Nurses' role transition from the clinical ward environment to the critical care environment.

PubMed

Gohery, Patricia; Meaney, Teresa

2013-12-01

To explore the experiences of nurses moving from the ward environment to the critical care environment. Critical care areas are employing nurses with no critical care experience due to staff shortage. There is a paucity of literature focusing on the experiences of nurses moving from the ward environment to the critical care environment. A Heideggerian phenomenology research approach was used in this study. In-depth semi structured interviews, supported with an interview guide, were conducted with nine critical care nurses. Data analysis was guided by Van Manen (1990) approach to phenomenological analysis. Four main themes emerged: The highs and lows, you need support, theory-practice gap, struggling with fear. The participants felt ill prepared and inexperienced to work within the stressful and technical environment of critical care due to insufficient education and support. The study findings indicated that a variety of feelings and emotions are experienced by ward nurses who move into the stressful and technical environment of critical care due to insufficient skills and knowledge. More education and support is required to improve this transition process. Copyright © 2013 Elsevier Ltd. All rights reserved.

Using mobile health technology to deliver decision support for self-monitoring after lung transplantation.

PubMed

Jiang, Yun; Sereika, Susan M; DeVito Dabbs, Annette; Handler, Steven M; Schlenk, Elizabeth A

2016-10-01

Lung transplant recipients (LTR) experience problems recognizing and reporting critical condition changes during their daily health self-monitoring. Pocket PATH(®), a mobile health application, was designed to provide automatic feedback messages to LTR to guide decisions for detecting and reporting critical values of health indicators. To examine the degree to which LTR followed decision support messages to report recorded critical values, and to explore predictors of appropriately following technology decision support by reporting critical values during the first year after transplantation. A cross-sectional correlational study was conducted to analyze existing data from 96 LTR who used the Pocket PATH for daily health self-monitoring. When a critical value is entered, the device automatically generated a feedback message to guide LTR about when and what to report to their transplant coordinators. Their socio-demographics and clinical characteristics were obtained before discharge. Their use of Pocket PATH for health self-monitoring during 12 months was categorized as low (≤25% of days), moderate (>25% to ≤75% of days), and high (>75% of days) use. Following technology decision support was defined by the total number of critical feedback messages appropriately handled divided by the total number of critical feedback messages generated. This variable was dichotomized by whether or not all (100%) feedback messages were appropriately followed. Binary logistic regression was used to explore predictors of appropriately following decision support. Of the 96 participants, 53 had at least 1 critical feedback message generated during 12 months. Of these 53 participants, the average message response rate was 90% and 33 (62%) followed 100% decision support. LTR who moderately used Pocket PATH (n=23) were less likely to follow technology decision support than the high (odds ratio [OR]=0.11, p=0.02) and low (OR=0.04, p=0.02) use groups. The odds of following decision support were reduced in LTR whose income met basic needs (OR=0.01, p=0.01) or who had longer hospital stays (OR=0.94, p=0.004). A significant interaction was found between gender and past technology experience (OR=0.21, p=0.03), suggesting that with increased past technology experience, the odds of following decision support to report all critical values decreased in men but increased in women. The majority of LTR responded appropriately to mobile technology-based decision support for reporting recorded critical values. Appropriately following technology decision support was associated with gender, income, experience with technology, length of hospital stay, and frequency of use of technology for self-monitoring. Clinicians should monitor LTR, who are at risk for poor reporting of recorded critical values, more vigilantly even when LTR are provided with mobile technology decision support. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Correlation Between Critical Thinking Disposition and Mental Self-Supporting Ability in Nursing Undergraduates: A Cross-Sectional Descriptive Study.

PubMed

Wu, Defang; Luo, Yang; Liao, Xinyu

2017-02-01

There is universal agreement on the essential role of critical thinking in nursing practice. Most studies into this topic have provided descriptive statistical information and insights on related external factors such as educational environment and teaching strategies. However, there has been limited research into the psychological factors that may predict the disposition of students toward critical thinking. This study explored the relationship between the disposition of nursing students toward critical thinking and their mental self-supporting ability to obtain a profile and determine the psychological predictors of critical thinking. A cross-sectional descriptive study was conducted in 2013 using a convenience sample from four nursing schools. Four hundred six Chinese nursing undergraduates completed two questionnaires including (a) the California Critical Thinking Disposition Inventory (Chinese version) and (b) the Mental Self-Supporting Questionnaire for University Students. Pearson's correlation and linear regression analysis were used to investigate the relationship between these two variables and the predicted positive psychological qualities for the critical thinking disposition of participants. Average participant scores for critical thinking disposition and mental self-supporting were 280.91 ± 28.43 and 76.40 ± 8.47, respectively. Positive correlations were observed between these two variables (r = .583, p < .01) and participants' self-decision, self-cognition, self-confidence, and self-responsibility, which suggest that these factors play a significant role in critical thinking disposition (R = .435, p < .01). The participants earned midlevel scores for both disposition toward critical thinking and mental self-supporting abilities.The four factors that had a major influence on critical thinking disposition included self-decision, self-cognition, self-confidence, and self-responsibility. Nursing educators should focus on improving the critical thinking ability of their students in these four aspects.

MISSION: Mission and Safety Critical Support Environment. Executive overview

NASA Technical Reports Server (NTRS)

Mckay, Charles; Atkinson, Colin

1992-01-01

For mission and safety critical systems it is necessary to: improve definition, evolution and sustenance techniques; lower development and maintenance costs; support safe, timely and affordable system modifications; and support fault tolerance and survivability. The goal of the MISSION project is to lay the foundation for a new generation of integrated systems software providing a unified infrastructure for mission and safety critical applications and systems. This will involve the definition of a common, modular target architecture and a supporting infrastructure.

Critical care in the surgical global period.

PubMed

Painter, Julie R

2013-03-01

This article explores the rules and regulations from Current Procedural Terminology (CPT) code set and US Medicare and Medicaid Services (Medicare) regarding multiple physicians reporting critical care services during the global period. The article takes into account the critical care definitions, regulations, documentation requirements, and services each provider can report to Medicare. A clinical scenario based on literature supporting the types of complications and care that might typically be included in the post-operative period for a patient who is surgically treated for a type A aortic dissection was analyzed. It was determined that multiple physicians may provide critical care services to a single patient during the global period. The physician who performed the primary procedure cannot report critical care separately unless documentation supporting use of modifier 25 (significant, separately identifiable services) or 24 (unrelated services) supports that critical care is unrelated to the global period. Other physicians may report critical care services separately if specific criteria are met. To report critical care services to Medicare, the patient's condition must meet the Medicare definition of critical care and the physicians should generally represent different specialties providing different aspects of care to the critically ill or injured patient as defined by Medicare. There should be no overlap in time of services provided by each physician. Each physician's documentation should clearly support medical necessity with the diagnosis demonstrating the critical nature of the patients' illness, the total time spent providing critical care, the critical care service provided, and other contributing factors.

Integrating Climate and Risk-Informed Science to Support Critical Decisions

ScienceCinema

None

2018-01-16

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

Integrating Climate and Risk-Informed Science to Support Critical Decisions

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

None

2016-07-27

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

Nutritional requirements of the critically ill patient.

PubMed

Chan, Daniel L

2004-02-01

The presence or development of malnutrition during critical illness has been unequivocally associated with increased morbidity and mortality in people. Recognition that malnutrition may similarly affect veterinary patients emphasizes the need to properly address the nutritional requirements of hospitalized dogs and cats. Because of a lack in veterinary studies evaluating the nutritional requirements of critically ill small animals, current recommendations for nutritional support of veterinary patients are based largely on sound clinical judgment and the best information available, including data from experimental animal models and human studies. This, however, should not discourage the veterinary practitioner from implementing nutritional support in critically ill patients. Similar to many supportive measures of critically ill patients, nutritional interventions can have a significant impact on patient morbidity and may even improve survival. The first step of nutritional support is to identify patients most likely to benefit from nutritional intervention. Careful assessment of the patient and appraisal of its nutritional needs provide the basis for a nutritional plan, which includes choosing the optimal route of nutritional support, determining the number of calories to provide, and determining the composition of the diet. Ultimately, the success of the nutritional management of critically ill dogs and cats will depend on close monitoring and frequent reassessment.

Neutron-absorber release device

DOEpatents

VAN Erp, Jan B.; Kimont, Edward L.

1976-01-01

A resettable device is provided for supporting an object, sensing when an environment reaches a critical temperature and releasing the object when the critical temperature is reached. It includes a flexible container having a material inside with a melting point at the critical temperature. The object's weight is supported by the solid material which gives rigidity to the container until the critical temperature is reached at which point the material in the container melts. The flexible container with the now fluid material inside has insufficient strength to support the object which is thereby released. Biasing means forces the container back to its original shape so that when the temperature falls below the melting temperature the material again solidifies, and the object may again be supported by the device.

Career Development Support in Pediatric Critical Care Medicine: A National Survey of Fellows and Junior Faculty.

PubMed

Cifra, Christina L; Balikai, Shilpa S; Murtha, Tanya D; Hsu, Benson; Riley, Carley L

2017-04-01

To determine the perceptions of current pediatric critical care medicine fellows and junior faculty regarding the extent and quality of career development support received during fellowship training. Web-based cross-sectional survey open from September to November 2015. Accreditation Council for Graduate Medical Education-accredited pediatric critical care medicine fellowship programs. Pediatric critical care medicine fellows (second yr or higher) and junior faculty (within 5 yr of completing a pediatric critical care medicine fellowship program). None. There were 129 respondents to the survey, representing 63% of Accreditation Council for Graduate Medical Education-accredited pediatric critical care medicine fellowship programs. Respondents were evenly divided between fellows and junior faculty. Nearly, half (49%) of respondents reported that their pediatric critical care medicine fellowship program provided a formal career development curriculum. Ideal career tracks chosen included academic clinician educator (64%), physician-scientist (27%), community-based (nonacademic) clinician (11%), and administrator (11%). There was a disparity in focused career development support provided by programs, with a minority providing good support for those pursuing a community-based clinician track (32%) or administrator track (16%). Only 43% of fellows perceived that they have a good chance of obtaining their ideal pediatric critical care medicine position, with the most common perceived barrier being increased competition for limited job opportunities. Most respondents expressed interest in a program specific to pediatric critical care medicine career development that is sponsored by a national professional organization. Most pediatric critical care medicine fellows and junior faculty reported good to excellent career development support during fellowship. However, important gaps remain, particularly for those pursuing community-based (nonacademic) and administrative tracks. Fellows were uncertain regarding future pediatric critical care medicine employment and their ability to pursue ideal career tracks. There may be a role for professional organizations to provide additional resources for career development in pediatric critical care medicine.

Independent Orbiter Assessment (IOA): Analysis of the life support and airlock support subsystems

NASA Technical Reports Server (NTRS)

Arbet, Jim; Duffy, R.; Barickman, K.; Saiidi, Mo J.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Life Support System (LSS) and Airlock Support System (ALSS). Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. The LSS provides for the management of the supply water, collection of metabolic waste, management of waste water, smoke detection, and fire suppression. The ALSS provides water, oxygen, and electricity to support an extravehicular activity in the airlock.

The education of health practitioners supporting breastfeeding women: time for critical reflection.

PubMed

Dykes, Fiona

2006-10-01

The protection, promotion and support of breastfeeding has now become a major international priority as emphasized in the Global Strategy for Infant and Young Child Feeding. Health practitioners, such as midwives, nurses and doctors, have a key role to play in providing support to breastfeeding women. This paper provides a critical discussion of educational requirements of health practitioners to equip them for their supportive role. The effective integration of embodied, vicarious, practice-based and theoretical knowledge requires opportunities for deep critical reflection. This approach should facilitate personal reflection and critical engagement with broader socio-political issues, thus allowing for collective understandings and change. Practitioners also need to understand breastfeeding as a biopsychosocial process that is dynamic, relational and changes over time. Recommendations are outlined with regards to multidisciplinary undergraduate education; mentorship schemes with knowledgeable role models supporting student practitioners; involvement of voluntary and peer supporters; post-registration education; setting of national standards for breastfeeding education; tailored education for specific groups; designated funding; and involvement of breastfeeding specialists.

Conceptualizing and Measuring Self-Criticism as Both a Personality Trait and a Personality State.

PubMed

Zuroff, David C; Sadikaj, Gentiana; Kelly, Allison C; Leybman, Michelle J

2016-01-01

Blatt's ( 2004 , 2008 ) conceptualization of self-criticism is consistent with a state-trait model that postulates meaningful variation in self-criticism both between persons (traits) and within person (states). We tested the state-trait model in a 7-day diary study with 99 college student participants. Each evening they completed a 6-item measure of self-criticism, as well as measures of perceived social support, positive and negative affect, compassionate and self-image goals during interactions with others, and interpersonal behavior, including overt self-criticism and given social support. As predicted, self-criticism displayed both trait-like variance between persons and daily fluctuations around individuals' mean scores for the week; slightly more than half of the total variance was between persons (ICC = .56). Numerous associations at both the between-persons and within-person levels were found between self-criticism and the other variables, indicating that individuals' mean levels of self-criticism over the week, and level of self-criticism on a given day relative to their personal mean, were related to their cognitions, affect, interpersonal goals, and behavior. The results supported the construct validity of the daily self-criticism measure. Moreover, the findings were consistent with the state-trait model and with Blatt's theoretical analysis of self-critical personality.

The Regression Level of Constructivist Learning Environment Characteristics on Classroom Environment Characteristics Supporting Critical Thinking

ERIC Educational Resources Information Center

Tunca, Nihal

2015-01-01

Problem Statement: One of the main aims of constructivism is to improve critical thinking skills/tendencies via experiences. In this sense, it is believed that the more the constructivist-learning environment is improved, the more the appropriateness of supporting critical thinking is improved. However, no study has yet statistically tested this…

"Don't Leave Us Out There Alone": A Framework for Supporting Supervisors

ERIC Educational Resources Information Center

Dangel, Julie Rainer; Tanguay, Carla

2014-01-01

Professional development that scaffolds and supports supervisors is critical for quality field experiences and is our responsibility as teacher educators. The literature supports this statement and two ideas that conceptually frame our work: (1) quality field experiences are a critical component of preservice programs and (2) training and support…

An Application of the Social Support Deterioration Deterrence Model to Rescue Workers

ERIC Educational Resources Information Center

Prati, Gabriele; Pietrantoni, Luca

2010-01-01

This study examined the role of social support in promoting quality of life in the aftermath of critical incidents involvement. Participants were a sample of 586 Italian rescue workers. Structural equation modelling was used to test the social support deterioration deterrence model. Results showed that the impact of critical incident involvement…

Perceived support at work after critical incidents and its relation to psychological distress: a survey among prehospital providers.

PubMed

Gouweloos-Trines, Juul; Tyler, Mark P; Giummarra, Melita J; Kassam-Adams, Nancy; Landolt, Markus A; Kleber, Rolf J; Alisic, Eva

2017-12-01

Prehospital providers are at increased risk for psychological distress. Support at work after critical incidents is believed to be important for providers, but current guidelines are in need of more scientific evidence. This study aimed to investigate: (1) to what extent prehospital providers experience support at work; (2) whether support at work is directly associated with lower distress and (3) whether availability of a formal peer support system is related to lower distress via perceived colleague support. This cross-sectional study surveyed prehospital providers from eight western industrialised countries between June and November 2014. A supportive work environment was operationalised as perceived management and colleague support (Job Content Questionnaire), availability of a formal peer support system and having enough time to recover after critical incidents. The outcome variable was psychological distress (Kessler 10). We conducted multiple linear regression analyses and mediation analysis. Of the 813 respondents, more than half (56.2%) were at moderate to high risk of psychological distress. Participants did not consistently report support at work (eg, 39.4% were not aware of formal peer support). Perceived management support (b (unstandardised regression coefficient)=-0.01, 95% CI -0.01 to 0.00), having enough time to recover after critical incidents (b=-0.07, 95% CI -0.09 to -0.04) and perceived colleague support (b=-0.01, 95% CI -0.01 to 0.00) were related to lower distress. Availability of formal peer support was indirectly related to lower distress via increased perceived colleague support (β=-0.04, 95% CI -0.02 to -0.01). Prehospital providers at risk of psychological distress may benefit from support from colleagues and management and from having time to recover after critical incidents. Formal peer support may assist providers by increasing their sense of support from colleagues. These findings need to be verified in a longitudinal design. © 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.

Trophic or full nutritional support?

PubMed

Arabi, Yaseen M; Al-Dorzi, Hasan M

2018-06-04

Full nutritional support during the acute phase of critical illness has traditionally been recommended to reduce catabolism and prevent malnutrition. Approaches to achieve full nutrition include early initiation of nutritional support, targeting full nutritional requirement as soon as possible and initiation of supplemental parenteral nutrition when enteral nutrition does not reach the target. Existing evidence supports early enteral nutrition over delayed enteral nutrition or early parenteral nutrition. Recent randomized controlled trials have demonstrated that permissive underfeeding or trophic feeding is associated with similar outcomes compared with full feeding in the acute phase of critical illness. In patients with refeeding syndrome, patients with high nutritional risk and patients with shock, early enteral nutrition targeting full nutritional targets may be associated with worse outcomes compared with less aggressive enteral nutrition strategy. A two-phase approach for nutritional support may more appropriately account for the physiologic changes during critical illness than one-phase approach. Further evidence is awaited for the optimal protein amount during critical illness and for feeding patients at high nutritional risk or with acute gastrointestinal injury.

Evidence to Support Tooth Brushing in Critically Ill Patients

PubMed Central

Ames, Nancy J.

2012-01-01

Tooth brushing in critically ill patients has been advocated by many as a standard of care despite the limited evidence to support this practice. Attention has been focused on oral care as the evidence accumulates to support an association between the bacteria in the oral microbiome and those respiratory pathogens that cause pneumonia. It is plausible to assume that respiratory pathogens originating in the oral cavity are aspirated into the lungs, causing infection. A recent study of the effects of a powered toothbrush on the incidence of ventilator-associated pneumonia was stopped early because of a lack of effect in the treatment group. This review summarizes the evidence that supports the effectiveness of tooth brushing in critically ill adults and children receiving mechanical ventilation. Possible reasons for the lack of benefit of tooth brushing demonstrated in clinical trials are discussed. Recommendations for future trials in critically ill patients are suggested. With increased emphasis being placed on oral care, the evidence that supports this intervention must be evaluated carefully. PMID:21532045

Evidence to support tooth brushing in critically ill patients.

PubMed

Ames, Nancy J

2011-05-01

Tooth brushing in critically ill patients has been advocated by many as a standard of care despite the limited evidence to support this practice. Attention has been focused on oral care as the evidence accumulates to support an association between the bacteria in the oral microbiome and those respiratory pathogens that cause pneumonia. It is plausible to assume that respiratory pathogens originating in the oral cavity are aspirated into the lungs, causing infection. A recent study of the effects of a powered toothbrush on the incidence of ventilator-associated pneumonia was stopped early because of a lack of effect in the treatment group. This review summarizes the evidence that supports the effectiveness of tooth brushing in critically ill adults and children receiving mechanical ventilation. Possible reasons for the lack of benefit of tooth brushing demonstrated in clinical trials are discussed. Recommendations for future trials in critically ill patients are suggested. With increased emphasis being placed on oral care, the evidence that supports this intervention must be evaluated carefully.

A family nursing educational intervention supports nurses and families in an adult intensive care unit.

PubMed

Eggenberger, Sandra K; Sanders, Marita

2016-11-01

The family experience of critical illness is filled with distress that may have a lasting impact on family coping and family health. A nurse can become a source of comfort that helps the family endure. Yet, nurses often report a lack of confidence in communicating with families and families report troubling relationships with nurses. In spite of strong evidence supporting nursing practice focused on the family, family nursing interventions often not implemented in the critical care setting. This pilot study examined the influence of an educational intervention on nurses' attitudes towards and confidence in providing family care, as well as families' perceptions of support from nurses in an adult critical care setting. An academic-clinical practice partnership used digital storytelling as an educational strategy. A Knowledge to Action Process Framework guided this study. Results of pre-intervention data collection from families and nurses were used to inform the educational intervention. A convenience sample of family members completed the Iceland Family Perceived Support Questionnaire (ICE-FPSQ) to measure perception of support provided by nurses. Video, voice, and narrative stories of nurses describing their experiences caring for family members during a critical illness and family members' experiences with a critically ill family member also guided education plans. When comparing the pre and post results of the Family Nurse Practice Scale (FNPS), nurses reported increased confidence, knowledge, and skill following the educational intervention. Qualitative data from nurses reported satisfaction with the educational intervention. Findings suggest that engaging nurses in educational opportunities focused on families while using storytelling methods encourages empathic understandings. Academic-clinician teams that drive directions show promise in supporting families and nurses in critical care settings. Plans are moving forward to use this study design and methods in other critical care settings. Copyright © 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

The role of critical ethnic awareness and social support in the discrimination-depression relationship among Asian Americans: path analysis.

PubMed

Kim, Isok

2014-01-01

This study used a path analytic technique to examine associations among critical ethnic awareness, racial discrimination, social support, and depressive symptoms. Using a convenience sample from online survey of Asian American adults (N = 405), the study tested 2 main hypotheses: First, based on the empowerment theory, critical ethnic awareness would be positively associated with racial discrimination experience; and second, based on the social support deterioration model, social support would partially mediate the relationship between racial discrimination and depressive symptoms. The result of the path analysis model showed that the proposed path model was a good fit based on global fit indices, χ²(2) = 4.70, p = .10; root mean square error of approximation = 0.06; comparative fit index = 0.97; Tucker-Lewis index = 0.92; and standardized root mean square residual = 0.03. The examinations of study hypotheses demonstrated that critical ethnic awareness was directly associated (b = .11, p < .05) with the racial discrimination experience, whereas social support had a significant indirect effect (b = .48; bias-corrected 95% confidence interval [0.02, 1.26]) between the racial discrimination experience and depressive symptoms. The proposed path model illustrated that both critical ethnic awareness and social support are important mechanisms for explaining the relationship between racial discrimination and depressive symptoms among this sample of Asian Americans. This study highlights the usefulness of the critical ethnic awareness concept as a way to better understand how Asian Americans might perceive and recognize racial discrimination experiences in relation to its mental health consequences.

Energy Requirements in Critically Ill Patients.

PubMed

Ndahimana, Didace; Kim, Eun-Kyung

2018-04-01

During the management of critical illness, optimal nutritional support is an important key for achieving positive clinical outcomes. Compared to healthy people, critically ill patients have higher energy expenditure, thereby their energy requirements and risk of malnutrition being increased. Assessing individual nutritional requirement is essential for a successful nutritional support, including the adequate energy supply. Methods to assess energy requirements include indirect calorimetry (IC) which is considered as a reference method, and the predictive equations which are commonly used due to the difficulty of using IC in certain conditions. In this study, a literature review was conducted on the energy metabolic changes in critically ill patients, and the implications for the estimation of energy requirements in this population. In addition, the issue of optimal caloric goal during nutrition support is discussed, as well as the accuracy of selected resting energy expenditure predictive equations, commonly used in critically ill patients.

Using the ECD Framework to Support Evidentiary Reasoning in the Context of a Simulation Study for Detecting Learner Differences in Epistemic Games

ERIC Educational Resources Information Center

Sweet, Shauna J.; Rupp, Andre A.

2012-01-01

The "evidence-centered design" (ECD) framework is a powerful tool that supports careful and critical thinking about the identification and accumulation of evidence in assessment contexts. In this paper, we demonstrate how the ECD framework provides critical support for designing simulation studies to investigate statistical methods…

The Critical Care Obesity Paradox and Implications for Nutrition Support.

PubMed

Patel, Jayshil J; Rosenthal, Martin D; Miller, Keith R; Codner, Panna; Kiraly, Laszlo; Martindale, Robert G

2016-09-01

Obesity is a leading cause of preventable death worldwide. The prevalence of obesity has been increasing and is associated with an increased risk for other co-morbidities. In the critical care setting, nearly one third of patients are obese. Obese critically ill patients pose significant physical and on-physical challenges to providers, including optimization of nutrition therapy. Intuitively, obese patients would have worse critical care-related outcome. On the contrary, emerging data suggests that critically ill obese patients have improved outcomes, and this phenomenon has been coined "the obesity paradox." The purposes of this review will be to outline the historical views and pathophysiology of obesity and epidemiology of obesity, describe the challenges associated with obesity in the intensive care unit setting, review critical care outcomes in the obese, define the obesity-critical care paradox, and identify the challenges and role of nutrition support in the critically ill obese patient.

Critical string from non-Abelian vortex in four dimensions

DOE PAGES

Shifman, M.; Yung, A.

2015-09-25

In a class of non-Abelian solitonic vortex strings supported in certain N = 2 super-Yang–Mills theories we search for the vortex which can behave as a critical fundamental string. We use the Polchinski–Strominger criterion of the ultraviolet completeness. We identify an appropriate four-dimensional bulk theory: it has the U(2) gauge group, the Fayet–Iliopoulos term and four flavor hypermultiplets. It supports semilocal vortices with the world-sheet theory for orientational (size) moduli described by the weighted CP(2,2) model. The latter is superconformal. Its target space is six-dimensional. The overall Virasoro central charge is critical. Lastly, we show that the world-sheet theory onmore » the vortex supported in this bulk model is the bona fide critical string.« less

Implementing an educational program to improve critical care nurses' enteral nutritional support.

PubMed

Kim, Hyunjung; Chang, Sun Ju

2018-05-11

Although international nutrition societies recommend enteral nutrition guidelines for patients in intensive care units (ICUs), large gaps exist between these recommendations and actual clinical practice. Education programs designed to improve nurses' knowledge about enteral nutrition are therefore required. In Korea, there are no educational intervention studies about evidence-based guidelines of enteral nutrition for critically ill patients. We aimed to evaluate the effects of an education program to improve critical care nurses' perceptions, knowledge, and practices towards providing enteral nutritional support for ICU patients. A quasi-experimental, one-group study with a pre- and post-test design was conducted from March to April 2015. Nurses (N = 205) were recruited from nine ICUs from four tertiary hospitals in South Korea. The education program comprised two sessions of didactic lectures. Data were collected before (pre-test) and 1 month after (post-test) the education program using questionnaires that addressed nurses' perceptions, knowledge, and practices relating to providing enteral nutritional support for ICU patients. After the program, nurses showed a significant improvement in their perceptions and knowledge of enteral nutrition for ICU patients. There was a significant improvement in inspecting nostrils daily, flushing the feeding tube before administration, providing medication that needs to be crushed correctly, changing feeding sets, and adjusting feeding schedules. The findings indicate that an enteral nutrition education program could be an effective strategy to increase critical care nurses' support for the critically ill. This education program can be incorporated into hospital education or in-service training for critical care nurses to strengthen their perceptions and knowledge of nutritional support in the ICU. This may improve the clinical outcomes of ICU patients. Copyright © 2018 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

End-of-life care practices of critical care nurses: A national cross-sectional survey.

PubMed

Ranse, Kristen; Yates, Patsy; Coyer, Fiona

2016-05-01

The critical care context presents important opportunities for nurses to deliver skilled, comprehensive care to patients at the end of life and their families. Limited research has identified the actual end-of-life care practices of critical care nurses. To identify the end-of-life care practices of critical care nurses. A national cross-sectional online survey. The survey was distributed to members of an Australian critical care nursing association and 392 critical care nurses (response rate 25%) completed the survey. Exploratory factor analysis using principal axis factoring with oblique rotation was undertaken on survey responses to identify the domains of end-of-life care practice. Descriptive statistics were calculated for individual survey items. Exploratory factor analysis identified six domains of end-of-life care practice: information sharing, environmental modification, emotional support, patient and family centred decision-making, symptom management and spiritual support. Descriptive statistics identified a high level of engagement in information sharing and environmental modification practices and less frequent engagement in items from the emotional support and symptom management practice areas. The findings of this study identified domains of end-of-life care practice, and critical care nurse engagement in these practices. The findings highlight future training and practice development opportunities, including the need for experiential learning targeting the emotional support practice domain. Further research is needed to enhance knowledge of symptom management practices during the provision of end-of-life care to inform and improve practice in this area. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Enhancing Defense Support of Civil Authorities within the National Capital Region

DTIC Science & Technology

2011-04-04

tenorist organizations center of gravity, critical capabilities, critical requirements, and critical vulnerabilities. For example, to execute the...London Underground bombings ( critical capability), the group (center of gravity) needed money ( critical requirement! critical vulnerability). 8 Usually...the movement of large amounts of money through banks, the internet, or via credit cards creates a critical vulnerability because law enforcement

Who should be responsible for supporting individuals with mental health problems? A critical literature review.

PubMed

Pope, Megan A; Malla, Ashok K; Iyer, Srividya N

2018-05-01

Individuals with mental health problems have many support needs that are often inadequately met; however, perceptions of who should be responsible for meeting these needs have been largely unexplored. Varying perceptions may influence whether, how, and to what extent relevant stakeholders support individuals with mental health problems. To critically evaluate the literature to determine who different stakeholders believe should be responsible for supporting individuals with mental health problems, what factors shape these perceptions, and how they relate to one another. A critical literature review was undertaken. Following an extensive literature search, the conceptual contributions of relevant works were critically evaluated. A concept map was created to build a conceptual framework of the topic. Views of individual versus societal responsibility for need provision and health; the morality of caring; and attributions of responsibility for mental illness offered valuable understandings of the review questions. Creating a concept map revealed that various interrelated factors may influence perceptions of responsibility. Varying perceptions of who should be responsible for supporting individuals with mental health problems may contribute to unmet support needs among this group. Our critical review helps build a much-needed conceptual framework of factors influencing perceptions of responsibility. Such a framework is essential as these views iteratively shape and reflect the complex divisions of mental healthcare roles and responsibilities. Understanding these perceptions can help define relevant stakeholders' roles more clearly, which can improve mental health services and strengthen stakeholder accountability.

Translational Cognition for Decision Support in Critical Care Environments: A Review

PubMed Central

Patel, Vimla L.; Zhang, Jiajie; Yoskowitz, Nicole A.; Green, Robert; Sayan, Osman R.

2008-01-01

The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers. PMID:18343731

Translational cognition for decision support in critical care environments: a review.

PubMed

Patel, Vimla L; Zhang, Jiajie; Yoskowitz, Nicole A; Green, Robert; Sayan, Osman R

2008-06-01

The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real-world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers.

From Situated Privilege to Dis/abilities: Developing Critical Literacies across Social Issues

ERIC Educational Resources Information Center

Young, Sara Lewis-Bernstein

2018-01-01

The purpose of this study was to investigate how curriculum grounded in critical literacy strategies supports critical language awareness and activism across social issues and identities. The research is grounded in theories of critical literacies, discursive practices, and situated privilege. Critical practitioner research was used to collect…

Toward a Critical HRD in Theory and Practice

ERIC Educational Resources Information Center

Fenwick, Tara J.

2004-01-01

Drawing from critical management studies and critical pedagogy, this article proposes principles and practices to support the emerging critical human resource development (HRD) field as one stream among existing theories and practice of HRD. A critical HRD would challenge the subjugation of human knowledge, skills, and relationships to…

Operations Research Support for Critical Infrastructure Resilience in the Province of British Columbia

DTIC Science & Technology

2012-10-01

support for various aspects of CI resilience in BC since 2008, initially for the Vancouver 2010 Olympic and Paralympic Winter Games and, subsequently... Paralympic Winter Games (V2010). Under this project, DRDC provided critical infrastructure (CI) support to two groups: the Integrated Security Unit (ISU...BC since 2008, initially for the Vancouver 2010 Olympic and Paralympic Winter Games and, subsequently, for the development of Emergency Management

Use of a wiki as a radiology departmental knowledge management system.

PubMed

Meenan, Christopher; King, Antoinette; Toland, Christopher; Daly, Mark; Nagy, Paul

2010-04-01

Information technology teams in health care are tasked with maintaining a variety of information systems with complex support requirements. In radiology, this includes picture archive and communication systems, radiology information systems, speech recognition systems, and other ancillary systems. Hospital information technology (IT) departments are required to provide 24 x 7 support for these mission-critical systems that directly support patient care in emergency and other critical care departments. The practical know-how to keep these systems operational and diagnose problems promptly is difficult to maintain around the clock. Specific details on infrequent failure modes or advanced troubleshooting strategies may reside with only a few senior staff members. Our goal was to reduce diagnosis and recovery times for issues with our mission-critical systems. We created a knowledge base for building and quickly disseminating technical expertise to our entire support staff. We used an open source, wiki-based, collaborative authoring system internally within our IT department to improve our ability to deliver a high level of service to our customers. In this paper, we describe our evaluation of the wiki and the ways in which we used it to organize our support knowledge. We found the wiki to be an effective tool for knowledge management and for improving our ability to provide mission-critical support for health care IT systems.

Empowering Teachers to Author Multimedia Learning Resources That Support Students' Critical Thinking

ERIC Educational Resources Information Center

Holley, Debbie; Boyle, Tom

2012-01-01

Students studying Marketing, Fashion, Public Relations, Advertising and similar subjects need to develop a "critical eye" in relation to images, media and digital technologies. This project aims to empower teachers to develop multimedia learning resources that would support students engaging in this essential activity. Developing such…

Student/Scientist Partnerships: A Teacher's Guide To Evaluating the Critical Components.

ERIC Educational Resources Information Center

Evans, Celia A.; Abrams, Eleanor D.; Rock, Barret N.; Spencer, Shannon L.

2001-01-01

Presents a guide to the critical components of partnerships in Students/Scientist Partnerships (SSPs), a project-based instruction. Uses examples from the Forest Watch (FW) program to support the ideas. Focuses on access to experts, workshops, training sessions, student congresses, support materials and research protocols, science education…

Developing Intuitive Reasoning with Graphs to Support Science Arguments

ERIC Educational Resources Information Center

Grueber, David

2011-01-01

Graphs are important for supporting critical thinking and scientific argumentation because students can use them to reason, make judgments and decisions, and solve problems like a scientist (Connery 2007). Yet teaching students how to use math to actually think critically continues to be difficult for teachers. This article describes two…

9/11 Ten Years After: Command, Control, Communications Remain an Issue

DTIC Science & Technology

2012-02-09

must respond, manage forces, and provide critical support as a cohesive team. These organizations span the gamut of local, tribal, state, and federal...and provide critical support as a cohesive team. These organizations span the gamut of local, tribal, state, and federal levels of government and of

A missing ethical competency? A review of critical reflection in health promotion.

PubMed

Tretheway, Rebecca; Taylor, Jane; O'Hara, Lily; Percival, Nikki

2015-12-01

There is increasing emphasis in the health promotion literature on the ethical imperative for the profession to move towards critical practice. A key challenge for health promotion is that critical practice appears both under-developed and under-practiced. This is evident in the omission of critical reflection from Australian and international competencies for health promotion practitioners. A narrative literature review was undertaken to explore the current use of critical reflection in health promotion. Critical reflection models relevant to health promotion were identified and critiqued. There was a dearth of literature on critical reflection within health promotion, despite recognition of its potential to support critical practice. The discipline of critical social work provided literature on the use, effect and outcome of critical reflection in practice. The interdisciplinary critical reflection model was identified as the model most applicable to health promotion. Underpinned by critical theory, this model emphasises both critical and ethical practice. Critical reflection is a core competency for health promotion practitioners to address the ethical imperative to move towards critical practice. There is a need to explore the application of a critical reflection model in health promotion to determine how it may support critical and ethical practice. So what? If health promotion is to meet its ethical responsibilities, then critical reflection needs to be articulated as a core health promotion competency and a model for its application in health promotion developed.

American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock.

PubMed

Davis, Alan L; Carcillo, Joseph A; Aneja, Rajesh K; Deymann, Andreas J; Lin, John C; Nguyen, Trung C; Okhuysen-Cawley, Regina S; Relvas, Monica S; Rozenfeld, Ranna A; Skippen, Peter W; Stojadinovic, Bonnie J; Williams, Eric A; Yeh, Tim S; Balamuth, Fran; Brierley, Joe; de Caen, Allan R; Cheifetz, Ira M; Choong, Karen; Conway, Edward; Cornell, Timothy; Doctor, Allan; Dugas, Marc-Andre; Feldman, Jonathan D; Fitzgerald, Julie C; Flori, Heidi R; Fortenberry, James D; Graciano, Ana Lia; Greenwald, Bruce M; Hall, Mark W; Han, Yong Yun; Hernan, Lynn J; Irazuzta, Jose E; Iselin, Elizabeth; van der Jagt, Elise W; Jeffries, Howard E; Kache, Saraswati; Katyal, Chhavi; Kissoon, Niranjan Tex; Kon, Alexander A; Kutko, Martha C; MacLaren, Graeme; Maul, Timothy; Mehta, Renuka; Odetola, Fola; Parbuoni, Kristine; Paul, Raina; Peters, Mark J; Ranjit, Suchitra; Reuter-Rice, Karin E; Schnitzler, Eduardo J; Scott, Halden F; Torres, Adalberto; Weingarten-Abrams, Jacki; Weiss, Scott L; Zimmerman, Jerry J; Zuckerberg, Aaron L

2017-06-01

The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine "Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shock." Society of Critical Care Medicine members were identified from general solicitation at Society of Critical Care Medicine Educational and Scientific Symposia (2006-2014). The PubMed/Medline/Embase literature (2006-14) was searched by the Society of Critical Care Medicine librarian using the keywords: sepsis, septicemia, septic shock, endotoxemia, persistent pulmonary hypertension, nitric oxide, extracorporeal membrane oxygenation, and American College of Critical Care Medicine guidelines in the newborn and pediatric age groups. The 2002 and 2007 guidelines were widely disseminated, translated into Spanish and Portuguese, and incorporated into Society of Critical Care Medicine and American Heart Association/Pediatric Advanced Life Support sanctioned recommendations. The review of new literature highlights two tertiary pediatric centers that implemented quality improvement initiatives to improve early septic shock recognition and first-hour compliance to these guidelines. Improved compliance reduced hospital mortality from 4% to 2%. Analysis of Global Sepsis Initiative data in resource rich developed and developing nations further showed improved hospital mortality with compliance to first-hour and stabilization guideline recommendations. The major new recommendation in the 2014 update is consideration of institution-specific use of 1) a "recognition bundle" containing a trigger tool for rapid identification of patients with septic shock, 2) a "resuscitation and stabilization bundle" to help adherence to best practice principles, and 3) a "performance bundle" to identify and overcome perceived barriers to the pursuit of best practice principles.

The critical care air transport program.

PubMed

Beninati, William; Meyer, Michael T; Carter, Todd E

2008-07-01

The critical care air transport team program is a component of the U.S. Air Force Aeromedical Evacuation system. A critical care air transport team consists of a critical care physician, critical care nurse, and respiratory therapist along with the supplies and equipment to operate a portable intensive care unit within a cargo aircraft. This capability was developed to support rapidly mobile surgical teams with high capability for damage control resuscitation and limited capacity for postresuscitation care. The critical care air transport team permits rapid evacuation of stabilizing casualties to a higher level of care. The aeromedical environment presents important challenges for the delivery of critical care. All equipment must be tested for safety and effectiveness in this environment before use in flight. The team members must integrate the current standards of care with the limitation imposed by stresses of flight on their patient. The critical care air transport team capability has been used successfully in a range of settings from transport within the United States, to disaster response, to support of casualties in combat.

Nuclear Data Activities in Support of the DOE Nuclear Criticality Safety Program

NASA Astrophysics Data System (ADS)

Westfall, R. M.; McKnight, R. D.

2005-05-01

The DOE Nuclear Criticality Safety Program (NCSP) provides the technical infrastructure maintenance for those technologies applied in the evaluation and performance of safe fissionable-material operations in the DOE complex. These technologies include an Analytical Methods element for neutron transport as well as the development of sensitivity/uncertainty methods, the performance of Critical Experiments, evaluation and qualification of experiments as Benchmarks, and a comprehensive Nuclear Data program coordinated by the NCSP Nuclear Data Advisory Group (NDAG). The NDAG gathers and evaluates differential and integral nuclear data, identifies deficiencies, and recommends priorities on meeting DOE criticality safety needs to the NCSP Criticality Safety Support Group (CSSG). Then the NDAG identifies the required resources and unique capabilities for meeting these needs, not only for performing measurements but also for data evaluation with nuclear model codes as well as for data processing for criticality safety applications. The NDAG coordinates effort with the leadership of the National Nuclear Data Center, the Cross Section Evaluation Working Group (CSEWG), and the Working Party on International Evaluation Cooperation (WPEC) of the OECD/NEA Nuclear Science Committee. The overall objective is to expedite the issuance of new data and methods to the DOE criticality safety user. This paper describes these activities in detail, with examples based upon special studies being performed in support of criticality safety for a variety of DOE operations.

Pathophysiology of the Gut and the Microbiome in the Host Response.

PubMed

Lyons, John D; Coopersmith, Craig M

2017-03-01

To describe and summarize the data supporting the gut as the motor driving critical illness and multiple organ dysfunction syndrome presented at the National Institute of Child Health and Human Development MODS Workshop (March 26-27, 2015). Summary of workshop keynote presentation. Not applicable. Presented by an expert in the field, the data assessing the role of gastrointestinal dysfunction driving critical illness were described with a focus on identifying knowledge gaps and research priorities. Summary of presentation and discussion supported and supplemented by relevant literature. The understanding of gut dysfunction in critical illness has evolved greatly over time, and the gut is now often considered as the "motor" of critical illness. The association of the gut with critical illness is supported by both animal models and clinical studies. Initially, the association between gut dysfunction and critical illness focused primarily on bacterial translocation into the bloodstream. However, that work has evolved to include other gut-derived products causing distant injury via other routes (e.g., lymphatics). Additionally, alterations in the gut epithelium may be associated with critical illness and influence outcomes. Gut epithelial apoptosis, intestinal hyperpermeability, and perturbations in the intestinal mucus layer have all been associated with critical illness. Finally, there is growing evidence that the intestinal microbiome plays a crucial role in mediating pathology in critical illness. Further research is needed to better understand the role of each of these mechanisms and their contribution to multiple organ dysfunction syndrome in children.

Critical Thinking as Cultural-Historical Practice.

ERIC Educational Resources Information Center

Panofsky, Carolyn P.

1999-01-01

Explores critical thinking as it has been constructed in schooling and in dominant traditions of psychological theory, presenting a dialectical view of critical thinking suggested in the social and philosophical writings of critical theorists (e.g., Theodor Adorno and Herbert Marcuse) and supported by the sociohistorical or cultural-historical…

Adaptive and Intelligent Systems for Collaborative Learning Support: A Review of the Field

ERIC Educational Resources Information Center

Magnisalis, I.; Demetriadis, S.; Karakostas, A.

2011-01-01

This study critically reviews the recently published scientific literature on the design and impact of adaptive and intelligent systems for collaborative learning support (AICLS) systems. The focus is threefold: 1) analyze critical design issues of AICLS systems and organize them under a unifying classification scheme, 2) present research evidence…

Developing an Impella Educational Program for the Critical Care Registered Nurse

ERIC Educational Resources Information Center

Jackson, Sara

2018-01-01

Every year, hundreds of thousands of patients have coronary angiograms performed in the United States. The Impella is a percutaneous ventricular support device that provides hemodynamic support for patients if hemodynamic instability occurs during the procedure. The critical care nurse is responsible for the recovery and management of the patient…

Proposed key elements of a critical incident intervention program for reducing the effects of potentially traumatic exposure on train crews to grade crossing and trespasser incidents.

DOT National Transportation Integrated Search

2014-04-01

This independent report presents work conducted regarding project FR-RDD-0024-11-01 to advise and support the formulation of : regulations and supporting materials concerning critical incident response plans for rail carriers covered by the Rai...

Critical Features Predicting Sustained Implementation of School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Mathews, Susanna; McIntosh, Kent; Frank, Jennifer L.; May, Seth L.

2014-01-01

The current study explored the extent to which a common measure of perceived implementation of critical features of Positive Behavioral Interventions and Supports (PBIS) predicted fidelity of implementation 3 years later. Respondents included school personnel from 261 schools across the United States implementing PBIS. School teams completed the…

Product Support Manager Guidebook

DTIC Science & Technology

2011-04-01

package is being developed using supportability analysis concepts such as Failure Mode, Effects and Criticality Analysis (FMECA), Fault Tree Analysis ( FTA ...Analysis (LORA) Condition Based Maintenance + (CBM+) Fault Tree Analysis ( FTA ) Failure Mode, Effects, and Criticality Analysis (FMECA) Maintenance Task...Reporting and Corrective Action System (FRACAS), Fault Tree Analysis ( FTA ), Level of Repair Analysis (LORA), Maintenance Task Analysis (MTA

Critical Discourse Analysis and Leadership

ERIC Educational Resources Information Center

Arriaza, Gilberto

2015-01-01

This article outlines the need of infusing critical discourse analysis into the preparation and support of prospective school leaders. It argues that in the process of school transformation, the school leader must possess the ability to self-reflect on his/her language and understand the potential power of language as a means that may support or…

Transition support for new graduate and novice nurses in critical care settings: An integrative review of the literature.

PubMed

Innes, Tiana; Calleja, Pauline

2018-05-01

Transition into critical care areas for new graduate nurses may be more difficult than transitioning into other areas due to the specialised knowledge needed. It is unknown which aspects of transition programs best support new graduate nurses improve competence and confidence to transition into critical care nursing specialties. Identifying these aspects would assist to design and implement best practice transition programs for new graduates in critical care areas. Themes identified in the literature include; having a designated resource person, workplace culture, socialisation, knowledge and skill acquisition, orientation, and rotation. Allocation of a quality resource person/s, supportive workplace culture, positive socialisation experiences, knowledge and skill acquisition and structured orientation based on new graduates' learning needs all positively supported increased confidence, competence and transition into nursing practice. Rotations between areas within graduate programs can potentially have both positive and negative impacts on the transition process. Negative impacts of including a rotation component in a transition program should be carefully considered alongside perceived benefits when designing new graduate nurse transition programs. Copyright © 2018. Published by Elsevier Ltd.

Developing Critically Thoughtful e-Learning Communities of Practice

ERIC Educational Resources Information Center

Balcaen, Philip L.; Hirtz, Janine R.

2007-01-01

In this paper, we consider an approach to developing critically thoughtful e-Learning communities of practice--where participants are deliberate about the use of specific intellectual tools supporting critical thinking. We address Garrison & Anderson's (2003) argument that such critical thinking should play a central role within the ecology of…

Systematic Review and Critical Analysis of Measures of Social Support Used in Studies of Persons With Type 2 Diabetes.

PubMed

Al-Dwaikat, Tariq N; Hall, Lynne A

2017-08-01

Social support is linked to improved glycemic control and psychosocial well-being of patients diagnosed with Type 2 diabetes mellitus. The purpose was to critically evaluate the psychometric properties of social support measures used in this population. A systematic review of measures of social support was performed using 5 databases. Two hundred and fifty-six studies were initially retrieved, and 48 studies met the inclusion criteria for review. The majority used general measures of perceived social support. Only 17% measured positive and negative social support; 92% used a single measure of social support. The Medical Outcomes Study Social Support Survey (MOS-SSS) was used in 25% of the studies. Using a combination of social support measures and further evaluation of their psychometric properties in this population is recommended.

