.7% were present on Twitter. Journal of Community Eye Health was the most popular on Facebook and JAMA Ophthalmology was most popular on Twitter. Among the 133 members of the International Council of Ophthalmology, 17.3% were present on Facebook, 12.8% were present on Twitter, and 7.5% were present on LinkedIn. The most popular on Facebook was the International Council of Ophthalmology, and the American Academy of Ophthalmology was most popular on Twitter and LinkedIn. Patient advocacy organizations were more popular on all sites compared with journals, professional association, and trade publications. Among the top ten most popular pages in each category, patient advocacy groups were most active followed by trade publications, professional associations, and journals. Conclusion Patient advocacy groups lead the way in social networking followed by professional organizations and journals. Although some journals use social media, most have yet to engage its full potential and maximize the number of potential interested individuals. PMID:25709390

'Do as we say, not as we do:' a cross-sectional survey of injuries in injury prevention professionals.

PubMed

Ezzat, Allison; Brussoni, Mariana; Schneeberg, Amy; Jones, Sarah J

2014-06-01

As the leading cause of death and among the top causes of hospitalisation in Canadians aged 1-44 years, injury is a major public health concern. Little is known about whether knowledge, training and understanding of the underlying causes and mechanisms of injury would help with one's own prevention efforts. Based on the Theory of Planned Behaviour, we hypothesised that injury prevention professionals would experience fewer injuries than the general population. An online cross-sectional survey was distributed to Canadian injury prevention practitioners, researchers and policy makers to collect information on medically attended injuries. Relative risk of injury in the past 12 months was calculated by comparing the survey data with injury incidence reported by a comparable subgroup of adults from the (Canadian Community Health Survey (CCHS)) from 2009 to 2010. We had 408 injury prevention professionals complete the survey: 344 (84.5%) women and 63 (15.5%) men. In the previous 12 months, 86 individuals reported experiencing at least one medically attended injury (21,235 people per 100,000 people); with sports being the most common mechanism (41, 33.6%). Fully 84.8% individuals from our sample believed that working in the field had made them more careful. After accounting for age distribution, education level and employment status, injury prevention professionals were 1.69 (95% CI 1.41 to 2.03) times more likely to be injured in the past year. Despite their convictions of increasing their own safety behaviour and that of others, injury prevention professionals' knowledge and training did not help them prevent their own injuries. 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.

Verbal messages strengthen bench press efficacy.

PubMed

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.

A group approach to genetic counselling of cardiomyopathy patients: satisfaction and psychological outcomes sufficient for further implementation.

PubMed

Otten, Ellen; Birnie, Erwin; Ranchor, Adelita V; van Tintelen, J Peter; van Langen, Irene M

2015-11-01

The introduction of next-generation sequencing in everyday clinical genetics practise is increasing the number of genetic disorders that can be confirmed at DNA-level, and consequently increases the possibilities for cascade screening. This leads to a greater need for genetic counselling, whereas the number of professionals available to provide this is limited. We therefore piloted group genetic counselling for symptomatic cardiomyopathy patients at regional hospitals, to assess whether this could be an acceptable alternative to individual counselling. We performed a cohort study with pre- and post-counselling patient measurements using questionnaires, supplemented with evaluations of the group counselling format by the professionals involved. Patients from eight regional hospitals in the northern part of the Netherlands were included. Questionnaires comprised patient characteristics, psychological measures (personal perceived control (PPC), state and trait anxiety inventory (STAI)), and satisfaction with counsellors, counselling content and design. In total, 82 patients (mean age 57.5 year) attended one of 13 group sessions. Median PPC and STAI scores showed significantly higher control and lower anxiety after the counselling. Patients reported they were satisfied with the counsellors, and almost 75% of patients were satisfied with the group counselling. Regional professionals were also, overall, satisfied with the group sessions. The genetics professionals were less satisfied, mainly because of their perceived large time investment and less-than-expected group interaction. Hence, a group approach to cardiogenetic counselling is feasible, accessible, and psychologically effective, and could be one possible approach to counselling the increasing patient numbers in cardiogenetics.

A group approach to genetic counselling of cardiomyopathy patients: satisfaction and psychological outcomes sufficient for further implementation

PubMed Central

Otten, Ellen; Birnie, Erwin; Ranchor, Adelita V; van Tintelen, J Peter; van Langen, Irene M

2015-01-01

The introduction of next-generation sequencing in everyday clinical genetics practise is increasing the number of genetic disorders that can be confirmed at DNA-level, and consequently increases the possibilities for cascade screening. This leads to a greater need for genetic counselling, whereas the number of professionals available to provide this is limited. We therefore piloted group genetic counselling for symptomatic cardiomyopathy patients at regional hospitals, to assess whether this could be an acceptable alternative to individual counselling. We performed a cohort study with pre- and post-counselling patient measurements using questionnaires, supplemented with evaluations of the group counselling format by the professionals involved. Patients from eight regional hospitals in the northern part of the Netherlands were included. Questionnaires comprised patient characteristics, psychological measures (personal perceived control (PPC), state and trait anxiety inventory (STAI)), and satisfaction with counsellors, counselling content and design. In total, 82 patients (mean age 57.5 year) attended one of 13 group sessions. Median PPC and STAI scores showed significantly higher control and lower anxiety after the counselling. Patients reported they were satisfied with the counsellors, and almost 75% of patients were satisfied with the group counselling. Regional professionals were also, overall, satisfied with the group sessions. The genetics professionals were less satisfied, mainly because of their perceived large time investment and less-than-expected group interaction. Hence, a group approach to cardiogenetic counselling is feasible, accessible, and psychologically effective, and could be one possible approach to counselling the increasing patient numbers in cardiogenetics. PMID:25649380

Effect of targeted magnetic nanoparticles containing 5-FU on expression of bcl-2, bax and caspase 3 in nude mice with transplanted human liver cancer

PubMed Central

Wang, Jian-Ming; Xiao, Bao-Lai; Zheng, Jian-Wei; Chen, Hai-Bing; Zou, Sheng-Quan

2007-01-01

AIM: To investigate the anti-tumor effect and mechanisms of magnetic nanoparticles targeting hepatocellular carcinoma. METHODS: Human hepatocellular carcinoma was induced in nude mice, and the mice were randomly divided into group A receiving normal saline, group B receiving magnetic nanoparticles containing 5-fluorouracil (5-FU), group C receiving 5-FU, and group D receiving magnetic nanoparticles containing 5-FU with a magnetic field built in tumor tissues. The tumor volume was measured on the day before treatment and 1, 4, 7, 10 and 13 d after treatment. Tumor tissues were isolated for examination of the expression of bcl-2, bax and caspase 3 by immunohistochemical method, reverse transcription polymerase chain reaction and Western blotting. RESULTS: The tumor volume was markedly lower in groups C and D than in groups A and B (group C or D vs group A or B, P < 0.01). The volume was markedly lower in group D than in group C (P < 0.05). The expression of protein and mRNA of bcl-2 was markedly lower in groups C and D than in groups A and B (group C or D vs group A or B, P < 0.01), and was markedly lower in group D than in group C (P < 0.01). The expression of bax and caspase 3 in groups C and D was significantly increased, compared with that in groups A and B (P < 0.01). CONCLUSION: The targeted magnetic nanoparticles containing 5-FU can improve the chemotherapeutic effect of 5-FU against hepatocellular carcinoma by decreasing the expression of bcl-2 gene, and increasing the expression of bax and caspase 3 genes. PMID:17589894

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…

The postoperative handover: a focus group interview study with nurse anaesthetists, anaesthesiologists and PACU nurses.

PubMed

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.

Social Media in Professional Medicine: New Resident Perceptions and Practices.

PubMed

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.

A rare complication of a unilateral vertebral artery occlusion, which resulted in a basilar emboli after a C5-C6 bifacet dislocation in a professional rugby player: case study.

PubMed

Davies, Simon R

2011-03-01

Vertebral artery damage after cervical fracture and especially cervical dislocations is a recognized phenomenon. The incidence of significant intracranial neurology after unilateral vertebral damage is extremely rare, and to our knowledge, no such injury has been sustained while playing sport. To describe a rare vascular complication of a bifacet C5-C6 dislocation. Case report and clinical discussion. We present a 28-year old white man who was a professional rugby player. He sustained a hyperflexion injury while playing scrum half in a recent league match, which resulted in a C5-C6 dislocation, diagnosed clinically and with a plain radiograph. The patient on admission had complete neurologic loss below C6. The patient underwent immediate computed tomography and magnetic resonance imaging (MRI) scans that revealed a 50% displacement of C5 on C6 with a complete unifacet dislocation and the other facet partially dislocated. The MRI revealed signal changes in the cord at the C5-C6 level and an intimal tear in the left vertebral artery. The decision was taken to reduce the dislocation when medically stable. A few hours after injury, after an episode of vomiting, the patient sustained a respiratory arrest owing to the embolization of a clot from the left vertebral artery into the basilar artery. Despite rapid embolectomy and subsequent permanent left vertebral artery occlusion, the patient sustained multiple infarcts in the cerebellar, thalamic, occipital, and pontine regions of the brain that eventually proved fatal. This case shows a rare complication of unilateral vertebral artery occlusion. Despite early identification of a basilar infarct and a successful embolectomy, intracranial infarction occurred. Although there is no guideline for the treatment of vertebral artery damage, early reduction and anticoagulation may reduce the risk of cerebral infarction. Copyright © 2011 Elsevier Inc. All rights reserved.

20 CFR 656.5 - Schedule A.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Schedule A may apply for that labor certification under § 656.15. Schedule A (a) Group I: (1) Persons who... National Council of State Boards of Nursing. (3) Definitions of Group I occupations: (i) Physical therapist... illness in others. A program of study for professional nurses generally includes theory and practice in...

C5a aggravates dysfunction of the articular cartilage and synovial fluid in rats with knee joint immobilization.

PubMed

Lu, Wei; Wang, Lin; Yao, Jing; Wo, Chunxin; Chen, Yu

2018-06-22

Degenerative alterations in articular cartilage are involved in the pathogenesis of osteoarthritis. The present study aimed to evaluate the role of complement component 5a (C5a) in osteoarthritic alterations in the articular cartilage and synovialis via a joint immobilization (IM) rat model. Rats were assigned to three groups: Control, IM and IM+anti‑C5a antibody (IM+anti‑C5a) groups. A terminal deoxynucleotidyl transferase dUTP nick end labeling assay and hematoxylin and eosin staining were used to evaluate the morphological alterations in the articular cartilage and synovialis. Reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) analysis, immunohistochemical analysis and western blotting were used to evaluate C5a expression in the articular cartilage and synovialis. An ELISA was used to evaluate C5a‑induced alterations in interleukin (IL)‑1β, IL‑17A and tumor necrosis factor (TNF)‑α levels in the serum and joint fluid. The results demonstrated that knee joint immobilization induced destruction of knee joint synovial fluid and cartilage in the IM and IM+anti‑C5a antibody groups. Immobilization significantly increased the expression levels of C5a in serum and joint fluid in the IM group. Immunohistochemistry, western blotting and RT‑qPCR analysis illustrated markedly increased expression of C5a in the IM group. Immobilization markedly increased the IL‑1β, IL‑17A and TNF‑α expression levels in the serum and joint fluid in the IM group. Anti‑C5a was able to decrease immobilization‑induced alterations in morphology and cytokines compared with the IM group. The expression of C5a was increased in synoviocytes and joint cartilage in the IM model. Pro‑inflammatory cytokines, including TNF‑α and IL‑1β were released in the activated synoviocytes via the induction of C5a, suggesting that C5a serves an important role in joint inflammatory processes.

A Self-Management Programme of Activity Coping and Education - SPACE for COPD(C) - in primary care: The protocol for a pragmatic trial.

PubMed

Bourne, Claire LA; Kanabar, Pratiksha; Mitchell, Katy; Schreder, Sally; Houchen-Wolloff, Linzy; Bankart, M John G; Apps, Lindsay; Hewitt, Stacey; Harvey-Dunstan, Theresa; Singh, Sally J

2017-07-10

National guidance for chronic obstructive pulmonary disease (COPD) suggests that self-management support be provided for patients. Our institution has developed a standardised, manual-based, supported self-management programme: Self-Management Programme of Activity Coping and Education (SPACE for COPD(C)). SPACE was previously piloted on a 1-2-1 basis, delivered by researchers, to individuals with COPD. Discussions with stakeholders highlighted considerable interest in delivering the SPACE for COPD(C) intervention as a group-based self-management programme facilitated by healthcare professionals (HCPs) in primary care settings. The study aims are to explore the feasibility, acceptability and efficacy for the intervention to be delivered and supported by HCPs and to examine whether group-based delivery of SPACE for COPD(C), with sustained support, improves patient outcomes following the SPACE for COPD(C) intervention. A prospective, multi-site, single-blinded randomised controlled trial (RCT) will be conducted, with follow-up at 6 and 9 months. Participants will be randomly assigned to either the control group (usual care) or intervention group (a six-session, group-based SPACE for COPD(C)self-management programme delivered over 5 months). The primary outcome is change in COPD assessment test at 6 months.A discussion session will be conducted with HCPs who deliver the intervention to discuss and gain insight into any potential facilitators/barriers to implementing the intervention in practice. Furthermore, we will conduct semi-structured focus groups with intervention participants to understand feasibility and acceptability. All qualitative data will be analysed thematically. The project has received a favourable opinion from South Hampshire B Research Ethics Committee, REC reference: 14/SC/1169 and full R&D approval from the University Hospitals of Leicester NHS Trust: 152408.Study results will be disseminated through appropriate peer-reviewed journals, national and international respiratory/physiotherapy conferences, via the Collaboration and Leadership in Applied Health Research and Care and through social media. ISRCTN17942821; pre-results. © 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.

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.

Managing player load in professional rugby union: a review of current knowledge and practices.

PubMed

Quarrie, Kenneth L; Raftery, Martin; Blackie, Josh; Cook, Christian J; Fuller, Colin W; Gabbett, Tim J; Gray, Andrew J; Gill, Nicholas; Hennessy, Liam; Kemp, Simon; Lambert, Mike; Nichol, Rob; Mellalieu, Stephen D; Piscione, Julien; Stadelmann, Jörg; Tucker, Ross

2017-03-01

The loads to which professional rugby players are subjected has been identified as a concern by coaches, players and administrators. In November 2014, World Rugby commissioned an expert group to identify the physical demands and non-physical load issues associated with participation in professional rugby. To describe the current state of knowledge about the loads encountered by professional rugby players and the implications for their physical and mental health. The group defined 'load' as it relates to professional rugby players as the total stressors and demands applied to the players. In the 2013-2014 seasons, 40% of professional players appeared in 20 matches or more, and 5% of players appeared in 30 matches or more. Matches account for ∼5-11% of exposure to rugby-related activities (matches, team and individual training sessions) during professional competitions. The match injury rate is about 27 times higher than that in training. The working group surmised that players entering a new level of play, players with unresolved previous injuries, players who are relatively older and players who are subjected to rapid increases in load are probably at increased risk of injury. A mix of 'objective' and 'subjective' measures in conjunction with effective communication among team staff and between staff and players was held to be the best approach to monitoring and managing player loads. While comprehensive monitoring holds promise for individually addressing player loads, it brings with it ethical and legal responsibilities that rugby organisations need to address to ensure that players' personal information is adequately protected. Administrators, broadcasters, team owners, team staff and the players themselves have important roles in balancing the desire to have the 'best players' on the field with the ongoing health of players. In contrast, the coaching, fitness and medical staff exert significant control over the activities, duration and intensity of training sessions. If load is a major risk factor for injury, then managing training loads should be an important element in enabling players to perform in a fit state as often as possible. 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/.

Synthesis of labeled oxalic acid derivatives

DOEpatents

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.

C5 nerve palsy after posterior reconstruction surgery: predictive risk factors of the incidence and critical range of correction for kyphosis.

PubMed

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.

Developing Consensus-Based Priority Outcome Domains for Trials in Kidney Transplantation: A Multinational Delphi Survey With Patients, Caregivers, and Health Professionals.

PubMed

Sautenet, Bénédicte; Tong, Allison; Manera, Karine E; Chapman, Jeremy R; Warrens, Anthony N; Rosenbloom, David; Wong, Germaine; Gill, John; Budde, Klemens; Rostaing, Lionel; Marson, Lorna; Josephson, Michelle A; Reese, Peter P; Pruett, Timothy L; Hanson, Camilla S; O'Donoghue, Donal; Tam-Tham, Helen; Halimi, Jean-Michel; Shen, Jenny I; Kanellis, John; Scandling, John D; Howard, Kirsten; Howell, Martin; Cross, Nick; Evangelidis, Nicole; Masson, Philip; Oberbauer, Rainer; Fung, Samuel; Jesudason, Shilpa; Knight, Simon; Mandayam, Sreedhar; McDonald, Stephen P; Chadban, Steve; Rajan, Tasleem; Craig, Jonathan C

2017-08-01

Inconsistencies in outcome reporting and frequent omission of patient-centered outcomes can diminish the value of trials in treatment decision making. We identified critically important outcome domains in kidney transplantation based on the shared priorities of patients/caregivers and health professionals. In a 3-round Delphi survey, patients/caregivers and health professionals rated the importance of outcome domains for trials in kidney transplantation on a 9-point Likert scale and provided comments. During rounds 2 and 3, participants rerated the outcomes after reviewing their own score, the distribution of the respondents' scores, and comments. We calculated the median, mean, and proportion rating 7 to 9 (critically important), and analyzed comments thematically. One thousand eighteen participants (461 [45%] patients/caregivers and 557 [55%] health professionals) from 79 countries completed round 1, and 779 (77%) completed round 3. The top 8 outcomes that met the consensus criteria in round 3 (mean, ≥7.5; median, ≥8; proportion, >85%) in both groups were graft loss, graft function, chronic rejection, acute rejection, mortality, infection, cancer (excluding skin), and cardiovascular disease. Compared with health professionals, patients/caregivers gave higher priority to 6 outcomes (mean difference of 0.5 or more): skin cancer, surgical complications, cognition, blood pressure, depression, and ability to work. We identified 5 themes: capacity to control and inevitability, personal relevance, debilitating repercussions, gaining awareness of risks, and addressing knowledge gaps. Graft complications and severe comorbidities were critically important for both stakeholder groups. These stakeholder-prioritized outcomes will inform the core outcome set to improve the consistency and relevance of trials in kidney transplantation.

Toward Stronger Ties: The AAS Working Group on Professional-Amateur Collaboration

NASA Astrophysics Data System (ADS)

Beatty, J. K.; White, J. C.

2004-05-01

Experienced amateur astronomers represent a unique resource for their professional counterparts. Many knowledgeable amateurs now have telescopes in the 0.2- to 0.5-m class equipped with high-grade CCDs and software. To foster stronger ties between these observers and astronomical researchers, the AAS Council established a Working Group for Professional-Amateur Collaboration (WGPAC) during the Society's 193rd meeting in January 1999. Initially given a five-year charter, the WGPAC was made permanent at the 202nd Council meeting in May 2003. Since its creation the WGPAC has coordinated its activities with major amateur-astronomy organizations, sponsored a tutorial workshop at the annual meeting of the Astronomical League, laid the groundwork for a national registry of highly qualified amateur observers, and promoted pro-am collaborations through articles in the AAS Newsletter and leading amateur-astronomy publications.

Occupation and mental health in a national UK survey.

PubMed

Stansfeld, Stephen Alfred; Rasul, F R; Head, J; Singleton, N

2011-02-01

To measure the prevalence of common mental disorder (CMD) by occupation in a representative sample of Great Britain and to identify occupations with increased and decreased risk of CMD. A cross-sectional interview-based survey was carried out including 5,497 working male and female respondents, 16-64 years from a stratified random survey of private households in Britain. Occupations were classified by the Standard Occupational Classification (SOC) into four groups: major, sub-major, minor and constituent unit groups. Common Mental Disorder was measured by the Revised Clinical Interview Schedule. Major SOC groups with higher prevalence of common mental disorder included clerical and secretarial, sales, and personal and protective services whereas craft and related, 'other' professional occupations and plant and machine operatives had lower prevalence compared to 13% overall prevalence in all adults. In sub-major SOC groups managers and administrators, teaching professionals, clerical and secretarial, 'other' sales and personal service occupations had higher prevalence whereas many professional and skilled occupations had lower prevalence. Specific SOC unit groups with higher prevalence included primary and secondary teachers, welfare community, youth workers, security staff, waiters, bar staff, nurse auxiliaries and care assistants. General managers in government and large organizations (OR=2.79, 95% CI 1.41-5.54), managers in transport and storing (OR=2.44, 95% CI 1.18-5.03), buyers and mobile sales persons (OR=2.48, 95% CI 1.09-5.60), sales occupations (NES) (OR=2.78, 95% CI 1.25-6.19) and clerks (NES) (OR=2.71, 95% CI 1.59-4.61) had increased risk of common mental disorder relative to specialist managers adjusting for social and financial factors and physical ill-health. Occupations with higher risk of common mental disorder may be typified by high levels of job demands, especially emotional demands and lack of job security. The reasons why occupations have low rates of common mental disorder are varied and may include high levels of job discretion, good job training and clearly defined job tasks.

High Levels of Soluble C5b-9 Complex in Dialysis Fluid May Predict Poor Prognosis in Peritonitis in Peritoneal Dialysis Patients

PubMed Central

Mizuno, Masashi; Suzuki, Yasuhiro; Higashide, Keiko; Sei, Yumi; Iguchi, Daiki; Sakata, Fumiko; Horie, Masanobu; Maruyama, Shoichi; Matsuo, Seiichi; Morgan, B. Paul; Ito, Yasuhiko

2017-01-01

Background We searched for indicators to predict the prognosis of infectious peritonitis by measuring levels of complement proteins and activation products in peritoneal dialysis (PD) fluid (PDF) of patients at early stages of peritonitis. We retrospectively analyzed the relationship between the levels of sC5b-9, C3 and C4 in PDF and the subsequent clinical prognosis. Methods We measured levels of sC5b-9, C3 and C4 in PDF on days 1, 2 and 5 post-onset of peritonitis in 104 episodes of infectious peritonitis in PD patients from 2008 and retrospectively compared levels with clinical outcomes. Further analysis for the presence of causative microorganisms or to demonstrate bacterial culture negative peritonitis was performed and correlated with change of levels of sC5b-9 in PDF. Results When PD patients with peritonitis were divided into groups that either failed to recover from peritonitis and were finally withdrawn from PD (group 1; n = 25) or recovered (group 2; n = 79), levels of sC5b-9, C3 and C4 in PDF were significantly higher in group 1 patients compared to those in group 2 on day5. Analysis of microorganisms showed significantly higher sC5b-9 levels in PDF of peritonitis cases caused by culture negative peritonitis in group 1 compared with group 2 when we analyzed for individual microorganisms. Of note, on day5, the sC5b-9 levels in PDF were similarly high in peritonitis caused by fungi or other organisms. Conclusion Our results suggested that levels of complement markers in PDF, especially sC5b-9, have potential as surrogate markers to predict prognosis of PD-related peritonitis. PMID:28046064

Perceptions of Elder Abuse From Community-Dwelling Older Persons and Professionals Working in Western Switzerland.

PubMed

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.

Effect of eight weeks of upper-body plyometric training during the competitive season on professional female volleyball players.

PubMed

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.

Social Media in Professional Medicine: New Resident Perceptions and Practices

PubMed Central

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

Quality in dementia care: A cross sectional study on the Bio-Psycho-Social competencies of health care professionals.

PubMed

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.

Reading Balint group work through Lacan's theory of the four discourses.

PubMed

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.

Are seasonal and income variations accountable for bowel and bladder dysfunction symptoms in children?

PubMed

Franco, Israel; Franco, Jacob; Harding, Sylvia; Rosconi, Dina; Cupelli, Emily; Collett-Gardere, Therese

2017-01-01

Certain illnesses tend to occur more commonly at certain times of the year. It is also known that individuals of different socioeconomic groups have a predilection for physical ailments that in some cases may be related to poor access to healthcare or may be related to environmental or work related causes. We hypothesized that there may be a difference between patients from season to season and from different socioeconomic groups and their presenting lower urinary tract symptoms (LUTS). We reviewed our electronic medical record going back for 5 years, selecting out all patients who presented to all 10 of our offices in a wide geographic area that covers 22 million people of all races and income levels in the Tristate area of New York. We identified 13,346 patients, 6,010 males and 6,957 females, and 379 were excluded for not meeting age inclusion criteria. The descriptive statistics based on age, median income for both males and females can be found in Tables I, II, III, and IV, respectively. Of note, males were older than females at presentation (8.1 vs. 6.9 years) with no difference in median incomes between families. There were more UTIs in females and more dysuria complaints in males. Urinary incontinence also appeared to be more prevalent in females than males, while males had more issues with fecal soiling than the females. What was obvious was that urgency and frequency was positively correlated with high income groups. On the other hand urinary incontinence represented either by itself or combined with UUI was more prevalent in the high school group. Fecal soiling was also more prevalent in the high school group. UTIs were more prevalent in the high school group but surprisingly there was no difference in patients that were not able to empty their bladders. Conversely we found that constipation was more prevalent in the professional group than in the other groups which is the opposite of the FS findings. Lastly dysuria appeared to be more prevalent in the P group. It is clear that there are marked differences in the results between high school income and professional income groups in particular with the U and F, along with C which correlate with high income professionals' children. UUI, UI, UTI, along with FS are associated with high school income parents. Neurourol. Urodynam. 36:148-154, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Legal professionals and witness statements from people with a suspected mental health diagnosis.

PubMed

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.

Playing-Related Musculoskeletal Disorders of Professional Orchestra Musicians from the North of Portugal: Comparing String and Wind Musicians.

PubMed

Sousa, Cláudia Maria; Machado, Jorge Pereira; Greten, Henry Johannes; Coimbra, Daniela

2017-04-28

It is well known that musicians are a group prone to suffer from playing-related musculoskeletal disorders. Professional orchestra musicians play for several hours a week and have to fight against pain caused by their profession. The aim of this study was to explore and describe self-reported complaints among professional orchestra musicians and to compare its intensity and the prevalence between string and wind instruments. Hundred and twelve professional orchestra musicians from the three main professional orchestras from the North of Portugal were individually interviewed about the prevalence and the intensity (measured by verbal numerical scale for pain) of their playing-related musculoskeletal disorders. About two third (62.5%) of the interviewed musicians presented playing-related musculoskeletal disorders during the time of the interview. Despite there are no significant statistic values between groups, results suggested that playing-related musculoskeletal disorders are more common in string players and more intense in wind players. Referring to the prevalence of playing-related musculoskeletal disorders, our data is in line with other studies from different countries. More than half of professional orchestra musicians in the North of Portugal are playing with a mild to moderate pain. Future studies focusing on working-related problems among professional orchestra musicians in Portugal would be useful to better describe the problem of occupational diseases among performing artist.

Effect of laser irradiation on crystalline structure of enamel surface during whitening treatment with hydrogen peroxide.

PubMed

Son, Jung-Hyun; An, Ji-Hae; Kim, Byung-Kuk; Hwang, In-Nam; Park, Yeong-Joon; Song, Ho-Jun

2012-11-01

This study is to evaluate the effect of laser activation on the whitening and crystalline structure of enamel surface during whitening treatment with hydrogen peroxide. Bovine teeth were treated with whitening gel containing 35% hydrogen peroxide. A whitening gel was applied on the enamel surface for a period of 5 min, and then irradiated using a diode laser (740 nm) during whitening treatment for 0, 30, 60, 120 and 180s for the GL0-W, GL30-W, GL60-W, GL120-W and GL180-W groups, respectively. The total whitening application time was 30 min for all groups. Laser-irradiated enamel groups showed a similar lightness compared to the GL0-W group. The thickness of porous layer observed on the enamel surface of GL0-W group was decreased by increasing the laser irradiation time. While the Ca and P contents of the GL0-W group were lower than those of the non-whitening treated group (GL0-C), the Ca and P contents of the GL180-W group were similar to those of the GL180-C group. The enamel crystallinity was dramatically decreased by whitening treatment without laser irradiation. However, the decrease of crystallinity was protected by laser irradiation during whitening treatment. Raman measurement verified that laser irradiation could prevent the loss of mineral compositions on enamel and maintain its crystalline structure. The professional whitening treatment with hydrogen peroxide and diode laser activation improves not only the whitening effect but also protects the change of enamel structure compared to the treatment with only gel. Copyright © 2012 Elsevier Ltd. All rights reserved.

42 CFR 456.206 - Organization and composition of UR committee; disqualification from UR committee membership.

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…

Comparison of flunixin meglumine and meloxicam influence on postoperative and oxidative stress in ovariohysterectomized bitches.

PubMed

Yilmaz, O; Korkmaz, M; Jaroszewski, J J; Yazici, E; Ulutas, E; Saritas, Z K

2014-01-01

The aim of this study was to compare the effect of flunixin meglumine (FM) and meloxicam (M) on postoperative and oxidative stress in ovariohysterectomized bitches. Twenty four bitches were divided into three groups (n = 8 in each) and treated during premedication as follows: FM (2.2 mg/kg, iv, Fluvil, Vilsan, Turkey), M (0.2 mg/kg, sc, Maxicam, Sanovel, Turkey) or 0.9% saline (1 ml, iv, IE, Turkey)--control (C) group. The concentrations of serum cortisol, nitric oxide (NO), malondialdehyde (MDA), antioxidant potential (AOP) and glutation (GSH) were measured in blood samples collected during incision (0 h), closure of incision line (0.5 h) and 1, 2.5, 12 and 24 hours after incision. It was observed that cortisol level was higher at 0.5, 1 and 2.5 h in group C (p < 0.05), 0.5 h in group FM (p < 0.001), and 1 and 2.5 h in group M (p < 0.01), as compared to that determine at 0 h. Group C showed higher cortisol level during 0.5 h (p < 0.05) than that found in the other groups. Group FM displayed lower levels during 1 h (p < 0.01) and 2.5 h (p < 0.05) as compared to those observed in other groups. Concentrations of MDA, AOP and GSH between all the groups did not show any significant differences. MDA level was higher at 0.5 and 1 h in group M (p < 0.05) than that found in group C and it was the lowest at 2.5 h in group C (p < 0.05). AOP was higher at 2.5 h in group FM and M (p < 0.05) than that observed in group C, and at 12 and 24 h in group M than that found in group C and FM. GSH did not show any significant differences between the groups. NO level in group FM after 12 h was higher (p < 0.05) than that at 0.5, 1 and 24 h. Moreover, NO level was lower at 0.5 (p < 0.01), 1 (p < 0.05) and 24 h (p < 0.05) in group FM than that observed in group C and M. In conclusion, flunixin meglumine decreases cortisol and NO levels more efficiently than meloxicam. Therefore, it is suggested that postoperative stress following ovariohysterectomy may be prevented by flunixin meglumine in bitches.

[Specialist's training for laparoscopic surgery in Wet-lab educational operating theatre].

PubMed

Khubezov, D A; Sazhin, V P; Ogoreltsev, A Yu; Puchkov, D K; Rodimov, S V; Ignatov, I S; Tazina, T V; Evsyukova, M A

2018-01-01

To develop system for students training in laparoscopic surgery by using of Wet-lab educational operating theatre. We have launched laparoscopic surgery teaching program for students of Ryazan State Medical University. This system includes several stages. At the first stage professional selection was carried out on 'dry' laparoscopic simulators among III-IV-year students of medical faculty. So, 10 people were selected. The second stage included theoretical and practical parts consisting of development of basic laparoscopic skills on 'dry' simulators. 5 students who scored the maximum points were admitted to the next stage. The third stage is working in Wet-lab operating theatre with a mentor. There were 10 sessions on 10 laboratory pigs. Final stage of our study compares two groups of participants: main group - 5 students who underwent above-described program and control group of 5 residents without experience for laparoscopic operations. The participants of the main group had significantly higher OSATS score compared with another group (20 vs. 10; p<0.05). Movements effectiveness estimated by measuring of movements trajectory total length was also higher in main group than in control group (6 vs. 20; p<0.05). Experts' subjective assessment according to 10-point scale was also higher for students than for interns (9 vs. 5, p<0.05). Participants in the main group required significantly less time to complete the task compared with the control group (40 vs. 90 minutes, p<0.05). Our experience has shown that training system with Wet-lab operating theatre is effective for quick and efficient training of medical students in main laparoscopic procedures. In our opinion, introduction of students into 'advanced' surgery from early age will make it possible to get finally highly professional specialists.

Apolipoprotein A5 and apolipoprotein C3 single nucleotide polymorphisms are correlated with an increased risk of coronary heart disease: a case-control and meta-analysis study.

PubMed

Yang, Guang; Lei, Ming-Ming; Yu, Chun-Lei; Liu, Xiao-Xiao; An, Zhe; Song, Chun-Li

2015-09-19

Triglycerides (TGs) are proatherogenic lipoproteins involving the risk of coronary heart disease (CHD), while apolipoprotein A5 (APOA5) and apolipoprotein C3 (APOC3) are main lipoproteins composing TG-rich lipoproteins. In this study, we aim to explore the correlation of CHD with APOA5 -1131 T > C and APOC3 -455 T > C single nucleotide polymorphisms (SNPs). A sum of 210 CHD patients, hospitalized between Jan. 2013 and Mar. 2015 at China-Japan Union Hospital, Jilin University, were selected as our case group and 223 healthy individuals who had physical examination at same hospital at the same period were selected as control group. The frequency distribution of genotypes of APOA5 -1131 T > C and APOC3 -455 T > C SNPs were measured by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The Stata 12.0 software was utilized for statistical analyses. There was no significant difference on age and sex between case and control group (P > 0.05). History of smoking, drinking, hypertension and diabetes mellitus, body mass index and levels of TG and fasting blood sugar in case group were shown to be higher than control group (P < 0.05), while levels of total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol in case group were lower than control group (P < 0.05). Both CC and TC' + CC frequencies of APOA5 -1131 T > C and APOC3 -455 T > C in case group were higher compared to control group (both P < 0.05). Additionally, T allele frequencies of the two SNPs in case group were lower than control group, while C allele in case group has higher frequencies compared to control group (both P < 0.05). The results of meta-analysis under allele and dominant models showed that APOA5 -1131 T > C and APOC3 -455 T > C SNPs are likely to increase the risk of CHD (both P < 0.05). APOA5 -1131 T > C and APOC3 -455 T > C SNPs may play potent roles in the development and progression of CHD.

Newly graduated nurses' job satisfaction: comparison with allied hospital professionals, social workers, and elementary school teachers.

