ERIC Educational Resources Information Center
Abraham, Reem Rachel; Raghavendra, Rao; Surekha, Kamath; Asha, Kamath
2009-01-01
A single examination does not fulfill all the functions of assessment. The present study was undertaken to determine the reliability and student satisfaction regarding the objective structured practical examination (OSPE) as a method of assessment of laboratory exercises in physiology before implementing it in the forthcoming university…
ERIC Educational Resources Information Center
Lakshmipathy, K.
2015-01-01
The objectives of the present study were to 1) assess student attitudes to physiology, 2) evaluate student opinions about the influence of an objective structured practical examination (OSPE) on competence, and 3) assess the validity and reliability of an indigenously designed feedback questionnaire. A structured questionnaire containing 16 item…
ERIC Educational Resources Information Center
Snodgrass, Suzanne J.; Ashby, Samantha E.; Rivett, Darren A.; Russell, Trevor
2014-01-01
Assessment of practical clinical skills is essential in the health fields. Objective Structured Clinical Exams (OSCEs), where examiners assess students performing clinical procedures on simulated patients (actors), are central to the evaluation of practical skills. However, traditional OSCEs require considerable time-investment to administer, and…
Breastfeeding Duration and Authoritative Feeding Practices in First-Time Mothers.
Jansen, Elena; Mallan, Kimberley M; Byrne, Rebecca; Daniels, Lynne A; Nicholson, Jan M
2016-08-01
Longer breastfeeding duration appears to have a protective effect against childhood obesity. This effect may be partially mediated by maternal feeding practices during the first years of life. However, the few studies that have examined links between breastfeeding duration and subsequent feeding practices have yielded conflicting results. Using a large sample of first-time mothers and a newly validated, comprehensive measure of maternal feeding (the Feeding Practices and Structure Questionnaire), this study examined associations between breastfeeding duration and maternal feeding practices at child age 24 months. Mothers (n = 458) enrolled in the NOURISH trial provided data on breastfeeding at child age 4, 14, and 24 months, and on feeding practices at 24 months. Structural equation modeling was used to examine associations between breastfeeding duration and 5 nonresponsive and 4 structure-related "authoritative" feeding practices, adjusting for a range of maternal and child characteristics. The model showed acceptable fit (χ(2)/df = 1.68; root mean square error of approximation = .04, comparative fit index = .91, and Tucker-Lewis index = .89) and longer breastfeeding duration was negatively associated with 4 out of 5 nonresponsive feeding practices and positively associated with 3 out of 4 structure-related feeding practices. Overall, these results suggest that mothers who breastfeed longer reported using more appropriate feeding practices. These data demonstrate an association between longer breastfeeding duration and authoritative feeding practices characterized by responsiveness and structure, which may partly account for the apparent protective effect of breastfeeding on childhood obesity. © The Author(s) 2015.
Stakeholder Expectations in Practice-Based Medicine
ERIC Educational Resources Information Center
Mills, Ann E.; Rorty, Mary V.; Werhane, Patricia H.
2003-01-01
Competitive pressures are forcing physicians from solo practice into new organizational structures. These new structures and the technologies supporting them have generated suggestions for improving medical practice. This article examines the unspoken assumption often accompanying these suggestions that practice improvement can come about through…
Holtrop, Jodi Summers; Ruland, Sandra; Diaz, Stephanie; Morrato, Elaine H; Jones, Eric
2018-05-01
Care management and care managers are becoming increasingly prevalent in primary care medical practice as a means of improving population health and reducing unnecessary care. Care managers are often involved in chronic disease management and associated transitional care. In this study, we examined the communication regarding chronic disease care within 24 primary care practices in Michigan and Colorado. We sought to answer the following questions: Do care managers play a key role in chronic disease management in the practice? Does the prominence of the care manager's connectivity within the practice's communication network vary by the type of care management structure implemented? Individual written surveys were given to all practice members in the participating practices. Survey questions assessed demographics as well as practice culture, quality improvement, care management activities, and communication regarding chronic disease care. Using social network analysis and other statistical methods, we analyzed the communication dynamics related to chronic disease care for each practice. The structure of chronic disease communication varies greatly from practice to practice. Care managers who were embedded in the practice or co-located were more likely to be in the core of the communication network than were off-site care managers. These care managers also had higher in-degree centrality, indicating that they acted as a hub for communication with team members in many other roles. Social network analysis provided a useful means of examining chronic disease communication in practice, and highlighted the central role of care managers in this communication when their role structure supported such communication. Structuring care managers as embedded team members within the practice has important implications for their role in chronic disease communication within primary care.
French, Julian M
2014-07-01
Variation in the interpretation of the regulatory guidelines has resulted in a diversity of techniques employed to examine the internal structures of the foetal rabbit head. Examination of the foetal rabbit brain, using a single transverse section as the sole technique, is considered not to be sufficiently thorough to be regarded as an adequate examination method. It is not compliant with published EPA and OECD guidelines covering required examination of the internal head structures, nor is it considered to conform to the spirit of the safety assessment required by the ICH guideline. Fixation of approximately half of the heads in each litter to allow the examination of multiple transverse sections enables the major structures within the head to be assessed effectively. This method is compliant with current guidelines, represents "good practice" and should be consistently adopted for the examination of the internal head structures of the term rabbit foetus. Copyright © 2014 Elsevier Inc. All rights reserved.
Best Practices for Reliable and Robust Spacecraft Structures
NASA Technical Reports Server (NTRS)
Raju, Ivatury S.; Murthy, P. L. N.; Patel, Naresh R.; Bonacuse, Peter J.; Elliott, Kenny B.; Gordon, S. A.; Gyekenyesi, J. P.; Daso, E. O.; Aggarwal, P.; Tillman, R. F.
2007-01-01
A study was undertaken to capture the best practices for the development of reliable and robust spacecraft structures for NASA s next generation cargo and crewed launch vehicles. In this study, the NASA heritage programs such as Mercury, Gemini, Apollo, and the Space Shuttle program were examined. A series of lessons learned during the NASA and DoD heritage programs are captured. The processes that "make the right structural system" are examined along with the processes to "make the structural system right". The impact of technology advancements in materials and analysis and testing methods on reliability and robustness of spacecraft structures is studied. The best practices and lessons learned are extracted from these studies. Since the first human space flight, the best practices for reliable and robust spacecraft structures appear to be well established, understood, and articulated by each generation of designers and engineers. However, these best practices apparently have not always been followed. When the best practices are ignored or short cuts are taken, risks accumulate, and reliability suffers. Thus program managers need to be vigilant of circumstances and situations that tend to violate best practices. Adherence to the best practices may help develop spacecraft systems with high reliability and robustness against certain anomalies and unforeseen events.
Objective structured practical examination (OSPE) in Forensic Medicine: students' point of view.
Menezes, Ritesh G; Nayak, Vinod C; Binu, V S; Kanchan, Tanuj; Rao, P P Jagadish; Baral, Prakash; Lobo, Stany W
2011-11-01
The purpose of this study was to assess the attitudes of undergraduate medical students towards the objective structured practical examination (OSPE) in Forensic Medicine, in a medical college in Nepal. Participants included 59 undergraduate medical students of the 7th semester. Findings indicated that the OSPE was an acceptable tool considering the conduct of practical examination in Forensic Medicine at the undergraduate level. The overall mean attitude score was towards the favourable side. Students strongly agreed that the OSPE tested a wide range of skills. They also strongly agreed that it was a good form of examination as well as a learning experience. The introduction of the OSPE replacing the conventional method of practical examination in Forensic Medicine is a step in the right direction taken to objectively assess undergraduate medical students. Copyright © 2011 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Productivity and turnover in PCPs: the role of staff participation in decision-making.
Hung, Dorothy Y; Rundall, Thomas G; Cohen, Deborah J; Tallia, Alfred F; Crabtree, Benjamin F
2006-10-01
Efforts to redesign primary care practices are beginning to address how decisions are made in the practice setting. This study contributes to these efforts by examining associations between staff participation in decision-making, productivity, and turnover in primary care practices. The study is informed by organizational theories of participation that emphasize cognitive and affective influences on employee output and behavior. This research used data collected from primary care practices involved in a national initiative sponsored by the Robert Wood Johnson Foundation. Cross-sectional survey data on organizational structures and attributes among 49 practices were analyzed. Regression analysis was used to examine associations among practice productivity, staff participation in decision-making, and formal structures such as staff meetings. Associations between staff turnover and participative decision-making were also examined. Staff participation in decisions regarding quality improvement, practice change, and clinical operations was positively associated with practice productivity, whereas formal structures such as staff meetings were not. In addition, higher levels of participation in decision-making were associated with reduced turnover among nonclinicians and administrative staff. Examination of organizational features is increasingly recognized as a key to improving primary care performance. Study findings suggest that one important strategy may be implementation of a participative model emphasizing greater staff involvement in practice decisions. This may enhance information-sharing, work satisfaction, and commitment to organizational decisions, all of which can lead to beneficial outcomes such as increased productivity and stability in primary care practices.
Davis, Drew; Lee, Gordon
2011-07-01
As of 2006, the Accreditation Council for Graduate Medical Education had defined six "core competencies" of residency education: interpersonal communication skills, medical knowledge, patient care, professionalism, practice-based learning and improvement, and systems-based practice. Objective structured clinical examinations using standardized patients are becoming effective educational tools, and the authors developed a novel use of the examinations in plastic surgery residency education that assesses all six competencies. Six plastic surgery residents, two each from postgraduate years 4, 5, and 6, participated in the plastic surgery-specific objective structured clinical examination that focused on melanoma. The examination included a 30-minute videotaped encounter with a standardized patient actor and a postencounter written exercise. The residents were scored on their performance in all six core competencies by the standardized patients and faculty experts on a three-point scale (1 = novice, 2 = moderately skilled, and 3 = proficient). Resident performance was averaged for each postgraduate year, stratified according to core competency, and scored from a total of 100 percent. Residents overall scored well in interpersonal communications skills (84 percent), patient care (83 percent), professionalism (86 percent), and practice-based learning (84 percent). Scores in medical knowledge showed a positive correlation with level of training (86 percent). All residents scored comparatively lower in systems-based practice (65 percent). The residents reported unanimously that the objective structured clinical examination was realistic and educational. The objective structured clinical examination provided comprehensive and meaningful feedback and identified areas of strengths and weakness for the residents and for the teaching program. The examination is an effective assessment tool for the core competencies and a valuable adjunct to residency training.
ERIC Educational Resources Information Center
Frauman, Eric
2017-01-01
Sustainability has gained increasing importance amongst both academic research and organizational practice over the past two decades (Davis & Challenger, 2014). The primary purpose of this study was to examine environmentally sustainable practices among college outdoor programs, while also examining how college level policy and infrastructural…
The Theory and Practice of Structural and Strategic Family Therapies: A Delphi Study.
ERIC Educational Resources Information Center
Fish, Linda Stone; Piercy, Fred P.
1987-01-01
Examined the similarities and differences in the theory and practice of structural and strategic family therapy. A national panel of structural and strategic therapists identified items they thought important to a profile of either structural or strategic family therapy. Mental Research Institute, Haley/Madanes, and Milan/Ackerman approaches to…
Effective communication network structures for hospital infection prevention: a study protocol.
Rangachari, Pavani
2013-01-01
Many hospitals are unable to successfully implement "evidence-based practices" at the unit level. For example, consistent implementation of the central line bundle (CLB), proven to prevent catheter-related bloodstream infections (CRBSIs) is often difficult. This problem has been broadly characterized as "change implementation failure" in health care organizations. Several studies have used retrospective designs to examine the problem; however, there are few prospective studies examining communication dynamics underlying successful implementation of change (eg, evidence-based practices). This prospective study will be set in 2 intensive care units at an academic medical center. At baseline, both units have low compliance with CLB and higher-than-expected CRBSIs. Periodic quality improvement (QI) interventions will be conducted over a 52-week period to promote implementation of CLB in both units. Simultaneously, the following parameters will be examined: (1) Structure and content of communication related to CLB in both units through "communication logs" completed weekly by nurses, physicians, and managers; and (2) outcomes, that is, CLB adherence in both units through weekly chart review. Catheter utilization and CRBSI (infection) rates will serve as additional unit-level outcome measures. The aim is 2-fold: (1) to examine associations between QI interventions and structure and content of communication at the unit level; and (2) to examine associations between structure and content of communication and outcomes at the unit level. The periodic QI interventions are expected to increase CLB adherence and reduce CRBSIs through their influence on structure and content of communication. The prospective design would help examine dynamics in unit-level communication structure and content related to CLB, as well as unit-level outcomes. The study has potential to make significant contributions to theory and practice, particularly if interventions are found to be effective in enabling successful practice change at the unit level. To this effect, the study has potential to provide insights into communication structure and content associated with collective learning and culture change at the unit level. Results and insights are expected to lay a foundation for generating context-sensitive "evidence-based management" strategies for successful practice change at the unit level. An ultimate expected deliverable is the development of an "action-learning framework" for successful implementation of evidence-based practices in health care organizations.
Frankel, Leslie A; Powell, Elisabeth; Jansen, Elena
Food parenting practices influence children's eating behaviors and weight status. Food parenting practices also influence children's self-regulatory abilities around eating, which has important implications for children's eating behaviors. The purpose of the following study is to examine use of structure-related food parenting practices and the potential impact on children's ability to self-regulate energy intake. Parents (n = 379) of preschool age children (M = 4.10 years, SD = 0.92) were mostly mothers (68.6%), Non-White (54.5%), and overweight/obese (50.1%). Hierarchical Multiple Regression was conducted to predict child self-regulation in eating from structure-related food parenting practices (structured meal setting, structured meal timing, family meal setting), while accounting for child weight status, parent age, gender, BMI, race, and yearly income. Hierarchical Multiple Regression results indicated that structure-related feeding practices (structured meal setting and family meal setting, but not structured meal timing) are associated with children's heightened levels of self-regulation in eating. Models examining the relationship within children who were normal weight and overweight/obese indicated the following: a relationship between structured meal setting and heightened self-regulation in eating for normal-weight children and a relationship between family meal setting and heightened self-regulation in eating for overweight/obese children. Researchers should further investigate these potentially modifiable parent feeding behaviors as a protective parenting technique, which possibly contributes to a healthy weight development by enhancing self-regulation in eating.
A Five-Year Evaluation of Examination Structure in a Cardiovascular Pharmacotherapy Course
Kolar, Claire; Janke, Kristin K.
2015-01-01
Objective. To evaluate the composition and effectiveness as an assessment tool of a criterion-referenced examination comprised of clinical cases tied to practice decisions, to examine the effect of varying audience response system (ARS) questions on student examination preparation, and to articulate guidelines for structuring examinations to maximize evaluation of student learning. Design. Multiple-choice items developed over 5 years were evaluated using Bloom’s Taxonomy classification, point biserial correlation, item difficulty, and grade distribution. In addition, examination items were classified into categories based on similarity to items used in ARS preparation. Assessment. As the number of items directly tied to clinical practice rose, Bloom’s Taxonomy level and item difficulty also rose. In examination years where Bloom’s levels were high but preparation was minimal, average grade distribution was lower compared with years in which student preparation was higher. Conclusion. Criterion-referenced examinations can benefit from systematic evaluation of their composition and effectiveness as assessment tools. Calculated design and delivery of classroom preparation is an asset in improving examination performance on rigorous, practice-relevant examinations. PMID:27168611
Pramod Kumar, G N; Sentitoshi; Nath, Dhritiman; Menezes, Ritesh G; Kanchan, Tanuj
2015-05-01
The objective of the present study was to know the perceptions of students regarding objective structured practical examination (OSPE) as a tool for assessment in Forensic Medicine. The present study was conducted in the Department of Forensic Medicine and Toxicology, Mahatma Gandhi Medical College and Research Institute (MGMCRI), Pondicherry, India. Undergraduate medical students of the 4th semester were enrolled in the study to know their perceptions regarding OSPE. The students were briefed regarding OSPE with a PowerPoint presentation and interaction. An examination was conducted using OSPE with10 stations and a total of 74 students participated in the study. The feedback was collected using a preformed proforma consisting of 12 items and analyzed. Most of the participants (82.4%) agreed that OSPE is a better method of examination than the conventional/traditional practical examination. The majority of the participants (77.0%) said that the OSPE covered wide range of knowledge than the conventional practical examination. A large number of students (63.5%) were of the opinion that the OSPE may be exhausting and stressful if number of stations are increased. Overall a larger proportion of the participants preferred OSPE over the conventional practical examination considering the various attributes examined in the study. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
ERIC Educational Resources Information Center
Spear, Caitlin F.; Piasta, Shayne B.; Yeomans-Maldonado, Gloria; Ottley, Jennifer R.; Justice, Laura M.; O'Connell, Ann A.
2018-01-01
In this study, we provide a contemporary examination of the similarities and differences between early childhood general educators (ECEs) and early childhood special educators (ECSEs) within a theoretically driven model that accounted for the associations of beliefs and knowledge with practice. We used structural equation modeling to examine the…
Jansen, Elena; Williams, Kate E; Mallan, Kimberley M; Nicholson, Jan M; Daniels, Lynne A
2016-05-01
Prospective studies and intervention evaluations that examine change over time assume that measurement tools measure the same construct at each occasion. In the area of parent-child feeding practices, longitudinal measurement properties of the questionnaires used are rarely verified. To ascertain that measured change in feeding practices reflects true change rather than change in the assessment, structure, or conceptualisation of the constructs over time, this study examined longitudinal measurement invariance of the Feeding Practices and Structure Questionnaire (FPSQ) subscales (9 constructs; 40 items) across 3 time points. Mothers participating in the NOURISH trial reported their feeding practices when children were aged 2, 3.7, and 5 years (N = 404). Confirmatory Factor Analysis (CFA) within a structural equation modelling framework was used. Comparisons of initial cross-sectional models followed by longitudinal modelling of subscales, resulted in the removal of 12 items, including two redundant or poorly performing subscales. The resulting 28-item FPSQ-28 comprised 7 multi-item subscales: Reward for Behaviour, Reward for Eating, Persuasive Feeding, Overt Restriction, Covert Restriction, Structured Meal Setting and Structured Meal Timing. All subscales showed good fit over 3 time points and each displayed at least partial scalar (thresholds equal) longitudinal measurement invariance. We recommend the use of a separate single item indicator to assess the family meal setting. This is the first study to examine longitudinal measurement invariance in a feeding practices questionnaire. Invariance was established, indicating that the subscales of the shortened FPSQ-28 can be used with mothers to validly assess change in 7 feeding constructs in samples of children aged 2-5 years of age. Copyright © 2016 Elsevier Ltd. All rights reserved.
Using checklists in a gross anatomy laboratory improves learning outcomes and dissection quality.