Critical thinking in nurse managers.

PubMed

Zori, Susan; Morrison, Barbara

2009-01-01

Formal education and support is needed for nurse managers to effectively function in their role in the current health care environment. Many nurse managers assume their positions based on expertise in a clinical role with little expertise in managerial and leadership skills. Operating as a manager and leader requires ongoing development of critical thinking skills and the inclination to use those skills. Critical thinking can have a powerful influence on the decision making and problem solving that nurse managers are faced with on a daily basis. The skills that typify critical thinking include analysis, evaluation, inference, and deductive and inductive reasoning. It is intuitive that nurse managers require both the skills and the dispositions of critical thinking to be successful in this pivotal role at a time of transformation in health care. Incorporating critical thinking into education and support programs for the nurse manager is necessary to position the nurse manager for success.

Progress and challenges: implementation and use of health information technology among critical-access hospitals.

PubMed

Gabriel, Meghan Hufstader; Jones, Emily B; Samy, Leila; King, Jennifer

2014-07-01

Despite major national investments to support the adoption of health information technology (IT), concerns persist that barriers are inhibiting that adoption and the use of advanced health IT capabilities in rural areas in particular. Using a survey of Medicare-certified critical-access hospitals, we examined electronic health record (EHR) adoption, key EHR functionalities, telehealth, and teleradiology, as well as challenges to EHR adoption. In 2013, 89 percent of critical-access hospitals had implemented a full or partial EHR. Adoption of key EHR capabilities varied. Critical-access hospitals that had certain types of technical assistance and resources available to support health IT were more likely to have adopted health IT capabilities and less likely to report significant challenges to EHR implementation and use, compared to other hospitals in the survey. It is important to ensure that the necessary resources and support are available to critical-access hospitals, especially those that operate independently, to assist them in adopting health IT and becoming able to electronically link to the broader health care system. Project HOPE—The People-to-People Health Foundation, Inc.

Independent Orbiter Assessment (IOA): Assessment of the life support and airlock support systems, volume 2

NASA Technical Reports Server (NTRS)

Barickman, K.

1988-01-01

The McDonnell Douglas Astronautics Company (MDAC) was selected in June 1986 to perform an Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL). The IOA effort first completed an analysis of the Life Support and Airlock Support Systems (LSS and ALSS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. The discrepancies were flagged for potential future resolution. This report documents the results of that comparison for the Orbiter LSS and ALSS hardware. Volume 2 continues the presentation of IOA worksheets and contains the critical items list and NASA FMEA to IOA worksheet cross reference and recommendations.

Pathophysiology of the gut and the microbiome in the host response

PubMed Central

Lyons, John D.; Coopersmith, Craig M.

2016-01-01

Objective To describe and summarize the data supporting the “gut” as the motor driving critical illness and multiple organ dysfunction syndrome (MODS) presented at the Eunice Kennedy Shriver National Institute of Child Health and Human Development MODS Workshop (March 26–27, 2015). Data Sources Summary of workshop keynote presentation. Study Selection Not applicable. Data Extraction Presented by an expert in the field, the data assessing the role of gastrointestinal dysfunction driving critical illness were described with a focus on identifying knowledge gaps and research priorities. Data Synthesis Summary of presentation and discussion supported and supplemented by relevant literature. Conclusions The understanding of gut dysfunction in critical illness has evolved greatly over time, and the gut is now often considered as the “motor” of critical illness. The association of the gut with critical illness is supported by both animal models and clinical studies. Initially, the association between gut dysfunction and critical illness focused primarily on bacterial translocation into the bloodstream. However, that work has evolved to include other gut-derived products causing distant injury via other routes (e.g. lymphatics). Additionally, alterations in the gut epithelium may be associated with critical illness and influence outcomes. Gut epithelial apoptosis, intestinal hyperpermeability and perturbations in the intestinal mucus layer have all been associated with critical illness. Finally, there is growing evidence that the intestinal microbiome plays a crucial role in mediating pathology in critical illness. Further research is needed to better understand the role of each of these mechanisms and their contribution to MODS in children. PMID:28248833

An Invitation to Grieve: Reconsidering Critical Incident Responses by Support Teams in the School Setting

ERIC Educational Resources Information Center

O'Brien, Patrick; Mills, Katrina; Fraser, Amanda; Andersson, John

2011-01-01

This article proposes that consideration could be given to an invitational intervention rather than an expectational intervention when support personnel respond to a critical incident in schools. Intuitively many practitioners know that it is necessary for guidance/counselling personnel to intervene in schools in and following times of trauma.…

Examining How Faculty Reflect on Instructional Data: A Call for Critical Awareness and Institutional Support. WCER Working Paper No. 2016-4

ERIC Educational Resources Information Center

Smolarek, Bailey B.; Hora, Matthew T.

2016-01-01

Drawing on insights from culturally responsive K-12 education frameworks and dual process theory, this qualitative study explores the situated nature of reflective practice among postsecondary faculty and calls for increased critical awareness and institutional support. Through interviews with 21 California research university faculty, this study…

78 FR 55261 - Draft Guidance for Industry on Generic Drug User Fee Amendments of 2012: Questions and Answers...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-10

... public and reduce costs to industry. GDUFA enables FDA to assess user fees to support critical and... assess user fees to support critical and measurable enhancements to FDA's generic drugs program. GDUFA...). The draft guidance, when finalized, will represent the Agency's current thinking on ``Generic Drug...

Computer Simulations to Support Science Instruction and Learning: A Critical Review of the Literature

ERIC Educational Resources Information Center

Smetana, Lara Kathleen; Bell, Randy L.

2012-01-01

Researchers have explored the effectiveness of computer simulations for supporting science teaching and learning during the past four decades. The purpose of this paper is to provide a comprehensive, critical review of the literature on the impact of computer simulations on science teaching and learning, with the goal of summarizing what is…

Seeing, Believing, and Learning to Be Skeptical: Supporting Language Learning through Advertising Analysis Activities

ERIC Educational Resources Information Center

Hobbs, Renee; He, Haixia; Robbgrieco, Michael

2015-01-01

This study documents how a high school ESL teacher working with new immigrants ages 14-20 supported the development of their critical thinking and English language skills by using advertising analysis activities. The article examines the use of key critical questions for analyzing media messages and documents instructional activities designed to…

A Layered Approach to Critical Friendship as a Means to Support Pedagogical Innovation in Pre-Service Teacher Education

ERIC Educational Resources Information Center

Fletcher, Tim; Ní Chróinín, Déirdre; O'Sullivan, Mary

2016-01-01

In this article we describe and interpret how two distinct layers of critical friendship were used to support a pedagogical innovation in pre-service teacher education. The innovation, "Learning about Meaningful Physical Education" (LAMPE), focuses on ways to teach future teachers to foster meaningful experiences for learners in physical…

Haemato-oncology patients' perceptions of health-related quality of life after critical illness: A qualitative phenomenological study.

PubMed

O'Gara, Geraldine; Tuddenham, Simon; Pattison, Natalie

2018-02-01

Haemato-oncology patients often require critical care support due to side-effects of treatment. Discharge can mark the start of an uncertain journey due to the impact of critical illness on health-related quality of life. Qualitatively establishing needs is a priority as current evidence is limited. To qualitatively explore perceptions of haemato-oncology patients' health-related quality of life after critical illness and explore how healthcare professionals can provide long-term support. Nine in-depth interviews were conducted three to eighteen months post-discharge from critical care. Phenomenology was used to gain deeper understanding of the patients' lived experience. A 19-bedded Intensive Care Unit in a specialist cancer centre. Five major themes emerged: Intensive care as a means to an end; Rollercoaster of illness; Reliance on hospital; Having a realistic/sanguine approach; Living in the moment. Haemato-oncology patients who experience critical illness may view it as a small part of a larger treatment pathway, thus health-related quality of life is impacted by this rather than the acute episode. Discharge from the intensive care unit can be seen as a positive end-point, allowing personal growth in areas such as relationships and living life to the full. The contribution of health-care professionals and support of significant others is regarded as critical to the recovery experience. Copyright © 2017 Elsevier Ltd. All rights reserved.

A critical review of the use of technology to provide psychosocial support for children and young people with long-term conditions.

PubMed

Aldiss, Susie; Baggott, Christina; Gibson, Faith; Mobbs, Sarah; Taylor, Rachel M

2015-01-01

Advances in technology have offered health professionals alternative mediums of providing support to patients with long-term conditions. This critical review evaluated and assessed the benefit of electronic media technologies in supporting children and young people with long-term conditions. Of 664 references identified, 40 met the inclusion criteria. Supportive technology tended to increase disease-related knowledge and improve aspects of psychosocial function. Supportive technology did not improve quality of life, reduce health service use or decrease school absences. The poor methodological quality of current evidence and lack of involvement of users in product development contribute to the uncertainty that supportive technology is beneficial. Copyright © 2015 Elsevier Inc. All rights reserved.

Nuclear Criticality Safety Data Book

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

Hollenbach, D. F.

The objective of this document is to support the revision of criticality safety process studies (CSPSs) for the Uranium Processing Facility (UPF) at the Y-12 National Security Complex (Y-12). This design analysis and calculation (DAC) document contains development and justification for generic inputs typically used in Nuclear Criticality Safety (NCS) DACs to model both normal and abnormal conditions of processes at UPF to support CSPSs. This will provide consistency between NCS DACs and efficiency in preparation and review of DACs, as frequently used data are provided in one reference source.

Reflections on the Use of Critical Incident Stress Debriefing in Schools

ERIC Educational Resources Information Center

Aucott, Clare; Soni, Anita

2016-01-01

Providing support to schools following a critical incident has become an established part of service delivery for many Educational Psychology Services (EPSs) in the UK. This article offers reflections on the use of Critical Incident Stress Debriefing (CISD) in schools. A review of the literature on critical incidents, trauma, resilience and…

Being Critical about Being Critical. A Response to "Toward a Transformative Criticality for Democratic Citizenship Education"

ERIC Educational Resources Information Center

Burbules, Nicholas C.

2016-01-01

This response to "Toward a Transformative Criticality for Democratic Citizenship Education" takes a positive and supportive stance toward pressing the arguments forward. By focusing on the communicative components of democratic citizenship education and activist pedagogy, it highlights some of the tensions and difficulties of actually…

A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review

PubMed Central

2010-01-01

Background The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically. Methods This paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed. Results The review identifies two main issues: 1) a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2) the definition of a base for the design of a conceptual framework for supporting the design of knowledge-based systems, to assist the adoption process of electronic health records in an automatic fashion. From our review, six critical adoption factors have been identified: user attitude towards information systems, workflow impact, interoperability, technical support, communication among users, and expert support. The main limitation of the taxonomy is the different impact of the adoption factors of electronic health records reported by some studies depending on the type of practice, setting, or attention level; however, these features are a determinant aspect with regard to the adoption rate for the latter rather than the presence of a specific critical adoption factor. Conclusions The critical adoption factors established here provide a sound theoretical basis for research to understand, support, and facilitate the adoption of electronic health records to physicians in benefit of patients. PMID:20950458

The association of family functioning and psychosis proneness in five countries that differ in cultural values and family structures.

PubMed

Wüsten, Caroline; Lincoln, Tania M

2017-07-01

For decades, researchers have attributed the better prognosis of psychosis in developing countries to a host of socio-cultural factors, including family functioning. Nevertheless, it is unknown whether family functioning and its association with symptoms differ across countries. This study assessed family functioning (support, satisfaction with family relations, and criticism) and psychosis proneness in community samples from Chile (n =399), Colombia (n=486), Indonesia (n=115), Germany (n=174) and the USA (n=143). Family functioning was compared between prototypical developing countries (Chile, Columbia, Indonesia) and highly industrialized countries (Germany, USA). Hierarchical regression analysis was used to test for the moderating effect of country on the associations between family functioning and psychosis proneness. Participants from developing countries perceived more support and felt more satisfied. However, they also perceived more criticism than participants from highly industrialized countries. Criticism and family satisfaction were significantly associated with psychosis proneness. Moreover, the relationship between criticism and psychosis proneness was significantly stronger in developing countries compared to highly industrialized countries. Generally, family satisfaction and criticism appear to be more relevant to psychosis proneness than the quantity of family support. Moreover, criticism seems to be more closely related to psychosis proneness in developing countries. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

The application of reduced-processing decision support systems to facilitate the acquisition of decision-making skills.

PubMed

Perry, Nathan C; Wiggins, Mark W; Childs, Merilyn; Fogarty, Gerard

2013-06-01

The study was designed to examine whether the availability of reduced-processing decision support system interfaces could improve the decision making of inexperienced personnel in the context of Although research into reduced-processing decision support systems has demonstrated benefits in minimizing cognitive load, these benefits have not typically translated into direct improvements in decision accuracy because of the tendency for inexperienced personnel to focus on less-critical information. The authors investigated whether reduced-processing interfaces that direct users' attention toward the most critical cues for decision making can produce improvements in decision-making performance. Novice participants made incident command-related decisions in experimental conditions that differed according to the amount of information that was available within the interface, the level of control that they could exert over the presentation of information, and whether they had received decision training. The results revealed that despite receiving training, participants improved in decision accuracy only when they were provided with an interface that restricted information access to the most critical cues. It was concluded that an interface that restricts information access to only the most critical cues in the scenario can facilitate improvements in decision performance. Decision support system interfaces that encourage the processing of the most critical cues have the potential to improve the accuracy and timeliness of decisions made by inexperienced personnel.

Can Hypocaloric, High-Protein Nutrition Support Be Used in Complicated Bariatric Patients to Promote Weight Loss?

PubMed

Beebe, Mara Lee; Crowley, Nina

2015-08-01

Bariatric surgery, an effective treatment for morbid obesity, may result in complications that require nutrition support. Common goals for nutrition support in post-bariatric surgery patients include nutrition repletion, avoiding overfeeding, preserving lean body mass, and promoting wound healing. It is often questioned if continued weight loss can be part of the nutrition goals and if weight loss is safe for patients who become critically ill following bariatric surgery. Recent clinical practice guidelines from both the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and Society of Critical Care Medicine (SCCM) have recommended the use of hypocaloric, high-protein nutrition support in both critically and non-critically ill obese patients. Hypocaloric feedings of 50%-70% of estimated energy requirements based on predictive equations or <14 kcal/kg actual body weight, as well as high-protein feedings of 1.2 g/kg actual weight or 2-2.5 g/kg ideal body weight, are suggested by A.S.P.E.N. in the 2013 clinical guidelines for nutrition support of hospitalized adult patients with obesity. Two small studies in complicated post-bariatric surgery patients requiring nutrition support have shown that the strategy of hypocaloric, high-protein feedings can result in positive outcomes, including positive nitrogen balance, wound healing, weight loss, and successful transition to oral diets. Additional research, including large, randomized studies, is still needed to validate these findings. However, based on a review of available clinical practice guidelines, predictive equations, indirect calorimetry, case studies, and systematic reviews, hypocaloric, high-protein nutrition support appears to at least be equal to eucaloric feedings and may be a useful tool for clinicians to achieve continued weight loss in complicated bariatric surgery patients requiring nutrition support. © 2015 American Society for Parenteral and Enteral Nutrition.

Network information attacks on the control systems of power facilities belonging to the critical infrastructure

NASA Astrophysics Data System (ADS)

Loginov, E. L.; Raikov, A. N.

2015-04-01

The most large-scale accidents occurred as a consequence of network information attacks on the control systems of power facilities belonging to the United States' critical infrastructure are analyzed in the context of possibilities available in modern decision support systems. Trends in the development of technologies for inflicting damage to smart grids are formulated. A volume matrix of parameters characterizing attacks on facilities is constructed. A model describing the performance of a critical infrastructure's control system after an attack is developed. The recently adopted measures and legislation acts aimed at achieving more efficient protection of critical infrastructure are considered. Approaches to cognitive modeling and networked expertise of intricate situations for supporting the decision-making process, and to setting up a system of indicators for anticipatory monitoring of critical infrastructure are proposed.

The Integrated Safety-Critical Advanced Avionics Communication and Control (ISAACC) System Concept: Infrastructure for ISHM

NASA Technical Reports Server (NTRS)

Gwaltney, David A.; Briscoe, Jeri M.

2005-01-01

Integrated System Health Management (ISHM) architectures for spacecraft will include hard real-time, critical subsystems and soft real-time monitoring subsystems. Interaction between these subsystems will be necessary and an architecture supporting multiple criticality levels will be required. Demonstration hardware for the Integrated Safety-Critical Advanced Avionics Communication & Control (ISAACC) system has been developed at NASA Marshall Space Flight Center. It is a modular system using a commercially available time-triggered protocol, ?Tp/C, that supports hard real-time distributed control systems independent of the data transmission medium. The protocol is implemented in hardware and provides guaranteed low-latency messaging with inherent fault-tolerance and fault-containment. Interoperability between modules and systems of modules using the TTP/C is guaranteed through definition of messages and the precise message schedule implemented by the master-less Time Division Multiple Access (TDMA) communications protocol. "Plug-and-play" capability for sensors and actuators provides automatically configurable modules supporting sensor recalibration and control algorithm re-tuning without software modification. Modular components of controlled physical system(s) critical to control algorithm tuning, such as pumps or valve components in an engine, can be replaced or upgraded as "plug and play" components without modification to the ISAACC module hardware or software. ISAACC modules can communicate with other vehicle subsystems through time-triggered protocols or other communications protocols implemented over Ethernet, MIL-STD- 1553 and RS-485/422. Other communication bus physical layers and protocols can be included as required. In this way, the ISAACC modules can be part of a system-of-systems in a vehicle with multi-tier subsystems of varying criticality. The goal of the ISAACC architecture development is control and monitoring of safety critical systems of a manned spacecraft. These systems include spacecraft navigation and attitude control, propulsion, automated docking, vehicle health management and life support. ISAACC can integrate local critical subsystem health management with subsystems performing long term health monitoring. The ISAACC system and its relationship to ISHM will be presented.

An Overview of a Programme of Research to Support the Assessment of Critical Thinking

ERIC Educational Resources Information Center

Black, Beth

2012-01-01

Cambridge Assessment has more than 20 years experience in assessing Critical Thinking (CT) in a number of diverse tests and qualifications, unrivalled by any other body within the UK. In recent years, a number of research activities have been carried out in order to support these assessments, with a focus on the validity of measurement. This paper…

Aviation Weather Information Communications Study (AWIN). Phase 1 and 2

NASA Technical Reports Server (NTRS)

Ball, J. W.; Herron, R. G.; Nozawa, E. T.; Thomas, E. A.; Witchey, R. D.

2000-01-01

This two part study examines the communication requirements to provide weather information in the cockpit as well as public and private communication systems available to address the requirements. Ongoing research projects combined with user needs for weather related information are used to identify and describe potential weather products that address decision support in three time frames: Far-Term Strategic, Near-Term Strategic and Tactical. Data requirements of these future products are identified and quantified. Communications systems and technologies available in the public as well as private sector are analyzed to identify potential solutions. Recommendations for further research identify cost, performance, and safety benefits to justify the investment. The study concludes that not all weather information has the same level of urgency to safety-of-flight and some information is more critical to one category of flight than another. Specific weather products need to be matched with communication systems with appropriate levels of reliability to support the criticality of the information. Available bandwidth for highly critical information should be preserved and dedicated to safety. Meanwhile, systems designed for in-flight-entertainment and other passenger/crew services could be used to support less critical information that is used only for planning and economic decision support.

[The development of a portable life support device for transporting pre-hospital critically ill patients].

PubMed

Song, Zhen-xing; Wu, Tai-hu; Meng, Xing-ju; Lu, Heng-zhi; Zheng, Jie-wen; Wang, Hai-tao

2012-06-01

To describe a portable life support device for transportation of pre-hospital patients with critical illness. The characteristics and requirements for urgent management during transportation of critically ill patients to a hospital were analyzed. With adoption of the original equipment, with the aid of staple of the art soft ware, the overall structure, its installation, fixation, freedom from interference, operational function were studied, and the whole system of life support and resuscitation was designed. The system was composed by different modules, including mechanical ventilation, transfusion, aspiration, critical care, oxygen supply and power supply parts. The system could be fastened quickly to a stretcher to form portable intensive care unit (ICU), and it could be carried by different size vehicles to provide nonstop treatment by using power supply of the vehicle, thus raising the efficiency of urgent care. With characteristics of its small size, lightweight and portable, the device is particularly suitable for narrow space and extreme environment.

Developing Critically Thoughtful, Media-Rich Lessons in Science: Process and Product

ERIC Educational Resources Information Center

Balcaen, Philip

2008-01-01

In this paper, I describe a professional development approach and a conceptual framework used to create critically thoughtful and media-rich science learning resources. Greater clarity about the nature of critical thinking and how to support teachers in learning to implement it are needed if we are to respond to broader calls for critical thinking…

Autonomy, Critical Thinking and the Wittgensteinian Legacy: Reflections on Christopher Winch, "Education, Autonomy and Critical Thinking"

ERIC Educational Resources Information Center

Siegel, Harvey

2008-01-01

In this review of Christopher Winch's new book, "Education, Autonomy and Critical Thinking" (2006), I discuss its main theses, supporting some and criticising others. In particular, I take issue with several of Winch's claims and arguments concerning critical thinking and rationality, and deplore his reliance on what I suggest are problematic…

Comprehensive Nuclear-Test-Ban Treaty: Issues and Arguments

DTIC Science & Technology

2008-03-12

further fissions. “ Criticality ” is the point at which this chain reaction occurs; a “ critical mass ” is the amount of fissile material just enough to...support criticality . The amount of material for a critical mass depends on many factors, such as shape, density, impurities that absorb neutrons, and use...less than a critical mass of fissile material; as the amount of this material was stepped up toward criticality from one experiment to the next, some of

Learning to manage vasoactive drugs-A qualitative interview study with critical care nurses.

PubMed

Häggström, Marie; Bergsman, Ann-Christin; Månsson, Ulrika; Holmström, Malin Rising

2017-04-01

Being a nurse in an intensive care unit entails caring for seriously ill patients. Vasoactive drugs are one of the tools that are used to restore adequate circulation. Critical care nurses often manage and administer these potent drugs after medical advice from physicians. To describe the experiences of critical care nurses learning to manage vasoactive drugs, and to highlight the competence required to manage vasoactive drugs. Twelve critical care nurses from three hospitals in Sweden were interviewed. Qualitative content analysis was applied. The theme "becoming proficient requires accuracy, practice and precaution" illustrated how critical care nurses learn to manage vasoactive drugs. Learning included developing cognitive, psychomotor, and effective skills. Sources for knowledge refers to specialist education combined with practical exercises, collegial support, and accessible routine documents. The competence required to manage vasoactive drugs encompassed well-developed safety thinking that included being careful, in control, and communicating failures. Specific skills were required such as titrating doses, being able to analyse and evaluate the technological assessments, adapting to the situation, and staying calm. Learning to manage vasoactive drugs requires a supportive introduction for novices, collegial support, lifelong learning, and a culture of safety. Copyright © 2016 Elsevier Ltd. All rights reserved.

Director of nursing and midwifery leadership: informed through the lens of critical social science.

PubMed

Solman, Annette

2010-05-01

Highlight the use of critical social science theories, practice development principles and a situational leadership framework within transformational leadership to inform Directors of Nursing and Midwifery (DoNM) practices as leaders. Healthcare is constantly changing, unpredictable, strives for quality service and cost containment, which can result in stress and crisis for healthcare workers. DoNM leadership is critical to supporting and leading staff through these complex times within healthcare. Understanding theories, frameworks and their application to real-world practice can assist in supporting individuals and teams to navigate through the changing healthcare environment. Blending critical social science theories with practice development principles and the situational leadership framework can assist the DoNM to enact transformational leadership to support the development of individuals and teams to meet the complex healthcare needs of patients within the clinical setting. IMPLICATIONS FOR NURSE MANAGEMENT: This article contributes through the practical application of critical social science theories, practice development principles and situational leadership framework within transformational leadership as an approach for enacting DoNM leadership. To further understand and develop in the role of the contemporary DoNM in leadership, these directors are encouraged to publish their work.

A Critical Review of Instruments Measuring Breastfeeding Attitudes, Knowledge, and Social Support.

PubMed

Casal, Corrine S; Lei, Ann; Young, Sera L; Tuthill, Emily L

2017-02-01

Breastfeeding provides beneficial health outcomes for infants and their mothers, and increasing its practice is a national priority in many countries. Despite increasing support to exclusively breastfeed, the prevalence at 6 months remains low. Breastfeeding behavior is influenced by a myriad of determinants, including breastfeeding attitudes, knowledge, and social support. Effective measurement of these determinants is critical to provide optimal support for women throughout the breastfeeding period. However, there are a multitude of available instruments measuring these constructs, which makes identification of an appropriate instrument challenging. Research aim: Our aim was to identify and critically examine the existing instruments measuring breastfeeding attitudes, knowledge, and social support. A total of 16 instruments was identified. Each instrument's purpose, theoretical underpinnings, and validity were analyzed. An overview, validation and adaptation for use in other settings was assessed for each instrument. Depth of reporting and validation testing differed greatly between instruments. Content, construct, and predictive validity were present for most but not all scales. When selecting and adapting instruments, attention should be paid to domains within the scale, number of items, and adaptation.

Computer supported collaborative learning in a clerkship: an exploratory study on the relation of discussion activity and revision of critical appraisal papers.

PubMed

Koops, Willem J M; van der Vleuten, Cees P M; de Leng, Bas A; Snoeckx, Luc H E H

2012-08-20

Medical students in clerkship are continuously confronted with real and relevant patient problems. To support clinical problem solving skills, students perform a Critical Appraisal of a Topic (CAT) task, often resulting in a paper. Because such a paper may contain errors, students could profit from discussion with peers, leading to paper revision. Active peer discussion by a Computer Supported Collaborative Learning (CSCL) environment show positive medical students perceptions on subjective knowledge improvement. High students' activity during discussions in a CSCL environment demonstrated higher task-focussed discussion reflecting higher levels of knowledge construction. However, it remains unclear whether high discussion activity influences students' decisions revise their CAT paper. The aim of this research is to examine whether students who revise their critical appraisal papers after discussion in a CSCL environment show more task-focussed activity and discuss more intensively on critical appraisal topics than students who do not revise their papers. Forty-seven medical students, stratified in subgroups, participated in a structured asynchronous online discussion of individual written CAT papers on self-selected clinical problems. The discussion was structured by three critical appraisal topics. After the discussion, the students could revise their paper. For analysis purposes, all students' postings were blinded and analysed by the investigator, unaware of students characteristics and whether or not the paper was revised. Postings were counted and analysed by an independent rater, Postings were assigned into outside activity, non-task-focussed activity or task-focussed activity. Additionally, postings were assigned to one of the three critical appraisal topics. Analysis results were compared by revised and unrevised papers. Twenty-four papers (51.6%) were revised after the online discussion. The discussions of the revised papers showed significantly higher numbers of postings, more task-focussed activities, and more postings about the two critical appraisal topics: "appraisal of the selected article(s)", and "relevant conclusion regarding the clinical problem". A CSCL environment can support medical students in the execution and critical appraisal of authentic tasks in the clinical workplace. Revision of CAT papers appears to be related to discussions activity, more specifically reflecting high task-focussed activity of critical appraisal topics.

6 CFR 27.215 - Security vulnerability assessments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... of potential critical assets; identification of hazards and consequences of concern for the facility, its surroundings, its identified critical asset(s), and its supporting infrastructure; and... determination of the relative degree of risk to the facility in terms of the expected effect on each critical...

6 CFR 27.215 - Security vulnerability assessments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of potential critical assets; identification of hazards and consequences of concern for the facility, its surroundings, its identified critical asset(s), and its supporting infrastructure; and... determination of the relative degree of risk to the facility in terms of the expected effect on each critical...

6 CFR 27.215 - Security vulnerability assessments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of potential critical assets; identification of hazards and consequences of concern for the facility, its surroundings, its identified critical asset(s), and its supporting infrastructure; and... determination of the relative degree of risk to the facility in terms of the expected effect on each critical...

6 CFR 27.215 - Security vulnerability assessments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of potential critical assets; identification of hazards and consequences of concern for the facility, its surroundings, its identified critical asset(s), and its supporting infrastructure; and... determination of the relative degree of risk to the facility in terms of the expected effect on each critical...

Developing thinking skill system for modelling creative thinking and critical thinking of vocational high school student

NASA Astrophysics Data System (ADS)

Dewanto, W. K.; Agustianto, K.; Sari, B. E.

2018-01-01

Vocational students must have practical skills in accordance with the purpose of vocational school that creating the skilled graduates according to their field. Graduates of vocational education are required not just as users, but be able to create. Thus requiring critical and creative thinking skills to assist students in generating ideas, analyzing and creating a product of value. Based on this, then this research aims to develop a system to know the level of ability to think critically and creative students, that resulted students can do self-reflection in improving the ability to think critically and creatively as a supporter of practical ability. The system testing using Naïve Bayes Correlation shown an average accuracy of 93.617% in assessing the students’ critical and creative thinking ability. By using modeling with this system will be known level of students’ critical and creative thinking ability, then the output of the system is used to determine the type of innovation in the learning process to improve the critical and creative thinking skills to support the practical skills of students as skilled vocational students.

Marine Air Ground Task Force Distribution In The Battlespace

DTIC Science & Technology

2016-09-01

benefit of this research is a proposed systemic structure with an associated web application that provides the MAGTF commander with critical...associated web application that provides the MAGTF commander with critical information for supporting operations. vi THIS PAGE INTENTIONALLY LEFT BLANK... web analytics in order to support the decision making process. The potential benefit of this research is a methodology with associated application

Enhancing the Safety of Children in Foster Care and Family Support Programs: Automated Critical Incident Reporting

ERIC Educational Resources Information Center

Brenner, Eliot; Freundlich, Madelyn

2006-01-01

The Adoption and Safe Families Act of 1997 has made child safety an explicit focus in child welfare. The authors describe an automated critical incident reporting program designed for use in foster care and family-support programs. The program, which is based in Lotus Notes and uses e-mail to route incident reports from direct service staff to…

Assessing criticality in seismicity by entropy

NASA Astrophysics Data System (ADS)

Goltz, C.

2003-04-01

There is an ongoing discussion whether the Earth's crust is in a critical state and whether this state is permanent or intermittent. Intermittent criticality would allow specification of time-dependent hazard in principle. Analysis of a spatio-temporally evolving synthetic critical point phenomenon and of real seismicity using configurational entropy shows that the method is a suitable approach for the characterisation of critical point dynamics. Results obtained rather support the notion of intermittent criticality in earthquakes. Statistical significance of the findings is assessed by the method of surrogate data.

Automatic Analysis of Critical Incident Reports: Requirements and Use Cases.

PubMed

Denecke, Kerstin

2016-01-01

Increasingly, critical incident reports are used as a means to increase patient safety and quality of care. The entire potential of these sources of experiential knowledge remains often unconsidered since retrieval and analysis is difficult and time-consuming, and the reporting systems often do not provide support for these tasks. The objective of this paper is to identify potential use cases for automatic methods that analyse critical incident reports. In more detail, we will describe how faceted search could offer an intuitive retrieval of critical incident reports and how text mining could support in analysing relations among events. To realise an automated analysis, natural language processing needs to be applied. Therefore, we analyse the language of critical incident reports and derive requirements towards automatic processing methods. We learned that there is a huge potential for an automatic analysis of incident reports, but there are still challenges to be solved.

Democracy, Critical Education, and Teachers Unions: Connections and Contradictions in the Neoliberal Epoch

ERIC Educational Resources Information Center

Weiner, Lois

2015-01-01

Why does a divide exist between scholars of critical education and teachers unions and how might it be bridged to develop a more robust, mutually beneficial relationship? In this article I explain why supporters of critical education have a huge stake in the transformation and regeneration teachers unions and describe how critical education might,…

Air Force Energy Program Policy Memorandum

DTIC Science & Technology

2009-06-16

Critical Asset Prioritization Methodology ( CAPM ) tool Manage costs. 3.4.2.5. Metrics Percentage of alternative/renewable fuel used for aviation fuel...supporting critical assets residing on military installations Field the Critical Asset Prioritization Methodology ( CAPM ) tool by Spring 2008. This CAPM ...Increase the number of flexible fuel systems • Identify/develop privately financed/operated energy production on Air Bases • Field the Critical

On Equivalence between Critical Probabilities of Dynamic Gossip Protocol and Static Site Percolation

NASA Astrophysics Data System (ADS)

Ishikawa, Tetsuya; Hayakawa, Tomohisa

The relationship between the critical probability of gossip protocol on the square lattice and the critical probability of site percolation on the square lattice is discussed. Specifically, these two critical probabilities are analytically shown to be equal to each other. Furthermore, we present a way of evaluating the critical probability of site percolation by approximating the saturation of gossip protocol. Finally, we provide numerical results which support the theoretical analysis.

78 FR 38878 - Critical Incident Stress Plans

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

...-0131, Notice No. 1] RIN 2130-AC00 Critical Incident Stress Plans AGENCY: Federal Railroad... incident stress plans that provide for appropriate support services to be offered to their employees who... railroad's critical incident stress plan, the type of employees to be covered by the plan, a requirement...

Critically Reflective Dialogues in Learning Communities of Professionals

ERIC Educational Resources Information Center

de Groot, Esther; Endedijk, Maaike D.; Jaarsma, A. Debbie C.; Simons, P. Robert-Jan; van Beukelen, Peter

2014-01-01

Communities in which professionals share and create knowledge potentially support their continued learning. To realise this potential more fully, members are required to reflect critically. For learning at work such behaviour has been described as critically reflective work behaviour, consisting of six aspects: challenging groupthink, critical…

A Federal Response: The President's Critical Infrastructure Protection Board.

ERIC Educational Resources Information Center

Schmidt, Howard

2002-01-01

Outlines the U.S. Critical Infrastructure Protection Board's purpose, budget, principles, and priorities. Describes the board's role in coordinating all federal activities related to protection of information systems and networks supporting critical infrastructures. Also discusses its responsibility in creating a policy and road map for government…

Supporting Optimal Neurodevelopmental Outcomes in Infants and Children With Congenital Heart Disease.

PubMed

Peterson, Jennifer K

2018-06-01

Improved survival has led to increased recognition of developmental delays in infants and children with congenital heart disease. Risk factors for developmental delays in congenital heart disease survivors may not be modifiable; therefore, it is important that lifesaving, high-technology critical care interventions be combined with nursing interventions that are also developmentally supportive. Implementing developmental care in a pediatric cardiac intensive care unit requires change implementation strategies and widespread support from all levels of health care professionals. This manuscript reviews developmentally supportive interventions such as massage, developmentally supportive positioning, kangaroo care, cue-based feeding, effective pain/anxiety management, and procedural preparation and identifies strategies to implement developmentally supportive interventions in the care of infants and children with congenital heart disease. Improving developmental support for these infants and children at high risk for developmental delay may improve their outcomes and help promote family-centered care. ©2018 American Association of Critical-Care Nurses.

System Dynamics Approach for Critical Infrastructure and Decision Support. A Model for a Potable Water System.

NASA Astrophysics Data System (ADS)

Pasqualini, D.; Witkowski, M.

2005-12-01

The Critical Infrastructure Protection / Decision Support System (CIP/DSS) project, supported by the Science and Technology Office, has been developing a risk-informed Decision Support System that provides insights for making critical infrastructure protection decisions. The system considers seventeen different Department of Homeland Security defined Critical Infrastructures (potable water system, telecommunications, public health, economics, etc.) and their primary interdependencies. These infrastructures have been modeling in one model called CIP/DSS Metropolitan Model. The modeling approach used is a system dynamics modeling approach. System dynamics modeling combines control theory and the nonlinear dynamics theory, which is defined by a set of coupled differential equations, which seeks to explain how the structure of a given system determines its behavior. In this poster we present a system dynamics model for one of the seventeen critical infrastructures, a generic metropolitan potable water system (MPWS). Three are the goals: 1) to gain a better understanding of the MPWS infrastructure; 2) to identify improvements that would help protect MPWS; and 3) to understand the consequences, interdependencies, and impacts, when perturbations occur to the system. The model represents raw water sources, the metropolitan water treatment process, storage of treated water, damage and repair to the MPWS, distribution of water, and end user demand, but does not explicitly represent the detailed network topology of an actual MPWS. The MPWS model is dependent upon inputs from the metropolitan population, energy, telecommunication, public health, and transportation models as well as the national water and transportation models. We present modeling results and sensitivity analysis indicating critical choke points, negative and positive feedback loops in the system. A general scenario is also analyzed where the potable water system responds to a generic disruption.

Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: neurocritical patient.

PubMed

Acosta Escribano, J; Herrero Meseguer, I; Conejero García-Quijada, R

2011-11-01

Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral-parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calorie intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL.

Fostering Critical Thinking in the Classroom

ERIC Educational Resources Information Center

Sahamid, Husniah

2014-01-01

The ability to cite reasons, to justify claims and give support to arguments is seen as primary characteristics of a critical thinker. This paper discusses how the "Elements of Reasoning" is employed with Socratic Questioning to develop critical thinking in the language classroom. The principles that guide the questioning are laid out…

Cultivating Critical Reflection: Educators Making Sense and Meaning of Professional Identity and Relational Dynamics in Complex Practice

ERIC Educational Resources Information Center

Morgan, Ann

2017-01-01

Critical reflection underpins socially just and inclusive practices that are distinguishing features of democratic learning communities. Critical reflection supports educators' interrogation of the underlying assumptions, intentions, values and beliefs that shape their worldview and sociocultural standpoint. Dominant sociocultural norms…

A Critical Co-Constructed Autoethnography of a Gendered Cross-Cultural Mentoring between Two Early Career Latin@ Scholars Working in the Deep South

ERIC Educational Resources Information Center

Suriel, Regina L.; Martinez, James; Evans-Winters, Venus

2018-01-01

Multicultural mentoring has been suggested to support Latin@ faculty success in their careers, yet current literature on effective mentorships of Latin@ faculty is limited. This critical co-constructed autoethnography draws on critical race theory (CRT) and latin@ critical race theory (LatCrit) frameworks to highlight the lived experiences and key…

Extracorporeal Life Support in Critically Ill Adults

PubMed Central

Muratore, Christopher S.

2014-01-01

Extracorporeal life support (ECLS) has become increasingly popular as a salvage strategy for critically ill adults. Major advances in technology and the severe acute respiratory distress syndrome that characterized the 2009 influenza A(H1N1) pandemic have stimulated renewed interest in the use of venovenous extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal to support the respiratory system. Theoretical advantages of ECLS for respiratory failure include the ability to rest the lungs by avoiding injurious mechanical ventilator settings and the potential to facilitate early mobilization, which may be advantageous for bridging to recovery or to lung transplantation. The use of venoarterial ECMO has been expanded and applied to critically ill adults with hemodynamic compromise from a variety of etiologies, beyond postcardiotomy failure. Although technology and general care of the ECLS patient have evolved, ECLS is not without potentially serious complications and remains unproven as a treatment modality. The therapy is now being tested in clinical trials, although numerous questions remain about the application of ECLS and its impact on outcomes in critically ill adults. PMID:25046529

The United States digital recording industry

NASA Technical Reports Server (NTRS)

Simonds, John L.

1993-01-01

The recording industry resembles the semiconductor industry in several aspects. Both are large (greater than $60 Billion/year revenues); both are considered critical technologies supporting national objectives; both are experiencing increased competition from foreign suppliers; they recognize significant opportunities for both technological and market growth in the decade to come; and both realize that a key to this future growth lies in alliances among industry, academia, and government. The semiconductor industry has made significant investments in alliances relating to manufacturing technologies (SEMATECH) and to joint long-term technology research centered in universities (SRC). The federal government has provided funding support of these efforts in recognition of the critical roles semiconductor technologies play in national interests. The recording industry is now also forming critical alliances, but has been slower in starting and in gaining broad recognition by government agencies and legislators that the industry needs federal support. Traditionally, the recording industry has been viewed as mature, stable, and, while critical to national interests, able to chart and fund its own course toward future national needs. That perception is fortunately changing.

Anger arousal and behavioral anger regulation in everyday life among people with chronic low back pain: Relationships with spouse responses and negative affect.

PubMed

Burns, John W; Gerhart, James I; Bruehl, Stephen; Post, Kristina M; Smith, David A; Porter, Laura S; Schuster, Erik; Buvanendran, Asokumar; Fras, Anne Marie; Keefe, Francis J

2016-01-01

To determine the degree to which anger arousal and anger regulation (expression, inhibition) in the daily lives of people with chronic pain were related to spouse support, criticism, and hostility as perceived by patients and as reported by spouses. Married couples (N = 105, 1 spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. On these diaries, patients completed items on their own anger arousal, anger expression, and inhibition, and on perceived spouse support, criticism, and hostility. Spouses reported on their responses toward patients and their negative affect. Hierarchical linear modeling tested concurrent and lagged relationships. Patient-reported increases in anger arousal and anger expression were predominantly related to concurrent decreases in patient-perceived and spouse-reported spouse support, concurrent increases in patient-perceived and spouse-reported spouse criticism and hostility, and increases in spouse-reported negative affect. Relationships for anger expression remained significant with anger arousal controlled. These effects were especially strong for male patients. Spouses reported greater negative affect when patients were present than when they were not. Social support may facilitate adjustment to chronic pain, with declining support and overt criticism and hostility possibly adversely impacting pain and function. Results suggest that patient anger arousal and expression may be related to a negative interpersonal environment for married couples coping with chronic low back pain. (c) 2015 APA, all rights reserved).

How Do Pharmacists Develop into Advanced Level Practitioners? Learning from the Experiences of Critical Care Pharmacists.

PubMed

Seneviratne, Ruth E; Bradbury, Helen; Bourne, Richard S

2017-07-07

The national UK standards for critical care highlight the need for clinical pharmacists to practise at an advanced level (equivalent to Royal Pharmaceutical Society, Great Britain, Faculty Advanced Stage II (MFRPSII)) and above. Currently the UK is unable to meet the workforce capacity requirements set out in the national standards in terms of numbers of pharmacist working at advanced level and above. The aim of this study was to identify the strategies, barriers and challenges to achieving Advanced Level Practice (ALP) by learning from the experiences of advanced level critical care pharmacists within the UK. Eight participants were recruited to complete semi-structured interviews on their views and experiences of ALP. The interviews were analysed thematically and three overarching themes were identified; support, work-based learning and reflective practice. The results of this study highlight that to increase the number of MFRPSII level practitioners within critical care support for their ALP development is required. This support involves developing face-to-face access to expert critical care pharmacists within a national training programme. Additionally, chief pharmacists need to implement drivers including in house mentorship and peer review programmes and the need to align job descriptions and appraisals to the Royal Pharmaceutical Society, Great Britain, Advanced Practice Framework (APF).

How Do Pharmacists Develop into Advanced Level Practitioners? Learning from the Experiences of Critical Care Pharmacists

PubMed Central

Seneviratne, Ruth E.; Bradbury, Helen

2017-01-01

The national UK standards for critical care highlight the need for clinical pharmacists to practise at an advanced level (equivalent to Royal Pharmaceutical Society, Great Britain, Faculty Advanced Stage II (MFRPSII)) and above. Currently the UK is unable to meet the workforce capacity requirements set out in the national standards in terms of numbers of pharmacist working at advanced level and above. The aim of this study was to identify the strategies, barriers and challenges to achieving Advanced Level Practice (ALP) by learning from the experiences of advanced level critical care pharmacists within the UK. Eight participants were recruited to complete semi-structured interviews on their views and experiences of ALP. The interviews were analysed thematically and three overarching themes were identified; support, work-based learning and reflective practice. The results of this study highlight that to increase the number of MFRPSII level practitioners within critical care support for their ALP development is required. This support involves developing face-to-face access to expert critical care pharmacists within a national training programme. Additionally, chief pharmacists need to implement drivers including in house mentorship and peer review programmes and the need to align job descriptions and appraisals to the Royal Pharmaceutical Society, Great Britain, Advanced Practice Framework (APF). PMID:28970450

Exploration Life Support Critical Questions for Future Human Space Missions

NASA Technical Reports Server (NTRS)

Kwert, Michael K.; Barta, Daniel J.; McQuillan, Jeff

2010-01-01

Exploration Life Support (ELS) is a current project under NASA's Exploration Systems Mission Directorate. The ELS Project plans, coordinates and implements the development of advanced life support technologies for human exploration missions in space. Recent work has focused on closed loop atmosphere and water systems for long duration missions, including habitats and pressurized rovers. But, what are the critical questions facing life support system developers for these and other future human missions? This paper explores those questions and how progress in the development of ELS technologies can help answer them. The ELS Project includes the following Elements: Atmosphere Revitalization Systems, Water Recovery Systems, Waste Management Systems, Habitation Engineering, Systems Integration, Modeling and Analysis, and Validation and Testing, which includes the Sub-Elements Flight Experiments and Integrated Testing. Systems engineering analysis by ELS seeks to optimize overall mission architectures by considering all the internal and external interfaces of the life support system and the potential for reduction or reuse of commodities. In particular, various sources and sinks of water and oxygen are considered along with the implications on loop closure and the resulting launch mass requirements. Systems analysis will be validated through the data gathered from integrated testing, which will demonstrate the interfaces of a closed loop life support system. By applying a systematic process for defining, sorting and answering critical life support questions, the ELS project is preparing for a variety of future human space missions

Social support satisfaction in adults with eating disorders: Does stance matter?

PubMed

Geller, Josie; Iyar, Megumi; Srikameswaran, Suja; Zelichowska, Joanna; Dunn, Erin C

2017-07-01

Although the role of social support is clearly established in the recovery of youth with eating disorders, little is known about factors that contribute to support satisfaction and improved treatment outcome in adults. This study examined the contribution of patient factors and perceived support stance used by family and friends in determining social support satisfaction. Individuals meeting DSM-IV criteria for an eating disorder (n = 182) completed measures of eating disorder and psychiatric severity, interpersonal functioning, perceived support stance used by family and friends, and social support satisfaction. Correlations indicated that both patient factors (lower psychiatric distress and fewer interpersonal difficulties) and perceived support stance (higher concerned and lower directive support) were associated with patient support satisfaction. Multiple regression analyses indicated that perceived support stance accounted for greater variance in social support satisfaction than did patient factors. Patient age was associated with differences in preferred support stance: expressions of caring were most critical for younger patients, whereas not being criticized or told what to do was most significant for older patients. This research suggests that the stance used when offering support is vital to the care of individuals with eating disorders. © 2017 Wiley Periodicals, Inc.