PubMed

Park, Mihyun; Lee, Ji Yun; Cho, Sung-Hyun

2012-09-01

The purposes of this study are to examine differences in job satisfaction among professional groups including nurses, allied hospital professionals, social workers, and elementary school teachers, and to identify specific characteristics of job satisfaction of nurses. The study design was a cross-sectional exploratory study using secondary data analysis with the 2009 Graduates Occupational Mobility Survey. The sample was female new graduates. The differences in job satisfaction among professional groups were analyzed using logistic regression (satisfied vs. not satisfied). Overall, 41.5% of nurses, 50.1% of allied hospital professionals, 58.2% of social workers, and 89% of elementary school teachers were satisfied with their job. Nurses were significantly less satisfied than the other professionals in 5 of the 11 job characteristics and had the lowest odds ratio (OR) when compared with elementary school teachers: work content (OR = 0.197, 95% CI [0.128, 0.304]), physical work environment (OR = 0.353, 95% CI [0.236, 0.529]), working hours (OR = 0.054, 95% CI [0.033, 0.088]), personal growth (OR = 0.242, 95% CI [0.160, 0.366]), and autonomy (OR = 0.188, 95% CI [0.123, 0.288]). Work content, physical work environment, interpersonal relationship, advancement system, and autonomy were significantly associated with the overall job satisfaction of nurses. Relatively dissatisfying job characteristics in nursing work environment that were significant predictors for nurses' job satisfaction should be improved. Newly graduated nurses are at risk for job dissatisfaction. This can result in high turnover rates and can exacerbate the nursing shortage. Efforts to improve the work environment are needed. Copyright © 2012. Published by Elsevier B.V.

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…

Effects of neck strength training on isometric neck strength in rugby union players.

PubMed

Geary, Kevin; Green, Brian S; Delahunt, Eamonn

2014-11-01

To investigate the effectiveness of a neck strengthening program on the isometric neck strength profile of male rugby union players. Controlled laboratory study. Professional rugby union club. Fifteen professional and 10 semiprofessional rugby union players. The 15 professional players undertook a 5-week neck strengthening intervention, which was performed twice per week, whereas the 10 semiprofessional players acted as the control group. Isometric strength of the neck musculature was tested using a hand-held dynamometer, for flexion (F), extension (E), left-side flexion (LSF), and right-side flexion (RSF). Preintervention and postintervention evaluations were undertaken. No significant between-group differences in isometric neck strength were noted preintervention. A significant main effect for time was observed (P < 0.05), whereby the intervention group increased isometric neck strength in all planes after the 5-week intervention (F preintervention = 334.45 ± 39.31 N vs F postintervention 396.05 ± 75.55 N; E preintervention = 606.19 ± 97.34 vs E postintervention = 733.88 ± 127.16 N; LSF preintervention = 555.56 ± 88.34 N vs LSF postintervention = 657.14 ± 122.99 N; RSF preintervention = 570.00 ± 106.53 N vs RSF postintervention = 668.00 ± 142.18 N). No significant improvement in neck strength was observed for control group participants. The results of the present study indicate that a 5-week neck strengthening program improves isometric neck strength in rugby union players, which may have implications for injury prevention, screening, and rehabilitation. The strengthening program described in the present study may facilitate rehabilitation specialists in the development of neck injury prevention, screening, and rehabilitation protocols.

Effect of depth and duration of cooling on deaths in the NICU among neonates with hypoxic ischemic encephalopathy: a randomized clinical trial.

PubMed

Shankaran, Seetha; Laptook, Abbot R; Pappas, Athina; McDonald, Scott A; Das, Abhik; Tyson, Jon E; Poindexter, Brenda B; Schibler, Kurt; Bell, Edward F; Heyne, Roy J; Pedroza, Claudia; Bara, Rebecca; Van Meurs, Krisa P; Grisby, Cathy; Huitema, Carolyn M Petrie; Garg, Meena; Ehrenkranz, Richard A; Shepherd, Edward G; Chalak, Lina F; Hamrick, Shannon E G; Khan, Amir M; Reynolds, Anne Marie; Laughon, Matthew M; Truog, William E; Dysart, Kevin C; Carlo, Waldemar A; Walsh, Michele C; Watterberg, Kristi L; Higgins, Rosemary D

Hypothermia at 33.5°C for 72 hours for neonatal hypoxic ischemic encephalopathy reduces death or disability to 44% to 55%; longer cooling and deeper cooling are neuroprotective in animal models. To determine if longer duration cooling (120 hours), deeper cooling (32.0°C), or both are superior to cooling at 33.5°C for 72 hours in neonates who are full-term with moderate or severe hypoxic ischemic encephalopathy. A randomized, 2 × 2 factorial design clinical trial performed in 18 US centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network between October 2010 and November 2013. Neonates were assigned to 4 hypothermia groups; 33.5°C for 72 hours, 32.0°C for 72 hours, 33.5°C for 120 hours, and 32.0°C for 120 hours. The primary outcome of death or disability at 18 to 22 months is ongoing. The independent data and safety monitoring committee paused the trial to evaluate safety (cardiac arrhythmia, persistent acidosis, major vessel thrombosis and bleeding, and death in the neonatal intensive care unit [NICU]) after the first 50 neonates were enrolled, then after every subsequent 25 neonates. The trial was closed for emerging safety profile and futility analysis after the eighth review with 364 neonates enrolled (of 726 planned). This report focuses on safety and NICU deaths by marginal comparisons of 72 hours' vs 120 hours' duration and 33.5°C depth vs 32.0°C depth (predefined secondary outcomes). The NICU death rates were 7 of 95 neonates (7%) for the 33.5°C for 72 hours group, 13 of 90 neonates (14%) for the 32.0°C for 72 hours group, 15 of 96 neonates (16%) for the 33.5°C for 120 hours group, and 14 of 83 neonates (17%) for the 32.0°C for 120 hours group. The adjusted risk ratio (RR) for NICU deaths for the 120 hours group vs 72 hours group was 1.37 (95% CI, 0.92-2.04) and for the 32.0°C group vs 33.5°C group was 1.24 (95% CI, 0.69-2.25). Safety outcomes were similar between the 120 hours group vs 72 hours group and the 32.0°C group vs 33.5°C group, except major bleeding occurred among 1% in the 120 hours group vs 3% in the 72 hours group (RR, 0.25 [95% CI, 0.07-0.91]). Futility analysis determined that the probability of detecting a statistically significant benefit for longer cooling, deeper cooling, or both for NICU death was less than 2%. Among neonates who were full-term with moderate or severe hypoxic ischemic encephalopathy, longer cooling, deeper cooling, or both compared with hypothermia at 33.5°C for 72 hours did not reduce NICU death. These results have implications for patient care and design of future trials. clinicaltrials.gov Identifier: NCT01192776.

Psychometric evaluation of the Chinese version of the fear of intimacy with helping professionals scale

PubMed Central

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

The influence of a dentifrice containing a zinc salt and a nonionic antimicrobial agent on the maintenance of gingival health.

PubMed

Svatun, B; Saxton, C A; van der Ouderaa, F; Rölla, G

1987-09-01

The purpose of the present investigation was to test the concept that a dentifrice containing zinc citrate and Triclosan could maintain gingival health. The gingival health of 101 young predominately female student nurses in Oslo was brought to a high level by professional cleaning supported by oral hygiene instruction. The criterion of gingival health was less than or equal to 5 elicited bleeding sites from a full mouth assessment. The mean bleeding value attained for the whole group was 3.5. 2 balanced groups were formed, based on the initial number of elicited bleeding sites and plaque values. One group used the test dentifrice and the other group the placebo for 6 months, with an intermediate assessment after 3 months. The placebo group failed to maintain the standard of oral hygiene and gingival health that had been achieved by professional care. In contrast, the group using the test dentifrice for 6 months exhibited similar levels of plaque and gingival health to that observed at baseline following oral hygiene instruction. After 6 months, less than 7% of the subjects in the placebo group possessed healthy gingivae in contrast to 60% of the test group. Thus a dentifrice containing a zinc salt and nonionic germicide had successfully maintained gingival health in a group of young adults.

Integrated palliative care is about professional networking rather than standardisation of care: A qualitative study with healthcare professionals in 19 integrated palliative care initiatives in five European countries

PubMed Central

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

Taiwanese and Sri Lankan students' dimensions and discourses of professionalism.

PubMed

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.

Integrated palliative care is about professional networking rather than standardisation of care: A qualitative study with healthcare professionals in 19 integrated palliative care initiatives in five European countries.

PubMed

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.

Puncture Reduction in Percutaneous Transforaminal Endoscopic Discectomy with HE's Lumbar LOcation (HELLO) System: A Cadaver Study.

PubMed

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).

Which subgroups of fire fighters are more prone to work-related diminished health requirements?

PubMed

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.

Selective chemical labeling reveals the genome-wide distribution of 5-hydroxymethylcytosine.

PubMed

Song, Chun-Xiao; Szulwach, Keith E; Fu, Ye; Dai, Qing; Yi, Chengqi; Li, Xuekun; Li, Yujing; Chen, Chih-Hsin; Zhang, Wen; Jian, Xing; Wang, Jing; Zhang, Li; Looney, Timothy J; Zhang, Baichen; Godley, Lucy A; Hicks, Leslie M; Lahn, Bruce T; Jin, Peng; He, Chuan

2011-01-01

In contrast to 5-methylcytosine (5-mC), which has been studied extensively, little is known about 5-hydroxymethylcytosine (5-hmC), a recently identified epigenetic modification present in substantial amounts in certain mammalian cell types. Here we present a method for determining the genome-wide distribution of 5-hmC. We use the T4 bacteriophage β-glucosyltransferase to transfer an engineered glucose moiety containing an azide group onto the hydroxyl group of 5-hmC. The azide group can be chemically modified with biotin for detection, affinity enrichment and sequencing of 5-hmC-containing DNA fragments in mammalian genomes. Using this method, we demonstrate that 5-hmC is present in human cell lines beyond those previously recognized. We also find a gene expression level-dependent enrichment of intragenic 5-hmC in mouse cerebellum and an age-dependent acquisition of this modification in specific gene bodies linked to neurodegenerative disorders.

The efficiency of telemedicine to optimize metabolic control in patients with type 1 diabetes mellitus: Telemed study.

PubMed

Esmatjes, Enric; Jansà, Margarida; Roca, Daria; Pérez-Ferre, Natalia; del Valle, Laura; Martínez-Hervás, Sergio; Ruiz de Adana, Marisol; Linares, Francisca; Batanero, Ricardo; Vázquez, Federico; Gomis, Ramon; de Solà-Morales, Oriol

2014-07-01

This study evaluated the impact of an Internet-based telematic system on the economic and clinical management of patients with type 1 diabetes mellitus. This 6-month prospective, randomized, comparative, open, multicenter study included patients with type 1 diabetes >18 years old treated with multiple insulin doses and with a glycated hemoglobin (HbA1c) level of >8%. We compared an intervention group (IG) (two face-to-face and five telematic appointments) with a control group (CG) (seven face-to-face appointments). The variables studied were (1) patient and healthcare team costs, (2) metabolic control, (3) knowledge of diabetes, (4) quality of life, and (5) self-care treatment adherence. Of the 154 patients included, 118 (76.6%) completed the study (IG, 54; CG, 64). The time used by the CG to follow the program was 823±645 min versus 353±222 min in the IG (P<0.0001). Compared with the CG, the IG required less healthcare time from the professionals (288±105 min vs. 232±89 min; P<0.001). HbA1c improved in both groups (IG, 9.2±1.5% [77.0±17.0 mmol/mol] vs. 8.7±1.5% [71.6±17.0 mmol/mol] [P<0.001]; CG, 9.2±0.9% [77.0±10.0 mmol/mol] vs. 8.6±0.9% [70.5±10.0 mmol/mol] [P<0.001], as did knowledge and self-care treatment adherence. The use of interactive telematic appointments in subjects with type 1 diabetes and inadequate metabolic control is an efficient strategy, providing results comparable to those of face-to-face appointments in relation to improvement in glycemic control, knowledge acquisition, and self-care treatment adherence, with a significant reduction in the time used, especially by patients.

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)…

Local insufflation of warm humidified CO₂increases open wound and core temperature during open colon surgery: a randomized clinical trial.

PubMed

Frey, Joana M; Janson, Martin; Svanfeldt, Monika; Svenarud, Peter K; van der Linden, Jan A

2012-11-01

The open surgical wound is exposed to cold and dry ambient air resulting in heat loss through radiation, evaporation, and convection. Also, general and neuraxial anesthesia decrease the patient's core temperature. Despite routine preventive measures mild intraoperative hypothermia is still common and contributes to postoperative morbidity and mortality. We hypothesized that local insufflation of warm fully humidified CO(2) would increase both the open surgical wound and core temperature. Eighty-three patients undergoing open colon surgery were equally and parallelly randomized to either standard warming measures including forced-air warming, warm fluids, and insulation of limbs and head, or to additional local wound insufflation of warm (37°C) humidified (100% relative humidity) CO(2) at a laminar flow (10 L/min) via a gas diffuser. Wound surface and core temperatures were followed with a heat-sensitive infrared camera and a tympanic thermometer. The mean wound area temperature during surgery was 31.3°C in the warm humidified CO(2) group compared with 29.6°C in the control group (P < 0.001, 95% confidence interval [CI], 1.2°C to 2.3°C). Also, the mean wound edge temperature during surgery was 30.1°C compared with 28.5°C in the control group (P < 0.001, 95% CI, 0.2°C to 0.7°C). Mean core temperature before start of surgery was similar with 36.7°C ± 0.5°C in the warm humidified CO(2) group versus 36.6°C ± 0.5°C in the control group (95% CI, 0.4 to -0.1°C). At end of surgery, the 2 groups differed significantly with 36.9 ± 0.5°C in the warm humidified CO(2) group versus 36.3 ± 0.5°C in the control group (P < 0.001, 95% CI, 0.38°C to 0.82°C). Moreover, only 8 patients of 40 in the warm humidified CO(2) group had a core temperature <36.5°C (20%, 95% CI, 7 to 33%), whereas in the control group this was the case in 24 of 39 (62%, 95% CI, 46% to 78%, P = 0.001) patients (difference of the percentages between the groups 42%, 95% CI, 22% to 61%, P < 0.001). With a cutoff at <36.0°C none of the patients in the warm humidified CO(2) group compared with 7 patients (18%, 95% CI, 5% to 31%, P = 0.005) in the control group was hypothermic at end of surgery (difference of the percentages between the groups 18%, 95% CI, 6% to 30%, P = 0.005). The median (25th/75th percentile) operating time was 181.5 (147.5/288) minutes in the warm humidified CO(2) group versus 217 (149/288) minutes in the control group (P = 0.312). Clinical variables did not show any significant differences between the groups. Insufflation of warm fully humidified CO(2) in an open surgical wound cavity increases surgical wound and core temperatures and helps to maintain normothermia.

Median nerve fascicle transfer versus ulnar nerve fascicle transfer to the biceps motor branch in C5-C6 and C5-C7 brachial plexus injuries: nonrandomized prospective study of 23 consecutive patients.

PubMed

Cho, Alvaro Baik; Paulos, Renata Gregorio; de Resende, Marcelo Rosa; Kiyohara, Leandro Yoshinobu; Sorrenti, Luiz; Wei, Teng Hsiang; Bolliger Neto, Raul; Mattar Júnior, Rames

2014-10-01

The purpose of this study was to observe whether the results of the median nerve fascicle transfer to the biceps are equivalent to the classical ulnar nerve fascicle transfer, in terms of elbow flexion strength and donor nerve morbidity. Twenty-five consecutive patients were operated between March 2007 and July 2013. The patients were divided into two groups. In Group 1 (n = 8), the patients received an ulnar nerve fascicle transfer to the biceps motor branch. In Group 2 (n = 15), the patients received a median nerve fascicle transfer to the biceps motor branch. Two patients with follow-up less than six months were excluded. Both groups were similar regarding age (P = 0.070), interval of injury (P = 0.185), and follow-up period (P = 0.477). Elbow flexion against gravity was achieved in 7 of 8 (87.5%) patients in Group 1, versus 14 of 15 (93.3%) patients in Group 2 (P = 1.000). The level of injury (C5-C6 or C5-C7) did not affect anti-gravity elbow flexion recovery in both the groups (P = 1.000). It was concluded that the median nerve fascicle transfer to the biceps is as good as the ulnar nerve fascicle transfer, even in C5-C7 injuries. © 2014 Wiley Periodicals, Inc.

[The alteration of vitamin status of adult population of the Russisn Federation in 1987-2009 (to the 40th anniversary of the Laboratory of Vitamins and Minerals of Institute of Nutrition at Russian Academy of Medical Sciences)].

PubMed

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.

The Influence of an undergraduate scientific initiation programme onn the professional profile of new physicians.

PubMed

Joaquim Teles Cyrillo, Raphael; Setúbal, Sérgio; da Silva Júnior, Cyro Teixeira; Guillermo Coca Velarde, Luis; de Mattos, Ana Carolina Musser Tavares; Bezerra Cardoso, Renato Bergallo; Cardoso, Gilberto Perez

2010-01-01

This paper studies the influence of a Scientific Initiation Programme (SIP) on the professional profile of new doctors from a Brazilian university. Evaluate fifty-two new doctors divided into two groups matched by sex, age and academic performance and differing only in participation in the SIP. Professional and socioeconomic data were collected, including schooling of parents; average income before, during and after the medical course; current professional situation; results of exams for civil servant recruitment; and titles and degrees obtained after graduation. Significant differences were found only in civil servant recruitment exam results (p=0.0098) and in income after graduation (p=0.02), which were both higher in the non-SIP group. Only one doctor got a M.Sc. degree after graduation, but many of them in both groups obtained technical titles, and had papers presented at congresses or published. Apparently, taking part in a SIP led to lower income and worse civil servant recruitment exam results. However, this may only reflect a transient phase in a long-term process. New research currently under way will answer this remaining question, now that more time has elapsed since graduation. Rev Port Pneumol 2010; XVI (5): 797-808. © 2010 Sociedade Portuguesa de Pneumologia/SPP.

Study on Quality of IUD Services Provided by Trained Professionals at Teaching Institutes.

PubMed

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.

Systemic effects of whole-body cooling to 35 °C, 33.5 °C, and 30 °C in a piglet model of perinatal asphyxia: implications for therapeutic hypothermia.

PubMed

Kerenyi, Aron; Kelen, Dorottya; Faulkner, Stuart D; Bainbridge, Alan; Chandrasekaran, Manigandan; Cady, Ernest B; Golay, Xavier; Robertson, Nicola J

2012-05-01

The precise temperature for optimal neuroprotection in infants with neonatal encephalopathy is unclear. Our aim was to assess systemic effects of whole-body cooling to 35 °C, 33.5 °C, and 30 °C in a piglet model of perinatal asphyxia. Twenty-eight anesthetized male piglets aged <24 h underwent hypoxia-ischemia (HI) and were randomized to normothermia or cooling to rectal temperature (Trec) 35 °C, 33.5 °C, or 30 °C during 2-26 h after insult (n = 7 in each group). HR, MABP, and Trec were recorded continuously. Five animals cooled to 30 °C had fatal cardiac arrests. During 30 °C cooling, heart rate (HR) was lower vs. normothermia (P < 0.001). Although mean arterial blood pressure (MABP) did not vary between groups, more fluid boluses were needed at 30 °C than at normothermia (P < 0.02); dopamine use was higher at 30 °C than at normothermia or 35 °C (P = 0.005 and P = 0.02, respectively). Base deficit was increased at 30 °C at 12, 24, and 36 h vs. all other groups (P < 0.05), pH was acidotic at 36 h vs. normothermia (P = 0.04), and blood glucose was higher for the 30 °C group at 12 h vs. the normothermia and 35 °C groups (P < 0.05). Potassium was lower at 12 h in the 30 °C group vs. the 33.5 °C and 35 °C groups. There was no difference in cortisol level between groups. Cooling to 30 °C led to metabolic derangement and more cardiac arrests and deaths than cooling to 33.5 °C or 35 °C. Inadvertent overcooling should be avoided.

Agencies and Organizations. Made in B.C.: A History of Postsecondary Education in British Columbia. Volume 6

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…

78 FR 23318 - Trust for Professional Managers and Aurora Investment Management L.L.C.; Notice of Application

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...

Comparative analysis of endothelial cell loss following phacoemulsification in pupils of different sizes.

PubMed

Maggon, Rakesh; Bhattacharjee, Raghudev; Shankar, Sandeep; Kar, Rajesh Chandra; Sharma, Vivek; Roy, Shyamal

2017-12-01

To compare Endothelial cell(EC) loss following Phacoemulsification (PKE) in pupils of different sizes. A prospective double masked observational study in which a total of 150 eyes of 150 patients between 50 & 70 years of age with senile cataract of nuclear sclerosis grade II were enrolled. Patients were allocated into three groups of 50 eyes each in Group A (pupil size <5 mm), Group B (pupil size 5-7 mm) and Group C (pupil size >7 mm). Pupillary size was measured by determining the height of slit on slit-lamp biomicroscope examination. PKE was done by the same expert surgeon using vertical chop technique and a foldable intraocular lens was implanted in the capsular bag. Corneal EC count and pachymetry were performed twice and average of 2 readings was taken for the purpose of this study. Measurements were taken preoperatively and postoperatively on day 1, day 7 and day 30. The mean EC count loss on postoperative day 1 in Group A was 19.45%, Group B 14.89%, Group C 10.19% with statistical significant difference between Group A and Group B, as also Group A and Group C. The difference was not significant between Group B and Group C, though there was a fall in EC count in Group C as well. Increase in corneal thickness on postoperative day 1 in group A was 5.43%, Group B 3.55%, Group C 2.14% with statistical significant difference between Group A and Group B, as also Group A and Group C with no difference in Group B and Group C. PKE done in eyes with maximal pupillary dilatation of <5 mm causes a greater EC loss and results in thicker corneas postoperatively as compared to eyes with pupillary dilatation of >5 mm at the end of one month.

Speed ratio but cabin temperature positively correlated with increased heart rates among professional drivers during car races.

PubMed

Yanagida, Ryo; Takahashi, Kiichi; Miura, Masaru; Nomura, Masahiro; Ogawa, Yojiro; Aoki, Ken; Iwasaki, Ken-Ichi

2016-11-01

The present study measures heart rate (HR) on a number of professional race-car drivers during actual car races through annual seasons to test hypotheses that faster relative speed and higher cabin temperature would induce higher HR. Heart rates in fifteen male drivers (31.2 ± 5.5 years old) were obtained by chest-strap sensors during official-professional 13 races. Average HR was calculated while the driver was racing from the start to the end of each race. The average HR during races was 164.5 ± 15.1 beats min -1 and the average amount of time each driver spent driving per race was 54.2 ± 13.7 min. Average HR significantly and positively correlated with mean speed ratio (P < 0.001), but not with the average cabin temperatures (P = 0.533, range 25.6-41.8 °C) by the multiple linear regression analysis. Both average HR and mean speed ratio were significantly lower under wet, than dry conditions (151.9 ± 16.5 vs. 168.3 ± 12.5 beats min -1 , 86.9 ± 4.4 vs. 93.4 ± 1.5 %). The cardiovascular system of drivers is considerably stressed at extremely high HR. This high average HR positively correlated with mean speed ratio, suggesting that faster driving speed would induce greater cardiovascular stress to professional drivers during actual races. However, contrary to our hypothesis, cabin temperature was not significantly correlated with average HR. It is speculated that direct body cooling systems used in this professional race category work well against increases in HR by thermal stress under the temperature range found herein.

[Team cohesiveness: opinions of a group of primary health care professionals from Salamanca].

PubMed

González, F J; de Cabo, A; Morán, M J; Manzano, J M

1993-04-01

To assess the view of a group of Primary care professionals on their level of perception of group cohesiveness in their teams' work dynamic. A descriptive and sectional study. Four urban health centres in Salamanca with a recognised teaching activity. Both health professionals and those outside the Health Service, working in Primary Care, who had been members of their teams for more than a year (N = 90). Descriptive statistics and "Chi squared" tests were employed. 72%. A high level of agreement on the need for team work (95.23%). They perceived their group cohesiveness as being very low (84.21% affirmed that they encounter problems of cohesiveness). The main statements concerning this lack of cohesiveness were: "lack of common objectives" (25.5%), "intolerance between workers" (20.13%), "work not shared" (19.46%) and "the taking of decisions individually" (19.44%). The main causes given were: lack of support from Management (23.74%) and too little training for team work (21.58%). There is a high degree of conviction that the team work model is the most efficacious way of developing Primary Care. However in three of the four teams questioned, there were serious problems preventing the teams' reaching an adequate level of group cohesiveness.

KNOWLEDGE AND ATTITUDE OF HEALTH CARE WORKERS TOWARD PATIENTS WITH HEPATITIS C INFECTION.

PubMed

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.

[Professionalization of surgical education in the daily clinical routine. Training concept of the Surgical Working Group for Teaching of the German Society of Surgery].

PubMed

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.

Palliative medicine Death Rounds: small group learning on a vital subject.

PubMed

Kitzes, Judith A; Kalishman, Summers; Kingsley, Darra D; Mines, Jan; Lawrence, Elizabeth

The medical student's experience with patients' dying and death has profound impact on personal and professional development. Death Rounds at the University of New Mexico School of Medicine is a small group educational model that promotes student self-reflection, metacognition, professional growth, and collegial support. To describe the implementation and evaluation activities of a third year clerkship Death Rounds which are a structured, institutionally supported resource for helping students to understand the clinical, ethical, legal, professional, cultural, and spiritual aspects of death. Medical students attend 2 to 3 small group palliative medicine Death Rounds sessions, facilitated by the attending clerkship director, chief residents, and a palliative care physician. The students' assessment of their palliative medicine knowledge and skills in 5 categories before and after participation in Death Rounds rated their skills after Death Rounds higher with effect sizes ranging from 0.9 to 1.9. Evidence from both the Death Rounds Questionnaire and Facilitators' Logs demonstrates that multiple issues and topics were addressed and all associated with the School of Medicine's 6 core competencies. Death Rounds minimally affect on clerkship time and faculty resources.

Driving anger and its relationships with type A behavior patterns and trait anger: Differences between professional and non-professional drivers

PubMed Central

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

HTML5: a new standard for the Web.

PubMed

Hoy, Matthew B

2011-01-01

HTML5 is the newest revision of the HTML standard developed by the World Wide Web Consortium (W3C). This new standard adds several exciting news features and capabilities to HTML. This article will briefly discuss the history of HTML standards, explore what changes are in the new HTML5 standard, and what implications it has for information professionals. A list of HTML5 resources and examples will also be provided.

The expression and recognition of emotions in the voice across five nations: A lens model analysis based on acoustic features.

PubMed

Laukka, Petri; Elfenbein, Hillary Anger; Thingujam, Nutankumar S; Rockstuhl, Thomas; Iraki, Frederick K; Chui, Wanda; Althoff, Jean

2016-11-01

This study extends previous work on emotion communication across cultures with a large-scale investigation of the physical expression cues in vocal tone. In doing so, it provides the first direct test of a key proposition of dialect theory, namely that greater accuracy of detecting emotions from one's own cultural group-known as in-group advantage-results from a match between culturally specific schemas in emotional expression style and culturally specific schemas in emotion recognition. Study 1 used stimuli from 100 professional actors from five English-speaking nations vocally conveying 11 emotional states (anger, contempt, fear, happiness, interest, lust, neutral, pride, relief, sadness, and shame) using standard-content sentences. Detailed acoustic analyses showed many similarities across groups, and yet also systematic group differences. This provides evidence for cultural accents in expressive style at the level of acoustic cues. In Study 2, listeners evaluated these expressions in a 5 × 5 design balanced across groups. Cross-cultural accuracy was greater than expected by chance. However, there was also in-group advantage, which varied across emotions. A lens model analysis of fundamental acoustic properties examined patterns in emotional expression and perception within and across groups. Acoustic cues were used relatively similarly across groups both to produce and judge emotions, and yet there were also subtle cultural differences. Speakers appear to have a culturally nuanced schema for enacting vocal tones via acoustic cues, and perceivers have a culturally nuanced schema in judging them. Consistent with dialect theory's prediction, in-group judgments showed a greater match between these schemas used for emotional expression and perception. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Lights, Camera, Action: Getting Back to the Basics

DTIC Science & Technology

2009-02-01

Donald Baucom, author of “The Professional Soldier and the Warrior Spirit,” asserts that the military leans towards technology, and leaders who...CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR (S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING...of the author and do not necessarily represent the views of the Air Force Research Institute, the United States Air Force, the Department of Defense

Lower Limb Symmetry: Comparison of Muscular Power Between Dominant and Nondominant Legs in Healthy Young Adults Associated With Single-Leg-Dominant Sports.

PubMed

Vaisman, Alex; Guiloff, Rodrigo; Rojas, Juan; Delgado, Iris; Figueroa, David; Calvo, Rafael

2017-12-01

Achieving a symmetrical power performance (difference <15%) between lower limbs is generally recommended during sports rehabilitation. However, athletes in single-leg-dominant sports, such as professional soccer players, could develop significant asymmetry between their dominant and nondominant legs, such that symmetry does not act as a viable comparison. To (1) compare maximal muscular power between the dominant and nondominant legs in healthy young adults, (2) evaluate the effect of a single-leg-dominant sport activity performed at the professional level, and (3) propose a parameter of normality for maximal power difference in the lower limbs of this young adult population. Controlled laboratory study. A total of 78 healthy, male, young adults were divided into 2 groups according to sport activity level. Group 1 consisted of 51 nonathletes (mean ± SD age, 20.8 ± 1.5 years; weight, 71.9 ± 10.5 kg) who participated in less than 8 hours a week of recreational physical activity with nonspecific training; group 2 consisted of 27 single-leg-dominant professional soccer players (age, 18.4 ± 0.6 years; weight, 70.1 ± 7.5 kg) who specifically trained and competed at their particular activity 8 hours or more a week. For assessment of maximal leg power, both groups completed the single-leg squat jump test. Dominance was determined when participants completed 2 of 3 specific tests with the same extremity. Statistical analysis included the Student t test. No statistical difference was found for maximal power between dominant and nondominant legs for nonathletes ( t = -1.01, P = .316) or single-leg-dominant professional soccer players ( t = -1.10, P = .281). A majority (95%) of participants studied showed a power difference of less than 15% between their lower extremities. Among young healthy adults, symmetrical power performance is expected between lower extremities independent of the existence of dominance and difference in sport activity level. A less than 15% difference in power seems to be a proper parameter to define symmetrical power performance assessed by vertical single-leg jump tests.

An Experimental Aneurysm Model: a Training Model for Neurointerventionalists

PubMed Central

Grunwald, I.Q.; Romeike, B.; Eymann, R.; Roth, C.; Struffert, T.; Reith, W.

2006-01-01

Summary Reproducible animal models not only facilitate the pre-clinical assessment of aneurysm therapy but can also help in training for interventional procedures. The objective of this study was to find an animal model that can be used to test different endovascular occlusion techniques. Aneurysms in the right common carotid artery were created in 35 NZW rabbits by distal ligation and intraluminal elastase infusion. A total of 27 aneurysms were occluded by endovascular embolization with GDC-Coils. The time needed for placement of the microcatheter into the aneurysm by a professional interventionalist, a semi-professional interventionalist and a trainee was measured. The percentage of occlusion (occlusion rate) of the aneurysms was determined angiographically after embolization and again three months later, followed by a histological examination. Aneurysms of 2-6 mm size were reliably created in all 35 animals; mean size was 3.0 mm in height and 5.5 mm in diameter. Occlusion was achieved in 27 animals. Five animals from the group of 35 were initially planned as a control group with no embolization. We added to the control group one animal whose aneurysm could not be occluded endovascularly because of partial thrombosis and small size of the aneurysm. The angiographically determined mean occlusion rate was 89.5% ± 11.3% standard deviation. Histological evaluation of the six aneurysms of the control group showed that they remained patent. Aneurysms that underwent embolization showed organized thrombus formation with no signs of recanalization. Two animals died from anaesthesia related or embolic complications. The time needed by the professional did not significantly decrease, after a little practice the trainee was nearly as quick as the professional. The beginner showed extensive progress, reducing the time for catheter placement by more than 50%. This paper describes the angiographic and histopathologic findings and also demonstrates possible methods for training in interventional procedures. Animal models will play a vital part in the training of future interventionalists. This model has the capability of testing different embolization devices (GDC, Onyx®) and methods. Histologic long-term prognosis and the physical effect of the coils can be evaluated with this model. PMID:20569546

Effect of Depth and Duration of Cooling on Deaths in the NICU Among Neonates With Hypoxic Ischemic Encephalopathy

PubMed Central

Shankaran, Seetha; Laptook, Abbot R.; Pappas, Athina; McDonald, Scott. A.; Das, Abhik; Tyson, Jon E.; Poindexter, Brenda B.; Schibler, Kurt; Bell, Edward F.; Heyne, Roy J.; Pedroza, Claudia; Bara, Rebecca; Van Meurs, Krisa P.; Grisby, Cathy; Petrie Huitema, Carolyn M.; Garg, Meena; Ehrenkranz, Richard A.; Shepherd, Edward G.; Chalak, Lina F.; Hamrick, Shannon E. G.; Khan, Amir M.; Reynolds, Anne Marie; Laughon, Matthew M.; Truog, William E.; Dysart, Kevin C.; Carlo, Waldemar A.; Walsh, Michele C.; Watterberg, Kristi L.; Higgins, Rosemary D.