Hofer, Ryan Engebretson; Nikolaus, O Brant; Pawlina, Wojciech
2011-01-01
Checklists have been widely used in the aviation industry ever since aircraft operations became more complex than any single pilot could reasonably remember. More recently, checklists have found their way into medicine, where cognitive function can be compromised by stress and fatigue. The use of checklists in medical education has rarely been reported, especially in the basic sciences. We explored whether the use of a checklist in the gross anatomy laboratory would improve learning outcomes, dissection quality, and students' satisfaction in the first-year Human Structure didactic block at Mayo Medical School. During the second half of a seven-week anatomy course, dissection teams were each day given a hardcopy checklist of the structures to be identified during that day's dissection. The first half of the course was considered the control, as students did not receive any checklists to utilize during dissection. The measured outcomes were scored on four practice practical examinations and four dissection quality assessments, two each from the first half (control) and second half of the course. A student satisfaction survey was distributed at the end of the course. Examination and dissection scores were analyzed for correlations between practice practical examination score and checklist use. Our data suggest that a daily hardcopy list of anatomical structures for active use in the gross anatomy laboratory increases practice practical examination scores and dissection quality. Students recommend the use of these checklists in future anatomy courses. Copyright © 2011 American Association of Anatomists.
Organizational Collaboration in Liberal Arts Colleges: Examining Structure, Culture, and Agency
ERIC Educational Resources Information Center
Salguero, Claudia F.
2009-01-01
Compelling evidence suggests that collaborative practices may enable higher education institutions to respond more effectively to changes in the external environment and implement more readily innovations in teaching and learning. However, historical practices, cultural values, and structural characteristics of higher education institutions are…
ERIC Educational Resources Information Center
Trede, Franziska; Smith, Megan
2014-01-01
In this paper, we examine workplace educators' interpretations of their assessment practices. We draw on a critical practice lens to conceptualise assessment practice as a social, relational and situated practice that becomes critical through critique and emancipation. We conducted semi-structured interviews followed by roundtable discussions with…
ERIC Educational Resources Information Center
Kemeny, M. Elizabeth
2010-01-01
Using the conceptual model of social structure and personality framework (House, 1981) as a theoretical guide, this cross sectional mixed-method design examined how organizational structure and culture relate to practices for training direct care workers in 328 aging and disability network service provider organizations in Pennsylvania. To…
ERIC Educational Resources Information Center
Chen, Junjun; Brown, Gavin T. L.; Hattie, John A. C.; Millward, Pam
2012-01-01
This study surveyed Chinese middle school (n = 951) teachers' conceptions of excellent teaching and examined the relationship of those conceptions to their self-reported teaching practices. Responses were analyzed using confirmatory factor analysis and structural equation modeling. These teachers identified one examination-oriented dimension and…
Computerized Grading of Anatomy Laboratory Practical Examinations
ERIC Educational Resources Information Center
Krippendorf, Beth B.; Bolender, David L.; Kolesari, Gary L.
2008-01-01
At the Medical College of Wisconsin, a procedure was developed to allow computerized grading and grade reporting of laboratory practical examinations in the Clinical Human Anatomy course. At the start of the course, first year medical students were given four Lists of Structures. On these lists, numbered items were arranged alphabetically; the…
What is an Objective Structured Practical Examination in Anatomy?
ERIC Educational Resources Information Center
Yaqinuddin, Ahmed; Zafar, Muhammad; Ikram, Muhammad Faisal; Ganguly, Paul
2013-01-01
Assessing teaching-learning outcomes in anatomical knowledge is a complex task that requires the evaluation of multiple domains: theoretical, practical, and clinical knowledge. In general, theoretical knowledge is tested by a written examination system constituted by multiple choice questions (MCQs) and/or short answer questions (SAQ). The…
Increased Authenticity in Practical Assessment Using Emergency Case OSCE Stations
ERIC Educational Resources Information Center
Ruesseler, Miriam; Weinlich, Michael; Byhahn, Christian; Muller, Michael P.; Junger, Jana; Marzi, Ingo; Walcher, Felix
2010-01-01
In case of an emergency, a fast and structured patient management is crucial for patient's outcome. The competencies needed should be acquired and assessed during medical education. The objective structured clinical examination (OSCE) is a valid and reliable assessment format to evaluate practical skills. However, traditional OSCE stations examine…
ERIC Educational Resources Information Center
Cho, Sei Hyoung; Song, Ji Hoon; Yun, Suk Chun; Lee, Cheol Ki
2013-01-01
The primary purpose of this research is to examine the structural relationships among several workplace-related constructs, including strategic human resource management (HRM) practices, organizational learning processes, and performance improvement in the Korean business context. More specifically, the research examined the mediating effect of…
ERIC Educational Resources Information Center
Illsley, Rachael; Waller, Richard
2017-01-01
This paper examines how the marketised funding system of vocational further education is affecting lecturers' working practices and professional integrity. Semi-structured interviews were conducted with a number of lecturing staff and managers within two vocational areas at an English FE college to examine the implications of working under the…
ERIC Educational Resources Information Center
Brulle, Robert J.; Benford, Robert D.
2012-01-01
One enduring question in social movements research is the relationship between cultural representations and organizational structure. In this article, we examine the development of different discursive frames over time, and how such frame shifts affect movement structure and practices. This approach seeks to illuminate the dialectical interplay…
The Feminization of Teaching and the Practice of Teaching: Threat or Opportunity?
ERIC Educational Resources Information Center
Griffiths, Morwenna
2006-01-01
In this essay, Morwenna Griffiths considers the effect of feminization on the practices of education. She outlines a feminist theory of practice that draws critically on theories of embodiment, diversity, and structures of power to show that any practice is properly seen as fluid, leaky, and viscous. Examining different and competing…
ERIC Educational Resources Information Center
John, Joanna; Creighton, John
2013-01-01
This paper examines the extent to which a structured undergraduate research intervention, UROP, permits undergraduate students early access to legitimate peripheral participation (LPP) in a research community of practice. Accounts of placement experiences suggest that UROP affords rich possibilities for engagement with research practice.…
ERIC Educational Resources Information Center
Iruka, Iheoma U.
2009-01-01
Research Findings: This study analyzed data from the Early Head Start Research and Evaluation Study (EHSRES) to examine whether the association between family structural characteristics (maternal education, number of parents, employment status, and number of children), parenting practices (sensitive and negative parenting, cognitively stimulating…
Changes in the Structure of Children's Isometric Force Variability with Practice
ERIC Educational Resources Information Center
Deutsch, Katherine M.; Newell, Karl M.
2004-01-01
This study examined the effect of age and practice on the structure of children's force variability to test the information processing hypothesis that a reduction of sensorimotor system noise accounts in large part for age-related reductions in perceptual-motor performance variability. In the study, 6-year-olds, 10-year-olds, and young adults…
Assessment for learning with Objectively Structured Practical Examination in Biochemistry
Jaswal, Shivani; Chattwal, Jugesh; Kaur, Jasbinder; Gupta, Seema; Singh, Tejinder
2015-01-01
Context: Despite a radical shift in assessment methodologies over the last decade, the majority of medical colleges still follow the Traditional Practical Examination (TPE). TPE raises concerns about examiner variability, standardization, and uniformity of assessment. To address these issues and in line with the notion of assessments as motivating what and how students learn, Objectively Structured Practical Examination (OSPE) was introduced, as an assessment modality. Despite its usefulness, awareness and motivation to use the same, still needs to be probed. Aims: To implement OSPE in the assessment of practical skills in biochemistry, and to know student and faculty perspectives regarding OSPE. Settings and Design: OSPE was introduced at the stage of formative assessment of practical skills, for 94 year one MBBS students. Subjects and Methods: Students were divided into two groups; the first group was evaluated by the traditional method and the second by OSPE. Students were crossed over on a second examination. The mean score obtained by both the methods was compared statistically. Students and faculty perspectives regarding OSPE were obtained by a questionnaire. Student performance was compared using “Bland–Altman technique,” and Student's t-test. Results: The mean scores of students was found to be significantly higher (P < 0.0001) when assessed with OSPE as compared to TPE. Number of students achieving >70% marks was also significantly higher with OSPE. Validity was supported by a significant correlation coefficient of comparison of marks by the two methods. Feedback from students and faculty indicated that they endorsed OSPE. Conclusions: This evaluation demonstrated the need for a structured approach to assessment. Going in line with the notion that assessment drives learning, introducing OSPE would help tailoring teaching-learning to optimize student satisfaction and learning. PMID:26380217
ERIC Educational Resources Information Center
Bogo, Marion; Regehr, Cheryl; Logie, Carmen; Katz, Ellen; Mylopoulos, Maria; Regehr, Glenn
2011-01-01
The development of standardized, valid, and reliable methods for assessment of students' practice competence continues to be a challenge for social work educators. In this study, the Objective Structured Clinical Examination (OSCE), originally used in medicine to assess performance through simulated interviews, was adapted for social work to…
Hampson, Sarah E; Edmonds, Grant W; Goldberg, Lewis R
2017-01-01
This study examined the factor structure and predictive validity of the commonly used multidimensional Health Behavior Checklist. A three-factor structure was found in two community samples that included men and women. The new 16-item Good Health Practices scale and the original Wellness Maintenance scale were the only Health Behavior Checklist scales to be related to cardiovascular and metabolic risk factors. While the other Health Behavior Checklist scales require further validation, the Good Health Practices scale could be used where more objective or longer measures are not feasible.
ERIC Educational Resources Information Center
Karaman, Pinar; Sahin, Çavus
2017-01-01
The purpose of this study was to adapt Teachers' Conceptions and Practices of Formative Assessment Scale (TCPFS) based on the Theory of Planned Behavior (TPB) into Turkish culture and apply the TPB to examine teachers' intentions and behaviors regarding formative assessment. After examining linguistic validity of the scale, Turkish scale was…
Connecting Research and Practice in TESOL: A Community of Practice Perspective
ERIC Educational Resources Information Center
Tavakoli, Parvaneh
2015-01-01
In line with a growing interest in teacher research engagement in second language education, this article is an attempt to shed light on teachers' views on the relationship between teaching and practice. The data comprise semi-structured interviews with 20 teachers in England, examining their views about the divide between research and practice in…
ERIC Educational Resources Information Center
National Home Study Council, Washington, DC.
A study examined the course structure and educational practices used by National Home Study Council (NHSC) member institutions. To gather data for the study, researchers mailed questionnaires to 60 members of the NHSC. Based on data from the 51 usable responses, the researchers determined that the average age of students enrolled in programs…
Beccaria, Lisa; Beccaria, Gavin; McCosker, Catherine
2018-03-01
It is crucial that nursing students develop skills and confidence in using Evidence-Based Practice principles early in their education. This should be assessed with valid tools however, to date, few measures have been developed and applied to the student population. To examine the structural validity of the Student Evidence-Based Practice Questionnaire (S-EBPQ), with an Australian online nursing student cohort. A cross-sectional study for constructing validity. Three hundred and forty-five undergraduate nursing students from an Australian regional university were recruited across two semesters. Confirmatory Factor Analysis was used to examine the structural validity. Confirmatory Factor Analysis was applied which resulted in a good fitting model, based on a revised 20-item tool. The S-EBPQ tool remains a psychometrically robust measure of evidence-based practice use, attitudes, and knowledge and skills and can be applied in an online Australian student context. The findings of this study provided further evidence of the reliability and four factor structure of the S-EBPQ. Opportunities for further refinement of the tool may result in improvements in structural validity. Copyright © 2018 Elsevier Ltd. All rights reserved.
Planned Focus on Form: Automatization of Procedural Knowledge
ERIC Educational Resources Information Center
Khatib, Mohammad; Nikouee, Majid
2012-01-01
The present study is premised on Anderson's ACT model that proposes declarative knowledge is automatizable through practice (1982). The research examined the extent to which declarative knowledge of one morphosyntactic structure, namely present perfect, can be automatized 2 days after practice and can be retained 2 weeks after practice. Twenty…
Pathways in Interactive Media Practices among Youths
ERIC Educational Resources Information Center
van den Beemt, Antoine; Akkerman, Sanne; Simons, P. Robert-Jan
2010-01-01
This qualitative study examines how 11 Dutch students aged 14-15 develop an interest in specific types of interactive media practices and how they perceive these practices in relation to others. The methods included semi-structured interviewing, autodriving visual elicitation and photo elicitation using moodboards. Our results show the importance…
Practice and transfer of the frequency structures of continuous isometric force.
King, Adam C; Newell, Karl M
2014-04-01
The present study examined the learning, retention and transfer of task outcome and the frequency-dependent properties of isometric force output dynamics. During practice participants produced isometric force to a moderately irregular target pattern either under a constant or variable presentation. Immediate and delayed retention tests examined the persistence of practice-induced changes of force output dynamics and transfer tests investigated performance to novel (low and high) irregular target patterns. The results showed that both constant and variable practice conditions exhibited similar reductions in task error but that the frequency-dependent properties were differentially modified across the entire bandwidth (0-12Hz) of force output dynamics as a function of practice. Task outcome exhibited persistent properties on the delayed retention test whereas the retention of faster time scales processes (i.e., 4-12Hz) of force output was mediated as a function of frequency structure. The structure of the force frequency components during early practice and following a rest interval was characterized by an enhanced emphasis on the slow time scales related to perceptual-motor feedback. The findings support the proposition that there are different time scales of learning at the levels of task outcome and the adaptive frequency bandwidths of force output dynamics. Copyright © 2014 Elsevier B.V. All rights reserved.
ERIC Educational Resources Information Center
Sampson, McClain; Parrish, Danielle E.; Washburn, Micki
2018-01-01
Within the last decade, there has been a significant shift in the field of social work toward competency-based education. This article details the use of the Objective Structured Clinical Examination (OSCE) Adapted for Social Work Performance Rating Scale. We used the measure to evaluate specific practice competencies among students (n = 33)…
Frank, Cornelia; Land, William M.; Popp, Carmen; Schack, Thomas
2014-01-01
Recent research on mental representation of complex action has revealed distinct differences in the structure of representational frameworks between experts and novices. More recently, research on the development of mental representation structure has elicited functional changes in novices' representations as a result of practice. However, research investigating if and how mental practice adds to this adaptation process is lacking. In the present study, we examined the influence of mental practice (i.e., motor imagery rehearsal) on both putting performance and the development of one's representation of the golf putt during early skill acquisition. Novice golfers (N = 52) practiced the task of golf putting under one of four different practice conditions: mental, physical, mental-physical combined, and no practice. Participants were tested prior to and after a practice phase, as well as after a three day retention interval. Mental representation structures of the putt were measured, using the structural dimensional analysis of mental representation. This method provides psychometric data on the distances and groupings of basic action concepts in long-term memory. Additionally, putting accuracy and putting consistency were measured using two-dimensional error scores of each putt. Findings revealed significant performance improvements over the course of practice together with functional adaptations in mental representation structure. Interestingly, after three days of practice, the mental representations of participants who incorporated mental practice into their practice regime displayed representation structures that were more similar to a functional structure than did participants who did not incorporate mental practice. The findings of the present study suggest that mental practice promotes the cognitive adaptation process during motor learning, leading to more elaborate representations than physical practice only. PMID:24743576
ERIC Educational Resources Information Center
Epp, Juanita Ross, Ed.; Watkinson, Ailsa M., Ed.
This collection illuminates some of the issues surrounding systemic violence in education, exposing the structures and processes of the schools and examining the effects of these structures on students. Part 1 concerns systemic violence in administrative practice; and Part 2 discusses systemic violence in pedagogical practice. Part 3 of the…
ERIC Educational Resources Information Center
Distance Education and Training Council, Washington, DC.
Course structures and educational practices in Distance Education and Training Council (DETC) member institutions were examined through a survey of all 58 DETC institutions. Usable responses were obtained from 55 (95%) of the institutions. Among the study's main conclusions were the following: (1) 52% of distance education students are male, 42%…
ERIC Educational Resources Information Center
Wong-Kam, JoAnn C. W. N.
2012-01-01
The focus of this study was on creating a climate for innovation in schools to lead to improvements in student achievement. Bolman and Deal's (2008) four frame model of organizational thinking was used as a framework for the study. The study examined the influence of leadership practices, structure, and school culture in the context of a K-12…
``GodMode is his video game name'': situating learning and identity in structures of social practice
NASA Astrophysics Data System (ADS)
Bricker, Leah A.; Bell, Philip
2012-12-01
In this paper, we report on the structural nexus of one youth's gaming practices across contexts and over time. We utilize data from an ethnography of youth science and technology learning, as well as expertise development, across settings and developmental time. We use Ole Dreier's theory of persons to understand how this youth is able to develop considerable gaming expertise. Additionally, we explicate the learning practices embedded in the structural nexus of this youth's gaming and we examine associated issues of learning and identity. We problematize the lack of continuity between his formal schooling experiences and the structural nexus of his gaming practices as situated in a variety of other contexts and we reflect on the implications for the design of STEM gaming experiences in formal school environments.
Commitment to Community Practice among Social Work Students: Contributing Factors
ERIC Educational Resources Information Center
Boehm, Amnon; Cohen, Ayala
2013-01-01
It is important to develop commitment to community practice among social work students to encourage their engagement in this field as professionals later in life. This research examines factors that affect commitment to community practice among social work students. A structured questionnaire was administered to 277 social work students in one…
Baker, Kenneth F; Jandial, Sharmila; Thompson, Ben; Walker, David; Taylor, Ken; Foster, Helen E
2016-10-21
Structured examination routines have been developed as educational resources for musculoskeletal clinical skills teaching, including Gait-Arms-Legs-Spine (GALS), Regional Examination of the Musculoskeletal System (REMS) and paediatric GALS (pGALS). In this study, we aimed to assess the awareness and use of these examination routines in undergraduate medical teaching in UK medical schools and UK postgraduate clinical practice. Electronic questionnaires were distributed to adult and paediatric musculoskeletal teaching leads at UK medical schools and current UK doctors in training. Responses were received from 67 tutors representing teaching at 22/33 [67 %] of all UK medical schools, and 70 trainee doctors across a range of postgraduate training specialities. There was widespread adoption, at responding medical schools, of the adult examination routines within musculoskeletal teaching (GALS: 14/16 [88 %]; REMS: 12/16 [75 %]) and assessment (GALS: 13/16 [81 %]; REMS: 12/16 [75 %]). More trainees were aware of GALS (64/70 [91 %]) than REMS (14/67 [21 %]). Of the 39 trainees who used GALS in their clinical practice, 35/39 [90 %] reported that it had improved their confidence in musculoskeletal examination. Of the 17/22 responding medical schools that included paediatric musculoskeletal examination within their curricula, 15/17 [88 %] used the pGALS approach and this was included within student assessment at 4 medical schools. We demonstrate the widespread adoption of these examination routines in undergraduate education and significant uptake in postgraduate clinical practice. Further study is required to understand their impact upon clinical performance.
Adams, Krystyna; Snyder, Jeremy; Crooks, Valorie A; Berry, Nicole S
2017-10-01
Los Algodones, Mexico is characteristic of other medical border towns whose proximity to the Mexico-United States border enables American and Canadian patients to take advantage of economic asymmetries on either side of the border to access desired health care. Los Algodones is unique, however, in its focus on the provision of dental care and claims by local residents that it has the highest concentration of dentists per capita in the world. In this paper, we present an analysis of interviews with employees working in Los Algodones' dental tourism industry to examine interviewees' participation in practices related to reputational management of the industry site. Drawing on our interview discussions, we argue that many of these reputational management practices reinforce structural injustices and raise concerns for structural exploitation in the industry. This analysis nuances ethical considerations for medical tourism by highlighting structural factors informing unjust practices within the industry, factors which might be relevant to other medical tourism contexts. Copyright © 2017 Elsevier Ltd. All rights reserved.
Community size and organization of practice predict family physician recertification success.