Lateral-Torsional Buckling Instability Caused by Individuals Walking on Wood Composite I-Joists

NASA Astrophysics Data System (ADS)

Villasenor Aguilar, Jose Maria

Recent research has shown that a significant number of the falls from elevation occur when laborers are working on unfinished structures. Workers walking on wood I-joists on roofs and floors are prone to fall hazards. Wood I-joists have been replacing dimension lumber for many floor systems and a substantial number of roof systems in light-frame construction. Wood I-joists are designed to resist axial stresses on the flanges and shear stresses on the web while minimizing material used. However, wood I-joists have poor resistance to applied lateral and torsional loads and are susceptible to lateral-torsional buckling instability. Workers walking on unbraced or partially braced wood I-joists can induce axial and lateral forces as well as twist. Experimental testing demonstrated that workers cause lateral-torsional buckling instability in wood I-joists. However, no research was found related to the lateral-torsional buckling instability induced by individuals walking on the wood I-joists. Furthermore, no research was found considering the effects of the supported end conditions and partial bracing in the lateral-torsional buckling instability of wood I-joists. The goal of this research was to derive mathematical models to predict the dynamic lateral-torsional buckling instability of wood composite I-joists loaded by individuals walking considering different supported end conditions and bracing system configurations. The dynamic lateral-torsional buckling instability was analyzed by linearly combining the static lateral-torsional buckling instability with the lateral bending motion of the wood Ijoists. Mathematical models were derived to calculate the static critical loads for the simply supported end condition and four wood I-joist hanger supported end conditions. Additionally, mathematical models were derived to calculate the dynamic maximum lateral displacements and positions of the individual walking on the wood Ijoists for the same five different supported end conditions. Three different lean-on bracing systems were investigated, non-bracing, one-bracing, and two-bracing systems. Mathematical models were derived to calculate the amount of constraint due to the lean-on bracing system. The derived mathematical models were validated by comparison to data from testing for all supported end conditions and bracing systems. The predicted critical loads using the static buckling theoretical models for the non-bracing system and the static buckling theoretical models combined with the bracing theoretical models for the simply and hanger supported end conditions agreed well with the critical loads obtained from testing for the two wood I-joist sizes investigated. The predicted maximum lateral displacements and individual positions using the bending motion theoretical models for the simply and hanger supported end conditions agreed well with the corresponding maximum lateral displacements and individual positions obtained from testing for both wood I-joist sizes. Results showed that; a) the supported end condition influenced the critical loads, maximum lateral displacements and individual positions, b) the bracing system increased the critical loads and reduced the maximum lateral displacements, c) the critical load increased as the load position displaced away from the wood I-joist mid-span, d) the critical load reduced as the initial lateral displacement of the wood I-joist increased and e) the wood I-joist mid-span was the critical point in the dynamic lateral-torsional buckling instability.

Perceptions of stress, burnout, and support systems in pediatric bone marrow transplantation nursing.

PubMed

Gallagher, Regan; Gormley, Denise K

2009-12-01

Bone marrow transplantation (BMT) is used to treat various conditions, ranging from immune disorders to many types of cancer. The critical complexity of patients and the environment in which BMT nurses work can lead to stress, burnout, and, ultimately, poor retention. This study aimed to investigate nurses' perceptions of work-related stress and burnout as well as current support systems for nurses. The study included 30 BMT staff nurses from a large pediatric medical center in the midwestern United States. Critical illness or acuity of patients was reported as the most stressful factor; long work hours was the least stressful factor. Most nurses perceived moderate to high levels of emotional exhaustion, and 33% reported moderate levels of depersonalization. Fifty percent perceived high levels of personal accomplishment, despite the critical illness or acuity of their patients, demanding patient families, rotating shifts, short staffing, and caring for dying patients. Most nurses felt that support systems were in place and that staff was accessible, but most respondents were undecided about the helpfulness of the support systems. Results suggest that support systems may significantly affect work satisfaction and feelings of accomplishment for BMT nurses.

A Possible Approach for Addressing Neglected Human Factors Issues of Systems Engineering

NASA Technical Reports Server (NTRS)

Johnson, Christopher W.; Holloway, C. Michael

2011-01-01

The increasing complexity of safety-critical applications has led to the introduction of decision support tools in the transportation and process industries. Automation has also been introduced to support operator intervention in safety-critical applications. These innovations help reduce overall operator workload, and filter application data to maximize the finite cognitive and perceptual resources of system operators. However, these benefits do not come without a cost. Increased computational support for the end-users of safety-critical applications leads to increased reliance on engineers to monitor and maintain automated systems and decision support tools. This paper argues that by focussing on the end-users of complex applications, previous research has tended to neglect the demands that are being placed on systems engineers. The argument is illustrated through discussing three recent accidents. The paper concludes by presenting a possible strategy for building and using highly automated systems based on increased attention by management and regulators, improvements in competency and training for technical staff, sustained support for engineering team resource management, and the development of incident reporting systems for infrastructure failures. This paper represents preliminary work, about which we seek comments and suggestions.

The nutritional and metabolic support of heart failure in the intensive care unit.

PubMed

Meltzer, Joseph S; Moitra, Vivek K

2008-03-01

Heart failure and cardiovascular disease are common causes of morbidity and mortality, contributing to many ICU admissions. Nutritional deficiencies have been associated with the development and worsening of chronic heart failure. Nutritional and metabolic support may improve outcomes in critically ill patients with heart failure. This review analyzes the role of this support in the acute care setting of the ICU. Cardiac cachexia is a complex pathophysiologic process. It is characterized by inflammation and anabolic-catabolic imbalance. Nutritional supplements containing selenium, vitamins and antioxidants may provide needed support to the failing myocardium. Evidence shows that there is utility in intensive insulin therapy in the critically ill. Finally, there is an emerging metabolic role for HMG-CoA reductase inhibition, or statin therapy, in the treatment of heart failure. Shifting the metabolic milieu from catabolic to anabolic, reducing free radicals, and quieting inflammation in addition to caloric supplementation may be the key to nutritional support in the heart failure patient. Tight glycemic control with intensive insulin therapy plays an expanding role in the care of the critically ill. Glucose-insulin-potassium therapy probably does not improve the condition of the patient with heart failure or acute myocardial infarction.

Critical care nursing: Embedded complex systems.

PubMed

Trinier, Ruth; Liske, Lori; Nenadovic, Vera

2016-01-01

Variability in parameters such as heart rate, respiratory rate and blood pressure defines healthy physiology and the ability of the person to adequately respond to stressors. Critically ill patients have lost this variability and require highly specialized nursing care to support life and monitor changes in condition. The critical care environment is a dynamic system through which information flows. The critical care unit is typically designed as a tree structure with generally one attending physician and multiple nurses and allied health care professionals. Information flow through the system allows for identification of deteriorating patient status and timely interventionfor rescue from further deleterious effects. Nurses provide the majority of direct patient care in the critical care setting in 2:1, 1:1 or 1:2 nurse-to-patient ratios. The bedside nurse-critically ill patient relationship represents the primary, real-time feedback loop of information exchange, monitoring and treatment. Variables that enhance information flow through this loop and support timely nursing intervention can improve patient outcomes, while barriers can lead to errors and adverse events. Examining patient information flow in the critical care environment from a dynamic systems perspective provides insights into how nurses deliver effective patient care and prevent adverse events.

In Defense of Norm Circles: A New Normative Foundation for Adult Education

ERIC Educational Resources Information Center

Plumb, Donovan

2014-01-01

According to Michael Welton, because of its capacity to support social learning, critical adult education has a pivotal role to play in human emancipation. Drawing on Jürgen Habermas's critical theory of communicative action, Welton argues that critical adult education's deepest contemporary purpose is to foster social learning that can enable…

Using Critical Thinking Rubrics to Increase Academic Performance

ERIC Educational Resources Information Center

Hohmann, Julie W.; Grillo, Michael C.

2014-01-01

The purpose of this study was to develop a way to measure students' abilities to think critically about concepts covered during academic support sessions. Tutors trained in a College Reading and Learning Association (CRLA)-certified program at the University of Louisville used a rubric based on the Paul-Elder Critical Thinking Model in order to…

Using Word Clouds in Online Discussions to Support Critical Thinking and Engagement

ERIC Educational Resources Information Center

deNoyelles, Aimee; Reyes-Foster, Beatriz

2015-01-01

Being actively engaged in a task is often associated with critical thinking. Cultivating critical thinking skills, such as purposefully reflecting and analyzing one's own thinking, is a major goal of higher education. However, there is a challenge in providing college students opportunities to clearly demonstrate these skills in online courses.…

Approaching Praxis: YPAR as Critical Pedagogical Process in a College Access Program

ERIC Educational Resources Information Center

Scott, Mary Alice; Pyne, Kimberly B.; Means, Darris R.

2015-01-01

To address the persistent failure of schooling to support underserved students, youth participatory action research (YPAR) has emerged as an alternative and critical paradigm for educational practice. YPAR re-centers authority on marginalized voices and understands research as a tool for social change. Grounded in critical pedagogy, such projects…

Exploring the Development of Critical Incident Response Teams

ERIC Educational Resources Information Center

Lockhart, Charlotte Fiona; Woods, Kevin

2017-01-01

Critical incidents, such as human or natural disasters, can have profound effects upon children and young people, and upon the adults who work with and care for them. Educational psychologists have contributed to and led the development of critical incident response teams to support those affected. This study sought to develop understanding of the…

The Impact of Process Capability on Service Reliability for Critical Infrastructure Providers

ERIC Educational Resources Information Center

Houston, Clemith J., Jr.

2013-01-01

This study investigated the relationship between organizational processes that have been identified as promoting resiliency and their impact on service reliability within the scope of critical infrastructure providers. The importance of critical infrastructure to the nation is evident from the body of research and is supported by instances where…

Lights, camera, condoms! Assessing college men's attitudes toward condom use in pornography.

PubMed

Kraus, Shane W; Rosenberg, Harold

2016-01-01

Investigate male college students' attitudes toward actors' use of condoms in pornography. Two hundred thirteen undergraduate males attending a large, state-supported midwestern university in the fall semester, 2012. Using a Web-based procedure, participants completed questionnaires assessing their pornography use, sexual history characteristics, and their attitudes toward condom use by adult performers. Factor analysis of the 11-item condom use attitudes questionnaire supported 2 distinct subscales: Condom Supportive Attitudes and Condom Critical Attitudes. Although participants typically agreed with statements supportive of condom use and generally disagreed with statements critical of condom use in pornography, gay men had significantly higher condom supportive subscale scores than did heterosexual men. Neither subscale was correlated with weekly viewing of pornography. Although some producers of adult films argue that actors wearing condoms will displease many viewers, current findings suggest that young men express support for use of condoms by pornographic film actors.

Organizational characteristics of the austere intensive care unit: the evolution of military trauma and critical care medicine; applications for civilian medical care systems.

PubMed

Grathwohl, Kurt W; Venticinque, Steven G

2008-07-01

Critical care in the U.S. military has significantly evolved in the last decade. More recently, the U.S. military has implemented organizational changes, including the use of multidisciplinary teams in austere environments to improve outcomes in severely injured polytrauma combat patients. Specifically, organizational changes in combat support hospitals located in combat zones during Operation Iraqi Freedom have led to decreased intensive care unit mortality and length of stay as well as resource use. These changes were implemented without increases in logistic support or the addition of highly technologic equipment. The mechanism for improvement in mortality is likely attributable to the adherence of basic critical care medicine fundamentals. This intensivist-directed team model provides sophisticated critical care even in the most austere environments. To optimize critically injured patients' outcomes, intensive care organizational models similar to the U.S. military, described in this article, can possibly be adapted to those of civilian care during disaster management to meet the challenges of emergency mass critical care.

Critical Compressive Stress for Flat Rectangular Plates Supported Along All Edges and Elastically Restrained Against Rotation along the Unloaded Edges

NASA Technical Reports Server (NTRS)

Lundquist, Eugene E; Stowell, Elbridge Z

1942-01-01

A chart is presented for the values of the coefficient in the formula for the critical compressive stress at which buckling may be expected to occur in flat rectangular plates supported along all edges and, in addition, elastically restrained against rotation along the unloaded edges. The mathematical derivations of the formulas required in the construction of the chart are given.

Technology Needs to Support Future Mars Exploration

NASA Technical Reports Server (NTRS)

Nilsen, Erik N.; Baker, John; Lillard, Randolph P.

2013-01-01

The Mars Program Planning Group (MPPG) under the direction of Dr. Orlando Figueroa, was chartered to develop options for a program-level architecture for robotic exploration of Mars consistent with the objective to send humans to Mars in the 2030's. Scientific pathways were defined for future exploration, and multiple architectural options were developed that meet current science goals and support the future human exploration objectives. Integral to the process was the identification of critical technologies which enable the future scientific and human exploration goals. This paper describes the process for technology capabilities identification and examines the critical capability needs identified in the MPPG process. Several critical enabling technologies that have been identified to support the robotic exploration goals and with potential feedforward application to human exploration goals. Potential roadmaps for the development and validation of these technologies are discussed, including options for subscale technology demonstrations of future human exploration technologies on robotic missions.

Critical care medicine training and certification for emergency physicians.

PubMed

Huang, David T; Osborn, Tiffany M; Gunnerson, Kyle J; Gunn, Scott R; Trzeciak, Stephen; Kimball, Edward; Fink, Mitchell P; Angus, Derek C; Dellinger, R Phillip; Rivers, Emanuel P

2005-09-01

Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivists. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine and critical care medicine. Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivists. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine (EM) and critical care medicine (CCM). Critical care is a continuum that includes prehospital, emergency department (ED), and intensive care unit (ICU) care teams. Both EM and CCM require expertise in treating life-threatening acute illness, with many critically ill patients often presenting first to the ED. Increased patient volumes and acuity have resulted in longer ED lengths of stay and more critical care delivery in the ED. However, the majority of CCM fellowships do not accept EM residents, and those who successfully complete a fellowship do not have access to a U.S. certification exam in CCM. Despite these barriers, interest in CCM training among EM physicians is increasing. Dual EM/CCM-trained physicians not only will help alleviate the intensivist shortage but also will strengthen critical care delivery in the ED and facilitate coordination at the ED-ICU interface. We therefore propose that all accreditation bodies work cooperatively to create a route to CCM certification for emergency physicians who complete a critical care fellowship.

How Critical Reflection Benefits Faculty as They Implement Learner-Centered Teaching

ERIC Educational Resources Information Center

Blumberg, Phyllis

2015-01-01

Critical reflection assists faculty as they transition to using learner-centered approaches. When this reflection occurs within the context of social media, they can obtain reinforcing feedback and support.

Critical incident stress management (CISM) in support of special agents and other first responders responding to the Fort Hood shooting: summary and recommendations.

PubMed

Strand, Russell; Felices, Karina; Williams, Kenneth

2010-01-01

On November 5, 2009, an individual entered the Fort Hood Soldier Readiness Processing (SRP) site and opened fire with a handgun. The result of the shooting was a total of 13 people killed and 31 wounded. A two-person critical incident peer support (CIPS) team from the United States Army Military Police School (USAMPS) provided critical incident stress management (CISM) in the forms of critical incident stress debriefings (CISD) and one-on-one crisis intervention for investigators and their spouses. This article provides a summary and discussion of the results of the interventions that were conducted. Key results for successful CISM were accessibility of CIPS team, the credibility of trained peers and the development of supportive relationships, the reduction of stigma by requiring attendance at interventions, and the commitment of the CIPS team to the principles of CISM (e.g., homogenous groups, utilizing a multicomponent approach, and facilitating the normalization of emotional reactions to the crisis). Recommendations include mandating critical incident peer support cells for Criminal Investigation Division (CID) units, Director of Emergency Services (DES) on military installations, and Military Police units; providing a pool of trained peers in the above-mentioned organizations; providing permanent funding for USAMPS' CIPS Course; and recognition of CIPS/CISMas an essential element of Comprehensive Soldier Fitness and Army Human Capital in promoting Soldier Family, and Civilian well-being and resiliency. This article would benefit leaders, chaplains, mental health professionals, and emergency services personnel in investigative, operational, and U.S. Army Garrison units.

Critical Care nurses' understanding of the NHS knowledge and skills framework. An interpretative phenomenological analysis.

PubMed

Stewart, Laura F M; Rae, Agnes M

2013-01-01

This small-scale research study aimed to explore Critical Care nurses' understanding of the National Health Service (NHS) Knowledge and Skills Framework (KSF) in relationship to its challenges and their nursing role. The NHS KSF is central to the professional development of nurses in Critical Care and supports the effective delivery of health care in the UK. KSF was implemented in 2004 yet engagement seems lacking with challenges often identified. This qualitative study adopted an Interpretative Phenomenological Analysis framework. Data were collected from five Critical Care nurses using semi-structured interviews that were transcribed for analysis. Two super-ordinate themes of 'engagement' and 'theory-practice gap' were identified. Six subthemes of 'fluency', 'transparency', 'self-assessment', 'achieving for whom', 'reflection' and 'the nursing role' further explained the super-ordinate themes. Critical Care nurses demonstrated layers of understanding about KSF. Challenges identified were primarily concerned with complex language, an unclear process and the use of reflective and self-assessment skills. Two theory-practice gaps were found. Critical Care nurses understood the principles of KSF but they either did not apply or did not realize they applied these principles. They struggled to relate KSF to Critical Care practice and felt it did not capture the 'essence' of their nursing role in Critical Care. Recommendations were made for embedding KSF into Critical Care practice, using education and taking a flexible approach to KSF to support the development and care delivery of Critical Care nurses. © 2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.

Critical thinking analysis based on Facione (2015) – Angelo (1995) logical mathematics material of vocational high school (VHS)

NASA Astrophysics Data System (ADS)

Seventika, S. Y.; Sukestiyarno, Y. L.; Mariani, Scolastika

2018-03-01

The research has purpose to analyze and categorize the critical thinking ability of VHS students based on modified critical thinking indicator according to Facione-Angelo covering: interpreting the problem, analyzing alternative solution, applying the problem, evaluating the solution and concluding the results gained – attached by supportive evidence. The subject of the research is 30 eleventh graders of TKJ in Yabujah VHS, Indramayu in the odd semester 2016/2017. The collected data are critical thinking test and interviews. The result shows 15% is in good category, 30% in fair category, and 55% in low category. The students in “Good” category has accomplished critical thinking steps although imperfect, especially the indicators of evaluating and concluding attached by supportive evidence. The “Fair” categorized students only show partial steps of the indicators. The analyzing, evaluating, and concluding indicators are the most seldom to do, meanwhile the “low” categorized students show all indicators in low quality even to identify has problem to do.

Part II: The Effects of Aromatherapy and Guided Imagery for the Symptom Management of Anxiety, Pain, and Insomnia in Critically Ill Patients: An Integrative Review of Current Literature.

PubMed

Meghani, Naheed; Tracy, Mary Fran; Hadidi, Niloufar Niakosari; Lindquist, Ruth

This review is part II of a 2-part series that presents evidence on the effectiveness of aromatherapy and guided imagery for the symptom management of anxiety, pain, and insomnia in adult critically ill patients. Evidence from this review supports the use of aromatherapy for management of pain, insomnia, and anxiety in critically ill patients. Evidence also supports the use of guided imagery for managing these symptoms in critical care; however, the evidence is sparse, mixed, and weak. More studies with larger samples and stronger designs are needed to further establish efficacy of guided imagery for the management of anxiety, pain, and insomnia of critically ill patients; to accomplish this, standardized evidence-based intervention protocols to ensure comparability and to establish optimal effectiveness are needed. Discussion and recommendations related to the use of these therapies in practice and needs for future research in these areas were generated.

Using research to determine support for a policy on family presence during resuscitation.

PubMed

Basol, Roberta; Ohman, Kathleen; Simones, Joyce; Skillings, Kirsten

2009-01-01

National guidelines and professional organizations have recommended allowing family presence during resuscitation and bedside invasive procedures. Studies found that only 5% of critical care units have written policies. Periodic requests by family members prompted the creation of a task force, including nurses, physicians, and respiratory therapists, to develop this controversial policy. Before development, a research study of healthcare personnel attitudes, concerns, and beliefs toward family presence during cardiopulmonary resuscitation and bedside invasive procedures was done. This descriptive and correlational study showed support for family presence by critical care and emergency department nurses. Findings revealed both support and non-support for families to be present during resuscitative efforts. Providing family presence as an option offers an opportunity for reluctant healthcare team members to refuse their presence and an opportunity for those who support family presence to welcome the family.

Using Intelligent Tutor Technology to Implement Adaptive Support for Student Collaboration

ERIC Educational Resources Information Center

Diziol, Dejana; Walker, Erin; Rummel, Nikol; Koedinger, Kenneth R.

2010-01-01

Research on computer-supported collaborative learning has shown that students need support to benefit from collaborative activities. While classical collaboration scripts have been effective in providing such support, they have also been criticized for being coercive and not allowing students to self-regulate their learning. Adaptive collaboration…

Teaching Students to Think Critically about Social Media

ERIC Educational Resources Information Center

Brookfield, Stephen D.

2015-01-01

Instructors can incorporate social media and the immediacy and accessibility to information these offer in ways that support student learning, while simultaneously encouraging students to be critical of these same media systems and platforms.

Critical Skill Job – Cyber Security Analyst

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

Washington, Tara

This video series provides a first-hand look at critical skills positions at the Savannah River Site and required qualifications. Meet the people behind the jobs and learn what they do to support important SRS missions.

Critical Skills at SRS Radcon Inspectors

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

Johnson, Don; Brant, Kristin

2017-05-02

This video series provides a first-hand look at critical skills positions at the Savannah River Site and required qualifications. Meet the people behind the jobs and learn what they do to support important SRS missions.

Critical Skills at SRS – Scientist

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

Washington, Aaron

This video series provides a first-hand look at critical skills positions at the Savannah River Site and required qualifications. Meet the people behind the jobs and learn what they do to support important SRS missions.

Comprehensive Nuclear-Test-Ban Treaty: Issues and Arguments

DTIC Science & Technology

2008-02-28

is the point at which this chain reaction occurs; a “ critical mass ” is the amount of fissile material just enough to support criticality . The...amount of material for a critical mass depends on many factors, such as shape, density, impurities that absorb neutrons, and use of material to reflect...the years. Hydronuclear experiments were conducted during the 1958-1961 nuclear test moratorium. They initially used less than a critical mass of

Army Officer Duty Module Manual.

DTIC Science & Technology

1975-10-01

14l 3( RELATIVE CRITICALITY OF THIS Not Least (2) (3) The most PART (MOOULE) TO ENTIRE JOB aplicable critical Average Critical critical a. In actual...3 Directs and controls operations of mobile communications O- support unit -36- I. - O-G-5 Establishes and controls mobile area signal center 0-6-6...ENGINEERING O-EE-1 Directs .and controls combat engineer unit O-EE-2 Directs and controls portable bridging O-EE-3 Directs and controls mobile water

Gays and Lesbians Older and Wiser (GLOW): A Support Group for Older Gay People.

ERIC Educational Resources Information Center

Slusher, Morgan P.; And Others

1996-01-01

Describes Gays and Lesbians Older and Wiser (GLOW), a support group sponsored by a geriatric medical clinic in the midwestern United States. Scheduling, professional involvement, and special attention to social support seem critical for the group's success. Concludes that carefully designed support groups can meet some support needs for this older…

Evaluating Your Program. Supported Education: A Promising Practice. Evidence-Based Practices KIT (Knowledge Informing Transformation)

ERIC Educational Resources Information Center

Unger, Karen V.

2011-01-01

Key stakeholders who implement Supported Education may find themselves asking two questions: (1) Has Supported Education been implemented as planned?; and (2) Has Supported Education resulted in the expected outcomes? Asking these two questions and using the answers to help improve Supported Education are critical for ensuring the success of one's…

76 FR 59773 - Endangered and Threatened Wildlife and Plants; Designation of Critical Habitat for Mississippi...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-27

... support a diverse ground cover of herbaceous plants, both in the uplands and in the breeding ponds (Hedman... Service 50 CFR Part 17 Endangered and Threatened Wildlife and Plants; Designation of Critical Habitat for... Wildlife and Plants; Designation of Critical Habitat for Mississippi Gopher Frog AGENCY: Fish and Wildlife...

A Queer Critical Media Literacies Framework in a Digital Age

ERIC Educational Resources Information Center

Leent, Lisa; Mills, Kathy

2018-01-01

Media literacy skills are focal for many educators across the globe in an age of ubiquitous access to the Internet and the rapid circulation of digital texts. A critical media literacies perspective is often a key element in teaching adolescents to read a range of texts. A queer critical media literacies pedagogy supports a social justice agenda…

Learning styles and critical thinking relationship in baccalaureate nursing education: a systematic review.

PubMed

Andreou, Christos; Papastavrou, Evridiki; Merkouris, Anastasios

2014-03-01

Critical thinking is a desirable competency for contemporary nurses although there are growing concerns supporting a disturbing paucity in its achievement. Learning styles reflect habitual behaviors which determine distinct preferences within learning situations. Evidence suggests that critical thinking could evolve through learning processes. Variances in critical thinking achievement by nursing students might therefore be influenced by individual learning preferences. The concepts "learning styles" and "critical thinking" have been independently examined in the nursing literature. No reviews were found however exploring their association in nursing education. To identify the potential relationships between learning styles and critical thinking in baccalaureate nursing students. Systematic review. Eleven electronic databases were utilized without geographical and time publishing filters. Hand-searching journals and scanning references from retrieved studies were also performed. Databases were searched for descriptive correlational studies which considered the relationship between learning styles and critical thinking in baccalaureate nursing students. The authors independently progressed three stage screening. Retrieved articles were reviewed at title, abstract and full text levels according to predetermined criteria. All included studies were quality appraised using a rating tool for descriptive studies. Six studies were finally included. Findings were grouped under four key themes: predominant learning styles, critical thinking scoring, critical thinking evolution across academic progress and learning styles-critical thinking correlations. Learning styles' diversities, weak critical thinking and inconsistent evolution through academic progress were revealed across studies. Critical thinking differed significantly between learning styles. Commonly accepted models in nursing education were lacking in both learning styles and critical thinking. Within studies identical learning styles were found to be positively or negatively related to critical thinking. However comparative findings across studies revealed that all learning styles might be positive determinants toward critical thinking evolution, suggesting that there is a relationship between learning styles and critical thinking. Certain links between learning styles and critical thinking were supported in given settings and given nursing student populations. Further field exploration is required. Copyright © 2013 Elsevier Ltd. All rights reserved.

Family centred care before and during life-sustaining treatment withdrawal in intensive care: A survey of information provided to families by Australasian critical care nurses.

PubMed

Ranse, Kristen; Bloomer, Melissa; Coombs, Maureen; Endacott, Ruth

2016-11-01

A core component of family-centred nursing care during the provision of end-of-life care in intensive care settings is information sharing with families. Yet little is known about information provided in these circumstances. To identify information most frequently given by critical care nurses to families in preparation for and during withdrawal of life-sustaining treatment. An online cross-sectional survey. During May 2015, critical care nurses in Australia and New Zealand were invited to complete the Preparing Families for Treatment Withdrawal questionnaire. Data analysis included descriptive statistics to identify areas of information most and least frequently shared with families. Cross tabulations with demographic data were used to explore any associations in the data. From the responses of 159 critical care nurses, information related to the emotional care and support of the family was most frequently provided to families in preparation for and during withdrawal of life-sustaining treatment. Variation was noted in the frequency of provision of information across body systems and their associated physical changes during the dying process. Significant associations (p<0.05) were identified between the variables gender, nursing experience and critical care experiences and some of the information items most and least frequently provided. The provision of information during end-of-life care reflects a family-centred care approach by critical care nurses with information pertaining to emotional care and support of the family paramount. The findings of this study provide a useful framework for the development of interventions to improve practice and support nurses in communicating with families at this time. Copyright © 2016 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Strategic considerations for support of humans in space and Moon/Mars exploration missions. Life sciences research and technology programs, volume 2

NASA Technical Reports Server (NTRS)

1992-01-01

Summary charts of the following topics are presented: the Percentage of Critical Questions in Constrained and Robust Programs; the Executive Committee and AMAC Disposition of Critical Questions for Constrained and Robust Programs; and the Requirements for Ground-based Research and Flight Platforms for Constrained and Robust Programs. Data Tables are also presented and cover the following: critical questions from all Life Sciences Division Discipline Science Plans; critical questions listed by category and criticality; all critical questions which require ground-based research; critical questions that would utilize spacelabs listed by category and criticality; critical questions that would utilize Space Station Freedom (SSF) listed by category and criticality; critical questions that would utilize the SSF Centrifuge; facility listed by category and criticality; critical questions that would utilize a Moon base listed by category and criticality; critical questions that would utilize robotic missions listed by category and criticality; critical questions that would utilize free flyers listed by category and criticality; and critical questions by deliverables.

[Basics of emergency ultrasound].

PubMed

Schellhaas, S; Breitkreutz, R

2012-09-05

Focused ultrasound is a key methodology of critical care medicine. By referencing few ultrasound differential diagnosis, it is possible to identifying in real-time the reason of the critical state of a patient. Therefore typical focused ultrasound protocols were developed. The well known Focused Assessment with Sonography for trauma (FAST) was incorporated into the Advanced Trauma Life Support (ATLS) for shock room. Focused echocardiographic evaluation in life support (FEEL) has been designed to be conformed with the universal Advanced Life Support (ALS) algorithm and to identify treatable conditions such as acute right ventricular pressure overload in pulmonary embolism, hypovolemia, or pericardial effusion/tamponade. Using lung ultrasound one can differentiate pulmonary edema, pleural effusion or pneumothorax.

Technology base for microgravity horticulture

NASA Technical Reports Server (NTRS)

Sauer, R. L.; Magnuson, J. W.; Scruby, R. R.; Scheld, H. W.

1987-01-01

Advanced microgravity plant biology research and life support system development for the spacecraft environment are critically hampered by the lack of a technology base. This inadequacy stems primarily from the fact that microgravity results in a lack of convective currents and phase separation as compared to the one gravity environment. A program plan is being initiated to develop this technology base. This program will provide an iterative flight development effort that will be closely integrated with both basic science investigations and advanced life support system development efforts incorporating biological processes. The critical considerations include optimum illumination methods, root aeration, root and shoot support, and heat rejection and gas exchange in the plant canopy.

Replacing ODCs in a Critical Hand Cleaning Manual Electronics Assembly Operation

NASA Technical Reports Server (NTRS)

Bonner, J. K.; Walton, Sharon

1997-01-01

The manufacture of high reliability electronics assemblies for spacecraft and ground support equipment still often involves manual assembly processes. In addition, rework and repair of critical assemblies aslo often entails manual assembly processes.

Children’s Inferential Styles, 5-HTTLPR Genotype, and Maternal Expressed Emotion-Criticism: An Integrated Model for the Intergenerational Transmission of Depression

PubMed Central

Gibb, Brandon E.; Uhrlass, Dorothy J.; Grassia, Marie; Benas, Jessica S.; McGeary, John

2010-01-01

We tested a model for the intergenerational transmission of depression integrating specific genetic (5-HTTLPR), cognitive (inferential style), and environmental (mother depressive symptoms and expressed-emotion criticism) risk factors. Supporting the hypothesis that maternal depression is associated with elevated levels of stress in children’s lives, mothers with a history of major depressive disorder (MDD) exhibited higher depressive symptoms across a 6-month multi-wave follow-up than mothers with no depression history. In addition, partially supporting our hypothesis, levels of maternal criticism during the follow-up were significantly related to mothers’ current depressive symptoms, but not history of MDD. Finally, we found support for an integrated gene × cognition × environment model of risk. Specifically, among children with negative inferential styles regarding their self-characteristics, there was a clear dose response of 5-HTTLPR genotype moderating the relation between maternal criticism and children’s depressive symptoms, with the highest depressive symptoms during the follow-up observed among children carrying two copies of the 5-HTTLPR lower expressing alleles (S or LG) who also exhibited negative inferential styles for self-characteristics and who experienced high levels of EE-Crit. In contrast, children with positive inferential styles exhibited low depressive symptoms regardless of 5-HTTLPR genotype or level of maternal criticism. PMID:19899843

Children's inferential styles, 5-HTTLPR genotype, and maternal expressed emotion-criticism: An integrated model for the intergenerational transmission of depression.

PubMed

Gibb, Brandon E; Uhrlass, Dorothy J; Grassia, Marie; Benas, Jessica S; McGeary, John

2009-11-01

The authors tested a model for the intergenerational transmission of depression integrating specific genetic (5-HTTLPR), cognitive (inferential style), and environmental (mother depressive symptoms and expressed-emotion criticism [EE-Crit]) risk factors. Supporting the hypothesis that maternal depression is associated with elevated levels of stress in children's lives, mothers with a history of major depressive disorder (MDD) exhibited higher depressive symptoms across a 6-month multiwave follow-up than mothers with no depression history. In addition, partially supporting our hypothesis, levels of maternal criticism during the follow-up were significantly related to mothers' current depressive symptoms but not to history of MDD. Finally, the authors found support for an integrated Gene x Cognition x Environment model of risk. Specifically, among children with negative inferential styles regarding their self-characteristics, there was a clear dose response of 5-HTTLPR genotype moderating the relation between maternal criticism and children's depressive symptoms, with the highest depressive symptoms during the follow-up observed among children carrying 2 copies of the 5-HTTLPR lower expressing alleles (short [S] or long [LG]) who also exhibited negative inferential styles for self-characteristics and who experienced high levels of EE-Crit. In contrast, children with positive inferential styles exhibited low depressive symptoms regardless of 5-HTTLPR genotype or level of maternal criticism. PsycINFO Database Record 2009 APA, all rights reserved.

Integration of Palliative Care in Chronic Critical Illness Management

PubMed Central

Nelson, Judith E; Hope, Aluko A

2016-01-01

Palliative care is an essential component of comprehensive care for all patients with chronic critical illness, including those receiving restorative or life-sustaining therapies. Core elements include alleviation of symptom distress, communication about care goals, alignment of treatment with the patient’s values and preferences, transitional planning, and family support. Here we address strategies for assessment and management of symptoms, including pain, dyspnea, and depression, and for assisting patients to communicate while endotracheally intubated. We also discuss approaches to optimize communication among clinicians, patients, and families about care goals. Challenges for supporting families and planning for transitions between care settings are identified, while the value of interdisciplinary input is emphasized. We review “consultative” and “integrative” models for integrating palliative care and restorative critical care. Finally, we highlight key ethical issues that arise in the care of chronically critically ill patients and their families. PMID:22663973

Individual and collective processes in the construction of the self: self-enhancement in the United States and self-criticism in Japan.

PubMed

Kitayama, S; Markus, H R; Matsumoto, H; Norasakkunkit, V

1997-06-01

A collective constructionist theory of the self proposes that many psychological processes, including enhancement of the self (pervasive in the United States) and criticism and subsequent improvement of the self (widespread in Japan), result from and support the very ways in which social acts and situations are collectively defined and subjectively experienced in the respective cultural contexts. In support of the theory, 2 studies showed, first, that American situations are relatively conducive to self-enhancement and American people are relatively likely to engage in self-enhancement and, second, that Japanese situations are relatively conducive to self-criticism and Japanese people are relatively likely to engage in self-criticism. Implications are discussed for the collective construction of psychological processes implicated in the self and, more generally, for the mutual constitution of culture and the self.

Parenteral nutrition in the critically ill.

PubMed

Gunst, Jan; Van den Berghe, Greet

2017-04-01

Feeding guidelines have recommended early, full nutritional support in critically ill patients to prevent hypercatabolism and muscle weakness. Early enteral nutrition was suggested to be superior to early parenteral nutrition. When enteral nutrition fails to meet nutritional target, it was recommended to administer supplemental parenteral nutrition, albeit with a varying starting point. Sufficient amounts of amino acids were recommended, with addition of glutamine in subgroups. Recently, several large randomized controlled trials (RCTs) have yielded important new insights. This review summarizes recent evidence with regard to the indication, timing, and dosing of parenteral nutrition in critically ill patients. One large RCT revealed no difference between early enteral nutrition and early parenteral nutrition. Two large multicenter RCTs showed harm by early supplementation of insufficient enteral nutrition with parenteral nutrition, which could be explained by feeding-induced suppression of autophagy. Several RCTs found either no benefit or harm with a higher amino acid or caloric intake, as well as harm by administration of glutamine. Although unanswered questions remain, current evidence supports accepting low macronutrient intake during the acute phase of critical illness and does not support use of early parenteral nutrition. The timing when parenteral nutrition can be initiated safely and effectively is unclear.

Case Management Models in Permanent Supported Housing Programs for People With Complex Behavioral Issues Who Are Homeless.

PubMed

Clark, Colleen; Guenther, Christina C; Mitchell, Jessica N

2016-01-01

The purpose of this article is to examine two evidence-based models of case management for people with co-occurring disorders and histories of chronic homelessness and to better understand their roles in permanent supported housing. Critical Time Intervention and Assertive Community Treatment are examined in terms of key elements, how they assist in ending homelessness, as well as the role they play in an individual's recovery from co-occurring disorders. Participants in two supported housing programs were interviewed at baseline and 6 months. One program used Critical Time Intervention (n = 144) and the other used Assertive Community Treatment (n = 90). Staff in both programs were interviewed about their experiences and fidelity assessments were conducted for each program. Both programs operated at high levels of fidelity. Despite similar criteria for participation, there were significant differences between groups. Critical Time Intervention participants were older, were more likely to be male, were more likely to be homeless, and reported greater psychiatric symptoms and higher levels of substance use (all p's < .001). Separate outcome analyses suggested that each program was successful in supporting people to transition from homelessness to stable housing; 88.6% of Assertive Community Treatment participants were homeless at baseline, while at 6 months 30% were homeless (p < .001), and 91.3% of those in the Critical Time Intervention were homeless at baseline, while 44.3% were homeless at 6 months (p < .001). Participants in the Critical Time Intervention program also showed significant decreases in alcohol use, drug use, and psychiatric symptoms (all p's < .01). The preliminary results suggest that each case management model is helpful in assisting people with complex behavioral health needs and chronic homelessness to move to stable housing. Permanent supported housing seems to be an effective way to end homelessness among people with co-occurring disorders. Further research is needed to determine which case management models work most effectively with supported housing to help policy makers and program directors make informed decisions in developing these programs.

A Multilevel Framework for Increasing Social Support in Schools

ERIC Educational Resources Information Center

Grapin, Sally L.; Sulkowski, Michael L.; Lazarus, Philip J.

2016-01-01

In school contexts, social support refers to the overall perception one has of feeling included and cared for in a community of peers, teachers, caregivers, and others. Social support is critical for promoting positive academic and psychosocial outcomes for students. Conversely, a lack of perceived social support may be associated with increased…

Critical health infrastructure for refugee resettlement in rural Australia: case study of four rural towns.

PubMed

Sypek, Scott; Clugston, Gregory; Phillips, Christine

2008-12-01

To explore the reported impact of regional resettlement of refugees on rural health services, and identify critical health infrastructure for refugee resettlement. Comparative case study, using interviews and situational analysis. Four rural communities in New South Wales, which had been the focus of regional resettlement of refugees since 1999. Refugees, general practitioners, practice managers and volunteer support workers in each town (n = 24). The capacity of health care workers to provide comprehensive care is threatened by low numbers of practitioners, and high levels of turnover of health care staff, which results in attrition of specialised knowledge among health care workers treating refugees. Critical health infrastructure includes general practices with interest and surge capacity, subsidised dental services, mental health support services; clinical support services for rural practitioners; care coordination in the early settlement period; and a supported volunteer network. The need for intensive medical support is greatest in the early resettlement period for 'catch-up' primary health care. The difficulties experienced by rural Australia in securing equitable access to health services are amplified for refugees. While there are economic arguments about resettlement of refugees in regional Australia, the fragility of health services in regional Australia should also be factored into considerations about which towns are best suited to regional resettlement.

Critical thinking instruction and technology enhanced learning from the student perspective: A mixed methods research study.

PubMed

Swart, Ruth

2017-03-01

Critical thinking is acclaimed as a valuable asset for graduates from higher education programs. Technology has advanced in quantity and quality; recognized as a requirement of 21st century learners. A mixed methods research study was undertaken, examining undergraduate nursing student engagement with critical thinking instruction, platformed on two technology-enhanced learning environments: a classroom response system face-to-face in-class and an online discussion forum out-of-class. The Community of Inquiry framed the study capturing constructivist collaborative inquiry to support learning, and facilitate critical thinking capability. Inclusion of quantitative and qualitative data sources aimed to gather a comprehensive understanding of students' development of critical thinking and engagement with technology-enhanced learning. The findings from the students' perspectives were positive toward the inclusion of technology-enhanced learning, and use in supporting their development of critical thinking. Students considered the use of two forms of technology beneficial in meeting different needs and preferences, offering varied means to actively participate in learning. They valued critical thinking instruction being intentionally aligned with subject-specific content facilitating understanding, application, and relevance of course material. While the findings are limited to student participants, the instructional strategies and technology-enhanced learning identified as beneficial can inform course design for the development of critical thinking. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Critical Role of Organic Chemistry in Drug Discovery.

PubMed

Rotella, David P

2016-10-19

Small molecules remain the backbone for modern drug discovery. They are conceived and synthesized by medicinal chemists, many of whom were originally trained as organic chemists. Support from government and industry to provide training and personnel for continued development of this critical skill set has been declining for many years. This Viewpoint highlights the value of organic chemistry and organic medicinal chemists in the complex journey of drug discovery as a reminder that basic science support must be restored.

Water Recovery System Architecture and Operational Concepts to Accommodate Dormancy

NASA Technical Reports Server (NTRS)

Carter, Layne; Tabb, David; Anderson, Molly

2017-01-01

Future manned missions beyond low Earth orbit will include intermittent periods of extended dormancy. The mission requirement includes the capability for life support systems to support crew activity, followed by a dormant period of up to one year, and subsequently for the life support systems to come back online for additional crewed missions. NASA personnel are evaluating the architecture and operational concepts that will allow the Water Recovery System (WRS) to support such a mission. Dormancy could be a critical issue due to concerns with microbial growth or chemical degradation that might prevent water systems from operating properly when the crewed mission began. As such, it is critical that the water systems be designed to accommodate this dormant period. This paper identifies dormancy issues, concepts for updating the WRS architecture and operational concepts that will enable the WRS to support the dormancy requirement.

Pursuing Improvement in Clinical Reasoning: The Integrated Clinical Education Theory.

PubMed

Jessee, Mary Ann

2018-01-01

The link between clinical education and development of clinical reasoning is not well supported by one theoretical perspective. Learning to reason during clinical education may be best achieved in a supportive sociocultural context of nursing practice that maximizes reasoning opportunities and facilitates discourse and meaningful feedback. Prelicensure clinical education seldom incorporates these critical components and thus may fail to directly promote clinical reasoning skill. Theoretical frameworks supporting the development of clinical reasoning during clinical education were evaluated. Analysis of strengths and gaps in each framework's support of clinical reasoning development was conducted. Commensurability of philosophical underpinnings was confirmed, and complex relationships among key concepts were elucidated. Six key concepts and three tenets comprise an explanatory predictive theory-the integrated clinical education theory (ICET). ICET provides critical theoretical support for inquiry and action to promote clinical education that improves development of clinical reasoning skill. [J Nurs Educ. 2018;57(1):7-13.]. Copyright 2018, SLACK Incorporated.

Defining "peerness": Developing peer supports for parents with mental illnesses.

PubMed

Nicholson, Joanne; Valentine, Anne

2018-06-01

This article addresses critical considerations in the development of peer supports for parents with mental illnesses, focusing on the question of what makes a peer a peer in the parent peer specialist domain. The implementation and testing of parent peer supports requires specification of the critical components of the model, including the qualities, characteristics, and unique contributions of the parent peer specialist. Themes emerged in Parent Peer Specialist Project Advisory Group discussions, with members drawing from lived experience, practice expertise, and conversations with experts. In addition to literature review, strategic stakeholder interviews were conducted. Lived experience of mental illness and family life, training, and ongoing support for parent peer specialists, along with key ingredients conveyed by perceived peer-parent similarity, will likely enhance the benefits of peer supports to parents and promote job satisfaction and career advancement for parent peer specialists. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Acute exacerbations of chronic obstructive pulmonary disease: diagnosis, management, and prevention in critically ill patients.

PubMed

Dixit, Deepali; Bridgeman, Mary Barna; Andrews, Liza Barbarello; Narayanan, Navaneeth; Radbel, Jared; Parikh, Amay; Sunderram, Jag

2015-06-01

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death and is a substantial source of disability in the United States. Moderate-to-severe acute exacerbations of COPD (AECOPD) can progress to respiratory failure, necessitating ventilator assistance in patients in the intensive care unit (ICU). Patients in the ICU with AECOPD requiring ventilator support have higher morbidity and mortality rates as well as costs compared with hospitalized patients not in the ICU. The mainstay of management for patients with AECOPD in the ICU includes ventilator support (noninvasive or invasive), rapid-acting inhaled bronchodilators, systemic corticosteroids, and antibiotics. However, evidence supporting these interventions for the treatment of AECOPD in critically ill patients admitted to the ICU is scant. Corticosteroids have gained widespread acceptance in the management of patients with AECOPD necessitating ventilator assistance, despite their lack of evaluation in clinical trials as well as controversies surrounding optimal dosage regimens and duration of treatment. Recent studies evaluating the safety and efficacy of corticosteroids have found that higher doses are associated with increased adverse effects, which therefore support lower dosing strategies, particularly for patients admitted to the ICU for COPD exacerbations. This review highlights recent findings from the current body of evidence on nonpharmacologic and pharmacologic treatment and prevention of AECOPD in critically ill patients. In addition, the administration of bronchodilators using novel delivery devices in the ventilated patient and the conflicting evidence surrounding antibiotic use in AECOPD in the critically ill is explored. Further clinical trials, however, are warranted to clarify the optimal pharmacotherapy management for AECOPD, particularly in critically ill patients admitted to the ICU. © 2015 Pharmacotherapy Publications, Inc.

An integrative review of rural and remote nursing graduate programmes and experiences of nursing graduates.

PubMed

Fowler, Amanda C; Twigg, Diane; Jacob, Elisabeth; Nattabi, Barbara

2018-03-01

To examine international studies that specifically focus on transition to practice for graduate registered nurses in rural and remote areas. Supportive graduate nursing programmes are essential for enabling nursing graduates' transition to practice and reducing attrition rates. Literature examining support measures for nursing graduates within metropolitan areas is abundant. However, there is a paucity of evidence on effective graduate programmes for rural and remote-based nursing graduates. A systematic approach was used to identify robust research within appropriate electronic databases. Eligible articles were critically reviewed using the Mixed Method Appraisal Tool critical appraisal tool. Eligible articles were thematically analysed using the Braun and Clark approach. Eight articles met the selection criteria for inclusion. Findings revealed that while most graduate nurses survived the transition process, they often felt overwhelmed and abandoned with intense feelings of frustration. Many suffered transition shock and did not feel ready for the role. Socialisation of graduates to the clinical environment was lacking. Support offered in many graduate programmes was ad hoc and unstructured. Senior staff were inadequately supported in their roles as preceptors to assist with the transition. Critical support measures recommended included both debrief sessions and regular one-on-one support. Graduate programmes need to be structured yet flexible to accommodate the needs of rural and remote nurse graduates. Graduates need to be transitioned into practice with decremental support processes for both workloads and education. Preceptors require education on how to mentor before they can provide the appropriate support for graduates. Without these measures in place, a decrease in transition shock may not be possible. Graduate programmes need to be structured yet flexible, including assistance with both clinical skills and socialisation. Senior staff require education before they can adequately support new graduates. © 2017 John Wiley & Sons Ltd.