2015-01-01

IMPORTANCE Hypothermia at 33.5°C for 72 hours for neonatal hypoxic ischemic encephalopathy reduces death or disability to 44% to 55%; longer cooling and deeper cooling are neuroprotective in animal models. OBJECTIVE To determine if longer duration cooling (120 hours), deeper cooling (32.0°C), or both are superior to cooling at 33.5°C for 72 hours in neonates who are full-term with moderate or severe hypoxic ischemic encephalopathy. DESIGN, SETTING, AND PARTICIPANTS Arandomized, 2 × 2 factorial design clinical trial performed in 18 US centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network between October 2010 and November 2013. INTERVENTIONS Neonates were assigned to 4 hypothermia groups; 33.5°C for 72 hours, 32.0°C for 72 hours, 33.5°C for 120 hours, and 32.0°C for 120 hours. MAIN OUTCOMES AND MEASURES The primary outcome of death or disability at 18 to 22 months is ongoing. The independent data and safety monitoring committee paused the trial to evaluate safety (cardiac arrhythmia, persistent acidosis, major vessel thrombosis and bleeding, and death in the neonatal intensive care unit [NICU]) after the first 50 neonates were enrolled, then after every subsequent 25 neonates. The trial was closed for emerging safety profile and futility analysis after the eighth review with 364 neonates enrolled (of 726 planned). This report focuses on safety and NICU deaths by marginal comparisons of 72 hours’ vs 120 hours’ duration and 33.5°C depth vs 32.0°C depth (predefined secondary outcomes). RESULTS The NICU death rates were 7 of 95 neonates (7%) for the 33.5°C for 72 hours group, 13 of 90 neonates (14%) for the 32.0°C for 72 hours group, 15 of 96 neonates (16%) for the 33.5°C for 120 hours group, and 14 of 83 neonates (17%) for the 32.0°C for 120 hours group. The adjusted risk ratio (RR) for NICU deaths for the 120 hours group vs 72 hours group was 1.37 (95% CI, 0.92–2.04) and for the 32.0°C group vs 33.5°C group was 1.24 (95% CI, 0.69–2.25). Safety outcomes were similar between the 120 hours group vs 72 hours group and the 32.0°C group vs 33.5°C group, except major bleeding occurred among 1% in the 120 hours group vs 3% in the 72 hours group (RR, 0.25 [95% CI, 0.07–0.91]). Futility analysis determined that the probability of detecting a statistically significant benefit for longer cooling, deeper cooling, or both for NICU death was less than 2%. CONCLUSIONS AND RELEVANCE Among neonates who were full-term with moderate or severe hypoxic ischemic encephalopathy, longer cooling, deeper cooling, or both compared with hypothermia at 33.5°C for 72 hours did not reduce NICU death. These results have implications for patient care and design of future trials. PMID:25536254

Human trafficking and health: a cross-sectional survey of NHS professionals' contact with victims of human trafficking.

PubMed

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.

Motility and fertility of boar semen after liquid preservation at 5°C for more than 2 weeks.

PubMed

Namula, Zhao; Sato, Yoko; Kodama, Risa; Morinaga, Kouta; Luu, Vien Viet; Taniguchi, Masayasu; Nakai, Michiko; Tanihara, Fuminori; Kikuchi, Kazuhiro; Nagai, Takashi; Otoi, Takeshige

2013-08-01

This study investigated the effects of skim milk on the quality and fertility of boar spermatozoa under long-term chilled preservation. Semen samples were stored in Modena solution supplemented with 0 (control) to 50 mg/mL skim milk at 5°C for 4 weeks; spermatozoa stored with 7.5 and 15 mg/mL of skim milk (7.5-SM and 15-SM groups, respectively) exhibited significantly higher motility indices than those of the control group up to 3 weeks (P < 0.05), and the 7.5-SM group showed improved motility indices even after 4 weeks (P < 0.05). In vitro fertilization using spermatozoa in the 7.5-SM and 15-SM groups stored at 5°C for 2 weeks showed significantly higher fertilization rates of spermatozoa and the development rates to blastocyst than the control group (P < 0.05), and the 7.5-SM group showed similar rates of fertilization and blastocyst formation in the fresh non-stored spermatozoa group. After artificial insemination using spermatozoa stored for 2 weeks in the 7.5-SM group, healthy piglets were obtained. Boar spermatozoa can be stored at 5°C in a Modena solution containing skim milk. Supplementation of 7.5 mg/mL skim milk improves boar spermatozoa motility and fertility even after liquid preservation at 5°C for 2 weeks. © 2013 Japanese Society of Animal Science.

Physical activity, sedentary lifestyle, and obesity among Indian dental professionals.

PubMed

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.

Systemic effects of whole-body cooling to 35°C, 33.5°C and 30°C in a piglet perinatal asphyxia model: implications for therapeutic hypothermia

PubMed Central

Kerenyi, Aron; Kelen, Dorottya; Faulkner, Stuart D; Bainbridge, Alan; Chandrasekaran, Manigandan; Cady, Ernest B; Golay, Xavier; Robertson, Nicola J

2014-01-01

The precise temperature for optimal neuroprotection in infants with neonatal encephalopathy is unclear. Our aim was to assess systemic effects of whole-body cooling to 35°C, 33.5°C and 30°C in a piglet perinatal asphyxia model. Twenty-eight anesthetised male piglets aged <24h underwent hypoxia-ischemia and randomized to normothermia; or cooling to rectal temperature (Trec) 35°C, 33.5°C, or 30°C during 2-26 h post insult (groups n=7). Heart rate (HR), mean arterial blood pressure (MABP) and Trec were recorded continuously. Five 30°C animals had fatal cardiac arrests. During 30°C cooling HR was lower vs normothermia (p<0.001). Although MABP did not vary between groups, more fluid boluses were needed at 30°C than normothermia (p<0.02); dopamine use was higher at 30°C than normothermia and 35°C (p=0.005, p=0.02). Base deficit was increased at 30°C at 12,24 and 36h vs all other groups (p<0.05), pH was acidotic at 36h vs normothermia (p=0.04) and blood glucose higher for 30°C at 12h vs normothermia and 35°C (p<0.05). Potassium was lower at 12h in the 30°C group vs 33.5°C and 35°C groups. Cortisol was no different between groups. Cooling to 30°C led to metabolic derangement, more cardiac arrests and deaths than cooling to 33.5°C or 35°C. Inadvertent overcooling should be avoided. PMID:22314664

Structural requirements of cholesterol for binding to Vibrio cholerae hemolysin.

PubMed

Ikigai, Hajime; Otsuru, Hiroshi; Yamamoto, Koichiro; Shimamura, Tadakatsu

2006-01-01

Cholesterol is necessary for the conversion of Vibrio cholerae hemolysin (VCH) monomers into oligomers in liposome membranes. Using different sterols, we determined the stereochemical structures of the VCH-binding active groups present in cholesterol. The VCH monomers are bound to cholesterol, diosgenin, campesterol, and ergosterol, which have a hydroxyl group at position C-3 (3betaOH) in the A ring and a C-C double bond between positions C-5 and C-6 (C-C Delta(5)) in the B ring. They are not bound to epicholesterol and dihydrocholesterol, which form a covalent link with a 3alphaOH group and a C-C single bond between positions C-5 and C-6, respectively. This result suggests that the 3betaOH group and the C-CDelta(5) bond in cholesterol are required for VCH monomer binding. We further examined VCH oligomer binding to cholesterol. However, this oligomer did not bind to cholesterol, suggesting that the disappearance of the cholesterol-binding potential of the VCH oligomer might be a result of the conformational change caused by the conversion of the monomer into the oligomer. VCH oligomer formation was observed in liposomes containing sterols with the 3betaOH group and the C-C Delta(5) bond, and it correlated with the binding affinity of the monomer to each sterol. Therefore, it seems likely that monomer binding to membrane sterol leads to the assembly of the monomer. However, since oligomer formation was induced by liposomes containing either epicholesterol or dihydrocholesterol, the 3betaOH group and the C-C Delta(5) bond were not essential for conversion into the oligomer.

Beyond one-size-fits-all: Tailoring diversity approaches to the representation of social groups.

PubMed

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).

Interprofessional collaboration regarding patients' care plans in primary care: a focus group study into influential factors.

PubMed

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.

[The Impact of Electroacupuncture Intervention on Expression of 5-HTR 1 B/2 C Genes in Mice under Radiation Stimulation from Mobile Phone].

PubMed

Dai, Jian-yu; Chen, Yi-guo; Zhang, Xiao-qing

2015-08-01

To observe the effect of electroacupuncture (EA) stimulation of "Yifen" (TE 17), "Shenshu" (BL 23) on the expression of 5-hydroxytryptamine receptor 1 B (5-HTR 1 B) mRNA and 5-hydroxytryptamine receptor 2 C (5-HTR 2 C) mRNA in the cochlear nucleus tissue in mice experiencing radiation from mobile phone, so as to explore its mechanisms underlying improvement of tinnitus. Thirty Kunming mice were randomly divided into control group (n = 6) and modeling group (n = 24). The tinnitus model was established by giving the mice with mobile phone-radiation for 1 h in the morning and 1 h in the afternoon, continuously for 40 days. EA stimulation was applied to "Yifeng" (TE 17) group (n = 6) and "Shenshu" (BL 23) group (n = 6) for 20 min, once a day for 7 days. The expression of 5-THR 1 B/2 C mRNA in the cochlear nucleus was assayed by fluorescence quantitative polymerase chain reaction (real time-PCR). The expression level of 5-HTR 1 B was significantly lower in the model group than in the control group (P < 0.05), while that of 5-HTR 2 C mRNA significantly increased (P < 0.01). TE 17 group received a significant acupoint intervention effect (P < 0.01). Compared with TE 17 group, BL 23 group received a weaker effect (P < 0.05). EA of TE 17 can up-regulate expression level of 5-HTR 1 B and down-regulate expression level of 5-HTR 2 C in the cochlear nucleus in mice experiencing mobile-phone radiation.

Continuous professional development for GPs: experience from Denmark.

PubMed

Kjaer, N K; Steenstrup, A P; Pedersen, L B; Halling, A

2014-07-01

Continuous professional development (CPD) for Danish general practitioners (GPs) is voluntary and based on funded accredited activities. There is an ongoing discussion on how to improve this current system by introducing mandatory elements. To inform this debate, we set out to identify GPs' current use of CPD and to explore the motives behind their choices. A mixed-methods study with a combined qualitative and quantitative approach was used. In 2012, two focus group interviews were conducted, followed up the same year by an online questionnaire sent to 1079 randomly chosen Danish GPs. Focus groups: CPD activities are chosen based on personal needs analysis, and in order to be professionally updated, to meet engaged colleagues and to prevent burnout. GPs also attend CPD to assess their own pre-existing level of competence. CPD activities need to be experienced as being both meaningful and relevant in order to have an impact. Questionnaire: The response rate was 686/1079 (63%). GPs spend on average 10.5 days per year on accredited, voluntary CPD activities. Workplace-related CPD activities and practice-based small group learning played a significant role. The main motivation for choice of CPD activities included academic interest, experience of patient-related problems in their own surgeries and medical topics where the GPs felt insufficiently confident. Danish GPs are frequent users of voluntary accredited CPD. Their CPD choices are motivated by topics strengthening their professional capacity and preventing burnout. There would seem to be no need for a mandatory system. 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.

Quality in dementia care: A cross sectional study on the Bio-Psycho-Social competencies of health care professionals

PubMed Central

De Vriendt, Patricia; Cornelis, Elise; Desmet, Valerie; Vanbosseghem, Ruben

2018-01-01

Objective 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’. Design and setting 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. Results 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). Conclusion 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. PMID:29389937

[Pulsatilla decoction inhibits vulvovaginal Candida albicans proliferation and reduces inflammatory cytokine levels in vulvovaginal candidiasis mice].

PubMed

Xia, Dan; Zhang, Mengxiang; Shi, Gaoxiang; Xu, Zhiqing; Wu, Daqiang; Shao, Jing; Wang, Tianming; Wang, Changzhong

2016-02-01

To explore the possible regulatory effect of Pulsatilla decoction on Th17 cells and inflammatory cytokines of vulvovaginal candidiasis (VVC) mice. Seventy-two female Kunming mice were randomly assigned into six groups: a blank control group, a VVC model group, a fluconazole group and three Pulsatilla decoction groups (dose levels: 22.5, 15.0 and 7.5 g/kg, respectively). The VVC mouse models were established by vaginal inoculation with Candida albicans (C. albicans) in female mice in pseudoestrus state caused by estradiol injection. After 7-day treatment on VVC mice, the vaginal C. albicans burden was assessed using dilution spread plate method; the vaginal C. albicans morphology was observed by Gram staining method; the levels of interleukin 6 (IL-6), IL-17, IL-21 and tumor necrosis factor α (TNF-α) in sera were detected by ELISA. The content of the transcription factor retinoid related orphan receptor gamma t (RORγt) in vaginal tissues was detected by immunohistochemistry. The VVC mouse models were successfully developed. After treatment, the vaginal C. albicans burden of the fluconazole group and 22.5 g/kg Pulsatilla decoction group dropped significantly compared with that of the VVC model group. Gram staining showed that the VVC mice had lots of C. albicans hyphae in vaginal discharge, that 7.5 g/kg Pulsatilla decoction group remained the mycelia-phase C. albicans, and that 15.0 g/kg Pulsatilla decoction group had the majority of yeast-phase C. albicans and a few of mycelia-phase, while no hyphae and only very few of yeast-phase C. albicans were observed in 22.5 g/kg Pulsatilla decoction group and fluconazole group. After 7-day treatment, compared with the model group, the levels of IL-6, IL- 17, IL-21 and TNF-α in the sera of the fluconazole group, 15.0 and 22.5 g/kg Pulsatilla decoction groups were reduced significantly and the levels of RORγt in the vaginal tissues of the fluconazole group, 15.0 and 22.5 g/kg Pulsatilla decoction groups also decreased significantly. Pulsatilla decoction could inhibit the proliferation of vulvovaginal C. albicans and reduces the levels of inflammatory cytokines in VVC mice.

42 CFR Appendix C to Part 5 - Criteria for Designation of Areas Having Shortages of Mental Health Professionals

Code of Federal Regulations, 2011 CFR

2011-10-01

... with a doctorate in psychology) who is practicing as a clinical or counseling psychologist and is... in the State of practice, an individual with a doctorate in psychology and two years of supervised...

42 CFR Appendix C to Part 5 - Criteria for Designation of Areas Having Shortages of Mental Health Professionals

Code of Federal Regulations, 2013 CFR

2013-10-01

... with a doctorate in psychology) who is practicing as a clinical or counseling psychologist and is... in the State of practice, an individual with a doctorate in psychology and two years of supervised...

42 CFR Appendix C to Part 5 - Criteria for Designation of Areas Having Shortages of Mental Health Professionals

Code of Federal Regulations, 2012 CFR

2012-10-01

... with a doctorate in psychology) who is practicing as a clinical or counseling psychologist and is... in the State of practice, an individual with a doctorate in psychology and two years of supervised...

42 CFR Appendix C to Part 5 - Criteria for Designation of Areas Having Shortages of Mental Health Professionals

Code of Federal Regulations, 2014 CFR

2014-10-01

... with a doctorate in psychology) who is practicing as a clinical or counseling psychologist and is... in the State of practice, an individual with a doctorate in psychology and two years of supervised...

Exploring the Rationale for Group Music Activities for Parents and Young Children: Parents' and Practitioners' Perspectives

ERIC Educational Resources Information Center

Pitt, Jessica; Hargreaves, David

2017-01-01

Children's Centres are widespread in England and comprise multi-professional staff teams seeking to work with families with children aged 0-5 years. Although parent-child group music sessions appear frequently in Children's Centre activity programmes, the rationale for their inclusion remains unclear. This article presents the results from phase…

[Level of knowledge of Quality Commitment Campaign and of "do not do" recommendations amongst general practitioners, pediatricians and nurses Primary Care].

PubMed

Mira, J J; Carrillo, I; Pérez-Pérez, P; Olivera, G; Silvestre, C; Nebot, C; González de Dios, J; Aranaz-Andrés, J

2018-04-30

To evaluate if the Quality Commitment Campaign (QCC) was sufficiently known among primary care professionals (PC), and second, to evaluate the knowledge about certain recommendations of what should not be done in PC. A observational study was conducted. General practitioners (GP), pediatricians (PED) and nursing (NUR) participated. A direct question was asked about whether QCC was known and a set of dichotomous questions based on the "do not do" recommendations to assess their knowledge. A sample size of 288 professionals from each group was the minimum required for a sampling error of 5%, 95% confidence level and p=0.75. The field study was conducted with the collaboration of health services and professional and scientific organizations. Data were described by frequencies and mean (standard deviation), and compared by means of ?2/Fisher or ANOVA and t-test. A total of 1,904 professionals (936 GP, 682 PED and 286 NUR) answered. The QCC initiative was known by 828 (43.5%) professionals: 524 (56.0%) GP, 234 (34.3%) PED and 70 (24.5%) NUR (p<0.001). All the questions were correctly answered by 652 (69.7%) GP, 631 (92.5%) PED and 116 (40.6%) NUR. Significantly more mistakes (p<0.001) were made by those who did not know the QCC, worked in the private sector or were not considered responsible for overuse. Despite not knowing the QCC, 60% GP and 90% PED answered all the questions of the test correctly. NUR and GP could benefit from a greater diffusion of the QCC. As could those working in the private sector and those who believe that professionals have little responsibility for unnecessary overuse.

Analysis of Your Professional Liability Insurance Policy

PubMed Central

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

PubMed Central

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

A blended-learning programme regarding professional ethics in physiotherapy students.

PubMed

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.

Social Media Use in Pediatric Dermatology.

PubMed

Fogel, Alexander L; Teng, Joyce M C

2016-01-01

Social media is predicted to become increasingly important in dermatology because of its potential to serve as a platform for public health campaigns, aid in participant recruitment for clinical trials, increase public engagement in health care, and facilitate scientific discourse. No study of social media use in pediatric dermatology has been performed, so we analyzed the use of the seven leading social media platforms in pediatric dermatology, with a focus on patient advocacy groups, professional societies, research journals, and research institutions. We observed that 89% of patient advocacy groups, 100% of professional societies, 62.5% of research journals, and 0% of academic pediatric dermatology departments maintained one or more social media accounts. Our observations suggest that all stakeholder groups, and in particular members of the research community, have the potential to further their engagement, connections, and communications through social media. © 2016 Wiley Periodicals, Inc.

PLCs in Action: Innovative Teaching for Struggling Grade 3-5 Readers

ERIC Educational Resources Information Center

D'Ardenne, Charna; Barnes, Debra G.; Hightower, Elaine S.; Lamason, Pamela R.; Mason, Mary; Patterson, Paula C.; Stephens, Nancy; Wilson, Carolyn E.; Smith, Vickie H.; Erickson, Karen A.

2013-01-01

A group of elementary school reading teachers used their time in a Professional Learning Community to develop a systematic intervention to address the needs of struggling readers in grades 3 to 5. Working as a team, they identified a collection of books that was culturally diverse, high interest, appealing to boys and girls, aligned with…

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.

Social identity contingencies: how diversity cues signal threat or safety for African Americans in mainstream institutions.

PubMed

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.

Clinical Decision-Making Tool for Safe and Effective Prescription of Exercise in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Results From an Interdisciplinary Delphi Survey and Focus Groups.

PubMed

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.

21 CFR 355.60 - Professional labeling.

Code of Federal Regulations, 2014 CFR

2014-04-01

... water supply contains 0.3 to 0.7 ppm fluoride ion, reduce the dose to 2.5 mL of 0.02 percent or 5 mL of... labeling. (a) The labeling for anticaries fluoride treatment rinses identified in § 355.10(a)(3) and (c)(3) that are specially formulated so they may be swallowed (fluoride supplements) and are provided to...

21 CFR 355.60 - Professional labeling.

Code of Federal Regulations, 2013 CFR

2013-04-01

... water supply contains 0.3 to 0.7 ppm fluoride ion, reduce the dose to 2.5 mL of 0.02 percent or 5 mL of... labeling. (a) The labeling for anticaries fluoride treatment rinses identified in § 355.10(a)(3) and (c)(3) that are specially formulated so they may be swallowed (fluoride supplements) and are provided to...

21 CFR 355.60 - Professional labeling.

Code of Federal Regulations, 2010 CFR

2010-04-01

... water supply contains 0.3 to 0.7 ppm fluoride ion, reduce the dose to 2.5 mL of 0.02 percent or 5 mL of... labeling. (a) The labeling for anticaries fluoride treatment rinses identified in § 355.10(a)(3) and (c)(3) that are specially formulated so they may be swallowed (fluoride supplements) and are provided to...

21 CFR 355.60 - Professional labeling.

Code of Federal Regulations, 2011 CFR

2011-04-01

... water supply contains 0.3 to 0.7 ppm fluoride ion, reduce the dose to 2.5 mL of 0.02 percent or 5 mL of... labeling. (a) The labeling for anticaries fluoride treatment rinses identified in § 355.10(a)(3) and (c)(3) that are specially formulated so they may be swallowed (fluoride supplements) and are provided to...

21 CFR 355.60 - Professional labeling.

Code of Federal Regulations, 2012 CFR

2012-04-01

... water supply contains 0.3 to 0.7 ppm fluoride ion, reduce the dose to 2.5 mL of 0.02 percent or 5 mL of... labeling. (a) The labeling for anticaries fluoride treatment rinses identified in § 355.10(a)(3) and (c)(3) that are specially formulated so they may be swallowed (fluoride supplements) and are provided to...

Occupation and mental health in a national UK survey

PubMed Central

Rasul, F. R.; Head, J.; Singleton, N.

2009-01-01

Objectives To measure the prevalence of common mental disorder (CMD) by occupation in a representative sample of Great Britain and to identify occupations with increased and decreased risk of CMD. Methods A cross-sectional interview-based survey was carried out including 5,497 working male and female respondents, 16–64 years from a stratified random survey of private households in Britain. Occupations were classified by the Standard Occupational Classification (SOC) into four groups: major, sub-major, minor and constituent unit groups. Common Mental Disorder was measured by the Revised Clinical Interview Schedule. Results Major SOC groups with higher prevalence of common mental disorder included clerical and secretarial, sales, and personal and protective services whereas craft and related, ‘other’ professional occupations and plant and machine operatives had lower prevalence compared to 13% overall prevalence in all adults. In sub-major SOC groups managers and administrators, teaching professionals, clerical and secretarial, ‘other’ sales and personal service occupations had higher prevalence whereas many professional and skilled occupations had lower prevalence. Specific SOC unit groups with higher prevalence included primary and secondary teachers, welfare community, youth workers, security staff, waiters, bar staff, nurse auxiliaries and care assistants. General managers in government and large organizations (OR = 2.79, 95% CI 1.41–5.54), managers in transport and storing (OR = 2.44, 95% CI 1.18–5.03), buyers and mobile sales persons (OR = 2.48, 95% CI 1.09–5.60), sales occupations (NES) (OR = 2.78, 95% CI 1.25–6.19) and clerks (NES) (OR = 2.71, 95% CI 1.59–4.61) had increased risk of common mental disorder relative to specialist managers adjusting for social and financial factors and physical ill-health. Conclusions Occupations with higher risk of common mental disorder may be typified by high levels of job demands, especially emotional demands and lack of job security. The reasons why occupations have low rates of common mental disorder are varied and may include high levels of job discretion, good job training and clearly defined job tasks. PMID:20033130

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.…

Effective professional intraoral tooth brushing instruction using the modified plaque score: a randomized clinical trial

PubMed Central

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

Female genital mutilation/cutting: changes and trends in knowledge, attitudes, and practices among health care professionals in The Gambia

PubMed Central

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

Innovative web-based multimedia curriculum improves cardiac examination competency of residents.

PubMed

Criley, Jasminka M; Keiner, Jennifer; Boker, John R; Criley, Stuart R; Warde, Carole M

2008-03-01

Proper diagnosis of cardiac disorders is a core competency of internists. Yet numerous studies have documented that the cardiac examination (CE) skills of physicians have declined compared with those of previous generations of physicians, attributed variously to inadequate exposure to cardiac patients and lack of skilled bedside teaching. With growing concerns about ensuring patient safety and quality of care, public and professional organizations are calling for a renewed emphasis on the teaching and evaluation of clinical skills in residency training. The objective of the study was to determine whether Web training improves CE competency, whether residents retain what they learn, and whether a Web-based curriculum plus clinical training is better than clinical training alone. Journal of Hospital Medicine 2008;3:124-133. (c) 2008 Society of Hospital Medicine. This was a controlled intervention study. The intervention group (34 internal and family medicine interns) participated in self-directed use of a Web-based tutorial and three 1-hour teaching sessions taught by a hospitalist. Twenty-five interns from the prior year served as controls. We assessed overall CE competency and 4 subcategories of CE competency: knowledge, audio skills, visual skills, and audio-visual integration. The over mean score of the intervention group significantly improved, from 54 to 66 (P = .002). This improvement was retained (63.5, P = .05). When compared with end-of-year controls, the intervention group had significantly higher end-of-year CE scores (57 vs. 63.5, P = .05), knowledge (P = .04), and audio skills (P = .01). At the end of the academic year, all improvements were retained (P

Feasibility of an International Multiple Sclerosis Rehabilitation Data Repository

PubMed Central

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

Feasibility of an International Multiple Sclerosis Rehabilitation Data Repository: Perceived Challenges and Motivators for Sharing Data.

PubMed

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.

A Computational Cluster for Multiscale Simulations of Ionic Liquids

DTIC Science & Technology

2008-09-16

AND SUBTITLE DURIP: A Computational Cluster for Multiscale Simulations of Ionic Liquids 5a. CONTRACT NUMBER 5b. GRANT NUMBER FA955007-1-0512 5c...AVAILABILITY STATEMENT ZO\\5oc\\\\%1>^ 13. SUPPLEMENTARY NOTES 14. ABSTRACT The focus of this project was to acquire and use computer cluster nodes...by ANSI Std. Z39.18 Adobe Professional 7.0 Comprehensive Final Report: Gregory A. Voth, PI Contract/Grant Title: DURIP: A Computational Cluster for

[The representation of care in the cultural image of nursing].

PubMed

Vieira, M J

1999-12-01

We analyzed Sergipan nurses' life stories, related to the cultural image of Nursing perceived in their professional choice, in order to assist students in this professional identification. Subjects were divided into four chronological groups, from retired nurses to those who had been graduated for 5 years, all of whom chose Nursing as their preferred career. We used the Social Representation approach in the cultural systems to analyze the life stories. Findings were analyzed through categories and themes, and it was presented by graphics and tables. Care was identified as a permanent cultural trace and it was verbalized using words from charity, religion to scientific Nursing and professionalism, to describe scientific knowledge and humanism, with temporal configuration.

Developing a parent-professional team leadership model in group work: work with families with children experiencing behavioral and emotional problems.

PubMed

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.

The effects of forskolin and rolipram on cAMP, cGMP and free fatty acid levels in diet induced obesity.

PubMed

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.

Professional Support of Self-Help Groups: A Support Group Project for Chronic Fatigue Syndrome Patients.

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…

Professionals' perceptions of support resources for battered immigrant women: chronicle of an anticipated failure.

PubMed

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.

A survey investigation of UK physiotherapists' use of online search engines for continuing professional development.

PubMed

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.

Soft tissue swelling incidence using demineralized bone matrix in the outpatient setting

PubMed Central

Chin, Kingsley R; Pencle, Fabio J R; Seale, Jason A; Valdivia, Juan M

2017-01-01

AIM To assess use of demineralized bone matrix (DBM) use in anterior cervical discectomy and fusion (ACDF) in outpatient setting. METHODS One hundred and forty-five patients with prospectively collected data undergoing single and two level ACDF with DBM packed within and anterior to polyetheretherketone (PEEK) cages. Two groups created, Group 1 (75) outpatients and control Group 2 (70) hospital patients. Prevertebral soft tissue swelling (PVSTS) was measured anterior to C2 and C6 on plain lateral cervical radiographs preoperatively and one week postoperatively and fusion assessed at two years. RESULTS There was no intergroup significance between preoperative and postoperative visual analogue scales (VAS) and neck disability index (NDI) scores between Group 1 and 2. Mean preoperative PVSTS in Group 1 was 4.7 ± 0.2 mm at C2 level and 11.1 ± 0.5 at C6 level compared to Group 2 mean PVSTS of 4.5 ± 0.5 mm and 12.8 ± 0.5, P = 0.172 and 0.127 respectively. There was no radiographic or clinical evidence of adverse reaction noted. In Group 1 mean postoperative PVSTS was 5.5 ± 0.4 mm at C2 and 14.9 ± 0.6 mm at C6 compared Group 2 mean PVSTS was 4.9 ± 0.3 mm at C2 and 14.8 ± 0.5 mm at C6, P = 0.212 and 0.946 respectively. No significant increase in prevertebral soft tissue space at C2 and C6 level demonstrated. CONCLUSION ACDF with adjunct DBM packed PEEK cages showed a statistical significant intragroup improvement in VAS neck pain scores and NDI scores (P = 0.001). There were no reported serious patient complications; post-operative radiographs demonstrated no significant difference in prevertebral space. We conclude that ACDF with DBM-packed PEEK cages can be safely done in an ASC with satisfactory outcomes. PMID:29094007

Global DNA hypomethylation has no impact on lung function or serum inflammatory and fibrosis cytokines in asbestos-exposed population.

PubMed

Yu, Min; Lou, Jianlin; Xia, Hailing; Zhang, Min; Zhang, Yixiao; Chen, Junqiang; Zhang, Xing; Ying, Shibo; Zhu, Lijin; Liu, Lihong; Jia, Guang

2017-04-01

To examine the effect of asbestos exposure on global DNA methylation and determine whether lung function and inflammatory and fibrosis biomarkers are correlated with the methylation state. A total of 26 healthy subjects without asbestos exposure (Group 1), 47 healthy subjects with exposure (Group 2), and 52 subjects with benign asbestos-related disorders (ARDs) (Group 3) participated in this cross-sectional study. Blood global 5-methylcytosine (5mC) and serum TNF-α, collagen IV, CCL5 and CC16 concentrations were analyzed using enzyme-linked immunosorbent assay-like assays. Spirometric maneuvers were performed to assess lung function. Decreased 5mC levels were observed in Groups 2 and 3 compared to Group 1, irrespective of lung function (p < 0.01). There was no significant change in 5mC between Groups 2 and 3. Overall, 5mC was negatively correlated with CCL5 and collagen IV (p < 0.05), but no significant inverse relationship was found between 5mC and CCL5 or collagen IV in each group. Additionally, both 5mC and CC16 were inversely associated with FEV1/FVC% (p = 0.001, adjusted R 2  = 0.145) for non-smokers, and consistently significant inverse relationships were found between CC16 and FEV1/FVC%, independent of asbestos exposure. Asbestos exposure causes global DNA hypomethylation. DNA hypomethylation has no influence on serum biomarkers and lung function in asbestos-exposed population with or without pleural and pulmonary parenchymal abnormalities.

Estimates of the relative and absolute diurnal contributions of fasting and post-prandial plasma glucose over a range of hyperglycaemia in type 2 diabetes.

PubMed

Peter, R; Dunseath, G; Luzio, S D; Owens, D R

2013-09-01

To re-examine the relative and absolute contributions of fasting/pre-prandial glucose (FPG) and post-prandial glucose (PPG) to 24-h hyperglycaemia and HbA1c respectively in non-insulin treated subjects with type 2 diabetes (T2DM). A total of 52 T2DM subjects (37 men) had daytime 12h plasma glucose (PG) profiles determined in response to three serial identical test meals commencing at 08 00h with pre-prandial and frequent post-prandial blood samples collected. The overnight PG profile was derived by projecting the 20 00h glucose concentration to the pre-breakfast value at 08 00h. PPG exposure was calculated above fasting/pre-prandial value for each meal. Excess hyperglycaemia was calculated based on a PG>5.5mmol/L with fasting hyperglycaemia being the difference between the two measurements. The subjects were divided into five groups according to the HbA1c (Group 1<7.0%; Group 2: 7.0-<7.5; Group 3: 7.5-<8.0%; Group 4: 8.0-<9.0%; Group 5:≥9.0%). The 24h relative contribution of PPG exposure and fasting hyperglycaemia to excess hyperglycaemia and the absolute contribution of PPG and fasting hyperglycaemia to excess HbA1c (HbA1c - 5.1%) was calculated. With deteriorating glycaemia, the relative contribution of PPG exposure decreased across the groups from 43.5% (HbA1c<7.0%) to 17.8% (HbA1c≥9.0%), whilst the contributions of fasting hyperglycaemia increased from 56.5% to 82.2% (P=0.004), respectively. The absolute contributions of PPG to excess HbA1c was 0.7%, which remained relatively stable across the spectrum of HbA1c, whilst fasting hyperglycaemia increased significantly from groups 1 to 5 (P<0.001). Fasting hyperglycaemia contributes substantially in all groups, increasing as HbA1c deteriorates. The absolute contribution of PPG to excess HbA1c did not vary across the range of HbA1c, representing a significant relative contribution even in well-controlled subjects with a HbA1c<7.0%. Copyright © 2013. Published by Elsevier Masson SAS.

GP and pharmacist inter-professional learning - a grounded theory study.

PubMed

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.

Use of communication technologies by people with type 1 diabetes in the social networking era. A chance for improvement.

PubMed

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.

Australian Infection Control Association members' use of skills and resources that promote evidence-based infection control.

PubMed

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.

Comparison between cervical disc arthroplasty and conservative treatment for patients with single level cervical radiculopathy at C5/6.

PubMed

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.

Long-term outcomes after adjunctive topical 5-flurouracil or mitomycin C for the treatment of surgically excised, localized ocular surface squamous neoplasia.

PubMed

Bahrami, Bobak; Greenwell, Timothy; Muecke, James S

2014-01-01

To report rates of recurrence and complications of localized ocular surface squamous neoplasia treated with 5-fluorouracil or mitomycin C as adjunctive treatment to surgical excision. Long-term follow up of two prospective, non-comparative interventional case series. One hundred fifty-three eyes with histologically confirmed localized, non-invasive ocular surface squamous neoplasia. 89 eyes were treated with adjuvant 5-fluorouracil and 64 eyes were treated with adjuvant mitomycin C. Following surgical excision±cryotherapy patients received topical 5-fluorouracil 1% four times daily for two weeks or topical mitomycin C 0.04% four times daily for two to three 1-week cycles. Ocular surface squamous neoplasia recurrence, complications of therapy and compliance. Median follow up was 33.6 (range 12-84) months and 57.9 (range 12-160) months in 5-fluorouracil and mitomycin C groups, respectively. There was one recurrence in the 5-fluorouracil group and no recurrences in the mitomycin C group. Side-effects occurred in 69% of 5-fluorouracil patients and 41% of mitomycin C patients. Five patients (6%) required intervention for treatment-related side-effects in the 5-fluorouracil group versus 11 (17%) in the mitomycin C group. No vision-threatening complications were noted. Long-term recurrence of localised ocular surface squamous neoplasia is rare when topical 5-fluorouracil or mitomycin C are used as adjunctive treatment to surgical excision. While side-effects are common, the majority are transient and rarely limit compliance. © 2013 Royal Australian and New Zealand College of Ophthalmologists.

Analysis of deep tissue hypersensitivity to pressure pain in professional pianists with insidious mechanical neck pain.