Schulte, Bradley M; Mannino, David M; Royal, Kenneth D; Brown, Sabrina L; Peterson, Lars E; Puffer, James C
2014-01-01
Health disparities exist between rural and urban areas. Rural physicians may lack sufficient medical knowledge, which may lead to poor quality of care. Therefore, we sought to determine whether medical knowledge differed between family physicians (FPs) practicing in rural areas compared with those practicing in metropolitan areas. We studied 8361 FPs who took the American Board of Family Medicine maintenance of certification (MOC) examination in 2009. Data sources were examination results and data from a demographic survey of practice structure and activities, completed as part of the examination application process. FPs' location of practice was categorized as either rural or metropolitan using a moderate and conservative definition based on reported community size. Univariate statistics assessed differences in FP characteristics between rural and metropolitan areas. Logistic regression analyses determined the adjusted relationship between rural status and the odds of passing the MOC examination. Metropolitan FPs were less likely than their rural counterparts to pass the MOC examination using both the moderate (odds ratio, 0.67; 95% confidence interval, 0.54-0.83) and conservative (odds ratio, 0.56; 95% confidence interval, 0.42-0.74) definitions. Physicians in solo practice were less likely to pass the examination than physicians in group practice. Rural physicians were more likely to pass the MOC examination, suggesting that rural health disparities do not result from a lack of provider knowledge.
The medical practice as business organization.
Bender, A D; Aaronson, W E; Krasnick, C J; Bender, J G
1996-03-01
Medical practices historically have not been examined in terms of their organizational structures and of the appropriateness of their structures for survival as business entities. In this paper, we propose a model for the typical medical practice and discuss its fit with current organizational theory. It is apparent that the medical practice organization does not fit with the demands of a rapidly changing and complex environment. To survive and grow, the medical practice organization must align itself with others that have an interest and stake in the health care system, develop teamwork among physicians, bridge the gap between physicians and others in the organization, and recognize that the work done in the organization depends on other components of the organization.
ERIC Educational Resources Information Center
Van Noy, Michelle; Trimble, Madeline; Jenkins, Davis; Barnett, Elisabeth; Wachen, John
2016-01-01
Objective: Some have hypothesized that community college programs are not sufficiently structured to support student success and that students would benefit from more highly structured programs. This study examines the specific ways that structure is expressed in policy and practice at representative community colleges. Method: Using data obtained…
The impact of distributed computing on education
NASA Technical Reports Server (NTRS)
Utku, S.; Lestingi, J.; Salama, M.
1982-01-01
In this paper, developments in digital computer technology since the early Fifties are reviewed briefly, and the parallelism which exists between these developments and developments in analysis and design procedures of structural engineering is identified. The recent trends in digital computer technology are examined in order to establish the fact that distributed processing is now an accepted philosophy for further developments. The impact of this on the analysis and design practices of structural engineering is assessed by first examining these practices from a data processing standpoint to identify the key operations and data bases, and then fitting them to the characteristics of distributed processing. The merits and drawbacks of the present philosophy in educating structural engineers are discussed and projections are made for the industry-academia relations in the distributed processing environment of structural analysis and design. An ongoing experiment of distributed computing in a university environment is described.
ERIC Educational Resources Information Center
Kerr, Paulette A.
2010-01-01
This research was conducted to investigate the relationships between conceptions and practice of information literacy in academic libraries. To create a structure for the investigation, the research adopted the framework of Argyris and Schon (1974) in which professional practice is examined via theories of action, namely espoused theories and…
ERIC Educational Resources Information Center
Chen, Xiangming; Wei, Ge; Jiang, Shuling
2017-01-01
Previous research concerning teacher practical knowledge has revealed its epistemological foundations, content structure and research methodology, but little research examines its ethical dimension. Based on a four-year project in China, this study probes the ethical dimension of an experienced teacher's practical knowledge, explicated in a…
NASA Astrophysics Data System (ADS)
Shahlan, M. Z.; Sidek, A. A.; Suffian, S. A.; Hazza, M. H. F. A.; Daud, M. R. C.
2018-01-01
In this paper, climate change and global warming are the biggest current issues in the industrial sectors. The green supply chain managements (GSCM) is one of the crucial input to these issues. Effective GSCM can potentially secure the organization’s competitive advantage and improve the environmental performance of the network activities. In this study, the aim is to investigate and examine how a small and medium enterprises (SMEs) stakeholder pressure and top management influence green supply chain management practices. The study is further advance green supply chain management research in Malaysia focusing on SMEs manufacturing sector using structural equation modelling. Structural equation modelling is a multivariate statistical analysis technique used to examine structural relationship. It is the combination of factor analysis and multi regression analysis and used to analyse structural relationship between measure variable and latent factor. This research found that top management support and stakeholder pressure is the major influence for SMEs to adopt green supply chain management. The research also found that top management is fully mediate with the relationship between stakeholder pressure and monitoring supplier environmental performance.
Integrating Prevention into Obstetrics/Gynecology.
ERIC Educational Resources Information Center
Carey, J. Christopher
2000-01-01
Discusses formats to teach preventive medicine in obstetrics and gynecology (including learning objectives, lectures/seminars, and rounds/office practice) and evaluation methods (oral examinations, computerized question banks, objective structured clinical examinations). Offers examples from specific programs at American medical schools, including…
Generalized Structured Component Analysis with Latent Interactions
ERIC Educational Resources Information Center
Hwang, Heungsun; Ho, Moon-Ho Ringo; Lee, Jonathan
2010-01-01
Generalized structured component analysis (GSCA) is a component-based approach to structural equation modeling. In practice, researchers may often be interested in examining the interaction effects of latent variables. However, GSCA has been geared only for the specification and testing of the main effects of variables. Thus, an extension of GSCA…
ERIC Educational Resources Information Center
Towndrow, Phillip A.
2008-01-01
This paper investigates the impact of a current educational policy initiative in Singapore called "Science Practical Assessment" (SPA). SPA is designed to overcome the limitations of single, high-stakes examinations by placing emphasis on research processes, entrepreneurship and the development of science practical skills. Structurally,…
Genres, Contexts, and Literacy Practices: Literacy Brokering among Sudanese Refugee Families
ERIC Educational Resources Information Center
Perry, Kristen H.
2009-01-01
This ethnographic study examined literacy brokering among Sudanese refugee families in Michigan. Literacy brokering occurs as individuals seek informal help with unfamiliar texts and literacy practices. Data collection involved participant observation, semi-structured interviews, and collection of artifacts over 18 months. Researcher analysis of…
Extending the validity of the Feeding Practices and Structure Questionnaire.
Jansen, Elena; Mallan, Kimberley M; Daniels, Lynne A
2015-06-30
Feeding practices are commonly examined as potentially modifiable determinants of children's eating behaviours and weight status. Although a variety of questionnaires exist to assess different feeding aspects, many lack thorough reliability and validity testing. The Feeding Practices and Structure Questionnaire (FPSQ) is a tool designed to measure early feeding practices related to non-responsive feeding and structure of the meal environment. Face validity, factorial validity, internal reliability and cross-sectional correlations with children's eating behaviours have been established in mothers with 2-year-old children. The aim of the present study was to further extend the validity of the FPSQ by examining factorial, construct and predictive validity, and stability. Participants were from the NOURISH randomised controlled trial which evaluated an intervention with first-time mothers designed to promote protective feeding practices. Maternal feeding practices (FP) and child eating behaviours were assessed when children were aged 2 years and 3.7 years (n = 388). Confirmatory Factor analysis, group differences, predictive relationships, and stability were tested. The original 9-factor structure was confirmed when children were aged 3.7 ± 0.3 years. Cronbach's alpha was above the recommended 0.70 cut-off for all factors except Structured Meal Timing, Over Restriction and Distrust in Appetite which were 0.58, 0.67 and 0.66 respectively. Allocated group differences reflected behaviour consistent with intervention content and all feeding practices were stable across both time points (range of r = 0.45-0.70). There was some evidence for the predictive validity of factors with 2 FP showing expected relationships, 2 FP showing expected and unexpected relationships and 5 FP showing no relationship. Reliability and validity was demonstrated for most subscales of the FPSQ. Future validation is warranted with culturally diverse samples and with fathers and other caregivers. The use of additional outcomes to further explore predictive validity is recommended as well as testing test-retest reliability of the questionnaire.
Chang, Leanne; Basnyat, Iccha
2015-02-01
In this article we examine how elderly Chinese Singaporean women navigated between biomedicine and traditional Chinese medicine in their practices of maintaining well-being. We interviewed 36 elderly women to understand their negotiation of medical choices in the interplay of structure, culture, and personal agency. Our findings show that participants made situational decisions under structural and cultural influences, such as family members' changing expectations and interpretations of medical practices, institutional preferences for biomedicine, and the patients' negotiating position between biomedicine and traditional Chinese medicine. Participants demonstrated their capacity to enact agency through their examination of the effects and side effects of each medical system and through their integrative use of different medical treatments, depending on the purpose. Through our findings, we unveil contextual meanings of health among elderly women and the unique coexistence of traditional and modern medical practices within the context of Singapore. © The Author(s) 2014.
Jensen, Peter S; Foster, Michael
2010-03-01
Failure to apply research on effective interventions spans all areas of medicine, including children's mental health services. This article examines the policy, structural, and economic problems in which this gap originates. We identify four steps to close this gap. First, the field should develop scientific measures of the research-practice gap. Second, payors should link incentives to outcomes-based performance measures. Third, providers and others should develop improved understanding and application of effective dissemination and business models. Fourth, efforts to link EBP to clinical practice should span patient/consumers, providers, practices, plans, and purchasers. The paper discusses each of these in turn and relates them to fundamental problems of service delivery.
ERIC Educational Resources Information Center
Greenwood, Janinka
2009-01-01
I propose a conceptualisation of drama in school education as improvisation within a framework that has a number of fixed but changing structures. I examine how the "drama in schooling" practice of one country, New Zealand, might be seen as a group improvisation in which, through dramatic negotiation, participants evolve their goals,…
Advantages and Challenges of Distributing Leadership in Middle-Level Schools
ERIC Educational Resources Information Center
Grenda, J. Patrick; Hackmann, Donald G.
2014-01-01
This multiple-site case study examined distributed leadership practices of three middle school principals, using observations, interviews, and document analysis. Findings disclosed that the principals built on the interdisciplinary teaming structure to develop empowering organizational structures that promoted democratic governance. Employing…
An Examination of Assistant Professors' Project Management Practices
ERIC Educational Resources Information Center
Alpert, Shannon Atkinson; Hartshorne, Richard
2013-01-01
Purpose: The purpose of this research was to identify factors that influence the use of project management in higher education research projects by investigating the project management practices of assistant professors. Design/methodology/approach: Using a grounded theory approach that included in-depth, semi-structured interviews with 22…
ERIC Educational Resources Information Center
Shi, Qingmin; Zhang, Shaoan; Lin, Emily
2014-01-01
Drawing on large-scale international teachers' data from Hungary, Korea, Norway, and Turkey in the Teaching and Learning International Survey in 2008 assessment, this study examined the relationships between new teachers' beliefs about instruction (direct transmission and constructivist beliefs) and teaching practices (structured, student…
Assistant Principals and Reform: A Socialization Paradox?
ERIC Educational Resources Information Center
Best, Marguerita L.
2013-01-01
Framed in the critical race theory of structuration (CRTS), this sequential explanatory mixed methods study seeks to identify the socialization practices by examining the realities of practices of assistant principals and the ways in which they impact the disciplinary actions of assistant principals at middle and high schools. The mixed methods…
Examining the factor structure of the Multiple Sclerosis Impact Scale.
Fitzgerald, Shawn M; Li, Jian; Rumrill, Phillip D; Merchant, William; Bishop, Malachy
2014-01-01
The purpose of this study was to investigate the factor structure of the Multiple Sclerosis Impact Scale (MSIS-29) to assess its suitability for modeling the impact of MS on a nation-wide sample of individuals from the United States. Investigators completed a Confirmatory Factor Analysis (CFA) to examine the two-factor structure proposed by Hobart et al. [17]. Although the original MSIS-29 factor structure did not fit the data exactly, the hypothesized two-factor model was partially supported in the current data. Implications for future instrument development and rehabilitation practice are discussed.
Pitfalls of implementing acute care surgery.
Kaplan, Lewis J; Frankel, Heidi; Davis, Kimberly A; Barie, Philip S
2007-05-01
Incorporating emergency general surgery into the current practice of the trauma and critical care surgeon carries sweeping implications for future practice and training. Herein, we examine the known benefits of the practice of emergency general surgery, contrast it with the emerging paradigm of acute care surgery, and examine pitfalls already encountered in integration of emergency general surgery into a traditional trauma/critical care surgery service. A MEDLINE literature search was supplemented with local experience and national presentations at major meetings to provide data for this review. Considerations including faculty complement, service structure, resident staffing, physician extenders, the decreased role of community hospitals in providing trauma and emergency general surgery care, and the effects on an elective operative schedule are inadequately explored at present. There are no firm recommendations as to how to incorporate emergency general surgery into a trauma/critical care practice that will satisfy both academic and community practice paradigms. The near future seems likely to embrace the expanded training and clinical care program termed acute care surgery. A host of essential elements have yet to be examined to undertake a critical analysis of the applicability, advisability, and appropriate structure of both emergency general surgery and acute care surgery in the United States. Proceeding along this pathway may be fraught with training, education, and implementation pitfalls that are ideally addressed before deploying acute care surgery as a national standard.
The value of the physical examination in clinical practice: an international survey.
Elder, Andrew T; McManus, I Chris; Patrick, Alan; Nair, Kichu; Vaughan, Louella; Dacre, Jane
2017-12-01
A structured online survey was used to establish the views of 2,684 practising clinicians of all ages in multiple countries about the value of the physical examination in the contemporary practice of internal medicine. 70% felt that physical examination was 'almost always valuable' in acute general medical referrals. 66% of trainees felt that they were never observed by a consultant when undertaking physical examination and 31% that consultants never demonstrated their use of the physical examination to them. Auscultation for pulmonary wheezes and crackles were the two signs most likely to be rated as frequently used and useful, with the character of the jugular venous waveform most likely to be rated as -infrequently used and not useful. Physicians in contemporary hospital general medical practice continue to value the contribution of the physical examination to assessment of outpatients and inpatients, but, in the opinion of trainees, teaching and demonstration could be improved. © Royal College of Physicians 2017. All rights reserved.
Genetic counseling and the disabled: feminism examines the stance of those who stand at the gate.
Patterson, Annette; Satz, Martha
2002-01-01
This essay examines the possible systematic bias against the disabled in the structure and practice of genetic counseling. Finding that the profession's "nondirective" imperative remains problematic, the authors recommend that methodology developed by feminist standpoint epistemology be used to incorporate the perspective of disabled individuals in genetic counselors' education and practice, thereby reforming society's view of the disabled and preventing possible negative effects of genetic counseling on the self-concept and material circumstance of disabled individuals.
Alongi, Jeanne
2015-04-01
I explored the structural and operational practices of the chronic disease prevention and control unit of a state health department and proposed a conceptual model of structure, function, and effectiveness for future study. My exploratory case study examined 7 elements of organizational structure and practice. My interviews with staff and external stakeholders of a single chronic disease unit yielded quantitative and qualitative data that I coded by perspective, process, relationship, and activity. I analyzed these for patterns and emerging themes. Chi-square analysis revealed significant correlations among collaboration with goal ambiguity, political support, and responsiveness, and evidence-based decisions with goal ambiguity and responsiveness. Although my study design did not permit conclusions about causality, my findings suggested that some elements of the model might facilitate effectiveness for chronic disease units and should be studied further. My findings might have important implications for identifying levers around which capacity can be built that may strengthen effectiveness.
A Case Study Examination of Structure and Function in a State Health Department Chronic Disease Unit
2015-01-01
Objectives. I explored the structural and operational practices of the chronic disease prevention and control unit of a state health department and proposed a conceptual model of structure, function, and effectiveness for future study. Methods. My exploratory case study examined 7 elements of organizational structure and practice. My interviews with staff and external stakeholders of a single chronic disease unit yielded quantitative and qualitative data that I coded by perspective, process, relationship, and activity. I analyzed these for patterns and emerging themes. Results. Chi-square analysis revealed significant correlations among collaboration with goal ambiguity, political support, and responsiveness, and evidence-based decisions with goal ambiguity and responsiveness. Conclusions. Although my study design did not permit conclusions about causality, my findings suggested that some elements of the model might facilitate effectiveness for chronic disease units and should be studied further. My findings might have important implications for identifying levers around which capacity can be built that may strengthen effectiveness. PMID:25689211
Regan, Sandra; Laschinger, Heather K S; Wong, Carol A
2016-01-01
The aim of this study was to examine the influence of structural empowerment, authentic leadership and professional nursing practice environments on experienced nurses' perceptions of interprofessional collaboration. Enhanced interprofessional collaboration (IPC) is seen as one means of transforming the health-care system and addressing concerns about shortages of health-care workers. Organizational supports and resources are suggested as key to promoting IPC. A predictive non-experimental design was used to test the effects of structural empowerment, authentic leadership and professional nursing practice environments on perceived interprofessional collaboration. A random sample of experienced registered nurses (n = 220) in Ontario, Canada completed a mailed questionnaire. Hierarchical multiple regression analysis was used. Higher perceived structural empowerment, authentic leadership, and professional practice environments explained 45% of the variance in perceived IPC (Adj. R² = 0.452, F = 59.40, P < 0.001). Results suggest that structural empowerment, authentic leadership and a professional nursing practice environment may enhance IPC. Nurse leaders who ensure access to resources such as knowledge of IPC, embody authenticity and build trust among nurses, and support the presence of a professional nursing practice environment can contribute to enhanced IPC. © 2015 John Wiley & Sons Ltd.
Structural Validity of the Professional Development Profile of the LoTi Digital-Age Survey
ERIC Educational Resources Information Center
Mehta, Vandhana; Hull, Darrell M.
2013-01-01
The present study was used to examine the structural construct validity of the Professional Development Profile of the LoTi Digital-Age Survey, a measure of teacher instructional practices with technology in the classroom. Teacher responses ("N" = 2,840) from across the United States were used to assess factor structure of the instrument…
Christou-Champi, Spyros; Farrow, Tom F D; Webb, Thomas L
2015-01-01
Emotion regulation (ER) is vital to everyday functioning. However, the effortful nature of many forms of ER may lead to regulation being inefficient and potentially ineffective. The present research examined whether structured practice could increase the efficiency of ER. During three training sessions, comprising a total of 150 training trials, participants were presented with negatively valenced images and asked either to "attend" (control condition) or "reappraise" (ER condition). A further group of participants did not participate in training but only completed follow-up measures. Practice increased the efficiency of ER as indexed by decreased time required to regulate emotions and increased heart rate variability (HRV). Furthermore, participants in the ER condition spontaneously regulated their negative emotions two weeks later and reported being more habitual in their use of ER. These findings indicate that structured practice can facilitate the automatic control of negative emotions and that these effects persist beyond training.