Professorial Views of the Use of Diversity Experiences to Develop Students' Critical Thinking Skills in the Pakistani College Context

ERIC Educational Resources Information Center

Tahir, Khazima

2017-01-01

This study explored the interplay of diversity experiences and critical thinking of Pakistani college students and determined how the classroom experience supported and exposed students to diversity and critical thinking. The researcher conducted teachers' interviews to gather data in a college in Pakistan. Teachers were asked to respond to a…

""I Wonder How This Little Seed Can Have so Much Potential"": Critical Exploration Supports Preservice Teachers' Development as Science Researchers and Teachers

ERIC Educational Resources Information Center

Hughes-McDonnell, Fiona

2009-01-01

A teacher educator and student of Duckworth's critical exploration approach to teaching shares three episodes taken from science methods courses she teaches for preservice teachers in graduate and undergraduate programs in elementary education. The episodes reveal the pedagogy of critical exploration to be particularly well suited to the…

A Culture of Thinking Like a Teacher: The Role of Critical Reflection in Teacher Preparation

ERIC Educational Resources Information Center

Lowenstein, Karen L.; Brill, Andra

2010-01-01

As teacher educators for an alternative urban teacher preparation program, we believe that because we cannot teach novice teachers everything they need to know in one year, our principal responsibility is to teach our novices to think like teachers. Central to this process is supporting novices to engage in critical reflection. Critical reflection…

The Global Positioning System: Assessing National Policies,

DTIC Science & Technology

1995-01-01

WASSEM • MONICA PINTO CRITICAL TECHNOLOGIES INSTITUTE RAND The research described in this report was supported by RAND’s Critical...MONICA PINTO Prepared for the Executive Office of the President Office of Science and Technology Policy CRITICAL TECHNOLOGIES INSTITUTE RAND...National Research Council Committee on the Future of the Global Positioning System, Washington, D.C., July 28-30,1994. Barbier, Jacques , and Thierry

Stress and Coping of Critical Care Nurses After Unsuccessful Cardiopulmonary Resuscitation.

PubMed

McMeekin, Dawn E; Hickman, Ronald L; Douglas, Sara L; Kelley, Carol G

2017-03-01

Participation by a critical care nurse in an unsuccessful resuscitation can create a unique heightened level of psychological stress referred to as postcode stress, activation of coping behaviors, and symptoms of posttraumatic stress disorder (PTSD). To explore the relationships among postcode stress, coping behaviors, and PTSD symptom severity in critical care nurses after experiencing unsuccessful cardiopulmonary resuscitations and to see whether institutional support attenuates these repeated psychological traumas. A national sample of 490 critical care nurses was recruited from the American Association of Critical-Care Nurses' eNewsline and social media. Participants completed the Post-Code Stress Scale, the Brief COPE (abbreviated), and the Impact of Event Scale-Revised, which were administered through an online survey. Postcode stress and PTSD symptom severity were weakly associated ( r = 0.20, P = .01). No significant associations between coping behaviors and postcode stress were found. Four coping behaviors (denial, self-distraction, self-blame, and behavioral disengagement) were significant predictors of PTSD symptom severity. Severity of postcode stress and PTSD symptoms varied with the availability of institutional support. Critical care nurses show moderate levels of postcode stress and PTSD symptoms when asked to recall an unsuccessful resuscitation and the coping behaviors used. Identifying the critical care nurses most at risk for PTSD will inform the development of interventional research to promote critical care nurses' psychological well-being and reduce their attrition from the profession. ©2017 American Association of Critical-Care Nurses.

A Turkish Version of the Critical-Care Pain Observation Tool: Reliability and Validity Assessment.

PubMed

Aktaş, Yeşim Yaman; Karabulut, Neziha

2017-08-01

The study aim was to evaluate the validity and reliability of the Critical-Care Pain Observation Tool in critically ill patients. A repeated measures design was used for the study. A convenience sample of 66 patients who had undergone open-heart surgery in the cardiovascular surgery intensive care unit in Ordu, Turkey, was recruited for the study. The patients were evaluated by using the Critical-Care Pain Observation Tool at rest, during a nociceptive procedure (suctioning), and 20 minutes after the procedure while they were conscious and intubated after surgery. The Turkish version of the Critical-Care Pain Observation Tool has shown statistically acceptable levels of validity and reliability. Inter-rater reliability was supported by moderate-to-high-weighted κ coefficients (weighted κ coefficient = 0.55 to 1.00). For concurrent validity, significant associations were found between the scores on the Critical-Care Pain Observation Tool and the Behavioral Pain Scale scores. Discriminant validity was also supported by higher scores during suctioning (a nociceptive procedure) versus non-nociceptive procedures. The internal consistency of the Critical-Care Pain Observation Tool was 0.72 during a nociceptive procedure and 0.71 during a non-nociceptive procedure. The validity and reliability of the Turkish version of the Critical-Care Pain Observation Tool was determined to be acceptable for pain assessment in critical care, especially for patients who cannot communicate verbally. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Sustaining staff nurse support for a patient care ergonomics program in critical care.

PubMed

Haney, Linda L; Wright, Laurette

2007-06-01

Applying management concepts from marketing and business sources can assist critical care units with establishing a planned change in the way nurses perform manual handling tasks, and thus, help insure that it is sustained.

A quantitative risk-based model for reasoning over critical system properties

NASA Technical Reports Server (NTRS)

Feather, M. S.

2002-01-01

This position paper suggests the use of a quantitative risk-based model to help support reeasoning and decision making that spans many of the critical properties such as security, safety, survivability, fault tolerance, and real-time.

Immunonutrition in Critical Illness: What Is the Role?

PubMed

McCarthy, Mary S; Martindale, Robert G

2018-06-01

Acute illness-associated malnutrition leads to muscle wasting, delayed wound healing, failure to wean from ventilator support, and possibly higher rates of infection and longer hospital stays unless appropriate metabolic support is provided in the form of nutrition therapy. Agreement is still lacking about the value of individual immune-modulating substrates for specific patient populations. However, it has long been agreed that there are 3 primary targets for these substrates: 1) mucosal barrier function, 2) cellular defense function, and 3) local and systemic inflammation. These targets guide the multitude of interventions necessary to stabilize and treat the hypercatabolic intensive care unit patient, including specialized nutrition therapy. The paradigm shift that occurred 30 years ago created a unique role for nutrition as an agent to support host defense mechanisms and prevent infectious complications in the critically ill patient. This overview of immunonutrition will discuss the evidence for its role in critical illness today. © 2018 American Society for Parenteral and Enteral Nutrition.

Tension pneumocephalus mimicking septic shock: a case report.

PubMed

Miranda, Caroline; Mahta, Ali; Wheeler, Lee Adam; Tsiouris, A John; Kamel, Hooman

2018-02-01

Tension pneumocephalus can lead to rapid neurologic deterioration. We report for the first time its association with aseptic systemic inflammatory response syndrome mimicking septic shock and the efficacy of prompt neurosurgical intervention and critical care support in treating this condition. A 64-year-old man underwent 2-stage olfactory groove meningioma resection. The patient developed altered mental status and gait instability on postoperative day 6. Imaging showed significant pneumocephalus. The patient subsequently developed worsening mental status, respiratory failure, and profound shock requiring multiple vasopressors. Bedside needle decompression, identification and repair of the cranial fossa defect, and critical care support led to improved mental status and reversal of shock and multiorgan dysfunction. Thorough evaluation revealed no evidence of an underlying infection. In this case, tension pneumocephalus incited an aseptic systemic inflammatory response syndrome mimicking septic shock. Prompt neurosurgical correction of pneumocephalus and critical care support not only improved neurologic status, but also reversed shock. Such a complication indicates the importance of close monitoring of patients with progressive pneumocephalus.

Open access support groups for people experiencing personality disorders: do group members' experiences reflect the theoretical foundations of the SUN project?

PubMed

Gillard, Steve; White, Rachel; Miller, Steve; Turner, Kati

2015-03-01

The SUN Project is an innovative, open access support group, based in the community, for people experiencing personality disorders, developed in response to UK Department of Health policy advocating improvements in personality disorders services. The aim of this article is to critically explore where and how the theoretically informed model underpinning the SUN Project is reflected in the view and experiences of people attending the project. This article reports an in-depth, qualitative interview-based study employing a critical realist approach. As part of a larger study about self-care and mental health, in-depth qualitative interviews were held with 38 people new to the SUN Project, and again 9 months later. Data were extracted that were relevant to core components of the project model and were subjected to thematic analysis. The critical realist approach was used to move back and forth between empirical data and theory underpinning the SUN project, providing critical insight into the model. Participant accounts were broadly concordant with core components of the SUN Project's underlying model: Open access and self-referral; group therapeutic processes; community-based support; service users as staff. There were some tensions between interviewee accounts and theoretical aspects of the model, notably around the challenges that group processes presented for some individuals. The model underlying the SUN Project is useful in informing good practice in therapeutic, community-based peer support groups for people experiencing personality disorders. Careful consideration should be given to a limited multi-modal approach, providing focused one-to-one support for vulnerable individuals who find it hard to engage in group processes. Facilitated peer support groups based in the community may act as a powerful therapeutic resource for people experiencing personality disorders. Promoting open access and self-referral to support groups may increase feelings of empowerment and engagement for people experiencing personality disorders. Some individuals experiencing personality disorders who could potentially benefit from therapeutic groups may need focused one-to-one support to do so. © 2014 The British Psychological Society.

A Unified Approach to the Thermodynamics and Quantum Scaling Functions of One-Dimensional Strongly Attractive SU(w) Fermi Gases

NASA Astrophysics Data System (ADS)

Yu, Yi-Cong; Guan, Xi-Wen

2017-06-01

We present a unified derivation of the pressure equation of states, thermodynamics and scaling functions for the one-dimensional (1D) strongly attractive Fermi gases with SU(w) symmetry. These physical quantities provide a rigorous understanding on a universality class of quantum criticality characterized by the critical exponents z = 2 and correlation length exponent ν = 1/2. Such a universality class of quantum criticality can occur when the Fermi sea of one branch of charge bound states starts to fill or becomes gapped at zero temperature. The quantum critical cone can be determined by the double peaks in specific heat, which serve to mark two crossover temperatures fanning out from the critical point. Our method opens to further study on quantum phases and phase transitions in strongly interacting fermions with large SU(w) and non-SU(w) symmetries in one dimension. Supported by the National Natural Science Foundation of China under Grant No 11374331 and the key NSFC under Grant No 11534014. XWG has been partially supported by the Australian Research Council.

Think Like a Nurse: A Critical Thinking Initiative.

PubMed

Ward, Terry D; Morris, Tiffany

2016-01-01

Critical thinking is essential in the practice of the nurse generalist, today. Nursing faculty is frequently trying to identify teaching strategies in promoting critical thinking and engaging students in active learning. To close the gap between critical thinking and student success, a school in the south east United States implemented the use of the 'think like a nurse initiative" for incoming junior nursing students. Faculty collaborated to adopt the fundamental and essential nursing concepts for nursing students to support thinking like a nurse.

Implementation Strategy for Coral Reef Transplantation Methods in Support of Natural Resource Planning, Management and NEPANESDI Project Number 491

DTIC Science & Technology

2016-05-01

species as either threatened or endangered under the Endangered Species Act (ESA) and to designate critical habitat. In a Federal Register notice... designation as “critical habitat.” The designation of critical habitat affects activities that involve a federal permit, license, or funding, and are likely...are not likely to jeopardize the continued existence of a listed species, or destroy or adversely modify its designated critical habitat. In some cases

Interpreting Political Agendas from a Critical Social Theory Perspective.

ERIC Educational Resources Information Center

Dickerson, Suzanne Steffan; Campbell-Heider, Nancy

1994-01-01

Critical social theory is used to analyze the American Medical Association's proposal to deal with the nursing shortage by creating registered care technologists. The discussion highlights strategies nurses can use in future efforts to support health care reform. (JOW)

Enteral vs. parenteral nutrition for the critically ill patient: a combined support should be preferred.

PubMed

Heidegger, Claudia-Paula; Darmon, Patrice; Pichard, Claude

2008-08-01

Current recommendations suggest starting enteral feeding as soon as possible whenever the gastrointestinal tract is functioning. The disadvantage of enteral support is that insufficient energy and protein coverage can occur. This review focuses on some recent findings regarding the nutritional support of critically ill patients and evaluates the data presented. An increasing nutritional deficit during a long ICU stay is associated with increased morbidity (infection rate, wound healing, mechanical ventilation, length of stay, duration of recovery), and costs. Evidence shows that enteral nutrition can result in underfeeding and that nutritional goals are frequently reached only after 1 week. Contrary to former beliefs, recent meta-analyses of ICU studies showed that parenteral nutrition is not related to a surplus mortality and may even be associated with improved survival. Early enteral nutrition is recommended for critically ill patients. Supplemental parenteral nutrition combined with enteral nutrition can be considered to cover the energy and protein targets when enteral nutrition alone fails to achieve the caloric goal. Whether such a combined nutritional support provides additional benefit on the overall outcome has to be proven in further studies on clinical outcome, including physical and cognitive functioning, quality of life, cost-effectiveness, and cost-utility.

Supporting the Federal Emergency Management Agency Rescuers: a variation of critical incident stress management.

PubMed

Garcia, Evangeline; Horton, Denise A

2003-02-01

The purpose of this article was to document the efforts of two military installations in facilitating Critical Incident Stress Management teams for Federal Emergency Management Agency Rescue and Recovery Units following the attacks on the World Trade Center on September 11, 2001. McGuire Air Force Base accepted the mission to support the rotating task forces with emotional support, and Fort Dix offered temporary lodging while the teams were in-bound and out-bound to the "Ground Zero" site. A team, comprised of staff from both installations due to the configuration of professional and support staffs, does the Critical Incident Stress Management work. Both installations are within commuting distance of New York City and could provide adequate safety, security, and logistics to the teams. The classic crisis management models were not called into play, as that service was not asked for; however, it was clear to the McGuire Air Force Base/Fort Dix Critical Incident Stress Management team members that the rescue and recovery teams needed their physical presence. Many rescue organizations have their own "debriefing teams," yet it is believed that "outside teams" may be helpful as interim measures to demonstrate the universality of the process of coping with traumatic stress and grief management. It is hoped that this article honors the workers who came together to help in a very difficult time for our country. This article documents the interim measures that were taken for a group of people moving through crisis.

Performance Support Tools: Delivering Value when and where It Is Needed

ERIC Educational Resources Information Center

McManus, Paul; Rossett, Allison

2006-01-01

Some call them Electronic Performance Support Systems (EPSSs). Others prefer Performance Support Tools (PSTs) or decision support tools. One might call EPSSs or PSTs job aids on steroids, technological tools that provide critical information or advice needed to move forward at a particular moment in time. Characteristic advantages of an EPSS or a…

Use of consensus development to establish national research priorities in critical care

PubMed Central

Vella, Keryn; Goldfrad, Caroline; Rowan, Kathy; Bion, Julian; Black, Nick

2000-01-01

Objectives To test the feasibility of using a nominal group technique to establish clinical and health services research priorities in critical care and to test the representativeness of the group's views. Design Generation of topics by means of a national survey; a nominal group technique to establish the level of consensus; a survey to test the representativeness of the results. Setting United Kingdom and Republic of Ireland. Subjects Nominal group composed of 10 doctors (8 consultants, 2 trainees) and 2 nurses. Main outcome measure Level of support (median) and level of agreement (mean absolute deviation from the median) derived from a 9 point Likert scale. Results Of the 325 intensive care units approached, 187 (58%) responded, providing about 1000 suggestions for research. Of the 106 most frequently suggested topics considered by the nominal group, 37 attracted strong support, 48 moderate support and 21 weak support. There was more agreement after the group had met—overall mean of the mean absolute deviations from the median fell from 1.41 to 1.26. The group's views represented the views of the wider community of critical care staff (r=0.73, P<0.01). There was no significant difference in the views of staff from teaching or from non-teaching hospitals. Of the 37 topics that attracted the strongest support, 24 were concerned with organisational aspects of critical care and only 13 with technology assessment or clinical research. Conclusions A nominal group technique is feasible and reliable for determining research priorities among clinicians. This approach is more democratic and transparent than the traditional methods used by research funding bodies. The results suggest that clinicians perceive research into the best ways of delivering and organising services as a high priority. PMID:10753149

Compliance with nutrition support guidelines in acutely burned patients.

PubMed

Holt, Brennen; Graves, Caran; Faraklas, Iris; Cochran, Amalia

2012-08-01

Adequate and timely provision of nutritional support is a crucial component of care of the critically ill burn patient. The goal of this study was to assess a single center's consistency with Society of Critical Care Medicine/American Society for Parenteral and Enteral Nutrition (SCCM/ASPEN) guidelines for nutritional support in critically ill patients. Acutely burned patients >45kg in weight admitted to a regional burn center during a two-year period and who required 5 or more days of full enteral nutritional support were eligible for inclusion in this retrospective review. Specific outcomes evaluated include time from admission to feeding tube placement and enteral feeding initiation and percent of nutritional goal received within the first week of hospital stay. Descriptive statistics were used for all analyses. IRB approval was obtained. Thirty-seven patients were included in this retrospective review. Median age of patients was 44.9 years (IQR: 24.2-55.1), and median burn injury size was 30% (IQR: 19-47). Median time to feeding tube placement was 31.1h post admission (IQR: 23.6-50.2h), while median time to initiation of EN was 47.9h post admission (IQR: 32.4-59.9h). The median time required for patients to reach 60% of caloric goal was 3 days post-admission (IQR: 3-4.5). The median time for initiation of enteral nutrition was within the SCCM/ASPEN guidelines for initial nutrition in the critically ill patient. This project identified a 16h time lag between placement of enteral access and initiation of enteral nutrition. Development of a protocol for feeding tube placement and enteral nutrition management may optimize early nutritional support in the acutely injured burn patient. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Fostering the Development of Critical Thinking Skills, and Reading Comprehension of Undergraduates Using a Web 2.0 Tool Coupled with a Learning System

ERIC Educational Resources Information Center

Mendenhall, Anne; Johnson, Tristan E.

2010-01-01

A social annotation model learning system (SAM-LS) was created using multiple instructional strategies thereby supporting the student in improving in critical thinking, critical writing and related literacy. There are four mechanisms in which the SAM-LS methodology is believed to improve learning and performance. These mechanisms include providing…

Independent Orbiter Assessment (IOA): Analysis of the Orbiter Experiment (OEX) subsystem

NASA Technical Reports Server (NTRS)

Compton, J. M.

1987-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA approach features a top-down analysis of the hardware to determine failure modes, criticality, and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. This report documents the independent analysis results corresponding to the Orbiter Experiments hardware. Each level of hardware was evaluated and analyzed for possible failure modes and effects. Criticality was assigned based upon the severity of the effect for each failure mode. The Orbiter Experiments (OEX) Program consists of a multiple set of experiments for the purpose of gathering environmental and aerodynamic data to develop more accurate ground models for Shuttle performance and to facilitate the design of future spacecraft. This assessment only addresses currently manifested experiments and their support systems. Specifically this list consists of: Shuttle Entry Air Data System (SEADS); Shuttle Upper Atmosphere Mass Spectrometer (SUMS); Forward Fuselage Support System for OEX (FFSSO); Shuttle Infrared Laced Temperature Sensor (SILTS); Aerodynamic Coefficient Identification Package (ACIP); and Support System for OEX (SSO). There are only two potential critical items for the OEX, since the experiments only gather data for analysis post mission and are totally independent systems except for power. Failure of any experiment component usually only causes a loss of experiment data and in no way jeopardizes the crew or mission.

Concepts and methods for describing critical phenomena in fluids

NASA Technical Reports Server (NTRS)

Sengers, J. V.; Sengers, J. M. H. L.

1977-01-01

The predictions of theoretical models for a critical-point phase transistion in fluids, namely the classical equation with third-degree critical isotherm, that with fifth-degree critical isotherm, and the lattice gas, are reviewed. The renormalization group theory of critical phenomena and the hypothesis of universality of critical behavior supported by this theory are discussed as well as the nature of gravity effects and how they affect cricital-region experimentation in fluids. The behavior of the thermodynamic properties and the correlation function is formulated in terms of scaling laws. The predictions of these scaling laws and of the hypothesis of universality of critical behavior are compared with experimental data for one-component fluids and it is indicated how the methods can be extended to describe critical phenomena in fluid mixtures.

Friends Can Be Good Medicine: Educating the Community about Social Support and Health.

ERIC Educational Resources Information Center

Hunter, Lisa; Lloyd-Kolkin, Donna

Traditionally, the medical field has researched the physical components of health but neglected interpersonal, social factors such as the quality of supportive relationships. To communicate the critical importance of social support to health maintenance, and to stimulate community activities which connect people and provide opportunities to…

Supporting Experienced and Beginning Teachers of Students with Disabilities.

ERIC Educational Resources Information Center

Billingsley, Bonnie S.; And Others

Administrative support is critical to the professional success and self-esteem of special education teachers. This chapter provides practical strategies for administrators at both the building and central office level to use to support special education teachers. J. S. House's framework is used for considering the different types of administrative…

Application of Campus Instructional Support: Two Case Studies

ERIC Educational Resources Information Center

Clauss-Ehlers, Caroline S.; Pasquerella, Lynn

2017-01-01

Purpose: The purpose of this paper is to demonstrate how instructional support is a critical tool to promote the use of technology in research and teaching. A Campus-Wide Collaborative Model of Technological Instructional Support (CCMTIS) is presented that incorporates: integration of technology across campus; technical assistance; allocation of…

Support for Learning from Multimedia Explanations. A Comparison of Prompting, Signaling, and Questioning

ERIC Educational Resources Information Center

García-Rodicio, Héctor

2014-01-01

In one experiment 97 undergraduate students learned about plate tectonics from a multimedia presentation involving narrated animations and support in one of four forms. Support in the prompting condition included hints inducing participants to self-explain critical information. The signaling condition included overviews recapping critical…

Students' Self-Perceptions of Support

ERIC Educational Resources Information Center

Villalobos, Anna Marie

2013-01-01

The purpose of this dissertation was to examine students with disabilities self-perceptions of their academic and social supports in the general and special education classroom and the impact of the students' counterstories to inform the design of classroom supports. This study was anchored in organizational theory, critical race theory, and the…

Supporting Children's Oral Language Development in the Preschool Classroom

ERIC Educational Resources Information Center

Whorrall, Jennifer; Cabell, Sonia Q.

2016-01-01

Supporting children's oral language development during the preschool years is critical for later reading success. Research shows that preschool teachers may be missing opportunities to engage children in the kinds of conversations that foster the development of rich oral language skills. Teachers hoping to support these skills can provide children…

Cross-cultural perspectives on critical thinking.

PubMed

Jenkins, Sheryl Daun

2011-05-01

The purpose of this cross-cultural study was to explore critical thinking among nurse scholars in Thailand and the United States. The study used qualitative methodology to examine how nurse scholars describe critical thinking in nursing. Nurse educators in Thailand and the United States were questioned concerning the following aspects of critical thinking: essential components; teaching and evaluation techniques; characteristics of critical thinkers; and the importance of a consensus definition for critical thinking in nursing. Their statements, which revealed both common and specific cultural aspects of critical thinking, were subjected to content analysis. Certain themes emerged that have not been widely discussed in the literature, including the link between staying calm and thinking critically, the assertion that happiness is an essential component of critical thinking, and the participants' nearly unanimous support for coming to a consensus definition of critical thinking for nursing. Copyright 2011, SLACK Incorporated.

The Communal Coping Model of Pain Catastrophizing in Daily Life: A Within-Couples Daily Diary Study

PubMed Central

Burns, John W.; Gerhart, James I.; Post, Kristina M.; Smith, David A.; Porter, Laura S.; Schuster, Erik; Buvanendran, Asokumar; Fras, Anne Marie; Keefe, Francis J.

2015-01-01

The Communal Coping Model (CCM) characterizes pain catastrophizing as a coping tactic whereby pain expression elicits assistance and empathic responses from others. Married couples (N = 105 couples; one spouse with chronic low back pain) completed electronic daily diary assessments 5 times/day for 14 days. On these diaries, patients reported pain catastrophizing, pain, function, and perceived spouse support, criticism and hostility. Non-patient spouses reported on their support, criticism, and hostility directed toward patients, as well as their observations of patient pain and pain behaviors. Hierarchical linear modeling tested concurrent and lagged (3 hours later) relationships. Principal findings included: a) within-person increases in pain catastrophizing were positively associated with spouse reports of patient pain behavior in concurrent and lagged analyses; b) within-person increases in pain catastrophizing were positively associated with patient perceptions of spouse support, criticism, and hostility in concurrent analyses; c) within-person increases in pain catastrophizing were negatively associated with spouse reports of criticism and hostility in lagged analyses. Spouses reported patient behaviors that were tied to elevated pain catastrophizing, and spouses changed their behavior during and following elevated pain catastrophizing episodes. Pain catastrophizing may affect the interpersonal environment of patients and spouses in ways consistent with the CCM. PMID:26320945

Implementation strategies in pediatric neurocritical care.

PubMed

Markham, Christopher; Proctor, Enola K; Pineda, Jose A

2017-06-01

Brain-directed critical care for children is a relatively new area of subspecialization in pediatric critical care. Pediatric neurocritical care teams combine the expertise of neurology, neurosurgery, and critical care medicine. The positive impact of delivering specialized care to pediatric patients with acute neurological illness is becoming more apparent, but the optimum way to implement and sustain the delivery of this is complicated and poorly understood. We aim to provide emerging evidence supporting that effective implementation of pediatric neurocritical care pathways can improve patient survival and outcomes. We also provide an overview of the most effective strategies across the field of implementation science that can facilitate deployment of neurocritical care pathways in the pediatric ICU. Implementation strategies can broadly be grouped according to six categories: planning, educating, restructuring, financing, managing quality, and attending to the policy context. Using a combination of these strategies in the last decade, several institutions have improved patient morbidity and mortality. Although much work remains to be done, emerging evidence supports that implementation of evidence-based care pathways for critically ill children with two common neurological diagnoses - status epilepticus and traumatic brain injury - improves outcomes. Pediatric and neonatal neurocritical care programs that support evidence-based care can be effectively structured using appropriately sequenced implementation strategies to improve outcomes across a variety of patient populations and in a variety of healthcare settings.

Self-reassurance, not self-esteem, serves as a buffer between self-criticism and depressive symptoms.

PubMed

Petrocchi, Nicola; Dentale, Francesco; Gilbert, Paul

2018-06-15

Several studies suggest that self-criticism and self-reassurance operate through different mechanisms and might interact with each other. This study examined the hypothesis that self-reassurance serves as a buffer between self-criticism and depressive symptoms in a way that self-esteem, which is rooted in a different motivational system, may not. We hypothesized that self-criticism would be correlated with high levels of depressive symptoms, but that this association would be weaker at higher levels of self-reassurance abilities. We also hypothesized that self-esteem, a self-relating process based on feeling able and competent to achieve life goals, would not buffer the relationship between self-criticism and depression. Self-criticism, self-reassurance, depressive symptoms, and self-esteem were assessed in a sample of 419 participants (66% females; M age  = 33.40, SD = 11.13). At higher levels of self-reassurance, the relationship between self-criticism and depressive symptoms became non-significant, supporting the buffering hypothesis of self-reassurance. Despite the high correlation between self-esteem and self-reassurance, self-esteem did not moderate the relationship between self-criticism and depressive symptoms. Results support the growing evidence that not all positive self-relating processes exert the same protective function against psychopathological consequences of self-criticism. Implications for psychotherapy and the validity of using compassion-focused interventions with clients with self-critical issues are discussed. Self-reassurance and self-criticism are distinct processes and they should not be considered positive and negative variations of a single dimension Different types of positive self-relating do not show the same correlation with depressive symptoms. The ability to be self-reassuring protects against the psychopathological correlates of self-criticism while having high self-esteem does not. Compassion-focused interventions are promising avenues to help clients counteract the negative impact of self-criticism on mood. © 2018 The British Psychological Society.

Structural dynamic analysis of the Space Shuttle Main Engine

NASA Technical Reports Server (NTRS)

Scott, L. P.; Jamison, G. T.; Mccutcheon, W. A.; Price, J. M.

1981-01-01

This structural dynamic analysis supports development of the SSME by evaluating components subjected to critical dynamic loads, identifying significant parameters, and evaluating solution methods. Engine operating parameters at both rated and full power levels are considered. Detailed structural dynamic analyses of operationally critical and life limited components support the assessment of engine design modifications and environmental changes. Engine system test results are utilized to verify analytic model simulations. The SSME main chamber injector assembly is an assembly of 600 injector elements which are called LOX posts. The overall LOX post analysis procedure is shown.

The Staff Perceptions of Behavior and Discipline Survey: A Tool to Help Achieve Systemic Change through Schoolwide Positive Behavior Support

ERIC Educational Resources Information Center

Feuerborn, Laura L.; Tyre, Ashli D.; King, Joe P.

2015-01-01

The practices of schoolwide positive behavior support (SWPBS) are dependent on staff implementation in classroom and common areas throughout the school. Thus, gaining the support and commitment of school staff is a critical step toward reaching full implementation of SWPBS. However, achieving buildingwide support can be challenging; many schools…

PRO-Elicere: A Study for Create a New Process of Dependability Analysis of Space Computer Systems

NASA Astrophysics Data System (ADS)

da Silva, Glauco; Netto Lahoz, Carlos Henrique

2013-09-01

This paper presents the new approach to the computer system dependability analysis, called PRO-ELICERE, which introduces data mining concepts and intelligent mechanisms to decision support to analyze the potential hazards and failures of a critical computer system. Also, are presented some techniques and tools that support the traditional dependability analysis and briefly discusses the concept of knowledge discovery and intelligent databases for critical computer systems. After that, introduces the PRO-ELICERE process, an intelligent approach to automate the ELICERE, a process created to extract non-functional requirements for critical computer systems. The PRO-ELICERE can be used in the V&V activities in the projects of Institute of Aeronautics and Space, such as the Brazilian Satellite Launcher (VLS-1).

Skylab Earth Resource Experiment Package critical design review. [conference

NASA Technical Reports Server (NTRS)

1973-01-01

An outline of the conference for reviewing the design of the EREP is presented. Systems design for review include: tape recorder, support equipment, view finder/tracking, support hardware, and control and display panel.

Critical Television Viewing Skills: Fitting Them into the Curriculum.

ERIC Educational Resources Information Center

Carpenter, Lee

1982-01-01

The need for teaching critical television viewing skills is seen as part of a greater need for a sequential media skills program and continued support for reactive art, music, and physical education programs in the schools. Twenty-eight references are listed. (Author/LLS)

Critical Practice: Teaching "Shakespeare."

ERIC Educational Resources Information Center

Mellor, Bronwyn; Patterson, Annette

2000-01-01

Describes how the authors taught their students to read "Hamlet" from a critical literacy perspective, analyzing how particular readings of texts and characters are constructed or produced; how they are determined by historical and cultural conventions; analyzing values that various readings support or challenge--rather than trying to…

Speed-Discussion: Engaging Students in Class Discussions

ERIC Educational Resources Information Center

Kornfield, Sarah; Noack, Kristen

2017-01-01

Courses: Communication Criticism, Rhetorical Criticism, Family and Communication, Gender and Communication, Popular Communication, and theory-based courses. Objectives: This activity engages students in dynamic, supportive, social discussion groups; helps them to identify and review the central ideas from the reading; and creates a record of their…

The Rational-Emotive Approach: A Critique

ERIC Educational Resources Information Center

Morris, G. Barry

1976-01-01

The critique of Rational-Emotive Therapy aims criticism at Ellis' concept of irrationality, analysis of human behavior and therapeutic techniques. Ellis suggests that his critic's claims lack the support of experimental evidence. He further suggests that an "existential" bias pervades which differs from his own brand of…

Posttraumatic distress in security guards and the various effects of social support.

PubMed

Declercq, Frédéric; Vanheule, Stijn; Markey, Samuel; Willemsen, Jochem

2007-12-01

This study investigates the effects of six types of social support on distress and posttraumatic stress disorders in security guards who did and did not encounter a critical incident. Three types of social support were significantly related to distress and posttraumatic stress disorder: emotional support in problem situations, instrumental support, and social companionship. Emotional support in problem situations paradoxically appeared to have an aggravating effect on distress and posttraumatic stress, whereas instrumental support and social companionship had a mitigating outcome.

When Antimicrobial Stewardship Isn′t Watching: The Educational Impact of Critical Care Prospective Audit and Feedback

PubMed Central

Fleming, Dimitra; Ali, Karim F.; Matelski, John; D'Sa, Ryan; Powis, Jeff

2016-01-01

Prospective audit and feedback (PAF) is an effective strategy to optimize antimicrobial use in the critical care setting, yet whether skills gained during PAF influence future antimicrobial prescribing is uncertain. This multisite study demonstrates that knowledge learned during PAF is translated and incorporated into the practice of critical care physicians even when not supported by an antimicrobial stewardship program. PMID:27382599

Office of Biological and Physical Research: Overview Transitioning to the Vision for Space Exploration

NASA Technical Reports Server (NTRS)

Crouch, Roger

2004-01-01

Viewgraphs on NASA's transition to its vision for space exploration is presented. The topics include: 1) Strategic Directives Guiding the Human Support Technology Program; 2) Progressive Capabilities; 3) A Journey to Inspire, Innovate, and Discover; 4) Risk Mitigation Status Technology Readiness Level (TRL) and Countermeasures Readiness Level (CRL); 5) Biological And Physical Research Enterprise Aligning With The Vision For U.S. Space Exploration; 6) Critical Path Roadmap Reference Missions; 7) Rating Risks; 8) Current Critical Path Roadmap (Draft) Rating Risks: Human Health; 9) Current Critical Path Roadmap (Draft) Rating Risks: System Performance/Efficiency; 10) Biological And Physical Research Enterprise Efforts to Align With Vision For U.S. Space Exploration; 11) Aligning with the Vision: Exploration Research Areas of Emphasis; 12) Code U Efforts To Align With The Vision For U.S. Space Exploration; 13) Types of Critical Path Roadmap Risks; and 14) ISS Human Support Systems Research, Development, and Demonstration. A summary discussing the vision for U.S. space exploration is also provided.

The role of nutritional support in the physical and functional recovery of critically ill patients: a narrative review.

PubMed

Bear, Danielle E; Wandrag, Liesl; Merriweather, Judith L; Connolly, Bronwen; Hart, Nicholas; Grocott, Michael P W

2017-08-26

The lack of benefit from randomised controlled trials has resulted in significant controversy regarding the role of nutrition during critical illness in terms of long-term recovery and outcome. Although methodological caveats with a failure to adequately appreciate biological mechanisms may explain these disappointing results, it must be acknowledged that nutritional support during early critical illness, when considered alone, may have limited long-term functional impact.This narrative review focuses specifically on recent clinical trials and evaluates the impact of nutrition during critical illness on long-term physical and functional recovery.Specific focus on the trial design and methodological limitations has been considered in detail. Limitations include delivery of caloric and protein targets, patient heterogeneity, short duration of intervention, inappropriate clinical outcomes and a disregard for baseline nutritional status and nutritional intake in the post-ICU period.With survivorship at the forefront of critical care research, it is imperative that nutrition studies carefully consider biological mechanisms and trial design because these factors can strongly influence outcomes, in particular long-term physical and functional outcome. Failure to do so may lead to inconclusive clinical trials and consequent rejection of the potentially beneficial effects of nutrition interventions during critical illness.

Effects of an experiential learning program on the clinical reasoning and critical thinking skills of occupational therapy students.

PubMed

Coker, Patty

2010-01-01

This study examined the effects of participation in a 1-week, experiential, hands-on learning program on the critical thinking and clinical reasoning skills of occupational therapy students. A quasi-experimental, nonrandomized pre- and post-test design was used with a sample of 25 students. The students had completed three semesters of didactic lecture coursework in a master's level OT educational program prior to participation in a hands-on therapy program for children with hemiplegic cerebral palsy. Changes in critical thinking and clinical reasoning skills were evaluated using the following dependent measures: Self-Assessment of Clinical Reflection and Reasoning (SACRR) and the California Critical Thinking Skills Test (CCTST). Changes in pretest and posttest scores on the SACRR and the CCTST were statistically significant (p>0.05) following completion of the experiential learning program. This study supports the use of hands-on learning to develop clinical reasoning and critical thinking skills in healthcare students, who face ever more diverse patient populations upon entry-level practice. Further qualitative and quantitative investigations are needed to support the results of this study and determine which components of experiential learning programs are essential for developing clinical reasoning and critical thinking skills in future allied health professionals.

Examining How Media Literacy and Personality Factors Predict Skepticism Toward Alcohol Advertising.

PubMed

Austin, Erica Weintraub; Muldrow, Adrienne; Austin, Bruce W

2016-05-01

To examine the potential effectiveness of media literacy education in the context of well-established personality factors, a survey of 472 young adults, focused on the issue of alcohol marketing messages, examined how individual differences in personality associate with constructs representing aspects of media literacy. The results showed that need for cognition predicted social expectancies and wishful identification with media portrayals in alcohol advertising only through critical thinking about media sources and media content, which are foci of media literacy education. Need for affect did not associate with increased or diminished levels of critical thinking. Critical thinking about sources and messages affected skepticism, represented by expectancies through wishful identification, consistent with the message interpretation process model. The results support the view that critical thinking about media sources is an important precursor to critical thinking about media messages. The results also suggest that critical thinking about media (i.e., media literacy) reflects more than personality characteristics and can affect wishful identification with role models observed in media, which appears to be a key influence on decision making. This adds support to the view that media literacy education can improve decision making across personality types regarding alcohol use by decreasing the potential influence of alcohol marketing messages.

Timing of the initiation of parenteral nutrition in critically ill children.

PubMed

Jimenez, Lissette; Mehta, Nilesh M; Duggan, Christopher P

2017-05-01

To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to enteral nutrition often leads to reliance on parenteral nutrition. The timing of parenteral nutrition initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves. A recent randomized control study among critically ill children suggests improved clinical outcomes with avoiding initiation of parenteral nutrition on day 1 of admission to the pediatric ICU. Although there is no consensus on the optimal timing of parenteral nutrition initiation among critically ill children, recent literature does not support the immediate initiation of parenteral nutrition on pediatric ICU admission. A common theme in the reviewed literature highlights the importance of accurate assessment of nutritional status and energy expenditure in deciding when to initiate parenteral nutrition. As with all medical interventions, the initiation of parenteral nutrition should be considered in light of the known benefits of judiciously provided nutritional support with the known risks of artificial, parenteral feeding.

Timing of the initiation of parenteral nutrition in critically ill children

PubMed Central

Jimenez, Lissette; Mehta, Nilesh M.; Duggan, Christopher

2018-01-01

Purpose of Review To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. Recent Findings Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition (EN) generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to EN often leads to reliance on parenteral nutrition (PN). The timing of PN initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves. A recent randomized control study among critically ill children suggests improved clinical outcomes with postponing initiation of PN to 1 week after admission to the pediatric intensive care unit (PICU). Summary Although there is no consensus on the optimal timing of PN initiation among critically ill children, recent literature does not support the immediate initiation of PN on PICU admission. A common theme in the reviewed literature highlights the importance of accurate assessment of nutritional status and energy expenditure in deciding when to initiate PN. As with all medical interventions, the initiation of PN should be considered in light of the known benefits of judiciously provided nutritional support with the known risks of artificial, parenteral feeding. PMID:28376054

Accelerating the translation of research into practice in long term services and supports: a critical need for federal infrastructure at the nexus of aging and disability.

PubMed

Washko, Michelle M; Campbell, Margaret; Tilly, Jane

2012-01-01

The nexus of aging and disability, characterized by the phenomenon of aging with a disability, will become more visible as the population ages and the number of people with disabilities surviving to midlife increases. This article addresses 3 interrelated issues critical to the fields of aging and disability: increasing demand for community-based long-term services and supports, a paucity of evidence-based programs demonstrating effectiveness in facilitating independence for those aging with a disability, and lack of a federal infrastructure to support coordinated investments in research-to-practice for this population. Suggestions for federal interagency collaborations are given, along with roles for key stakeholders.

The eXtensible ontology development (XOD) principles and tool implementation to support ontology interoperability.

PubMed

He, Yongqun; Xiang, Zuoshuang; Zheng, Jie; Lin, Yu; Overton, James A; Ong, Edison

2018-01-12

Ontologies are critical to data/metadata and knowledge standardization, sharing, and analysis. With hundreds of biological and biomedical ontologies developed, it has become critical to ensure ontology interoperability and the usage of interoperable ontologies for standardized data representation and integration. The suite of web-based Ontoanimal tools (e.g., Ontofox, Ontorat, and Ontobee) support different aspects of extensible ontology development. By summarizing the common features of Ontoanimal and other similar tools, we identified and proposed an "eXtensible Ontology Development" (XOD) strategy and its associated four principles. These XOD principles reuse existing terms and semantic relations from reliable ontologies, develop and apply well-established ontology design patterns (ODPs), and involve community efforts to support new ontology development, promoting standardized and interoperable data and knowledge representation and integration. The adoption of the XOD strategy, together with robust XOD tool development, will greatly support ontology interoperability and robust ontology applications to support data to be Findable, Accessible, Interoperable and Reusable (i.e., FAIR).

Water Recovery System Design to Accommodate Dormant Periods for Manned Missions

NASA Technical Reports Server (NTRS)

Tabb, David; Carter, Layne

2015-01-01

Future manned missions beyond lower Earth orbit may include intermittent periods of extended dormancy. Under the NASA Advanced Exploration System (AES) project, NASA personnel evaluated the viability of the ISS Water Recovery System (WRS) to support such a mission. The mission requirement includes the capability for life support systems to support crew activity, followed by a dormant period of up to one year, and subsequently for the life support systems to come back online for additional crewed missions. Dormancy could be a critical issue due to concerns with microbial growth or chemical degradation that might prevent water systems from operating properly when the crewed mission began. As such, it is critical that the water systems be designed to accommodate this dormant period. This paper details the results of this evaluation, which include identification of dormancy issues, results of testing performed to assess microbial stability of pretreated urine during dormancy periods, and concepts for updating to the WRS architecture and operational concepts that will enable the ISS WRS to support the dormancy requirement.

Elastomer mounted rotors - An alternative for smoother running turbomachinery

NASA Technical Reports Server (NTRS)

Tecza, J. A.; Jones, S. W.; Smalley, A. J.; Cunningham, R. E.; Darlow, M. S.

1979-01-01

This paper describes the design of elastomeric bearing supports for a rotor built to simulate the power turbine of an advanced gas turbine engine which traverses two bending critical speeds. The elastomer dampers were constructed so as to minimize rotor dynamic response at the critical speeds. Results are presented of unbalance response tests performed with two different elastomer materials. These results showed that the resonances on the elastomer-mounted rotor were well damped for both elastomer materials and showed linear response to the unbalance weights used for response testing. Additional tests were performed using solid steel supports at either end (hand-mounted), which resulted in drastically increased sensitivity and nonlinear response, and with steel supports in one end of the rotor and the elastomer at the other, which yielded results which were between the soft- and hard-mounted cases. It is concluded that elastomeric supports are a viable alternative to other methods of mounting flexible rotors, that damping was well in excess of predictions and that elastomeric supports are tolerant of small rotor misalignments.

Critical care of tropical disease in low income countries: Report from the Task Force on Tropical Diseases by the World Federation of Societies of Intensive and Critical Care Medicine.

PubMed

Baker, Tim; Khalid, Karima; Acicbe, Ozlem; McGloughlin, Steve; Amin, Pravin

2017-12-01

Tropical disease results in a great burden of critical illness. The same life-saving and supportive therapies to maintain vital organ functions that comprise critical care are required by these patients as for all other diseases. In low income countries, the little available data points towards high mortality rates and big challenges in the provision of critical care. Improving critical care in low income countries requires a focus on hospital design, training, triage, monitoring & treatment modifications, the basic principles of critical care, hygiene and the involvement of multi-disciplinary teams. As a large proportion of critical illness from tropical disease is in low income countries, the impact and reductions in mortality rates of improved critical care in such settings could be substantial. Copyright © 2017. Published by Elsevier Inc.

Investing in soils as an infrastructure to maintain and enhance food water and carbon services

NASA Astrophysics Data System (ADS)

Davies, Jessica

2017-04-01

Soils are a life support system for global society and our planet. In addition to providing the vast majority of our food; soils regulate water quality and quantity reducing the risk of floods, droughts and pollution; and as the largest store of carbon in the earth system they are critical to climate change. By providing these multiple essential services, soils act a natural form of infrastructure that is critical to supporting both rural and urban communities and economies. Can natural infrastructure and natural capital concepts be used to motivate and enable investment and regulation of soils for purposes such as soil carbon sequestration? What scientific knowledge and tools would we need to support soil infrastructure decision making - in policy arenas and elsewhere? This poster will present progress from a new research project supported by the UK research council (EP/N030532/1) that addresses these questions.

Nonlinear vibration analysis of an eccentric rotor with unbalance magnetic pull

NASA Astrophysics Data System (ADS)

Song, Z.; Ma, Z.

2010-08-01

The unbalance magnetic pull of an eccentric water turbine generator set rotor has important influence on its vibration. The magnetic stiffness matrix is introduced to express the energy of the air gap magnetic field. Two vibration models are constructed through the Lagrange Equation. The difference of the two models is the boundary supporting conditions: one is rigid support and the other is elastic support through bearing. The influence of the magnetic stiffness and the elastic support on the critical speed of the rotor is studied using the Liapunov nonlinear vibration theory. The vibration amplitude of the rotor is calculated taking the magnetic stiffness and level eccentricity force into account. The sensitivity of the magnetic, mechanical and bearing parameters to the critical speed is analyzed. Some conclusions may be benefit to the study the dynamic characters of the generator set shaft system which concludes all the magnetic, mechanical and hydraulic parameters.

Critical care nurses' experiences when technology malfunctions.

PubMed

Haghenbeck, Karen Toby

2005-01-01

When caring for critically ill patients, critical care nurses work with technology every day. Technology and equipment malfunctions can have a profound effect on nurses' practice and self-image. In this article, a descriptive phenomenological methodology was chosen to explicate the experience of seven critical care nurses. While participants realized that machines might malfunction, they experienced surprise, shock, and feelings of being "let down" and inadequate when malfunctions occurred. They questioned their competence and felt malfunctioning technology jeopardized their credibility and professional image. These findings are useful when structuring educational sessions on technology and in facilitating a supportive environment for critical care nurses when technology malfunctions.