PubMed

Linari-Melfi, Marcela; Cantarero-Villanueva, Irene; Fernández-Lao, Carolina; Fernández-de-Las-Peñas, César; Guisado-Barrilao, Rafael; Arroyo-Morales, Manuel

2011-11-24

The aim of this study was to investigate whether pressure pain hyperalgesia is a feature of professional pianists suffering from neck pain as their main playing-related musculoskeletal disorder. Twenty-three active expert pianists, 6 males and 17 females (age: 36 ± 12 years) with insidious neck pain and 23 pianists, 9 males and 14 females (age: 38 ± 10 years) without neck pain the previous year were recruited. A numerical pain rate scale, Neck Disability Index, hand size and pressure pain thresholds (PPT) were assessed bilaterally over the C5-C6 zygapophyseal joint, deltoid muscle, the second metacarpal and the tibialis anterior muscle in a blinded design. The results showed that PPT levels were significantly decreased bilaterally over the second metacarpal and tibialis anterior muscles (P < 0.05), but not over C5-C6 zygapophyseal joint and deltoid muscle (P > 0.10), in pianists with neck pain as compared to healthy pianists. Pianists with neck pain had a smaller (P < 0.05) hand size (mean: 181.8 ± 11.8) as compared to pianists without neck pain (mean: 188. 6 ± 13.1). PPT over the tibialis anterior muscles was negatively correlated with the intensity of neck pain. Our findings revealed pressure pain hypersensitivity over distant non-symptomatic distant points but not over the symptomatic areas in pianists suffering from neck pain. In addition, pianists with neck pain also had smaller hand size than those without neck pain. Future studies are needed to further determine the relevance of these findings in the clinical course of neck pain as playing-related musculoskeletal disorder in professional pianists.

Analysis of deep tissue hypersensitivity to pressure pain in professional pianists with insidious mechanical neck pain

PubMed Central

2011-01-01

Background The aim of this study was to investigate whether pressure pain hyperalgesia is a feature of professional pianists suffering from neck pain as their main playing-related musculoskeletal disorder. Methods Twenty-three active expert pianists, 6 males and 17 females (age: 36 ± 12 years) with insidious neck pain and 23 pianists, 9 males and 14 females (age: 38 ± 10 years) without neck pain the previous year were recruited. A numerical pain rate scale, Neck Disability Index, hand size and pressure pain thresholds (PPT) were assessed bilaterally over the C5-C6 zygapophyseal joint, deltoid muscle, the second metacarpal and the tibialis anterior muscle in a blinded design. Results The results showed that PPT levels were significantly decreased bilaterally over the second metacarpal and tibialis anterior muscles (P < 0.05), but not over C5-C6 zygapophyseal joint and deltoid muscle (P > 0.10), in pianists with neck pain as compared to healthy pianists. Pianists with neck pain had a smaller (P < 0.05) hand size (mean: 181.8 ± 11.8) as compared to pianists without neck pain (mean: 188. 6 ± 13.1). PPT over the tibialis anterior muscles was negatively correlated with the intensity of neck pain. Conclusions Our findings revealed pressure pain hypersensitivity over distant non-symptomatic distant points but not over the symptomatic areas in pianists suffering from neck pain. In addition, pianists with neck pain also had smaller hand size than those without neck pain. Future studies are needed to further determine the relevance of these findings in the clinical course of neck pain as playing-related musculoskeletal disorder in professional pianists. PMID:22111912

The impacts of occupational risks and their effects on work stress levels of health professional (The sample from the Southeast region of Turkey).

PubMed

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.

Catalytic ionic hydrogenation of ketones using tungsten or molybdenum organometallic species

DOEpatents

Voges, Mark; Bullock, R. Morris

2000-01-01

The present invention is a process for the catalytic hydrogenation of ketones and aldehydes to alcohols at low temperatures and pressures using organometallic molybdenum and tungsten complexes. The functional group is selected from groups represented by the formulas R(C.dbd.O)R' and R(C.dbd.O)H, wherein R and R' are selected from hydrogen or any alkyl or aryl group. The active catalyst for the process has the form: [CpM(CO).sub.2 (PR*.sub.3) L].sup.+ A.sup.-, where Cp=.eta..sup.5 -R.sup..tangle-solidup..sub.m C.sub.5 H.sub.5-m and R.sup..tangle-solidup. represents an alkyl group or a halogen (F, Cl, Br, I) or R.sup..tangle-solidup. =OR' (where R'=H, an alkyl group or an aryl group) or R.sup..tangle-solidup. =CO.sub.2 R' (where R'=H, an alkyl group or an aryl group) and m=0 to 5; M represents a molybdenum atom or a tungsten atom; R*.sub.3 represents three hydrocarbon groups selected from a cyclohexyl group (C.sub.6 H.sub.11), a methyl group (CH.sub.3), and a phenyl group (C.sub.6 H.sub.5) and all three R* groups can be the same or different or two of the three groups can be the same; L represents a ligand; and A.sup.- represents an anion. In another embodiment, one, two or three of the R* groups can be an OR*.

Synthesis and structural characterization of PHP[(C(5)Me(4))(2)], a monodentate chiral phosphine derived from intramolecular C-C coupling of tetramethylcyclopentadienyl groups: an evaluation of steric and electronic properties.

PubMed

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)

Effects of the professional identity development programme on the professional identity, job satisfaction and burnout levels of nurses: A pilot study.

PubMed

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.

["Hope Dies Last …" - Cross-Sectoral Cooperation in Integrated Care].

PubMed

Ruppert, Daniel; Stegbauer, Constanze; Bramesfeld, Anke; Bestmann, Beate; Szecsenyi, Joachim; Götz, Katja

2017-04-01

Objective Multiple models of Integrated Care (IC) have been implemented in German mental health services in the last decade in order to improve cross-sectoral, interdisciplinary cooperation. This study investigates an IC network model providing home treatment, case management and a 24/7 hotline. The aim of the study was to explore how health professionals working in this service model perceive both cooperation within their facilities and with external stakeholders. Methods 5 focus groups with 39 health professionals working in an IC mental health network were conducted and analyzed with qualitative content analysis. Results Focus groups participants reported on excellent cooperation within their facilities. The cooperation with external stakeholders, i. e. physicians, psychotherapists and psychiatric clinics, leaves room for improvement. Conclusions Until now little consideration has been given to the perspectives of health professionals. Cooperation within IC mental health networks seems to be effective. Cooperation with stakeholders outside the networks needs to be enhanced. © Georg Thieme Verlag KG Stuttgart · New York.

The Mental Health Team: Evaluation From a Professional Viewpoint. A Qualitative Study.

PubMed

Pileño, María Elena; Morillo, Javier; Morillo, Andrea; Losa-Iglesias, Marta

2018-04-01

Health care institutions include workers who must operate in accordance with the requirements of the position, even though there are psychosocial influences that can affect the stability of the worker. To analyze the organizational culture of the team of professionals who work in the mental health network. A qualitative methodology was used to assess a sample of 55 mental health professionals who have been practicing for at least 5years. "Team" was the overall topic. The subtopics within "Team" were: getting along in the unit, getting along with the patient, personal resources for dealing with patients, adaptive resources of team members and, resources that the team uses in their group activities. It was observed that the team does not work with a common objective and needs an accepted leader to manage the group. The definition and acceptance of roles can result in conflict. By increasing the skill level of each worker, the multidisciplinary team would be more collaborative. Copyright © 2017 Elsevier Inc. All rights reserved.

Measuring professional identity formation early in medical school.

PubMed

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.

[Comparative studies of personal and steady-state sampling for determining dust exposure in different job groups].

PubMed

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.

[Investigation on the incidence of genital herpes in different professional groups in Qingdao].

PubMed

Quan, L

1993-10-01

Genital herpes is one of 8 legally reportable sexually transmitted diseases (STD) in China. Using a HSV antigen ELISA kit we detected and typed HSV antigen in 1,148 clinical specimens collected from the genital organs (penis, cervix, vagina and vulva) of 446 men and 702 women in Qindao and divided into 11 different professional and 2 special groups (patients with cervical cancer and pregnant women). The highest positive rate of HSV antigen was found among long-distance transport drivers (48.0%). The second and third high positive rates were among waiters and waitresses in private, restaurants (39.2%) and patients with cervical cancer (38.2%). The positive rates among self-employed retailers and employees in private inns and restaurants were notably higher than those among employees in state-run shops, restaurants and hotels. And, the positive rate among workers was higher than that among peasants. There was no notable difference between the positive rate of HSV antigen among men (24.2%) and that among women (21.5%). But the incidence of HSV-2 infection was much higher than that of HSV-1 infection. The results indicate that some special professional groups have high rates of genital HSV infection. More attention needs to be paid to these special groups in order to control sexually transmitted herpes diseases.

Virtual Reality Skills Training for Health Care Professionals in Alcohol Screening and Brief Intervention

PubMed Central

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

Developing a Parent-Professional Team Leadership Model in Group Work: Work with Families with Children Experiencing Behavioral and Emotional Problems

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…

Finding A Way: Encouraging Underrepresented Groups in Geography. An Annotated Bibliography. Pathways in Geography Series Resource Publication, Title No. 5.

ERIC Educational Resources Information Center

LeVasseur, Michal

This bibliography is intended to begin the process of awareness necessary to encourage young women and racial and ethnic minorities in geography classes across the nation. Women and minority racial and ethnic groups have long been seriously underrepresented in the discipline of geography both in the applied and professional world and in academic…

Using Research in the Professional Life of Mathematics Teachers. International Congress on Mathematical Education (5th, Adelaide, Australia, August 24-30, 1984).

ERIC Educational Resources Information Center

Romberg, Thomas A., Ed.

The papers in this monograph are grouped by the five session topics of the Using Research Group meetings. Perspectives on Using Research was first, with papers on research and the teaching job (Romberg), utility (Wheeler), review and dissemination (Dessart), preparing materials (Jurdak), and the teacher's view (Williams). The second session was on…

Long-term Serologic Follow-up of Children Vaccinated with a Pediatric Formulation of Virosomal Hepatitis A Vaccine Administered With Routine Childhood Vaccines at 12-15 Months of Age.

PubMed

Dagan, Ron; Ashkenazi, Shai; Livni, Gilat; Go, Oscar; Bagchi, Partha; Sarnecki, Michal

2016-07-01

The aim of this open-label, active-controlled, parallel group, phase 2 follow-up study was to assess the long-term immunogenicity of Epaxal Junior, the pediatric dose of an aluminum-free virosomal inactivated hepatitis A virus (HAV) vaccine, in children receiving routine childhood vaccines (RCV). Healthy children (12-15 months old, ≥8 kg weight) were randomized (1:1:1) to group A: Epaxal Junior + RCV (day 1); group B: Epaxal Junior (day 1) + RCV (day 29) and group C: Havrix 720 + RCV (day 1). All 3 groups received 2 doses of HAV vaccines 6 months apart. Children who completed the primary study were followed up from 18 months to 7.5 years post booster. Of 291/327 randomized children who had completed the primary study, 157 were followed for the 7.5-year analysis (group A: 50; group B: 54; and group C: 53). Of these, 152 children had protective levels of anti-HAV antibodies [≥10 mIU/mL; 98% (group A); 96.3% (group B); 96.2% (group C)]. Anti-HAV geometric mean concentrations were similar in groups A and B at all the time points (1.5-, 2.5-, 3.5-, 5.25- and 7.5-year time point) but slightly lower in group C. Predictions of the median duration of persistence of seroprotective antibody levels, using the linear mixed model were similar in all groups: (group A: 19.1 years, group B: 18.7 years, group C: 17.3 years). Immunization with Epaxal Junior administered with RCVs at 12 months elicited protective response beyond 7.5 years in almost all children. Assessing the kinetic of anti-HAV antibody titers decline over time, the moment to reach antibody concentrations below the accepted protective level may occur earlier than previously estimated.

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…

Impact of Active Leisure (Noncompetitive) Contact Sports Activities on the Space Available for the Cord of the Subaxial Cervical Spine of Asymptomatic Adults.

PubMed

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.

[Evaluation of the effectiveness of a Mindfulness and Self-Compassion program to reduce stress and prevent burnout in Primary Care health professionals].

PubMed

Aranda Auserón, Gloria; Elcuaz Viscarret, M Rosario; Fuertes Goñi, Carmen; Güeto Rubio, Victoria; Pascual Pascual, Pablo; Sainz de Murieta García de Galdeano, Enrique

2018-03-01

To evaluate the effectiveness of a Mindfulness and Self-Compassion Program on the levels of stress and burnout in Primary Care health professionals. Randomised, controlled clinical trial. Training in Mindfulness was offered to 1,281 health professionals in Navarra (Spain) Primary Care, and 48 of them accepted. The participants were randomly assigned to groups: 25 to the intervention group, and the remaining 23 to the control group. The Mindfulness and Self-Compassion training program consisted of sessions of 2.5chours/week for 8 weeks. The participants had to attend at least 75% of the sessions and perform a daily practical of 45minutes. The levels of mindfulness, self-compassion, perceived stress, and burnout were measured using four questionnaires before and after the intervention. After the intervention, the scores of the intervention group improved significantly in mindfulness (P<.001); perceived stress (P<.001); self-compassion: self-kindness P<.001, shared humanity P=.004, mindfulness P=.001; and burnout: emotional fatigue (P=.046). The comparison with the control group showed significant differences in mindfulness (P<.001), perceived stress (P<.001), self-kindness (P<.001) and emotional fatigue (P=.032). This work suggests that it may be beneficial to encourage mindfulness and self-compassion practices in the health environment. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Health Professionals' Explanations of Suicidal Behaviour: Effects of Professional Group, Theoretical Intervention Model, and Patient Suicide Experience.

PubMed

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.

The influence of time of maternal exposure to 2,4,5,2 prime ,4 prime ,5 prime -hexachlorobiphenyl on its accumulation in their nursing offspring

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

Gallenberg, L.A.; Ring, B.J.; Vodicnik, M.J.

2,4,5,2',4',5'-Hexachlorobiphenyl (6-CB) is mobilized from rodent tissues during the lipid depletion associated with food restriction or lactation, the latter condition resulting in the substantial elimination of the maternal body burden of the chemical to nursing offspring. The present study was undertaken to determine whether the rate and/or magnitude of accumulation of 6-CB in nursing offspring differed with time following PCB administration to the maternal animal. Female ICR mice were administered two doses of 6-CB. Group I animals received (14C)-6-CB as weanlings (15-20 g) followed by unlabeled 6-CB 5 weeks later, after mating, on Day 1 of gestation. Group II receivedmore » unlabeled 6-CB as weanlings and (14C)-6-CB on Day 1 of gestation. Thus, 14C identified the mobilization and elimination of either the first or the second dose of 6-CB in the treatment groups (I = (14C)-6-CB, 6-CB; II = 6-CB, (14C)-6-CB). Both groups of animals retained approximately 80% of the administered radiolabeled dose. The tissue distribution of (14C)-6-CB in group II as a percentage of the body burden was not different from that in group I as determined from maternal tissue concentrations on Day 14 of gestation. The percentage of the maternal body burden of (14C)-6-CB accumulated in suckling offspring of group II mothers was significantly greater than that in group I offspring on Day 1 (I, 2.2 +/- 0.5%; II, 3.5 +/- 0.4%), Day 3 (I, 14.8 +/- 1.9%; II, 24.6 +/- 2.7%), Day 5 (I, 16.8 +/- 1.4%; II, 24.8 +/- 0.8%), and Day 12 (I, 32.3 +/- 0.5%; II, 45.5 +/- 1.7%) postpartum. This differential elimination was reflected in the t1/2 of elimination of the radiolabeled dose from parametrial fat during lactation, which was significantly longer in group I (14 days) than group II maternal animals (9 days).« less

Blending Non-Group-3 Transition Metal and Rare-Earth Metal into a C80 Fullerene Cage with D5h Symmetry.

PubMed

Wei, Tao; Jin, Fei; Guan, Runnan; Huang, Jing; Chen, Muqing; Li, Qunxiang; Yang, Shangfeng

2018-02-11

Rare-earth metals have been mostly entrapped into fullerene cages to form endohedral clusterfullerenes, whereas non-Group-3 transition metals that can form clusterfullerenes are limited to titanium (Ti) and vanadium (V), and both are exclusively entrapped within an I h -C 80 cage. Non-Group-3 transition-metal-containing endohedral fullerenes based on a C 80 cage with D 5h symmetry, V x Sc 3-x N@D 5h -C 80 (x=1, 2), have now been synthesized, which exhibit two variable cluster compositions. The molecular structure of VSc 2 N@D 5h -C 80 was unambiguously determined by X-ray crystallography. According to a comparative study with the reported Ti- and V-containing clusterfullerenes based on a I h -C 80 cage and the analogous D 5h -C 80 -based metal nitride clusterfullerenes containing rare-earth metals only, the decisive role of the non-Group-3 transition metal on the formation of the corresponding D 5h -C 80 -based clusterfullerenes is unraveled. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

[The effect of the membrane attack complex C5b-9 on liver cells during traumatic hemorrhagic shock in rat].

PubMed

Zhao, Zhi-ling; Cao, Shu-hua; Wang, Yong-qiang

2011-03-01

To observe whether the membrane attack complex C5b-9 would accumulate in the rats' liver after receiving the assault of traumatic hemorrhagic shock, and whether the membrane attack complex deals an impact on liver apoptosis. Fifty male healthy Wistar rats were randomly divided into five groups: normal group, 1, 3, 6, 24 hour model groups. The model of traumatic hemorrhagic shock was reproduced by withdrawal of blood from carotid artery after a bone fracture till the blood pressure lowered to 40 mm Hg (1 mm Hg=0.133 kPa). Plasma membrane attack complex C5b-9 concentration was assayed using enzyme linked immunoadsorbent assay. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in blood was determined by Rate method. Immunohistochemistry was used to detect C5b-9 deposition in the liver. Apoptosis of liver cells was then detected by the terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) assay. The pathological changes in paraffin sections stained with hematoxylin eosin (HE) were observed under light microscope. A small amount of C5b 9 in plasma was found in normal group, and the values (ng/L) of 1, 3, 6 hour models were significantly higher than those of the normal group (272.91 ± 9.56, 192.01 ± 9.04, 156.78 ± 8.37 vs. 25.98 ± 5.87, all <0.05 ). ALT (U/L) in 3 hour model group and AST (U/L) in 1 hour model group were increased significantly (92.90 ± 8.83, 264.83 ± 31.4), peaked at 24 hours (184.30 ± 12.98, 647.36 ± 60.02), and there was significant difference compared with normal group (38.75 ± 5.40, 66.69 ± 19.95, all P <0.05). In the normal group and the 1 hour and 6 hour model groups, no C5b 9 was found in liver, but in the 3 hour model group a large number of liver parenchymal cells in the portal area were found to contain C5b 9 22.60 ± 1.06), however the number decreased significantly in the 24 hour model (2.20 ± 0.60, P<0.05). In normal group there was no apoptotic cell, and in 1, 6, 24 hour model groups there were scattered apoptotic cells (1.20 ± 0.25, 5.60 ± 0.37, 1.60 ± 0.26). In the 3 hour model group apoptosis of hepatic cells around the central vein was increased to the peak (20.60 ± 0.47), and there was significant difference compared with other groups (all P <0.05) . In the model groups the liver cells became edematous, and the integrity of the membrane was lost, and some cells were even lysed.The pathological damage is most serious in 24 hour model group. The membrane attack complex C5b-9 insulted the rats' liver after a traumatic hemorrhagic shock, and apoptosis of hepatic cells and the content of C5b-9 peaked in 3 hour model , though they do not occur in the same site. A low level of C5b-9 in blood 3 hours after shock predict a poor prognosis.

[Employees with mental illness - possibilities and barriers in professional activity].

PubMed

Cybula-Fujiwara, Anna; Merecz-Kot, Dorota; Walusiak-Skorupa, Jolanta; Marcinkiewicz, Andrzej; Wiszniewska, Marta

2015-01-01

In Poland patients with psychiatric problems form a large group; in 2010 there were almost 1.5 million people for whom outpatient psychiatric care was provided, whereas approximately 200 thousand ill individuals were treated in 24-h psychiatric wards. Only 17% of the mentally disabled are professionally active. The results of many researches show that despite the detrimental influence of mental disorders on the employment (e.g., lower productivity, absenteeism, presenteism, increased risk of accidents at the workplace), professional activity can play a key role in the7stabilization of the mental state, it can also help in disease recovery. People with mental disorders are a social group that is at the higher risk of exclusion from the job market. The opinion prevailing among employers is that mentally ill individuals have decreased ability to conduct professional activity, and social attitudes towards them tend to be based on marking and stigmatizing. This review tackles the advantages of working during the illness, barriers which people with mental disorders face on the job market when they want to either start or continue work, and professional functioning of people with diagnosed depression (e.g., affective disorders) and schizophrenia (representing psychotic disorders). The analysis of existing data show that to improve the situation of mentally ill people present on the job market close cooperation between the representatives of various medical specializations is necessary, as well as their active participation in the process of social and professional rehabilitation of people affected by mental disorders.

Relational coordination among home healthcare professions and goal attainment in nursing care.

PubMed

Sakai, Mahiro; Naruse, Takashi; Nagata, Satoko

2016-07-01

To examine whether interprofessional coordination is related to goal attainment in home visit nursing care. Self-administered questionnaire surveys were administered to home visit nursing agencies in Chiba Prefecture, Japan, from July to December 2014. Nurses evaluated their interprofessional coordination with professional groups (nursing colleague and managers, home doctors, care managers, home care workers, visiting therapists, day service and day care professionals, visiting bath professionals, and short stay professionals) using the Japanese version of the Relational Coordination Scale (RCS-J). Goal attainment across all clients during the most recent 3 months was measured with a rating scale ranging from incompletely attained (0) to completely attained (10). Data were analyzed with multivariate logistic regression analysis. A total of 83 nurses in 14 agencies responded, and data from 74 nurses were analyzed. The mean RCS-J and goal attainment scores were 3.59 (standard deviation = 0.47) and 6.51 (1.40), respectively. The RCS-J scores of the low and high goal attainment groups were 3.41 (0.46) and 3.73 (0.42), respectively. Multivariate logistic regression analysis revealed that RCS-J scores were positively associated with goal attainment (odds ratio, 5.71; 95% confidence interval, 1.65-19.79). The finding of this study suggest that well-coordinated professionals may fulfill client needs better than poorly coordinated professionals do. Future research is needed to determine whether similar results are obtained in individual clients using a well-validated goal attainment scale. © 2016 Japan Academy of Nursing Science.

Surveying Requirements Meeting Management Sessions, 1-5 February 1982,

DTIC Science & Technology

1983-02-01

organized and conducted by the Engineering Division, Directorate of Civil Works, Office of the Chief of Engineers, to improve management and...Development) 1. Technical User Groups Overview - M. K. Miles, OCE 2. Organizing a Successful Computer Aided Applications Program - Dr. N. Radhakrishnan...2. Organization Structure 3. In-House Capabilities 4. Expertise Requirements 5. Professionalism TUESDAY-2 FEBRUARY No Management Activities WEDNESDAY

Experienced speech-language pathologists' responses to ethical dilemmas: an integrated approach to ethical reasoning.

PubMed

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.

[Relationship between C-reactive protein gene polymorphaisms and chronic periodontitis].

PubMed

Liu, Juan; Meng, Shu; Ding, Yi; Wu, Ya-fei

2010-06-01

To investigate the relationship between C-reactive protein (CRP) + 1444C/T, CRP+1059G/C polymorphisms and chronic periodontitis (CP) in a Han Chinese population. Clinical periodontal parameters [attachment loss (AL) probing depth (PD) and bleeding on probing (BOP)], and serum CRP levels were examined in CP patients (n = 126) and healthy subjects (n = 113). The mean serum CRP level [(1.74 ± 1.67) mg/L] was significantly higher in the CP group than in the control group [(0.57 ± 0.39) mg/L], P < 0.001. In the control group, serum CRP levels were significantly lower in subjects with the CRP +1059 GC and CC genotypes than those with the CRP +1059 GG genotype (P < 0.01). There was no significant difference between genotypes in the CP group. In CP and the control groups, serum CRP levels were significantly higher in subjects with the CRP + 1444 CT and TT genotypes compared to those with the CRP + 1444 CC genotype (P < 0.5). The percentage of CRP + 1059 C allele was 6.7% (17/252) in the CP group and 4.9% (11/226) in the control group. The percentage of CRP + 1444 T allele was 6.3% (16/252) in the CP group and 5.3% (12/226) in the control group (P > 0.5). There was no significant difference between groups in both allele frequencies (P > 0.5). The association of CRP + 1059G/C, CRP + 1444 C/T polymorphisms with CP was not found in a regression model (P > 0.5). The presence of a CRP + 1059C-allele was associated with lower serum CRP levels and the presence of a CRP + 1444T-allele was associated with higher serum CRP levels. However, the data suggested that CRP + 1059G/C, CRP + 1444 C/T polymorphisms were not significantly associated with serum CRP levels of chronic periodontitis patients in ethnic Han Chinese.

Simulating a patient's fall as a means to improve routine communication: Joint training for nursing and fifth-year medical students.

PubMed

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.

Effort-Reward Imbalance, Work-Privacy Conflict, and Burnout Among Hospital Employees.

PubMed

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.

Military Review: The Professional Journal of the U.S. Army. Volume 89, Number 1, January-February 2009

DTIC Science & Technology

2009-02-01

GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S...with services in Qarguhliyah, resulting in iraqi government projects to resurface a key road in the area, build a bridge to replace a damaged span...to an iraqi civil conservation force to perform public works functions such as trash removal and municipal improvement projects under the direction

[Inhibitory effect of compound cantharides capsule on the proliferation of xenografts of human hepatocellular carcinoma HepG(2)215 in mice].

PubMed

Han, Jian-jun; Yu, Jin-ming; Wu, Hui-yong; Liu, Ji-bing; Song, Bao; Xue, De-wen

2012-11-01

To investigate the inhibitory effect of compound cantharides capsules on the proliferation of xenografts of human hepatocellular carcinoma HepG(2215) in mice and their mechanism of action. One hundred healthy Balb/c mice (5-week old, male:female 1:1) were used in this study. Mouse models of human HepG(2215) hepatocarcinoma were established. The tumor-bearing mice were divided into five groups randomly. The control group A received daily intragastric administration of physiologic saline. The intervention groups B1, B2 and B3 were treated with compound cantharides capsule in a dose of 12.5 mg×kg(-1)×d(-1), 25 mg×kg(-1)×d(-1) and 37.5 mg×kg(-1)×d(-1), respectively, for 10 consecutive days. The group C had intraperitoneal injection of cyclophosphamide (25 mg×kg(-1)×d(-1)) for 10 consecutive days. The mice were sacrificed after the completion of administration. The tumors were taken out, the tumor volume was measured, the inhibitory rate of body weight was calculated, and the serum AFP concentration and the level of HBV DNA were determined. The survival of each group mice was analyzed. The levels of mRNA expression of apoptosis-related genes were assayed by quantitative RT-PCR. Apoptosis in the tumor cells was assayed with TUNEL staining. Flow cytometry was used to detect the levels of CD3(+), CD19(+), CD4(+) and CD8(+), and microvessel density (MVD) of the tumors was assessed by immunohistochemistry. After completion of the treatment, the inhibition rate of tumor growth of the groups B1, B2 and B3 was 29.8%, 38.7% and 48.1%, respectively, and that of the group C was 52.4%, with a significant difference among the groups (P < 0.05). The median survival time of the groups A, B1, B2, B3 and C was (30.0 ± 3.2) days, (49.0 ± 5.1) days, (50.0 ± 5.2) days, (57.5 ± 6.5) days and (49.0 ± 4.7) days, respectively. The median survival time of the group B3 was significantly longer than that of other groups (P < 0.05). The serum AFP level in the groups A, B1, B2, B3 and C was (492.7 ± 48.5) ng/ml, (281.2 ± 25.6) ng/ml, (194.3 ± 18.7) ng/ml, (170.1 ± 15.8) ng/ml and (138.7 ± 12.5) ng/ml, respectively, indicating that it was significantly inhibited in the group C. The inhibition rate of HBV DNA replication of the groups B1, B2, B3 and C was (46.0 ± 5.1)%, (65.5 ± 6.9)%, (81.3 ± 7.8)% and (19.5 ± 2.1)%, respectively, showing that compound cantharides capsules inhibited HBV DNA replication in a dose-dependent manner. The apoptosis rate of the groups A, B1, B2, B3 and C was (0.27 ± 0.03)%, (7.18 ± 2.12)%, (9.17 ± 2.42)%, (11.27 ± 3.03)% and (5.44 ± 2.45)%, respectively, and that of the group B3 was significantly higher than that of the groups A, B1, B2 and C (P < 0.05). The expression level of bax mRNA was significantly higher than that of the group C (P < 0.05). The drug could significantly decrease the bcl-2 mRNA expression level, more remarkably along with the increasing dose of cantharides, and it was significantly lower than that in the group C (P < 0.05). The levels of CD4(+), CD8(+), CD3(+) and CD19(+) were significantly higher than that in the groups A and C (P < 0.05). The value of MVD of the group B3 was significantly lower that that of groups A and C (P < 0.05). Compound cantharides capsules may inhibit the replication of HBV DNA in HepG(2215) cells, inducing apoptosis in the tumor cells, enhancing the immune function to inhibit the growth of liver cancer cells in mice, and significantly prolong the median survival time of tumor-bearing mice.

Female genital mutilation and cutting: a systematic literature review of health professionals' knowledge, attitudes and clinical practice.

PubMed

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.

[Streptozotocin-induced maternal intrauterine hyperglycemia environment and its influence on development and metabolic in adult offspring with high birth weight in rats].

PubMed

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.

Allogeneic BMT and patient eligibility based on psychosocial criteria: a survey of BMT professionals.

PubMed

Foster, L W; McLellan, L J; Rybicki, L A; Dabney, J; Welsh, E; Bolwell, B J

2006-01-01

BMT professionals were compared regarding their willingness to proceed with allogeneic BMT given select psychosocial issues. A questionnaire was sent to 660 physician members of ASBMT, 92 social work members of BMT Special Interest Group, Association of Oncology Social Work, and 626 nurse members of BMT Special Interest Group, Oncology Nursing Society; 597 responded with a response rate of 43.5%. Items included background information, followed by 17 case vignettes; each represented a different psychosocial issue to which respondents indicated whether or not they would recommend proceeding with allogeneic BMT. In every vignette, at least 10% of respondents indicated they would not proceed. In six vignettes, at least 64% indicated do not proceed: suicidal ideation (86.8%), uses addictive illicit drugs (81.7%), history of noncompliance (80.5%), no lay caregiver (69.3%), alcoholic (64.8%), and mild dementia/Alzheimer's (64.4%). In 10 vignettes, at least 73% indicated proceed. On four vignettes, professional subgroups differed in their recommendation on whether or not to proceed with allogeneic BMT. Qualitative data suggest that this decision is contingent on the perceived acuity, severity, and currency of the psychosocial issue, patient ability to comply with treatment given the issue, and its manageability as a risk factor for treatment related vulnerability and outcomes.

TRAINING HEALTH SERVICE WORKERS--THE CRITICAL CHALLENGE, PROCEEDINGS OF THE CONFERENCE ON JOB DEVELOPMENT AND TRAINING FOR WORKERS IN HEALTH SERVICES (WASHINGTON, D.C., FEBRUARY 14-17, 1966).

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…

Pharmacological effects of Vitamin C & E on Diclofenac Sodium intoxicated Rats.

PubMed

El-Shafei, Reham A; Saleh, Rasha M

2016-12-01

The aim of this study was to evaluate the probable protective effect of vitamin C and vitamin E on diclofenac-induced acute nephrotoxicity using biochemical, molecular and histopathological examination in rats following administration of diclofenac sodium (50mg/kg, I.M). Ninety male Wister rats were allotted in six equal groups. Rats in the 1st group (control group) were injected with physiological saline, while rats in the 2nd group (C-group) were given vitamin C (100mg/kg orally via stomach tube) for 5 successive days. The 3rd group (E-group) was given vitamin E (250mg/kg orally in diet) for 5 successive days. Rats in the 4th group (D-group) were injected by diclofenac sodium (50mg/kg, I.M) for 5 successive days. The 5th group (DvC-group) was given diclofenac sodium (50mg/kg, I.M) and vitamin C (100mg/kg orally via stomach tube) for 5 successive days. Rats in the 6th group (DvE-group) were given diclofenac sodium (50mg/kg, I.M) and vitamin E (250mg/kg orally in diet) for 5 successive days. Blood samples were collected two days post treatment (1st week of experiment), 2nd and 4th week of the experiment for assessment of urea, creatinine, malondialdehyde, nitric oxide and superoxide dismutase activities. At the end of 4th week, rats were sacrificed and kidneys were excised for biochemical analyses, histopathological evaluation and determination of kidney interleukin-1β, interleukin-18, demsin and nepherin expressions in by reverse transcriptase-polymerase chain reaction (RT-PCR). The results showed that, diclofenac induced severe kidney damage as indicated by histopathological changes and increased serum oxidative stress parameters. Behavioral changes were monitored; a significant increase in uremia in intoxicated animals was also noted indicating that diclofenac sodium provoked kidney damage in rats. Application of vitamin C (DvC-group) and vitamin E (DvE-group) were found to improve the abovementioned abnormalities. The present data suggest that, vitamin C and vitamin E might play an important role in reducing oxidative stress and kidney damage induced by diclofenac sodium. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

[Role expectations of various professional groups in the operating theatre].

PubMed

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].

PubMed

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.

The Factors Determining Professional Career of Females from Different Social Groups: Reflexive Attitude

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…

Interleukin-6 genotype is associated with high-density lipoprotein cholesterol responses to exercise training.

PubMed

Halverstadt, Amy; Phares, Dana A; Roth, Stephen; Ferrell, Robert E; Goldberg, Andrew P; Hagberg, James M

2005-05-15

High-density lipoprotein cholesterol (HDL-C) and its subfractions are modifiable with exercise training and these responses are heritable. The interleukin-6 (IL6)-174G/C polymorphism may be associated with HDL-C levels. We hypothesized that the IL6-174G/C polymorphism would be associated with plasma HDL-C response to exercise training. Sixty-five 50- to 75-year-olds on a standardized diet were studied before and after 24 weeks of aerobic exercise training. Significant differences existed among genotype groups for change with exercise training in HDL-C, HDL3-C, integrated HDL4,5NMR-C, and HDLsize. The CC genotype group increased HDL-C more than the GG (7.0 +/- 1.3 v. 1.0 +/- 1.1 mg/dL, p = 0.001) and GC groups (3.3 +/- 0.9 mg/dL, p = 0.02); for HDL3-C, the CC group increased more than the GG (6.1 +/- 1.0 v. 0.9 +/- 0.9, mg/dL p < 0.001) and GC groups (2.5 +/- 0.7 mg/dL, p = 0.006). Integrated HDL4,5NMR-C increased more in the CC than GG group (6.5 +/- 1.6 mg/dL v. 1.0 +/- 1.3 mg/dL, p = 0.01), as did HDLsize compared to the GG (CC: 0.3 +/- 0.1 v. GG: 0.1 +/- 0.1 nm, p = 0.02) and GC (0.0 +/- 0.0 nm, p = 0.007) groups. IL6 genotype is associated with HDL-C response to exercise training.