Kundu, Dipankar; Das, H N; Sen, Gargi; Osta, Manish; Mandal, T; Gautam, Divyendu
2013-01-01
Undergraduate medical examination is undergoing extensive re evaluation with new core educational objectives being defined. Consequently, new exam systems have also been designed to test the objectives. Objective structured practical examination (OSPE) is one of them. To introduce OSPE as a method of assessment of practical skills and learning and to determine student satisfaction regarding the OSPE. Furthermore, to explore the faculty perception of OSPE as a learning and assessment tool. The first M.B.B.S students of 2011 12 batch of Medical College, Kolkata, were the subjects for the study. OSPE was organized and conducted on "Identification of Unknown Abnormal Constituents in Urine." Coefficient of reliability of questions administered was done by calculating Cronbach's alpha. A questionnaire on various components of the OSPE was administered to get the feedback. 16 students failed to achieve an average of 50% or above in the assessment. However, 49 students on an average achieved >75%, 52 students achieved between 65% and 75%, and 29 students scored between 50% and 65%. Cronbach's alpha of the questions administered showed to be having high internal consistency with a score of 0.80. Ninety nine percent of students believed that OSPE helps them to improve and 81% felt that this type of assessment fits in as both learning and evaluation tools. Faculty feedback reflected that such assessment tested objectivity, measured practical skills better, and eliminated examiner bias to a greater extent. OSPE tests different desired components of competence better and eliminated examiner bias. Student feedback reflects that such assessment helps them to improve as it is effective both as teaching and evaluation tools.
Female Gang Members: A Profile of Aggression and Victimization.
ERIC Educational Resources Information Center
Molidor, Christian E.
1996-01-01
Most gang membership research studies males; few examine the etiology of female gang membership. Presents themes of female gang membership gathered from interviews with 15 young women. Examines demographic material, family structure, initiation rites, and criminal behaviors. Explores implications for social work practice and research. (FC)
Social Upheaval and School Reform
ERIC Educational Resources Information Center
Beabout, Brian R.; Stokes, Helga; Polyzoi, Eleoussa; Carr-Chellman, Alison
2011-01-01
This analysis of postupheaval educational change examines the extent to which massive changes in a school system's sociocultural environment lead to changes in the structure and practice of schooling. Framed broadly within systems theory and complexity theory, this examination of two cases of postupheaval educational change--post-1989 Czech…
Relationships among Tasks, Time, and Student Practice in Elementary Physical Education
ERIC Educational Resources Information Center
Rasmussen, Jennifer F.; Scrabis-Fletcher, Kristin A.; Silverman, Stephen
2014-01-01
The purpose of this study was to examine how teachers structure class in elementary physical education and the impact their decisions have on the amount of appropriate practice students receive. Participants for this study were 10 third grade physical education teachers and their students. Each teacher taught two successive skill-related lessons…
ERIC Educational Resources Information Center
Artzt, Alice F.; Armour-Thomas, Eleanor
1998-01-01
Uses a "teaching as problem solving" perspective to examine the components of metacognition underlying the instructional practice of seven experienced and seven beginning secondary-school mathematics teachers. Data analysis of observations, lesson plans, videotapes, and audiotapes of structured interviews suggests that the metacognition of…
Insurance Agencies' Organizational Learning in a Turbulent Time: A Community of Practice Perspective
ERIC Educational Resources Information Center
Gau, Wen-Bing; Wen, Chen-Hao
2011-01-01
In a turbulent time, communities of practice (CoPs) have become an important mechanism to develop organizational learning. Because of the rapid changes of global market and population structure, organizations in the private sector keep examining their leaning processes to adjust themselves to different challenges. However, few studies try to…
ERIC Educational Resources Information Center
Ifegbesan, Ayodeji
2010-01-01
This study examined the level of awareness, knowledge and practices of secondary schools students with regard to waste management. Few studies have captured waste management problems in Nigerian educational institutions, particularly the views of students. Using a structured, self-administered questionnaire, 650 students were surveyed from six…
Trajectories of Family Management Practices and Early Adolescent Behavioral Outcomes
ERIC Educational Resources Information Center
Wang, Ming-Te; Dishion, Thomas J.; Stormshak, Elizabeth A.; Willett, John B.
2011-01-01
Stage-environment fit theory was used to examine the reciprocal lagged relations between family management practices and early adolescent problem behavior during the middle school years. In addition, the potential moderating roles of family structure and of gender were explored. Hierarchical linear modeling was used to describe patterns of growth…
ERIC Educational Resources Information Center
Will-Dubyak, Kathryn Deeanne
2016-01-01
Research indicates that teachers benefit from education coursework in their preparation that provides opportunities to develop and practice pedagogical understandings (Darling-Hammond, 2000, 2006). Research also indicates that opportunities to enact learning from coursework are beneficial in teacher efficacy development within teacher preparation…
ERIC Educational Resources Information Center
Bang, Hee Jin
2012-01-01
This study examines the homework practices of eight teachers working in a high school designed to serve newcomer immigrant students. Individual structured interviews were conducted in which teachers working in an innovative setting explained their purposes of assigning homework, their beliefs about factors affecting their students' homework…
University Business Models and Online Practices: A Third Way
ERIC Educational Resources Information Center
Rubin, Beth
2013-01-01
Higher Education is in a state of change, and the existing business models do not meet the needs of stakeholders. This article contrasts the current dominant business models of universities, comparing the traditional non-profit against the for-profit online model, examining the structural features and online teaching practices that underlie each.…
Confirmatory Factor Analysis on the Professional Suitability Scale for Social Work Practice
ERIC Educational Resources Information Center
Tam, Dora M. Y.; Twigg, Robert C.; Boey, Kam-Wing; Kwok, Siu-Ming
2013-01-01
Objective: This article presents a validation study to examine the factor structure of an instrument designed to measure professional suitability for social work practice. Method: Data were collected from registered social workers in a provincial mailed survey. The response rate was 23.2%. After eliminating five cases with multivariate outliers,…
ERIC Educational Resources Information Center
Song, Ji Hoon; Bae, Sang Hoon; Park, Sunyoung; Kim, Hye Kyoung
2013-01-01
This study examined the structural relationships among perceived school support, transformational leadership, teachers' work engagement, and teachers' knowledge creation practices. It also investigated the mediating effects of transformational leadership and work engagement in explaining the association between perceived school support…
DOT National Transportation Integrated Search
2013-12-01
This study is a supplement to a previous study of bridge washing practices that focused on steel : superstructures. This study examined the perceived costs and benefits of routine washing of both : steel and concrete bridges, with emphasis on substru...
ERIC Educational Resources Information Center
Yu, Rongrong; Singh, Kusum
2018-01-01
The authors examined the relationships among teacher classroom practices, student motivation, and mathematics achievement in high school. The data for this study was drawn from the base-year data of High School Longitudinal Study of 2009. Structural equation modeling method was used to estimate the relationships among variables. The results…
Development and Validation of a Short Form of the Alabama Parenting Questionnaire
ERIC Educational Resources Information Center
Elgar, Frank J.; Waschbusch, Daniel A.; Dadds, Mark R.; Sigvaldason, Nadine
2007-01-01
Brief assessments of parenting practices can provide important information about the development of disruptive behavior disorders in children. We examined the factor structure of a widely used assessment of parenting practices, the Alabama Parenting Questionnaire, and produced a 9-item short scale around its three supported factors: Positive…
Outcomes Based Education Re-Examined: From Structural Functionalism to Poststructuralism.
ERIC Educational Resources Information Center
Capper, Colleen A.; Jamison, Michael T.
Outcomes Based Education (OBE) is viewed as a drastic break from current educational practices and a means of providing educational success for all students. OBE is also advocated as a practice that lead to educational inequity. This paper reexamines OBE from a multiparadigm perspective of organizations and educational administration. OBE is based…
Building a Village through Data: A Research-Practice Partnership to Improve Youth Outcomes
ERIC Educational Resources Information Center
Biag, Manuelito
2017-01-01
There is growing recognition that the traditional research paradigm fails to address the needs of school practitioners. As such, more collaborative and participatory approaches are being encouraged. Yet few articles examine the structures, processes, and dynamics of research-practice partnerships. To address this gap, this essay analyzes a…
ERIC Educational Resources Information Center
Buchanan, Rebecca
2017-01-01
This dissertation investigates a perennial problem in teacher education: the theory-practice divide. There has always been a rift between theory and practice; however, this gap and the responses to it take on different shapes and meanings based on the reforms, politics, and structures of the time. For example, in the 1980s and 90s Professional…
Using an interprofessional competency framework to examine collaborative practice.
Hepp, Shelanne L; Suter, Esther; Jackson, Karen; Deutschlander, Siegrid; Makwarimba, Edward; Jennings, Jake; Birmingham, Lisa
2015-03-01
Healthcare organisations are starting to implement collaborative practice to increase the quality of patient care. However, operationalising and measuring progress towards collaborative practice has proven to be difficult. Various interprofessional competency frameworks have been developed that outline essential collaborative practice competencies for healthcare providers. If these competencies were enacted to their fullest, collaborative practice would be at its best. This article examines collaborative practice in six acute care units across Alberta using the Canadian Interprofessional Health Collaborative (CIHC) competency framework (CIHC, 2010 ). The framework entails the six competencies of patient-centred care, communication, role clarification, conflict resolution, team functioning and collaborative leadership (CIHC, 2010 ). We conducted a secondary analysis of interviews with 113 healthcare providers from different professions, which were conducted as part of a quality improvement study. We found positive examples of communication and patient-centred care supported by unit structures and processes (e.g. rapid rounds and collaborative plan of care). Some gaps in collaborative practice were found for role clarification and collaborative leadership. Conflict resolution and team functioning were not well operationalised on these units. Strategies are presented to enhance each competency domain in order to fully enact collaborative practice. Using the CIHC competency framework to examine collaborative practice was useful for identifying strength and areas needing improvement.
McGuire, Alan B; Salyers, Michelle P; White, Dominique A; Gilbride, Daniel J; White, Laura M; Kean, Jacob; Kukla, Marina
2015-12-01
Illness management and recovery (IMR) is an evidence-based practice that assists consumers in managing their illnesses and pursuing personal recovery goals. Although research has examined factors affecting IMR implementation facilitated by multifaceted, active roll-outs, the current study attempted to elucidate factors affecting IMR implementation outside the context of a research-driven implementation. Semi-structured interviews with 20 local recovery coordinators and 18 local IMR experts were conducted at 23 VA medical centers. Interviews examined perceived and experienced barriers and facilitators to IMR implementation. Data were analyzed via thematic inductive/deductive analysis in the form of crystallization/immersion. Six factors differed between sites implementing IMR from those not providing IMR: awareness of IMR, importer-champions, autonomy-supporting leadership, veteran-centered care, presence of a sensitive period, and presence of a psychosocial rehabilitation and recovery center. Four factors were common in both groups: recovery orientation, evidence-based practices orientation, perceived IMR fit within program structure, and availability of staff time. IMR can be adopted in lieu of active implementation support; however, knowledge dissemination appears to be key. Future research should examine factors affecting the quality of implementation. (c) 2015 APA, all rights reserved).
Elementary Teachers' Formative Evaluation Practices in an Era of Curricular Reform in Quebec, Canada
ERIC Educational Resources Information Center
Thomas, Lynn; Deaudelin, Colette; Desjardins, Julie; Dezutter, Olivier
2011-01-01
This study examines the formative evaluation practices of 13 experienced elementary school teachers in Quebec, Canada at the level of teacher-student interaction. The qualitative study is based on both semi-structured and stimulated recall interviews as well as videotapes of classroom activities. The participating teachers were found to be using…
ERIC Educational Resources Information Center
van de Wiel, Margje W. J.; Van den Bossche, Piet
2013-01-01
This study examined physicians' motivation to engage in work-related learning and its contribution to expertise development beyond work experience. Based on deliberate practice theory, semi-structured interviews were conducted with 17 residents and 28 experienced physicians in internal medicine, focusing on the activities they engaged in during…
Evaluation of a Motion-Based Platform for Practicing Phonological Awareness of Preschool Children
ERIC Educational Resources Information Center
Goffredo, Michela; Bernabucci, Ivan; Lucarelli, Cristiana; Conforto, Silvia; Schmid, Maurizio; Nera, Maria Matilde; Lopez, Luisa; D'Alessio, Tommaso; Grasselli, Bruna
2016-01-01
The aim of this study is to introduce a new platform, called "En Plein", for the kinesthetic practice of phonological skills by preschool children and to examine its feasibility in combination with more traditional teaching methods. The rationale is that the manipulation of structural phonological units is important to train the…
ERIC Educational Resources Information Center
Bassot, Barbara
2012-01-01
After several years of political agendas focused on social inclusion, career guidance practice needs to return to its roots of promoting equality and social justice. This conceptual article argues that for many years there has been an overreliance on theories focused on the individual, and examines the relationship between social structures and…
How Iranian Instructors Teach L2 Pragmatics in Their Classroom Practices? A Mixed-Methods Approach
ERIC Educational Resources Information Center
Muthasamy, Paramasivam; Farashaiyan, Atieh
2016-01-01
This study examined the teaching approaches and techniques that Iranian instructors utilize for teaching L2 pragmatics in their classroom practices. 238 Iranian instructors participated in this study. The data for this study were accumulated through questionnaire and semi-structured interviews. In terms of the instructional approaches, both the…
What Teachers Say about Addressing Culture in Their EFL Teaching Practices: The Vietnamese Context
ERIC Educational Resources Information Center
Nguyen, Long; Harvey, Sharon; Grant, Lynn
2016-01-01
This paper examines Vietnamese EFL teachers' beliefs about the role of culture in language teaching. It also considers how they address culture in their teaching practices in a Vietnamese university. Ethnographic data collected from semi-structured interviews indicated that opportunities for culture to find its way into EFL classroom activities…
Leadership and Decision-Making Practices in Public versus Private Universities in Pakistan
ERIC Educational Resources Information Center
Zulfqar, A.; Valcke, M.; Devos, G.; Tuytens, M.; Shahzad, A.
2016-01-01
The goal of this study is to examine differences in leadership and decision-making practices in public and private universities in Pakistan, with a focus on transformational leadership (TL) and participative decision-making (PDM). We conducted semi-structured interviews with 46 deans and heads of department from two public and two private…
Ellis, Isabelle; Howard, Peter; Larson, Ann; Robertson, Jeanette
2005-01-01
This article examines the process of translating evidence into practice using a facilitation model developed by the Western Australian Centre for Evidence Based Nursing and Midwifery. Using the conceptual framework Promoting Action on Research Implementation in Health Services (PARIHS), the aims of the study were (1) to explore the relative and combined importance of context and facilitation in the successful implementation of a new evidence-based clinical practice protocol and (2) to examine the establishment of more lasting change to individuals and organizations that resulted in greater incorporation of the principles of evidence-based practice (EBP). A pre-workshop, semi-structured telephone survey with 16 nurse managers in six rural hospitals; a summative evaluation immediately post-workshop with 54 participants; and follow-up, semi-structured interviews with 23 workshop participants. The contexts in each of the participating hospitals were very different; of the six hospitals, only one had not implemented the new protocol. Five had reviewed their practices and brought them in line with the protocol developed at the workshop. The rate of adoption varied considerably from 2 weeks to months. The participants reported being better informed about EBP in general and were positive about their ability to improve their practice and search more efficiently for best practice information. Underlying motivations for protocol development should be included in the PARIHS framework. IMPLICATIONS FOR EDUCATION: Good facilitation appears to be more influential than context in overcoming the barriers to the uptake of EBP.
Jansen, Elena; Mallan, Kimberley M; Nicholson, Jan M; Daniels, Lynne A
2014-06-04
Early feeding practices lay the foundation for children's eating habits and weight gain. Questionnaires are available to assess parental feeding but overlapping and inconsistent items, subscales and terminology limit conceptual clarity and between study comparisons. Our aim was to consolidate a range of existing items into a parsimonious and conceptually robust questionnaire for assessing feeding practices with very young children (<3 years). Data were from 462 mothers and children (age 21-27 months) from the NOURISH trial. Items from five questionnaires and two study-specific items were submitted to a priori item selection, allocation and verification, before theoretically-derived factors were tested using Confirmatory Factor Analysis. Construct validity of the new factors was examined by correlating these with child eating behaviours and weight. Following expert review 10 factors were specified. Of these, 9 factors (40 items) showed acceptable model fit and internal reliability (Cronbach's α: 0.61-0.89). Four factors reflected non-responsive feeding practices: 'Distrust in Appetite', 'Reward for Behaviour', 'Reward for Eating', and 'Persuasive Feeding'. Five factors reflected structure of the meal environment and limits: 'Structured Meal Setting', 'Structured Meal Timing', 'Family Meal Setting', 'Overt Restriction' and 'Covert Restriction'. Feeding practices generally showed the expected pattern of associations with child eating behaviours but none with weight. The Feeding Practices and Structure Questionnaire (FPSQ) provides a new reliable and valid measure of parental feeding practices, specifically maternal responsiveness to children's hunger/satiety signals facilitated by routine and structure in feeding. Further validation in more diverse samples is required.
Universal Preventive Interventions for Children in the Context of Disasters and Terrorism
Pfefferbaum, Betty; Varma, Vandana; Nitiéma, Pascal; Newman, Elana
2014-01-01
Synopsis This review addresses universal disaster and terrorism services and preventive interventions delivered to children pre and post event. The paper describes the organization and structure of services used to meet the needs of children in the general population (practice applications), examines screening and intervention approaches (tools for practice), and suggests future directions for the field. A literature search identified 17 empirical studies which were analyzed to examine timing and setting of intervention delivery, providers, conditions addressed and outcomes, and intervention approaches and components. PMID:24656585
Multidisciplinary Analysis and Optimal Design: As Easy as it Sounds?
NASA Technical Reports Server (NTRS)
Moore, Greg; Chainyk, Mike; Schiermeier, John
2004-01-01
The viewgraph presentation examines optimal design for precision, large aperture structures. Discussion focuses on aspects of design optimization, code architecture and current capabilities, and planned activities and collaborative area suggestions. The discussion of design optimization examines design sensitivity analysis; practical considerations; and new analytical environments including finite element-based capability for high-fidelity multidisciplinary analysis, design sensitivity, and optimization. The discussion of code architecture and current capabilities includes basic thermal and structural elements, nonlinear heat transfer solutions and process, and optical modes generation.
Assuring structural integrity in Army systems
NASA Technical Reports Server (NTRS)
1985-01-01
The object of this study was to recommend possible improvements in the manner in which structural integrity of Army systems is assured. The elements of a structural integrity program are described, and relevant practices used in various industries and government organizations are reviewed. Some case histories of Army weapon systems are examined. The mandatory imposition of a structural integrity program patterned after the Air Force Aircraft Structural Integrity Program is recommended and the benefits of such an action are identified.
Zarriello, Phillip J.; Breault, Robert F.; Weiskel, Peter K.