Visual Thinking Strategies = Creative and Critical Thinking

ERIC Educational Resources Information Center

Moeller, Mary; Cutler, Kay; Fiedler, Dave; Weier, Lisa

2013-01-01

Implementation of Visual Thinking Strategies (VTS) into the Camelot Intermediate School curriculum in Brookings, South Dakota, has fostered the development of creative and critical thinking skills in 4th- and 5th-grade students. Making meaning together by observing carefully, deciphering patterns, speculating, clarifying, supporting opinions, and…

Support Services in Social Studies Courses for Students with Hearing Loss

ERIC Educational Resources Information Center

Akay, Elif

2018-01-01

Social Studies courses aimed to promote the development of critical thinking skills in students. This study focused on the problems two students with hearing loss encountered while they are using three strategies: "identifying and using reference sources", "perception of chronology" and "critical reasoning"…

A Threshold Model of Social Support, Adjustment, and Distress after Breast Cancer Treatment

ERIC Educational Resources Information Center

Mallinckrodt, Brent; Armer, Jane M.; Heppner, P. Paul

2012-01-01

This study examined a threshold model that proposes that social support exhibits a curvilinear association with adjustment and distress, such that support in excess of a critical threshold level has decreasing incremental benefits. Women diagnosed with a first occurrence of breast cancer (N = 154) completed survey measures of perceived support…

Seeking Support: Researching First-Year Students' Experiences of Coping with Academic Life

ERIC Educational Resources Information Center

Morosanu, Laura; Handley, Karen; O'Donovan, Berry

2010-01-01

Students' transition to academia comes with a number of challenges which, if inadequately addressed, may negatively affect their academic performance and psychological well-being. Hence, the question of support becomes critical and has been reflected in the variety of practical measures to provide support with learning and facilitate newcomers'…

Families of Individuals with Intellectual and Developmental Disabilities: Policy, Funding, Services, and Experiences

ERIC Educational Resources Information Center

Hewitt, Amy; Agosta, John; Heller, Tamar; Williams, Ann Cameron; Reinke, Jennifer

2013-01-01

Families are critical in the provision of lifelong support to individuals with intellectual and developmental disabilities (IDD). Today, more people with IDD receive long-term services and supports while living with their families. Thus, it is important that researchers, practitioners, and policy makers understand how to best support families who…

Quality Support Infrastructure in Early Childhood: Still (Mostly) Missing

ERIC Educational Resources Information Center

Azzi-Lessing, Lenette

2009-01-01

Support for early care and education among policy makers and the public is at an unprecedented high. As investments in early care and education programs in the United States continue to rise, the issue of quality becomes increasingly critical. This article addresses the need for adequate infrastructure to support high-quality early care and…

Support for Arts Education. State Arts Agency Fact Sheet

ERIC Educational Resources Information Center

National Assembly of State Arts Agencies, 2011

2011-01-01

Supporting lifelong learning in the arts is a top priority for state arts agencies. By supporting arts education in the schools, state arts agencies foster young imaginations, address core academic standards, and promote the critical thinking and creativity skills essential to a 21st century work force. State arts agencies also support…

The Effects of Mobile-Computer-Supported Collaborative Learning: Meta-Analysis and Critical Synthesis

ERIC Educational Resources Information Center

Sung, Yao-Ting; Yang, Je-Ming; Lee, Han-Yueh

2017-01-01

One of the trends in collaborative learning is using mobile devices for supporting the process and products of collaboration, which has been forming the field of mobile-computer-supported collaborative learning (mCSCL). Although mobile devices have become valuable collaborative learning tools, evaluative evidence for their substantial…

Knowledge base and sensor bus messaging service architecture for critical tsunami warning and decision-support

NASA Astrophysics Data System (ADS)

Sabeur, Z. A.; Wächter, J.; Middleton, S. E.; Zlatev, Z.; Häner, R.; Hammitzsch, M.; Loewe, P.

2012-04-01

The intelligent management of large volumes of environmental monitoring data for early tsunami warning requires the deployment of robust and scalable service oriented infrastructure that is supported by an agile knowledge-base for critical decision-support In the TRIDEC project (TRIDEC 2010-2013), a sensor observation service bus of the TRIDEC system is being developed for the advancement of complex tsunami event processing and management. Further, a dedicated TRIDEC system knowledge-base is being implemented to enable on-demand access to semantically rich OGC SWE compliant hydrodynamic observations and operationally oriented meta-information to multiple subscribers. TRIDEC decision support requires a scalable and agile real-time processing architecture which enables fast response to evolving subscribers requirements as the tsunami crisis develops. This is also achieved with the support of intelligent processing services which specialise in multi-level fusion methods with relevance feedback and deep learning. The TRIDEC knowledge base development work coupled with that of the generic sensor bus platform shall be presented to demonstrate advanced decision-support with situation awareness in context of tsunami early warning and crisis management.

Chemical terrorism for the intensivist.

PubMed

Chalela, Julio A; Burnett, Thomas

2012-05-01

The use of chemical agents for terrorist attacks or military warfare is a major concern at the present time. Chemical agents can cause significant morbidity, are relatively inexpensive, and are easy to store and use. Weaponization of chemical agents is only limited by the physicochemical properties of some agents. Recent incidents involving toxic industrial chemicals and chemical terrorist attacks indicate that critical care services are frequently utilized. For obvious reasons, the critical care literature on chemical terrorism is scarce. This article reviews the clinical aspects of diagnosing and treating victims of chemical terrorism while emphasizing the critical care management. The intensivist needs to be familiar with the chemical agents that could be used in a terrorist attack. The military classification divides agents into lung agents, blood agents, vesicants, and nerve agents. Supportive critical care is the cornerstone of treatment for most casualties, and dramatic recovery can occur in many cases. Specific antidotes are available for some agents, but even without the antidote, aggressive intensive care support can lead to favorable outcome in many cases. Critical care and emergency services can be overwhelmed by a terrorist attack as many exposed but not ill will seek care.

In Search of How Principals Change: A Qualitative Study of Events That Help and Hinder Administrator Support for School-Wide PBIS

ERIC Educational Resources Information Center

McIntosh, Kent; Kelm, Joanna L.; Canizal Delabra, Alondra

2016-01-01

Research has shown principal support to be a critical variable for implementing and sustaining evidence-based practices. However, there remains little understanding of the factors that may influence a principal's personal decision to support a practice. The purpose of the current study was to examine events that influenced principals' support for…

Nutrition considerations in traumatic brain injury.

PubMed

Cook, Aaron M; Peppard, Amy; Magnuson, Barbara

The provision of adequate nutrition support for patients with traumatic brain injury (TBI) has been a clinical challenge for decades. The primary and secondary injuries create unique metabolic derangements along with accompanying issues such as optimal timing and route of nutrition, appropriate fluid and electrolytes, drug administration, rehabilitation, and dysphagia. Enteral nutrition is clearly established as the preferential route of nutrition support for this population vs parenteral nutrition. There appears to be a consensus on early initiation of enteral nutrition, but less definitive are recommendations on advancement timing and formula components. Nutrition therapies should include exact fluid resuscitation goals specific for TBI and strict electrolyte monitoring to avoid extreme fluid, electrolyte, or glucose shifts that could be detrimental to the patient. While the critical care patient often tolerates small bowel feeding, the long-term rehabilitation patient should transition to and tolerate gastric feeding. Drug-nutrient and adverse drug reactions such as diarrhea should be routinely evaluated in patients receiving enteral nutrition. Monitoring for dysphagia is critical to avoid the costly negative aspects associated with aspiration and to capitalize on quality of life and appropriate oral nutrition. Emphasizing the priority of early nutrition support within a multi-disciplinary team may be the critical key for successful provision and tolerance of nutrition support in the TBI population.

Independent Orbiter Assessment (IOA): Assessment of the life support and airlock support systems, volume 1

NASA Technical Reports Server (NTRS)

Arbet, J. D.; Duffy, R. E.; Barickman, K.; Saiidi, M. J.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the Life Support and Airlock Support Systems (LSS and ALSS) hardware, generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the NASA FMEA/CIL baseline with proposed Post 51-L updates included. The discrepancies were flagged for potential future resolution. This report documents the results of that comparison for the Orbiter LSS and ALSS hardware. The IOA product for the LSS and ALSS analysis consisted of 511 failure mode worksheets that resulted in 140 potential critical items. Comparison was made to the NASA baseline which consisted of 456 FMEAs and 101 CIL items. The IOA analysis identified 39 failure modes, 6 of which were classified as CIL items, for components not covered by the NASA FMEAs. It was recommended that these failure modes be added to the NASA FMEA baseline. The overall assessment produced agreement on all but 301 FMEAs which caused differences in 111 CIL items.

Ending on a positive: Examining the role of safety leadership decisions, behaviours and actions in a safety critical situation.

PubMed

Donovan, Sarah-Louise; Salmon, Paul M; Horberry, Timothy; Lenné, Michael G

2018-01-01

Safety leadership is an important factor in supporting safe performance in the workplace. The present case study examined the role of safety leadership during the Bingham Canyon Mine high-wall failure, a significant mining incident in which no fatalities or injuries were incurred. The Critical Decision Method (CDM) was used in conjunction with a self-reporting approach to examine safety leadership in terms of decisions, behaviours and actions that contributed to the incidents' safe outcome. Mapping the analysis onto Rasmussen's Risk Management Framework (Rasmussen, 1997), the findings demonstrate clear links between safety leadership decisions, and emergent behaviours and actions across the work system. Communication and engagement based decisions featured most prominently, and were linked to different leadership practices across the work system. Further, a core sub-set of CDM decision elements were linked to the open flow and exchange of information across the work system, which was critical to supporting the safe outcome. The findings provide practical implications for the development of safety leadership capability to support safety within the mining industry. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): neurocritical patient].

PubMed

Acosta Escribano, J; Herrero Meseguer, I; Conejero García-Quijada, R

2011-11-01

Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral-parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calore intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL. Copyright © 2011 Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L. All rights reserved.

How Activism Features in the Career Lives of Four Generations of Canadian Nurses.

PubMed

MacDonnell, Judith A; Buck-McFadyen, Ellen

2016-11-01

Recent nursing research using a critical feminist lens challenges the prevailing view of political inertia in nursing. This comparative life history study using a critical feminist lens explores the relevance of activism with four generations of Canadian nurses. Purposeful sampling of Ontario nurses resulted in 40 participants who were diverse in terms of generation, practice setting, and activist practice. Interviews and focus groups were completed with the sample of Ontario registered nurses or undergraduate and graduate nursing students: 8 Generation X, 9 Generation Y (Millennials), 20 Boomers, and 3 Overboomers. Factors such as professional norms and personal and organizational supports shaped contradictory nursing activist identities, practices, and impacts. Gendered norms, organizational dynamics, and the political landscape influenced the meanings nurses attributed to critical incidents and influences that prompted activism inside and outside the workplace, shaping the transformative potential of nursing. Despite its limitations, the study has implications for creating professional and organizational supports for consideration of health politics and policy, and spaces for dialogue to support practice and research aligned with social justice goals.

Influence of peer support on HIV/STI prevention and safety amongst international migrant sex workers: A qualitative study at the Mexico-Guatemala border

PubMed Central

Brouwer, Kimberly C.; Rocha-Jimenez, Teresita; Fernandez-Casanueva, Carmen; Morales-Miranda, Sonia; Goldenberg, Shira M.

2018-01-01

Background Migrant women engaged in precarious employment, such as sex work, frequently face pronounced social isolation alongside other barriers to health and human rights. Although peer support has been identified as a critical HIV and violence prevention intervention for sex workers, little is known about access to peer support or its role in shaping health and social outcomes for migrant sex workers. This article analyses the role of peer support in shaping vulnerability and resilience related to HIV/STI prevention and violence among international migrant sex workers at the Mexico-Guatemala border. Methods This qualitative study is based on 31 semi-structured interviews conducted with international migrant sex workers in the Mexico-Guatemala border communities of Tapachula, Mexico and Tecún Umán and Quetzaltenango, Guatemala. Results Peer support was found to be critical for reducing social isolation; improving access to HIV/STI knowledge, prevention and resources; and mitigating workplace violence, particularly at the initial stages of migration and sex work. Peer support was especially critical for countering social isolation, and peers represented a valuable source of HIV/STI prevention knowledge and resources (e.g., condoms), as well as essential safety supports in the workplace. However, challenges to accessing peer support were noted, including difficulties establishing long-lasting relationships and other forms of social participation due to frequent mobility, as well as tensions among peers within some work environments. Variations in access to peer support related to country of work, work environment, sex work and migration stage, and sex work experience were also identified. Conclusions Results indicate that peer-led and community empowerment interventions represent a promising strategy for promoting the health, safety and human rights of migrant sex workers. Tailored community empowerment interventions addressing the unique migration-related contexts and challenges faced by migrant sex workers should be a focus of future community-based research, alongside promotion of broader structural changes. PMID:29304164

Influence of peer support on HIV/STI prevention and safety amongst international migrant sex workers: A qualitative study at the Mexico-Guatemala border.

PubMed

Febres-Cordero, Belen; Brouwer, Kimberly C; Rocha-Jimenez, Teresita; Fernandez-Casanueva, Carmen; Morales-Miranda, Sonia; Goldenberg, Shira M

2018-01-01

Migrant women engaged in precarious employment, such as sex work, frequently face pronounced social isolation alongside other barriers to health and human rights. Although peer support has been identified as a critical HIV and violence prevention intervention for sex workers, little is known about access to peer support or its role in shaping health and social outcomes for migrant sex workers. This article analyses the role of peer support in shaping vulnerability and resilience related to HIV/STI prevention and violence among international migrant sex workers at the Mexico-Guatemala border. This qualitative study is based on 31 semi-structured interviews conducted with international migrant sex workers in the Mexico-Guatemala border communities of Tapachula, Mexico and Tecún Umán and Quetzaltenango, Guatemala. Peer support was found to be critical for reducing social isolation; improving access to HIV/STI knowledge, prevention and resources; and mitigating workplace violence, particularly at the initial stages of migration and sex work. Peer support was especially critical for countering social isolation, and peers represented a valuable source of HIV/STI prevention knowledge and resources (e.g., condoms), as well as essential safety supports in the workplace. However, challenges to accessing peer support were noted, including difficulties establishing long-lasting relationships and other forms of social participation due to frequent mobility, as well as tensions among peers within some work environments. Variations in access to peer support related to country of work, work environment, sex work and migration stage, and sex work experience were also identified. Results indicate that peer-led and community empowerment interventions represent a promising strategy for promoting the health, safety and human rights of migrant sex workers. Tailored community empowerment interventions addressing the unique migration-related contexts and challenges faced by migrant sex workers should be a focus of future community-based research, alongside promotion of broader structural changes.

Telecommunications and data acquisition systems support for Voyager missions to Jupiter and Saturn, 1972-1981, prelaunch through Saturn encounter

NASA Technical Reports Server (NTRS)

Traxler, M. R.; Beauchamp, D. F.

1983-01-01

The Deep Space Network has supported the Voyager Project for approximately nine years, during which time implementation, testing, and operational support was provided. Four years of this time involved testing prior to launch; the final five years included network operations support and additional network implementation. Intensive and critical support intervals included launch and four planetary encounters. The telecommunications and data acquisition support for the Voyager Missions to Jupiter and Saturn are summarized.

The trajectory of experience of critical care nurses in providing end-of-life care: A qualitative descriptive study.

PubMed

Ong, Keh Kiong; Ting, Kit Cheng; Chow, Yeow Leng

2018-01-01

To understand the perceptions of critical care nurses towards providing end-of-life care. There has been an increasing interest in end-of-life care in the critical care setting. In Singapore, approximately half of deaths in the hospital occur during critical care. While nurses are well positioned to provide end-of-life care to patients and their family members, they faced barriers to providing end-of-life care. Also, providing end-of-life care has profound positive and negative psychological effects on nurses, with the latter being more prominent. Qualitative descriptive design. Data collection was performed in a medical intensive care unit of a public tertiary hospital in Singapore. Ten registered nurses were purposively sampled and interviewed individually using a semi-structured interview guide. A codebook was developed to guide coding, and data were thematically analysed. Rigour was maintained. Nurses went through a trajectory of experience. They experienced the culture of care and developed dissatisfaction with it. The tension shaped their perception and meaning of life and death, and they developed mechanisms to reach resolution. This study provides insight on nurses' perception as a trajectory of experience and raised several implications on clinical practice, policy and research. There is a need to alleviate the tension nurses face and to facilitate coming to terms with the tension by improving the culture of care and supporting nurses. Nurses could be involved more in decision-making and empowered to start end-of-life care conversations within the team and with family members. Communication with family members and between nurses and doctors could be improved. Support for nurses providing end-of-life care could be enhanced through promoting social networks, education and bereavement support. Further research is needed to explore ways to support and empower nurses to provide end-of-life care in critical care. © 2017 John Wiley & Sons Ltd.

Life support decision making in critical care: Identifying and appraising the qualitative research evidence.

PubMed

Giacomini, Mita; Cook, Deborah; DeJean, Deirdre

2009-04-01

The objective of this study is to identify and appraise qualitative research evidence on the experience of making life-support decisions in critical care. In six databases and supplementary sources, we sought original research published from January 1990 through June 2008 reporting qualitative empirical studies of the experience of life-support decision making in critical care settings. Fifty-three journal articles and monographs were included. Of these, 25 reported prospective studies and 28 reported retrospective studies. We abstracted methodologic characteristics relevant to the basic critical appraisal of qualitative research (prospective data collection, ethics approval, purposive sampling, iterative data collection and analysis, and any method to corroborate findings). Qualitative research traditions represented include grounded theory (n = 15, 28%), ethnography or naturalistic methods (n = 15, 28%), phenomenology (n = 9, 17%), and other or unspecified approaches (n = 14, 26%). All 53 documents describe the research setting; 97% indicate purposive sampling of participants. Studies vary in their capture of multidisciplinary clinician and family perspectives. Thirty-one (58%) report research ethics board review. Only 49% report iterative data collection and analysis, and eight documents (15%) describe an analytically driven stopping point for data collection. Thirty-two documents (60%) indicated a method for corroborating findings. Qualitative evidence often appears outside of clinical journals, with most research from the United States. Prospective, observation-based studies follow life-support decision making directly. These involve a variety of participants and yield important insights into interactions, communication, and dynamics. Retrospective, interview-based studies lack this direct engagement, but focus on the recollections of fewer types of participants (particularly patients and physicians), and typically address specific issues (communication and stress). Both designs can provide useful reflections for improving care. Given the diversity of qualitative research in critical care, room for improvement exists regarding both the quality and transparency of reported methodology.

Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: obese patient.

PubMed

Mesejo, A; Sánchez Álvarez, C; Arboleda Sánchez, J A

2011-11-01

As a response to metabolic stress, obese critically-ill patients have the same risk of nutritional deficiency as the non-obese and can develop protein-energy malnutrition with accelerated loss of muscle mass. The primary aim of nutritional support in these patients should be to minimize loss of lean mass and accurately evaluate energy expenditure. However, routinely used formulae can overestimate calorie requirements if the patient's actual weight is used. Consequently, the use of adjusted or ideal weight is recommended with these formulae, although indirect calorimetry is the method of choice. Controversy surrounds the question of whether a strict nutritional support criterion, adjusted to the patient's requirements, should be applied or whether a certain degree of hyponutrition should be allowed. Current evidence suggested that hypocaloric nutrition can improve results, partly due to a lower rate of infectious complications and better control of hyperglycemia. Therefore, hypocaloric and hyperproteic nutrition, whether enteral or parenteral, should be standard practice in the nutritional support of critically-ill obese patients when not contraindicated. Widely accepted recommendations consist of no more than 60-70% of requirements or administration of 11-14 kcal/kg current body weight/day or 22-25 kcal/kg ideal weight/day, with 2-2.5 g/kg ideal weight/day of proteins. In a broad sense, hypocaloric-hyperprotein regimens can be considered specific to obese critically-ill patients, although the complications related to comorbidities in these patients may require other therapeutic possibilities to be considered, with specific nutrients for hyperglycemia, acute respiratory distress syndrome (ARDS) and sepsis. However, there are no prospective randomized trials with this type of nutrition in this specific population subgroup and the available data are drawn from the general population of critically-ill patients. Consequently, caution should be exercised when interpreting these data.

Research utilisation and critical thinking among newly graduated nurses: predictors for research use. A quantitative cross-sectional study.

PubMed

Wangensteen, Sigrid; Johansson, Inger S; Björkström, Monica E; Nordström, Gun

2011-09-01

The aim was to describe research utilisation among newly graduated nurses and to explore critical thinking dispositions and other individual and contextual factors as possible predictors for research use. Nurses are expected to be research users, and variations in research utilisation are explained by individual and contextual factors. To our knowledge, critical thinking dispositions have not earlier been explored as predictors for research use. A cross-sectional design was chosen. Data collection was carried out from October 2006 to April 2007 using the Research Utilization Questionnaire (RUQ) and the California Critical Thinking Disposition Inventory (CCTDI). The response rate was 33% (n =617). Pearson's chi-square test and regression analyses were used for statistical calculations. The respondents reported a positive attitude towards research, but only 24% (n = 148) were defined as research users. A significantly higher proportion of research users reported high critical thinking scores. Critical thinking explained 20% of the variance in attitude towards research and 11% of the variance in research use. Availability and support to implement research findings was the second strongest predictor for research use. Critical thinking, a significant predictor for attitude towards research and for the use of research, should be recognised and strengthened in nursing education and clinical practice. Contextual factors seem to be important for newly graduated nurses' use of research. Nurse leaders play an important role in nurturing newly graduated nurses' critical thinking and assisting them in transferring their positive attitude towards research into research use. Nurse educators play a significant role in supporting, challenging and supervising nursing students to be critical thinkers and strong believers in research utilisation. © 2011 Blackwell Publishing Ltd.

Developing strategic systems supporting communities of practice in the Georgia Department of Transportation.

DOT National Transportation Integrated Search

2011-12-01

This study is designed to explore strategies through which the Georgia Department of : Transportation (GDOT) can develop communities of practice to help employees facilitate critical : exchanges of knowledge, support organizational learning, and ulti...

Probiotics and diarrhoea management in enterally tube fed critically ill patients--what is the evidence?

PubMed

Jack, Leanne; Coyer, Fiona; Courtney, Mary; Venkatesh, Bala

2010-12-01

The aim of this literature review is to identify the role of probiotics in the management of enteral tube feeding (ETF) diarrhoea in critically ill patients. Diarrhoea is a common gastrointestinal problem seen in ETF patients. The incidence of diarrhoea in tube fed patients varies from 2% to 68% across all patients. Despite extensive investigation, the pathogenesis surrounding ETF diarrhoea remains unclear. Evidence to support probiotics to manage ETF diarrhoea in critically ill patients remains sparse. Literature on ETF diarrhoea and probiotics in critically ill, adult patients was reviewed from 1980 to 2010. The Cochrane Library, Pubmed, Science Direct, Medline and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) electronic databases were searched using specific inclusion/exclusion criteria. Key search terms used were: enteral nutrition, diarrhoea, critical illness, probiotics, probiotic species and randomised clinical control trial (RCT). Four RCT papers were identified with two reporting full studies, one reporting a pilot RCT and one conference abstract reporting an RCT pilot study. A trend towards a reduction in diarrhoea incidence was observed in the probiotic groups. However, mortality associated with probiotic use in some severely and critically ill patients must caution the clinician against its use. Evidence to support probiotic use in the management of ETF diarrhoea in critically ill patients remains unclear. This paper argues that probiotics should not be administered to critically ill patients until further research has been conducted to examine the causal relationship between probiotics and mortality, irrespective of the patient's disease state or projected prophylactic benefit of probiotic administration. Copyright © 2010 Elsevier Ltd. All rights reserved.

Using Digital Comics to Develop Digital Literacy: Fostering Functionally, Critically, and Rhetorically Literate Students

ERIC Educational Resources Information Center

Kirchoff, Jeff

2017-01-01

Literacy scholarship has established the importance of teaching, supporting, and facilitating digital literacy education for 21st century students. Stuart Selber goes a step further, arguing that students must be functionally (using digital technology), critically (questioning digital technology), and rhetorically (producing effective digital…

EVALUATING HYDROLOGICAL RESPONSE TO FORECASTED LAND-USE CHANGE: SCENARIO TESTING IN TWO WESTERN U.S. WATERSHEDS

EPA Science Inventory

Envisioning and evaluating future scenarios has emerged as a critical component of both science and social decision-making. The ability to assess, report, map, and forecast the life support functions of ecosystems is absolutely critical to our capacity to make informed decisions ...

Is There Room for Criticism of Studies of Psychodynamic Psychotherapy?

ERIC Educational Resources Information Center

Thombs, Brett D.; Jewett, Lisa R.; Bassel, Marielle

2011-01-01

Comments on the original article, "The efficacy of psychodynamic psychotherapy," by J. Shedler. Shedler declared unequivocally that "empirical evidence supports the efficacy of psychodynamic therapy" (p. 98). He did not mention any specific criticisms that have been made of evidence on psychodynamic psychotherapies or address possible distinctions…

Critical Mentoring Practices to Support Diverse Students in Higher Education: Chicana/Latina Faculty Perspectives

ERIC Educational Resources Information Center

Figueroa, Julie López; Rodriguez, Gloria M.

2015-01-01

This chapter outlines critical practices that emerged from utilizing social justice frameworks to mentor first-generation, underrepresented minority students at the undergraduate to doctoral levels. The mentoring strategies include helping students to reframe instances when faculty and peers unconsciously conflate academic rigor with color-blind…

Critical evaluation and thermodynamic assessment of the ZrPb system

NASA Astrophysics Data System (ADS)

Arias, D.; Abriata, J.; Gribaudo, L.

1996-04-01

In the present work we have critically evaluated the existing experimental information regarding phase stabilities in the ZrPb system. From this, the ZrPb phase diagram has been assessed up to 50 at.% Pb. The proposed diagram has been further supported by a thermodynamic model calculation.

Exploring Practice-Research Networks for Critical Professional Learning

ERIC Educational Resources Information Center

Appleby, Yvon; Hillier, Yvonne

2012-01-01

This paper discusses the contribution that practice-research networks can make to support critical professional development in the Learning and Skills sector in England. By practice-research networks we mean groups or networks which maintain a connection between research and professional practice. These networks stem from the philosophy of…

"Migratory Literature": A "Third Place" for Intercultural Teaching and Learning of Chinese as a Second Language?

ERIC Educational Resources Information Center

Hay, Trevor; Wang, Yongyang

2010-01-01

This paper, drawing upon multidisciplinary studies such as critical and cultural studies, literary criticism, intercultural communication and second language acquisition, suggests a specific literary genre--"migratory literature"--to support intercultural competence for learners of Chinese. We begin by elucidating key…

Fostering Critical Thinking in Undergraduate Nursing Students

ERIC Educational Resources Information Center

LuPone, Kathleen A.

2017-01-01

Results from previous studies indicated nursing students needed to further develop critical thinking (CT) especially with respect to employing it in their clinical reasoning. Thus, the study was conducted to support development of students' CT in the areas of inference subskills that could be applied as they engaged in clinical reasoning during…

Postsecondary Instructor Attitudes toward Tablet Use for Collaboration and Critical Thinking Development

ERIC Educational Resources Information Center

Hubbard, Jerry D.

2017-01-01

Although research has identified critical thinking (CT) as an objective of higher education, limited quantitative research has focused on how postsecondary instructors view using handheld devices for classroom collaboration to support CT. There are studies examining how the use of tablet technologies influence collaborative learning (CL), showing…

Open Education and Critical Pedagogy

ERIC Educational Resources Information Center

Farrow, Robert

2017-01-01

This paper argues for a revaluation of the potential of open education to support more critical forms of pedagogy. Section 1 examines contemporary discourses around open education, offering a commentary on the perception of openness as both a disruptive force in education, and a potential solution to contemporary challenges. Section 2 examines the…

Critically Reflective Work Behaviour within Autonomous Professionals' Learning Communities

ERIC Educational Resources Information Center

de Groot, Esther; van den Berg, B. A. M.; Endedijk, M. D.; van Beukelen, P.; Simons, P. R. J.

2011-01-01

Informal learning communities in which participants show critically reflective work behaviour (CRWB) have the potential to support lifelong learning. In practice this behaviour does not always occur in groups of autonomous professionals. This study explores design principles (DPs) that could act as social affordances for CRWB, within the context…

U.S.-EU Cooperation Against Terrorism

DTIC Science & Technology

2014-12-01

Administration continues to support the VWP as a key facilitator of transatlantic commerce and tourism , and rejects calls from some critics to suspend it...were subject to widespread criticism in Europe; these included the U.S.-run detention facility at Guantánamo Bay, Cuba ; U.S. plans to try enemy

Nutrition of the critically ill patient in field hospitals on operations.

PubMed

Henning, J; Scott, T; Price, S

2008-12-01

Although much of the evidence is inconclusive, most of it is based on small patient groups it is generally supportive of early, enteral feeding of critically ill patients. It has become a standard of care in the UK and as such should be encouraged in deployed operational ITUs.

Applications of Diagnostic Classification Models: A Literature Review and Critical Commentary

ERIC Educational Resources Information Center

Sessoms, John; Henson, Robert A.

2018-01-01

Diagnostic classification models (DCMs) classify examinees based on the skills they have mastered given their test performance. This classification enables targeted feedback that can inform remedial instruction. Unfortunately, applications of DCMs have been criticized (e.g., no validity support). Generally, these evaluations have been brief and…

Critical Success Factors in a High School Healthcare Education Program

ERIC Educational Resources Information Center

Thessin, Rebecca A.; Scully-Russ, Ellen; Lieberman, Daina S.

2017-01-01

Research has demonstrated career and technical education (CTE) programs have a strong positive influence on secondary students' behavior, attendance, academic achievement, and college persistence. Critical success factors common to career academies, small schools, and CTE programs include socio-emotional support and community, along with a culture…

Approaching Reflexivity through Reflection: Issues for Critical Management Education

ERIC Educational Resources Information Center

Hibbert, Paul

2013-01-01

This conceptual article seeks to develop insights for teaching reflexivity in undergraduate management classes through developing processes of critical reflection. Theoretical inferences to support this aim are developed and organized in relation to four principles. They are as follows: first, preparing and making space for reflection in the…

Critical Success Factors for Knowledge Transfer Collaborations between University and Industry

ERIC Educational Resources Information Center

Schofield, Tatiana

2013-01-01

In a fast moving business environment university-industry collaborations play a critical role in contributing to national economies and furthering a competitive advantage. Knowledge transfer from university to industry is supported by national governments as part of their innovation, national growth and competitiveness agenda. A…

The Topological Primacy Thesis: Genetic and Didactic Aspects.

ERIC Educational Resources Information Center

Schipper, Wilhelm

1983-01-01

Several critical questions concerning the topological primacy thesis were raised in an extensive literature survey (SE 531 428). Three points related to this criticism are discussed and reinforced, including a reexamination of Laurendeau and Pinard's data (showing that they do not support the hypothesis of topological primacy in children's…

Visual Literacy, Creativity and the Teaching of Argument

ERIC Educational Resources Information Center

Shivers, James; Levenson, Cyra; Tan, Mei

2017-01-01

A vibrant theory of change capable of fueling critical practice may be an indispensable feature of teaching argument in secondary education. According to the PIE model (Perception, Interpretation, Expression), layers of experience build a cognitive scaffold to support the development of critical skills. In addition, incorporating works of art and…

A Cross-Industry Review of B2B Critical Success Factors.

ERIC Educational Resources Information Center

Eid, Riyad; Trueman, Myfanwy; Ahmed, Abdel Moneim

2002-01-01

Presents a comprehensive review of B2B (business-to- business) international Internet marketing and identifies 21 critical success factors in five categories: marketing strategy, including management support, strategic goals, and collaboration; Web site factors, including Web site design; global factors, including multilanguage sites and cultural…

QoS enabled dissemination of managed information objects in a publish-subscribe-query information broker

NASA Astrophysics Data System (ADS)

Loyall, Joseph P.; Carvalho, Marco; Martignoni, Andrew, III; Schmidt, Douglas; Sinclair, Asher; Gillen, Matthew; Edmondson, James; Bunch, Larry; Corman, David

2009-05-01

Net-centric information spaces have become a necessary concept to support information exchange for tactical warfighting missions using a publish-subscribe-query paradigm. To support dynamic, mission-critical and time-critical operations, information spaces require quality of service (QoS)-enabled dissemination (QED) of information. This paper describes the results of research we are conducting to provide QED information exchange in tactical environments. We have developed a prototype QoS-enabled publish-subscribe-query information broker that provides timely delivery of information needed by tactical warfighters in mobile scenarios with time-critical emergent targets. This broker enables tailoring and prioritizing of information based on mission needs and responds rapidly to priority shifts and unfolding situations. This paper describes the QED architecture, prototype implementation, testing infrastructure, and empirical evaluations we have conducted based on our prototype.

Critical Seismic Vector Random Excitations for Multiply Supported Structures

NASA Astrophysics Data System (ADS)

Sarkar, A.; Manohar, C. S.

1998-05-01

A method for determining critical power spectral density matrix models for earthquake excitations which maximize steady response variance of linear multiply supported extended structures and which also satisfy constraints on input variance, zero crossing rates, frequency content and transmission time lag has been developed. The optimization problem is shown to be non-linear in nature and solutions are obtained by using an iterative technique which is based on linear programming method. A constraint on entropy rate as a measure of uncertainty which can be expected in realistic earthquake ground motions is proposed which makes the critical excitations more realistic. Two special cases are also considered. Firstly, when knowledge of autospectral densities is available, the critical response is shown to be produced by fully coherent excitations which are neither in-phase nor out-of-phase. The critical phase between the excitation components depends on structural parameters, but independent of the auto-spectral densities of the excitations. Secondly, when the knowledge of autospectral densities and phase spectrum of the excitations is available, the critical response is shown to be produced by a system dependent coherence function representing neither fully coherent nor fully incoherent ground motions. The applications of these special cases are discussed in the context of land-based extended structures and secondary systems such as nuclear piping assembly. Illustrative examples on critical inputs and response of sdof and a long-span suspended cable which demonstrated the various features of the approach developed are presented.

Configuration Management (CM) Support for KM Processes at NASA/Johnson Space Center (JSC)

NASA Technical Reports Server (NTRS)

Cioletti, Louis

2010-01-01

Collection and processing of information are critical aspects of every business activity from raw data to information to an executable decision. Configuration Management (CM) supports KM practices through its automated business practices and its integrated operations within the organization. This presentation delivers an overview of JSC/Space Life Sciences Directorate (SLSD) and its methods to encourage innovation through collaboration and participation. Specifically, this presentation will illustrate how SLSD CM creates an embedded KM activity with an established IT platform to control and update baselines, requirements, documents, schedules, budgets, while tracking changes essentially managing critical knowledge elements.

Evaluating the fundamental critical care support course in critical care education in Japan: a survey of Japanese fundamental critical care support course experience.

PubMed

Atagi, Kazuaki; Nishi, Shinichi; Fujitani, Shigeki; Kodama, Takamitsu; Ishikawa, Junya; Shimaoka, Hideki

2013-01-01

The Fundamental Critical Care Support (FCCS) course has been introduced after minimal adaptation according to Japanese clinical settings. The original course in the USA is often used to prepare residents for rotations in the intensive care unit (ICU). Therefore, the FCCS program can be appropriate for the basic training of critical care in Japan to standardize critical care management. The purpose of this study is to evaluate whether Japanese FCCS course is useful and has a possibility to deserve a basis of critical care management in Japan. The course program was provided with the form of lecture and skills stations. Pre- and post-training knowledge was assessed. After completion of the 2-day course, a questionnaire survey was administered to all course participants. Participants were asked to fill out the questions regarding socio-demographic characteristics. Participants were also asked to identify which lectures or skill stations they thought to be useful for clinical practice. Then, they were asked to rate their performance of each field: 'Assessment,' 'Diagnosis,' 'Recognition,' 'Response,' and 'Transfer'. The number of participants increased year after year and reached 1,804 during the past 4 years. Nearly 70% of the participants were physicians. Most of the others were nurses. In the established year, the percentage of physicians who had clinical experience more than 5 years exceeded 50%, however, this percentage gradually decreased. On the contrary, the percentages of residents and nurses increased. Regarding useful sessions, nearly half of the participants thought that mechanical ventilation was the most useful. With regard to the results of pre- and post-tests, the participants had already shown a high average mark (78.8 ± 14.1) at the pre-test. Furthermore, the score at the post-test was significantly improved (82.0 ± 6.6, p < 0.01). The participants' confidence in any field regarding critical care management was almost 4 points (5-point scale). It is considered that Japanese FCCS course is useful and has a promising basis of critical care management in Japan. Therefore, it is reasonable to think that Japanese FCCS mission has been successfully achieved.

Choice is good, but relevance is excellent: autonomy-enhancing and suppressing teacher behaviours predicting students' engagement in schoolwork.

PubMed

Assor, Avi; Kaplan, Haya; Roth, Guy

2002-06-01

This article examines two questions concerning teacher-behaviours that are characterised in Self-Determination Theory (Ryan & Deci, 2000) as autonomy-supportive or suppressive: (1) Can children differentiate among various types of autonomy-enhancing and suppressing teacher behaviours? (2) Which of those types of behaviour are particularly important in predicting feelings toward and engagement in schoolwork? It was hypothesised that teacher behaviours that help students to understand the relevance of schoolwork for their personal interests and goals are particularly important predictors of engagement in schoolwork. Israeli students in grades 3-5 (N = 498) and in grades 6-8 (N = 364) completed questionnaires assessing the variables of interest. Smallest Space Analyses indicated that both children and early adolescents can differentiate among three types of autonomy enhancing teacher behaviours - fostering relevance, allowing criticism, and providing choice - and three types of autonomy suppressing teacher behaviours - suppressing criticism, intruding, and forcing unmeaningful acts. Regression analyses supported the hypothesis concerning the importance of teacher behaviours that clarify the personal relevance of schoolwork. Among the autonomy-suppressing behaviours, 'Criticism-suppression' was the best predictor of feelings and engagement. The findings underscore the active and empathic nature of teachers' role in supporting students' autonomy, and suggest that autonomy-support is important not only for early adolescents but also for children. Discussion of potential determinants of the relative importance of various autonomy-affecting teacher actions suggests that provision of choice should not always be viewed as a major indicator of autonomy support.

Measurement and comparison of nursing faculty members' critical thinking skills.

PubMed

Blondy, Laurie C

2011-03-01

Nursing faculty members strive to teach students to think critically. It has long been assumed that nursing faculty members are good at critical thinking because they are expected to teach these skills to students, but this assumption has not been well supported empirically. Faculty members question their ability to think critically and are unsure of their skills. The purpose of this study was to address this assumption by measuring nursing faculty members' critical thinking skills and compare the faculty mean score to that of a student norming group, and to the mean scores of other nursing faculty studies. Findings can be used to increase nursing faculty members' understanding of their critical thinking skills, prompt discussion about critical thinking skills, and to help faculty members address concerns and uncertainty about the concept of critical thinking. This study also helps establish an empirical basis for future research.

Ideology and Palliative Care: Moral Hazards at the Bedside.

PubMed

Rhodes, Rosamond; Strain, James J

2018-01-01

Palliative care has had a long-standing commitment to teaching medical students and other medical professionals about pain management, communication, supporting patients in their decisions, and providing compassionate end-of-life care. Palliative care programs also have a critical role in helping patients understand medical conditions, and in supporting them in dealing with pain, fear of dying, and the experiences of the terminal phase of their lives. We applaud their efforts to provide that critical training and fully support their continued important work in meeting the needs of patients and families. Although we appreciate the contributions of palliative care services, we have noted a problem involving some palliative care professionals' attitudes, methods of decisionmaking, and use of language. In this article we explain these problems by discussing two cases that we encountered.

LANL Institutional Decision Support By Process Modeling and Analysis Group (AET-2)

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

Booth, Steven Richard

2016-04-04

AET-2 has expertise in process modeling, economics, business case analysis, risk assessment, Lean/Six Sigma tools, and decision analysis to provide timely decision support to LANS leading to continuous improvement. This capability is critical during the current tight budgetary environment as LANS pushes to identify potential areas of cost savings and efficiencies. An important arena is business systems and operations, where processes can impact most or all laboratory employees. Lab-wide efforts are needed to identify and eliminate inefficiencies to accomplish Director McMillan’s charge of “doing more with less.” LANS faces many critical and potentially expensive choices that require sound decision supportmore » to ensure success. AET-2 is available to provide this analysis support to expedite the decisions at hand.« less

The Role of GIS and Data Librarians in Cyber-infrastructure Support and Governance

NASA Astrophysics Data System (ADS)

Branch, B. D.

2012-12-01

A governance road-map for cyber-infrastructure in the geosciences will include an intentional librarian core capable of technical skills that include GIS and open source support for data curation that involves all aspects of data life cycle management. Per Executive Order 12906 and other policy; spatial data, literacy, and curation are critical cyber-infrastructure needs in the near future. A formal earth science and space informatics librarian may be an outcome of such development. From e-science to e-research, STEM pipelines need librarians as critical data intermediaries in technical assistance and collaboration efforts with scientists' data and outreach needs. Future training concerns should advocate trans-disciplinary data science and policy skills that will be necessary for data management support and procurement.

Resident and user support for urban natural areas restoration practices

Treesearch

Paul H. Gobster; Kristin Floress; Lynne M. Westphal; Cristy A. Watkins; Joanne Vining; Alaka Wali

2016-01-01

Public support is important to the success of natural areas restoration programs. Support can be especially critical in urban settings where stakeholders recreate in or reside near natural areas but may lack familiarity with practices for managing ecological processes. Surveys of on-site recreationists and nearby residents (N= 888) of 11 Chicago metropolitan natural...

A Community Support Program for Children with Autism and Their Typically Developing Siblings: Initial Investigation

ERIC Educational Resources Information Center

Kryzak, Lauren A.; Cengher, Mirela; Feeley, Kathleen M.; Fienup, Daniel M.; Jones, Emily A.

2015-01-01

Siblings are a critical part of lifelong support for individuals with autism spectrum disorder (ASD). But siblings face their own social-emotional adjustment needs. These needs may be addressed through programs that include support groups specifically for the siblings. This study examined the effects of a community program on typical siblings'…

External Technical Support for School Improvement: Critical Issues from the Chilean Experience

ERIC Educational Resources Information Center

Osses, Alejandra; Bellei, Cristián; Valenzuela, Juan Pablo

2015-01-01

To what extent school improvement processes can be initiated and sustained from the outside has been a relevant question for policy-makers seeking to increase quality in education. Since 2008, the Chilean Government is strongly promoting the use of external technical support (ETS) services to support school improvement processes, as part of the…

The Retreat from Widening Participation? The National Scholarship Programme and New Access Agreements in English Higher Education

ERIC Educational Resources Information Center

McCaig, Colin

2016-01-01

This article critically analyses the impact of reforms to the student financial support system in English higher education. Comparative analysis of financial support mechanisms and patterns of outreach engagement with groups underrepresented in higher education show a marked deterioration in the levels of cash support available and an increasingly…

Families Support Their Children's Success in Science Learning by Influencing Interest and Self-efficacy

ERIC Educational Resources Information Center

Sha, Li; Schunn, Christian; Bathgate, Meghan; Ben-Eliyahu, Adar

2016-01-01

How is a child's successful participation in science learning shaped by their family's support? We focus on the critical time period of early adolescents, testing (i) whether the child's perception of family support is important for both choice preferences to participate in optional learning experiences and engagement during science learning, and…

Using a Blog to Create and Support a Community of Inquiry in Secondary Education

ERIC Educational Resources Information Center

Pifarre, Manoli; Guijosa, Alex; Argelagos, Esther

2014-01-01

Understanding how blogs can support collaborative learning is a vital concern for researchers and teachers. This article explores how blogs may be used to support secondary education students' collaborative interaction and how such an interaction process can promote the creation of a Community of Inquiry to enhance critical thinking and…

NASA Advanced Exploration Systems: Advancements in Life Support Systems

NASA Technical Reports Server (NTRS)

Shull, Sarah A.; Schneider, Walter F.

2016-01-01

The NASA Advanced Exploration Systems (AES) Life Support Systems (LSS) project strives to develop reliable, energy-efficient, and low-mass spacecraft systems to provide environmental control and life support systems (ECLSS) critical to enabling long duration human missions beyond low Earth orbit (LEO). Highly reliable, closed-loop life support systems are among the capabilities required for the longer duration human space exploration missions assessed by NASA’s Habitability Architecture Team.

Application of the network robustness index to identify critical links supporting Vermont's Bulk milk transportation.

DOT National Transportation Integrated Search

2011-08-18

The food supply chain is an interwoven network consisting of producers, processors, : manufacturers, distributors, retailers, and consumers. With the exception of direct : marketing or community-supported agriculture systems, some or all of these int...

The Department of Energy Nuclear Criticality Safety Program

NASA Astrophysics Data System (ADS)

Felty, James R.

2005-05-01

This paper broadly covers key events and activities from which the Department of Energy Nuclear Criticality Safety Program (NCSP) evolved. The NCSP maintains fundamental infrastructure that supports operational criticality safety programs. This infrastructure includes continued development and maintenance of key calculational tools, differential and integral data measurements, benchmark compilation, development of training resources, hands-on training, and web-based systems to enhance information preservation and dissemination. The NCSP was initiated in response to Defense Nuclear Facilities Safety Board Recommendation 97-2, Criticality Safety, and evolved from a predecessor program, the Nuclear Criticality Predictability Program, that was initiated in response to Defense Nuclear Facilities Safety Board Recommendation 93-2, The Need for Critical Experiment Capability. This paper also discusses the role Dr. Sol Pearlstein played in helping the Department of Energy lay the foundation for a robust and enduring criticality safety infrastructure.

Theory, Design, and Algorithms for Optimal Control of wireless Networks

DTIC Science & Technology

2010-06-09

The implementation of network-centric warfare technologies is an abiding, critical interest of Air Force Science and Technology efforts for the Warfighter. Wireless communications, strategic signaling are areas of critical Air Force Mission need. Autonomous networks of multiple, heterogeneous Throughput enhancement and robust connectivity in communications and sensor networks are critical factors in net-centric USAF operations. This research directly supports the Air Force vision of information dominance and the development of anywhere, anytime operational readiness.

Configurational entropy of critical earthquake populations

NASA Astrophysics Data System (ADS)

Goltz, C.; Böse, M.

2002-10-01

We present an approach to describe the evolution of distributed seismicity by configurational entropy. We demonstrate the detection of phase transitions in the sense of a critical point phenomenon in a 2D site-percolation model and in temporal and spatial vicinity to the 1992, M7.3 Landers earthquake in Southern California. Our findings support the assumption of intermittent criticality in the Earth's crust. We also address the potential usefulness of the method for earthquake catalogue declustering.