Prevalence of IgE against neuromuscular blocking agents in hairdressers and bakers.

PubMed

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.

The Effect of Water Temperature during Cold-Water Immersion on Recovery from Exercise-Induced Muscle Damage.

PubMed

Vieira, A; Siqueira, A F; Ferreira-Junior, J B; do Carmo, J; Durigan, J L Q; Blazevich, A; Bottaro, M

2016-11-01

This study investigated the effects of 5 and 15°C cold-water immersion on recovery from exercise resulting in exercise-induced muscle damage. 42 college-aged men performed 5×20 drop-jumps and were randomly allocated into one of 3 groups: (1) 5°C; (2) 15°C; or (3) control. After exercise, individuals from the cold-water immersion groups had their lower limbs immerged in iced water for 20 min. Isometric knee extensor torque, countermovement jump, muscle soreness, and creatine kinase were measured before, immediately after, 24, 48, 72, 96 and 168 h post-exercise. There was no between-group difference in isometric strength recovery (p=0.73). However, countermovement jump recovered quicker in cold-water immersion groups compared to control group (p<0.05). Countermovement jump returned to baseline after 72 h in 15°C, 5°C group recovered after 96 h and control did not recovered at any time point measured. Also, creatine kinase returned to baseline at 72 h and remained stable for all remaining measurements for 15°C group, whereas remained elevated past 168 h in both 5°C and control groups. There was a trend toward lower muscle soreness (p=0.06) in 15°C group compared to control at 24 h post-exercise. The result suggests that cold-water immersion promote recovery of stretch-shortening cycle performance, but not influence the recovery of maximal contractile force. Immersion at warmer temperature may be more effective than colder temperatures promoting recovery from strenuous exercise. © Georg Thieme Verlag KG Stuttgart · New York.

Grace Under Pressure: a drama-based approach to tackling mistreatment of medical students.

PubMed

Scott, Karen M; Berlec, Špela; Nash, Louise; Hooker, Claire; Dwyer, Paul; Macneill, Paul; River, Jo; Ivory, Kimberley

2017-03-01

A positive and respectful learning environment is fundamental to the development of professional identities in healthcare. Yet medical students report poor behaviour from healthcare professionals that contradict professionalism teaching. An interdisciplinary group designed and implemented a drama-based workshop series, based on applied theatre techniques, to help students develop positive professional qualities and interpersonal skills to deal with challenges in the healthcare setting. We piloted the workshops at the University of Sydney in 2015. Attendees completed evaluation questionnaires and participated in a focus group or interview. Of 30 workshop attendances, there were 29 completed questionnaires and three participants attended a focus group or interview. Workshop activities were rated as 'very good' or 'good' by 21/22 (95.5%). Thematic analysis of qualitative data highlighted the rationale for participation (to deal with bullying, prevent becoming a bully, learn social skills), workshop benefits (express emotions, learn about status dynamics and deconstructing personalities, empathy, fun), challenges (meeting participants' expectations, participants' need for further practice) and implications for medical education (need to develop awareness of others' perspectives). Our research has shown that there is momentum to challenge mistreatment in medical education. While a multipronged approach is needed to generate systemic change, this pilot offers a positive and creative innovation. It helps students improve their interpersonal skills and sense of self to deal with challenges in the healthcare setting, including mistreatment. 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/.

Status report, The Public Health and Planning 101 project: strengthening collaborations between the public health and planning professions.

PubMed

Mahendra, A; Vo, T; Einstoss, C; Weppler, J; Gillen, P; Ryan, L; Haley, K

2017-01-01

Land use planning is a complex field comprised of legislation, policies, processes and tools. A growing body of evidence supports the relationship between land use planning decisions, community design and health. The built environment has been shown to be associated with physical inactivity, obesity, cardiovascular disease, respiratory disease and mental illness. Consequently, there is a growing interest within public health to work with planners on land use planning initiatives such as official plans and transportation master plans. Two surveys were developed: one for public health professionals and the other for planning professionals (survey questions available upon request to the corresponding author). The surveys were pilot tested in two separate focus group sessions with public health and planning professionals. Focus group volunteers helped to validate the surveys by verifying survey questions, design and overall flow. In early 2012, 304 public health professionals and 301 planning professionals completed the two separate surveys, comprising the total survey respondents for each respective profession used to calculate proportions. The survey results represent a convenience sample and are not generalizable to the entire population of public health and planning professionals in Ontario. Results compare survey responses from both groups where appropriate. Most respondents worked either as public health staff (78%) or planners/senior planners (58%). A smaller percentage of public health and planning professionals worked either as managers (15% and 11%, respectively) or directors (5% and 9%, respectively). Health is associated with how communities are planned and built, and the services and resources provided within them. Inspired by the results of our survey and based on user feedback from the pilot tests, a free online training program entitled "Public Health and Planning 101: An Online Course for Public Health and Planning Professionals to Create Healthier Built Environments" was launched in 2016 by OPHA as a collaborative project with OPPI and PHAC. This course is designed to bridge the gaps between the two professions, as well as provide greater opportunities for developing collaborative partnerships to help create and foster healthy built environments.

[Expression and significance of c-fos in resistant cell line TU177/VCR of larynx squamous cell carcinoma].

PubMed

Li, G D; Hu, X L; Xing, J F; Shi, R Y; Li, X; Li, J F; Li, T L

2018-04-07

Objective: To explore the effect of c-fos on multidrug resistance of laryngeal cancer TU177 cells. Method: Increasing drug concentration gradient is adopted to establish the stability of the laryngeal cancer drug resistance in cell line; RT-PCR and Western blot were used to detect difference of the c-fos between TU177 and TU177/VCR cells; plasmids with human c-fos knockdown or over expression were transfected into TU177/VCR and TU177 cells respectively, and the effects of different treatment on cell proliferation were investigated with MTT. Results: The drug resistance of TU177/VCR cells was 26.25-fold in vincristine (VCR), 7.33-fold in Paclitaxel (TAX), 2.41 in cisplatin (DDP), and 5.50 in 5-fluorouracil (5-FU), comparing with TU177( P <0.05). The TU177/VCR cells had significantly higher c-fos expression compared to TU177 cells( P <0.05). The results showed that the IC(50) values of 5-FU for the NC group and c-fos shRNA group were (306.2±6.3)μmol/L and (81.3±3.9)μmol/L, respectively, which was decreased by 73% in the c-fos shRNA group compared to that in the NC group ( P <0.05). Similarly, the results showed that the IC(50) values for 5-FU were (55.3±9.4) μmol/L in NC group and (288.1±7.3)μmol/L in c-fos WT group, which was increased 5.21-fold in c-fos WT cells. Conclusion: C-fos plays important role in multidrug resistance of larynx cancer cell TU177/VCR, and might become a new molecular target for laryngeal cancer treatment.

Prospective, randomized and controlled trial on magnesium sulfate administration during laparoscopic gastrectomy: effects on surgical space conditions and recovery profiles.

PubMed

Ryu, J H; Koo, B W; Kim, B G; Oh, A Y; Kim, H H; Park, D J; Lee, C M; Kim, S T; Do, S H

2016-11-01

The degree of neuromuscular blockade is one of the important factors that determine the condition of surgical space during laparoscopic surgery. Magnesium sulfate potentiates the actions of neuromuscular blocking agent, and we hypothesized that intraoperative magnesium sulfate infusion may improve surgical space condition during laparoscopic surgery. Eighty-four patients undergoing elective laparoscopic gastrectomy were randomized to receive isotonic saline (group C) or magnesium sulfate (group M, loading dose with 50 mg/kg over 10 min and then 15 mg/kg/h by continuous infusion) to maintain the moderate neuromuscular blockade using rocuronium. Two experienced surgeons scored the quality of surgical space condition using a 5-point surgical rating scale (SRS). The secondary outcomes included recovery profiles, postoperative pain and adverse events. The SRS in group M was higher than that of group C. The proportion of patients with a SRS of 5 (optimal) was 2.7 % in the group C and 40.5 % in the group M (P < 0.0001) although a lower amount of rocuronium was required in group M than group C [24.2 (6.5) mg/h for group M vs. 27.5 (6) mg/h for group C; P = 0.017]. Pain after operation site was less severe in group M than in group C at postoperative 24 h (P = 0.009). Recovery profiles and adverse events were similar between the two groups. Intraoperative administration of magnesium sulfate improved the quality of surgical space conditions and decreased neuromuscular blocking agent requirement and postoperative pain in patients undergoing laparoscopic gastrectomy.

42 CFR Appendix G to Part 5 - Criteria for Designation of Areas Having Shortages of Veterinary Professional(s)

Code of Federal Regulations, 2011 CFR

2011-10-01

... of Veterinary Professional(s) G Appendix G to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS DESIGNATION OF HEALTH PROFESSIONAL(S) SHORTAGE AREAS Pt. 5, App. G Appendix G to Part 5—Criteria for Designation of Areas Having Shortages of Veterinary...

Effect of initial temperature changes on myocardial enzyme levels and cardiac function in acute myocardial infarction.

PubMed

Qian, Yuanyu; Liu, Jie; Ma, Jinling; Meng, Qingyi; Peng, Chaoying

2014-07-01

In the present study, the effect of initial body temperature changes on myocardial enzyme levels and cardiac function in acute myocardial infarction (AMI) patients was investigated. A total of 315 AMI patients were enrolled and the mean temperature was calculated based on their body temperature within 24 h of admission to hospital. The patients were divided into four groups according to their normal body temperature: Group A, <36.5°C; group B, ≥36.5°C and <37.0°C; group C, ≥37.0°C and <37.5°C and group D, ≥37.5°C. The levels of percutaneous coronary intervention, myocardial enzymes and troponin T (TNT), as well as cardiac ultrasound images, were analyzed. Statistically significant differences in the quantity of creatine kinase at 12 and 24 h following admission were identified between group A and groups C and D (P<0.01). A significant difference in TNT at 12 h following admission was observed between groups A and D (P<0.05), however, this difference was not observed with groups B and C. The difference in TNT between the groups at 24 h following admission was not statistically significant (P>0.05). Significant differences in lactate dehydrogenase at 12 and 24 h following admission were observed between groups A and D (P<0.05), however, differences were not observed with groups B and C (P>0.05). Significant differences in glutamic-oxaloacetic transaminase at 12 and 24 h following admission were observed between groups A and D (P<0.05), however, differences were not observed in groups B and C (P>0.05). However, no significant differences were identified in cardiac function index between all the groups. Therefore, the results of the present study indicated that AMI patients with low initial body temperatures exhibited decreased levels of myocardial enzymes and TNT. Thus, the observation of an initially low body temperature may be used as a protective factor for AMI and may improve the existing clinical program.

A longitudınal study on the effect of tailored training and counseling on the professional attitude of nursing students.

PubMed

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.

5 CFR 315.710 - Professional and administrative career employees serving under Schedule B appointments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... result of a deliberate decision by management. (c) Tenure on conversion. An employee converted under... employees serving under Schedule B appointments. 315.710 Section 315.710 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Conversion to Career...

42 CFR 410.61 - Plan of treatment requirements for outpatient rehabilitation services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the occupational therapy services. (5) A nurse practitioner, a clinical nurse specialist, or a physician assistant. (c) Content of the plan. The plan prescribes the type, amount, frequency, and duration... the speech-language pathology services. (v) A registered professional nurse or a staff physician, in...

42 CFR 410.61 - Plan of treatment requirements for outpatient rehabilitation services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the occupational therapy services. (5) A nurse practitioner, a clinical nurse specialist, or a physician assistant. (c) Content of the plan. The plan prescribes the type, amount, frequency, and duration... the speech-language pathology services. (v) A registered professional nurse or a staff physician, in...

Comparison of augmented and nonaugmented modified Knapp procedure for the treatment of nonrestrictive double elevator palsies.

PubMed

Li, YuePing; Sun, LiLi; Zhang, Wei; Zhao, KanXing

2016-10-01

To compare surgical results of augmented and nonaugmented modified Knapp procedure, for the treatment of nonrestrictive double elevator palsies (DEP). The medical records of patients with congenital DEP were reviewed retrospectively. Patients were divided into three treatment groups: standard transposition (group A), Foster transposition (group B), and resection transposition (group C). Pre- and postoperative vertical deviation in primary position, ocular motility, and binocular vision were compared. Thirty patients were enrolled. The pre- and postoperative deviations in group A were 34.7 Δ ± 8.6 Δ and 6.5 Δ ± 6.5 Δ ; in group B, 38.6 Δ ± 14.6 Δ and 5.7 Δ ± 9.3 Δ ; and in group C, 43.1 Δ ± 10.3 Δ and 8.5 Δ ± 6.1 Δ . The corrected vertical deviation of group B (32.9 Δ  ± 5.7 Δ ) and group C (34.6 Δ  ± 5.0 Δ ) were greater than that of group A (28.1 Δ  ± 3.6 Δ ; P = 0.03, 0.002). The pre- and postoperative measures of upgaze in group A were -3.7 and -1.8; in group B, -4.0 and -1.3; and in group C, -3.6 and -2.0. The average improved upgaze in group B (2.6 ± 0.5) was statistically significantly better than that in group A (1.9 ± 0.6) and group C (1.5 ± 0.5; P = 0.03, 0.002). There was no significant difference in the surgical effect on downgaze in three groups (P > 0.05). The surgical outcome was satisfactory in 19 (63.3%) patients with preoperative vertical devation of ≤40 Δ . All transpositions are reasonably effective in treating vertical deviations of <35 Δ without obviously limiting downgaze in DEP. Augmented procedures could correct greater vertical deviation of 30 Δ -40 Δ . The Foster transposition demonstrates the strongest effect in improving upgaze. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Contribution of four lifelong factors of cognitive reserve on late cognition in normal aging and Parkinson's disease.

PubMed

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.

Immediate effects on electromyographic activity and pressure pain thresholds after a cervical manipulation in mechanical neck pain: a randomized controlled trial.

PubMed

de Camargo, Viviane Maduro; Alburquerque-Sendín, Francisco; Bérzin, Fausto; Stefanelli, Vinicius Cobos; de Souza, Daiana P Rodrigues; Fernández-de-las-Peñas, César

2011-05-01

The purpose of this study was to identify the immediate effects of a manipulation of C5/C6 level on electromyography (EMG) of the deltoid muscle and in pressure pain thresholds (PPTs) in patients with mechanical neck pain. Thirty-seven subjects with mechanical neck pain were randomly divided into 2 groups: manipulative group, which received a cervical spine manipulation targeted to C5/C6 segment, and a control group, which did not receive any procedure. Outcomes were EMG data of the deltoid muscle (rest, isometric contraction for 5 or 30 seconds, and isotonic contraction) and PPT over upper trapezius and deltoid muscles and C5 spinous process. They were assessed before and 5 minutes after treatment by a blinded assessor. A 3-way repeated-measures analysis of variance was used to examine the effects of the manipulation. A significant group time interaction for MF at the beginning of isometric contraction for 30 seconds (F = 7.957, P = .006) was also found: the manipulative group experienced a greater increase in MF at the beginning of the isometric contraction than did the control group. A significant group time interaction was also found for root mean square during isometric contraction for 30 seconds (P = .003); however, changes were small. Patients within the manipulative group experienced an increase on PPT over the deltoid (P = .010) and C5 spinous process (P = .025), but not over upper trapezius (P = .776). Manipulation at C5/C6 level in the study participants seemed to increase EMG amplitude signal and fatigue resistance in a nonspinal (deltoid) muscle innervated by the same segment in patients with mechanical neck pain. However, these changes were relative small. An increase on PPT over those tissues innervated by the manipulated segment was also found after the manipulative procedure. Copyright © 2011 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Protein S deficiency complicated pregnancy in women with recurrent pregnancy loss.

PubMed

Shinozaki, Nanae; Ebina, Yasuhiko; Deguchi, Masashi; Tanimura, Kenji; Morizane, Mayumi; Yamada, Hideto

2016-08-01

This prospective study aimed to evaluate pregnancy outcome and complications in women with recurrent pregnancy loss (RPL) and protein S (PS) deficiency, who received low dose aspirin (LDA) or LDA plus heparin (LDA/H) therapies. Clinical characteristics, pregnancy outcome and complications of 38 women with two or more RPL and <60% of plasma free PS antigen were compared among three groups: antiphospholipid antibody (aPL)-negative women who received LDA (group A), aPL-negative women who received LDA/H (group B) and aPL-positive women who received LDA/H (group C). Gestational weeks (GW) at delivery in group C (median 32 GW) were earlier than 40 GW in group A and 38.5 GW in group B (p < 0.05). The birth weight in group C (median 1794 g) was less than 2855 g in group B (p < 0.05). The incidences of fetal growth restriction (37.5%), pregnancy-induced hypertension (37.5%), and preterm delivery (62.5%) in group C were higher than those (4.5%, 0%, and 4.5%, respectively) in group B (p<0.05). Women with RPL, PS deficiency, and positive aPL had high risks for adverse pregnancy outcome and complications, even when they received LDA/H therapy. Among women with RPL, PS, and negative aPL, there was no difference in these risks between LDA alone and LDA/H therapies.

Attention-Deficit/Hyperactivity Disorder (ADHD) Symptoms in Pediatric Narcolepsy: A Cross-Sectional Study.

PubMed

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.

C5 palsy after posterior cervical decompression and fusion: cost and quality-of-life implications.

PubMed

Miller, Jacob A; Lubelski, Daniel; Alvin, Matthew D; Benzel, Edward C; Mroz, Thomas E

2014-12-01

C5 palsy is a debilitating postoperative complication of cervical decompression surgery. Although the prognosis is typically good, patients may be unable to perform basic activities of daily living, resulting in a decreased quality of life. No studies have investigated the quality-of-life and financial implications. The aim of the study was to determine the impact on quality-of-life and costs of C5 palsy after posterior cervical decompression and fusion (PCDF). A 2:1 matched retrospective cohort study was conducted at a single tertiary-care institution between 2007 and 2012. Individuals who had undergone PCDF were included. Self-reported: Euroqol-5 Dimensions quality-of-life survey. Physiologic: postoperative change in deltoid and biceps strength via manual muscle testing. Functional: cost of interventions and missed workdays postoperatively. Individuals with postoperative C5 palsy were matched to controls based on age, gender, body mass index, and diagnosis. Demographic, operative, postoperative, quality-of-life, and cost data were collected for both the C5 palsy and control groups, with 1-year follow-up. We reviewed 245 patients who underwent PCDF and 17 were identified (6.9%) with C5 palsy and matched to 34 controls. No significant differences in demographic or operative characteristics were observed between groups. The C5 palsy group had a significantly reduced capacity for self-care in the immediate postoperative (2.0±0.71 vs. 1.2±0.4, p<.001) and long-term (1.6±0.6 vs. 1.2±0.4, p=.004) periods and a significantly reduced capacity for completion of usual activities (2.4±0.7 vs. 1.9±0.6, p=.014) compared with controls. Furthermore, the C5 group had a significantly greater cost of physical/occupational therapy, an increase of $2,078 ($4,386±$2,801 vs. $2,307±$1,907, p=.013). There were no significant differences between groups in the cost of hospital stay, surgery, or other direct or indirect costs. Overall, there was a significantly greater cost ($1,918) for the C5 palsy group compared with the control group ($7,584±$3,992 vs. $5,666±$2,359, respectively, p=.038). This study represents the first quantification of the impact of C5 palsy on patients' quality of life and the associated costs for care. We found that C5 palsy adds a significant burden on patients' quality of life and presents a financial burden to the health-care system. Copyright © 2014 Elsevier Inc. All rights reserved.

Professional quality of life and organizational changes: a five-year observational study in Primary Care

PubMed Central

Martin-Fernandez, Jesus; Gomez-Gascon, Tomas; Beamud-Lagos, Milagros; Cortes-Rubio, Jose Alfonso; Alberquilla-Menendez-Asenjo, Angel

2007-01-01

Background The satisfaction and the quality of life perceived by professionals have implications for the performance of health organizations. We have assessed the variations in professional quality of life (PQL) and their explanatory factors during a services management decentralization process. Methods It was designed as a longitudinal analytical observational study in a Health Area in Madrid, Spain. Three surveys were sent out during an ongoing management decentralization process between 2001 and 2005. The professionals surveyed were divided into three groups: Group I (97.3% physicians), group II (92.5% nurses) and group III (auxiliary personnel). Analysis of the tendency and elaboration of an explanatory multivariate model was made. The PQL -35 questionnaire, based on Karasek's demand-control theory, was used to measure PQL. This questionnaire recognizes three PQL dimensions: management support (MS), workload (WL) and intrinsic motivation (IM). Results 1444 responses were analyzed. PQL increased 0.16 (CI 95% 0.04 – 0.28) points in each survey. Group II presents over time a higher PQL score than group I of 0.38 (IC 95% 0.18 – 0.59) points. There is no difference between groups I and III. For each point that MS increases, PQL increases between 0.44 and 0.59 points. PQL decreases an average of between 0.35 and 0.49 point, for each point that WL increases. Age appears to have a marginal association with PQL (CI 95% 0.00 – 0.02), as it occurs with being single or not having a stable relationship (CI 95% 0.01 – 0.41). Performing management tasks currently or in the past is related to poorer PQL perception (CI 95% -0.45 – -0.06), and the same occurs with working other than morning shifts (CI 95% -0.03 – -0.40 points). PQL is not related to sex, location of the centre (rural/urban), time spent working in the organization or contractual situation. Conclusion With the improvement in work control and avoiding increases in workloads, PQL perception can be maintained despite deep organizational changes at the macro-management level. Different professional groups experience different perceptions depending on how the changes impact their position in the organization. PMID:17610728

Compound oxidized styrylphosphine. [flame resistant vinyl polymers

NASA Technical Reports Server (NTRS)

Paciorek, K. J. L. (Inventor)

1979-01-01

A process is described for preparing flame resistant, nontoxic vinyl polymers which contain phosphazene groups and which do not emit any toxic or corrosive products when they are oxidatively degraded. Homopolymers, copolymers, and terpolymers of a styrene based monomer are prepared by polymerizing at least one oxidized styrylphosphine monomer from a group of organic azides, or by polymerizing p-diphenylphosphinestyrene and then oxidizing that monomer with an organoazide from the group of (C6H5)2P(O)N3, (C6H5O)2P(O)N3, (C6H5)2C3N3(N3), and C6H5C3N3(N3)2. Copolymers can also be prepared by copolymerizing styrene with at least one oxidized styrylphosphine monomer.

From Novice to Seasoned Practitioner: a Qualitative Investigation of Genetic Counselor Professional Development.

PubMed

Zahm, Kimberly Wehner; Veach, Patricia McCarthy; Martyr, Meredith A; LeRoy, Bonnie S

2016-08-01

Research on genetic counselor professional development would characterize typical developmental processes, inform training and supervision, and promote life-long development opportunities. To date, however no studies have comprehensively examined this phenomenon. The aims of this study were to investigate the nature of professional development for genetic counselors (processes, influences, and outcomes) and whether professional development varies across experience levels. Thirty-four genetic counselors participated in semi-structured telephone interviews exploring their perspectives on their professional development. Participants were sampled from three levels of post-degree genetic counseling experience: novice (0-5 years), experienced (6-14 years), and seasoned (>15 years). Using modified Consensual Qualitative Research and grounded theory methods, themes, domains, and categories were extracted from the data. The themes reflect genetic counselors' evolving perceptions of their professional development and its relationship to: (a) being a clinician, (b) their professional identity, and (c) the field itself. Across experience levels, prevalent influences on professional development were interpersonal (e.g., experiences with patients, genetic counseling colleagues) and involved professional and personal life events. Common developmental experiences included greater confidence and less anxiety over time, being less information-driven and more emotion-focused with patients, delivering "bad news" to patients remains challenging, and individuals' professional development experiences parallel genetic counseling's development as a field. With a few noteworthy exceptions, professional development was similar across experience levels. A preliminary model of genetic counselor professional development is proposed suggesting development occurs in a non-linear fashion throughout the professional lifespan. Each component of the model mutually influences the others, and there are positive and negative avenues of development.

Effects of cooking temperatures on the physicochemical properties and consumer acceptance of chicken stock.

PubMed

Krasnow, Mark; Bunch, Tucker; Shoemaker, Charles; Loss, Christopher R

2012-01-01

As a base for sauces, soups, and cooking liquids for meats, grains, and vegetables, stocks can be integral to the overall quality of restaurant menu items, however, science-based studies on the effects of cooking methods on the physiochemical and sensory properties of stock are lacking. The effects of starting (22 °C, 85 °C, and 99 °C) and cooking temperatures (85 °C and 99 °C) of chicken stock on clarity, color, viscosity, protein content, amino acid content, mineral content, and overall liking were measured. Protein content and viscosity were significantly higher for stocks cooked at 99 °C, but no effect on amino acid content, color, or clarity was observed. Calcium concentration in stocks cooked at 99 °C was significantly (P < 0.0001) lower (9.3 and 10.1 mg/mL, for stocks started at temperatures of 22 and 99 °C, respectively) than stock cooked at 85 °C (16.6 and 17.5 mg/mL for stocks started at temperatures of 22 and 85 °C, respectively). Stocks prepared at 99 °C scored higher on overall liking compared to commercial samples and those cooked at 85 °C (P= 0.0101). These data can be used by culinary scientists and professionals to develop more efficient techniques in the kitchen, and by product developers to optimize the overall quality and acceptance of stock. This work documents the effects of preparation method on the physical and chemical properties, and consumer acceptance of chicken stock. This information can be used by product developers, culinary scientists, and professional chefs to optimize stock-based products. Culinary educators can use this information to provide students with objective evidence-based rationale for the techniques underlying a celebrated culinary tradition. This is also an example of how research can facilitate collaboration between culinary and food science professionals. © 2011 Institute of Food Technologists®

Acute administration of vitamin C abrogates protection from ischemic preconditioning in rabbits.

PubMed

Tsovolas, Konstantinos; Iliodromitis, Efstathios K; Andreadou, Ioanna; Zoga, Anastasia; Demopoulou, Maritina; Iliodromitis, Konstantinos E; Manolaki, Theodora; Markantonis, Sophia L; Kremastinos, Dimitrios Th

2008-04-01

Vitamin C is considered to be an antioxidant agent that is broadly used. Free radicals are involved in the protective mechanism of preconditioning (PC), but some antioxidant compounds abolish this benefit. The aim of the present study was to evaluate the effect of vitamin C on the protective effect of PC with respect to infarct size and oxidative stress in anesthetized rabbits. Male rabbits were randomly divided into six groups and subjected to 30 min of myocardial ischemia and 3h of reperfusion with the following interventions per group: (1) Control (no intervention), (2) Vit C 150 group (i.v. vitamin C at a total dose of 150 mg/kg for 75 min, starting 40 min before the onset of long ischemia and lasting up to the 5th min of reperfusion), (3) Vit C 300 group (i.v. vitamin C at a total dose of 300 mg/kg as previously described), (4) PC group (two cycles of 5 min ischemia and 10 min reperfusion), (5) combined PC-Vit C 150 group and (6) combined PC-Vit C 300 group. Blood samples were taken at different time points for malondialdehyde (MDA) assessment as a lipid peroxidation marker and for superoxide dismutase (SOD) activity. At the end of the experiment the infarct size was determined. Vitamin C, at both doses, did not reduce the infarct size (35.5+/-4.1%, 38.3+/-7.0% vs. 44.9+/-3.3% in the control group) and diminished the protection afforded by PC (32.0+/-2.7%, 43.8+/-3.3% vs. 15.7+/-2.9% in the PC group, P<0.05). At reperfusion there was an elevation of circulating MDA levels in the control and PC groups while in both vitamin C groups the levels were decreased. SOD activity was enhanced in the PC group compared to the controls; vitamin C did not change SOD activity during ischemia-reperfusion. Vitamin C abrogates the beneficial effect of ischemic PC on infarct size and elicits antioxidant properties during ischemia-reperfusion.

Impact of education and network for avian influenza H5N1 in human: knowledge, clinical practice, and motivation on medical providers in Vietnam.

PubMed

Manabe, Toshie; Pham, Thi Phuong Thuy; Kudo, Koichiro; Vu, Thi Tuong Van; Takasaki, Jin; Nguyen, Dang Tuan; Dao, Xuan Co; Dang, Hung Minh; Izumi, Shinyu; Nguyen, Gia Binh; Ngo, Quy Chau; Tran, Thuy Hanh

2012-01-01

Knowledge, clinical practice, and professional motivation of medical providers relating to H5N1 infection have an important influence on care for H5N1 patients who require early diagnosis and early medical intervention. Novel educational programs including training and workshops for medical providers relating to H5N1 infection in Vietnam were originally created and implemented in 18 provincial hospitals in northern Vietnam between 2008 and 2010. A self-administered, structured questionnaire survey was conducted in 8 provincial hospitals where both educational training and workshops were previously provided. A total of 326 medical providers, including physicians, nurses, and laboratory technicians who attended or did not attend original programs were enrolled in the survey. Knowledge, clinical attitudes and practice (KAP), including motivation surrounding caring for H5N1 patients, were evaluated. The study indicated a high level of knowledge and motivation in all professional groups, with especially high levels in laboratory technicians. Conferences and educational programs were evaluated to be the main scientific information resources for physicians, along with information from colleagues. The chest radiographs and the initiation of antiviral treatment in the absence of RT-PCR result were identified as gaps in education. Factors possibly influencing professional motivation for caring for H5N1 patients included healthcare profession, the hospital where the respondents worked, age group, attendance at original educational programs and at educational programs which were conducted by international health-related organizations. Educational programs provide high knowledge and motivation for medical providers in Vietnam caring for H5N1 patients. Additional educational programs related to chest radiographs and an initiation of treatment in the absence of RT-PCR are needed. Networking is also necessary for sharing updated scientific information and practical experiences. These enhanced KAPs by educational programs and integrated systems among hospitals should result in appropriate care for H5N1 patients and may reduce morbidity and mortality.

Synthesis and redox properties of crowded triarylphosphines possessing ferrocenyl groups.

PubMed

Sutoh, Katsuhide; Sasaki, Shigeru; Yoshifuji, Masaaki

2006-02-06

Crowded triarylphosphines possessing ferrocenyl groups [(4-ferrocenyl-2,6-diisopropylphenyl)(n)(2,4,6-triisopropylphenyl)(3-n)P (5a, n = 1; 5b, n = 2; 5c, n = 3)] were synthesized by the reaction of the corresponding arylcopper(I) reagents with the diarylchlorophosphines. Structures of the triarylphosphines were studied by 1H, 13C, and 31P NMR spectroscopies, and the characteristic patterns of the proton signals of the 2,6-isopropyl groups and upfielded 31P chemical shifts suggest structural similarities of the triarylphosphine moiety to the previously reported tris(2,4,6-triisopropylphenyl)phosphine (2). X-ray crystallography of 5c also revealed that the structure around the phosphorus is similar to that of 1, where the average bond angle and length around the phosphorus atom are 110.8 degrees and 1.854 A, respectively. According to the electrochemical measurements, phosphines 5a, 5b, and 5c are reversibly oxidized in two, three, and four steps, respectively, which suggests significant electronic interaction among the triarylphosphine and the ferrocene redox centers as well as weak interaction among the ferrocene redox centers. The EPR spectra obtained at cryogenic temperature after oxidation of phosphines 5a, 5b, and 5c are superpositions of those for the cation radicals of the crowded triarylphosphine and ferricinium. The solution spectra obtained at 293 K, which consist of two lines typical of the cation radical of the crowded triarylphosphines, become weaker as the number of the ferrocenyl groups increases and the cation radical of 5c does not show EPR signals. These findings suggest not only instability of the tetra(cation radical) of 5c but also the course of oxidation where the ferrocenyl groups in the periphery of the molecules are oxidized at first.

Survival Pattern of Hodgkin Lymphoma Patients in the Last 25 Years in Lebanon.

PubMed

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.

The Association of Normal Range Glycated Hemoglobin with Restrictive Lung Pattern in the General Population

PubMed Central

Oh, Il Hwan; Park, Jung Hwan; Lee, Chang Hwa; Park, Joon-Sung

2015-01-01

Glycated hemoglobin (HbA1c) is an important diagnostic indicator of diabetes mellitus, and some authors have argued that it is related to impaired lung function in the diabetic population. However, there was rare study for association between lung function and HbA1c in the non-diabetic population. We investigated whether HbA1c below the diagnostic threshold is related to deficits in lung function. We analyzed biochemical and spirometry data from a nation-wide, population-based, case-control study (the KNHANES IV and V). Eligible as cases were all native Koreans aged 40 years or more with no medical illness. A total of 3670 participants were divided into 4 groups according to HbA1c (%) as follows: Group I (n = 842), ≥ 4.0 and ≤ 5.3; Group II (n = 833), > 5.3 and ≤ 5.5; Group III (n = 898), > 5.5 and ≤ 5.7; and Group IV (n = 1097), > 5.7 and ≤ 6.4. Group I had the greatest forced vital capacity (FVC, 96.3 ± 0.5% pred, P < 0.0001), forced expiratory volume per second (FEV1, 93.8 ± 0.5% pred, P < 0.0001) and FEV1/FVC (0.792 ± 0.003, P < 0.0001) compared with the other groups. Linear regression showed that HbA1c was closely related to FVC (β = -6.972154, P < 0.0001) and FEV1 (β = -5.591589, P < 0.0001), but not to FEV1/FVC. Logistic regression analysis revealed a significant association between HbA1c and a restrictive spirometric pattern (FVC < 80% pred., FEV1/FVC ≥ 0.70; OR = 3.772, 95% CI = 1.234-11.53), indicating that elevated HbA1c is closely associated with lung impairment in the non-diabetic population. In the healthy population, relatively high HbA1c level is associated with decrements of FVC and FEV1 and may be a reliable predictor of poor lung function, especially the restrictive pattern. PMID:25658743

The Interaction between Group Processes and Personal Professional Trajectories in a Professional Development Community for Teacher Educators

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…

Clinical outcomes of radiotherapy for esophageal cancer between 2004 and 2008: the second survey of the Japanese Radiation Oncology Study Group (JROSG).