2002-01-01
The water quality of the lower Charles River is periodically impaired by combined sewer overflows (CSOs) and non-CSO stormwater runoff. This study examined the potential non-CSO load reductions of suspended solids, fecal coliform bacteria, total phosphorus, and total lead that could reasonably be achieved by implementation of stormwater best management practices, including both structural controls and systematic street sweeping. Structural controls were grouped by major physical or chemical process; these included infiltration-filtration (physical separation), biofiltration-bioretention (biological mechanisms), or detention-retention (physical settling). For each of these categories, upper and lower quartiles, median, and average removal efficiencies were compiled from three national databases of structural control performance. Removal efficiencies obtained indicated a wide range of performance. Removal was generally greatest for infiltration-filtration controls and suspended solids, and least for biofiltration-bioretention controls and fecal coliform bacteria. Street sweeping has received renewed interest as a water-quality control practice because of reported improvements in sweeper technology and the recognition that opportunities for implementing structural controls are limited in highly urbanized areas. The Stormwater Management Model that was developed by the U.S. Geological Survey for the lower Charles River Watershed was modified to simulate the effects of street sweeping in a single-family land-use basin. Constituent buildup and washoff variable values were calibrated to observed annual and storm-event loads. Once calibrated, the street sweeping model was applied to various permutations of four sweeper efficiencies and six sweeping frequencies that ranged from every day to once every 30 days. Reduction of constituent loads to the lower Charles River by the combined hypothetical practices of structural controls and street sweeping was estimated for a range of removal efficiencies because of their inherent variability and uncertainty. This range of efficiencies, with upper and lower estimates, provides reasonable bounds on the load that could be removed by the practices examined. The upper estimated load reduction from combined street sweeping and structural controls, as a percentage of the total non-CSO load entering the lower Charles River downstream of Watertown Dam, was 44 percent for suspended solids, 34 percent for total lead, 14 percent for total phosphorus, and 17 percent for fecal coliform bacteria. The lower estimated load reduction from combined street sweeping and structural controls from non-CSO sources downstream of Watertown Dam, was 14 percent for suspended solids, 11 percent for total lead, 4.9 percent for total phosphorus, and 7.5 percent for fecal coliform bacteria. Load reductions by these combined management practices can be a small as 1.4 percent for total phosphorus to about 4 percent for the other constituents if the total load above Watertown Dam is added to the load from below the dam. Although the reductions in stormwater loads to the lower Charles River from the control practices examined appear to be minor, these practices would likely provide water-quality benefits to portions of the river during those times that they are most impaired-during and immediately after storms. It should also be recognized that only direct measurements of changes in stormwater loads before and after implementation of control practices can provide definitive evidence of the beneficial effects of these practices on water-quality conditions in the lower Charles River.
High-temperature superconductor antenna investigations
NASA Technical Reports Server (NTRS)
Karasack, Vincent G.
1990-01-01
The use of superconductors to increase antenna radiation efficiency and gain is examined. Although the gain of all normal-metal antennas can be increased through the use of superconductors, some structures have greater potential for practical improvement than others. Some structures suffer a great degradation in bandwidth when replaced with superconductors, while for others the improvement in efficiency is trivial due to the minimal contribution of the conductor loss mechanism to the total losses, or the already high efficiency of the structure. The following antennas and related structures are discussed: electrically small antennas, impedance matching of antennas, microstrip antennas, microwave and millimeter-wave antenna arrays, and superdirective arrays. The greatest potential practical improvements occur for large microwave and millimeter-wave arrays and the impedance matching of antennas.
Sutton, A
1997-01-01
Standards for professional training and practice are defined by accrediting organisations or statutory bodies. These describe the arena in which the practitioner may speak with authority. The sphere of authorised practice is further delineated by the external resources available. Within this explicit framework, unconscious mental processes can affect the professional response in potentially adverse ways. This is particularly important in mental health practice. Professionals must be prepared to examine their own responses on this basis in order to enhance their knowledge of the patient and minimise the possibilities of the patient becoming the victim of the professional's own psychopathology. The maintenance of such a position in an institution or organisation requires a similar process within its structure in order to provide the necessary setting and define the limits of good practice. In this paper, the field of adolescent mental health is specifically examined. PMID:9055159
The Role of Classroom Goal Structure in Students' Use of Self-Handicapping Strategies.
ERIC Educational Resources Information Center
Urdan, Tim; Midgley, Carol; Anderman, Eric M.
1998-01-01
Surveyed 656 fifth graders on their use of self-handicapping strategies and examined predictors of self-handicapping. Boys used handicapping more than girls did, and grade point average and perceived academic competence were negatively related to handicapping. Ability goal structure and teaching practices highlighting relative ability were…
Postpartum Patient Teaching Success: Implications from Nursing and Patient Perspectives
ERIC Educational Resources Information Center
Day, Dawn
2014-01-01
A recent examination of postpartum patient satisfaction scores in an inner-city hospital revealed decreased satisfaction of discharge teaching practices. Guided by Knowles' model of andragogy and Donabedian's model of structure-process-outcome, the purpose of this study was to gain an understanding of how the structure and process of discharge…
ePortfolios and Faculty Engagement: Measuring Change through Structured Experiences
ERIC Educational Resources Information Center
Ring, Gail; Ramirez, Barbara; Brackett, Bob
2016-01-01
In this paper we examine a faculty development structure that supports general education, specifically ePortfolio, assessment focusing on identifying the characteristics of engaged faculty. It is through this inquiry that we have developed an action plan that includes a system of best practices that can lead to increased faculty engagement.…
ERIC Educational Resources Information Center
Smith, Gregory C.; Hancock, Gregory R.
2010-01-01
An adaptation of the Family Stress Model was examined using structural equation modeling with data from 193 custodial grandmother-grandfather dyads. The model's measurement and structural components were largely invariant by grandparent gender. For grandmothers and grandfathers alike, the effects of their psychological and marital distress on…
NASA Astrophysics Data System (ADS)
Johnson, Virginia Abbott; Lockard, J. David
The effects of kinetic structure and micrograph content on student achievement of reading micrograph skills were examined. The purpose of the study was to determine which form of kinetic structure, high or low, and/or micrograph content, unified or varied, was most effective and if there were any interactive effects. Randomly assigned to four treatment groups, 100 introductory college biology students attended three audiovisual presentations and practice sessions on reading light, transmission electron, and scanning electron micrographs. The micrograph skills test, administered at two points in time, assessed knowledge acquisition and retention. The test measured general concept skills and actual reading micrograph skills separately. All significant tests were considered with an = 0.05. High kinetic structure was found to be more effective than low kinetic structure in developing general concepts about micrographs. This finding supports Anderson's kinetic theory research. High kinetic structure instruction does not affect actual reading micrograph skills, but micrograph content does. Unified micrograph content practice sessions were more effective than varied micrograph content practice sessions. More attention should be given to the visual components of perceptual learning tasks.
Structural capabilities in small and medium-sized patient-centered medical homes.
Alidina, Shehnaz; Schneider, Eric C; Singer, Sara J; Rosenthal, Meredith B
2014-07-01
1) Evaluate structural capabilities associated with the patient-centered medical home (PCMH) model in PCMH pilots in Colorado, Ohio, and Rhode Island; 2) evaluate changes in capabilities over 2 years in the Rhode Island pilot; and 3) evaluate facilitators and barriers to the adoption of capabilities. We assessed structural capabilities in the 30 pilot practices using a cross-sectional study design and examined changes over 2 years in 5 Rhode Island practices using a pre/post design. We used National Committee for Quality Assurance's Physician Practice Connections-Patient-Centered Medical Home (PPC/PCMH) accreditation survey data to measure capabilities. We stratified by high and low performance based on total score and by practice size. We analyzed change from baseline to 24 months for the Rhode Island practices. We analyzed qualitative data from interviews with practice leaders to identify facilitators and barriers to building capabilities. On average, practices scored 73 points (out of 100 points) for structural capabilities. High and low performers differed most on electronic prescribing, patient self-management, and care-management standards. Rhode Island practices averaged 42 points at baseline, and reached 90 points by the end of year 2. Some of the key facilitators that emerged were payment incentives, "transformation coaches," learning collaboratives, and data availability supporting performance management and quality improvement. Barriers to improvement included the extent of transformation required, technology shortcomings, slow cultural change, change fatigue, and lack of broader payment reform. For these early adopters, prevalence of structural capabilities was high, and performance was substantially improved for practices with initially lower capabilities. We conclude that building capabilities requires payment reform, attention to implementation, and cultural change.
Spence Laschinger, Heather K; Fida, Roberta
2015-05-01
A model linking authentic leadership, structural empowerment, and supportive professional practice environments to nurses' perceptions of patient care quality and job satisfaction was tested. Positive work environment characteristics are important for nurses' perceptions of patient care quality and job satisfaction (significant factors for retention). Few studies have examined the mechanism by which these characteristics operate to influence perceptions of patient care quality or job satisfaction. A cross-sectional provincial survey of 723 Canadian nurses was used to test the hypothesized models using structural equation modeling. The model was an acceptable fit and all paths were significant. Authentic leadership had a positive effect on structural empowerment, which had a positive effect on perceived support for professional practice and a negative effect on nurses' perceptions that inadequate unit staffing prevented them from providing high-quality patient care. These workplace conditions predicted job satisfaction. Authentic leaders play an important role in creating empowering professional practice environments that foster high-quality care and job satisfaction.
ERIC Educational Resources Information Center
Shneidman, N. Norman
Serving as an introduction to Soviet physical education which endeavors to give a concise outline of the organizational structure and the theoretical foundatons of Soviet sport, this book attempts to discuss Soviet physical education in relation to Soviet education and culture generally and to examine critically the practical applications of the…
ERIC Educational Resources Information Center
Stahmer, Aubyn C.; Suhrheinrich, Jessica; Schetter, Patricia L.; Hassrick, Elizabeth McGee
2018-01-01
This study examines how system-wide (i.e., region, district, and school) mechanisms such as leadership support, training requirements, structure, collaboration, and education affect the use of evidence-based practices (EBPs) in schools and how this affects the outcomes for students with autism spectrum disorder (ASD). Despite growing evidence for…
ERIC Educational Resources Information Center
Kirton, Stewart B.; Al-Ahmad, Abdullah; Fergus, Suzanne
2014-01-01
Increase in tuition fees means there will be renewed pressure on universities to provide "value for money" courses that provide extensive training in both subject-specific and generic skills. For graduates of chemistry this includes embedding the generic, practical, and laboratory-based skills associated with industrial research as an…
ERIC Educational Resources Information Center
New York State Commission on Quality of Care for the Mentally Disabled, Albany.
This report examines issues concerned with the use of aversive behavior modification techniques in actual treatment practices at one intermediate care facility for the mentally retarded. The review of these practices reveals how, once the philosophy of using aversives takes hold at a program (to deal with seemingly intractable behaviors), its…
ERIC Educational Resources Information Center
Hamdan, Amani K.
2014-01-01
This case study explored the need for culturally relevant pedagogy (CRP) in Saudi Arabian higher education, especially when students have a cultural background that differs from that of their instructor. The study documented how expatriate teachers structured their pedagogical practices in the Saudi Arabian context. It examined how these…
ERIC Educational Resources Information Center
von der Embse, Nathaniel P.; Schoemann, Alexander M.; Kilgus, Stephen P.; Wicoff, Maribeth; Bowler, Mark
2017-01-01
The present study examined the use of student test performance for merit pay and teacher evaluation as predictive of both educator stress and counterproductive teaching practices, and the moderating role of perceived test value. Structural equation modelling of data from a sample of 7281 educators in a South-eastern state in the United States…
ERIC Educational Resources Information Center
Bailey, Jennifer A.; Hill, Karl G.; Oesterle, Sabrina; Hawkins, J. David
2009-01-01
Using data from grandparents (G1), parents (G2), and children (G3), this study examined continuity in parental monitoring, harsh discipline, and child externalizing behavior across generations, and the contribution of parenting practices and parental drug use to intergenerational continuity in child externalizing behavior. Structural equation and…
Re-examining the paradox of structure: a child health network perspective.
McPherson, Charmaine M; Popp, Janice K; Lindstrom, Ronald R
2006-01-01
In their lead paper, Huerta, Casebeer and VanderPlaat argue that there are several key forces driving the development of health services delivery (HSD) networks, and propose a series of paradoxes and propositions to initiate this timely and essential dialogue. Ultimately, they submit that networks are likely to remain within the healthcare system to build system capacity and drive integration. Given this, they challenge us to further the dialogue and investigate these networks. While this peer commentary shares many of the lead author's perspectives, the generic nature of the discussion does not bring us to the relative complexities revealed in some HSD network practices. A Canadian child health network lens is used to re-examine the lead paper's conceptualization of network typologies and the proposed paradox of structure. We combine network practice and academic expertise to highlight the structural, governance and leadership tensions between traditional hierarchical public service organizations and the non-hierarchical nature of inter-organizational networks. Child health network leaders and members must examine and work with the challenges associated with importing traditional organizational cultures into an inter-organizationally networked context, while simultaneously maintaining these dual (or duelling) cultures.
The embodiment of tourism among bisexually-behaving Dominican male sex workers.
Padilla, Mark B
2008-10-01
While theories of "structure" and social inequality have increasingly informed global health efforts for HIV prevention--with growing recognition of the linkages between large-scale political and economic factors in the distribution and impact of the HIV/AIDS epidemic--there is still little theorization of precisely how structural factors shape the very bodies and sexualities of specific populations and groups. In order to extend the theoretical understanding of these macro-micro linkages, this article examines how the growth of the tourism industry in the Dominican Republic has produced sexual practices and identities that reflect both the influence of large-scale structural processes and the resistant responses of local individuals. Drawing on social science theories of political economy, embodiment, and authenticity, I argue that an understanding of patterns of sexuality and HIV risk in the region requires analysis of how political-economic transformations related to tourism intersect with the individual experiences and practices of sexuality on the ground. The analysis draws on long-term ethnographic research with bisexually behaving male sex workers in two cities in the Dominican Republic, including participant observation, in-depth interviews, focus groups, and surveys. By examining the global and local values placed on these men's bodies and the ways sex workers use their bodies to broker tourists' pleasure, we may better understand how the large-scale structures of the tourism industry are linked to the specific meanings and practices of sexuality.
Seitsinger, Anne M; Felner, Robert D; Brand, Stephen; Burns, Amy
2008-08-01
As schools move forward with comprehensive school reform, parents' roles have shifted and been redefined. Parent-teacher communication is critical to student success, yet how schools and teachers contact parents is the subject of few studies. Evaluations of school-change efforts require reliable and useful measures of teachers' practices in communicating with parents. The structure of teacher-parent-contact practices was examined using data from multiple, longitudinal cohorts of schools and teachers from a large-scale project and found to be a reliable and stable measure of parent contact across building levels and localities. Teacher/school practices in contacting parents were found to be significantly related to parent reports of school contact performance and student academic adjustment and achievement. Implications for school improvement efforts are discussed.
2014-01-01
Background Early feeding practices lay the foundation for children’s eating habits and weight gain. Questionnaires are available to assess parental feeding but overlapping and inconsistent items, subscales and terminology limit conceptual clarity and between study comparisons. Our aim was to consolidate a range of existing items into a parsimonious and conceptually robust questionnaire for assessing feeding practices with very young children (<3 years). Methods Data were from 462 mothers and children (age 21–27 months) from the NOURISH trial. Items from five questionnaires and two study-specific items were submitted to a priori item selection, allocation and verification, before theoretically-derived factors were tested using Confirmatory Factor Analysis. Construct validity of the new factors was examined by correlating these with child eating behaviours and weight. Results Following expert review 10 factors were specified. Of these, 9 factors (40 items) showed acceptable model fit and internal reliability (Cronbach’s α: 0.61-0.89). Four factors reflected non-responsive feeding practices: ‘Distrust in Appetite’, ‘Reward for Behaviour’, ‘Reward for Eating’, and ‘Persuasive Feeding’. Five factors reflected structure of the meal environment and limits: ‘Structured Meal Setting’, ‘Structured Meal Timing’, ‘Family Meal Setting’, ‘Overt Restriction’ and ‘Covert Restriction’. Feeding practices generally showed the expected pattern of associations with child eating behaviours but none with weight. Conclusion The Feeding Practices and Structure Questionnaire (FPSQ) provides a new reliable and valid measure of parental feeding practices, specifically maternal responsiveness to children’s hunger/satiety signals facilitated by routine and structure in feeding. Further validation in more diverse samples is required. PMID:24898364
Modular shipbuilding and its relevance to construction of nuclear power plants. Master's thesis
DOE Office of Scientific and Technical Information (OSTI.GOV)
Seubert, T.W.
1988-05-01
The modern techniques of modular shipbuilding based on the Product Work Breakdown Structure as developed at the Ishikawajima-Harima Heavy Industries Co., Ltd. of Japan are examined and compared to conventional shipbuilding methods. The application of the Product Work Breakdown Structure in the building of the U.S. Navy's DDG-51 class ship at Bath Iron Works is described and compared to Japanese shipbuilding practices. Implementation of the Product Work Breakdown Structure at Avondale Shipyards, Incorporated is discussed and compared to Bath Iron Works shipbuilding practices. A proposed generic implementation of the Product Work Breakdown Structure to the modular construction of nuclear powermore » plants is described. Specific conclusions for the application of Product Work Breakdown Structure to the construction of a light water reactor nuclear power plant are discussed.« less
ERIC Educational Resources Information Center
Finlay, S. Craig; Hank, Carolyn; Sugimoto, Cassidy R.; Johnson, Michael
2013-01-01
The biblioblogosphere is comprised of the institutional publication of blogs of libraries and the personal, professionally-oriented publication of blogs by librarians. Since introduction of this neologism in 2004, a number of researchers have examined this particular class of bloggers and blogging. However, there is limited investigation into the…
Examining the Use of a Structured Analysis Framework to Support Prospective Teacher Noticing
ERIC Educational Resources Information Center
Mitchell, Rebecca N.; Marin, Katherine Ariemma
2015-01-01
The ability to notice important events in a teaching situation and make decisions about these events is a key component of teaching well. Prospective teachers tend to notice more superficial aspects of classroom practice, such as class management. This article examines a video club in which four student teachers utilized the Mathematical Quality…
Music Student Teaching Seminars: An Examination of Current Practices Across the United States
ERIC Educational Resources Information Center
Baumgartner, Christopher M.; Councill, Kimberly H.
2017-01-01
The purpose of this study was to examine the structure and content of music student teaching seminars at 4-year, degree-granting institutions accredited by the National Association of Schools of Music across the United States. A secondary purpose was to determine how these seminars (a) addressed perceived needs of student teachers and beginning…
ERIC Educational Resources Information Center
Watson, Robert Stephen
2010-01-01
This dissertation illuminates relationships between micro-level practices of schools and macro-level structures of society through the socio-historical lens of New York State Regents mathematics examinations, which were administered to public school students throughout the State of New York between 1866 and 2009, inclusive. Fundamental research…
Jitendra, Asha K; Petersen-Brown, Shawna; Lein, Amy E; Zaslofsky, Anne F; Kunkel, Amy K; Jung, Pyung-Gang; Egan, Andrea M
2015-01-01
This study examined the quality of the research base related to strategy instruction priming the underlying mathematical problem structure for students with learning disabilities and those at risk for mathematics difficulties. We evaluated the quality of methodological rigor of 18 group research studies using the criteria proposed by Gersten et al. and 10 single case design (SCD) research studies using criteria suggested by Horner et al. and the What Works Clearinghouse. Results indicated that 14 group design studies met the criteria for high-quality or acceptable research, whereas SCD studies did not meet the standards for an evidence-based practice. Based on these findings, strategy instruction priming the mathematics problem structure is considered an evidence-based practice using only group design methodological criteria. Implications for future research and for practice are discussed. © Hammill Institute on Disabilities 2013.