A tensor product state approach to spin-1/2 square J1-J2 antiferromagnetic Heisenberg model: evidence for deconfined quantum criticality

NASA Astrophysics Data System (ADS)

Wang, Ling; Gu, Zheng-Cheng; Verstraete, Frank; Wen, Xiang-Gang

We study this model using the cluster update algorithm for tensor product states (TPSs). We find that the ground state energies at finite sizes and in the thermodynamic limit are in good agreement with the exact diagonalization study. At the largest bond dimension available D = 9 and through finite size scaling of the magnetization order near the transition point, we accurately determine the critical point J2c1 = 0 . 53 (1) J1 and the critical exponents β = 0 . 50 (4) . In the intermediate region we find a paramagnetic ground state without any static valence bond solid (VBS) order, supported by an exponentially decaying spin-spin correlation while a power law decaying dimer-dimer correlation. By fitting a universal scaling function for the spin-spin correlation we find the critical exponents ν = 0 . 68 (3) and ηs = 0 . 34 (6) , which is very close to the observed critical exponents for deconfined quantum critical point (DQCP) in other systems. Thus our numerical results strongly suggest a Landau forbidden phase transition from Neel order to VBS order at J2c1 = 0 . 53 (1) J1 . This project is supported by the EU Strep project QUEVADIS, the ERC Grant QUERG, and the FWF SFB Grants FoQuS and ViCoM; and the Institute for Quantum Information and Matter.

Sarcopenia and critical illness: a deadly combination in the elderly.

PubMed

Hanna, Joseph S

2015-03-01

Sarcopenia is the age-associated loss of lean skeletal muscle mass. It is the result of multiple physiologic derangements, ultimately resulting in an insidious functional decline. Frailty, the clinical manifestation of sarcopenia and physical infirmity, is associated with significant morbidity and mortality in the elderly population. The underlying pathology results in a disruption of the individual's ability to tolerate internal and external stressors such as injury or illness. This infirmity results in a markedly increased risk of falls and subsequent morbidity and mortality from the resulting traumatic injury, as well as an inability to recover from medical insults, resulting in critical illness. The increasing prevalence of sarcopenia and critical illness in the elderly has resulted in a deadly intersection of disease processes. The lethality of this combination appears to be the result of altered muscle metabolism, decreased mitochondrial energetics needed to survive critical illness, and a chronically activated catabolic state likely mediated by tumor necrosis factor-α. Furthermore, these underlying derangements are independently associated with an increased incidence of critical illness, resulting in a progressive downward spiral. Considerable evidence has been gathered supporting the role of aggressive nutrition support and physical therapy in improving outcomes. Critical care practitioners must consider sarcopenia and the resulting frailty phenotype a comorbid condition so that the targeted interventions can be instituted and research efforts focused. © 2015 American Society for Parenteral and Enteral Nutrition.

Application of queueing models to multiprogrammed computer systems operating in a time-critical environment

NASA Technical Reports Server (NTRS)

Eckhardt, D. E., Jr.

1979-01-01

A model of a central processor (CPU) which services background applications in the presence of time critical activity is presented. The CPU is viewed as an M/M/1 queueing system subject to periodic interrupts by deterministic, time critical process. The Laplace transform of the distribution of service times for the background applications is developed. The use of state of the art queueing models for studying the background processing capability of time critical computer systems is discussed and the results of a model validation study which support this application of queueing models are presented.

The Changing Role of Palliative Care in the ICU

PubMed Central

Aslakson, Rebecca A.; Curtis, J. Randall; Nelson, Judith E.

2015-01-01

Objectives Palliative care is an interprofessional specialty as well as an approach to care by all clinicians caring for patients with serious and complex illness. Unlike hospice, palliative care is based not on prognosis but on need and is an essential component of comprehensive care for critically ill patients from the time of ICU admission. In this clinically focused article, we review evidence of opportunities to improve palliative care for critically ill adults, summarize strategies for ICU palliative care improvement, and identify resources to support implementation. Data Sources We searched the MEDLINE database from inception through January 2014. We also searched the Reference Library of The Improving Palliative Care in the ICU Project website sponsored by the National Institutes of Health and the Center to Advance Palliative Care, which is updated monthly. We hand-searched reference lists and author files. Study Selection Selected studies included all English-language articles concerning adult patients using the search terms "intensive care" or "critical care" with "palliative care," "supportive care," "end-of-life care," or "ethics." Data Extraction After examination of peer-reviewed original scientific articles, consensus statements, guidelines, and reviews resulting from our literature search, we made final selections based on author consensus. Data Synthesis Existing evidence is organized to address: 1) opportunities to alleviate physical and emotional symptoms, improve communication, and provide support for patients and families; 2) models and specific interventions for improving ICU palliative care; 3) available resources for ICU palliative care improvement; and 4) ongoing challenges and targets for future research. Key domains of ICU palliative care have been defined and operationalized as measures of quality. There is increasing recognition that effective integration of palliative care during acute and chronic critical illness may help patients and families face challenges after discharge from intensive care. Conclusions Palliative care is increasingly accepted as an essential component of comprehensive care for critically ill patients, regardless of diagnosis or prognosis. A variety of strategies to improve ICU palliative care appear to be effective, and resources including technical assistance and tools are available to support improvement efforts. As the longer-term impact of intensive care on those surviving acute critical illness is increasingly documented, palliative care can help prepare and support patients and families for challenges after ICU discharge. Further research is needed to inform efforts to integrate palliative care with intensive care more effectively and efficiently in and after the ICU and to document improvement using valid and responsive outcome measures. PMID:25167087

Critical experiments at Sandia National Laboratories : technical meeting on low-power critical facilities and small reactors.

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

Harms, Gary A.; Ford, John T.; Barber, Allison Delo

2010-11-01

Sandia National Laboratories (SNL) has conducted radiation effects testing for the Department of Energy (DOE) and other contractors supporting the DOE since the 1960's. Over this period, the research reactor facilities at Sandia have had a primary mission to provide appropriate nuclear radiation environments for radiation testing and qualification of electronic components and other devices. The current generation of reactors includes the Annular Core Research Reactor (ACRR), a water-moderated pool-type reactor, fueled by elements constructed from UO2-BeO ceramic fuel pellets, and the Sandia Pulse Reactor III (SPR-III), a bare metal fast burst reactor utilizing a uranium-molybdenum alloy fuel. The SPR-IIImore » is currently defueled. The SPR Facility (SPRF) has hosted a series of critical experiments. A purpose-built critical experiment was first operated at the SPRF in the late 1980's. This experiment, called the Space Nuclear Thermal Propulsion Critical Experiment (CX), was designed to explore the reactor physics of a nuclear thermal rocket motor. This experiment was fueled with highly-enriched uranium carbide fuel in annular water-moderated fuel elements. The experiment program was completed and the fuel for the experiment was moved off-site. A second critical experiment, the Burnup Credit Critical Experiment (BUCCX) was operated at Sandia in 2002. The critical assembly for this experiment was based on the assembly used in the CX modified to accommodate low-enriched pin-type fuel in water moderator. This experiment was designed as a platform in which the reactivity effects of specific fission product poisons could be measured. Experiments were carried out on rhodium, an important fission product poison. The fuel and assembly hardware for the BUCCX remains at Sandia and is available for future experimentation. The critical experiment currently in operation at the SPRF is the Seven Percent Critical Experiment (7uPCX). This experiment is designed to provide benchmark reactor physics data to support validation of the reactor physics codes used to design commercial reactor fuel elements in an enrichment range above the current 5% enrichment cap. A first set of critical experiments in the 7uPCX has been completed. More experiments are planned in the 7uPCX series. The critical experiments at Sandia National Laboratories are currently funded by the US Department of Energy Nuclear Criticality Safety Program (NCSP). The NCSP has committed to maintain the critical experiment capability at Sandia and to support the development of a critical experiments training course at the facility. The training course is intended to provide hands-on experiment experience for the training of new and re-training of practicing Nuclear Criticality Safety Engineers. The current plans are for the development of the course to continue through the first part of fiscal year 2011 with the development culminating is the delivery of a prototype of the course in the latter part of the fiscal year. The course will be available in fiscal year 2012.« less

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

Hopper, Calvin Mitchell

In May 1973 the University of New Mexico conducted the first nationwide criticality safety training and education week-long short course for nuclear criticality safety engineers. Subsequent to that course, the Los Alamos Critical Experiments Facility (LACEF) developed very successful 'hands-on' subcritical and critical training programs for operators, supervisors, and engineering staff. Since the inception of the US Department of Energy (DOE) Nuclear Criticality Technology and Safety Project (NCT&SP) in 1983, the DOE has stimulated contractor facilities and laboratories to collaborate in the furthering of nuclear criticality as a discipline. That effort included the education and training of nuclear criticality safetymore » engineers (NCSEs). In 1985 a textbook was written that established a path toward formalizing education and training for NCSEs. Though the NCT&SP went through a brief hiatus from 1990 to 1992, other DOE-supported programs were evolving to the benefit of NCSE training and education. In 1993 the DOE established a Nuclear Criticality Safety Program (NCSP) and undertook a comprehensive development effort to expand the extant LACEF 'hands-on' course specifically for the education and training of NCSEs. That successful education and training was interrupted in 2006 for the closing of the LACEF and the accompanying movement of materials and critical experiment machines to the Nevada Test Site. Prior to that closing, the Lawrence Livermore National Laboratory (LLNL) was commissioned by the US DOE NCSP to establish an independent hands-on NCSE subcritical education and training course. The course provided an interim transition for the establishment of a reinvigorated and expanded two-week NCSE education and training program in 2011. The 2011 piloted two-week course was coordinated by the Oak Ridge National Laboratory (ORNL) and jointly conducted by the Los Alamos National Laboratory (LANL) classroom education and facility training, the Sandia National Laboratory (SNL) hands-on criticality experiments training, and the US DOE National Criticality Experiment Research Center (NCERC) hands-on criticality experiments training that is jointly supported by LLNL and LANL and located at the Nevada National Security Site (NNSS) This paper provides the description of the bases, content, and conduct of the piloted, and future US DOE NCSP Criticality Safety Engineer Training and Education Project.« less

Scaffolding reflective journal writing - negotiating power, play and position.

PubMed

Harris, M

2008-04-01

A three-year qualitative study based on an action-research design, framed within the critical genre and using a multi-method approach, was used to establish how a model of critical reflective practice [Van Aswegen, E.J., Brink, H.I., Steyn, P.J., 2000. A model for facilitation of critical reflective practice: Part I- Introductory discussion and explanation of the phases followed to construct the model. Part ll - Conceptual analysis within the context of constructing the model. Part III - Description of the model. Curationis 23 (4), 117-135.] could be implemented. Reflective journals were introduced as one of the educational strategies within the model to support and sustain 'deep' transformatory learning. A component of this larger study focused on how scaffolding deep learning through reflective writing is enhanced by supportive structures. These include critiquing (feedback), a mutually developed self-evaluation strategy, as well as an awareness of and sensitivity to the need for student/writer-responder negotiation. Three student groups of part-time post-basic, practicing South African nurses engaged in reflective writing over the period of an academic year. This article is based on their perceptions, mid-way through their writing, of these strategies. It reflects the story of assumptions made by educators, and challenges for change. Students find reflective writing difficult, and although they are willing to accept its value and engage in the process, they require a regular, specific and sensitive critical response from their writer-responder and follow-up supportive contact. Self-evaluation for the purposes of 'owning' their own ideas is difficult, and requires constant support and validation. Transformatory learning comes at a cost, and a revisiting of the balance of power between student and educator is in order.

The Rhetoric of Issue Advertising: A Rationale, a Case Study, a Critical Perspective--And More.

ERIC Educational Resources Information Center

Heath, Robert L.

1988-01-01

Supports the use of issue advertising. Argues that speech communication scholars can facilitate the responsible and effective use of issue ads. Reviews critics and proponents of issue advertising. Develops a rationale to guide the practice of issue advertising. Examines issue advertising in the current pro-nuclear campaign. (MS)

Complexity, Methodology and Method: Crafting a Critical Process of Research

ERIC Educational Resources Information Center

Alhadeff-Jones, Michel

2013-01-01

This paper defines a theoretical framework aiming to support the actions and reflections of researchers looking for a "method" in order to critically conceive the complexity of a scientific process of research. First, it starts with a brief overview of the core assumptions framing Morin's "paradigm of complexity" and Le…

EVALUATING HYDROLOGICAL RESPONSE TO FORECASTED LAND-USE CHANGE: SCENARIO TESTING WITH THE AUTOMATED GEOSPATIAL WATERSHED ASSESSMENT (AGWA) TOOL

EPA Science Inventory

Envisioning and evaluating future scenarios has emerged as a critical component of both science and social decision-making. The ability to assess, report, map, and forecast the life support functions of ecosystems is absolutely critical to our capacity to make informed decisions...

Evidence Based Clinical Assessment of Child and Adolescent Social Phobia: A Critical Review of Rating Scales

ERIC Educational Resources Information Center

Tulbure, Bogdan T.; Szentagotai, Aurora; Dobrean, Anca; David, Daniel

2012-01-01

Investigating the empirical support of various assessment instruments, the evidence based assessment approach expands the scientific basis of psychotherapy. Starting from Hunsley and Mash's evaluative framework, we critically reviewed the rating scales designed to measure social anxiety or phobia in youth. Thirteen of the most researched social…

Critical Thinking in Asynchronous Online Discussion: An Investigation of Student Facilitation Techniques

ERIC Educational Resources Information Center

Lim, Sze Chung Raymond; Cheung, Wing Sum; Hew, Khe Foon

2011-01-01

Background: In the last decade, asynchronous online discussion forums have become a primary focus of many educational researchers. Some advocates believed that the process of typing out messages in itself can promote in-depth critical thinking skills. Nevertheless, empirical research has not provided much support for this claim in natural…

Teaching to Teach (with) Game Design: Game Design and Learning Workshops for Preservice Teachers

ERIC Educational Resources Information Center

Akcaoglu, Mete; Kale, Ugur

2016-01-01

Engagement in game design tasks can help preservice teachers develop pedagogical and technical skills for teaching and promoting critical thinking and problem-solving skills. Through the design process, preservice teachers not only exercise critical-thinking and problem-solving skills, but also learn about an instructional method to support their…

Critical Interactions Shaping Early Academic Career Development in Two Higher Education Institutions

ERIC Educational Resources Information Center

Hemmings, Brian; Hill, Doug; Sharp, John G.

2013-01-01

This study was aimed at identifying the critical interactions within work environments that support the development of early career academics as researchers in institutions with lower order research profiles, that is, environments that differ from research-intensive universities. Ten early career academics, five from Australia and five from the…

Co-Constructing Identities, Literacies, and Contexts: Sustaining Critical Meta-Awareness with/in Urban Communities

ERIC Educational Resources Information Center

Caraballo, Limarys; Souto-Manning, Mariana

2017-01-01

Mariana Souto-Manning calls for educational researchers to move beyond traditional/oppressive forms of research toward frameworks and methods that center the concerns of participants. Such critical research represents attempts to honor and support participants' cultures, knowledge, and emerging identities in diverse urban educational contexts,…

Collaborative Learning Supported by Rubrics Improves Critical Thinking

ERIC Educational Resources Information Center

Saiz, Carlos; Rivas, Silvia F.; Olivares, Sonia

2015-01-01

In previous works we developed and assessed a teaching program, ARDESOS v.1, with which we aimed to improve the fundamental skills of critical thinking. The results obtained were positive, but modest. After analyzing the limitations of the program we introduced certain modifications and assessed the new version. The changes involved designing the…

"Do It Yourself" Scholarship: From Punk Rock to Qualitative Research

ERIC Educational Resources Information Center

Relles, Stefani; Clemens, Randall

2018-01-01

The purpose of this paper is to introduce the "Do It Yourself" (DIY) framework as a mode of critical qualitative scholarship. The authors argue that the production and distribution methods used by punks, zine-makers, graffitists, and skateboarders--among others--may support the social justice intentions of critical qualitative inquiry.…

Mindfulness as an Alternative for Supporting University Student Mental Health: Cognitive-Emotional and Depressive Self-Criticism Measures

ERIC Educational Resources Information Center

Azam, Muhammad Abid; Mongrain, Myriam; Vora, Khushboo; Pirbaglou, Meysam; Azargive, Saam; Changoor, Tina; Wayne, Noah; Guglietti, Crissa; Macpherson, Alison; Irvine, Jane; Rotondi, Michael; Smith, Dawn; Perez, Daniel; Ritvo, Paul

2016-01-01

Increases in university-based mental health problems require alternative mental health programs, applicable to students with elevated psychological risks due to personality traits. This study examined the cognitive-emotional outcomes of a university mindfulness meditation (MM) program and their relationship with Self-Criticism (SC), a personality…

Elements, Principles, and Critical Inquiry for Identity-Centered Design of Online Environments

ERIC Educational Resources Information Center

Dudek, Jaclyn; Heiser, Rebecca

2017-01-01

Within higher education, a need exists for learning designs that facilitate education and support students in sharing, examining, and refining their critical identities as learners and professionals. In the past, technology-mediated identity work has focused on individual tool use or a learning setting. However, we as professional learning…

Critical Review: Medical Students' Motivation after Failure

ERIC Educational Resources Information Center

Holland, Chris

2016-01-01

About 10% of students in each years' entrants to medical school will encounter academic failure at some stage in their programme. The usual approach to supporting these students is to offer them short term remedial study programmes that often enhance approaches to study that are orientated towards avoiding failure. In this critical review I will…

Critical Factors in Mobile Learning: A Quasi-Systematic Review

ERIC Educational Resources Information Center

Rodrigues, Sergio Assis; dos Santos, Rodrigo Pereira; Arnaud, Lucas; de Souza, Jano Moreira

2013-01-01

The advance of mobile industry and research has expanded e-learning in order to support an efficient and effective educational process. However, the promised benefits are as much attractive as the existing difficulties and barriers. In this paper, we intend to identify and summarize the critical factors in mobile learning through a…

Agency, Socialization, and Support: A Critical Review of Doctoral Student Attrition

ERIC Educational Resources Information Center

Rigler, Kenneth L., Jr.; Bowlin, Linda K.; Sweat, Karen; Watts, Stephen; Throne, Robin

2017-01-01

Almost universally, residential doctoral programs have reported attrition rates of up to 50% for face-to-face programs and 50-70% for online doctoral programs. The purpose of this critical review was to explore current literature for doctoral attrition and persistence to explore reasons and attributes for improved persistence to completion. We…

The Dual Pedagogy of YPAR: Teaching Students and Students as Teachers

ERIC Educational Resources Information Center

Scorza, D'Artagnan; Bertrand, Melanie; Bautista, Mark A.; Morrell, Ernest; Matthews, Corey

2017-01-01

This article explores the pedagogical practices employed in the critical learning community of the Council of Youth Research in the 2010-2011 school year and seeks to articulate the ways in which the use of youth participatory action research (YPAR) supported problem-posing education, conscientization, and critical reflection. In reviewing the use…

Mate, You Should Know This! Re-Negotiating Practice after a Critical Incident in the Assessment of On-Job Learning

ERIC Educational Resources Information Center

Vaughan, Karen; Kear, Andrew; MacKenzie, Heath

2014-01-01

This article examines a critical incident during research investigating a new assessment system for on-job learning in carpentry. The system was designed to establish clear relationships between supportive learning environments and purposeful, professional assessment of learners' progress through "naturally occurring evidence" on…

Critical Discourse Analysis and Science Education Texts: Employing Foucauldian Notions of Discourse and Subjectivity

ERIC Educational Resources Information Center

Bazzul, Jesse

2014-01-01

This article supports critical, social justice oriented science education research by providing a theoretical and methodological basis for examining how subjectivities may be constituted through discourses found in science education texts. Such research explores how discourses orient teachers and students to the world, others, and themselves, as…

Tier 1 and Tier 2 Early Intervention for Handwriting and Composing

ERIC Educational Resources Information Center

Berninger, Virginia W.; Rutberg, Judith E.; Abbott, Robert D.; Garcia, Noelia; Anderson-Youngstrom, Marci; Brooks, Allison; Fulton, Cynthia

2006-01-01

Three studies evaluated Tier 1 early intervention for handwriting at a critical period for literacy development in first grade and one study evaluated Tier 2 early intervention in the critical period between third and fourth grades for composing on high stakes tests. The results contribute to knowledge of research-supported handwriting and…

Scenario Analysis: Evaluating Biodiversity Response to Forecasted Land-Use Change in the San Pedro River Basin (U.S.-Mexico)

EPA Science Inventory

Envisioning and evaluating future scenarios has emerged as a critical component of both science and social decision-making. The ability to assess, report, map, and forecast the life support functions of ecosystems is absolutely critical to our capacity to make informed decisions...

International Analog Criticism: The "Scandignation" Addresses of Willy Brandt and Richard Nixon.

ERIC Educational Resources Information Center

Chaly, Ingeborg

The resignation speeches of West German Chancellor Willy Brandt and United States President Richard Nixon are compared and the rhetorical efficacy of each figure is assessed in this paper. Analog criticism is employed to support the argument that in the particular subgenre of "scandignation" addresses, Brandt came much closer than Nixon…

Inclusive Education in Sweden? A Critical Analysis

ERIC Educational Resources Information Center

Goransson, Kerstin; Nilholm, Claes; Karlsson, Kristina

2011-01-01

When it comes to pupils in need of special support and pupils with disabilities, Sweden's compulsory school system is sometimes considered a one-track system. This article analyses and critically discusses current policy and practices at various levels of Sweden's compulsory school system for these pupils. The analysis traces three themes at the…

Making Meaning through Media: Scaffolding Academic and Critical Media Literacy with Texts about Schooling

ERIC Educational Resources Information Center

Kelly, Courtney; Brower, Carleigh

2017-01-01

This study investigated how an interdisciplinary first-year seminar focused on representations of schooling in popular culture supported the acquisition of an academic version of critical media literacy. The authors explore how tapping into students' funds of knowledge, constructing carefully scaffolded assignments, and offering targeted,…

What REALLY Works: Optimizing Classroom Discussions to Promote Comprehension and Critical-Analytic Thinking

ERIC Educational Resources Information Center

Murphy, P. Karen; Firetto, Carla M.; Wei, Liwei; Li, Mengyi; Croninger, Rachel M. V.

2016-01-01

Many American students struggle to perform even basic comprehension of text, such as locating information, determining the main idea, or supporting details of a story. Even more students are inadequately prepared to complete more complex tasks, such as critically or analytically interpreting information in text or making reasoned decisions from…

Supporting English Language Learners in the Science Classroom through Critical Pedagogy

ERIC Educational Resources Information Center

Alegria, Adelina

2014-01-01

This article presents an exploratory case study of a teacher's knowledge, understanding, and practice of critical pedagogy in a sheltered instruction high school biology classroom. This case study relied on the use of fieldnotes, videotape recordings, interviews, and transcripts to showcase the practices and activities taking place in the…

The Unexpected Connection: Serendipity and Human Mediation in Networked Learning

ERIC Educational Resources Information Center

Kop, Rita

2012-01-01

Major changes on the Web in recent years have contributed to an abundance of information for people to harness in their learning. Emerging technologies have instigated the need for critical literacies to support learners on open online networks in the mastering of critical information gathering during their learning journeys. This paper will argue…

Criticism of the Press: Its Social, Psychological and Political Origins.

ERIC Educational Resources Information Center

Becker, Lee B.; And Others

This study examines data from several national polls about press coverage during the Watergate scandal, in order to assess the origins of press criticism. The polls were conducted between 28 September and 6 October 1973, during June 1974, and in August 1974. The data suggest that political variables--particularly support of Nixon, party…

Development of Self-Criticism in Adolescent Girls: Roles of Maternal Dissatisfaction, Maternal Coldness, and Insecure Attachment.

ERIC Educational Resources Information Center

Thompson, Richard; Zuroff, David C.

1999-01-01

Proposed a model of the development of self-criticism in adolescent girls in which maternal dissatisfaction leads to maternal coldness. The model was supported in a sample of 54 early adolescent girls and their mothers. Discusses implications of the findings for theory and future research. (SLD)

Critical Reflection as a Framework for Transformative Learning in Teacher Education

ERIC Educational Resources Information Center

Liu, Katrina

2015-01-01

This paper presents a framework for critical reflection that teacher educators can employ to analyze prospective teachers' reflection and support their transformative learning. The author argues that teacher educators should not only pay attention to the cognitive processes of prospective teachers (how they reflect), but also the content of their…

Designing HRD Interventions for Employee-Robot Interaction

ERIC Educational Resources Information Center

Heo, Se Jin

2011-01-01

The purpose of this study was to identify critical causes of work stress and job satisfaction of nurses, which can contribute to find appropriate organizational supports to help nurses effectively work with a surgical robot. Delphi method was employed to identify the critical stressors and the key causes of job satisfaction of nurses working with…

Learning Is Like a Lava Lamp: The Student Journey to Critical Thinking

ERIC Educational Resources Information Center

Walker, Rosie

2017-01-01

This article explores the ways in which a university Foundation Degree programme supports undergraduate Early Years students to develop critical thinking, mindfulness and self-actualisation through their lived personal and professional experiences. It considers the impact of this on graduates employed within the Early Years sector. Findings inform…

Automatic Generation and Ranking of Questions for Critical Review

ERIC Educational Resources Information Center

Liu, Ming; Calvo, Rafael A.; Rus, Vasile

2014-01-01

Critical review skill is one important aspect of academic writing. Generic trigger questions have been widely used to support this activity. When students have a concrete topic in mind, trigger questions are less effective if they are too general. This article presents a learning-to-rank based system which automatically generates specific trigger…

R-WISE: A Computerized Environment for Tutoring Critical Literacy.

ERIC Educational Resources Information Center

Carlson, P.; Crevoisier, M.

This paper describes a computerized environment for teaching the conceptual patterns of critical literacy. While the full implementation of the software covers both reading and writing, this paper covers only the writing aspects of R-WISE (Reading and Writing in a Supportive Environment). R-WISE consists of a suite of computerized…

Assessing Learning in Service-Learning Courses through Critical Reflection

ERIC Educational Resources Information Center

Molee, Lenore M.; Henry, Mary E.; Sessa, Valerie I.; McKinney-Prupis, Erin R.

2010-01-01

The purpose of this study was to describe and examine a model for assessing student learning through reflection in service-learning courses. This model utilized a course-embedded process to frame, facilitate, support, and assess students' depth of learning and critical thinking. Student reflection products in two service-learning courses (a…

A Methodological Critique of "Interventions for Boys with Conduct Problems"

ERIC Educational Resources Information Center

Kent, Ronald; And Others

1976-01-01

Kent criticizes Patterson's study on treating the behavior problems of boys, on several methodological bases concluding that more rigorous research is required in this field. Patterson answers Kent's criticisms arguing that they are not based on sound grounds. Patterson offers further evidence to support the efficacy of his treatment procedures.…

Ambient Pressure Structural Quantum Critical Point in the Phase Diagram of (CaxSr1-x)3Rh4Sn13

NASA Astrophysics Data System (ADS)

Goh, Swee K.; Tompsett, D. A.; Saines, P. J.; Chang, H. C.; Matsumoto, T.; Imai, M.; Yoshimura, K.; Grosche, F. M.

The quasiskutterudite superconductor Sr3Rh4Sn13 features a pronounced anomaly in electrical resistivity at T* ~ 138 K. The anomaly is caused by a second-order structural transition, which can be tuned to 0 K by applying physical pressure and chemical pressure via the substitution of Ca for Sr. A broad superconducting dome is centered around the structural quantum critical point. Detailed analysis of the tuning parameter dependence of T* as well as insights from lattice dynamics calculations strongly support the existence of a structural quantum critical point at ambient pressure when the fraction of Ca is 0.9 (xc=0.9). This establishes the (CaxSr1-x)3Rh4Sn13 series as an important system for exploring the physics of structural quantum criticality and its interplay with the superconductivity, without the need of applying high pressures. This work was supported by CUHK (Startup Grant, Direct Grant No. 4053071), UGC Hong Kong (ECS/24300214), Trinity College (Cam- bridge), Grants-in-Aid from MEXT (No. 22350029 and 23550152) and Glasstone Bequest (Oxford).

Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004-2005.

PubMed

Davidson, Judy E; Powers, Karen; Hedayat, Kamyar M; Tieszen, Mark; Kon, Alexander A; Shepard, Eric; Spuhler, Vicki; Todres, I David; Levy, Mitchell; Barr, Juliana; Ghandi, Raj; Hirsch, Gregory; Armstrong, Deborah

2007-02-01

To develop clinical practice guidelines for the support of the patient and family in the adult, pediatric, or neonatal patient-centered ICU. A multidisciplinary task force of experts in critical care practice was convened from the membership of the American College of Critical Care Medicine (ACCM) and the Society of Critical Care Medicine (SCCM) to include representation from adult, pediatric, and neonatal intensive care units. The task force members reviewed the published literature. The Cochrane library, Cinahl, and MedLine were queried for articles published between 1980 and 2003. Studies were scored according to Cochrane methodology. Where evidence did not exist or was of a low level, consensus was derived from expert opinion. The topic was divided into subheadings: decision making, family coping, staff stress related to family interactions, cultural support, spiritual/religious support, family visitation, family presence on rounds, family presence at resuscitation, family environment of care, and palliative care. Each section was led by one task force member. Each section draft was reviewed by the group and debated until consensus was achieved. The draft document was reviewed by a committee of the Board of Regents of the ACCM. After steering committee approval, the draft was approved by the SCCM Council and was again subjected to peer review by this journal. More than 300 related studies were reviewed. However, the level of evidence in most cases is at Cochrane level 4 or 5, indicating the need for further research. Forty-three recommendations are presented that include, but are not limited to, endorsement of a shared decision-making model, early and repeated care conferencing to reduce family stress and improve consistency in communication, honoring culturally appropriate requests for truth-telling and informed refusal, spiritual support, staff education and debriefing to minimize the impact of family interactions on staff health, family presence at both rounds and resuscitation, open flexible visitation, way-finding and family-friendly signage, and family support before, during, and after a death.

Chinese Intellectuals' May 16 Statement in Support of the Student Movement.

ERIC Educational Resources Information Center

Chronicle of Higher Education, 1989

1989-01-01

The statement by Chinese intellectuals worldwide in support of the Chinese university students' pro-democracy movement is translated. The statement criticizes corruption in the government and denounces its handling of the movement and the containment of information about it. (MSE)

Critical Issues: Keys to Successful Contracting

ERIC Educational Resources Information Center

Zopf, Michael

2010-01-01

In today's restrictive school-funding environment, many school districts are evaluating different strategies for providing noninstructional support services to preserve financial resources for the classroom. Among the strategies they are considering on a wide scale is the contracting of support functions, including pupil transportation, custodial…

Supporting research and technology for automotive Stirling engine development

NASA Technical Reports Server (NTRS)

Tomazic, W. A.

1980-01-01

The technology advancement topics described are a part of the supporting research and technology (SRT) program conducted to support the major Stirling engine development program. This support focuses on developing alternatives or backups to the engine development in critical areas. These areas are materials, seals control, combustors and system analysis. Specific objectives and planned milestone schedules for future activities as now envisioned are described. These planned SRT activities are related to the timeline of the engine development program that they must support.

Nuclear Criticality Experimental Research Center (NCERC) Overview

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

Goda, Joetta Marie; Grove, Travis Justin; Hayes, David Kirk

The mission of the National Criticality Experiments Research Center (NCERC) at the Device Assembly Facility (DAF) is to conduct experiments and training with critical assemblies and fissionable material at or near criticality in order to explore reactivity phenomena, and to operate the assemblies in the regions from subcritical through delayed critical. One critical assembly, Godiva-IV, is designed to operate above prompt critical. The Nuclear Criticality Experimental Research Center (NCERC) is our nation’s only general-purpose critical experiments facility and is only one of a few that remain operational throughout the world. This presentation discusses the history of NCERC, the general activitiesmore » that makeup work at NCERC, and the various government programs and missions that NCERC supports. Recent activities at NCERC will be reviewed, with a focus on demonstrating how NCERC meets national security mission goals using engineering fundamentals. In particular, there will be a focus on engineering theory and design and applications of engineering fundamentals at NCERC. NCERC activities that relate to engineering education will also be examined.« less

Restraint and the question of validity.

PubMed

Paterson, Brodie; Duxbury, Joy

2007-07-01

Restraint as an intervention in the management of acute mental distress has a long history that predates the existence of psychiatry. However, it remains a source of controversy with an ongoing debate as to its role. This article critically explores what to date has seemingly been only implicit in the debate surrounding the role of restraint: how should the concept of validity be interpreted when applied to restraint as an intervention? The practice of restraint in mental health is critically examined using two post-positivist constructions of validity, the pragmatic and the psychopolitical, by means of a critical examination of the literature. The current literature provides only weak support for the pragmatic validity of restraint as an intervention and no support to date for its psychopolitical validity. Judgements regarding the validity of any intervention that is coercive must include reference to the psychopolitical dimensions of both practice and policy.

Exploration Life Support Critical Questions for Future Human Space Missions

NASA Technical Reports Server (NTRS)

Ewert, Michael K.; Barta, Daniel J.; McQuillan, Jeff

2009-01-01

Exploration Life Support (ELS) is a project under NASA s Exploration Technology Development Program. The ELS Project plans, coordinates and implements the development of advanced life support technologies for human exploration missions in space. Recent work has focused on closed loop atmosphere and water systems for a lunar outpost, including habitats and pressurized rovers. But, what are the critical questions facing life support system developers for these and other future human missions? This paper explores those questions and discusses how progress in the development of ELS technologies can help answer them. The ELS Project includes Atmosphere Revitalization Systems (ARS), Water Recovery Systems (WRS), Waste Management Systems (WMS), Habitation Engineering, Systems Integration, Modeling and Analysis (SIMA), and Validation and Testing, which includes the sub-elements Flight Experiments and Integrated Testing. Systems engineering analysis by ELS seeks to optimize the overall mission architecture by considering all the internal and external interfaces of the life support system and the potential for reduction or reuse of commodities. In particular, various sources and sinks of water and oxygen are considered along with the implications on loop closure and the resulting launch mass requirements.

Psychological support based on positive suggestions in the treatment of a critically ill ICU patient – A case report

PubMed Central

Varga, Zsófia; Fritúz, Gábor

2013-01-01

This case report describes the way psychological support based on positive suggestions (PSBPS) was added to the traditional somatic treatment of an acute pancreatitis 36-year-old male patient. Psychological support based on positive suggestions (PSBPS) is a new adjunct therapeutic tool focused on applying suggestive techniques in medical settings. The suggestive techniques usually applied with critically ill patients are based on a number of pre-prepared scripts like future orientation, reframing, positivity, supporting autonomy, etc., and other, very unique and personalized interventions, which are exemplified with verbatim quotations. We describe the way several problems during treatment of intensive care unit (ICU) patients were solved using suggestive methods: uncooperativeness, difficulties of weaning, building up enteral nutrition, supporting recovery motivation, and so on, which permanently facilitated the patient’s medical state: the elimination of gastrointestinal bleeding, recovery of the skin on the abdomen, etc. Medical effects follow-up data at 10 months show that the patient recovered and soon returned to his original work following discharge. PMID:24381733

The Social Environment and Illness Uncertainty in Chronic Obstructive Pulmonary Disease

PubMed Central

Hoth, Karin F.; Wamboldt, Frederick S.; Ford, Dee W.; Sandhaus, Robert A.; Strange, Charlie; Bekelman, David B.; Holm, Kristen E.

2014-01-01

Purpose Illness uncertainty is associated with worse outcomes in patients with chronic health conditions. Research on social factors associated with uncertainty has focused on the beneficial role of social support. The goal of this study was to develop a more nuanced understanding of the social factors that are associated with uncertainty. Methods 462 individuals with alpha-1 antitrypsin deficiency (AATD) associated chronic obstructive pulmonary disease (COPD) completed a mailed questionnaire. Measures of the social environment included general family functioning, perceived criticism from family members, whether the participant had family members with AATD or COPD, and participation in support groups. Uncertainty was measured using the Mishel Uncertainty in Illness Scale including subscales for ambiguity (uncertainty about physical cues and symptoms) and complexity (uncertainty about treatment and the medical system). Hierarchical regression was used to identify social correlates of ambiguity and complexity while adjusting for demographic and medical characteristics and psychological distress. Results Perceived criticism was associated with more complexity (b=0.21, SE=0.09, p=0.015) and ambiguity (b=0.40, SE=0.12, p=0.001). Having a family member with AATD or COPD was associated with more ambiguity (b=3.28, SE=1.00, p=0.001). Participation in support groups was associated with less ambiguity. Individuals who attended three or more support groups in the prior year reported less ambiguity than individuals who had not attended any (b=−3.31, SE=1.29, p=0.010). Conclusions The social environment is complex and encompasses more than social support. Multiple aspects of the social environment are associated with uncertainty, including perceived criticism, having a family member with a similar illness, and participation in support groups. PMID:25008041

Radiochemistry Student, Postdoc and Invited Speaker Support for New Directions in Isotope Production, Nuclear Forensics and Radiochemistry Supported by the DOE

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

Jurisson, Silvia, S.

The Division of Nuclear Chemistry and Technology (NUCL) of the American Chemistry Society (ACS) is sponsoring a symposium entitled "New Directions in Isotope Production, Nuclear Forensics and Radiochemistry Supported by the DOE" at the 240th ACS National Meeting in Boston, MA 22-26 August 2010. Radiochemistry and nuclear science is a critical area of research and funding for which the DOE has provided support over the years. Radiochemistry is undergoing a renaissance in interdisciplinary areas including medicine, materials, nanotechnology, nuclear forensics and energy. For example, interest in nuclear energy is growing in response to global warming. The field of nuclear forensicsmore » has grown significantly since 9/11 in response to potential terror threats and homeland security. Radioactive molecular imaging agents and targeted radiotherapy are revolutionizing molecular medicine. The need for radiochemists is growing, critical, and global. The NUCL Division of the ACS has been involved in various areas of radiochemistry and nuclear chemistry for many years, and is the host of the DOE supported Nuclear Chemistry Summer Schools. This Symposium is dedicated to three of the critical areas of nuclear science, namely isotope production, nuclear forensics and radiochemistry. An important facet of this meeting is to provide support for young radiochemistry students/postdoctoral fellows to attend this Symposium as participants and contributors. The funding requested from DOE in this application will be used to provide bursaries for U.S. students/postdoctoral fellows to enable them to participate in this symposium at the 240th ACS National Meeting, and for invited scientists to speak on the important issues in these areas.« less

Progress Report on the US Critical Zone Observatory Program

NASA Astrophysics Data System (ADS)

Barrera, E. C.

2014-12-01

The Critical Zone Observatory (CZO) program supported by the National Science Foundation originated from the recommendation of the Earth Science community published in the National Research Council report "Basic Research Opportunities in Earth Sciences" (2001) to establish natural laboratories to study processes and systems of the Critical Zone - the surface and near-surface environment sustaining nearly all terrestrial life. After a number of critical zone community workshops to develop a science plan, the CZO program was initiated in 2007 with three sites and has now grown to 10 sites and a National Office, which coordinates research, education and outreach activities of the network. Several of the CZO sites are collocated with sites supported by the US Long Term Ecological Research (LTER) and the Long Term Agricultural Research (LTAR) programs, and the National Ecological Observatory Network (NEON). Future collaboration with additional sites of these networks will add to the potential to answer questions in a more comprehensive manner and in a larger regional scale about the critical zone form and function. At the international level, CZOs have been established in many countries and strong collaborations with the US program have been in place for many years. The next step is the development of a coordinated international program of critical zone research. The success of the CZO network of sites can be measured in transformative results that elucidate properties and processes controlling the critical zone and how the critical zone structure, stores and fluxes respond to climate and land use change. This understanding of the critical zone can be used to enhance resilience and sustainability, and restore ecosystem function. Thus, CZO science can address major societal challenges. The US CZO network is a facility open to research of the critical zone community at large. Scientific data and information about the US program are available at www.criticalzone.org.

Supporting Data-Informed Practice among Early Career Teachers: The Role of Mentors

ERIC Educational Resources Information Center

Jimerson, Jo Beth; Choate, Marnie R.; Dietz, Laurel K.

2015-01-01

Equipping teachers to use data is a critical piece of the school improvement puzzle. To help early career teachers (ECT) develop data-use acumen, some districts utilize mentoring supports. While research on mentoring in general is well-developed, research on how mentoring can or does support data-informed practice is not. To address this gap, we…

Principals' and School Counselors' Perception of Counseling Supports for African American Male High School Students

ERIC Educational Resources Information Center

Haley, Stacey J.

2016-01-01

Understanding and providing the appropriate supports for African American male high school students is critical to their academic success. This study provided the opportunity to examine how principals and school counselors perceive the support given to African American male high school students in high schools in New York City. School counselors…

Quantifying the Personal Creative Experience: Evaluation of Digital Creativity Support Tools Using Self-Report and Physiological Responses

ERIC Educational Resources Information Center

Carroll, Erin Ashley

2013-01-01

Creativity is understood intuitively, but it is not easily defined and therefore difficult to measure. This makes it challenging to evaluate the ability of a digital tool to support the creative process. When evaluating creativity support tools (CSTs), it is critical to look beyond traditional time, error, and other productivity measurements that…

How the Every Student Succeeds Act Can Support Social and Emotional Learning. Research Brief. RB-9988-WF

ERIC Educational Resources Information Center

Grant, Sean; Hamilton, Laura S.; Wrabel, Stephani L.; Gomez, Celia J.; Whitaker, Anamarie; Leschitz, Jennifer T.; Unlu, Fatih; Chavez-Herrerias, Emilio R.; Baker, Garrett; Barrett, Mark; Harris, Mark; Ramos, Alyssa

2017-01-01

Social and emotional competencies are proving critical to students' success in the classroom and in life. Although the Every Student Succeeds Act (ESSA) does not explicitly reference social and emotional learning (SEL), this legislation in fact offers opportunities to support school-based SEL interventions. How is SEL supported by ESSA? Which SEL…

The Empathetic Librarian: Rural Librarians as a Source of Support for Rural Cyberbullied Young Adults

ERIC Educational Resources Information Center

Phillips, Abigail Leigh

2016-01-01

Cyberbullying is a problem many young adults ages 12 to 18 have experienced on a daily basis. Adult support is critical in both the prevention and intervention of cyberbullying. Although parents, teachers, and school administrators have been highlighted as sources of support for cyberbullied young adults, librarians have not been studied as a…

Disaster Response and Decision Support in Partnership with the California Earthquake Clearinghouse

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Rosinski, A.; Vaughan, D.; Morentz, J.

2014-12-01

Getting the right information to the right people at the right time is critical during a natural disaster. E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) is a NASA decision support system designed to produce remote sensing and geophysical modeling data products that are relevant to the emergency preparedness and response communities and serve as a gateway to enable the delivery of NASA decision support products to these communities. The E-DECIDER decision support system has several tools, services, and products that have been used to support end-user exercises in partnership with the California Earthquake Clearinghouse since 2012, including near real-time deformation modeling results and on-demand maps of critical infrastructure that may have been potentially exposed to damage by a disaster. E-DECIDER's underlying service architecture allows the system to facilitate delivery of NASA decision support products to the Clearinghouse through XchangeCore Web Service Data Orchestration that allows trusted information exchange among partner agencies. This in turn allows Clearinghouse partners to visualize data products produced by E-DECIDER and other NASA projects through incident command software such as SpotOnResponse or ArcGIS Online.

Technical Steps to Support Nuclear Arsenal Downsizing: A Report by the APS Panel on Public Affairs

DTIC Science & Technology

2010-02-01

play a critical role in advancing the US plan to balance deter- rence with downsizing the US nuclear arsenal. In particular, S&T are essential to enable...nuclear-armed nations must be assured that they will continue to be able to meet those critical security needs. While individual nuclear-armed...steps are essential to progress towards the eventual elimination of nuclear arsenals. Science and technology (S&T) will play a critical role in

Supporting ward staff in acute care areas: the past, the present and the future?

PubMed

Coad, Sharon; Haines, Susan; Lawrence, Barbara

2002-01-01

Clinical education for acute ward staff caring for critically ill patients has continued to be a strong focus for practice development. Adopting a work-based learning approach to empower ward staff has led to the development of a five-day competency-based high dependency skills course. Developing leadership potential and enhancing networking opportunities for nurses from within critical care and ward areas is essential for the realisation of the aims of Comprehensive Critical Care.

Elasticity and critical bending moment of model colloidal aggregates.

PubMed

Pantina, John P; Furst, Eric M

2005-04-08

The bending mechanics of singly bonded colloidal aggregates are measured using laser tweezers. We find that the colloidal bonds are capable of supporting significant torques, providing a direct measurement of the tangential interactions between particles. A critical bending moment marks the limit of linear bending elasticity, past which small-scale rearrangements occur. These mechanical properties underlie the rheology and dynamics of colloidal gels formed by diffusion-limited cluster aggregation, and give critical insight into the contact interactions between Brownian particles.

Rotary-Balance Testing for Aircraft Dynamics (Les Essais sur Balance Rotative pour l’Etude de la Dynamique du Vol de l’Avion)

DTIC Science & Technology

1990-01-01

critical examination of the rotary-balance techniques used in the AGARD community for the analysis of high-angle-of-attack dynamic behavior of aircraft. It...aircraft. It was felt that sudi a critical examination should encompass both the experimental techniques used to obtain rotary-flow aerodynamic data and the...monitor the vibrational and critical structural characteristies of the apparatus and tunnel support system. Many of these systems are integrated directly

Dexmedetomidine Use in Critically-Ill Children with Acute Respiratory Failure

PubMed Central

Grant, Mary Jo C.; Schneider, James B.; Asaro, Lisa A.; Dodson, Brenda L.; Hall, Brent A.; Simone, Shari L.; Cowl, Allison S.; Munkwitz, Michele M.; Wypij, David; Curley, Martha A.Q.