PubMed

Nishimura, Yasumasa; Jingu, Keiichi; Itasaka, Satoshi; Negoro, Yoshiharu; Murakami, Yuji; Karasawa, Katsuyuki; Kawaguchi, Gen; Isohashi, Fumiaki; Kobayashi, Masao; Itoh, Yoshiyuki; Ariga, Takuro

2016-02-01

This second questionnaire-based survey was performed to determine the clinical results of definitive esophageal cancer treatment with radiotherapy (RT) or chemoradiotherapy (CRT) between 2004 and 2008. Clinical results of definitive RT for patients were collected from major Japanese institutions. Patients were classified into three groups: (A) stage I, (B) resectable stages II-III, (C) unresectable stages III-IVA. For group A, all patients treated with RT alone or CRT were included. For groups B and C, only those treated with CRT were included. In total, 990 patients (group A 259, group B 333, group C 398 patients) were included from 11 institutions. In group A, 199 patients (78 %) were treated with CRT, and 60 patients (23 %) received RT alone. In groups B and C, 420 patients (57 %) were treated with full-dose cisplatin/5-FU, and 181 patients (25 %) with low-dose protracted-infusion cisplatin/5-FU. The median and range of the 5-year overall survival rate were 73 % (40-94 %) for group A, 40 % (0-57 %) for group B, and 18 % (6-26 %) for group C, respectively. The 5-year overall survival rates were consistently good for five high-volume centers where more than 20 patients/year with esophageal cancer were treated definitively as compared with the remaining six medium-volume centers (5-15 patients/year). The median and range of the incidence of grade ≥3 late toxicities were 10 % and 6-22 %, respectively. A wide disparity in 5-year overall survival rates among the institutions was still apparent in the second survey for groups A and B.

Nine-year risk of depression diagnosis increases with increasing self-reported concussions in retired professional football players.

PubMed

Kerr, Zachary Y; Marshall, Stephen W; Harding, Herndon P; Guskiewicz, Kevin M

2012-10-01

Concussions may accelerate the progression to long-term mental health outcomes such as depression in athletes. To prospectively determine the effects of recurrent concussions on the clinical diagnosis of depression in a group of retired football players. Cohort study; Level of evidence, 2. Members of the National Football League Retired Players Association responded to a baseline General Health Survey (GHS) in 2001. They also completed a follow-up survey in 2010. Both surveys asked about demographic information, number of concussions sustained during their professional football career, physical/mental health, and prevalence of diagnosed medical conditions. A physical component summary (Short Form 36 Measurement Model for Functional Assessment of Health and Well-Being [SF-36 PCS]) was calculated from responses for physical health. The main exposure, the history of concussions during the professional playing career (self-report recalled in 2010), was stratified into 5 categories: 0 (referent), 1 to 2, 3 to 4, 5 to 9, and 10+ concussions. The main outcome was a clinical diagnosis of depression between the baseline and follow-up GHS. Classic tabular methods computed crude risk ratios. Binomial regression with a Poisson residual and robust variance estimation to stabilize the fitting algorithm estimated adjusted risk ratios. χ(2) analyses identified associations and trends between concussion history and the 9-year risk of a depression diagnosis. Of the 1044 respondents with complete data from the baseline and follow-up GHS, 106 (10.2%) reported being clinically diagnosed as depressed between the baseline and follow-up GHS. Approximately 65% of all respondents self-reported sustaining at least 1 concussion during their professional careers. The 9-year risk of a depression diagnosis increased with an increasing number of self-reported concussions, ranging from 3.0% in the "no concussions" group to 26.8% in the "10+" group (linear trend: P < .001). A strong dose-response relationship was observed even after controlling for confounders (years retired from professional football and 2001 SF-36 PCS). Retired athletes with a depression diagnosis also had a lower SF-36 PCS before diagnosis. The association between concussions and depression was independent of the relationship between decreased physical health and depression. Professional football players self-reporting concussions are at greater risk for having depressive episodes later in life compared with those retired players self-reporting no concussions.

A fixed inhaled nitrous oxide/oxygen mixture as an analgesic for adult cancer patients with breakthrough pain: study protocol for a randomized controlled trial.

PubMed

Liu, Qiang; Wang, Yu; Luo, Xiang-Jiang; Wang, Ning-Ju; Chen, Ping; Jin, Xin; Mu, Guo-Xia; Chai, Xiao-Min; Zhang, Yue-Juan; Li, Yu-Xiang; Yu, Jian-Qiang

2017-01-11

The management of breakthrough pain in cancer patients is always a challenge for medical professions. Occurring in 80% of cancer patients with advanced disease, breakthrough pain significantly decreases both patient's and caregiver's quality of life. The aim of this study is to assess the analgesic efficacy of a fixed inhaled nitrous oxide/oxygen mixture for adult cancer patients with breakthrough pain. This is a randomized, placebo-controlled, double-blind study; it will be conducted in the General Hospital of Ningxia Medical University. The target study subjects are at least 18 years old, and are hospitalized cancer patients who are receiving routine opioids to control cancer-related pain but still experience breakthrough pain. A total of 240 patients will be recruited and randomly allocated between three treatment groups (A, B, C) and a control group (group D) in a ratio of 3:1. All treatment groups (A, B, C) will receive standard pain treatment (oral immediate-release morphine) plus a pre-prepared nitrous oxide/oxygen mixture, and the control group (D) will receive the standard pain treatment plus oxygen. Patients, doctors, nurses, and data collectors are all blind to the experiment. Assessments will be taken before treatment (T0), at 5 min (T1) and 15 min (T2) during treatment, and at 5 min after treatment (T3). The primary endpoint measures will be the percentage of patients whose pain is relieved at T1, T2, and T3. Secondary outcome measures will include the safety of treatment, adverse events, and satisfaction from both health professionals and patients. This study aims to provide an effective and practical intervention for a fast breakthrough pain relief and to improve cancer patients' quality of life significantly. The Evidence-Based Medicine Working Group claim that a randomized, double-blind, placebo-controlled experimental intervention is the most appropriate design to demonstrate its efficacy, so this study could give a new approach to controlling breakthrough pain episodes. ChiCTR-INC-16008075 . Registered on 8 March 2016.

A multi-faceted tailored strategy to implement an electronic clinical decision support system for pressure ulcer prevention in nursing homes: a two-armed randomized controlled trial.

PubMed

Beeckman, Dimitri; Clays, Els; Van Hecke, Ann; Vanderwee, Katrien; Schoonhoven, Lisette; Verhaeghe, Sofie

2013-04-01

Frail older people admitted to nursing homes are at risk of a range of adverse outcomes, including pressure ulcers. Clinical decision support systems are believed to have the potential to improve care and to change the behaviour of healthcare professionals. To determine whether a multi-faceted tailored strategy to implement an electronic clinical decision support system for pressure ulcer prevention improves adherence to recommendations for pressure ulcer prevention in nursing homes. Two-armed randomized controlled trial in a nursing home setting in Belgium. The trial consisted of a 16-week implementation intervention between February and June 2010, including one baseline, four intermediate, and one post-testing measurement. Primary outcome was the adherence to guideline-based care recommendations (in terms of allocating adequate pressure ulcer prevention in residents at risk). Secondary outcomes were the change in resident outcomes (pressure ulcer prevalence) and intermediate outcomes (knowledge and attitudes of healthcare professionals). Random sample of 11 wards (6 experimental; 5 control) in a convenience sample of 4 nursing homes in Belgium. In total, 464 nursing home residents and 118 healthcare professionals participated. The experimental arm was involved in a multi-faceted tailored implementation intervention of a clinical decision support system, including interactive education, reminders, monitoring, feedback and leadership. The control arm received a hard-copy of the pressure ulcer prevention protocol, supported by standardized 30 min group lecture. Patients in the intervention arm were significantly more likely to receive fully adequate pressure ulcer prevention when seated in a chair (F=16.4, P=0.003). No significant improvement was observed on pressure ulcer prevalence and knowledge of the professionals. While baseline attitude scores were comparable between both groups [exp. 74.3% vs. contr. 74.5% (P=0.92)], the mean score after the intervention was 83.5% in the experimental group vs. 72.1% in the control group (F=15.12, P<0.001). The intervention was only partially successful to improve the primary outcome. Attitudes improved significantly while the knowledge of the healthcare workers remained unsatisfactorily low. Further research should focus on the underlying reasons for these findings. Copyright © 2012 Elsevier Ltd. All rights reserved.

Multiple bonds between transition metals and main-group elements. 73. Synthetic routes to rhenium(V) alkyl and rhenium(VII) alkylidyne complexes. X-ray crystal structures of (. eta. sup 5 -C sub 5 Me sub 5 )Re( double bond O)(CH sub 3 )(CH sub 2 C(CH sub 3 ) sub 3 ) and (. eta. sup 5 -C sub 5 Me sub 5 )(Br) sub 3 Re triple bond CC(CH sub 3 ) sub 3

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

Herrmann, W.A.; Felixberger, J.K.; Anwander, R.

1990-05-01

Dialkyloxo({eta}{sup 5}pentamethylcyclopentadienyl)rhenium(V) complexes ({eta}{sup 5}-C{sub 5}Me{sub 5})Re({double bond}O)(CH{sub 3})R{prime}(R{prime} = C{sub 2}H{sub 5}, CH{sub 2}Si(CH{sub 3}){sub 3}, CH{sub 2}C(CH{sub 3}){sub 3}), 1c-e, have become accessible through alkylation of ({eta}{sup 5}-C{sub 5}Me{sub 5})Re({double bond}O)(Cl)(CH{sub 3}) (7) with R{prime}MgCl. 1c-e are the first rhenium complexes containing different alkyl ligands. The neopentyl derivative 1e (R{prime} = CH{sub 2}C(CH{sub 3}){sub 3}) crystallizes in the orthorhombic space group Pbca with a = 960.7 (2), b = 2.844.5 (4), c = 1,260.7 (2) pm, and Z = 8. The X-ray crystal structure was refined to R{sub W} = 3.9%. The chiral molecule shows a distorted tetrahedralmore » geometry around the rhenium center. The tribromide 3b has been structurally characterized. Brown crystals of 3b belong to space group P2{sub 1}/c with unit cell dimensions a = 1,311.5 (2), b = 723.0 (1), c = 1,901.6 (2) pm, {beta} = 92.68 (1){degree}, and Z = 4. The structure exhibits a four-legged piano stool geometry with no trans influence of the neopentylidyne ligand to the bromine atom.« less

Identification of major factors in Australian primary care pharmacists' practice environment that have a bearing on the implementation of professional models of practice.

PubMed

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.

Efficacy of antiviral therapy on hepatitis C recurrence after liver transplantation: a randomized controlled study.

PubMed

Carrión, José A; Navasa, Miquel; García-Retortillo, Montserrat; García-Pagan, Juan Carlos; Crespo, Gonzalo; Bruguera, Miquel; Bosch, Jaime; Forns, Xavier

2007-05-01

Recurrence of hepatitis C virus (HCV) infection is a relevant problem of liver transplantation programs. We evaluated the effect of antiviral therapy on disease progression in 81 HCV-infected liver transplantation recipients. Patients with mild hepatitis C recurrence (fibrosis stage F0 to F2, n = 54) were randomized to no treatment (group A, n = 27) or peginterferon alfa-2b/ribavirin for 48 weeks (group B, n = 27). Patients with severe recurrence (F3 to F4, cholestatic hepatitis) were treated (group C, n = 27). All patients (n = 81) underwent a liver biopsy at baseline and after follow-up; paired hepatic venous pressure gradient (HVPG) measurements were available in 51 patients. Thirteen (48%) patients of group B and 5 (18.5%) of group C achieved sustained virological response. Liver fibrosis progressed > or =1 stage in 40 (49%) of 81 patients: 19 (70%) of group A versus 7 (26%) of group B (P = .001) and in 14 (54%) of group C. HVPG increased (6.5 to 13 mm Hg, P < .01) in patients in whom fibrosis worsened, whereas it decreased (5 to 3.5 mm Hg, P = .017) or remained unchanged in those with fibrosis improvement or stabilization, respectively. The only variable independently associated with fibrosis improvement/stabilization was treatment (odds ratio [OR] =3.7, 95% confidence interval [CI] 1.3 to 10, P = .009). Among treated patients, alanine aminotransferase (ALT) normalization and viral clearance were independently associated with histological or hemodynamic improvement/stabilization (OR 5.3, 95% CI 1.5 to 18, P < .01; OR 7.4, 95% CI 1.4 to 38, P = .01; respectively). Our data demonstrate that in liver transplantation recipients, antiviral therapy slows disease progression (particularly in sustained virological responders), as shown by its effects on liver histology and on HVPG.

Efficacy of a New Recrystallized Enrofloxacin Hydrochloride-Dihydrate against Leptospirosis in a Hamster Model.

PubMed

Carrascosa, Alma; Gutierrez, Lilia; De la Peña, Alejandro; Candanosa, Irma E; Tapia, Graciela; Sumano, Hector

2017-11-01

A trial on Syrian hamsters ( Mesocricetus auratus ) infected with Leptospira interrogans serovar Canicola was established to compare treatment efficacies of daily intramuscular (i.m.) injections of either 10 mg/kg of 5% enrofloxacin (Baytril [BE]; Bayer Animal Health, Mexico) or the same dose of enrofloxacin hydrochloride-dihydrate (enro-C). Hamsters were experimentally infected via the oral submucosa with 400 microorganisms/animal, in a sequential time schedule aligned to the initial treatment day, and were treated in groups as follows: a group treated with 5% enrofloxacin daily for 7 days after 24 h of infection (group BE 24 ); a group treated as described for group BE 24 but with enro-C (enro-C 24 ); a group also treated with 5% enrofloxacin but starting at 72 h after infection (BE 74 ); a group treated as described for group BE 74 but with injection of enro-C (enro-C 74 ). An untreated-uninfected control group (group CG - ) and an infected-untreated control group (group CG + ) were assembled ( n = 18 in all groups). Weights and temperatures of the hamsters were monitored daily for 28 days. After hamsters were euthanatized or following death, necropsy, histopathology, macroscopic agglutination tests (MAT), bacterial culture, and PCR were performed. The mortality rates were 38.8% in group BE 24 and 100% in group BE 74 No mortality was observed in group enro-C 24 , and 11.1% mortality was recorded in group enro-C 74 The mortality rates in groups CG + and CG - were 100% and zero, respectively. Combined necropsy and histopathologic findings revealed signs of septicemia and organ damage in groups BE 24 , BE 72 , and CG + Groups enro-C 24 and CG - showed no lesions. Moderated lesions were registered in 3 hamsters in group enro-C 72 MAT results were positive in 83.3% of BE 24 hamsters (83.3%) and 100% of BE 72 and CG + hamsters; MAT results were positive in 16.7% in group Enro-C 24 and 38.9% in group enro-C 72 Only 4/18 were PCR positive in group enro-C 72 and only 1 in group enro-C 24 ( P < 0.05). It can be concluded that enro-C may be a viable option to treat leptospirosis in hamsters and that this may be the case in other species. Copyright © 2017 American Society for Microbiology.

Professionalism and Communication Education in Pediatric Critical Care Medicine: The Learner Perspective.

PubMed

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.

Poor oral health including active caries in 187 UK professional male football players: clinical dental examination performed by dentists.

PubMed

Needleman, Ian; Ashley, Paul; Meehan, Lyndon; Petrie, Aviva; Weiler, Richard; McNally, Steve; Ayer, Chris; Hanna, Rob; Hunt, Ian; Kell, Steven; Ridgewell, Paul; Taylor, Russell

2016-01-01

The few studies that have assessed oral health in professional/elite football suggest poor oral health with minimal data on impact on performance. The aim of this research was to determine oral health in a representative sample of professional footballers in the UK and investigate possible determinants of oral health and self-reported impact on well-being, training and performance. Clinical oral health examination of senior squad players using standard methods and outcomes carried out at club training facilities. Questionnaire data were also collected. 8 teams were included, 5 Premier League, 2 Championship and 1 League One. 6 dentists examined 187 players who represented >90% of each senior squad. Oral health was poor: 37% players had active dental caries, 53% dental erosion and 5% moderate-severe irreversible periodontal disease. 45% were bothered by their oral health, 20% reported an impact on their quality of life and 7% on training or performance. Despite attendance for dental check-ups, oral health deteriorated with age. This is the first large, representative sample study in professional football. Oral health of professional footballers is poor, and this impacts on well-being and performance. Successful strategies to promote oral health within professional football are urgently needed, and research should investigate models based on best evidence for behaviour change and implementation science. Furthermore, this study provides strong evidence to support oral health screening within professional football. 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/

[The emigration of physicians in Venezuela].

PubMed

Hernández, Tulia; Ortiz Gómez, Yamileth

2011-08-01

Ascertain the factors that could affect the intention of Venezuelan health professionals to emigrate to other countries. Exploratory study that applied a semistructured interview and survey, respectively, to a population consisting of four health professionals and 36 medical students. The interview data were analyzed by deductive and inductive categorization and the survey data by means of univariate and bivariate analysis. It was observed that 13.8% of the students generally intended to emigrate, with differences between the two study groups. It was found that work-related issues had a high motivating effect (16.6%), particularly the possibility of balancing work with personal life, better pay, access to continuing education, working in a better health system, and having the basic resources necessary for professional practice. It was determined that professional reasons had a moderate motivating effect (13.8%), whereas personal and contextual reasons had little influence (less than 3%). Although the interviews of physicians who had obtained their medical degree revealed clashes involving political and economic interests, only 5.5% of the students surveyed considered the political or economic situation a determinant in the emigration of professionals. It is recommended that the management and professional development of medical personnel be strengthened, reconciling their expectations with the legal framework and needs of the health system. A formal system for tracking the emigration of professionals and broadening the study of the causative factors at the national level should be set up, since better knowledge about the phenomena linked with emigration would help generate and support proposals to guarantee self-sufficiency with respect to human resources for health.

Establishment of a Multi-State Experiential Pharmacy Program Consortium

PubMed Central

Unterwagner, Whitney L.; Byrd, Debbie C.

2008-01-01

In 2002, a regional consortium was created for schools and colleges of pharmacy in Georgia and Alabama to assist experiential education faculty and staff members in streamlining administrative processes, providing required preceptor development, establishing a professional network, and conducting scholarly endeavors. Five schools and colleges of pharmacy with many shared experiential practice sites formed a consortium to help experiential faculty and staff members identify, discuss, and solve common experience program issues and challenges. During its 5 years in existence, the Southeastern Pharmacy Experiential Education Consortium has coordinated experiential schedules, developed and implemented uniform evaluation tools, coordinated site and preceptor development activities, established a work group for educational research and scholarship, and provided opportunities for networking and professional development. Several consortium members have received national recognition for their individual experiential education accomplishments. Through the activities of a regional consortium, members have successfully developed programs and initiatives that have streamlined administrative processes and have the potential to improve overall quality of experiential education programs. Professionally, consortium activities have resulted in 5 national presentations. PMID:18698386

Cross-cultural differences in the management of children and adolescents with diabetes.

PubMed

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

The Marketability of Army Officers

DTIC Science & Technology

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

Intrauterine Growth Restricted Rats Exercised at Pregnancy: Maternal-Fetal Repercussions.

PubMed

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.

Eyes-Closed Single-Limb Balance is Not Related to Hypermobility Status in Dancers.

PubMed

Marulli, Tiffany A; Harmon-Matthews, Lindsay E; Davis-Coen, J Hope; Willigenburg, Nienke W; Hewett, Timothy E

2017-06-15

Hypermobility may be associated with decreased lower extremity proprioception, which in turn may increase injury risk. The prevalence of hypermobility in dancers varies across studies, but joint hypermobility appears to be more common in dancers than in the general population. The purpose of this study was to determine how hypermobility affects eyes-closed single-limb balance as an indirect measure of proprioception in dancers. The secondary aim was to compare hypermobility and balance across dancer affiliation groups. Data were collected from 45 professional dancers, 11 collegiate modern dancers, 227 student dancers, and 15 pre-professional dancers during routine dance screens. Dancer hypermobility status was assessed via an eight-point Beighton-Horan Laxity test. Single-limb balance time, in seconds, was assessed in parallel position with the eyes closed. Hypermobile (HM) and non-hypermobile (NHM) dancers showed very similar balance times (HM median: 36.5 seconds; NHM median: 33.0 seconds; p = 0.982). Hypermobility was not significantly different between dancer affiliation groups (p = 0.154): 47% in ballet academy students, 27% in collegiate modern dancers, 62% in pre-professional dancers, and 36% in professional dancers. The student, pre-professional, and professional ballet dancers all demonstrated longer balance times than the collegiate modern dancers; however, this difference was only significant between the professional ballet dancers and collegiate modern dancers (p = 0.026). Dancers demonstrated a higher prevalence of hypermobility than what has been reported for the general population. Joint hypermobility did not affect eyes-closed single-limb balance time. Future studies are needed to determine if joint hypermobility affects more sensitive measures of proprioception and risk of injury.

Earlier triple therapy with pioglitazone in patients with type 2 diabetes.

PubMed

Charpentier, G; Halimi, S

2009-09-01

This study assessed the efficacy of add-on pioglitazone vs. placebo in patients with type 2 diabetes uncontrolled by metformin and a sulphonylurea or a glinide. This multicentre, double-blind, parallel-group study randomized 299 patients with type 2 diabetes to receive 30 mg/day pioglitazone or placebo for 3 months. After this time, patients continued with pioglitazone, either 30 mg [if glycated haemoglobin A1c (HbA(1c)) 6.5%), or placebo for a further 4 months. The primary efficacy end-point was improvement in HbA(1c) (per cent change). Secondary end-points included changes in fasting plasma glucose (FPG), insulin, C-peptide, proinsulin and lipids. The proinsulin/insulin ratio and homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of beta-cell function (HOMA-B) were calculated. Pioglitazone add-on therapy to failing metformin and sulphonylurea or glinide combination therapy showed statistically more significant glycaemic control than placebo addition. The between-group difference after 7 months of triple therapy was 1.18% in HbA(1c) and -2.56 mmol/l for FPG (p < 0.001). Almost half (44.4%) of the patients in the pioglitazone group who had a baseline HbA(1c) level of <8.5% achieved the HbA(1c) target of < 7.0% by final visit compared with 4.9% in the placebo group. When the baseline HbA(1c) level was >or= 8.5%, 13% achieved the HbA(1c) target of < 7.0% in the pioglitazone group and none in the placebo group. HOMA-IR, insulin, proinsulin and C-peptide decreased and HOMA-B increased in the pioglitazone group relative to the placebo group. In patients who were not well controlled with dual combination therapy, the early addition of pioglitazone improved HbA(1c), FPG and surrogate measures of beta-cell function. Patients were more likely to reach target HbA(1c) levels (< 7.0%) with pioglitazone treatment if their baseline HbA(1c) levels were < 8.5%, highlighting the importance of early triple therapy.

Effects of BSO, GSH, Vit-C and DMPS on the nephrotoxicity of mercury.

PubMed

Xu, Zhaofa; Yang, Jinghua; Yu, Jiaming; Yin, Zhongwei; Sun, Wei; Li, Jing

2007-08-01

To study the effects of BSO, GSH, Vit-C and DMPS on the nephrotoxicity of mercury. The rats in groups 1, 2 and 3 were sc injected with 0.75, 1.5 and 2.5 mg/kg HgCl2, respectively. Fourth group rats were ip injected with 0.5 mmol/kg BSO and 4h later sc administrated with 0.75 mg/kg HgCl2. The rats in groups 5, 6 and 7 were ip injected with 3 mmol/kg GSH, 4 mmol/kg Vit-C, 200 micromol/kg DMPS, respectively, and 2 h later sc administrated with 2.5 mg/kg HgCl2. Eighth group rats were sc injected with saline as a control. Mercury concentrations in the liver, renal cortex and urine, urinary NAG, ALP, LDH activities, protein and BUN contents were determined. Urinary NAG, ALP activities, protein and BUN contents in the rats of BSO pretreatment group were significantly higher than that of 0.75 mg/kg HgCl2 alone group and control group. As compared with 2.5 mg/kg HgCl2 alone group, urinary NAG, ALP, LDH activities, urinary protein and BUN contents decreased significantly. BSO pretreatment could enhance the renal toxicity of mercury and GSH, Vit-C and DMPS pretreatment had antagonistic effects on nephrotoxicity of mercury.

Postgraduate training at the ends of the earth - a way to retain physicians?

PubMed

Straume, Karin; Søndenå, Mona S; Prydz, Peter

2010-01-01

The recruitment and retention of health workers, crucial to health service delivery, is a major challenge in many rural and remote areas. Finnmark, the most remote and northern county in Norway, has faced recurrent shortages during the last 5 decades, especially of primary care physicians. This article describes a postgraduate training model for family physicians and public health/community medicine physicians, based on group tutorial and in-service training in rural areas. The effect of the training programs on physician retention in Finnmark is evaluated by a longitudinal cohort study. In total, 65-67% of the physicians from the programs are still working in the county 5 years after completion of the group tutorial. Rural practice provides good learning conditions when accompanied by appropriate tutelage, and in-service training allows the trainees and their families to 'grow roots' in the remote area while in training. The group tutorial develops peer support and professional networks to alleviate professional isolation. On the basis of these findings, traditional centralistic training models are challenged. Postgraduate (vocational) training (residency) for primary care physicians can be successfully carried out in-service in remote areas, in a manner that enhances retention without compromising the quality of the training.

42 CFR Appendix D to Part 5 - Criteria for Designation of Areas Having Shortages of Vision Care Professional(s)

Code of Federal Regulations, 2010 CFR

2010-10-01

... of Vision Care Professional(s) D Appendix D to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT... Pt. 5, App. D Appendix D to Part 5—Criteria for Designation of Areas Having Shortages of Vision Care... of vision care professional(s) if the following three criteria are met: 1. The area is a rational...

42 CFR Appendix D to Part 5 - Criteria for Designation of Areas Having Shortages of Vision Care Professional(s)

Code of Federal Regulations, 2011 CFR

2011-10-01

... of Vision Care Professional(s) D Appendix D to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT... Pt. 5, App. D Appendix D to Part 5—Criteria for Designation of Areas Having Shortages of Vision Care... of vision care professional(s) if the following three criteria are met: 1. The area is a rational...

42 CFR Appendix B to Part 5 - Criteria for Designation of Areas Having Shortages of Dental Professional(s)

Code of Federal Regulations, 2013 CFR

2013-10-01

... of Dental Professional(s) B Appendix B to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF..., App. B Appendix B to Part 5—Criteria for Designation of Areas Having Shortages of Dental Professional... designated as having a shortage of dental professional(s) if both the following criteria are met: (a) The...

42 CFR Appendix B to Part 5 - Criteria for Designation of Areas Having Shortages of Dental Professional(s)

Code of Federal Regulations, 2012 CFR

2012-10-01

... of Dental Professional(s) B Appendix B to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF..., App. B Appendix B to Part 5—Criteria for Designation of Areas Having Shortages of Dental Professional... designated as having a shortage of dental professional(s) if both the following criteria are met: (a) The...

42 CFR Appendix B to Part 5 - Criteria for Designation of Areas Having Shortages of Dental Professional(s)

Code of Federal Regulations, 2010 CFR

2010-10-01

... of Dental Professional(s) B Appendix B to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF..., App. B Appendix B to Part 5—Criteria for Designation of Areas Having Shortages of Dental Professional... designated as having a shortage of dental professional(s) if both the following criteria are met: (a) The...

42 CFR Appendix B to Part 5 - Criteria for Designation of Areas Having Shortages of Dental Professional(s)

Code of Federal Regulations, 2014 CFR

2014-10-01

... of Dental Professional(s) B Appendix B to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF..., App. B Appendix B to Part 5—Criteria for Designation of Areas Having Shortages of Dental Professional... designated as having a shortage of dental professional(s) if both the following criteria are met: (a) The...

42 CFR Appendix B to Part 5 - Criteria for Designation of Areas Having Shortages of Dental Professional(s)

Code of Federal Regulations, 2011 CFR

2011-10-01

... of Dental Professional(s) B Appendix B to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF..., App. B Appendix B to Part 5—Criteria for Designation of Areas Having Shortages of Dental Professional... designated as having a shortage of dental professional(s) if both the following criteria are met: (a) The...

Abnormal hip physical examination findings in asymptomatic female soccer athletes

PubMed Central

Hunt, Devyani; Rho, Monica; Yemm, Ted; Fong, Kathryn; Brophy, Robert H.

2016-01-01

Purpose Examination of the hip provides information regarding risk for pre-arthritic hip disorders, knee injuries, and low back pain. The purpose of this study was to report a hip screening examination of asymptomatic female soccer athletes and to test the hypothesis that these findings vary by competition experience. Methods Asymptomatic females from a youth soccer club, a college, and a professional team were evaluated. Passive hip range of motion, hip abduction strength, and hip provocative tests were assessed. Data were compared for the grade/middle school, high school, college, and professional athletes. Results One hundred and seventy-two athletes with a mean age of 16.7 ± 5 years (range 10–30) participated. Professional athletes had less flexion (HF) for both hips (p < 0.0001) and less internal rotation (IR) for the preferred kicking leg (p < 0.05) compared to all other groups. Grade/middle school athletes had more external rotation in both hips as compared to all other groups (p < 0.0001). For the preferred kicking leg, collegiate athletes had less hip abduction strength as compared to other groups (p < 0.01). Positive provocative hip tests were found in 22 % of all players and 36 % of the professionals. In professionals, a positive provocative test was associated with ipsilateral decreased HF (p = 0.04). Conclusion Asymptomatic elite female soccer athletes with the most competition experience had less bilateral hip flexion and preferred kicking leg IR than less-experienced athletes. Positive provocative hip tests were found in 22 % of athletes. Future studies are needed to show whether these findings link to risk for intra-articular hip or lumbar spine and knee disorders. Level of evidence III. PMID:24150125

[Care for immigrant patients: facts and professionals' perception in 6 primary health care zones in Navarre].

PubMed

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.

Breast feeding basic competence in primary care: Development and validation of the CAPA questionnaire.

PubMed

Pol-Pons Rn Ibclc, Anna; Aubanell-Serra ScB, Mercè; Vidal Rn, Mireia; Ojeda-Ciurana Rn, Imma; Martí-Lluch PhD, Ruth; Ponjoan PhD, Anna

2016-11-01

validated and reliable tools measuring the level of competence about breastfeeding amongst health professionals who attend mothers in primary care are scarce. to develop and validate a self-administered online questionnaire to assess basic competence about breastfeeding in the full range of health professionals attending lactating mothers in primary care. methodological study. the study was conducted in 33 primary care centers administered by the Catalan Health Institute (Institut Català de la Salut) in the Girona Region (northeast Spain). the questionnaire was sent to 398 health professionals who were likely to be in contact with breast feeding mothers. We included midwives, general practitioners, pediatric nurses (who provide care for children from birth to 14 years old), non-pediatric nurses (who provide care for patients older than 14 year), pediatricians, and gynecologists. The random sampling was stratified by discipline to ensure representativeness. the development and validation of the self-administered online questionnaire had five phases: (1) literature review, preparation of a draft for evaluation by an expert panel and pilot study; (2) design of a questionnaire based on observations from Phase 1; (3) questionnaire administration to a random sample of 398 health professionals, stratified by discipline; (4) re-testing after four weeks; and (5) assessment of construct validity using factor analysis and hypothesis-testing, comparing scores between professional groups and estimating effect size. Internal consistency was assessed by Cronbach alpha and reproducibility by the intraclass correlation coefficient. The response rate was 69.3%. The final version of the questionnaire has 24 items. The uni-dimensionality of the questionnaire was confirmed by the factor analysis. The score differed significantly between professional groups (F=12.904; p<0.001), among whom midwives achieved the highest score (129±10 points) and non-pediatric nurses the lowest (111±14 points).The effect sized values ranged from 0.6 and 1.5. Cronbach alpha was 0.870 (95% CI: 0.847, 0.891) and intraclass correlation coefficient was 0.856 (95%CI: 0.817, 0.888). this is a valid and reliable questionnaire to assess a basic level of competence about breast feeding among primary care professionals involved in supporting breast-feeding mothers. This questionnaire may help to identify health professionals who require support to improve their capability to manage women who are breast feeding. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The genomes and comparative genomics of Lactobacillus delbrueckii phages.

PubMed

Riipinen, Katja-Anneli; Forsman, Päivi; Alatossava, Tapani

2011-07-01

Lactobacillus delbrueckii phages are a great source of genetic diversity. Here, the genome sequences of Lb. delbrueckii phages LL-Ku, c5 and JCL1032 were analyzed in detail, and the genetic diversity of Lb. delbrueckii phages belonging to different taxonomic groups was explored. The lytic isometric group b phages LL-Ku (31,080 bp) and c5 (31,841 bp) showed a minimum nucleotide sequence identity of 90% over about three-fourths of their genomes. The genomic locations of their lysis modules were unique, and the genomes featured several putative overlapping transcription units of genes. LL-Ku and c5 virions displayed peptidoglycan hydrolytic activity associated with a ~36-kDa protein similar in size to the endolysin. Unexpectedly, the 49,433-bp genome of the prolate phage JCL1032 (temperate, group c) revealed a conserved gene order within its structural genes. Lb. delbrueckii phages representing groups a (a phage LL-H), b and c possessed only limited protein sequence homology. Genomic comparison of LL-Ku and c5 suggested that diversification of Lb. delbrueckii phages is mainly due to insertions, deletions and recombination. For the first time, the complete genome sequences of group b and c Lb. delbrueckii phages are reported.

Student-Retention and Career-Placement Rates Between Bachelor's and Master's Degree Professional Athletic Training Programs.

PubMed

Bowman, Thomas G; Mazerolle, Stephanie M; Pitney, William A; Dodge, Thomas M; Hertel, Jay

2015-09-01

The debate over what the entry-level degree should be for athletic training has heightened. A comparison of retention and career-placement rates between bachelor's and master's degree professional athletic training programs may inform the debate. To compare the retention rates and career-placement rates of students in bachelor's and master's degree professional programs. Cross-sectional study. Web-based survey. A total of 192 program directors (PDs) from bachelor's degree (n = 177) and master's degree (n = 15) professional programs. The PDs completed a Web-based survey. We instructed the PDs to provide a retention rate and career-placement rate for the students in the programs they lead for each of the past 5 years. We also asked the PDs if they thought retention of students was a problem currently facing athletic training education. We used independent t tests to compare the responses between bachelor's and master's degree professional programs. We found a higher retention rate for professional master's degree students (88.70% ± 9.02%, 95% confidence interval [CI] = 83.71, 93.69) than bachelor's degree students (80.98% ± 17.86%, 95% CI = 78.30, 83.66) (t25 = -2.86, P = .008, d = 0.55). Similarly, PDs from professional master's degree programs reported higher career-placement percentages (88.50% ± 10.68%, 95% CI = 82.33, 94.67) than bachelor's degree professional PDs (71.32% ± 18.47%, 95% CI = 68.54, 74.10) (t20 = -5.40, P < .001, d = 1.14). Finally, we observed no difference between groups regarding whether retention is a problem facing athletic training (χ(2)1 = 0.720, P = .40, Φ = .061). Professional master's degree education appears to facilitate higher retention rates and greater career-placement rates in athletic training than bachelor's degree education. Professional socialization, program selectivity, and student commitment and motivation levels may help to explain the differences noted.