Universal preventive interventions for children in the context of disasters and terrorism.
Pfefferbaum, Betty; Varma, Vandana; Nitiéma, Pascal; Newman, Elana
2014-04-01
This review addresses universal disaster and terrorism services and preventive interventions delivered to children before and after an event. The article describes the organization and structure of services used to meet the needs of children in the general population (practice applications), examines screening and intervention approaches (tools for practice), and suggests future directions for the field. A literature search identified 17 empirical studies that were analyzed to examine the timing and setting of intervention delivery, providers, conditions addressed and outcomes, and intervention approaches and components. Copyright © 2014 Elsevier Inc. All rights reserved.
Research as Profession and Practice: Frameworks for Guiding the Responsible Conduct of Research.
Chen, Jiin-Yu
2016-01-01
Programs in the responsible conduct of research (RCR) vary between institutions, demonstrated by disparate structures and goals. These variations may be attributed to the absence of grounding frameworks within which to examine research and RCR education programs. This article examines research as a practice and a profession, using these frames to draw out defining features of research and the moral obligations entailed. Situating research within virtue ethics can clarify how researchers might cultivate the virtues necessary for meeting its obligations and aims. By elucidating these features, these perspectives can serve to guide the development of RCR education programs.
Social work and gender: An argument for practical accounts
2015-01-01
This article contributes to the debate on gender and social work by examining dominant approaches within the field. Anti-discriminatory, woman-centered and intersectional accounts are critiqued for reliance upon both reification and isolation of gender. Via examination of poststructural, queer and trans theories within social work, the author then presents accounts based upon structural/materialist, ethnomethodological and discursive theories, in order to open up debates about conceptualization of gender. These are used to suggest that social work should adopt a focus on gender as a practical accomplishment that occurs within various settings or contexts. PMID:26273228
Policy in Practice: The Implementation of Structured English Immersion in Arizona
ERIC Educational Resources Information Center
Lillie, Karen E.; Markos, Amy; Estrella, Alexandria; Nguyen, Tracy; Trifiro, Anthony; Arias, M. Beatriz; Wiley, Terrence G.; Peer, Karisa; Perez, Karla
2010-01-01
This study examines the implementation and organization of the state mandated curriculum in the 4-hour SEI block in 18 K-12 classrooms in 5 different districts. We focus on the effects of grouping by language proficiency, the delivery of the structure-based ESL curriculum, the provision of resources and limiting of access to grade-level…
Case Designs for Ill-Structured Problems: Analysis and Implications for Practice
ERIC Educational Resources Information Center
Dabbagh, Nada; Blijd, Cecily Williams
2009-01-01
This study is a third in a series of studies that examined students' information seeking and problem solving behaviors while interacting with one of two types of web-based representations of an ill-structured instructional design case: hierarchical (tree-like) and heterarchical (network-like). A Java program was used to track students' hypermedia…
ERIC Educational Resources Information Center
Zangori, Laura; Forbes, Cory T.
2014-01-01
Elementary science standards emphasize that students should develop conceptual understanding of the characteristics and life cycles of plants (National Research Council, 2012), yet few studies have focused on early learners' reasoning about seed structure and function. The purpose of this study is twofold: to (a) examine third-grade…
Victoria L. Sork; Peter E. Smouse; Victoria J. Apsit; Rodney J. Dyer; Robert D. Westfall
2005-01-01
Anthropogenic landscape change can disrupt gene flow. As part of the Missouri Ozark Forest Ecosystem Project, this study examined whether silvicultural practices influence pollen-mediated gene movement in the insect-pollinated species, Cornus florida L., by comparing pollen pool structure (ΦST) among clear-cutting,...
A Study of the Structure and Content of Principal Selection Interviews in Pennsylvania
ERIC Educational Resources Information Center
Weber, Elizabeth A.
2012-01-01
The principal plays a key role in student success. The employment interview is a critical element in the principal selection process. This study examined the interview structure and the content of the interview questions that districts used in their principal search for the 2011-2012 school year. The research-based practices for interview…
2012-01-01
Background Primary care for chronic illness varies across European healthcare systems. In patients suffering from coronary heart disease (CHD), factors associated with patients’ experiences of receiving structured chronic care and counselling at the patient and practice level were investigated. Methods In an observational study comprising 140 general practices from five European countries (Austria, Germany, the Netherlands, Switzerland and the United Kingdom), 30 patients with Coronary Heart Disease (CHD) per practice were chosen at random to partake in this research. Patients were provided with a questionnaire and the Patient Assessment of Chronic Illness Care (PACIC-5A) - instrument. Practice characteristics were assessed through a practice questionnaire and face to face interviews. Data were aggregated to obtain two practice scores representing quality management and CHD care, respectively. A hierarchical multilevel analysis was performed to examine the impact of patient and practice characteristics on PACIC scores. Results The final sample included 1745 CHD-patients from 131 general practices with a mean age of 67.8 (SD 9.9) years. The overall PACIC score was 2.84 (95%CI: 2.79; 2.89) and the 5A score reflecting structured lifestyle counselling was 2.75 (95% CI: 2.69; 2.79). At the patient level, male gender, more frequent practice contact and fewer related or unrelated conditions were associated with higher PACIC scores. At the practice level, performance scores reflecting quality management (p = 0.013) and CHD care (p = 0.009) were associated with improved assessment of the structured chronic care and counselling received. Conclusions Patients’ perceived quality of care varies. However, good practice management and organisation of care were positively reflected in patients’ assessments of receiving structured chronic illness care. This highlights the importance of integrating patient experiences into quality measurements to provide feedback to health care professionals. PMID:22838403
Bölter, Regine; Freund, Tobias; Ledig, Thomas; Boll, Bernhard; Szecsenyi, Joachim; Roos, Marco
2012-01-01
Introduction: The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibility to spend one quarter of the internship, in the last year of their academic studies, in a practice of family medicine. The demonstrated teaching method aims at giving feedback to the student based on video recordings of patient consultations (student-patient) with the help of a checklist. Video-feedback is already successful used in medical teaching in Germany and abroad. This feasibility study aims at assessing the practicability of video-assisted feedback as a teaching method during internship in general practice. Teaching method: First of all, the general practice chooses a guideline as the learning objective. Secondly, a subsequent patient – student – consultation is recorded on video. Afterwards, a video-assisted formative feedback is given by the physician. A checklist with learning objectives (communication, medical examination, a structured case report according to the guideline) is used to structure the feedback content. Feasibility: The feasibility was assessed by a semi structured interview in order to gain insight into barriers and challenges for future implementation. The teaching method was performed in one general practice. Afterwards the teaching physician and the trainee intern were interviewed. The following four main categories were identified: feasibility, performance, implementation in daily routine, challenges of the teaching concept. The results of the feasibility study show general practicability of this approach. Installing a video camera in one examination room may solve technical problems. The trainee intern mentioned theoretical and practical benefits using the guideline. The teaching physician noted the challenge to reflect on his daily routines in the light of evidence-based guidelines. Conclusion: This teaching method supports quality control and standardizing of learning objectives during the internship in general practice by using general practice guidelines. The use of a checklist enhances this method in general practice. We consider the presented teaching method in the context of the planned modification of the Medical Licenses Act is part of quality control and standardisation of medical teaching during general practice internships. In order to validate these presumptions, further, evaluation of this method concerning the learning objectives using the guidelines of general practice need to be carried out. PMID:23255963
Bölter, Regine; Freund, Tobias; Ledig, Thomas; Boll, Bernhard; Szecsenyi, Joachim; Roos, Marco
2012-01-01
The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibility to spend one quarter of the internship, in the last year of their academic studies, in a practice of family medicine. The demonstrated teaching method aims at giving feedback to the student based on video recordings of patient consultations (student-patient) with the help of a checklist. Video-feedback is already successful used in medical teaching in Germany and abroad. This feasibility study aims at assessing the practicability of video-assisted feedback as a teaching method during internship in general practice. First of all, the general practice chooses a guideline as the learning objective. Secondly, a subsequent patient - student - consultation is recorded on video. Afterwards, a video-assisted formative feedback is given by the physician. A checklist with learning objectives (communication, medical examination, a structured case report according to the guideline) is used to structure the feedback content. The feasibility was assessed by a semi structured interview in order to gain insight into barriers and challenges for future implementation. The teaching method was performed in one general practice. Afterwards the teaching physician and the trainee intern were interviewed. The Following four main categories were identified: feasibility, performance, implementation in daily routine, challenges of the teaching concept.The results of the feasibility study show general practicability of this approach. Installing a video camera in one examination room may solve technical problems. The trainee intern mentioned theoretical and practical benefits using the guideline. The teaching physician noted the challenge to reflect on his daily routines in the light of evidence-based guidelines. This teaching method supports quality control and standardizing of learning objectives during the internship in general practice by using general practice guidelines. The use of a checklist enhances this method in general practice. We consider the presented teaching method in the context of the planned modification of the Medical Licenses Act is part of quality control and standardisation of medical teaching during general practice internships. In order to validate these presumptions, further, evaluation of this method concerning the learning objectives using the guidelines of general practice need to be carried out.
Valued Social Roles and Measuring Mental Health Recovery: Examining the Structure of the Tapestry
Hunt, Marcia G.; Stein, Catherine H.
2014-01-01
The complexity of the concept of mental health recovery often makes it difficult to systematically examine recovery processes and outcomes. The concept of social role is inherent within many acknowledged dimensions of recovery such as community integration, family relationships, and peer support and can deepen our understanding of these dimensions when social roles are operationalized in ways that directly relate to recovery research and practice. Objective This paper reviews seminal social role theories and operationalizes aspects of social roles: role investment, role perception, role loss, and role gain. The paper provides a critical analysis of the ability of social role concepts to inform mental health recovery research and practice. Method PubMed and PsychInfo databases were used for the literature review. Results A more thorough examination of social role aspects allows for a richer picture of recovery domains that are structured by the concept social roles. Increasing understanding of consumers’ investment and changes in particular roles, perceptions of consumers’ role performance relative to peers, and consumers’ hopes for the future with regards to the different roles that they occupy could generate tangible, pragmatic approaches in addressing complex recovery domains. Conclusions and Implications for Practice This deeper understanding allows a more nuanced approach to recovery-related movements in mental health system transformation. PMID:23276237
Examining the relationship between socio-economic status, WASH practices and wasting
Raihan, Mohammad Jyoti; Farzana, Fahmida Dil; Sultana, Sabiha; Haque, Md Ahshanul; Rahman, Ahmed Shafiqur; Waid, Jillian L.; McCormick, Ben; Choudhury, Nuzhat; Ahmed, Tahmeed
2017-01-01
Childhood wasting is a global problem and is significantly more pronounced in low and middle income countries like Bangladesh. Socio Economic Status (SES) and Water, Sanitation and Hygiene (WASH) practices may be significantly associated with wasting. Most previous research is consistent about the role of SES, but the significance of WASH in the context of wasting remains ambiguous. The effect of SES and WASH on weight for length (WHZ) is examined using a Structural Equation Model (SEM) to explicitly describe the direct and indirect role of WASH in the context of SES.A nationally representative survey of 10,478 Bangladeshi children under 5 were examined. An expert defined SEM was used to construct latent variables for SES and WASH. The SEM included a direct pathway from SES to WHZ and an indirect pathway from SES to WHZ via WASH along with regression of relevant covariates on the outcome WHZ and the latent variables. Both SES (p<0.01) and WASH (p<0.05) significantly affect WHZ. SES (p<0.01) also significantly affects WASH. Other structural components showed that child’s age (p<0.01) affects WHZ and types of residence (p<0.01) affects SES. WASH practices at least partially mediate the association between SES and wasting status. WASH and SES are both significantly associated with WHZ. PMID:28278161
ERIC Educational Resources Information Center
Gonzalez, Jacqueline Bocachica
2016-01-01
The phenomenon of school leadership in Puerto Rico is explored in this study, which was an examination of the perceptions and practices of 12 elementary school principals. Puerto Rico is a U.S. territory that functions within a unique political structure yet is held to the same standards as all U.S. districts. The primary method of data collection…
ERIC Educational Resources Information Center
Cavanagh, Jillian; Southcombe, Amie; Bartram, Tim
2014-01-01
This study examines the role and impact of collaborative learning on training and development practices in Australian Men's Sheds. We use a case study approach, underpinned by Peters and Armstrong's theoretical framework of collaborative learning in adult education, to investigate five Men's Sheds. Semi-structured interviews were carried out with…
ERIC Educational Resources Information Center
Pampel, Robert
2017-01-01
This qualitative, multisite case study used Dee Fink's taxonomy of significant learning as a lens through which to examine the curricular structure, academic practices, and graduate outcomes for honors programs at Jesuit colleges and universities in the United States. Special attention was given to the distinctive quality of Ignatian pedagogy and…
Effects of yoga on brain waves and structural activation: A review.
Desai, Radhika; Tailor, Anisha; Bhatt, Tanvi
2015-05-01
Previous research has shown the vast mental and physical health benefits associated with yoga. Yoga practice can be divided into subcategories that include posture-holding exercise (asana), breathing (pranayama, Kriya), and meditation (Sahaj) practice. Studies measuring mental health outcomes have shown decreases in anxiety, and increases in cognitive performance after yoga interventions. Similar studies have also shown cognitive advantages amongst yoga practitioners versus non-practitioners. The mental health and cognitive benefits of yoga are evident, but the physiological and structural changes in the brain that lead to this remain a topic that lacks consensus. Therefore, the purpose of this study was to examine and review existing literature on the effects of yoga on brain waves and structural changes and activation. After a narrowed search through a set of specific inclusion and exclusion criteria, 15 articles were used in this review. It was concluded that breathing, meditation, and posture-based yoga increased overall brain wave activity. Increases in graygray matter along with increases in amygdala and frontal cortex activation were evident after a yoga intervention. Yoga practice may be an effective adjunctive treatment for a clinical and healthy aging population. Further research can examine the effects of specific branches of yoga on a designated clinical population. Copyright © 2015 Elsevier Ltd. All rights reserved.
Liddy, Clare; Rowan, Margo; Valiquette-Tessier, Sophie-Claire; Drosinis, Paul; Crowe, Lois; Hogg, William
2017-03-01
Practice facilitation can help family physicians adopt evidence-based guidelines. However, many practices struggle to effectively implement practice changes that result in meaningful improvement. Building on our previous research, we examined the barriers to and enablers of implementation perceived by practice facilitators (PF) in helping practices to adopt the Improved Delivery of Cardiovascular Care (IDOCC) program, which took place at 84 primary care practices in Ottawa, Canada between April 2008 and March 2012. We conducted a qualitative analysis of PFs' narrative reports using a multiple case study design. We used a combined purposeful sampling approach to identify cases that 1) reflected experiences typical of the broader sample and 2) presented sufficient breadth of experience from each project step and family practice model. Sampling continued until data saturation was reached. Team members conducted a qualitative analysis of reports using an open and axial coding style and a constant comparative approach. Barriers and enablers were divided into five constructs: structural, organizational, provider, patient, and innovation. Narratives from 13 practice sites were reviewed. A total of 8 barriers and 11 enablers were consistently identified across practices. Barriers were most commonly reported at the organizational (n = 3) and structural level, (n = 2) while enablers were most common at the innovation level (n = 6). While physicians responded positively to PFs' presence and largely supported their recommendations for practice change, organizational and structural aspects such as lack of time, minimal staff engagement, and provider reimbursement remained too great for practices to successfully implement practice-level changes. Trial Registration: ClinicalTrials.gov, NCT00574808.
Paul, Fiona
2010-09-01
Cardiopulmonary resuscitation (CPR) is an essential skill taught within undergraduate nursing programmes. At the author's institution, students must pass the CPR objective structured clinical examination (OSCE) before progressing to second year. However, some students have difficulties developing competence in CPR and evidence suggests that resuscitation skills may only be retained for several months. This has implications for practice as nurses are required to be competent in CPR. Therefore, further opportunities for students to develop these skills are necessary. An action research project was conducted with six students who were assessed by an examiner at a video-recorded mock OSCE. Students self-assessed their skills using the video and a checklist. Semi-structured interviews were conducted to compare checklist scores, and explore students' thoughts and experiences of the OSCE. The findings indicate that students may need to repeat this exercise by comparing their previous and current performances to develop both their self-assessment and CPR skills. Although there were some differences between the examiner's and student's checklist scores, all students reported the benefits of participating in this project, e.g. discussion and identification of knowledge and skills deficits, thus emphasising the benefits of formative assessments to prepare students for summative assessments and ultimately clinical practice. (c) 2010 Elsevier Ltd. All rights reserved.
The role of retrieval structures in memorizing music.
Williamon, Aaron; Valentine, Elizabeth
2002-02-01
This article explores the use of structure in the encoding and retrieval of music and its relation to level of skill. Twenty-two pianists, classified into four levels of skill, were asked to learn and memorize an assigned composition by J. S. Bach (different for each level). All practice was recorded on cassette tape. At the end of the learning process, the pianists performed their assigned composition in a recital setting. The performances were subsequently evaluated by three experienced pianists according to a standardized grading system. From the cassette tapes, values for the frequency with which pianists started and stopped their practice on "structural," "difficult," and "other" bars were obtained. Starts and stops on each bar type were compared across three stages of the learning process. The analyses reveal that all pianists, regardless of level, started and stopped their practice increasingly on structural bars and decreasingly on difficult bars across the learning process. Moreover, the data indicate that starts and stops increased on structural bars and decreased on difficult bars systematically with increases in level of skill. These findings are interpreted and discussed so as to elucidate characteristics of the retrieval structures adopted by musicians in their practice and performance and how the formation and use of retrieval structures develop as a function of expertise. Finally, the elicited values for starts on structural, difficult, and other bars are examined and discussed according to how they relate to the pianists' scores on performance quality. Copyright 2002 Elsevier Science (USA).
ERIC Educational Resources Information Center
National Registry of Emergency Medical Technicians, Columbus, OH.