2016-01-01

Objective Care of critically-ill children includes sedation but current therapies are suboptimal. To describe dexmedetomidine (DEX) use in children supported on mechanical ventilation for acute respiratory failure. Design Secondary analysis of data from the RESTORE clinical trial. Setting Thirty-one pediatric ICUs. Patients Data from 2449 children; 2 weeks to 17 years old. Interventions Sedation practices were unrestrained in the usual care arm. Patients were categorized as receiving dexmedetomidine as a primary sedative (DEXp), secondary sedative (DEXs), periextubation agent (DEXe), or never prescribed. DEX exposure and sedation and clinical profiles are described. Measurements and Main Results Of 1224 usual care patients, 596 (49%) received DEX. DEXp patients (N=138; 11%) were less critically ill (PRISM III-12 score median 6 [IQR 3–11]) and when compared to all other cohorts, experienced more episodic agitation. In the intervention group, time in sedation target improved from 28% to 50% within one day of initiating DEXp. DEXs usual care patients (N=280; 23%) included more children with severe PARDS or organ failure. DEXs patients experienced more inadequate pain (22% vs 11%) and sedation (31% vs 16%) events. DEXe patients (N=178; 15%) were those known to not tolerate an awake, intubated state and experienced a shorter ventilator weaning process (2.1 vs 2.3 days). Conclusions Our data support the use of dexmedetomidine as a primary agent in low criticality patients offering the benefit of rapid achievement of targeted sedation levels. Dexmedetomidine as a secondary agent does not appear to add benefit. The use of dexmedetomidine to facilitate extubation in children intolerant of an awake, intubated state may abbreviate ventilator weaning. These data support a broader armamentarium of pediatric critical care sedation. PMID:27654816

Geospatial decision support framework for critical infrastructure interdependency assessment

NASA Astrophysics Data System (ADS)

Shih, Chung Yan

Critical infrastructures, such as telecommunications, energy, banking and finance, transportation, water systems and emergency services are the foundations of modern society. There is a heavy dependence on critical infrastructures at multiple levels within the supply chain of any good or service. Any disruptions in the supply chain may cause profound cascading effect to other critical infrastructures. A 1997 report by the President's Commission on Critical Infrastructure Protection states that a serious interruption in freight rail service would bring the coal mining industry to a halt within approximately two weeks and the availability of electric power could be reduced in a matter of one to two months. Therefore, this research aimed at representing and assessing the interdependencies between coal supply, transportation and energy production. A proposed geospatial decision support framework was established and applied to analyze interdependency related disruption impact. By utilizing the data warehousing approach, geospatial and non-geospatial data were retrieved, integrated and analyzed based on the transportation model and geospatial disruption analysis developed in the research. The results showed that by utilizing this framework, disruption impacts can be estimated at various levels (e.g., power plant, county, state, etc.) for preventative or emergency response efforts. The information derived from the framework can be used for data mining analysis (e.g., assessing transportation mode usages; finding alternative coal suppliers, etc.).

The impact of the Baby Friendly Health Initiative in the Australian health care system: a critical narrative review of the evidence.

PubMed

Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

2013-07-01

Studies have identified that the practices of maternity facilities and health professionals are crucial to women's experience of support and breastfeeding 'success'. The Baby Friendly Hospital Initiative (BFHI) was launched globally in 1991 to protect, promote and support breastfeeding. While a direct causal effect has not been established and critics suggest the rhetoric conflicts with women's lived experiences as new mothers, a positive association between the Initiative and breastfeeding prevalence is apparent. Internationally, impact studies have demonstrated that where the Initiative is well integrated, there is an increase in rates of breastfeeding initiation and, to a lesser extent, duration. In consideration of the known health risks associated with the use of artificial baby milks this would suggest that BFHI implementation and accreditation should be a desirable strategy for committed health facilities. However, a variation in both BFHI uptake and breastfeeding prevalence between nations has been reported. This narrative review critically discusses a variety of issues relevant to the uptake and support of breastfeeding and the BFHI, utilising Australia as a case study. Whilst it enjoys 'in principle' policy support, Australia also suffers from a lack of uniformity in uptake and perception of the benefits of BFHI at all levels of the health system. Australian and international studies have identified similar enablers and barriers to implementation.

Experiences and needs of parents of critically injured children during the acute hospital phase: A qualitative investigation.

PubMed

Foster, Kim; Young, Alexandra; Mitchell, Rebecca; Van, Connie; Curtis, Kate

2017-01-01

Physical injury is a leading cause of death and disability among children worldwide and the largest cause of paediatric hospital admission. Parents of critically injured children are at increased risk of developing mental and emotional distress in the aftermath of child injury. In the Australian context, there is limited evidence on parent experiences of child injury and hospitalisation, and minimal understanding of their support needs. The aim of this investigation was to explore parents' experiences of having a critically injured child during the acute hospitalisation phase of injury, and to determine their support needs during this time. This multi-centre study forms part of a larger longitudinal mixed methods study investigating the experiences, unmet needs and well-being of parents of critically injured children over the two-year period following injury. This paper describes parents' experiences of having a child 0-13 years hospitalised with critical injury in one of four Australian paediatric hospitals. Semi-structured interviews were conducted with forty parents and transcribed verbatim. The data were managed using NVIVO 10 software and thematically analysed. Forty parents (26 mothers and 14 fathers) of 30 children (14 girls and 16 boys aged 1-13 years) from three Australian States participated. The majority of children were Australian born. Three main themes with sub-themes were identified: navigating the crisis of child injury; coming to terms with the complexity of child injury; and finding ways to meet the family's needs. There is a need for targeted psychological care provision for parents of critically injured children in the acute hospital phase, including psychological first aid and addressing parental blame attribution. Parents and children would benefit from the implementation of anticipatory guidance frameworks informed by a family-centred social ecological approach to prepare them for the trauma journey and for discharge. This approach could inform care delivery throughout the child injury recovery trajectory. The development and implementation of a major trauma family support coordinator in paediatric trauma centres would make a tangible difference to the care of critically injured children and their families. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Adaptation to sensory input tunes visual cortex to criticality

NASA Astrophysics Data System (ADS)

Shew, Woodrow L.; Clawson, Wesley P.; Pobst, Jeff; Karimipanah, Yahya; Wright, Nathaniel C.; Wessel, Ralf

2015-08-01

A long-standing hypothesis at the interface of physics and neuroscience is that neural networks self-organize to the critical point of a phase transition, thereby optimizing aspects of sensory information processing. This idea is partially supported by strong evidence for critical dynamics observed in the cerebral cortex, but the impact of sensory input on these dynamics is largely unknown. Thus, the foundations of this hypothesis--the self-organization process and how it manifests during strong sensory input--remain unstudied experimentally. Here we show in visual cortex and in a computational model that strong sensory input initially elicits cortical network dynamics that are not critical, but adaptive changes in the network rapidly tune the system to criticality. This conclusion is based on observations of multifaceted scaling laws predicted to occur at criticality. Our findings establish sensory adaptation as a self-organizing mechanism that maintains criticality in visual cortex during sensory information processing.

Providing care for critically ill surgical patients: challenges and recommendations.

PubMed

Tisherman, Samuel A; Kaplan, Lewis; Gracias, Vicente H; Beilman, Gregory J; Toevs, Christine; Byrnes, Matthew C; Coopersmith, Craig M

2013-07-01

Providing optimal care for critically ill and injured surgical patients will become more challenging with staff shortages for surgeons and intensivists. This white paper addresses the historical issues behind the present situation, the need for all intensivists to engage in dedicated critical care per the intensivist model, and the recognition that intensivists from all specialties can provide optimal care for the critically ill surgical patient, particularly with continuing involvement by the surgeon of record. The new acute care surgery training paradigm (including trauma, surgical critical care, and emergency general surgery) has been developed to increase interest in trauma and surgical critical care, but the number of interested trainees remains too few. Recommendations are made for broadening the multidisciplinary training and practice opportunities in surgical critical care for intensivists from all base specialties and for maintaining the intensivist model within acute care surgery practice. Support from academic and administrative leadership, as well as national organizations, will be needed.

International expert statement on training standards for critical care ultrasonography.

PubMed

2011-07-01

Training in ultrasound techniques for intensive care medicine physicians should aim at achieving competencies in three main areas: (1) general critical care ultrasound (GCCUS), (2) "basic" critical care echocardiography (CCE), and (3) advanced CCE. A group of 29 experts representing the European Society of Intensive Care Medicine (ESICM) and 11 other critical care societies worldwide worked on a potential framework for organizing training adapted to each area of competence. This framework is mainly aimed at defining minimal requirements but is by no means rigid or restrictive: each training organization can be adapted according to resources available. There was 100% agreement among the participants that general critical care ultrasound and "basic" critical care echocardiography should be mandatory in the curriculum of intensive care unit (ICU) physicians. It is the role of each critical care society to support the implementation of training in GCCUS and basic CCE in its own country.

Decision Support for Renewal of Wastewater Collection and Water Distribution Systems

EPA Science Inventory

The objective of this study was to identify the current decision support methodologies, models and approaches being used for determining how to rehabilitate or replace underground utilities; identify the critical gaps of these current models through comparison with case history d...

Prevention in Mental Health: Organizational and Ideological Perspectives.

ERIC Educational Resources Information Center

Walsh, Joseph A.

1982-01-01

Studied 33 community mental health centers to determine what types of organizational variables and ideological factors might affect whether a community health center conducted prevention programs. Results indicated organizational support and ideological support of mental health professionals were critical variables for prevention programs.…

Expanded Notions of Strategic Instructional Leadership: The Principal's Role with Student Support Personnel.

ERIC Educational Resources Information Center

Geltner, Beverley B.; Shelton, Maria M.

1991-01-01

Definitions of effective instructional leadership inadequately address supervision and strategic deployment of student support personnel (counselors, psychologists, social workers, and others) as critical resources for school success. Engaging their skills and understanding expands professional discourse, improves teaching and learning, and…

Commentary: recognizing and tracking philanthropy's critical support of health research.

PubMed

Bond, Queta; Gallin, Elaine K

2012-11-01

Given the current fiscal climate limiting both government and industry support for health research, philanthropic support of health research is increasingly relevant because it provides some of the critical "risk capital" that stimulates innovation, helps translate basic research findings into clinical applications, helps support the career development of investigators, builds new infrastructure, and helps fill key funding gaps. Unfortunately, because of the philanthropic sector's diversity and scope, it is challenging to track the sector's health research investments. The authors briefly review the landscape of philanthropic organizations, identify several success stories resulting from philanthropic investments, and finally underscore the importance of gaining more knowledge about the sector through purposeful data collection efforts such as those of the Health Research Alliance (HRA), a consortium of nonprofit funders of biomedical research and training. Recent HRA efforts of this type are highlighted in this commentary and described in detail in the report by Myers et al in this issue of Academic Medicine.

The Role of the Technical Specialist in Disaster Response and Recovery

NASA Astrophysics Data System (ADS)

Curtis, J. C.

2017-12-01

Technical Specialists provide scientific expertise for making operational decisions during natural hazards emergencies. Technical Specialists are important members of any Incident Management Team (IMT) as is described in in the National Incident Management System (NIMS) that has been designed to respond to emergencies. Safety for the responders and the threatened population is the foremost consideration in command decisions and objectives, and the Technical Specialist is on scene and in the command post to support and promote safety while aiding decisions for incident objectives. The Technical Specialist's expertise can also support plans, logistics, and even finance as well as operations. This presentation will provide actual examples of the value of on-scene Technical Specialists, using National Weather Service "Decision Support Meteorologists" and "Incident Meteorologists". These examples will demonstrate the critical role of scientists that are trained in advising and presenting life-critical analysis and forecasts during emergencies. A case will be made for local, state, and/or a national registry of trained and deployment-ready scientists that can support emergency response.

A developmental perspective on congenital muscular torticollis: a critical appraisal of the evidence.

PubMed

Tessmer, Angela; Mooney, Paula; Pelland, Lucie

2010-01-01

The aims of this review were to (1) identify and evaluate research evidence regarding the developmental outcomes of infants with congenital muscular torticollis (CMT) and (2) critically appraise and compare the outcomes of interventions targeting neck muscle extensibility and strength with those considering neck muscle function within the broader context of global infant development. An association between CMT and early developmental delay is supported by levels 3B, 4, and 5 evidence; no evidence was found of longer-term influences of CMT on the development of perceptual, cognitive, and motor skills. The effectiveness of passive manual stretching is supported by levels 2A, 3B, 4, and 5 evidence; no clear evidence was found of the effectiveness of developmentally supportive interventions. Controlled studies are needed to clarify the developmental consequences of CMT.

The young Ramón y Cajal as a cell-theory dissenter.

PubMed

Iturbe, Ulises; Pretó, Juli; Lazcano, Antonio

2008-06-01

The intellectual development of scientists normally traverses several different phases as they mature in their professions. In many cases, strong support of certain ideas and theories gives way to more critical, productive views that set the stage for major theories and discoveries. This appears to have been the case of Santiago Ramón y Cajal (1852-1934). In his youth, he supported the protoplasmic theory of life, and as he matured he maintained a critical, yet open view of the cell theory, which postulated that life phenomena could not take place below the cellular level. In later years, however, an older and wiser Ramón y Cajal abandoned all traces of dissent and joined in fully supporting a refined version of cell theory, to which his own discoveries significantly contributed.

Authors' financial relationships with the food and beverage industry and their published positions on the fat substitute olestra.

PubMed

Levine, Jane; Gussow, Joan Dye; Hastings, Diane; Eccher, Amy

2003-04-01

This study examined the association between authors' published positions on the safety and efficacy in assisting with weight loss of the Procter & Gamble (P&G) fat substitute olestra and their financial relationships with the food and beverage industry. Journal articles about olestra, and their authors, were classified as supportive, critical, or neutral with respect to its use. Authors not known to have industry affiliations were surveyed about their financial relationships. Supportive authors were significantly more likely than critical or neutral authors to have financial relationships with P&G (80% vs 11% and 21%, respectively; P <.0001). All authors disclosing an affiliation with P&G were supportive. Because authors' published opinions were associated with their financial relationships, obtaining noncommercial funding may be more essential to maintaining objectivity than disclosing personal financial interests.

Studying critical string emerging from non-Abelian vortex in four dimensions

DOE PAGES

Koroteev, P.; Shifman, M.; Yung, A.

2016-05-26

Recently a special vortex string was found in a class of soliton vortices supported in four-dimensional Yang–Mills theories that under certain conditions can become infinitely thin and can be interpreted as a critical ten-dimensional string. The appropriate bulk Yang–Mills theory has the U(2) gauge group and the Fayet–Iliopoulos term. It supports semilocal non-Abelian vortices with the world-sheet theory for orientational and size moduli described by the weighted CP(2,2) model. Here, the full target space ismore » $$\\mathbb R$$ 4 x Y 6 where is a non-compact Calabi–Yau space.« less

Implementing Family-Centered Care Through Facilitated Sensemaking.

PubMed

Davidson, Judy E; Zisook, Sidney

2017-01-01

The Society of Critical Care Medicine has released updated recommendations for care of the family in neonatal, pediatric, and adult intensive care units. Translation of the recommendations into practice may benefit from a supporting theoretical framework. Facilitated sensemaking is a mid-range theory built from the same literature that formed the basis for recommendations within the guidelines. The process of facilitated sensemaking may be used to help nurses adopt the SCCM recommendations into practice through the development of caring relationships, promoting family presence, teaching family engagement strategies, and supporting families with communication, information gathering, and participation in decision-making. ©2017 American Association of Critical-Care Nurses.

Interpreting support vector machine models for multivariate group wise analysis in neuroimaging

PubMed Central

Gaonkar, Bilwaj; Shinohara, Russell T; Davatzikos, Christos

2015-01-01

Machine learning based classification algorithms like support vector machines (SVMs) have shown great promise for turning a high dimensional neuroimaging data into clinically useful decision criteria. However, tracing imaging based patterns that contribute significantly to classifier decisions remains an open problem. This is an issue of critical importance in imaging studies seeking to determine which anatomical or physiological imaging features contribute to the classifier’s decision, thereby allowing users to critically evaluate the findings of such machine learning methods and to understand disease mechanisms. The majority of published work addresses the question of statistical inference for support vector classification using permutation tests based on SVM weight vectors. Such permutation testing ignores the SVM margin, which is critical in SVM theory. In this work we emphasize the use of a statistic that explicitly accounts for the SVM margin and show that the null distributions associated with this statistic are asymptotically normal. Further, our experiments show that this statistic is a lot less conservative as compared to weight based permutation tests and yet specific enough to tease out multivariate patterns in the data. Thus, we can better understand the multivariate patterns that the SVM uses for neuroimaging based classification. PMID:26210913

Modeling and Analysis of Mixed Synchronous/Asynchronous Systems

NASA Technical Reports Server (NTRS)

Driscoll, Kevin R.; Madl. Gabor; Hall, Brendan

2012-01-01

Practical safety-critical distributed systems must integrate safety critical and non-critical data in a common platform. Safety critical systems almost always consist of isochronous components that have synchronous or asynchronous interface with other components. Many of these systems also support a mix of synchronous and asynchronous interfaces. This report presents a study on the modeling and analysis of asynchronous, synchronous, and mixed synchronous/asynchronous systems. We build on the SAE Architecture Analysis and Design Language (AADL) to capture architectures for analysis. We present preliminary work targeted to capture mixed low- and high-criticality data, as well as real-time properties in a common Model of Computation (MoC). An abstract, but representative, test specimen system was created as the system to be modeled.

Preparing for Mars: The Evolvable Mars Campaign 'Proving Ground' Approach

NASA Technical Reports Server (NTRS)

Bobskill, Marianne R.; Lupisella, Mark L.; Mueller, Rob P.; Sibille, Laurent; Vangen, Scott; Williams-Byrd, Julie

2015-01-01

As the National Aeronautics and Space Administration (NASA) prepares to extend human presence beyond Low Earth Orbit, we are in the early stages of planning missions within the framework of an Evolvable Mars Campaign. Initial missions would be conducted in near-Earth cis-lunar space and would eventually culminate in extended duration crewed missions on the surface of Mars. To enable such exploration missions, critical technologies and capabilities must be identified, developed, and tested. NASA has followed a principled approach to identify critical capabilities and a "Proving Ground" approach is emerging to address testing needs. The Proving Ground is a period subsequent to current International Space Station activities wherein exploration-enabling capabilities and technologies are developed and the foundation is laid for sustained human presence in space. The Proving Ground domain essentially includes missions beyond Low Earth Orbit that will provide increasing mission capability while reducing technical risks. Proving Ground missions also provide valuable experience with deep space operations and support the transition from "Earth-dependence" to "Earth-independence" required for sustainable space exploration. A Technology Development Assessment Team identified a suite of critical technologies needed to support the cadence of exploration missions. Discussions among mission planners, vehicle developers, subject-matter-experts, and technologists were used to identify a minimum but sufficient set of required technologies and capabilities. Within System Maturation Teams, known challenges were identified and expressed as specific performance gaps in critical capabilities, which were then refined and activities required to close these critical gaps were identified. Analysis was performed to identify test and demonstration opportunities for critical technical capabilities across the Proving Ground spectrum of missions. This suite of critical capabilities is expected to provide the foundation required to enable a variety of possible destinations and missions consistent with the Evolvable Mars Campaign.. The International Space Station will be used to the greatest extent possible for exploration capability and technology development. Beyond this, NASA is evaluating a number of options for Proving Ground missions. An "Asteroid Redirect Mission" will demonstrate needed capabilities (e.g., Solar Electric Propulsion) and transportation systems for the crew (i.e., Space Launch System and Orion) and for cargo (i.e., Asteroid Redirect Vehicle). The Mars 2020 mission and follow-on robotic precursor missions will gather Mars surface environment information and will mature technologies. NASA is considering emplacing a small pressurized module in cis-lunar space to support crewed operations of increasing duration and to serve as a platform for critical exploration capabilities testing (e.g., radiation mitigation; extended duration deep space habitation). In addition, "opportunistic mission operations" could demonstrate capabilities not on the Mars critical path that may, nonetheless, enhance exploration operations (e.g., teleoperations, crew assisted Mars sample return). The Proving Ground may also include "pathfinder" missions to test and demonstrate specific capabilities at Mars (e.g., entry, descent, and landing). This paper describes the (1) process used to conduct an architecture-driven technology development assessment, (2) exploration mission critical and supporting capabilities, and (3) approach for addressing test and demonstration opportunities encompassing the spectrum of flight elements and destinations consistent with the Evolvable Mars Campaign.

A Retrospective Evaluation of Critical Care Blood Culture Yield - Do Support Services Contribute to the "Weekend Effect"?

PubMed

Morton, Ben; Nagaraja, Shankara; Collins, Andrea; Pennington, Shaun H; Blakey, John D

2015-01-01

The "weekend effect" describes an increase in adverse outcomes for patients admitted at the weekend. Critical care units have moved to higher intensity working patterns to address this with some improved outcomes. However, support services have persisted with traditional working patterns. Blood cultures are an essential diagnostic tool for patients with sepsis but yield is dependent on sampling technique and processing. We therefore used blood culture yield as a surrogate for the quality of support service provision. We hypothesized that blood culture yields would be lower over the weekend as a consequence of reduced support services. We performed a retrospective observational study examining 1575 blood culture samples in a university hospital critical care unit over a one-year period. Patients with positive cultures had, on average, higher APACHE II scores (p = 0.015), longer durations of stay (p = 0.03), required more renal replacement therapy (p<0.001) and had higher mortality (p = 0.024). Blood culture yield decreased with repeated sampling with an increased proportion of contaminants. Blood cultures were 26.7% less likely to be positive if taken at the weekend (p = 0.0402). This effect size is the equivalent to the impact of sampling before and after antibiotic administration. Our study demonstrates that blood culture yield is lower at the weekend. This is likely caused by delays or errors in incubation and processing, reflecting the reduced provision of support services at the weekend. Reorganization of services to address the "weekend effect" should acknowledge the interdependent nature of healthcare service delivery.

Mothers and Fathers Experience Stress of Congenital Heart Disease Differently: Recommendations for Pediatric Critical Care.

PubMed

Sood, Erica; Karpyn, Allison; Demianczyk, Abigail C; Ryan, Jennie; Delaplane, Emily A; Neely, Trent; Frazier, Aisha H; Kazak, Anne E

2018-03-10

To inform pediatric critical care practice by examining how mothers and fathers experience the stress of caring for a young child with congenital heart disease and use hospital and community supports. Qualitative study of mothers and fathers of young children with congenital heart disease. Tertiary care pediatric hospital in the Mid-Atlantic region of the United States. Thirty-four parents (20 mothers, 14 fathers) from diverse backgrounds whose child previously underwent cardiac surgery during infancy. Subjects participated in semi-structured, individual interviews about their experiences and psychosocial needs at the time of congenital heart disease diagnosis, surgical admission, and discharge to home after surgery. Qualitative interview data were coded, and consistent themes related to emotional states, stressors, and supports were identified. Fathers experience and respond to the stressors and demands of congenital heart disease in unique ways. Fathers often described stress from not being able to protect their child from congenital heart disease and the associated surgeries/pain and from difficulties balancing employment with support for their partner and care of their congenital heart disease child in the hospital. Fathers were more likely than mothers to discuss support from the work environment (coworkers/managers, flexible scheduling, helpful distraction) and were less likely to describe the use of hospital-based resources or congenital heart disease peer-to-peer supports. This study highlights the importance of understanding the paternal experience and tailoring interventions to the unique needs of both mothers and fathers. Opportunities for critical care practice change to promote the mental health of mothers and fathers following a diagnosis of congenital heart disease are discussed.

Neoliberal Common Sense and Race-Neutral Discourses: A Critique of "Evidence-Based" Policy-Making in School Policing

ERIC Educational Resources Information Center

Nolan, Kathleen

2015-01-01

The author of this paper uses critical discourse analysis and draws on critical social theory and policy studies to analyze the interdiscursivity between neoliberal common sense discourses around crime and safety and race-neutral discourses, "evidence-based" policy, and the research that supports school policing programs. The author…

Using Role-Play and Case Study to Promote Student Research on Environmental Science

ERIC Educational Resources Information Center

Deaton, Cynthia C. M.; Cook, Michelle

2012-01-01

Reform efforts encourage teachers to engage students in critical thinking skills and research. They also encourage teachers to meet the needs of their diverse student population and support students in developing communication skills. One way to step outside of traditional teaching approaches and engage middle school students in critical thinking,…

Critical Adult Education in Canada in the Time of CASAE

ERIC Educational Resources Information Center

Plumb, Donovan

2009-01-01

From very early in its history, the Canadian Association for the Study of Adult Education (CASAE) has supported a rich tradition of critique. This chapter argues, however, that in important ways, the magnitude and rapidity of social transformations since the late 1970s have largely overwhelmed the critical capacities of Canadian adult educators.…

School Effectiveness Research: From a Review of the Criticism to Recommendations for Further Development

ERIC Educational Resources Information Center

Luyten, Hams; Visscher, Adrie; Witziers, Bob

2005-01-01

School effectiveness research (SER) has flourished since the 1980s. In recent years, however, various authors have criticised several aspects of SER. A thorough review of recent criticism can serve as a good starting point for addressing the flaws of SER, where appropriate, thereby supporting its further development. This article begins by…

Critical Argument and Writer Identity: Social Constructivism as a Theoretical Framework for EFL Academic Writing

ERIC Educational Resources Information Center

McKinley, Jim

2015-01-01

This article makes the argument that we need to situate student's academic writing as socially constructed pieces of writing that embody a writer's cultural identity and critical argument. In support, I present and describe a comprehensive model of an original English as a Foreign Language (EFL) writing analytical framework. This article explains…

Uninformed in the Information Age: Why Media Necessitate Critical Thinking Education

ERIC Educational Resources Information Center

McBrien, J. Lynn

2005-01-01

Much has been written about the power of media to influence the public through instruments of advertising and a variety of venues (Considine & Haley, 1999; Cortes, 2000; Kilbourne, 1999). In this chapter, the author has chosen to use a singular media focus--news--to support the critical importance of teaching media literacy skills to students. She…

77 FR 51814 - Draft Guidance for Industry on Generic Drug User Fee Amendments of 2012: Questions and Answers...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-27

... costs to industry. GDUFA enables FDA to assess user fees to support critical and measurable enhancements... critical and measurable enhancements to FDA's generic drugs program. GDUFA establishes fees for abbreviated... current thinking on generic drug user fee amendments of 2012. It does not create or confer any rights for...

Paying Attention to Procedural Texts: Critically Reading School Routines as Embodied Achievement

ERIC Educational Resources Information Center

Zanden, Sarah Vander; Wohlwend, Karen E.

2011-01-01

In this article, we look closely at the way power circulates through school routines with ordinary texts in everyday moments. We address texts that support different types of achievement and how critical literacy helps us redefine achievement and examine what we're doing with texts and students in classrooms. We interrogate the notion of…

Space station high gain antenna concept definition and technology development

NASA Technical Reports Server (NTRS)

Wade, W. D.

1972-01-01

The layout of a technology base is reported from which a mechanically gimballed, directional antenna can be developed to support a manned space station proposed for the late 1970's. The effort includes the concept definition for the antenna assembly, an evaluation of available technology, the design of critical subassemblies and the design of critical subassembly tests.

Critical Democracy through Digital Media Production in a Third-Grade Classroom

ERIC Educational Resources Information Center

Montgomery, Sarah E.

2014-01-01

This article explores the ways that alternative digital media production by elementary students can support education for critical democracy. The article centers on a collaborative, qualitative study in which students in a 3rd-grade class at a Title One school created and disseminated podcasts about issues of historical injustice rooted in the key…

Supporting New Educators to Teach for Social Justice: The Critical Inquiry Project Model

ERIC Educational Resources Information Center

Picower, Bree

2007-01-01

Urban public schools and their teachers are under siege. From increased standardization, privatization and testing to a growing number of students whose needs are not being met by schools, urban public school teachers face a daunting task. Without a space in which to critically examine their daily experiences within schools, many well-intentioned…

Active Learning and Threshold Concepts in Multiple Testing That Can Further Develop Student Critical Statistical Thinking

ERIC Educational Resources Information Center

White, Desley

2015-01-01

Two practical activities are described, which aim to support critical thinking about statistics as they concern multiple outcomes testing. Formulae are presented in Microsoft Excel spreadsheets, which are used to calculate the inflation of error associated with the quantity of tests performed. This is followed by a decision-making exercise, where…

Urban High School Students' Critical Science Agency: Conceptual Understandings and Environmental Actions around Climate Change

ERIC Educational Resources Information Center

McNeill, Katherine L.; Vaughn, Meredith Houle

2012-01-01

This study investigates how the enactment of a climate change curriculum supports students' development of critical science agency, which includes students developing deep understandings of science concepts and the ability to take action at the individual and community levels. We examined the impact of a four to six week urban ecology curriculum…

Defining and Measuring Parenting for Educational Success: A Critical Discourse Analysis of the Parent Education Profile

ERIC Educational Resources Information Center

Prins, Esther; Toso, Blaire Willson

2008-01-01

The Parent Education Profile (PEP) is an instrument used by family literacy programs to rate parents' support for children's literacy development. This article uses Critical Discourse Analysis to examine how the PEP constructs the ideal parent, the text's underlying assumptions about parenting and education, and its ideological effects. The…

Multimedia Case-Based Support of Experiential Teacher Education: Critical Self Reflection and Dialogue in Multi-Cultural Contexts.

ERIC Educational Resources Information Center

McCurry, David S.

This paper describes a qualitative study exploring the efficacy of using selected multimedia technologies to engage preservice and practicing teachers in critical dialogue. Visual representations, such as 360-degree panoramic views of classrooms hyperlinked to text descriptions, audio clips, and video of learning environments are used as anchor…

iDemocracy: Critical Literacy, Civic Engagement, and Podcasting in an Elementary Classroom

ERIC Educational Resources Information Center

Montgomery, Sarah E.

2009-01-01

The present study explored the ways in which the production of digital media, specifically podcasts (i.e., downloadable digital audio files), rooted in the key tenets of critical literacy, can support education for democracy, in addition to the overall benefits and barriers of podcasting in an elementary classroom. The project can be considered a…

Layering Networked and Symphonic Selves: A Critical Role for e-Portfolios in Employability through Integrative Learning

ERIC Educational Resources Information Center

Cambridge, Darren

2008-01-01

Purpose: E-portfolios, which document and facilitate learning and performance, have recently attracted interest in the USA, UK, and Europe as means to increase employability and support lifelong learning. This article aims to critically examine these objectives in order to guide the future e-portfolio practice. Design/methodology/approach: Social…

Contrasting Cross-Sectional and Longitudinal Early School Leaver Rates in Canada

ERIC Educational Resources Information Center

Timmons, Vianne; Ostridge, Randy

2009-01-01

Data analysis is critical to educational planning. Determining the number of school leavers is crucial for a school board when planning for interventions and supports. In researching the number of early school leavers in the province of Prince Edward Island, the method in which the data were reported affected the rates. Two critical considerations…

The Critical Role of Stewardship in Fund Raising: The Coaches vs. Cancer Campaign.

ERIC Educational Resources Information Center

Worley, Debra A.; Little, Jennifer K.

2002-01-01

Examines the critical role of stewardship in the process of fund raising. Uses the Coaches vs. Cancer campaign to illustrate the limitations of the public relations ROPE (research, objectives, planning, and evaluation) model in explaining fund raising success, and supports K.S. Kelly's contention that addition of a fifth step to the model, the…

The New Right and the Schools: Why Mainstream America is Listening to Our Critics.

ERIC Educational Resources Information Center

Ravitch, Diane

1982-01-01

Some of the New Right's criticisms of our education system, particularly those relating to sex and values education, reflect legitimate discontent in the wider population. School officials should be prepared to explain and defend their choice of curriculum materials; the best support for the public schools is an informed public. (Author/GC)

High School World History Textbooks: An Analysis of Content Focus and Chronological Approaches

ERIC Educational Resources Information Center

Marino, Michael P.

2011-01-01

Research about social studies textbooks overwhelmingly supports the conclusion that these books are unpopular and often the subject of intense criticisms. These criticisms concern anything ranging from the language they employ, to the way they are utilized by teachers, to the undue influence they exert on shaping and defining curriculum. This…

Using News Articles to Build a Critical Literacy Classroom in an EFL Setting

ERIC Educational Resources Information Center

Park, Yujong

2011-01-01

This article examines an effort to support critical literacy in an English as a foreign language (EFL) setting by analyzing one college EFL reading classroom in which students read and responded to articles from "The New Yorker". Data include transcribed audiotapes of classroom interaction and interviews with students, classroom materials, and…

Dublin Institute of Technology's Programme for Students Learning with Communities: A Critical Account of Practice

ERIC Educational Resources Information Center

Gamble, Elena; Bates, Catherine

2011-01-01

Purpose: This paper aims to focus on the process of critically evaluating Dublin Institute of Technology's Programme for Students Learning With Communities after its first year of operation. The programme supports and promotes community-based learning/service-learning across DIT. Design/methodology/approach: The paper is presented in the form of a…

Analysis of Critical Thinking Skills on The Topic of Static Fluid

NASA Astrophysics Data System (ADS)

Puspita, I.; Kaniawati, I.; Suwarma, I. R.

2017-09-01

This study aimed to know the critical thinking skills profil of senior high school students. This research using a descriptive study to analysis student test results of critical thinking skill of 40 students XI grade in one of the senior high school in Bogor District. The method used is survey research with sample determined by purposive sampling technique. The instrument used is test of critical thinking skill by 5 indicators on static fluid topics. Questions consist of 11 set. It is has been developed by researcher and validated by experts. The results showed students critical thinking skills are still low. Is almost every indicator of critical thinking skills only reaches less than 30%. 28% for elementary clarification, 10% for the basic for decisions/basic support, 6% for inference, 6% for advanced clarification, 4% for strategies and tactics.

Supporting staff recovery and reintegration after a critical incident resulting in infant death.

PubMed

Roesler, Roberta; Ward, Debra; Short, Mary

2009-08-01

A critical incident is described as any sudden unexpected event that has the power to overwhelm the usual effective coping skills of an individual or a group and can cause significant psychological distress in usually healthy persons. A Just Culture model to deal with critical incidents is an approach that seeks to identify and balance system events and personal accountability. This article reports a critical incident that occurred at the Neonatal Intensive Care Unit, Methodist Hospital of Indianapolis, when 5 infants received an overdose of heparin that resulted in the death of 3 infants. Although care of the family after the critical incident was the immediate priority, the focus of this article was on the recovery and reintegration of the NICU staff after a critical incident based on the Just Culture philosophy.

Better Together: Expanding Rural Partnerships to Support Families

ERIC Educational Resources Information Center

Shaklee, Harriet; Bigbee, Jeri; Wall, Misty

2012-01-01

Chronic shortages of health, social service, and mental health professionals in rural areas necessitate creative partnerships in support of families. Cooperative extension professionals in Family and Consumer Sciences and community health nurses, who can bring critical skills to human services teams, are introduced as trusted professionals in…

A Case Study Examining How School Leaders Support Schoolwide Implementation of Problem-Based Learning in a Comprehensive Public High School

ERIC Educational Resources Information Center

Callison, Matthew

2017-01-01

A critical step in addressing a call for schools to use curricula such as problem-based learning (PBL) is developing an understanding of how school leaders can support its implementation. The purpose of this study was to examine ways school leaders at a comprehensive, public high school provided supports to teachers as they implemented this…

[Guidelines for specialized nutritional and metabolic support in the critically ill-patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): obese patient].

PubMed

Mesejo, A; Sánchez Álvarez, C; Arboleda Sánchez, J A

2011-11-01

As a response to metabolic stress, obese critically-ill patients have the same risk of nutritional deficiency as the non-obese and can develop protein-energy malnutrition with accelerated loss of muscle mass. The primary aim of nutritional support in these patients should be to minimize loss of lean mass and accurately evaluate energy expenditure. However, routinely-used formulae can overestimate calorie requirements if the patient's actual weight is used. Consequently, the use of adjusted or ideal weight is recommended with these formulae, although indirect calorimetry is the method of choice. Controversy surrounds the question of whether a strict nutritional support criterion, adjusted to the patient's requirements, should be applied or whether a certain degree of hyponutrition should be allowed. Current evidence suggested that hypocaloric nutrition can improve results, partly due to a lower rate of infectious complications and better control of hyperglycemia. Therefore, hypocaloric and hyperproteic nutrition, whether enteral or parenteral, should be standard practice in the nutritional support of critically-ill obese patients when not contraindicated. Widely accepted recommendations consist of no more than 60-70% of requirements or administration of 11-14 kcal/kg current body weight/day or 22-25 kcal/kg ideal weight/day, with 2-2.5 g/kg ideal weight/day of proteins. In a broad sense, hypocaloric-hyperprotein regimens can be considered specific to obese critically-ill patients, although the complications related to comorbidities in these patients may require other therapeutic possibilities to be considered, with specific nutrients for hyperglycemia, acute respiratory distress syndrome (ARDS) and sepsis. However, there are no prospective randomized trials with this type of nutrition in this specific population subgroup and the available data are drawn from the general population of critically-ill patients. Consequently, caution should be exercised when interpreting these data. Copyright © 2011 Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L. All rights reserved.

Measuring functional, interactive and critical health literacy of Chinese secondary school students: reliable, valid and feasible?

PubMed

Guo, Shuaijun; Davis, Elise; Yu, Xiaoming; Naccarella, Lucio; Armstrong, Rebecca; Abel, Thomas; Browne, Geoffrey; Shi, Yanqin

2018-04-01

Health literacy is an increasingly important topic in the global context. In mainland China, health literacy measures mainly focus on health knowledge and practices or on the functional domain for adolescents. However, little is known about interactive and critical domains. This study aimed to adopt a skills-based and three-domain (functional, interactive and critical) instrument to measure health literacy in Chinese adolescents and to examine the status and determinants of each domain. Using a systematic review, the eight-item Health Literacy Assessment Tool (HLAT-8) was selected and translated from English to Chinese (c-HLAT-8). Following the translation process, a cross-sectional study was conducted in four secondary schools in Beijing, China. A total of 650 students in Years 7-9 were recruited to complete a self-administered questionnaire that assessed socio-demographics, self-efficacy, social support, school environment, community environment and health literacy. Results showed that the c-HLAT-8 had satisfactory reliability (Cronbach's α = 0.79; intra-class correlation coefficient = 0.72) and strong validity (translation validity index (TVI) ≥0.95; χ 2 / df = 3.388, p < 0.001; comparative fit index = 0.975, Tucker and Lewis's index of fit = 0.945, normed fit index = 0.965, root mean error of approximation = 0.061; scores on the c-HLAT-8 were moderately correlated with the Health Literacy Study-Taiwan, but weakly with the Newest Vital Sign). Chinese students had an average score of 26.37 (±5.89) for the c-HLAT-8. When the determinants of each domain of health literacy were examined, social support was the strongest predictor of interactive and critical health literacy. On the contrary, self-efficacy and school environment played more dominant roles in predicting functional health literacy. The c-HLAT-8 was demonstrated to be a reliable, valid and feasible instrument for measuring functional, interactive and critical health literacy among Chinese students. The current findings indicate that increasing self-efficacy, social support and creating supportive environments are important for promoting health literacy in secondary school settings in China.

Critical care in resource-poor settings: lessons learned and future directions.

PubMed

Riviello, Elisabeth D; Letchford, Stephen; Achieng, Loice; Newton, Mark W

2011-04-01

Critical care faces the same challenges as other aspects of healthcare in the developing world. However, critical care faces an additional challenge in that it has often been deemed too costly or complicated for resource-poor settings. This lack of prioritization is not justified. Hospital care for the sickest patients affects overall mortality, and public health interventions depend on community confidence in healthcare to ensure participation and adherence. Some of the most effective critical care interventions, including rapid fluid resuscitation, early antibiotics, and patient monitoring, are relatively inexpensive. Although cost-effectiveness studies on critical care in resource-poor settings have not been done, evidence from the surgical literature suggests that even resource-intensive interventions can be cost effective in comparison to immunizations and human immunodeficiency virus care. In the developing world, where many critically ill patients are younger and have fewer comorbidities, critical care presents a remarkable opportunity to provide significant incremental benefit, arguably much more so than in the developed world. Key areas of consideration in developing critical care in resource-poor settings include: Personnel and training, equipment and support services, ethics, and research. Strategies for training and retaining skilled labor include tying education to service commitment and developing protocols for even complex processes. Equipment and support services need to focus on technologies that are affordable and sustainable. Ethical decision making must be based on data when possible and on transparent articulated policies always. Research should be performed in resource-poor settings and focus on needs assessment, prognostication, and cost effectiveness. The development of critical care in resource-poor settings will rely on the stepwise introduction of service improvements, leveraging human resources through training, a focus on sustainable technology, ongoing analysis of cost effectiveness, and the sharing of context-specific best practices. Although prevention, public health, and disease-specific agendas dominate many current conversations in global health, this is nonetheless a time ripe for the development of critical care. Leaders in global health funding hope to improve quality and length of life. Critical care is an integral part of the continuum of care necessary to make that possible.

Argumentation in Secondary School Students' Structured and Unstructured Chat Discussions

ERIC Educational Resources Information Center

Salminen, Timo; Marttunen, Miika; Laurinen, Leena

2012-01-01

Joint construction of new knowledge demands that persons can express their statements in a convincing way and explore other people's arguments constructively. For this reason, more knowledge on different means to support collaborative argumentation is needed. This study clarifies whether structured interaction supports students' critical and…

Help

ERIC Educational Resources Information Center

Tollefson, Ann

2009-01-01

Planning to start or expand a K-8 critical language program? Looking for support in doing so? There "may" be help at the federal level for great ideas and strong programs. While there have been various pools of federal dollars available to support world language programs for a number of years, the federal government's interest in…

Business Simulations Applied in Support of ERP Training

ERIC Educational Resources Information Center

Conroy, George

2012-01-01

This quantitative, quasi-experimental study examined the application of a business simulation against training in support of an Enterprise Resource Planning (ERP) system. Defining more effective training strategies is a critical concern for organizational leaders and stakeholders concerned by today's economic challenges. The scope of this…

Penumbra: Doctoral Support as Drama--From the "Lightside" to the "Darkside." From Front of House to Trapdoors and Recesses

ERIC Educational Resources Information Center

Wisker, Gina; Robinson, Gillian; Bengtsen, Søren S. E.

2017-01-01

Much international doctoral learning research focuses on personal, institutional and learning support provided by supervisors, managed relationships,"nudging" robust, conceptual, critical, creative work. Other work focuses on stresses experienced in supervisor-student relationships and doctoral journeys. Some considers formal and…

Supporting Parents through Parent Education. Building Community Systems for Young Children.

ERIC Educational Resources Information Center

Zepeda, Marlene; Morales, Alex

California's Proposition 10, the "Children and Families Act," has targeted three general areas for improvement in support of families and young children: improved family functioning, improved child development, and improved child health. Proposition 10 views parents as critical to the development of young children. Noting that parent…

Critical Incidents in Sustaining School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Andreou, Theresa E.; McIntosh, Kent; Ross, Scott W.; Kahn, Joshua D.

2015-01-01

The purpose of this exploratory study was to identify, categorize, and describe practitioners' perspectives regarding factors that help and hinder sustainability of Tier I (universal) systems within School-wide Positive Behavioral Interventions and Supports (SWPBIS). Seventeen participants involved in sustaining Tier I SWPBIS over several years…

Critical Incidents in Sustaining School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Andreou, Theresa E.; McIntosh, Kent; Ross, Scott W.; Kahn, Joshua D.

2015-01-01

The purpose of this study was to identify, categorize, and describe practitioners' perspectives regarding factors that help and hinder sustainability of Tier I (universal) systems within School-Wide Positive Behavioral Interventions and Supports (SWPBIS). Seventeen participants involved in sustaining Tier I SWPBIS over several years within a…

Risk Assessment Methodology for Software Supportability (RAMSS): guidelines for Adapting Software Supportability Evaluations

DTIC Science & Technology

1986-04-14

CONCIPT DIFINITION OIVILOPMINTITIST I OPERATION ANO ■ MAINTENANCE ■ TRACK MOifCTIO PROGRAMS • «VIIW CRITICAL ISSUIS . Mt PARI INPUTS TO PMO...development and beyond, evaluation criteria must Include quantitative goals (the desired value) and thresholds (the value beyond which the charac

Student Support Services: A Practice Brief Based On BEAMS Project Outcomes

ERIC Educational Resources Information Center

Bridges, Brian K.

2008-01-01

Student support services are critical to student success, especially at campuses that enroll large numbers of academically under-prepared students. These programs assist students in addressing areas of academic deficiency and provide necessary resources to maximize students' intellectual and social capital while in college. Several…

Management Control System Support of Initiatives for Disruptive Students

ERIC Educational Resources Information Center

Scott, Colin

2011-01-01

Purpose: The purpose of the paper is to investigate the management control system (MCS) support of school initiatives to develop the school climate and to re-engage disruptive students. Design/methodology/approach: The paper adopts an approach of critical action research interviews with management and document reviews informed by Habermasian…

Relationship between Workplace Spatial Settings and Occupant-Perceived Support for Collaboration

ERIC Educational Resources Information Center

Hua, Ying; Loftness, Vivian; Heerwagen, Judith H.; Powell, Kevin M.

2011-01-01

The increasingly collaborative nature of knowledge-based work requires workplaces to support both dynamic interactions and concentrated work, both of which are critical for collaboration performance. Given the prevalence of open-plan settings, this requirement has created new challenges for workplace design. Therefore, an understanding of the…

Life Science Professional Societies Expand Undergraduate Education Efforts

ERIC Educational Resources Information Center

Matyas, Marsha Lakes; Ruedi, Elizabeth A.; Engen, Katie; Chang, Amy L.

2017-01-01

The "Vision and Change in Undergraduate Biology Education" reports cite the critical role of professional societies in undergraduate life science education and, since 2008, have called for the increased involvement of professional societies in support of undergraduate education. Our study explored the level of support being provided by…

"Choose the Future Wisely": Supporting Better Ethics through Critical Thinking

ERIC Educational Resources Information Center

Meisel, Steven I.; Fearon, David S.

2006-01-01

Most people learn and internalize their sense of ethical behavior many years before they assume positions of organizational responsibility. Continued training in ethics helps to develop new understanding and supports ethical behavior. It is also useful to increase the cognitive skills of executives making decisions affecting firms and…

Self-Determination for Individuals with the Most Severe Disabilities: Moving beyond Chimera.

ERIC Educational Resources Information Center

Brown, Fredda; Gothelf, Carole R.; Guess, Doug; Lehr, Donna H.

1998-01-01

This article explores implications of people's interpretations of communicative efforts by people with severe disabilities. Recent initiatives to support and promote self-determination are critically assessed as possibly functioning to limit self-determination. Use of preference assessments and behavior supports is discussed as a key to…

Pioneering Program Teaches Families Sign Language through Tele-Intervention

ERIC Educational Resources Information Center

Poeppelmeyer, Diana; Reichert, Lynn

2015-01-01

Support for parents who wish to develop communication skills is critical. When parents have communication with their children, they are better able to express their concerns, expectations, and support. Bonding with children--and their social, emotional, cognitive, and linguistic development--depends on communication with those who love them. This…

Faculty Development: A Stage Model Matched to Blended Learning Maturation

ERIC Educational Resources Information Center

Fetters, Michael L.; Duby, Tova Garcia

2011-01-01

Faculty development programs are critical to the implementation and support of curriculum innovation. In this case study, the authors present lessons learned from ten years of experience in faculty development programs created to support innovation in technology enhanced learning. Stages of curriculum innovation are matched to stages of faculty…

Chronic Pain and Depression: Does the Evidence Support a Relationship?

ERIC Educational Resources Information Center

Romano, Joan M.; Turner, Judith A.