Histological grading of ovarian clear cell adenocarcinoma: proposal for a simple and reproducible grouping system based on tumor growth architecture.

PubMed

Yamamoto, Sohei; Tsuda, Hitoshi; Shimazaki, Hideyuki; Takano, Masashi; Yoshikawa, Tomoyuki; Kuzuya, Kazuo; Tsuda, Hiroshi; Kurachi, Hirohisa; Kigawa, Junzo; Kikuchi, Yoshihiro; Sugiyama, Toru; Matsubara, Osamu

2012-03-01

In this study, we aimed to develop a histological grading system for ovarian clear cell adenocarcinoma (CCA), based on the tumor growth architectures. Cases were defined as Group A if ≥90% of a tumor examined was composed of well-differentiated tubulocystic and/or papillary architectures; Group C if at least 10% of the tumor was composed of very poorly differentiated histology (i.e. solid masses or individual infiltrating tumor cells with no or little glandular/papillary differentiation); and tumors not corresponding to the first 2 descriptions were defined as Group B. The interobserver reproducibility and prognostic value of the assigned groups were analyzed for 159 CCAs from 5 institutions. The level of agreement in assigning the groups between 2 pathologists was 88.7% (=0.82). After consensus was reached, 46 (29%), 79 (50%), and 34 (21%) tumors were classified in Groups A, B, and C, respectively. In early-stage cases [International Federation of Gynecology and Obstetrics (FIGO) stage I-II], Group A tumors had significantly better outcomes (100% 5-yr survival) than Group B tumors (82% 5-yr survival, P=0.024 by log-rank test) or Group C tumors (56% 5-yr survival, P=0.00054 by log-rank test). Moreover, early-stage Group B tumors had significantly better outcomes than Group C tumors (P<0.001 by a generalized Wilcoxon test). In advanced cases (FIGO stage III-IV), Group A tumors had significantly better outcomes than Group C tumors (52% vs. 16% 5-yr survival, respectively, P=0.043). Group A and C tumors defined with our system were identified to have favorable and unfavorable prognostic factors, respectively, independent of the clinical stage of the disease and presence of residual tumors after the initial surgery. The proposed grouping system could divide patients with CCA into 3 subgroups with distinct prognostic indications, providing a 3-tier histological grading system for ovarian CCA.

Optimal target concentration of remifentanil during cataract surgery with monitored anesthesia care.

PubMed

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.

Role of Candida species from HIV infected children in enamel caries lesions: an in vitro study.

PubMed

Charone, Senda; Portela, Maristela Barbosa; Martins, Karol de Oliveira; Soares, Rosangela Maria; Castro, Gloria Fernanda

2017-01-01

This study analyzed the capacity of Candida spp. from dental biofilm of HIV infected (HIV+) children to demineralize primary molar enamel in vitro by Transversal Microhardness (TMH), Polarized Light Microscopy (PLM) and the quantity of calcium ions (Ca2+) released from the enamel. Candida spp. samples were isolated from the supragingival biofilm of HIV+ children. A hundred and forty (140) enamel blocks were randomly assigned to six groups: biofilm formed by C. albicans (Group 1); mixed biofilm formed by C. albicans and C. tropicalis (Group 2); mixed biofilm formed by C. albicans and C. parapsilosis (Group 3); mixed biofilm formed by C. albicans, C. parapsilosis and C. glabrata (Group 4); biofilm formed by C. albicans ATCC (Group 5) and medium without Candida (Group 6). Enamel blocks from each group were removed on days 3, 5, 8 and 15 after biofilm formation to evaluate the TMH and images of enamel were analyzed by PLM. The quantity of Ca2+ released, from Groups 1 and 6, was determined using an Atomic Absorption Spectrophotometer. The SPSS program was used for statistical analysis and the significance level was 5%. TMH showed a gradual reduction in enamel hardness (p<0.05) from the 1st to 15th day, but mainly five days after biofilm formation in all groups. The PLM showed superficial lesions indicating an increase in porosity. C. albicans caused the release of Ca2+ into suspension during biofilm formation. Candida species from dental biofilm of HIV+ children can cause demineralization of primary enamel in vitro.

Role of Candida species from HIV infected children in enamel caries lesions: an in vitro study

PubMed Central

CHARONE, Senda; PORTELA, Maristela Barbosa; MARTINS, Karol de Oliveira; SOARES, Rosangela Maria; CASTRO, Gloria Fernanda

2017-01-01

Abstract Objectives This study analyzed the capacity of Candida spp. from dental biofilm of HIV infected (HIV+) children to demineralize primary molar enamel in vitro by Transversal Microhardness (TMH), Polarized Light Microscopy (PLM) and the quantity of calcium ions (Ca2+) released from the enamel. Material and Methods Candida spp. samples were isolated from the supragingival biofilm of HIV+ children. A hundred and forty (140) enamel blocks were randomly assigned to six groups: biofilm formed by C. albicans (Group 1); mixed biofilm formed by C. albicans and C. tropicalis (Group 2); mixed biofilm formed by C. albicans and C. parapsilosis (Group 3); mixed biofilm formed by C. albicans, C. parapsilosis and C. glabrata (Group 4); biofilm formed by C. albicans ATCC (Group 5) and medium without Candida (Group 6). Enamel blocks from each group were removed on days 3, 5, 8 and 15 after biofilm formation to evaluate the TMH and images of enamel were analyzed by PLM. The quantity of Ca2+ released, from Groups 1 and 6, was determined using an Atomic Absorption Spectrophotometer. The SPSS program was used for statistical analysis and the significance level was 5%. Results TMH showed a gradual reduction in enamel hardness (p<0.05) from the 1st to 15th day, but mainly five days after biofilm formation in all groups. The PLM showed superficial lesions indicating an increase in porosity. C. albicans caused the release of Ca2+ into suspension during biofilm formation. Conclusion Candida species from dental biofilm of HIV+ children can cause demineralization of primary enamel in vitro. PMID:28198976

Randomized, Controlled Trial of CBT Training for PTSD Providers

DTIC Science & Technology

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

"Creating Unity from Diversity: Finding Our Commonalities, Respecting Our Differences." Presenter Abstracts of the Annual National Conference of the National Multicultural Institute (9th, Washington, D.C., May 19-22, 1994).

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)…

Communication and Influencing for ED Professionals: A training programme developed in the emergency department for the emergency department.

PubMed

Rixon, Andrew; Rixon, Sascha; Addae-Bosomprah, Hansel; Ding, Mingshuang; Bell, Anthony

2016-08-01

The objective of the present study is to develop and pilot a communication and influencing skills training programme that meets ED health professionals' needs at an urban district hospital. Qualitative methods within a participatory action research framework were utilised. An interdisciplinary team guided the programme's design and development. A training needs analysis saw team meetings, interviews, focus groups and observations conducted across the ED. Thematic analysis of the data identified health professionals' communication and influencing challenges. The training needs analysis informed the training programme curriculum's development. The pilot programme involved an interdisciplinary group of seven health professionals across 5 × 2 h sessions over 3 months, followed by a post-training survey. Five themes of communication and influencing challenges were identified: participating in effective handovers, involving patients in bedside handovers, effectively communicating with interdepartmental colleagues, asking ED colleagues to do tasks and understanding ED colleagues' roles, expectations and assumptions. Based on these challenges, the formulated RESPECT model (which stands for Relationships, Expectations, Styles, Partnerships, Enquiry, Coaching and Teamwork) informed the training curriculum. The peer coaching model used in the training programme was highly regarded by participants. Communication and Influencing for ED Professionals™ (Babel Fish Group Pty Ltd, Melbourne, Victoria, Australia) addresses a gap for communication programmes developed in the ED for the ED. Future research will evaluate the programme's impact in this ED. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Extending inter-professional learning through the use of a multi-disciplinary Wiki.

PubMed

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.

Learning through Interactive Talk: A School-Based Mentor Teacher Study Group as a Context for Professional Learning

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…

Melatonin and vitamin C exacerbate Cannabis sativa-induced testicular damage when administered separately but ameliorate it when combined in rats.

PubMed

Alagbonsi, Isiaka A; Olayaki, Luqman A; Salman, Toyin M

2016-05-01

The mechanisms involved in the spermatotoxic effect of Cannabis sativa are inconclusive. The involvement of oxidative stress in male factor infertility has been well documented, and the antioxidative potential of melatonin and vitamin C in many oxidative stress conditions has been well reported. This study sought to investigate whether melatonin and vitamin C will ameliorate C. sativa-induced spermatotoxicity or not. Fifty-five (55) male albino rats (250-300 g) were randomly divided in a blinded fashion into five oral treatment groups as follows: group I (control, n=5) received 1 mL/kg of 10% ethanol for 30 days; groups IIa, IIb, and IIc (n=5 each) received 2 mg/kg C. sativa for 20, 30, and 40 days, respectively; groups IIIa, IIIb, and IIIc (n=5 each) received a combination of 2 mg/kg C. sativa and 4 mg/kg melatonin for 20, 30, and 40 days, respectively; groups IVa, IVb, and IVc (n=5 each) received a combination of 2 mg/kg C. sativa and 1.25 g/kg vitamin C for 20, 30, and 40 days, respectively; group V (n=5) received a combination of 2 mg/kg C. sativa, 4 mg/kg melatonin, and 1.25 g/kg vitamin C for 30 days. Cannabis treatments reduced the Johnsen score, sperm count, motility, morphology, paired testicular/body weight ratio, and total antioxidant capacity, but increased lactate dehydrogenase activity. In addition, supplementation of cannabis-treated rats with either melatonin or vitamin C exacerbates the effect of cannabis on those parameters, whereas combination of melatonin and vitamin C reversed the trend to the level comparable to control. This study further showed the gonadotoxic effect of C. sativa, which could be mediated by oxidative stress. It also showed that melatonin and vitamin C exacerbate C. sativa-induced testicular damage when administered separately but ameliorate it when combined in rats.

Partition and metabolic fate of dietary glycerol in muscles and liver of juvenile tilapia.

PubMed

da Costa, Diego Vicente; Dias, Jorge; Colen, Rita; Rosa, Priscila Vieira; Engrola, Sofia

2017-04-01

This study investigated the effect of dietary glycerol on the metabolism of juvenile tilapia (Oreochromis mossambicus) and to determine its metabolic fate. The experimental diets contained 0% (Group CON), 5% (Group G5) and 15% glycerol (Group G15) and were fed for 40 d to apparent satiation, three times a day. For the metabolism trials, six fish from each treatment were randomly chosen and tube-fed with five pellets labelled with 14 C-glycerol [ 14 C(U)] in order to evaluate the absorption, catabolism, retention and partition of glycerol in muscle and liver. Group G5 presented the highest 14 C-glycerol retention and the lowest catabolism, with no significant differences between Groups CON and G15. In Group CON, the highest percentage of 14 C was incorporated in muscle lipids; with no significant differences between Groups G5 and G15. Furthermore, no treatment effects were found for hepatic 14 C-lipid and for 14 C in hepatic and muscle non-lipid extract. In the non-lipid and non-protein fraction, the highest radioactivity was measured in livers of Group G5, however no significant differences were found for this fraction between Groups CON and G15 in liver and for all treatments in muscle. The results of the present study can have practical implications in diet formulations for tilapia and for other aquaculture species with similar feeding pattern since juvenile tilapia are able to metabolise dietary glycerol into lipids, protein and/or carbohydrates and to use it as energy source.

[Self-determined but with professional leadership? On the effectiveness and definition of self-help groups].

PubMed

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.

Human Connections and Their Roles in the Occupational Well-being of Healthcare Professionals: A Study on Loneliness and Empathy.

PubMed

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.

Scoliosis in Duchenne’s muscular dystrophy: a changing trend in surgical management

PubMed Central

Srinivas, S.; Mehdian, S. M. H.

2009-01-01

A non-randomised retrospective study to compare the results of surgical correction of scoliosis in Duchenne’s muscular dystrophy (DMD) patients using three different instrumentation systems—Sublaminar instrumentation system (Group A), a hybrid of sublaminar and pedicle screw systems (Group B) and pedicle screw system alone (Group C). Between 1993 and 2003, 43 patients with DMD underwent posterior spinal fusion and instrumentation. Group A (n = 19) had sublaminar instrumentation system, Group B (n = 13) had a hybrid construct and Group C (n = 11) was treated with pedicle system. The mean blood loss in Group A was 4.1 l, 3.2 l in Group B and 2.5 l in Group C. Average operating times in Group A, B and C were 300, 274 and 234 min, respectively. Mean pre-operative, post-operative and final Cobb angle in Group A was 50.05 ± 15.46°, 15.68 ± 11.23° and 21.57 ± 11.63°, Group B was 17.76 ± 8.50°, 3.61 ± 2.53° and 6.69 ± 4.19° and Group C was 25.81 ± 9.94°, 5.45 ± 3.88°, 8.90 ± 5.82°, respectively. Flexibility index or the potential correction calculated from bending radiographs were 60 ± 6.33, 70 ± 4.65 and 67 ± 6.79% for Group A, Group B and Group C respectively. The percentage correction achieved was 72.5 ± 14.5% in Group A, 82 ± 6% in Group B and 82 ± 8% in Group C. The difference between percentage correction achieved and the flexibility index was 12.45 ± 8.22, 12.05 ± 1.3 and 15.00 ± 1.21% in Group A, B and C, respectively The percentage loss of correction in Cobb angles at final follow-up in Group A, B and C was 12.5 ± 3.5, 16.5 ± 1. and 12.5 ± 2.5%, respectively. Complications seen in Group A were three cases of wound infection and two cases of implant failure; Group B had a single case of implant failure and Group C had one patient with wound infection and one case with a partial screw pull out. Early surgery and smaller curve corrections appears to be the current trend in the management of scoliosis in DMD. This has been possible due to early curve detection and surgery thus having the advantage of less post-operative respiratory complications and stay in paediatric intensive care. Also, early surgery avoids development of pelvic deformity and extension of instrumentation to the pelvis thereby reducing blood loss. This trend reflects the advent of newer and safer instrumentation systems, advanced techniques in anaesthesia and cord monitoring. Sublaminar instrumentation system group had increased operating times and blood loss compared to both the hybrid and pedicle screw instrumentation systems due to increased bleeding from epidural vessels and pelvic instrumentation. Overall, the three instrumentation constructs appear to provide and maintain an optimal degree of correction at medium to long term follow up but the advantages of lesser blood loss and surgical time without the need for pelvic fixation seem to swing the verdict in favour of the pedicle screw system. PMID:19760271

Perfectionism and burnout in women professional golfers.

PubMed

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.

The relationship between professional behaviour grades and tutor performance ratings in problem-based learning.

PubMed

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.

13. DETAIL NO. 2. Vasona Light Rail Project, Asbuilt Plan, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. DETAIL NO. 2. Vasona Light Rail Project, As-built Plan, Diridon Station Water Tank. Interior and Exterior Column Details, all at 1:5. Drawing no. SD702, submitted by Biggs Cardosa Associates, Inc., 1871 The Alameda, Suite 200, San Jose, California. Contract no. C326, CADD file 326SD702. Stamped by Roy M. Schnabel, California registered professional engineer no. C46828. - Southern Pacific Depot, Water Tower, 65 Cahill Street, San Jose, Santa Clara County, CA

A Policy Analysis of U.S. Army Professional Filler System (PROFIS) Sourcing Management at the Regional Medical Command Level in Support of an Expeditionary Army at War

DTIC Science & Technology

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

Posterior Endoscopic Excision of Os Trigonum in Professional National Ballet Dancers.

PubMed

Ballal, Moez S; Roche, Andy; Brodrick, Anna; Williams, R Lloyd; Calder, James D F

2016-01-01

Previous studies have compared the outcomes after open and endoscopic excision of an os trigonum in patients of mixed professions. No studies have compared the differences in outcomes between the 2 procedures in elite ballet dancers. From October 2005 to February 2010, 35 professional ballet dancers underwent excision of a symptomatic os trigonum of the ankle after a failed period of nonoperative treatment. Of the 35 patients, 13 (37.1%) underwent endoscopic excision and 22 (62.9%) open excision. We compared the outcomes, complications, and time to return to dancing. The open excision group experienced a significantly greater incidence of flexor hallucis longus tendon decompression compared with the endoscopic group. The endoscopic release group returned to full dance earlier at a mean of 9.8 (range 6.5 to 16.1) weeks and those undergoing open excision returned to full dance at a mean of 14.9 (range 9 to 20) weeks (p = .001). No major complications developed in either group, such as deep infection or nerve or vessel injury. We have concluded that both techniques are safe and effective in the treatment of symptomatic os trigonum in professional ballet dancers. Endoscopic excision of the os trigonum offers a more rapid return to full dance compared with open excision. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Attitudes of the first cohort of student groups trained together at the University of Portsmouth Dental Academy towards dental interprofessional education.

PubMed

Colonio Salazar, F B; Andiappan, M; Radford, D R; Gallagher, J E

2017-05-01

This study explored, and compared, the attitudes of student groups trained at the University of Portsmouth Dental Academy (UPDA) in 2010/2011 towards dental interprofessional education (IPE). The study population consisted of fifth-year student dentists (n = 80) from King's College London Dental Institute, second- and third-year dental hygiene and therapy (n = 38) and first-year dental nursing (n = 14) students from UPDA. A 19-item, validated and dentally modified questionnaire, 'Readiness for Inter-Professional Learning Scale (RIPLS)', was administered. RIPLS contains three subscales: teamwork and collaboration, professional identity and roles and responsibilities. Mean (x¯) and standard deviation (SD) of the scores were calculated, following reversal of negative items. All the analyses were carried out using SPSS version 20 and STATA version 11. An overall response rate of 71% (n = 94) was achieved. In reference to teamwork and collaboration, all groups strongly indicated that IPE can contribute to learning teamwork skills (x¯ = 24.98, SD = 3.5) and improving relationships with team members (x¯ = 12.93, SD = 1.63); however, the scores did not differ between the groups (P = 0.09 and P = 0.16, respectively). Concerning professional identity, student dentists had significantly higher preference for a discipline-based approach (P = 0.002); were more likely to agree that 'it is not necessary for undergraduate dental and dental care professional students to learn together' (P = 0.01); and perceived that 'clinical problem-solving skills can only be learnt effectively with other students from their own discipline' (P = 0.02) than dental hygiene and therapy students. In relation to roles and responsibilities, participants demonstrated a strong sense of their own professional role. Student dentists reported that they had 'to gain more knowledge and skills' than dental hygiene and therapy (P = 0.01) and dental nursing (P = 0.01) students. Dental hygiene and therapy students were less likely than student dentists to agree that 'the role of dental nurses and hygienists was to mainly provide support for dentists' (P = 0.001). The findings suggest that IPE was perceived as beneficial in relation to teamwork; however, the study raises issues regarding professional identity and roles. Educators should consider differing perceptions of professional roles and identities when planning and delivering interprofessional programmes. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

8 CFR 204.5 - Petitions for employment-based immigrants.

Code of Federal Regulations, 2013 CFR

2013-01-01

... parent or individual; (B) One of two legal entities owned and controlled by the same group of individuals... controls the work of other supervisory, professional, or managerial employees, or manages an essential..., directly or indirectly, more than half of the entity and controls the entity; or owns, directly or...

38 CFR 14.664 - Scope of authority and effective date.

Code of Federal Regulations, 2010 CFR

2010-07-01

... personal property incident to such person's service. Authority is delegated by § 2.6(e)(5) of this chapter to the General Counsel, Deputy General Counsel, Assistant General Counsel (Professional Staff Group... LEGAL SERVICES, GENERAL COUNSEL, AND MISCELLANEOUS CLAIMS Personnel Claims § 14.664 Scope of authority...

38 CFR 14.664 - Scope of authority and effective date.

Code of Federal Regulations, 2013 CFR

2013-07-01

... personal property incident to such person's service. Authority is delegated by § 2.6(e)(5) of this chapter to the General Counsel, Deputy General Counsel, Assistant General Counsel (Professional Staff Group... LEGAL SERVICES, GENERAL COUNSEL, AND MISCELLANEOUS CLAIMS Personnel Claims § 14.664 Scope of authority...

38 CFR 14.664 - Scope of authority and effective date.

Code of Federal Regulations, 2014 CFR

2014-07-01

... personal property incident to such person's service. Authority is delegated by § 2.6(e)(5) of this chapter to the General Counsel, Deputy General Counsel, Assistant General Counsel (Professional Staff Group... LEGAL SERVICES, GENERAL COUNSEL, AND MISCELLANEOUS CLAIMS Personnel Claims § 14.664 Scope of authority...

38 CFR 14.664 - Scope of authority and effective date.

Code of Federal Regulations, 2012 CFR

2012-07-01

... personal property incident to such person's service. Authority is delegated by § 2.6(e)(5) of this chapter to the General Counsel, Deputy General Counsel, Assistant General Counsel (Professional Staff Group... LEGAL SERVICES, GENERAL COUNSEL, AND MISCELLANEOUS CLAIMS Personnel Claims § 14.664 Scope of authority...

38 CFR 14.664 - Scope of authority and effective date.

Code of Federal Regulations, 2011 CFR

2011-07-01

... personal property incident to such person's service. Authority is delegated by § 2.6(e)(5) of this chapter to the General Counsel, Deputy General Counsel, Assistant General Counsel (Professional Staff Group... LEGAL SERVICES, GENERAL COUNSEL, AND MISCELLANEOUS CLAIMS Personnel Claims § 14.664 Scope of authority...

Children's Literature & Disability. Resources You Can Use. NICHCY Bibliography 5. Second Edition.

ERIC Educational Resources Information Center

National Information Center for Children and Youth with Disabilities, Washington, DC.

This bibliography of 95 items is intended to help parents and professionals identify books that are written about or include characters with a disability. The list is grouped according to the following disabilities or issues: attention deficit/hyperactivity disorder, autism, Down syndrome, hearing impairment (including deafness, learning…

Human sciences in the first semester of the dental undergraduate course at the Karolinska Institute, Stockholm.

PubMed

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.

Application of 5-Fluorouracil-Polycaprolactone Sustained-Release Film in Ahmed Glaucoma Valve Implantation Inhibits Postoperative Bleb Scarring in Rabbit Eyes.

PubMed

Bi, Xiu-Zeng; Pan, Wei-Hua; Yu, Xin-Ping; Song, Zong-Ming; Ren, Zeng-Jin; Sun, Min; Li, Cong-Hui; Nan, Kai-Hui

2015-01-01

This study was designed to investigate whether 5-fluorouracil (5-Fu)-polycaprolactone sustained-release film in Ahmed glaucoma valve implantation inhibits postoperative bleb scarring in rabbit eyes. Eighteen New Zealand white rabbits were randomly divided into three groups (A, B and C; n = 6 per group). Group A received combined 5-Fu-polycaprolactone sustained-release film application and Ahmed glaucoma valve implantation, group B received local infiltration of 5-Fu and Ahmed glaucoma valve implantation, and group C received Ahmed glaucoma valve implantation. Postoperative observations were made of the anterior segment, intraocular pressure, central anterior chamber depth, blebs, drainage tube, and accompanying ciliary body detachment. The pathology of the blebs and surrounding tissues were observed at month 3 postoperatively. We revealed that the 5-Fu-polycaprolactone sustained-release film maintained a release concentration range of 13.7 ± 0.12 to 37.41 ± 0.47 μg/ml over three months in vitro. Postoperatively, diffuse blebs with ridges were found in all eyes in group A, two blebs were observed in group B, and no bleb formation was present in group C. The postoperative central anterior chamber depth in group A was significantly less than that of the other two groups. The postoperative intraocular pressure of group A stabilized at 6.33-8.67 mmHg, whereas that of group C gradually remained at 7.55-10.02 mmHg. The histopathology showed that the fibrous tissue thickness of the blebs in group A was significantly thinner than that of the other groups. We conclude that the 5-Fu-polycaprolactone sustained-release film had a sustained drug release effect, which promoted the inhibition of bleb scarring after Ahmed glaucoma valve implantation.

Context-Based Pedagogy: A Framework From Experience.

PubMed

Kantar, Lina D

2016-07-01

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

Competence training in evidence-based medicine for patients, patient counsellors, consumer representatives and health care professionals in Austria: a feasibility study.

PubMed

Berger, Bettina; Gerlach, Anja; Groth, Sylvia; Sladek, Ulla; Ebner, Katharina; Mühlhauser, Ingrid; Steckelberg, Anke

2013-01-01

Informed and shared decision-making require competences for both partners - healthcare professionals and patients. There is a lack of training courses in evidence-based medicine for patients and counsellors. We investigated feasibility, acceptability and the potential effects of a 2 x 2.5 days training course on critical health competences in patients, patient counsellors, consumer representatives and healthcare professionals in Austria. We adapted a previously developed curriculum for patient and consumer representatives. The adaptation comprised the specific needs of our target group in Austria and was founded on Carl Rogers' theory of person-centred education. For the formative evaluation a questionnaire was applied to address the domains: 1) organisational conditions (time and duration of the course, location, and information given in advance, registration); 2) assistance outside the courses; 3) teaching methods (performance of lecturers, teaching materials, structure of modules and blocks) and 4) satisfaction; 5) subjective assessment of competences. Participants evaluated the course, using a 5-point Likert scale. Long-term implementation was assessed using semi-structured interviews three to six months after the course. To estimate the increase in critical health competences we used the validated Critical Health Competence Test (CHC test). Eleven training courses were conducted including 142 participants: patients (n=21); self-help group representatives (n=17); professional counsellors (n=29); healthcare professionals (n=10); psychologists (n=8); teachers (n=10) and others (n=29). 97 out of 142 (68 %) participants returned the questionnaire. On average, participants strongly agreed or agreed to 1) organisational conditions: 71 % / 23 %; 2) assistance outside the courses: 96 % / 10 %; 3) teaching methods: 60 % / 28 %; and 4) satisfaction: 78 % / 20 %, respectively. Interviews showed that the training course raised awareness, activated and empowered participants. Participants passed the CHC test with mean person parameters of 463±111 (pre-test, n=120) and 547±135 (post-test, n=91). For participants who returned both tests (n=71) person parameters were comparable: pre-test 466±121 versus post-test 574±100, p<0,001. Training in evidence-based medicine for patients, patient counsellors, consumer representatives and healthcare professionals is feasible. For a broad implementation, train-the trainer courses and further research are needed. Copyright © 2012. Published by Elsevier GmbH.

Guidelines for psychological practice with older adults.

PubMed

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.

PubMed

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.

Systematic review of peer education intervention programmes among individuals with type 2 diabetes.

PubMed

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.

'A world of difference': a qualitative study of medical students' views on professionalism and the 'good doctor'.

PubMed

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.

Development of a Lifespan-Based Novel Composite Person-Reported Outcome Measure Using Data from the CINRG Duchenne Natural History Study

DTIC Science & Technology

2017-10-01

drug approval. 2. KEYWORDS: Provide a brief list of keywords (limit to 20 words). Duchenne muscular dystrophy Person-reported outcomes Health ...related quality of life Functional health assessment UC Davis / CINRG Duchenne Natural History Study 5 3. ACCOMPLISHMENTS: The PI is reminded...content, we will conduct focus group discussions with an expert advisory group of DMD clinical research professionals, health care providers, parent

A reduced core to skin temperature gradient, not a critical core temperature, affects aerobic capacity in the heat.

PubMed

Cuddy, John S; Hailes, Walter S; Ruby, Brent C

2014-07-01

The purpose of this study was to determine the impact of the core to skin temperature gradient during incremental running to volitional fatigue across varying environmental conditions. A secondary aim was to determine if a "critical" core temperature would dictate volitional fatigue during running in the heat. 60 participants (n=49 male, n=11 female; 24±5 yrs, 177±11 cm, 75±13 kg) completed the study. Participants were uniformly stratified into a specific exercise temperature group (18 °C, 26 °C, 34 °C, or 42 °C) based on a 3-mile run performance. Participants were equipped with core and chest skin temperature sensors and a heart rate monitor, entered an environmental chamber (18 °C, 26 °C, 34 °C, or 42 °C), and rested in the seated position for 10 min before performing a walk/run to volitional exhaustion. Initial treadmill speed was 3.2 km h(-1) with a 0% grade. Every 3 min, starting with speed, speed and grade increased in an alternating pattern (speed increased by 0.805 km h(-1), grade increased by 0.5%). Time to volitional fatigue was longer for the 18 °C and 26 °C group compared to the 42 °C group, (58.1±9.3 and 62.6±6.5 min vs. 51.3±8.3 min, respectively, p<0.05). At the half-way point and finish, the core to skin gradient for the 18 °C and 26 °C groups was larger compared to 42 °C group (halfway: 2.6±0.7 and 2.0±0.6 vs. 1.3±0.5 for the 18 °C, 26 °C and 42 °C groups, respectively; finish: 3.3±0.7 and 3.5±1.1 vs. 2.1±0.9 for the 26 °C, 34 °C, and 42 °C groups, respectively, p<0.05). Sweat rate was lower in the 18 °C group compared to the 26 °C, 34 °C, and 42 °C groups, 3.6±1.3 vs. 7.2±3.0, 7.1±2.0, and 7.6±1.7 g m(-2) min(-1), respectively, p<0.05. There were no group differences in core temperature and heart rate response during the exercise trials. The current data demonstrate a 13% and 22% longer run time to exhaustion for the 18 °C and 26 °C group, respectively, compared to the 42 °C group despite no differences in beginning and ending core temperatures or baseline 3-mile run time. This capacity difference appears to result from a magnified core to skin gradient via an environmental temperature advantageous to convective heat loss, and in part from an increased sweat rate. Copyright © 2014 Elsevier Ltd. All rights reserved.

Essential Tiedeman: Anchoring the North Star for Human Development

ERIC Educational Resources Information Center

Miller-Tiedeman, Anna

2008-01-01

In quantum physics, whatever is observed is changed; therefore, it is all perception. Given those findings and to save Tiedeman from interpretation, in this article, he speaks for himself in 5 areas: (a) his professional credo, (b) the Harvard Studies in Career Development, (c) the 1983 Assembly to Advance Career, (d) statistics of vocational…

42 CFR Appendix C to Part 5 - Criteria for Designation of Areas Having Shortages of Mental Health Professionals

Code of Federal Regulations, 2010 CFR

2010-10-01

... with a doctorate in psychology) who is practicing as a clinical or counseling psychologist and is... clinical or counseling experience. (School psychologists are not included.) (iv) Clinical social worker..., vocational or educational counseling, and social services unrelated to mental health will be excluded; if a...

45 CFR 60.11 - Reporting adverse actions on clinical privileges.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (5 U.S.C. 552a note), (v) Date of birth, (vi) Name of each professional school attended and year of... 45 Public Welfare 1 2012-10-01 2012-10-01 false Reporting adverse actions on clinical privileges. 60.11 Section 60.11 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION...

45 CFR 60.11 - Reporting adverse actions on clinical privileges.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (5 U.S.C. 552a note), (v) Date of birth, (vi) Name of each professional school attended and year of... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reporting adverse actions on clinical privileges. 60.11 Section 60.11 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION...

45 CFR 60.11 - Reporting adverse actions on clinical privileges.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (5 U.S.C. 552a note), (v) Date of birth, (vi) Name of each professional school attended and year of... 45 Public Welfare 1 2011-10-01 2011-10-01 false Reporting adverse actions on clinical privileges. 60.11 Section 60.11 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION...

42 CFR 484.12 - Condition of participation: Compliance with Federal, State, and local laws, disclosure and...

Code of Federal Regulations, 2013 CFR

2013-10-01

... ownership and management information. The HHA must comply with the requirements of Part 420, Subpart C of... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Compliance with Federal, State, and local laws, disclosure and ownership information, and accepted professional standards and...

42 CFR 484.12 - Condition of participation: Compliance with Federal, State, and local laws, disclosure and...

Code of Federal Regulations, 2014 CFR

2014-10-01

... ownership and management information. The HHA must comply with the requirements of part 420, Subpart C of... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Compliance with Federal, State, and local laws, disclosure and ownership information, and accepted professional standards and...

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.

Web-Based Interventions Alone or Supplemented with Peer-Led Support or Professional Email Counseling for Weight Loss and Weight Maintenance in Women from Rural Communities: Results of a Clinical Trial

PubMed Central

Pullen, Carol H.; Pozehl, Bunny; Eisenhauer, Christine; Boeckner, Linda S.

2017-01-01

Objective. This trial compared the effectiveness of a web-based only (WO) intervention with web-based supplemented by peer-led discussion (WD) or professional email counseling (WE) across 3 phases to achieve weight loss and weight maintenance in women from underserved rural communities. Methods. 301 women (BMI of 28–45 kg/m2) randomly assigned to groups participated in guided weight loss (baseline to 6 months), guided weight loss and maintenance (6 to 18 months), and self-managed weight maintenance (18 to 30 months). Results. Retention was 88.7%, 76.5%, and 71.8% at 6, 18, and 30 months, respectively. Intent-to-treat analyses demonstrated no group differences in change in weight within any phases. At 6 months, observed mean (SD) weight loss was 5.1 (6.0) kg in WO, 4.1 (5.6) kg in WD, and 6.0 (6.3) kg in WE, with 42%, 38%, and 51%, respectively, meeting ≥ 5% weight loss. These proportions dropped by a third after phase 2 with no further change during phase 3. Conclusion. Web-based interventions assisted women from rural communities in achieving 6-month weight loss, with weight regain by half at 30 months. No group differences were potentially due to the robust nature of the web-based intervention. Trial Registration. This trial is registered with ClinicalTrials.gov NCT01307644. PMID:28480078

Zinc and Vitamin Supplementation in an Under-5 Indigenous Population of Guatemala: Influence of Lay Health Promoters in Decreasing Incidence of Diarrhea.

PubMed

Grossmann, Vicki M; Turner, Barbara S; Snyder, Denise; Stewart, Robert D; Bowen, Toni; Cifuentes, Ariadna A; Cliff, Cheryl

2015-09-01

Malnutrition is an urgent problem in the developing world, especially for children under 5 years of age. The article describes the utilization of a standard of practice designed to prevent illness in a malnourished, under-5 indigenous population and reinforced by weekly basic health messages taught by lay community health promoters. The two villages were chosen for observation after administration of the standard of care among the Maya-Kíché, the most numerous Mayan group in Guatemala. The standard of practice, 20 mg of daily oral zinc, was administered for 10 days in the home and followed by daily vitamin supplementation that continued throughout the 3 months of the project. All patients received four monthly clinic visits, with one of the village groups receiving weekly health promoter visits. Data evaluated after the quality improvement project showed significant differences in adherence to the zinc regimen (χ(2) = 3.677, p ≤ .05) as well as lower rates of diarrheal illnesses (χ(2) = 5.850, p ≤ .05), with both of these improved in the health promoter group. This study suggests that the training and implementation of para-health professionals from the lay community in response to specific health care needs could be considered a best practice in developing countries. Public health professionals are key to health promoter training and direction, and their importance in the global setting cannot be understated. © The Author(s) 2014.