A structured, time-referenced, performance examination was designed as part of the certification procedure for Emergency Medical Technicians-Ambulance in an attempt to increase objectivity and standardization. This examination is based on a model developed by the University of Southern California, School of Medicine, Department of Emergency…
Escudier, M P; Woolford, M J; Tricio, J A
2018-05-01
Clinical reasoning is a fundamental and core clinical competence of healthcare professionals. The study aimed to investigate the utility of the Structured Professional Reasoning Exercise (SPRE), a new competence assessment method designed to measure dental students' clinical reasoning in simulated scenarios, covering the clinical areas of Oral Disease, Primary Dental Care and Restorative Dentistry, Child Dental Health and Dental Practice and Clinical Governance. A total of 313 year-5 students sat for the assessment. Students spent 45 minutes assimilating the scenarios, before rotating through four pairs of 39 trained examiners who each independently assessed a single scenario over a ten-minute period, using a structured marking sheet. After the assessment, all students and examiners were invited to complete an anonymous perception questionnaire of the exercise. These questionnaires and the examination scores were statistically analysed. Oral Disease showed the lowest scores; Dental Practice and Governance the highest. The overall Intraclass Correlation Coefficient (ICC) was 0.770, whilst examiner training helped to increase the ICC from 0.716 in 2013 to 0.835 in 2014. Exploratory factor analysis revealed one major factor with an eigenvalue of 2.75 (68.8% of total variance). The Generalizability coefficient was consistent at 0.806. A total of 295 students and 32 examiners completed the perception questionnaire. Students' lowest examination perceptions were an "Unpleasant" and "Unenjoyable" experience, whilst the highest were "Interesting", "Valuable" and "Important". The majority of students and examiners reported the assessment as acceptable, fair and valid. The SPRE offers a reliable, valid and acceptable assessment method, provided it comprises at least four scenarios with two independently marking and trained assessors. 3. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Spallek, Michael; Kuhn, Walter; Schwarze, Sieglinde; Hartmann, Bernd
2007-10-29
Occupational physicians are very often confronted with questions as to the fitness of the postural and locomotor systems, especially the spinal column. Occupational medical assessment and advice can be required by patients with acute symptoms, at routine check-ups, by persons who have problems doing certain jobs, and for expert medical reports as to the fitness of persons with chronic disorders or after operations. Therefore, for occupational medical purposes a physical examination must aim primarily to investigate functions and not structures or radiologic evidence. The physical examination should be structured systematically and according to regions of the body and, together with a specific (pain) anamnesis should provide a basis for the medical assessment.This paper presents a function-oriented system for physical examination of the locomotor system, named fokus(C) (Funktionsorientierte Koerperliche Untersuchungssystematik, also available on DVD). fokus(C) has been developed with a view to its relevance for occupational medical practice and does not aim primarily to provide a precise diagnosis. Decisive for an occupational medical assessment of disorders of the musculoskeletal system is rather information about functional disorders and any impairment of performance or mobility which they can cause. The division of the physical examination into a rapid screening phase and a subsequent more intensive functional diagnostic phase has proved its practicability in many years of day-to-day use. Here, in contrast to the very extensive measures recommended for orthopaedic and manual diagnosis, for reasons of efficiency and usability of the system in routine occupational medical examinations the examination is structured according to the findings. So it is reduced to that which is most necessary and feasible.
Cohen, Deborah J; Balasubramanian, Bijal A; Gordon, Leah; Marino, Miguel; Ono, Sarah; Solberg, Leif I; Crabtree, Benjamin F; Stange, Kurt C; Davis, Melinda; Miller, William L; Damschroder, Laura J; McConnell, K John; Creswell, John
2016-06-29
The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to those with fewer than ten physicians per clinic). Examples of external support include practice facilitation, expert consultation, performance feedback, and educational materials and activities. This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). This prospective observational study will examine the portfolio of EvidenceNOW Cooperatives using both qualitative and quantitative data. Qualitative data include: online implementation diaries, observation and interviews at Cooperatives and practices, and systematic assessment of context from the perspective of Cooperative team members. Quantitative data include: practice-level performance on clinical quality measures (aspirin prescribing, blood pressure and cholesterol control, and smoking cessation; ABCS) collected by Cooperatives from electronic health records (EHRs); practice and practice member surveys to assess practice capacity and other organizational and structural characteristics; and systematic tracking of intervention delivery. Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness. ESCALATES is a national evaluation of an ambitious large-scale dissemination and implementation effort focused on transforming smaller primary care practices. Insights will help to inform the design of national health care practice extension systems aimed at supporting practice transformation efforts in the USA. NCT02560428 (09/21/15).
Lilholt, Lars; Haubro, Camilla Dremstrup; Møller, Jørn Munkhof; Aarøe, Jens; Højen, Anne Randorff; Gøeg, Kirstine Rosenbeck
2013-01-01
It is well-established that to increase acceptance of electronic clinical documentation tools, such as electronic health record (EHR) systems, it is important to have a strong relationship between those who document the clinical encounters and those who reaps the benefit of digitalized and more structured documentation. [1] Therefore, templates for EHR systems benefit from being closely related to clinical practice with a strong focus on primarily solving clinical problems. Clinical use as a driver for structured documentation has been the focus of the acute-physical-examination template (APET) development in the North Denmark Region. The template was developed through a participatory design where precision and clarity of documentation was prioritized as well as fast registration. The resulting template has approximately 700 easy accessible input possibilities and will be evaluated in clinical practice in the first quarter of 2013.
Landes, Constantin A; Hoefer, Sebastian; Schuebel, Florian; Ballon, Alexander; Teiler, Anna; Tran, Andreas; Weber, Roxane; Walcher, Felix; Sader, Robert
2014-07-01
Basic skills in oral/CMF surgery should be taught effectively to dental students as surgical skills training is traditionally under-represented in the dental curriculum compared to its later need in daily clinical practice. Rigid curricular time frames and prospectively condensed professional education foster new effective teaching and examination formats. Transmitting and assessing clinical competence objectively (independent of subjective bias), reliably (repeatable, inter-rater consistency) and valid (representative, structured task selection) was intended and evaluated in oral/CMF surgery skills acquisition starting in summer 2009. A small-group practical skills training (PST) day initiated a one-week practical training course, covering previously formulated learning objectives. An objective structured clinical evaluation (OSCE) was held at the end of each semester. Theoretical background knowledge and clinical skills should have to be memorized within a representative number of practical tasks (test stations). A first semester (26 students) used classical practical training alone as controls, the following semesters (171 students) had PST, considered as a study group. All 197 students were assessed with OSCE's over a 3-year period. An instructor held PST based on presentations, videos and practical training, including mannequins, with pairs of students. This included history taking, communication and interpretation of laboratory/image diagnostics, structured clinical facial examination, fracture diagnosis, venipuncture, suturing, biopsy and wire loops on pig jaws for manual and clinical skills, which were later incorporated in OSCE stations. OSCE average results increased from 63.3 ± 9.7% before and to 75.5 ± 10% after the inclusion of PST (p < 0.05). Knowledge diffusion between sittings on the same test date and between consecutive semesters was insignificant. Students and faculty rated their learning/teaching experience "very good" to "good". PST was effective in optimizing clinical skills as evaluated by OSCE. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Ozen Kutanis, Rana; Tunc, Tulin; Tunc, Murat
2011-01-01
In this study, it was aimed to explore whether a single-step examination is adequate for ranking the medical graduates for specialty training in medicine which is practically similar to doctoral training (PhD) in other disciplines. For this purpose, a semi- structured interview-based qualitative research was carried out at a university medical…
ERIC Educational Resources Information Center
Knight, R. E.; Shoveller, J. A.; Carson, A. M.; Contreras-Whitney, J. G.
2014-01-01
Although barriers related to lesbian, gay, bisexual, transgender and queer (LGBTQ) youth's experiences accessing sexual health services have been examined in detail, research into the experiences and perceptions of clinicians providing these services has been conspicuously absent. The aim of this article is to explore the perceptions and…
ERIC Educational Resources Information Center
Benson, Nicholas; Hulac, David M.; Kranzler, John H.
2010-01-01
Published empirical evidence for the Wechsler Adult Intelligence Scale--Fourth Edition (WAIS-IV) does not address some essential questions pertaining to the applied practice of intellectual assessment. In this study, the structure and cross-age invariance of the latest WAIS-IV revision were examined to (a) elucidate the nature of the constructs…
ERIC Educational Resources Information Center
Gayles, Jochebed G.; Coatsworth, J. Douglas; Pantin, Hilda M.; Szapocznik, Jose
2009-01-01
This study examined the influence of family and neighborhood contexts on Hispanic youth problem behavior. The effects of parents' perceptions of neighborhood context and parenting practices on problem behavior were examined in 167 one-parent (n = 75) and two-parent (n = 92) families. Results from multigroup path analyses showed significant main…
ERIC Educational Resources Information Center
Archambault, Leanna; Kennedy, Kathryn; Shelton, Catharyn; Dalal, Medha; McAllister, Laura; Huyett, Sabrina
2016-01-01
Despite the call for a transformation of teacher education in the 21st century, surprisingly little has changed. This includes how the practical, hands-on component, known as a field experience is structured. Previous research, conducted in 2010, specifically examining how teacher education programs address K-12 online learning through their field…
Supporting students undertaking the Specialist Practitioner Qualification in District Nursing.
Ginger, Tracey; Ritchie, Georgina
2017-11-02
The ever-evolving role of the Specialist Practitioner Qualified District Nurse (SPQDN) presents an increasing number of challenges for Practice Teachers and mentors in preparing SPQDN students for the elevated level clinical and transformational leadership necessary to ensure high-quality patient care. The daily challenges of clinical practice within the community nursing setting in addition to undertaking educational interventions in the clinical arena demand that a structured approach to supervision and mentorship is crucial. Employing learning plans to assess individual students learning needs, prepare plans for educational developments and interventions and evaluate a student's progress can be a helpful tool in aiding the learning journey for both the SPQDN student and Practice Teacher or mentor. This article examines how and why a structured learning plan may be used in supporting learning and competency in achieving the necessary level of practice to meet the requirements of the SPQDN.
Footer, Katherine H A; Lim, Sahnah; Brantley, Meredith R; Sherman, Susan G
2018-03-01
This paper provides longitudinal examination of women's health and sexual risk trajectories in US exotic dance clubs, which represent an important commercial setting for the economic mainstreaming of sexual services and an important target for public health programmes. Between July 2014 and May 2015, two semi-structured interviews (at baseline and at three months) were conducted with 24 female exotic dancers who had recently started working in in Baltimore City, USA. Results from a constant comparative analysis point to the interrelationship between the structures of the club setting, including the social context, and women's agentic practices concerning their sexual health. Study findings highlight the centrality of the interrelationship between individual- and structural-level experiences in influencing dancers' risk behavior. Findings point to the need for interventions to empower women both individually and collectively so as to provide the foundation for longer-term structural change.
Stahmer, Aubyn C.
2007-01-01
Autism researchers have identified a set of common effective practice elements for early intervention (EI) (e.g., intensive programming). The current study examined the reported about use of common elements of effective interventions in community EI settings. Eighty EI providers reported about their programs. The majority of participants reported using common effective elements, however, the depth and quality of the use of these elements was highly variable. Taking community program structure into account in future research will facilitate the development of methodologies, which immediately fit into the context of community programming rather than requiring program adaptation for use in the real world. Recommendations for using current community program structure to improve use of evidence-based practices are discussed. PMID:17086438
Gwynn, Josephine; Lock, Mark; Turner, Nicole; Dennison, Ray; Coleman, Clare; Kelly, Brian; Wiggers, John
2015-08-01
Gaps exist in researchers' understanding of the 'practice' of community governance in relation to research with Aboriginal and Torres Strait Islander peoples. We examine Aboriginal community governance of two rural NSW research projects by applying principles-based criteria from two independent sources. One research project possessed a strong Aboriginal community governance structure and evaluated a 2-year healthy lifestyle program for children; the other was a 5-year cohort study examining factors influencing the mental health and well-being of participants. The National Health and Medical Research Council of Australia's 'Values and ethics: guidelines for ethical conduct in Aboriginal and Torres Strait Islander research' and 'Ten principles relevant to health research among Indigenous Australian populations' described by experts in the field. Adopt community-based participatory research constructs. Develop clear governance structures and procedures at the beginning of the study and allow sufficient time for their establishment. Capacity-building must be a key component of the research. Ensure sufficient resources to enable community engagement, conduct of research governance procedures, capacity-building and results dissemination. The implementation of governance structures and procedures ensures research addresses the priorities of the participating Aboriginal and Torres Strait Islander communities, minimises risks and improves outcomes for the communities. Principles-based Aboriginal and Torres Strait Islander community governance of research is very achievable. Next steps include developing a comprehensive evidence base for appropriate governance structures and procedures, and consolidating a suite of practical guides for structuring clear governance in health research. © 2015 National Rural Health Alliance Inc.
ERIC Educational Resources Information Center
Morrissey, Catrin; Cooke, David; Michie, Christine; Hollin, Clive; Hogue, Todd; Lindsay, William R.; Taylor, John L.
2010-01-01
The Psychopathy Checklist-Revised (PCL-R) is the most widely used measure of psychopathy in forensic clinical practice, but the generalizability of the measure to offenders with intellectual disabilities (ID) has not been clearly established. This study examined the structural equivalence and scalar equivalence of the PCL-R in a sample of 185 male…
Detection of structural deterioration and associated airline maintenance problems
NASA Technical Reports Server (NTRS)
Henniker, H. D.; Mitchell, R. G.
1972-01-01
Airline operations involving the detection of structural deterioration and associated maintenance problems are discussed. The standard approach to the maintenance and inspection of aircraft components and systems is described. The frequency of inspections and the application of preventive maintenance practices are examined. The types of failure which airline transport aircraft encounter and the steps taken to prevent catastrophic failure are reported.
[Interrater-reliability of the OPD-CA, the axes conflict and structure].
Stefini, Annette; Reich, Günter; Horn, Hildegard; Winkelmann, Klaus; Ohmes, Ursula; Frost, Ulrike; Kronmüller, Klaus-Thomas
2013-01-01
The reliability of the meanwhile widely used Operationalized Psychodynamic Diagnostics in childhood and adolescence (OPD-CA) is only rarely examined. By means of audiovisual recordings of OPD-CA-interviews with 39 adolescents in the context of a randomized-controlled psychotherapy study for the treatment female adolescents with bulimia nervosa and atypical bulimia nervosa the reliability of the axis conflict and the axis structure were examined. This was carried out by the calculation of Intraklassen-correlations of three raters. The rater agreements ranged from good to excellent, except for impulse control in the axis structure, where the results were satisfactory. The relevance of the results for clinical practice is discussed.
Knight, R. E.; Shoveller, J. A.; Carson, A. M.; Contreras-Whitney, J. G.
2014-01-01
Although barriers related to lesbian, gay, bisexual, transgender and queer (LGBTQ) youth’s experiences accessing sexual health services have been examined in detail, research into the experiences and perceptions of clinicians providing these services has been conspicuously absent. The aim of this article is to explore the perceptions and experiences of clinicians providing sexual health services for LGBTQ youth. Drawing on in-depth, semi-structured interviews, this study examines 24 clinicians’ experiences providing sexual health services to LGBTQ youth in five communities in British Columbia, Canada. Our findings reveal how many clinicians provide services to LGBTQ youth with a lack of cultural competency—either implicitly (e.g. by describing heteronormative practices) or explicitly (e.g. by expressing frustration that they had not been sufficiently provided with appropriate training related to LGBTQ youth sexual health). Institutional norms and values were identified as the dominant barriers in the effective provision of LGBTQ-tailored services. Many clinicians find themselves unprepared to provide culturally competent sexual health services that have both the capacity to address individual-level issues (e.g. promoting condom use) while considering (and adapting services to) the broader socio-cultural and structural conditions that can render LGBTQ youth socially vulnerable. PMID:24412811
Addressing the “Risk Environment” for Injection Drug Users: The Mysterious Case of the Missing Cop
Burris, Scott; Blankenship, Kim M; Donoghoe, Martin; Sherman, Susan; Vernick, Jon S; Case, Patricia; Lazzarini, Zita; Koester, Stephen
2004-01-01
Ecological models of the determinants of health and the consequent importance of structural interventions have been widely accepted, but using these models in research and practice has been challenging. Examining the role of criminal law enforcement in the “risk environment” of injection drug users (IDUs) provides an opportunity to apply structural thinking to the health problems associated with drug use. This article reviews international evidence that laws and law enforcement practices influence IDU risk. It argues that more research is needed at four levels—laws; management of law enforcement agencies; knowledge, attitudes, beliefs, and practices of frontline officers; and attitudes and experiences of IDUs—and that such research can be the basis of interventions within law enforcement to enhance IDU health. PMID:15016246
A Forensic Examination of Online Search Facility URL Record Structures.
Horsman, Graeme
2018-05-29
The use of search engines and associated search functions to locate content online is now common practice. As a result, a forensic examination of a suspect's online search activity can be a critical aspect in establishing whether an offense has been committed in many investigations. This article offers an analysis of online search URL structures to support law enforcement and associated digital forensics practitioners interpret acts of online searching during an investigation. Google, Bing, Yahoo!, and DuckDuckGo searching functions are examined, and key URL attribute structures and metadata have been documented. In addition, an overview of social media searching covering Twitter, Facebook, Instagram, and YouTube is offered. Results show the ability to extract embedded metadata from search engine URLs which can establish online searching behaviors and the timing of searches. © 2018 American Academy of Forensic Sciences.
How well do final year undergraduate medical students master practical clinical skills?
Störmann, Sylvère; Stankiewicz, Melanie; Raes, Patricia; Berchtold, Christina; Kosanke, Yvonne; Illes, Gabrielle; Loose, Peter; Angstwurm, Matthias W.
2016-01-01
Introduction: The clinical examination and other practical clinical skills are fundamental to guide diagnosis and therapy. The teaching of such practical skills has gained significance through legislative changes and adjustments of the curricula of medical schools in Germany. We sought to find out how well final year undergraduate medical students master practical clinical skills. Methods: We conducted a formative 4-station objective structured clinical examination (OSCE) focused on practical clinical skills during the final year of undergraduate medical education. Participation was voluntary. Besides the examination of heart, lungs, abdomen, vascular system, lymphatic system as well as the neurological, endocrinological or orthopaedic examination we assessed other basic clinical skills (e.g. interpretation of an ECG, reading a chest X-ray). Participants filled-out a questionnaire prior to the exam, inter alia to give an estimate of their performance. Results: 214 final year students participated in our study and achieved a mean score of 72.8% of the total score obtainable. 9.3% of participants (n=20) scored insufficiently (<60%). We found no influence of sex, prior training in healthcare or place of study on performance. Only one third of the students correctly estimated their performance (35.3%), whereas 30.0% and 18.8% over-estimated their performance by 10% and 20% respectively. Discussion: Final year undergraduate medical students demonstrate considerable deficits performing practical clinical skills in the context of a formative assessment. Half of the students over-estimate their own performance. We recommend an institutionalised and frequent assessment of practical clinical skills during undergraduate medical education, especially in the final year. PMID:27579358
Perception of pediatric neurology among non-neurologists.
Jan, Mohammed M S
2004-01-01
Pediatric neurology is considered a relatively new and evolving subspecialty. In Saudi Arabia, neurologic disorders in children are common, and the demand for trained pediatric neurologists is strong. The aim was to study the perception of the pediatric neurology specialty among practicing generalists and their referral practices. Attendees of a symposium on pediatric epilepsy comprehensive review for the generalist were included. A structured 25-item questionnaire was designed to examine their demographics, training, practice, and referral patterns. One hundred nineteen participants attended the symposium, and 90 (76%) questionnaires were returned. Attendees' ages were 22 to 70 years (mean 32 years), with 65.5% female physicians. There were 32% consultants, 51% trainees, and 17% students. Most physicians (67%) were practicing general pediatrics. Only 36% received a structured pediatric neurology rotation during training. Children with neurologic complaints constituted 28.5% of those seen in their practice, and they referred 32.5% of them to pediatric neurology. Only 32% were moderately or highly confident in making the diagnosis or providing the appropriate treatment. Those who received a structured pediatric neurology rotation felt more comfortable in their management (P = .03). Many physicians (38.5%) had no direct access to a pediatric neurologist for referrals. To conclude, pediatric neurologic disorders are common in daily practice. Most generalists did not receive a structured neurology rotation during their training and were not highly confident in diagnosing and treating these children. Given the limited number of pediatric neurologists, I highly recommend that generalists receive appropriate neurologic training.