1985-01-01

A critical evaluation of the relevant literature provides some support for an association between depression and chronic pain. Common conceptual and methodological problems are discussed. Current biological and psychological models of the mechanisms by which the two syndromes may interact are summarized, and suggestions are made for future…

Meeting National Expectations for Partnering with Families

ERIC Educational Resources Information Center

Sánchez, Claudia; Walsh, Bridget

2017-01-01

The field of early childhood education supports the notions that early childhood programs need the active support of families and that the school and the home are the most critical environments impacting children's development (Mart, Dusenbury, & Weissberg, 2011). The vast majority of state standards do not align with family involvement…

Supervision on Site: A Critical Factor in the Online Facilitated Internship

ERIC Educational Resources Information Center

Dotson, Kaye B.; Bian, Hui

2013-01-01

Online education is increasingly prevalent in graduate schools of teacher education. Questions arise, however, as to the effectiveness of the online facilitated graduate internship. This article examines perspectives of librarian site supervisors within online supported internships. Perspectives in regard to program support and self-perceived…

Designing to Support Critical Engagement with Statistics

ERIC Educational Resources Information Center

Gresalfi, Melissa Sommerfeld

2015-01-01

The purpose of this paper is to describe a trajectory of designing for particular forms of engagement with mathematics. The forms of engagement that were targeted through these design experiments involved making intentional choices about which procedures to leverage in order to support particular claims (what I call "critical…

Autonomy Support for Online Students

ERIC Educational Resources Information Center

Lee, Eunbae; Pate, Joseph A.; Cozart, Deanna

2015-01-01

Despite the rapid growth of online learning in higher education, the dropout rates for online courses has reached 50 percent. Lack of student engagement rank as a critical reason for frequent online course dropout. This article discusses autonomy support as a strategy to enhance online students' intrinsic motivation and engagement. Drawing from…

Implementing Positive Behavior Support with Chinese American Families: Enhancing Cultural Competence

ERIC Educational Resources Information Center

Wang, Mian; McCart, Amy; Turnbull, Ann P.

2007-01-01

In positive behavior support (PBS) practices, one critical issue involves helping professionals understand and respect the values of families from culturally diverse backgrounds. This article summarizes embedded cultural values of PBS represented in four key features of the PBS process: collaborative partnerships, functional assessment, contextual…

A Collaborative Professional Development Initiative Supporting Early Literacy Coaches

ERIC Educational Resources Information Center

Mraz, Maryann; Kissel, Brian; Algozzine, Bob; Babb, Julie; Foxworth, Kimberly

2011-01-01

Many believe that the key to translating research into successful practice lies in providing teachers with continuous professional development and ongoing coaching support. In this article, we provide an overview of the relevant coaching literature and describe 4 critical features of an evidence-based preschool literacy coaching model: the coach…

Risk Managers’ Descriptions of Programs to Support Second Victims after Adverse Events

PubMed Central

White, Andrew A.; Brock, Doug; McCotter, Patricia I.; Hofeldt, Ron; Edrees, Hanan H.; Wu, Albert W.; Shannon, Sarah; Gallagher, Thomas H.

2015-01-01

Guidelines call for healthcare organizations to provide emotional support for clinicians involved in adverse events, but little is known about these organizations seek to meet this need. We surveyed U.S. members of ASHRM about the presence, features, and perceived efficacy of their organization’s provider support program. The majority reported that their organization had a support program, but features varied widely and there are substantial opportunities to improve services. Provider support programs should enhance referral mechanisms and peer support, critically appraise the role of Employee Assistance Programs, and demonstrate their value to institutional leaders. PMID:25891288

Advanced catalyst supports for PEM fuel cell cathodes

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

Du, Lei; Shao, Yuyan; Sun, Junming

2016-11-01

Electrocatalyst support materials are key components for polymer exchange membrane (PEM) fuel cells, which play a critical role in determining electrocatalyst durability and activity, mass transfer and water management. The commonly-used supports, e.g. porous carbon black, cannot meet all the requirements under the harsh operation condition of PEM fuel cells. Great efforts have been made in the last few years in developing alternative support materials. In this paper, we selectively review recent progress on three types of important support materials: carbon, non-carbon and hybrid carbon-oxides nanocomposites. A perspective on future R&D of electrocatalyst support materials is also provided.

A Knowledge-based System for Intelligent Support in Pharmacogenomics Evidence Assessment: Ontology-driven Evidence Representation and Retrieval.

PubMed

Lee, Chia-Ju; Devine, Beth; Tarczy-Hornoch, Peter

2017-01-01

Pharmacogenomics holds promise as a critical component of precision medicine. Yet, the use of pharmacogenomics in routine clinical care is minimal, partly due to the lack of efficient and effective use of existing evidence. This paper describes the design, development, implementation and evaluation of a knowledge-based system that fulfills three critical features: a) providing clinically relevant evidence, b) applying an evidence-based approach, and c) using semantically computable formalism, to facilitate efficient evidence assessment to support timely decisions on adoption of pharmacogenomics in clinical care. To illustrate functionality, the system was piloted in the context of clopidogrel and warfarin pharmacogenomics. In contrast to existing pharmacogenomics knowledge bases, the developed system is the first to exploit the expressivity and reasoning power of logic-based representation formalism to enable unambiguous expression and automatic retrieval of pharmacogenomics evidence to support systematic review with meta-analysis.

Design for Safety - The Ares Launch Vehicles Paradigm Change

NASA Technical Reports Server (NTRS)

Safie, Fayssal M.; Maggio, Gaspare

2010-01-01

The lessons learned from the S&MA early involvement in the Ares I launch vehicle design phases proved that performing an in-line function jointly with engineering is critical for S&MA to have an effective role in supporting the system, element, and component design. These lessons learned were used to effectively support the Ares V conceptual design phase and planning for post conceptual design phases. The Top level Conceptual LOM assessment for Ares V performed by the S&MA community jointly with the engineering Advanced Concept Office (ACO) was influential in the final selection of the Ares V system configuration. Post conceptual phase, extensive reliability effort should be planned to support future Heavy Lift Launch Vehicles (HLLV) design. In-depth reliability analysis involving the design, manufacturing, and system engineering communities is critical to understand design and process uncertainties and system integrated failures.

The state of research into children with cancer across Europe: new policies for a new decade

PubMed Central

Pritchard-Jones, K; Lewison, G; Camporesi, S; Vassal, G; Ladenstein, R; Benoit, Y; Predojevic, JS; Sterba, J; Stary, J; Eckschlager, T; Schroeder, H; Doz, F; Creutzig, U; Klingebiel, T; Kosmidis, HV; Garami, M; Pieters, R; O’Meara, A; Dini, G; Riccardi, R; Rascon, J; Rageliene, L; Calvagna, V; Czauderna, P; Kowalczyk, JR; Gil-da-Costa, MJ; Norton, L; Pereira, F; Janic, D; Puskacova, J; Jazbec, J; Canete, A; Hjorth, L; Ljungman, G; Kutluk, T; Morland, B; Stevens, M; Walker, D; Sullivan, R

2011-01-01

Overcoming childhood cancers is critically dependent on the state of research. Understanding how, with whom and what the research community is doing with childhood cancers is essential for ensuring the evidence-based policies at national and European level to support children, their families and researchers. As part of the European Union funded EUROCANCERCOMS project to study and integrate cancer communications across Europe, we have carried out new research into the state of research in childhood cancers. We are very grateful for all the support we have received from colleagues in the European paediatric oncology community, and in particular from Edel Fitzgerald and Samira Essiaf from the SIOP Europe office. This report and the evidence-based policies that arise from it come at a important junction for Europe and its Member States. They provide a timely reminder that research into childhood cancers is critical and needs sustainable long-term support. PMID:22276053

The "nation's conscience:" assessing bioethics commissions as public forums.

PubMed

Dzur, Albert W; Levin, Daniel

2004-12-01

As the fifth national bioethics commission has concluded its work and a sixth is currently underway, it is time to step back and consider appropriate measures of success. This paper argues that standard measures of commissions' influence fail to fully assess their role as public forums. From the perspective of democratic theory, a critical dimension of this role is public engagement: the ability of a commission to address the concerns of the general public, to learn how average citizens resolve moral issues in healthcare, and to monitor public opinion on the topics addressed in the commission. Such a public forum role is supported by the critical literature within bioethics, which has deemed some commissions successful, supported more generally by the history of bioethics as a reform discourse that has brought socially important values into the medical domain, and supported more generally still by the example of the great social issues commissions of the 1960s.

[Health promotion in families with paramyloidosis: the role of elders with younger family members].

PubMed

Oliveira, Carla Roma; Mendes, Álvaro; Sousa, Liliana

2017-06-12

Citizens are now partners in the formal health promotion system. In the management of hereditary diseases, the role of family members is a vital source of support. Elders play a crucial role due to their long relationship with the disease and with patients in the family. However, this role has still been insufficiently explored, particularly in genetic disorders like paramyloidosis. This exploratory qualitative study analyzes the role of elders in families with paramyloidosis, in health promotion for younger members. The critical incidents technique was applied using a semi-structured interview. The study involved 18 participants who reported 76 critical incidents. The interviews were taped and submitted to content analysis. The principal results suggest the following roles for elders with younger family members: act as role models (in behaviors), encourage, inform, and support. The older generations can be mobilized by health professionals as partners to support younger generations in families with paramyloidosis.

Authors’ Financial Relationships With the Food and Beverage Industry and Their Published Positions on the Fat Substitute Olestra

PubMed Central

Levine, Jane; Gussow, Joan Dye; Hastings, Diane; Eccher, Amy

2003-01-01

Objectives. This study examined the association between authors’ published positions on the safety and efficacy in assisting with weight loss of the Procter & Gamble (P&G) fat substitute olestra and their financial relationships with the food and beverage industry. Methods. Journal articles about olestra, and their authors, were classified as supportive, critical, or neutral with respect to its use. Authors not known to have industry affiliations were surveyed about their financial relationships. Results. Supportive authors were significantly more likely than critical or neutral authors to have financial relationships with P&G (80% vs 11% and 21%, respectively; P < .0001). All authors disclosing an affiliation with P&G were supportive. Conclusions. Because authors’ published opinions were associated with their financial relationships, obtaining noncommercial funding may be more essential to maintaining objectivity than disclosing personal financial interests. PMID:12660215

Internal Waves in CVX

NASA Technical Reports Server (NTRS)

Berg, Robert F.

1996-01-01

Near the liquid-vapor critical point, density stratification supports internal gravity waves which affect 1-g viscosity measurements in the CVX (Critical Viscosity of Xenon) experiment. Two internal-wave modes were seen in the horizontal viscometer. The frequencies of the two modes had different temperature dependences: with decreasing temperature, the higher frequency increased monotonically from 0.7 to 2.8 Hz, but the lower frequency varied non-monotonically, with a maximum of 1.0 Hz at 20 mK above the critical temperature. The measured frequencies agree with independently calculated frequencies to within 15%.

Coal gasification systems engineering and analysis. Appendix F: Critical technology items/issues

NASA Technical Reports Server (NTRS)

1980-01-01

Critical technology items and issues are defined in which there is a need for developmental research in order to assure technical and economic success for the state of the art of coal gasification in the United States. Technology development needs for the main processing units and the supporting units are discussed. While development needs are shown for a large number of systems, the most critical areas are associated with the gasifier itself and those systems which either feed the gasifier or directly receive products form the gasifier.

Critical Viscosity of Xenon team

NASA Technical Reports Server (NTRS)

2001-01-01

The Critical Viscosity of Xenon Experiment (CVX-2) on the STS-107 Research 1 mission in 2002 will measure the viscous behavior of xenon, a heavy inert gas used in flash lamps and ion rocket engines, at its critical point. The thermostat for CVX sits inside the white cylinder on a support structure (at left) that is placed inside a pressure canister. A similar canister (right) holds the electronics and control systems. The CVX-2 arrangement is identical. The principal investigator is Dr. Robert F. Berg (left) of the National Institutes of Standards and Technology, Gaithersburg, MD.

Critical Viscosity of Xenon team

NASA Technical Reports Server (NTRS)

2001-01-01

The Critical Viscosity of Xenon Experiment (CVX-2) on the STS-107 Research 1 mission in 2002 will measure the viscous behavior of xenon, a heavy inert gas used in flash lamps and ion rocket engines, at its critical point. The thermostat for CVX sits inside the white cylinder on a support structure (at left) that is placed inside a pressure canister. A similar canister (right) holds the electronics and control systems. The CVX-2 arrangement is identical. The principal investigator is Dr. Robert F. Berg (not shown) of the National Institutes of Standards and Technology, Gaithersburg, MD.

Advanced Analytic Cognition: Critical Thinking

DTIC Science & Technology

2013-09-01

showed no significant differences between the experimental and control groups . Further, posttest means were not significantly different from pretest ...means in either group ( Pretest : Experimental M = 296, Control M = 297; Posttest : Experimental M = 298, Control M = 302). It appears that taking a...Delphi group - this was the largest dissident group on any topic - supported the view expressed in this chapter, that critical thinking should be

Regards sur le Cinema (A Look at the Film Industry).

ERIC Educational Resources Information Center

Arroyo, Francine; Avelino, Cristina

1996-01-01

Examines the role of films as an instructional aid in class activities devoted to learning a foreign language as well as one's native tongue with the support of modern technology. One of the primary ways of using film to encourage learning is to interest the students in criticizing the film and then to expose them to published criticism of the…

Are We Having Fun Yet? Institutional Resistance and the Introduction of Play and Experimentation into Learning Innovation through Social Media

ERIC Educational Resources Information Center

Bryant, Peter; Coombs, Antony; Pazio, Monika

2014-01-01

Recognising and responding to behaviours and patterns of resistance is critical to the successful implementation of technology-enhanced learning strategies at higher education institutions. At institutional, academic and student levels, resistance manifests itself in a variety of forms, at best supporting a critical culture and at worst creating…

An Examination of the Instruction Provided in Australian Essay Guides for Students' Development of a Critical Viewpoint

ERIC Educational Resources Information Center

Hammer, Sara

2017-01-01

The argumentative essay has endured as a popular form of university assessment, yet students still struggle to meet key intended learning outcomes, such as those associated with critical thinking. This paper presents the results of a study that examines the instruction provided by Australian essay writing guides to support students' development of…

Problem-Based Learning on Students' Critical Thinking Skills in Teaching Business Education in Malaysia: A Literature Review

ERIC Educational Resources Information Center

Zabit, Mohd Nazir Md

2010-01-01

This review forms the background to explore and to gain empirical support among lecturers to improve the students' critical thinking skills in business education courses in Malaysia, in which the main teaching and learning methodology is Problem-Based Learning (PBL). The PBL educational approach is known to have maximum positive impacts in…

Integrated Interdisciplinary Science of the Critical Zone as a Foundational Curriculum for Addressing Issues of Environmental Sustainability

ERIC Educational Resources Information Center

White, Timothy; Wymore, Adam; Dere, Ashlee; Hoffman, Adam; Washburne, James; Conklin, Martha

2017-01-01

Earth's critical zone (CZ) is the uppermost layer of Earth's continents, which supports ecosystems and humans alike. CZ science aims to understand how interactions among rock, soil, water, air, and terrestrial organisms influence Earth as a habitable system. Thus, CZ science provides the framework for a holistic-systems approach to teaching Earth…

Safe Spaces, Support, Social Capital: A Critical Analysis of Artists Working with Vulnerable Young People in Educational Contexts

ERIC Educational Resources Information Center

Sellman, Edward

2015-01-01

This article provides a critical and thematic analysis of three research projects involving artists working with vulnerable young people in educational contexts. It argues that artists create safe spaces in contrast to traditional educational activities but it will also raise questions about what constitutes such a space for participants. It will…

"Math Is All around Us and … We Can Use It to Help Us": Teacher Agency in Mathematics Education through Critical Reflection

ERIC Educational Resources Information Center

Felton, Mathew D.; Koestler, Courtney

2015-01-01

As social-justice mathematics teacher educators, we have always engaged and supported the prospective and practicing teachers in our classes in critical reflection about mathematics and the teaching and learning of mathematics (Felton, 2010, 2012; Felton & Koestler, 2012; Koestler, 2012). Although there are different notions, purposes, and…

2015 Survey of Board Professionals: Who They Are, What They Do, and Their Important Role in Governance

ERIC Educational Resources Information Center

Hodge-Clark, Kristen

2015-01-01

Board professionals provide critical support, planning, and coordination of important board functions. Their work is often unheralded and conducted behind the scenes, but it is critical to the success and performance of the board. Since 1991, the Association of Governing Boards (AGB) has surveyed this group to capture the changing nature of their…

Method of calculation of critical values of financial indicators for developing food security strategy

NASA Astrophysics Data System (ADS)

Aigyl Ilshatovna, Sabirova; Svetlana Fanilevna, Khasanova; Vildanovna, Nagumanova Regina

2018-05-01

On the basis of decision making theory (minimax and maximin approaches) the authors propose a technique with the results of calculations of the critical values of effectiveness indicators of agricultural producers in the Republic of Tatarstan for 2013-2015. There is justified necessity of monitoring the effectiveness of the state support and the direction of its improvement.

Critical Literacy and Transgender Topics in an Upper Elementary Classroom: A Portrait of Possibility

ERIC Educational Resources Information Center

Hermann-Wilmarth, Jill M.; Lannen, Rosemary; Ryan, Caitlin L.

2017-01-01

In this paper, we explore the intersection of critical literacy pedagogy, queer pedagogy, and transgender topics by turning our attention to the learning that supported the writing of an acrostic poem about Title IX and transgender students. We examine how this writing, in turn, created additional content and context that spurred others' learning.…

"In the Middle of Difficulty Lies Opportunity"--Using a Case Study to Identify Critical Success Factors Contributing to the Initiation of International Collaborative Projects

ERIC Educational Resources Information Center

Johnson, Ian M.

2005-01-01

This paper identifies factors that contribute to the successful initiation of international collaborative projects intended to support the development of education for librarianship and information sciences. It discusses the widespread failure to analyse the Critical Success Factors in international collaborative projects and proposes a case study…

Critical care in the austere environment: providing exceptional care in unusual places.

PubMed

Venticinque, Steven G; Grathwohl, Kurt W

2008-07-01

War and other disasters are inexorably linked to illness and injury. As a consequence of this, healthcare providers will be challenged to provide advanced physiological support to preserve human life. Given the mobility and modularity of modern medical systems, the ability to provide critical care outside of the confines of traditional hospitals under such circumstances has become not only a reality and periodic necessity, but an expectation. Austerity amplifies the complexity of providing high-level critical care, because resources are frequently limited, providers are asked to fill unexpected roles determined by necessity, security may be threatened, and the population at risk and their afflictions can be highly diverse. Our current deployed military medical experience and a review of published literature pertaining to civilian medical disaster response efforts support these stated challenges. The fundamentals of successful critical care practice in unusual settings include proper planning with an emphasis on attention to detail, the careful management of all resources, using the proper equipment, leveraging aeromedical evacuation assets, and employing the right people with the right skills. Adherence to sound, evidence-based, routine practice, within bounds of the circumstances, must underscore everything.

Safety Analysis of Soybean Processing for Advanced Life Support

NASA Technical Reports Server (NTRS)

Hentges, Dawn L.

1999-01-01

Soybeans (cv. Hoyt) is one of the crops planned for food production within the Advanced Life Support System Integration Testbed (ALSSIT), a proposed habitat simulation for long duration lunar/Mars missions. Soybeans may be processed into a variety of food products, including soymilk, tofu, and tempeh. Due to the closed environmental system and importance of crew health maintenance, food safety is a primary concern on long duration space missions. Identification of the food safety hazards and critical control points associated with the closed ALSSIT system is essential for the development of safe food processing techniques and equipment. A Hazard Analysis Critical Control Point (HACCP) model was developed to reflect proposed production and processing protocols for ALSSIT soybeans. Soybean processing was placed in the type III risk category. During the processing of ALSSIT-grown soybeans, critical control points were identified to control microbiological hazards, particularly mycotoxins, and chemical hazards from antinutrients. Critical limits were suggested at each CCP. Food safety recommendations regarding the hazards and risks associated with growing, harvesting, and processing soybeans; biomass management; and use of multifunctional equipment were made in consideration of the limitations and restraints of the closed ALSSIT.

Mixed Criticality Scheduling for Industrial Wireless Sensor Networks

PubMed Central

Jin, Xi; Xia, Changqing; Xu, Huiting; Wang, Jintao; Zeng, Peng

2016-01-01

Wireless sensor networks (WSNs) have been widely used in industrial systems. Their real-time performance and reliability are fundamental to industrial production. Many works have studied the two aspects, but only focus on single criticality WSNs. Mixed criticality requirements exist in many advanced applications in which different data flows have different levels of importance (or criticality). In this paper, first, we propose a scheduling algorithm, which guarantees the real-time performance and reliability requirements of data flows with different levels of criticality. The algorithm supports centralized optimization and adaptive adjustment. It is able to improve both the scheduling performance and flexibility. Then, we provide the schedulability test through rigorous theoretical analysis. We conduct extensive simulations, and the results demonstrate that the proposed scheduling algorithm and analysis significantly outperform existing ones. PMID:27589741

Critical Thinking and the Use of Nontraditional Instructional Methodologies.

PubMed

Orique, Sabrina B; McCarthy, Mary Ann

2015-08-01

The purpose of this study was to examine the relationship between critical thinking and the use of concept mapping (CM) and problem-based learning (PBL) during care plan development. A quasi-experimental study with a pretest-posttest design was conducted using a convenience sample (n = 49) of first-semester undergraduate baccalaureate nursing students. Critical thinking was measured using the Holistic Critical Thinking Scoring Rubric. Data analysis consisted of a repeated measures analysis of variance with post hoc mean comparison tests using the Bonferroni method. Findings indicated that mean critical thinking at phase 4 (CM and PBL) was significantly higher, compared with phase 1 (baseline), phase 2 (PBL), and phase 3 (CM [p < 0.001]). The results support the utilization of nontraditional instructional (CM and PBL) methodologies in undergraduate nursing curricula. Copyright 2015, SLACK Incorporated.

Universal relations between non-Gaussian fluctuations in heavy-ion collisions

NASA Astrophysics Data System (ADS)

Chen, Jiunn-Wei; Deng, Jian; Kohyama, Hiroaki; Labun, Lance

2017-01-01

We show that universality near a critical end point implies a characteristic relation between third- and fourth-order baryon susceptibilities χ3 and χ4, resulting in a banana-shaped loop when χ4 is plotted as a function of χ3 along a freeze-out line. This result relies only on the derivative relation between χ3 and χ4, the enhancement of the correlation length and the scaling symmetry near a critical point, and the freeze-out line near the critical point not too parallel to the μB axis. Including the individual enhancements of χ3 and χ4 near a critical point, these features may be a consistent set of observations supporting the interpretation of baryon fluctuation data as arising from criticality.

The challenges of caring in a technological environment: critical care nurses' experiences.

PubMed

McGrath, Mary

2008-04-01

This paper presents and discusses the findings from a phenomenological study which illuminated the lived experiences of experienced critical care nurses caring within a technological environment. While nursing practice is interwoven with technology, much of the literature in this area is speculative. Moreover, there is a debate as to whether and how 'high tech' and 'high touch' are reconcilable; this orientation is referred to as the optimism vs. pessimism debate. On a personal level, the motivation for this study came from the author's 13 years' experience in the critical care area. Following ethical approval, 10 experienced nurses from two cardiothoracic critical care units in Ireland participated in the study. A Heideggerian phenomenological methodology was used. Data collection consisted of unstructured interviews. A method of data analysis described by Walters was used. The findings provide research-based evidence to illuminate further the optimistic/pessimistic debate on technology in nursing. While the study demonstrates that the debate is far from resolved, it reveals a new finding: life-saving technology that supports the lives of critically ill patients can bring experienced nurses very close to their patients/families. The three main themes that emerged: 'alien environment', 'pulling together' and 'sharing the journey' were linked by a common thread of caring. Experienced critical care nurses are able to transcend the obtrusive nature of technology to deliver expert caring to their patients. However, the journey to proficiency in technology is very demanding and novice nurses have difficulty in caring with technology. Relevance to clinical practice. It is recommended that more emphasis be placed on supporting, assisting and educating inexperienced nurses in the critical care area and that the use of technology in nursing be given serious consideration.

Health-Related Quality of Life: Expanding a Conceptual Framework to Include Older Adults Who Receive Long-Term Services and Supports

ERIC Educational Resources Information Center

Zubritsky, Cynthia; Abbott, Katherine M.; Hirschman, Karen B.; Bowles, Kathryn H.; Foust, Janice B.; Naylor, Mary D.

2013-01-01

For older adults receiving long-term services and supports (LTSS), health-related quality of life (HRQoL) has emerged as a critical construct to examine because of its focus on components of well-being, which are affected by progressive changes in health status, health care, and social support. HRQoL is a health-focused quality of life (QOL)…

The International Treaty on Global Warming: Is it Good or Bad for the Economy?

NASA Astrophysics Data System (ADS)

Wei, Xinyu; Bao, Wenbin

2018-06-01

Global warming is one of the hottest topics all over the world. International authorities have worked together to negotiate the Paris Agreement on global warming. This Agreement has its supporters and critics. The key question is whether on balance is the Paris Assignment good or bad for the United States economy. This paper begins with some background information leading up to the passage of the treaty. Next, I outline what is in treaty. I then critically analyze the arguments in support of and against the Assignment. Finally, I explain the basis for my opinion that in the long run the treaty will benefit the United States economy.

Critical review: medical students' motivation after failure.

PubMed

Holland, Chris

2016-08-01

About 10 % of students in each years' entrants to medical school will encounter academic failure at some stage in their programme. The usual approach to supporting these students is to offer them short term remedial study programmes that often enhance approaches to study that are orientated towards avoiding failure. In this critical review I will summarise the current theories about student motivation that are most relevant to this group of students and describe how they are enhanced or not by various contextual factors that medical students experience during their programme. I will conclude by suggesting ways in which support programmes for students who have encountered academic failure might be better designed and researched in the future.

Against anti-health epidemiology: corporate obstruction of public health via manipulation of epidemiology.

PubMed

Egilman, David; Howe, Samantha

2007-01-01

In response to several articles on corporate corruption of science that appeared earlier in this journal, a critic outlined an epistemological model based on an unsupported assertion that epidemiologic evidence is always required to support cause-effect relationships. This model, if adopted, would eliminate compensation to victims of toxic exposures and impede regulation of accepted hazards. Epidemiology is only one element in support of cause-effect determinations. The critic's proposal of an anti-health epidemiology was initially developed by corporations with the goal of providing defense in litigation, and is based not on science but on a corporate need to enhance profits at the expense of public health.

An aspect-oriented approach for designing safety-critical systems

NASA Astrophysics Data System (ADS)

Petrov, Z.; Zaykov, P. G.; Cardoso, J. P.; Coutinho, J. G. F.; Diniz, P. C.; Luk, W.

The development of avionics systems is typically a tedious and cumbersome process. In addition to the required functions, developers must consider various and often conflicting non-functional requirements such as safety, performance, and energy efficiency. Certainly, an integrated approach with a seamless design flow that is capable of requirements modelling and supporting refinement down to an actual implementation in a traceable way, may lead to a significant acceleration of development cycles. This paper presents an aspect-oriented approach supported by a tool chain that deals with functional and non-functional requirements in an integrated manner. It also discusses how the approach can be applied to development of safety-critical systems and provides experimental results.

Examining critical care nurses' critical incident stress after in hospital cardiopulmonary resuscitation (CPR).

PubMed

Laws, T

2001-05-01

The object of this study was to determine if critical care nurses' emotional responses to having performed cardiopulmonary resuscitation were indicative of critical incident stress. A descriptive approach was employed using a survey questionnaire of 31 critical care nurses, with supportive interview data from 18 of those participants. Analysis of the data generated from the questionnaire indicated that the respondents experienced thought intrusion and avoidance behaviour. A majority of those interviewed disclosed that they had experienced a wide range of emotional stressors and physical manifestations in response to having performed the procedure. The findings from both questionnaire and interview data were congruent with signs of critical incident stress, as described in the literature. This has been found to be detrimental to employees' mental health status and, for this reason, employers have a duty of care to minimise the risk of its occurrence and to manage problems as they arise.

Effect of load eccentricity on the buckling of thin-walled laminated C-columns

NASA Astrophysics Data System (ADS)

Wysmulski, Pawel; Teter, Andrzej; Debski, Hubert

2018-01-01

The study investigates the behaviour of short, thin-walled laminated C-columns under eccentric compression. The tested columns are simple-supported. The effect of load inaccuracy on the critical and post-critical (local buckling) states is examined. A numerical analysis by the finite element method and experimental tests on a test stand are performed. The samples were produced from a carbon-epoxy prepreg by the autoclave technique. The experimental tests rest on the assumption that compressive loads are 1.5 higher than the theoretical critical force. Numerical modelling is performed using the commercial software package ABAQUS®. The critical load is determined by solving an eigen problem using the Subspace algorithm. The experimental critical loads are determined based on post-buckling paths. The numerical and experimental results show high agreement, thus demonstrating a significant effect of load inaccuracy on the critical load corresponding to the column's local buckling.

Voltage Imaging of Waking Mouse Cortex Reveals Emergence of Critical Neuronal Dynamics

PubMed Central

Scott, Gregory; Fagerholm, Erik D.; Mutoh, Hiroki; Leech, Robert; Sharp, David J.; Shew, Woodrow L.

2014-01-01

Complex cognitive processes require neuronal activity to be coordinated across multiple scales, ranging from local microcircuits to cortex-wide networks. However, multiscale cortical dynamics are not well understood because few experimental approaches have provided sufficient support for hypotheses involving multiscale interactions. To address these limitations, we used, in experiments involving mice, genetically encoded voltage indicator imaging, which measures cortex-wide electrical activity at high spatiotemporal resolution. Here we show that, as mice recovered from anesthesia, scale-invariant spatiotemporal patterns of neuronal activity gradually emerge. We show for the first time that this scale-invariant activity spans four orders of magnitude in awake mice. In contrast, we found that the cortical dynamics of anesthetized mice were not scale invariant. Our results bridge empirical evidence from disparate scales and support theoretical predictions that the awake cortex operates in a dynamical regime known as criticality. The criticality hypothesis predicts that small-scale cortical dynamics are governed by the same principles as those governing larger-scale dynamics. Importantly, these scale-invariant principles also optimize certain aspects of information processing. Our results suggest that during the emergence from anesthesia, criticality arises as information processing demands increase. We expect that, as measurement tools advance toward larger scales and greater resolution, the multiscale framework offered by criticality will continue to provide quantitative predictions and insight on how neurons, microcircuits, and large-scale networks are dynamically coordinated in the brain. PMID:25505314

Control System Applicable Use Assessment of the Secure Computing Corporation - Secure Firewall (Sidewinder)

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

Hadley, Mark D.; Clements, Samuel L.

2009-01-01

Battelle’s National Security & Defense objective is, “applying unmatched expertise and unique facilities to deliver homeland security solutions. From detection and protection against weapons of mass destruction to emergency preparedness/response and protection of critical infrastructure, we are working with industry and government to integrate policy, operational, technological, and logistical parameters that will secure a safe future”. In an ongoing effort to meet this mission, engagements with industry that are intended to improve operational and technical attributes of commercial solutions that are related to national security initiatives are necessary. This necessity will ensure that capabilities for protecting critical infrastructure assets aremore » considered by commercial entities in their development, design, and deployment lifecycles thus addressing the alignment of identified deficiencies and improvements needed to support national cyber security initiatives. The Secure Firewall (Sidewinder) appliance by Secure Computing was assessed for applicable use in critical infrastructure control system environments, such as electric power, nuclear and other facilities containing critical systems that require augmented protection from cyber threat. The testing was performed in the Pacific Northwest National Laboratory’s (PNNL) Electric Infrastructure Operations Center (EIOC). The Secure Firewall was tested in a network configuration that emulates a typical control center network and then evaluated. A number of observations and recommendations are included in this report relating to features currently included in the Secure Firewall that support critical infrastructure security needs.« less

The European ALMA Regional Centre: a model of user support

NASA Astrophysics Data System (ADS)

Andreani, P.; Stoehr, F.; Zwaan, M.; Hatziminaoglou, E.; Biggs, A.; Diaz-Trigo, M.; Humphreys, E.; Petry, D.; Randall, S.; Stanke, T.; van Kampen, E.; Bárta, M.; Brand, J.; Gueth, F.; Hogerheijde, M.; Bertoldi, F.; Muxlow, T.; Richards, A.; Vlemmings, W.

2014-08-01

The ALMA Regional Centres (ARCs) form the interface between the ALMA observatory and the user community from the proposal preparation stage to the delivery of data and their subsequent analysis. The ARCs provide critical services to both the ALMA operations in Chile and to the user community. These services were split by the ALMA project into core and additional services. The core services are financed by the ALMA operations budget and are critical to the successful operation of ALMA. They are contractual obligations and must be delivered to the ALMA project. The additional services are not funded by the ALMA project and are not contractual obligations, but are critical to achieve ALMA full scientific potential. A distributed network of ARC nodes (with ESO being the central ARC) has been set up throughout Europe at the following seven locations: Bologna, Bonn-Cologne, Grenoble, Leiden, Manchester, Ondrejov, Onsala. These ARC nodes are working together with the central node at ESO and provide both core and additional services to the ALMA user community. This paper presents the European ARC, and how it operates in Europe to support the ALMA community. This model, although complex in nature, is turning into a very successful one, providing a service to the scientific community that has been so far highly appreciated. The ARC could become a reference support model in an age where very large collaborations are required to build large facilities, and support is needed for geographically and culturally diverse communities.

High-risk medical devices, children and the FDA: regulatory challenges facing pediatric mechanical circulatory support devices.

PubMed

Almond, Christopher S D; Chen, Eric A; Berman, Michael R; Less, Joanne R; Baldwin, J Timothy; Linde-Feucht, Sarah R; Hoke, Tracey R; Pearson, Gail D; Jenkins, Kathy; Duncan, Brian W; Zuckerman, Bram D

2007-01-01

Pediatric mechanical circulatory support is a critical unmet need in the United States. Infant- and child-sized ventricular assist devices are currently being developed largely through federal contracts and grants through the National Heart, Lung, and Blood Institute (NHLBI). Human testing and marketing of high-risk devices for children raises epidemiologic and regulatory issues that will need to be addressed. Leaders from the US Food and Drug Administration (FDA), NHLBI, academic pediatric community, and industry convened in January 2006 for the first FDA Workshop on the Regulatory Process for Pediatric Mechanical Circulatory Support Devices. The purpose was to provide the pediatric community with an overview of the federal regulatory process for high-risk medical devices and to review the challenges specific to the development and regulation of pediatric mechanical circulatory support devices. Pediatric mechanical circulatory support present significant epidemiologic, logistic, and financial challenges to industry, federal regulators, and the pediatric community. Early interactions with the FDA, shared appreciation of challenges, and careful planning will be critical to avoid unnecessary delays in making potentially life-saving devices available for children. Collaborative efforts to address these challenges are warranted.

NASA DOEPOD NDE Capabilities Data Book

NASA Technical Reports Server (NTRS)

Generazio, Edward R.

2015-01-01

This data book contains the Directed Design of Experiments for Validating Probability of Detection (POD) Capability of NDE Systems (DOEPOD) analyses of the nondestructive inspection data presented in the NTIAC, Nondestructive Evaluation (NDE) Capabilities Data Book. DOEPOD is designed as a decision support system to validate inspection system, personnel, and protocol demonstrating 0.90 POD with 95% confidence at critical flaw sizes, a90/95. Although 0.90 POD with 95% confidence at critical flaw sizes is often stated as an inspection requirement in inspection documents, including NASA Standards, NASA critical aerospace applications have historically only accepted 0.978 POD or better with a 95% one-sided lower confidence bound exceeding 0.90 at critical flaw sizes, a90/95.

Initiation of nutritional support is delayed in critically ill obese patients: a multicenter cohort study.

PubMed

Borel, Anne-Laure; Schwebel, Carole; Planquette, Benjamin; Vésin, Aurélien; Garrouste-Orgeas, Maité; Adrie, Christophe; Clec'h, Christophe; Azoulay, Elie; Souweine, Bertrand; Allaouchiche, Bernard; Goldgran-Toledano, Dany; Jamali, Samir; Darmon, Michael; Timsit, Jean-François

2014-09-01

A high catabolic rate characterizes the acute phase of critical illness. Guidelines recommend an early nutritional support, regardless of the previous nutritional status. We aimed to assess whether the nutritional status of patients, which was defined by the body mass index (BMI) at admission in an intensive care unit (ICU), affected the time of nutritional support initiation. We conducted a cohort study that reported a retrospective analysis of a multicenter ICU database (OUTCOMEREA) by using data prospectively entered from January 1997 to October 2012. Patients who needed orotracheal intubation within the first 72 h and >3 d were included. Data from 3257 ICU stays were analyzed. The delay before feeding was different according to BMI groups (P = 0.035). The delay was longer in obese patients [BMI (in kg/m²) ≥30; n = 663] than in other patients with either low weight (BMI <20; n = 501), normal weight (BMI ≥20 and <25; n = 1135), or overweight (BMI ≥25 and <30; n = 958). The association between nutritional status and a delay in nutrition initiation was independent of potential confounding factors such as age, sex, and diabetes or other chronic diseases. In comparison with normal weight, the adjusted RR (95% CI) associated with a delayed nutrition initiation was 0.92 (0.86, 0.98) for patients with low weight, 1.00 (0.94, 1.05) for overweight patients, and 1.06 (1.00, 1.12) for obese patients (P = 0.004). The initiation of nutritional support was delayed in obese ICU patients. Randomized controlled trials that address consequences of early compared with delayed beginnings of nutritional support in critically ill obese patients are needed. © 2014 American Society for Nutrition.

Serum concentrations of vitamin A and oxidative stress in critically ill patients with sepsis.

PubMed

Ribeiro Nogueira, C; Ramalho, A; Lameu, E; Da Silva Franca, C A; David, C; Accioly, E

2009-01-01

Sepsis is one of the main causes of mortality in patients in Intensive Care Units. As a result of the systemic inflammatory response and of the decrease of the aerobic metabolism in sepsis, the oxidative stress occurs. Vitamin A is recognized by the favorable effect that it exerts on the immune response to infections and antioxidant action. To bring new elements for reviewing of the nutritional support addressed to critically ill patients with sepsis, with emphasis to vitamin A. Critically ill patients with sepsis had circulating concentrations of retinol, beta-carotene, thiobarbituric acid-reactive substances (TBARS) and C-reactive protein (CRP) measured in Medicosurgical Intensive Care Unit in the city of Rio de Janeiro, Brazil. The patients were divided into two groups: patients who were receiving nutritional support and those without support. At the act of the patient's admission, APACHE II score was calculated. 46 patients were studied (with diet n = 24 and without diet n = 22). Reduced levels of retinol and beta-carotene were found in 65.2% and 73.9% of the patients, respectively. Among the patients who presented lower concentrations of CRP it was found higher beta-carotene inadequacy (64.8%) and 50% of retinol inadequacy. There was no significant difference as regards retinol, TBARS and APACHE II levels among the patients with and without nutritional support. However, higher levels of CRP (p = 0.001) and lower levels of serum beta-carotene (p = 0.047) were found in patients without nutritional support. Septic patients presented an important inadequacy of retinol and beta-carotene. The present study bring elements to the elaboration/review of the nutritional protocol directed to the group studied, especially as regards vitamin A intake.

Self-Criticism as a Transdiagnostic Process in Nonsuicidal Self-Injury and Disordered Eating: Systematic Review and Meta-Analysis.

PubMed

Zelkowitz, Rachel L; Cole, David A

2018-03-05

Nonsuicidal self-injury (NSSI) and disordered eating (DE) are highly comorbid and may be regarded as belonging to a spectrum of self-harm behaviors. We investigated self-criticism as a transdiagnostic correlate of these behaviors, in keeping with etiological theories of both NSSI and DE. We reviewed the literature and meta-analyzed the relation of self-criticism to both NSSI (15 studies; 17 effect sizes) and DE (24 studies; 29 effect sizes). Results showed equivalent, moderate-to-large effects for the relation of self-criticism to NSSI (r = .38; CI: .29-.46) and DE (r = .40; CI: .34-.45). The relation of NSSI to self-criticism generalized across multiple potential moderators. DE behavior type moderated the relation of self-criticism to DE, with a stronger relation emerging for purging than restriction. Findings support self-criticism as a possible candidate for transdiagnostic pathways to self-harm. © 2018 The American Association of Suicidology.

[Prevention and management of refeeding syndrome in patients with chronic critical illness].

PubMed

Chen, Jun; Fan, Chaogang

2016-07-01

Nutritional support is an important means to treat the patients with chronic critical illness for commonly associated malnutrition. Refeeding syndrome is a serious complication during the process, mainly manifested as severe electrolyte with hypophosphataemia being the most common. Refeeding syndrome is not uncommon but it is often ignored. In our future clinical work, we need to recognize this chinical situation and use preventative and treatment measures. According to NICE clinical nutrition guideline, we discussed the risk factors, treatment methods and preventive measures of refeeding syndrome in patients with chronic critical illness. We argued that for patients with high risk refeeding syndrome, nutritional support treatment should be initially low calorie and slowly increased to complete requirement. Circulation capacity should be recovered, fluid balance must be closely monitored and supplement of vitamins, microelement, electrolytes should be noted. After the emergence of refeeding syndrome, we should reduce or even stop the calorie intake, give an active treatment for electrolyte disorder, provide vitamin B, and maintain the functions of multiple organs.

LIDAR technology developments in support of ESA Earth observation missions

NASA Astrophysics Data System (ADS)

Durand, Yannig; Caron, Jérôme; Hélière, Arnaud; Bézy, Jean-Loup; Meynart, Roland

2017-11-01

Critical lidar technology developments have been ongoing at the European Space Agency (ESA) in support of EarthCARE (Earth Clouds, Aerosols, and Radiation Explorer), the 6th Earth Explorer mission, and A-SCOPE (Advanced Space Carbon and Climate Observation of Planet Earth), one of the candidates for the 7th Earth Explorer mission. EarthCARE is embarking an Atmospheric backscatter Lidar (ATLID) while A-SCOPE is based on a Total Column Differential Absorption Lidar. As EarthCARE phase B has just started, the pre-development activities, aiming at validating the technologies used in the flight design and at verifying the overall instrument performance, are almost completed. On the other hand, A-SCOPE pre-phase A has just finished. Therefore technology developments are in progress, addressing critical subsystems or components with the lowest TRL, selected in the proposed instrument concepts. The activities described in this paper span over a broad range, addressing all critical elements of a lidar from the transmitter to the receiver.

The Use of Learning Study in Designing Examples for Teaching Physics

NASA Astrophysics Data System (ADS)

Guo, Jian-Peng; Yang, Ling-Yan; Ding, Yi

2017-07-01

Researchers have consistently demonstrated that studying multiple examples is more effective than studying one example because comparing multiple examples can promote schema construction and facilitate discernment of critical aspects. Teachers, however, are usually absent from those self-led text-based studies. In this experimental study, a learning study approach based on variation theory was adopted to examine the effectiveness of teachers' different ways of designing multiple examples in helping students learn a physics principle. Three hundred and fifty-one tenth-grade students learned to distinguish action-reaction from equilibrium (a) by comparing examples that varied critical aspects first separately and then simultaneously, or (b) by comparing examples that separately varied critical aspects only. Results showed that students with average academic attainment benefited more from comparing examples in the first condition. Students with higher academic attainment learned equally within both conditions. This finding supports the advantage of simultaneous variation. The characteristics of students and instructional support should be taken into account when considering the effectiveness of patterns of variation.

[Relationship between cognitive content and emotions following dilatory behavior: considering the level of trait procrastination].

PubMed

Hayashi, Junichiro

2009-02-01

The present study developed and evaluated the Automatic Thoughts List following Dilatory Behavior (ATL-DB) to explore the mediation hypothesis and the content-specificity hypothesis about the automatic thoughts with trait procrastination and emotions. In Study 1, data from 113 Japanese college students were used to choose 22 items to construct the ATL-DB. Two factors were indentified, I. Criticism of Self and Behavior, II. Difficulty in Achievement. These factors had high degrees of internal consistency and had positive correlations to trait procrastination. In Study 2, the relationships among trait procrastination, the automatic thoughts, depression, and anxiety were examined in 261 college students by using Structural Equation Modeling. The results showed that the influence of trait procrastination on depression was mainly mediated through Criticism of Self and Behavior only, while the influence of trait procrastination to anxiety was mediated through Criticism of Self and Behavior and Difficulty in Achievement. Therefore, the mediation hypothesis was supported and the content-specificity hypothesis was partially supported.

Implementation and evaluation of critical thinking strategies to enhance critical thinking skills in Middle Eastern nurses.

PubMed

Simpson, Elaine; Courtney, Mary

2008-12-01

The purpose of this study was to develop, implement and evaluate critical thinking strategies to enhance critical thinking skills in Middle Eastern nurses. Critical thinking strategies such as questioning, debate, role play and small group activity were developed and used in a professional development programme, which was trialled on a sample of Middle Eastern nurses (n = 20), to promote critical thinking skills, encourage problem solving, development of clinical judgment making and care prioritization in order to improve patient care and outcomes. Classroom learning was transformed from memorization to interaction and active participation. The intervention programme was successful in developing critical thinking skills in both the nurse educators and student nurses in this programme. This programme successfully integrated critical thinking strategies into a Middle Eastern nursing curriculum. Recommendations are as follows: (1) utilize evidence-based practice and stem questions to encourage the formulation of critical thinking questions; (2) support the needs of nurse educators for them to effectively implement teaching strategies to foster critical thinking skills; and (3) adopt creative approaches to (i) transform students into interactive participants and (ii) open students' minds and stimulate higher-level thinking and problem-solving abilities.

Body weight-supported bedside treadmill training facilitates ambulation in ICU patients: An interventional proof of concept study.

PubMed

Sommers, Juultje; Wieferink, Denise C; Dongelmans, Dave A; Nollet, Frans; Engelbert, Raoul H H; van der Schaaf, Marike

2017-10-01

Early mobilisation is advocated to improve recovery of intensive care unit (ICU) survivors. However, severe weakness in combination with tubes, lines and machinery are practical barriers for the implementation of ambulation with critically ill patients. The aim of this study was to explore the feasibility of Body Weight-Supported Treadmill Training (BWSTT) in critically ill patients in the ICU. A custom build bedside Body Weight-Supported Treadmill was used and evaluated in medical and surgical patients in the ICU. Feasibility was evaluated according to eligibility, successful number of BWSTT, number of staff needed, adverse events, number of patients that could not have walked without BWSTT, patient satisfaction and anxiety. Twenty participants, underwent 54 sessions BWSTT. Two staff members executed the BWSTT and no adverse events occurred. Medical equipment did not have to be disconnected during all treatment sessions. In 74% of the sessions, the participants would not have been able to walk without the BWSTT. Patient satisfaction with BWSTT was high and anxiety low. This proof of concept study demonstrated that BWSTT is safe, reduces staff resource, and facilitates the first time to ambulation in critically ill patients with severe muscle weakness in the ICU. Copyright © 2017 Elsevier Inc. All rights reserved.