Grains Are Similarly Categorized by 8- to 13-Year-Old Children

PubMed Central

Beltran, Alicia; Sepulveda, Karina Knight; Watson, Kathy; Baranowski, Tom; Baranowski, Janice; Islam, Noemi; Missaghian, Mariam

2009-01-01

This study assessed how 8- to 13-year-old children categorized and labeled grain foods and how these categories and labels were influenced by child characteristics. The main hypotheses were that children categorized foods in consistent ways and these food categories differed from the professional food categories. A set of 71 cards with pictures and names of grain foods from eight professionally denned food groups was sorted by each child into piles of similar foods. There were 149 8- to 13-year-old children (133 English-speaking, 16 Spanish-speaking) in this exploratory study. One-way analysis of variance and Robinson matrices for identification of clusters of food items were calculated. Children created a mean (± standard deviation) of 8.3±3.8 piles with 8.6±9.1 cards per pile. No substantial differences in Robinson clustering were detected across subcategories for each of the demographic characteristics. For the majority of the piles, children provided “taxonomic-professional” (34.5%) labels, such as bread for the professional category of breads, rolls, and tortillas, or “script” (26.1%) labels, such as breakfast for the professional category of pancakes, waffles, and flapjacks. These categories may be used to facilitate food search in a computerized 24-hour dietary recall for children in this age group. PMID:18954585

Implementing and evaluating a professional practice framework in child and family health nursing: a pilot project.

PubMed

Guest, Eileen M; Keatinge, Diana R; Reed, Jennifer; Johnson, Karen R; Higgins, Helen M; Greig, Jennifer

2013-09-01

This paper describes the implementation and evaluation of the NSW Child and Family Health Nursing Professional Practice Framework in one health district in New South Wales, Australia. Child and family health nurses provide specialised, community based primary health care to families with children 0-5 years. A state wide professional practice framework was recently developed to support child and family health nurses. Online learning, clinical practice consultancies and skill assessments related to routine infant and child health surveillance were developed and implemented. Child and family health nurse reviewers gained competency in the various education and assessment components. Reviewers replicated this process in partnership with 21 child and family health nurses from two rural and one regional cluster. Evaluation questionnaires and focus groups were held with stakeholder groups. Participation provided nurses with affirmation of clinical practice and competency. Education and assessment processes were user friendly and particularly helpful for rural and remote nurses. Managers reported greater confidence in staff competence following project participation. Detailed planning and consultation is recommended before implementation of the Framework. Online learning, skills assessments and model of clinical practice consultancies were identified as central to ongoing orientation, education and professional development. Copyright © 2012 Elsevier Ltd. All rights reserved.

The capability of professional- and lay-rescuers to estimate the chest compression-depth target: a short, randomized experiment.

PubMed

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.

Combination of vitamin E and vitamin C alleviates renal function in hyperoxaluric rats via antioxidant activity.

PubMed

Jaturakan, Orapun; Dissayabutra, Thasinas; Chaiyabutr, Narongsak; Kijtawornrat, Anusak; Tosukhowong, Piyaratana; Rungsipipat, Anudep; Nhujak, Thumnoon; Buranakarl, Chollada

2017-05-18

Hyperoxaluria and oxidative stress are risk factors in calcium oxalate (CaOx) stone formation. Supplement with antioxidant could be effective in prevention of recurrent stone formation. The present study aims to evaluate the protective effects of vitamin E and vitamin C in hyperoxaluric rat. The experiment was performed in rats for 21 days. Rats were divided into 5 groups as follows: control (group 1, n=8), hyperoxaluric rats (group 2, n=8), hyperoxaluric rats with vitamin E supplement (group 3, n=7), hyperoxaluric rats with vitamin C supplement (group 4, n=7) and hyperoxaluric rats with vitamin E and C supplement (group 5, n=7). Hyperoxaluria was induced by feeding hydroxyl L-proline (HLP) 2% w/v dissolved in drinking water. Intraperitoneal 200 mg/kg of vitamin E was given in groups 3 and 5 on days 1, 6, 11 and 16, while 500 mg of vitamin C was injected intravenously in groups 4 and 5 on days 1 and 11. Renal functions and oxidative status were measured. The urinary oxalate excretion was increased in HLP supplement rats, while glomerular filtration rate, proximal water and sodium reabsorption were significantly lower in group 2 compared with a control (P<0.05). Giving antioxidants significantly lower urinary calcium oxalate crystals (P<0.05). Hyperoxaluric rats had higher plasma malondialdehyde (PMDA) and lower urinary total antioxidant status (UTAS), which were alleviated by vitamin E and/or vitamin C supplement. In conclusion, giving combination of vitamin E and vitamin C exerts a protective role against HLP-induced oxalate nephropathy.

Combination of vitamin E and vitamin C alleviates renal function in hyperoxaluric rats via antioxidant activity

PubMed Central

JATURAKAN, Orapun; DISSAYABUTRA, Thasinas; CHAIYABUTR, Narongsak; KIJTAWORNRAT, Anusak; TOSUKHOWONG, Piyaratana; RUNGSIPIPAT, Anudep; NHUJAK, Thumnoon; BURANAKARL, Chollada

2017-01-01

Hyperoxaluria and oxidative stress are risk factors in calcium oxalate (CaOx) stone formation. Supplement with antioxidant could be effective in prevention of recurrent stone formation. The present study aims to evaluate the protective effects of vitamin E and vitamin C in hyperoxaluric rat. The experiment was performed in rats for 21 days. Rats were divided into 5 groups as follows: control (group 1, n=8), hyperoxaluric rats (group 2, n=8), hyperoxaluric rats with vitamin E supplement (group 3, n=7), hyperoxaluric rats with vitamin C supplement (group 4, n=7) and hyperoxaluric rats with vitamin E and C supplement (group 5, n=7). Hyperoxaluria was induced by feeding hydroxyl L-proline (HLP) 2% w/v dissolved in drinking water. Intraperitoneal 200 mg/kg of vitamin E was given in groups 3 and 5 on days 1, 6, 11 and 16, while 500 mg of vitamin C was injected intravenously in groups 4 and 5 on days 1 and 11. Renal functions and oxidative status were measured. The urinary oxalate excretion was increased in HLP supplement rats, while glomerular filtration rate, proximal water and sodium reabsorption were significantly lower in group 2 compared with a control (P<0.05). Giving antioxidants significantly lower urinary calcium oxalate crystals (P<0.05). Hyperoxaluric rats had higher plasma malondialdehyde (PMDA) and lower urinary total antioxidant status (UTAS), which were alleviated by vitamin E and/or vitamin C supplement. In conclusion, giving combination of vitamin E and vitamin C exerts a protective role against HLP-induced oxalate nephropathy. PMID:28392511

The results of interconnection of the evidence of professional exposure to genotoxic factors (regex) and cancer registry in the Czech Republic.

PubMed

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.

Chinese Obstetrics & Gynecology journal club: a randomised controlled trial.

PubMed

Tsui, Ilene K; Dodson, William C; Kunselman, Allen R; Kuang, Hongying; Han, Feng-Juan; Legro, Richard S; Wu, Xiao-Ke

2016-01-28

To assess whether a journal club model could improve comprehension and written and spoken medical English in a population of Chinese medical professionals. The study population consisted of 52 medical professionals who were residents or postgraduate master or PhD students in the Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, China. After a three-part baseline examination to assess medical English comprehension, participants were randomised to either (1) an intensive journal club treatment arm or (2) a self-study group. At the conclusion of the 8-week intervention participants (n=52) were re-tested with new questions. The primary outcome was the change in score on a multiple choice examination. Secondary outcomes included change in scores on written and oral examinations which were modelled on the Test of English as a Foreign Language (TOEFL). Both groups had improved scores on the multiple choice examination without a statistically significant difference between them (90% power). However, there was a statistically significant difference between the groups in mean improvement in scores for both written (95% CI 1.1 to 5.0; p=0.003) and spoken English (95% CI 0.06 to 3.7; p=0.04) favouring the journal club intervention. Interacting with colleagues and an English-speaking facilitator in a journal club improved both written and spoken medical English in Chinese medical professionals. Journal clubs may be suitable for use as a self-sustainable teaching model to improve fluency in medical English in foreign medical professionals. NCT01844609. 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/

Evaluation of a Continuing Educational Intervention for Primary Health Care Professionals about Nutritional Care of Patients at Home.

PubMed

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.

Evaluating an holistic assessment tool for palliative care practice.

PubMed

McIlfatrick, Sonja; Hasson, Felicity

2014-04-01

To evaluate a holistic assessment tool for palliative care practice. This included identifying patients' needs using the holistic tool and exploring the usability, applicability and barriers and facilitators towards implementation in practice. The delivery of effective holistic palliative care requires a careful assessment of the patients' needs and circumstances. Whilst holistic assessment of palliative care needs is advocated, questions exist around the appropriateness of tools to assist this process. Mixed-method research design. Data collection involved an analysis of piloted holistic assessments undertaken using the tool (n = 132) and two focus groups with healthcare professionals (n = 10). The tool enabled health professionals to identify and gain an understanding of the needs of the patients, specifically in relation to the physical healthcare needs. Differences, however, between the analysis of the tool documentation and focus group responses were identified in particular areas. For example, 59 (68·8%) respondents had discussed preferred priorities of care with the patient; however, focus group comments revealed participants had concerns around this. Similarly, whilst over half of responses (n = 50; 57·5%) had considered a prognostic clinical indicator for the patient as an action, focus group results indicated questions around healthcare professionals' knowledge and perceived usefulness of such indicators. Positive aspects of the tool were that it was easy to understand and captured the needs of individuals. Negative aspects of the tool were that it was repetitive and the experience of assessors required consideration. The tool evaluation identified questions regarding holistic assessment in palliative care practice and the importance of communication. A holistic assessment tool can support patient assessment and identification of patients' needs in the 'real world' of palliative care practice, but the 'tool' is merely an aid to assist professionals to discuss difficult and sensitive aspects of care. © 2013 John Wiley & Sons Ltd.

[Frequent attendance in a Primary Health Care District].

PubMed

Menéndez Granados, Nicolás; Vaquero Abellán, Manuel; Toledano Estepa, Manuel; Pérez Díaz, Manuel Modesto; Redondo Pedraza, Rosa

2017-10-09

To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain). An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural). The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics. A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Professional Development and Use of Digital Technologies by Science Teachers: a Review of Theoretical Frameworks

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.

Are family-oriented interventions in Portuguese genetics services a remote possibility? Professionals' views on a multifamily intervention for cancer susceptibility families.

PubMed

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.

Correlations between polymorphisms in the uridine diphosphate-glucuronosyltransferase 1A and C-C motif chemokine receptor 5 genes and infection with the hepatitis B virus in three ethnic groups in China.

PubMed

Zhang, Chan; He, Yan; Shan, Ke-Ren; Tan, Kui; Zhang, Ting; Wang, Chan-Juan; Guan, Zhi-Zhong

2018-02-01

Objective To determine whether genetic polymorphisms in the uridine diphosphate-glucuronosyltransferase 1A ( UGT1A) and the C-C motif chemokine receptor 5 ( CCR5) genes are associated with hepatitis B virus (HBV) infection in Yi, Yao and Han ethnic groups in the Guizhou Province of China. Methods The study enrolled subjects with and without HBV infection. Whole blood was used for DNA genotyping using standard techniques. The study determined the frequencies of several polymorphic alleles ( UGT1A6 [rs2070959], UGT1A1 [rs8175347], CCR5-59029 [rs1799987] and CCR5Δ32 [rs333]) and then characterized their relationship with HBV infection. Results A total of 404 subjects were enrolled in the study: 138 from the Yao group, 101 from the Yi group and 165 from the Han group. There was a significant difference in the frequency of UGT1A1 rs8175347 polymorphisms among the three groups. The rates of 7TA carriers of UGT1A1 rs8175347 in all three groups were significantly higher than the other genotypes. Individuals with genotype AA of UGT1A6 rs2070959 in the Yi group had a higher risk for HBV infection than in the Yao and Han groups. The frequency of genotype GG in CCR5-59029 in the Yao group was significantly higher than in the Yi group. The genotypes of CCR5Δ32 were not associated with HBV infection. Conclusion These findings provide genetic and epidemiological evidence for an association of UGT1A and CCR5-59029 polymorphisms with HBV infection in Chinese Yi and Yao populations.

Smile esthetics: Impact of variations in the vertical and horizontal dimensions of the maxillary lateral incisors

PubMed Central

Al Taki, Amjad; Hamdan, Ahmad Mohammad; Mustafa, Ziad; Hassan, Mawada; Abu-Alhuda, Sami

2017-01-01

Objective: The purpose of this study was to determine the perception of trained dental professionals and laypersons toward the esthetic impact of variations in the vertical position, width, and gingival height of the maxillary lateral incisor. Materials and Methods: The present study analyzed the perspective of smile photographs by dental professionals such as “fifty orthodontics and fifty general dental practitioners (GDPs)” as well as fifty laypersons, consisting of an equal number of male and female participants. Photographs edited to depict alteration of golden proportion, incisal length, and gingival height of lateral incisor. SPSS software was used to analyze the data and determine the significant difference within all the participants, at 0.05% level (95% confidence interval). Results: There was no significant difference in ranking between the genders. Golden proportion of 62%–67% were ranked the highest by orthodontists, whereas GDPs and laypersons preferred 67%. Regarding gingival display, corrected height of −0.5 and −1 mm received highest ranking from all the three groups. In case of lateral incisal length, −0.5 mm was ranked highest by laypersons, in contrast to −1 mm by orthodontists and GDPs. Conclusion: Specific differences were observed in the ranking of smile esthetics by health-care professionals and laypersons. Golden proportion of 62% and 67% were ranked the highest by orthodontists, whereas GDPs and laypersons preferred 67%. Corrected gingival height of −0.5 and −1 mm received highest ranking from all the three groups. In case of lateral incisal length, −0.5 mm was ranked highest by laypersons, in contrast to −1 mm by orthodontists and GDPs. PMID:29279680

Perspectives of HIV-related stigma in a community in Vietnam: a qualitative study.

PubMed

Gaudine, Alice; Gien, Lan; Thuan, Tran T; Dung, Do V

2010-01-01

While HIV/AIDS is increasing in Vietnam, very few published studies focus on HIV-related stigma in Vietnam. This study reports on findings from a community development project to reduce HIV-related stigma within one community in Vietnam. The purpose of this qualitative study is to describe HIV-related stigma from the perspective of three groups within one community in Vietnam: people living with HIV, their family members, and community members and leaders, including health care professionals. SETTING, PARTICIPANTS AND METHODS: Fifty-eight individuals from a poor, industrial district on the outskirts of a large city participated in the study and were asked to describe HIV-related stigma. Interviews were conducted with 10 people living with HIV, 10 family members of a person living with HIV, and 10 community members and 5 community leaders including health care professionals. We also conducted three focus groups, one with people living with HIV (n=8), one with family members of people living with HIV (n=8), and one with community leaders including health care professionals (n=7). Stigma across the three groups is characterized by four dimensions of HIV-related stigma: feeling shamed and scorned, behaving differently, stigma due to association, and fear of transmission. The manifestation of these dimensions differs for each group. Four themes of HIV-related stigma as described by people living with HIV are: being avoided, experiencing anger and rejection, being viewed as a social ill, and hiding the illness. Seven themes of HIV-related stigma as described by family members are: shunned by neighbors, viewed as poor parents, discriminated by health professionals, overhearing discussions about people with HIV, maintaining the secret, financial hardship for family, and fear of contracting HIV. Four themes of HIV-related stigma as described by community members and leaders including health professionals are: stigma as a fair reward, avoidance and shunning by neighbors, ruined family reputation, and fear of contracting HIV. HIV-related stigma is experienced in a different manner by each of these groups, a finding that should help in developing culturally sensitive strategies to reduce HIV-related stigma in Vietnam.

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

PubMed

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

2006-07-01

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

42 CFR 5.3 - Procedures for designation of health professional(s) shortage areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Procedures for designation of health professional(s... SERVICES GENERAL PROVISIONS DESIGNATION OF HEALTH PROFESSIONAL(S) SHORTAGE AREAS § 5.3 Procedures for designation of health professional(s) shortage areas. (a) Using data available to the Department from national...

Complement activation and liver impairment in trichloroethylene-sensitized BALB/c mice.

PubMed

Zhang, Jiaxiang; Zha, Wansheng; Wang, Feng; Jiang, Tao; Xu, Shuhai; Yu, Junfeng; Zhou, Chengfan; Shen, Tong; Wu, Changhao; Zhu, Qixing

2013-01-01

Our recent studies have shown that trichloroethylene (TCE) was able to induce multisystem injuries in the form of occupational medicamentosa-like dermatitis, including skin, kidney, and liver damages. However, the role of complement activation in the immune-mediated liver injury is not known. This study examined the role of complement activation in the liver injury in a mouse model of TCE-induced sensitization. Treatment of female BALB/c mice with TCE under specific dosing protocols resulted in skin inflammation and sensitization. Skin edema and erythema occurred in TCE-sensitized groups. Trichloroethylene sensitization produced liver histopathological lesions, increased serum alanine aminotransferase, aspartate transaminase activities, and the relative liver weight. The concentrations of serum complement components C3a-desArg, C5a-desArg, and C5b-9 were significantly increased in 24-hour, 48-hour, and 72-hour sensitization-positive groups treated with TCE and peaked in the 72-hour sensitization-positive group. Depositions of C3a, C5a, and C5b-9 into the liver tissue were also revealed by immunohistochemistry. Immunofluorescence further verified high C5b-9 expression in 24-hour, 48-hour, and 72-hour sensitization-positive groups in response to TCE treatment. Reverse transcription-polymerase chain reaction detected C3 messenger RNA expression in the liver, and this was significantly increased in 24-hour and 48-hour sensitization-positive groups with a transient reduction at 72 hours. These results provide the first experimental evidence that complement activation may play a key role in the generation and progression of immune-mediated hepatic injury by exposure to TCE.

Impacts of fullerene C60 and virgin olive oil on cadmium-induced genotoxicity in rats.

PubMed

Aly, Fayza M; Kotb, Ahmed M; Haridy, Mohie A M; Hammad, Seddik

2018-07-15

Currently, cadmium is considered to be one of the major environmental pollutants. Environmentally, cadmium is released in various forms e.g. oxide, chloride and sulphide. The aim of the present study was to examine the genotoxic impact of fullerene nanoparticles C 60 (C 60 ) and virgin olive oil (VOO) on cadmium chloride (CdCl 2 )-induced genotoxicity in rats. To evaluate these effects on DNA damage and chromosomal frequency, 25 albino rats were randomly assigned to 5 groups (n=5 per group): Group 1 served as a control; Group 2 received a single intraperitoneal dose of CdCl 2 (3.5mg/kg); Group 3 animals were treated with C 60 (4mg/kg, orally) every other day for 20days; Group 4 received a single intraperitoneal dose of CdCl 2 (3.5mg/kg) and an oral dose of C 60 (4mg/kg); and Group 5 received a single intraperitoneal dose of CdCl 2 (3.5mg/kg) and oral doses of VOO every other day for 20 consecutive days. Genotoxic and anti-genotoxic effects of C 60 and VOO were evaluated in the liver, kidney and bone marrow using molecular and cytogenetic assays. As expected, CdCl 2 and C 60 administration was associated with band number alterations in both liver and kidney; however, C 60 pretreatment recovered to approximately basal number. Surprisingly, C 60 and VOO significantly attenuated the genotoxic effects caused by CdCl 2 in livers and kidneys. In bone marrow, in addition to a reduction in the chromosomal number, several chromosomal aberrations were caused by CdCl 2 . These chromosomal alterations were also reversed by C 60 and VOO. In conclusion, molecular and cytogenetic studies showed that C 60 and VOO exhibit anti-genotoxic agents against CdCl 2 -induced genotoxicity in rats. Further studies are needed to investigate the optimal conditions for potential biomedical applications of these anti-genotoxic agents. Copyright © 2018 Elsevier B.V. All rights reserved.

All-Ceramic Single Crown Restauration of Zirconia Oral Implants and Its Influence on Fracture Resistance: An Investigation in the Artificial Mouth

PubMed Central

Kohal, Ralf-Joachim; Kilian, Jolanta Bernadette; Stampf, Susanne; Spies, Benedikt Christopher

2015-01-01

The aim of the current investigation was to evaluate the fracture resistance of one-piece zirconia oral implants with and without all-ceramic incisor crowns after long-term thermomechanical cycling. A total of 48 implants were evaluated. The groups with crowns (C, 24 samples) and without crowns (N, 24 samples) were subdivided according to the loading protocol, resulting in three groups of 8 samples each: Group “0” was not exposed to cyclic loading, whereas groups “5” and “10” were loaded with 5 and 10 million chewing cycles, respectively. This resulted in 6 different groups: C0/N0, C5/N5 and C10/N10. Subsequently, all 48 implants were statically loaded to fracture and bending moments were calculated. All implants survived the artificial aging. For the static loading the following average bending moments were calculated: C0: 326 Ncm; C5: 339 Ncm; C10: 369 Ncm; N0: 339 Ncm; N5: 398 Ncm and N10: 355 Ncm. To a certain extent, thermomechanical cycling resulted in an increase of fracture resistance which did not prove to be statistically significant. Regarding its fracture resistance, the evaluated ceramic implant system made of Y-TZP seems to be able to resist physiological chewing forces long-term. Restauration with all-ceramic single crowns showed no negative influence on fracture resistance. PMID:28788018

Professional identity formation in the transition from medical school to working life: a qualitative study of group-coaching courses for junior doctors.

PubMed

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.

Effect of Catalase and Sodium Fluoride on Human Enamel bleached with 35% Carbamide Peroxide.

PubMed

Thakur, Ruchi; Shigli, Anand L; Sharma, Divya S; Thakur, Gagan

2015-01-01

To evaluate the effects of postbleaching antioxidant application fluoridation treatment on the surface morphology and microhardness of human enamel. Ten freshly extracted human maxillary central incisors were cut at cementoenamel junction. Crown portion was sectioned into six slabs which were divided into five groups: group A - untreated controls; group B - 35% carbamide peroxide (CP); group C - 35% CP and catalase; group D - treatment with 35% CP and 5% sodium fluoride; group E - 35% CP, catalase and 5% sodium fluoride. Thirty-five percent carbamide peroxide application included two applications of 30 minutes each at a 5-day interval. After treatment, the slabs were thoroughly washed with water for 10 seconds and stored in artificial saliva at 37°C until the next treatment. Two percent sodium fluoride included application for 5 minutes. Three catalase included application for 3 minutes. After 5 days, groups B and C showed significantly decreased enamel microhardness compared to control. Group D specimens showed relatively less reduction in enamel micro-hardness than group C specimens. There is a marked increase in enamel microhardness in group E specimens. Fluoride take up was comparatively enhanced after catalase application resulting in less demineralization and increased microhardness. How to cite this article: Thakur R, Shigli AL, Sharma DS, Thakur G. Effect of Catalase and Sodium Fluoride on Human Enamel bleached with 35% Carbamide Peroxide. Int J Clin Pediatr Dent 2015;8(1):12-17.

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…

Identification of the related substances of tilmicosin by liquid chromatography/ion trap mass spectrometry.

PubMed

Stoev, Georgi; Nazarov, Valeri

2008-06-01

Structures of seven impurities of the veterinary drug tilmicosin have been elucidated by multiple fragmentation with ion trap tandem mass spectrometry. All related compounds possess the main lactone ring of tilmicosin. The differences in their structures are due to the hydroxyl, mycaminose, 3,5-dimethylpiperidine and mycinose groups connected to C(3), C(5), C(6), C(14) of the lactone ring, respectively. The following compounds of the impurity profile of tilmicosin were identified: B - tilmicosin with a hydroxyl group at C(3); C - tilmicosin without a methyl group at the N-atom connected to C(3) of the mycaminose ring; D - tilmicosin with a hydroxyl group at C(6) of the mycaminose ring; E - tilmicosin with a methoxy group at C(3), F - desmicosin; G - 20-dihydrodesmicosin; and H - tilmicosin without a mycaminose ring. Isomers of the compounds B, C, D, E and H were identified by their mass chromatograms and retention times. The concentrations of the impurities varied in the range of 0.1% to 2.9%.

Room for Improvement in Nutrition Knowledge and Dietary Intake of Male Football (Soccer) Players in Australia.

PubMed

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.

Personal resources and satisfaction with life in Marfan syndrome patients with aortic pathology and in abdominal aortic aneurysm patients.

PubMed

Stanišić, Michał-Goran; Rzepa, Teresa; Gawrońska, Alicja; Kubaszewski, Przemysław; Putowski, Maciej; Stefaniak, Sebastian; Perek, Bartłomiej

2018-03-01

Whether or not the source of aortic pathology is Marfan syndrome (MFS) or other processes leading to development of abdominal aorta aneurysms (AAA), the awareness of pathology may lead to an emotional upset and low assessment of satisfaction with life. To assess, in regard to MFS patients with aortic pathology and to abdominal aortic aneurysm patients: 1) whether or not self-efficacy (SE) and health locus of control (HLoC) affect the patients' satisfaction with life; 2) whether the two groups of patients differ in terms of mental dispositions. The study population consisted of 16 MFS patients with aortic pathology and 16 AAA patients, 9 men and 7 women in each group. The mean age of the MFS patients was 28.5 ±8.214, and of the AAA patients 64.25 ±7.019. The following scales were applied: Generalized Self-Efficacy Scale, Satisfaction With Life Scale, Multidimensional Health Locus of Control Scale. Abdominal aorta aneurysms patients compared to MFS patients gave a higher rating for SE ( MD = 33.94 and MD = 29.56), internal health locus of control ( MD = 25.00 and MD = 21.13), external personal HL o C ( MD = 24.50 and MD = 19.25), external impersonal HLoC ( MD = 23.06 and MD = 18.25), and satisfaction with life ( M = 22.06 and M = 20.13). Internal and external HL o C were significantly lower in MFS patients compared to AAA patients. In patients with aortic diseases, special attention must be paid to the state of personal resources (PR). Interactions made by medical professionals should focus on enhancing PR supporting the patients' self-knowledge on their SE. This will help to improve their satisfaction with life and form a positive attitude to the illness.

The effect of thalidomide on spinal cord ischemia/reperfusion injury in a rabbit model.

PubMed

Lee, C-J; Kim, K-W; Lee, H-M; Nahm, F S; Lim, Y-J; Park, J-H; Kim, C-S

2007-02-01

Randomized study. To evaluate the effects of thalidomide on spinal cord ischemia/reperfusion injury via reduced TNF-alpha production. Animal experimental laboratory, Clinical Research Institute of Seoul National University Hospital, Seoul, Korea. Spinal cord ischemia was induced in rabbits by occluding the infrarenal aorta. Rabbits in group N did not undergo ischemic insult, but rabbits in groups C (the untreated group), THA, and THB underwent ischemic insult for 15 min. The THA and THB groups received thalidomide (20 mg/kg) intraperitoneally (i.p.) before ischemia, but only the THB group received thalidomide (i.p., 20 mg/kg) after 24 and 48 h of reperfusion. After evaluating neurologic functions at 1.5 h, 3, and 5 days of reperfusion, rabbits were killed for histopathologic examination and Western blot analysis of TNF-alpha. The THA and THB groups showed significantly less neurologic dysfunction than the C group at 1.5 h, 3, and 5 days of reperfusion. The number of normal spinal motor neurons in ventral gray matter was higher in THA and THB than in C, but no difference was observed between THA and THB. Western blot analysis showed a significantly higher level of TNF-alpha in C than in THA and THB at 1.5 h of reperfusion, but no difference was observed between C, THA, or THB at 3 or 5 days of reperfusion. Thalidomide treatment before ischemic insult reduces early phase ischemia/reperfusion injury of the spinal cord in rabbits.

The first 3':5'-cyclic nucleotide-amino acid complex: L-His-cIMP.

PubMed

Slepokura, Katarzyna

2012-08-01

In the crystal structure of the L-His-cIMP complex, i.e. L-histidinium inosine 3':5'-cyclic phosphate [systematic name: 5-(2-amino-2-carboxyethyl)-1H-imidazol-3-ium 7-hydroxy-2-oxo-6-(6-oxo-6,9-dihydro-1H-purin-9-yl)-4a,6,7,7a-tetrahydro-4H-1,3,5,2λ(5)-furo[3,2-d][1,3,2λ(5)]dioxaphosphinin-2-olate], C(6)H(10)N(3)O(2)(+)·C(10)H(10)N(4)O(7)P(-), the Hoogsteen edge of the hypoxanthine (Hyp) base of cIMP and the Hyp face are engaged in specific amino acid-nucleotide (His···cIMP) recognition, i.e. by abutting edge-to-edge and by π-π stacking, respectively. The Watson-Crick edge of Hyp and the cIMP phosphate group play a role in nonspecific His···cIMP contacts. The interactions between the cIMP anions (anti/C3'-endo/trans-gauche/chair conformers) are realized mainly between riboses and phosphate groups. The results for this L-His-cIMP complex, compared with those for the previously reported solvated L-His-IMP crystal structure, indicate a different nature of amino acid-nucleotide recognition and interactions upon the 3':5'-cyclization of the nucleotide phosphate group.

Counter-Unmanned Aerial Vehicle Warfare: Kill Authorizations for the Carrier Strike Group

DTIC Science & Technology

2016-06-10

COUNTER-UNMANNED AERIAL VEHICLE WARFARE: KILL AUTHORIZATIONS FOR THE CARRIER STRIKE GROUP A thesis presented to the Faculty...the Carrier Strike Group 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) LCDR Joshua C. Mattingly, U.S...including armed UAVs in an offensive role, but counter- UAV warfare is a new warfare area within the larger realm of air defense. Small Group 1 and 2

Physiological differences in professional basketball players as a function of playing position and level of play.

PubMed

Sallet, P; Perrier, D; Ferret, J M; Vitelli, V; Baverel, G

2005-09-01

The aim of this investigation is to evaluate the physical and physiological characteristics of different first (ProA) and second division (ProB) professional basketball players, and to relate them to playing position and level of play. A total of 58 players were divided into ProA and ProB groups and were assessed for physical characteristics, maximal treadmill test and a 30 s all-out test. The sample included 22 centers, 22 forwards and 14 guards. Centers were significantly taller and heavier (203.9+/-5.3 cm and 103.9+/-12.4 kg) than forwards (195.8+/-4.8 cm and 89.4+/-7.1 kg) and guards (185.7+/-6.9 and 82+/-8.8 kg) and also had higher body fat percentages than the other groups. Forwards were also significantly taller than guards. Centers presented a lower maximal aerobic velocity (kmxh-1) than guards (15.5+/-1.2 vs 16.8+/-1.5, P<0.05) on the maximal treadmill test and a lower maximal velocity (rpm) than forwards (156.5+/-18.4 vs 170.3+/-18.3, P<0.05) on the 30 s all-out test. VO2max (mlxmin-1xkg-1) was significantly lower for ProA (53.7+/-6.7) compared to ProB (56.5+/-7.7) players and the fatigue index on the 30 s all-out test was higher for the ProA group (P<0.05). Many physical differences, most notably size, exist between players as a function of their playing position. But these differences have no relationship to the level of play of professional players. General aerobic capacity is fairly homogeneous between playing position and level of play, even if there are observable VO2max differences due to inter-individual profiles. On the other hand, anaerobic capacity seems to be a better predictor of playing level even though it is not clear whether such capacity comes from specific training in ProA, or from an initial selection criteria.

Students' views on the impact of peer physical examination and palpation as a pedagogic tool for teaching and learning living human anatomy.

PubMed

Chinnah, Tudor I; de Bere, Sam Regan; Collett, Tracey

2011-01-01

Modern medical education teaching and learning approaches now lay emphasis on students acquiring knowledge, skills and attitudes relevant to medical practice. To explore students' perceived impacts of using hands-on approaches involving peer/life model physical examination and palpation in teaching and learning living human anatomy on their practice of physical examination of real patients. This study used exploratory focus groups and a questionnaire survey of years 3-5 medical students. The focus group discussions revealed new insights into the positive impacts of the hands-on approaches on students' clinical skills and professional attitudes when dealing with patients. Students' exposure to the hands-on approaches helped them to feel comfortable with therapeutically touching unclothed patients' bodies and physically examining them in the clinical environment. At least 60% of the questionnaire survey respondents agreed with the focus group participants on this view. Over 75% also agreed that the hands-on experiences helped them develop good professional attitudes in their encounter with patients. This study highlights the perceived educational value of the hands-on approaches as a pedagogic tool with a positive impact on students' clinical skills and professional attitudes that helps in easing their transition into clinical practice.

Organ trafficking and transplant tourism: the role of global professional ethical standards-the 2008 Declaration of Istanbul.

PubMed

Danovitch, Gabriel M; Chapman, Jeremy; Capron, Alexander M; Levin, Adeera; Abbud-Filho, Mario; Al Mousawi, Mustafa; Bennett, William; Budiani-Saberi, Debra; Couser, William; Dittmer, Ian; Jha, Vivek; Lavee, Jacob; Martin, Dominique; Masri, Marwan; Naicker, Saraladevi; Takahara, Shiro; Tibell, Annika; Shaheen, Faissal; Anantharaman, Vathsala; Delmonico, Francis L

2013-06-15

By 2005, human organ trafficking, commercialization, and transplant tourism had become a prominent and pervasive influence on transplantation therapy. The most common source of organs was impoverished people in India, Pakistan, Egypt, and the Philippines, deceased organ donors in Colombia, and executed prisoners in China. In response, in May 2008, The Transplantation Society and the International Society of Nephrology developed the Declaration of Istanbul on Organ Trafficking and Transplant Tourism consisting of a preamble, a set of principles, and a series of proposals. Promulgation of the Declaration of Istanbul and the formation of the Declaration of Istanbul Custodian Group to promote and uphold its principles have demonstrated that concerted, strategic, collaborative, and persistent actions by professionals can deliver tangible changes. Over the past 5 years, the Declaration of Istanbul Custodian Group organized and encouraged cooperation among professional bodies and relevant international, regional, and national governmental organizations, which has produced significant progress in combating organ trafficking and transplant tourism around the world. At a fifth anniversary meeting in Qatar in April 2013, the DICG took note of this progress and set forth in a Communiqué a number of specific activities and resolved to further engage groups from many sectors in working toward the Declaration's objectives.