Robinson, Karen; Eck, Carol; Keck, Becky; Wells, Nancy
2003-09-01
Professional practice programs are designed to attract, retain, and reward nurses. This three-part series will describe Vanderbilt's performance-based career advancement system, the Vanderbilt Professional Nursing Practice Program (VPNPP). Part 1 outlines the overall program's foundation, philosophical background, and basic structure. The VPNPP is built upon Benner's work, distinguishing among four levels of practice: novice, competent, proficient, and expert. Work by many in the organization identified the expected behaviors for nurses at each level, which were then used to develop clear process evaluation criteria. Part 2 will examine the performance measurement and evaluation system created to support the program. The process of advancing within the program will be described in part 3.
Activity Structures and the Unfolding of Problem-Solving Actions in High-School Chemistry Classrooms
NASA Astrophysics Data System (ADS)
Criswell, Brett A.; Rushton, Greg T.
2014-02-01
In this paper, we argue for a more systematic approach for studying the relationship between classroom practices and scientific practices—an approach that will likely better support the systemic reforms being promoted in the Next Generation Science Standards in the USA and similar efforts in other countries. One component of that approach is looking at how the nature of the activity structure may influence the relative alignment between classroom and scientific practices. To that end, we build on previously published research related to the practices utilized by five high-school chemistry teachers as they enacted problem-solving activities in which students were likely to generate proposals that were not aligned with normative scientific understandings. In that prior work, our analysis had emphasized micro-level features of the talk interactions and how they related to the way students' ideas were explored; in the current paper, the analysis zooms out to consider the macro-level nature of the enactments associated with the activity structure of each lesson examined. Our data show that there were two general patterns to the activity structure across the 14 lessons scrutinized, and that each pattern had associated with it a constellation of features that impinged on the way the problem space was navigated. A key finding is that both activity structures (the expansive and the open) had features that aligned with scientific practices espoused in the Next Generation Science Standards—and both had features that were not aligned with those practices. We discuss the nature of these two structures, evidence of the relationship of each structure to key features of how the lessons unfolded, and the implications of these findings for both future research and the training of teachers.
Kim, Jungyoon; Wehbi, Nizar; Dellifraine, Jami L; Brannon, Diane
2014-01-01
Human resource (HR) practices, such as training and communication, have been linked to positive employee job commitment and lower turnover intent for direct care workers (DCWs). Not many studies have looked at the combined interaction of HR practices and organizational structure. The aim of this study is to examine the relationship between organizational structure (centralization, formalization, and span of control) and HR practices (training, horizontal communication, and vertical communication) on DCW's job satisfaction and turnover intent. Data were collected from 58 long-term care facilities in five states. We used latent class analysis to group facility characteristics into three sets of combinations: "organic," "mechanistic," and "minimalist." We used multivariate regression to test the relationship of each of these groups on DCW's job satisfaction and turnover intent. After controlling for state, organizational, and individual covariates, the organic group, which represents decentralized and less formalized structures and high levels of job training and communication, was positively related to job satisfaction and negatively related to intent to leave. On the other hand, the minimalist group, which is characterized by low levels of job-related training and communication, showed no significant differences from the mechanistic group (referent) on job satisfaction and intent to leave. These findings imply that managers in long-term care facilities may want to consider adopting organic, decentralized structures and HR practices to retain DCWs.
Longworth, Mary K
2013-08-01
the aim of this study was to examine the attitudes of student midwives towards skills training and practise. The objectives were to explore the factors in the skills laboratory environment and in clinical practice which affect how successfully student midwives transfer into clinical practice the various skills they have learnt in preparation for an Objective Structured Clinical Examination. a review of the background literature revealed that there were many variables related to successful transfer of skills in general but there appeared to be a gap around perceived factors affecting transfer of skills of student midwives. a mixed methods design was conducted using both questionnaires and semi-structured interviews between June and August 2010. questionnaires were administered to all midwifery students at one university in Wales. These were later followed by semi-structured interviews for 6 student midwives who were purposively selected from all year groups. the results from the questionnaires revealed that a majority of students had positive attitudes to educators and mentors and to their skills acquisition experience in the skills laboratory and to the available opportunities to practise in clinical practice. Although students believed in the transferability of skills from the laboratory setting to clinical practice, a majority thought that clinical practice provided them with a better opportunity to learn clinical skills. The semi-structured interviews demonstrated that facilitating factors in the skills laboratory included having adequate instruction as well as having a designated space. Hindering factors included unrealistic models and equipment. In clinical practice, facilitating factors included having the opportunities to practise skills and support and feedback from the mentor. Hindering factors included deficits in the student-mentor relationship. this study highlighted that midwifery students must be adequately prepared to carry out clinical skills competently and effectively. Educators and mentors must provide adequate support and feedback to promote transfer of knowledge and skills into the workplace to optimise high standards of care for women and their babies. Copyright © 2012 Elsevier Ltd. All rights reserved.
Ek, Anna; Sorjonen, Kimmo; Eli, Karin; Lindberg, Louise; Nyman, Jonna; Marcus, Claude; Nowicka, Paulina
2016-01-01
Introduction Insight into parents’ perceptions of their children’s eating behaviors is crucial for the development of successful childhood obesity programs. However, links between children’s eating behaviors and parental feeding practices and concerns have yet to be established. This study aims to examine associations between parental perceptions of preschoolers’ eating behaviors and parental feeding practices. First, it tests the original 8-factor structure of the Child Eating Behavior Questionnaire (CEBQ). Second, it examines the associations with parental feeding practices, measured with the Child Feeding Questionnaire (CFQ). Materials and Methods Questionnaires were sent to parents from 25 schools/preschools in Stockholm, Sweden and to parents starting a childhood obesity intervention. The CEBQ factor structure was tested with confirmatory factor analysis (CFA). Associations between CEBQ subscales Food approach and Food avoidance and CFQ factors Restriction, Pressure to eat and Monitoring were examined with structural equation modelling (SEM), adjusting for child and parental characteristics, and parental confidence, measured with the Lifestyle Behavior Checklist (LBC). CFQ Concern for child weight and Perceived responsibility for child eating were used as mediators. Results 478 parents completed the questionnaires (children: 52% girls, mean age 5.5 years, 20% overweight/obese). A modified 8-factor structure showed an acceptable fit (TLI = 0.91, CFI = 0.92, RMSEA = 0.05 and SRMR = 0.06) after dropping one item and allowing three pairs of error terms to correlate. The SEM model demonstrated that Food approach had a weak direct effect on Restriction, but a moderate (β = 0.30) indirect effect via Concern, resulting in a substantial total effect (β = 0.37). Food avoidance had a strong positive effect on Pressure to eat (β = 0.71). Discussion The CEBQ is a valid instrument for assessing parental perceptions of preschoolers’ eating behaviors. Parental pressure to eat was strongly associated with children’s food avoidance. Parental restriction, however, was more strongly associated with parents’ concerns about their children’s weights than with children’s food approach. This suggests that childhood obesity interventions should address parents’ perceptions of healthy weight alongside perceptions of healthy eating. PMID:26799397
Ek, Anna; Sorjonen, Kimmo; Eli, Karin; Lindberg, Louise; Nyman, Jonna; Marcus, Claude; Nowicka, Paulina
2016-01-01
Insight into parents' perceptions of their children's eating behaviors is crucial for the development of successful childhood obesity programs. However, links between children's eating behaviors and parental feeding practices and concerns have yet to be established. This study aims to examine associations between parental perceptions of preschoolers' eating behaviors and parental feeding practices. First, it tests the original 8-factor structure of the Child Eating Behavior Questionnaire (CEBQ). Second, it examines the associations with parental feeding practices, measured with the Child Feeding Questionnaire (CFQ). Questionnaires were sent to parents from 25 schools/preschools in Stockholm, Sweden and to parents starting a childhood obesity intervention. The CEBQ factor structure was tested with confirmatory factor analysis (CFA). Associations between CEBQ subscales Food approach and Food avoidance and CFQ factors Restriction, Pressure to eat and Monitoring were examined with structural equation modelling (SEM), adjusting for child and parental characteristics, and parental confidence, measured with the Lifestyle Behavior Checklist (LBC). CFQ Concern for child weight and Perceived responsibility for child eating were used as mediators. 478 parents completed the questionnaires (children: 52% girls, mean age 5.5 years, 20% overweight/obese). A modified 8-factor structure showed an acceptable fit (TLI = 0.91, CFI = 0.92, RMSEA = 0.05 and SRMR = 0.06) after dropping one item and allowing three pairs of error terms to correlate. The SEM model demonstrated that Food approach had a weak direct effect on Restriction, but a moderate (β = 0.30) indirect effect via Concern, resulting in a substantial total effect (β = 0.37). Food avoidance had a strong positive effect on Pressure to eat (β = 0.71). The CEBQ is a valid instrument for assessing parental perceptions of preschoolers' eating behaviors. Parental pressure to eat was strongly associated with children's food avoidance. Parental restriction, however, was more strongly associated with parents' concerns about their children's weights than with children's food approach. This suggests that childhood obesity interventions should address parents' perceptions of healthy weight alongside perceptions of healthy eating.
District nurses' prescribing practice and its link to structural conditions.
Blanck, Susanne; Engström, Maria
2015-10-01
To describe district nurses' (DNs') prescribing practice and examine associations between DNs' self-reported prescribing frequency, opinions about prescribing, and structural conditions/empowerment. A cross-sectional and correlational design was employed. Data were collected during 2012 using questionnaires and a prescribing register. A random sample of 150 DNs from 32 primary care centers in Sweden was invited. DNs' ability to prescribe is used to a relatively small extent and access to "opportunities" and "informal power" seems to be the most important structural empowerment conditions for increased prescribing frequency and positive opinions about prescribing. The results support Kanter's theory of structural empowerment. This article regarding restricted prescribing shows how important structural conditions/empowerment is to DNs' prescribing and employers have to enhance nurses' access to especially the structures "opportunities" and "informal power" to increase nurse prescribing. More targeted support and training are needed in different prescribing areas to make use of DNs' prescription qualification to a greater extent. ©2015 American Association of Nurse Practitioners.
Acquainting Future Office Employees with Productivity-Improvement Techniques.
ERIC Educational Resources Information Center
Quible, Zane K.
1982-01-01
Examines factors affecting productivity (government regulations, energy costs, decline in the work ethic, capital investment, number of service workers, work force characteristics, management practices, and unions), and techniques to improve productivity (employee involvement, job structure, communication, flexitime, employee upgrading, incentive…
Kwok, Cannas; Pillay, Rona; Lee, Chun Fan
2016-01-01
Indian women have been consistently reported as having low participation in breast cancer screening practices. A valid and reliable instrument to explore their breast cancer beliefs is essential for development of interventions to promote breast cancer screening practices. The aim of this study was to report the psychometric properties of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) in an Indian community in Australia. A convenience sample of 242 Indian Australian women was recruited from Indian community organizations and personal networking. Explanatory factor analysis was conducted to study the factor structure. Clinical validity was examined by Cuzick's nonparametric test, and Cronbach's α was used to assess internal consistency reliability. Exploratory factor analysis showed a similar fit to the hypothesized 3-factor structure. The frequency of breast cancer screening practices was significantly associated with attitudes toward general health check-up. Knowledge and perceptions about the breast cancer scale were not significantly associated with clinical breast examinations and mammography. Perceived barriers to mammography were much less evident among women who engaged in breast awareness and clinical breast examination. Results indicated that the BCSBQ had satisfactory validity and internal consistency. Cronbach's α of the 3 subscales ranged from .81 to .91. The BCSBQ is a culturally appropriate, valid, and reliable instrument for assessing the beliefs, knowledge, and attitudes about breast cancer and breast cancer screening practices among women of Indian ethnic extraction living in Australia. The BCSBQ can be used to provide nurses with information relevant for the development of culturally sensitive breast health education programs.
Bergsmann, Evelyn M; Van De Schoot, Rens; Schober, Barbara; Finsterwald, Monika; Spiel, Christiane
2013-04-01
Teachers promote student learning and well-being in school by establishing a supportive classroom structure. The term classroom structure refers to how teachers design tasks, maintain authority, and evaluate student achievement. Although empirical studies have shown the relation of classroom structure to student motivation, achievement, and well-being, no prior investigations have examined the influence of classroom structure on aggression among peers. The present study examined whether a supportive classroom structure has an impact on verbal and physical aggression. At two points in time, data were collected from 1680 students in Grades 5 to 7 using self-report questionnaires. The results of structural equation modeling revealed that a supportive classroom structure at Time 1 was associated with less perpetrated verbal aggression at Time 2, 9months later. This finding has practical relevance for teacher training as well as for aggression prevention and intervention among children. Copyright © 2012 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
Neonatal physical therapy. Part II: Practice frameworks and evidence-based practice guidelines.
Sweeney, Jane K; Heriza, Carolyn B; Blanchard, Yvette; Dusing, Stacey C
2010-01-01
(1) To outline frameworks for neonatal physical therapy based on 3 theoretical models, (2) to describe emerging literature supporting neonatal physical therapy practice, and (3) to identify evidence-based practice recommendations. Three models are presented as a framework for neonatal practice: (1) dynamic systems theory including synactive theory and the theory of neuronal group selection, (2) the International Classification of Functioning, Disability and Health, and (3) family-centered care. Literature is summarized to support neonatal physical therapists in the areas of examination, developmental care, intervention, and parent education. Practice recommendations are offered with levels of evidence identified. Neonatal physical therapy practice has a theoretical and evidence-based structure, and evidence is emerging for selected clinical procedures. Continued research to expand the science of neonatal physical therapy is critical to elevate the evidence and support practice recommendations.
Spence Laschinger, Heather K; Zhu, Junhong; Read, Emily
2016-07-01
To test a model examining the effects of structural empowerment and support for professional practice on new graduate nurses' perceived professional practice behaviours, perceptions of care quality and subsequent job satisfaction and career turnover intentions. The nursing worklife model describes relationships between supportive nursing work environments and nurse and patient outcomes. The influence of support for professional practice on new nurses' perceptions of professional nursing behaviours within this model has not been tested. Structural equation modelling in Mplus was used to analyse data from a national survey of new nurses across Canada (n = 393). The hypothesised model was supported: χ²(122) = 346.726, P = 0.000; CFI = 0.917; TLI = 0.896; RMSEA = 0.069. Professional practice behaviour was an important mechanism through which empowerment and supportive professional practice environments influenced nurse-assessed quality of care, which was related to job satisfaction and lower intentions to leave nursing. Job satisfaction and career retention of new nurses are related to perceptions of work environment factors that support their professional practice behaviours and high-quality patient care. Nurse managers can support new graduate nurses' professional practice behaviour by providing empowering supportive professional practice environments. © 2016 John Wiley & Sons Ltd.
Seeing your way to health: the visual pedagogy of Bess Mensendieck's physical culture system.
Veder, Robin
2011-01-01
This essay examines the images and looking practices central to Bess M. Mensendieck's (c.1866-1959) 'functional exercise' system, as documented in physical culture treatises published in Germany and the United States between 1906 and 1937. Believing that muscular realignment could not occur without seeing how the body worked, Mensendieck taught adult non-athletes to see skeletal alignment and muscular movement in their own and others' bodies. Three levels of looking practices are examined: didactic sequences; penetrating inspection and appreciation of physiological structures; and ideokinetic visual metaphors for guiding movement. With these techniques, Mensendieck's work bridged the body cultures of German Nacktkultur (nudism), American labour efficiency and the emerging physical education profession. This case study demonstrates how sport historians could expand their analyses to include practices of looking as well as questions of visual representation.
The social ecology of girls' bullying practices: exploratory research in two London schools.
Jamal, Farah; Bonell, Chris; Harden, Angela; Lorenc, Theo
2015-06-01
This exploratory study adopts a socio-ecological approach to examine the context of school bullying. It asks: (1) what are students' accounts of bullying practices?; (2) how are these enabled and constrained by the school-environment?; (3) how is gender implicated? Qualitative data were collected from girls in two schools in London via focus groups (one in each school; students aged 12-15) and seven semi-structured interviews (in one school; students aged 16-18); and from school policy documents. Our interpretation of girls' accounts, informed by Giddens' structuration theory, suggests that bullying practices were spatially patterned in the schools and often characterised by the regulation of girls' sexuality and sexual-harassment. Repeated acts of aggression were fluid with regard to the bully and victim role, challenging the dominant view of bullying as characterised by consistent disparities in power between individuals. Schools structured bullying behaviour via policies and practices that ignored these forms of abuse and which focused on and may have been complicit in the making of stable 'bully' and 'victim' roles, thus indirectly contributing to the reproduction of unhealthy relationships between students. In terms of gender, traditional gendered and sexual discourses appear to structure the identities of the schools and girls in our study. © 2015 Foundation for the Sociology of Health & Illness.
Toporek, Rebecca L; Pope-Davis, Donald B
2005-08-01
Increased attention to multiculturalism and social justice in psychology has been accompanied by assertions that there is a need for more acknowledgment of system-level oppression. Multicultural training (MCT) may help increase counselors' awareness of structural forces in the lives of clients facing poverty by examining structural influences in racial discrimination. This study examined the relationship between multicultural counseling training, attitudes about race, and attributions of poverty. Data from 158 African American and White American graduate counseling students were examined to determine the extent to which MCT and cognitive and affective racial attitudes predicted tendencies to attribute poverty to structural barriers or to individuals facing poverty. Regression analyses indicated that more MCT and more sensitive cognitive racial attitudes predicted a greater tendency to endorse structural explanations of poverty. Fewer multicultural workshops and less sensitive cognitive racial attitudes predicted a greater tendency to endorse individual explanations of poverty. Implications for training, practice, and research are discussed. ((c) 2005 APA, all rights reserved).
Rhodes, Darson L; Kirchofer, Gregg; Hammig, Bart J; Ogletree, Roberta J
2013-05-01
This study examined the impact of professional preparation and class structure on sexuality topics taught and use of practice-based instructional strategies in US middle and high school health classes. Data from the classroom-level file of the 2006 School Health Policies and Programs were used. A series of multivariable logistic regression models were employed to determine if sexuality content taught was dependent on professional preparation and /or class structure (HE only versus HE/another subject combined). Additional multivariable logistic regression models were employed to determine if use of practice-based instructional strategies was dependent upon professional preparation and/or class structure. Years of teaching health topics and size of the school district were included as covariates in the multivariable logistic regression models. Findings indicated professionally prepared health educators were significantly more likely to teach 7 of the 13 sexuality topics as compared to nonprofessionally prepared health educators. There was no statistically significant difference in the instructional strategies used by professionally prepared and nonprofessionally prepared health educators. Exclusively health education classes versus combined classes were significantly more likely to have included 6 of the 13 topics and to have incorporated practice-based instructional strategies in the curricula. This study indicated professional preparation and class structure impacted sexuality content taught. Class structure also impacted whether opportunities for students to practice skills were made available. Results support the need for continued advocacy for professionally prepared health educators and health only courses. © 2013, American School Health Association.
Abera, Hiwot; Mengistu, Daniel; Bedaso, Asres
2017-01-01
The prevalence of cancer is growing rapidly in all parts of the word and Ethiopia is no exception. Secondary prevention, as simple as monthly breast self-examination, is the best option to tackle the rising of this epidemic. Health awareness programs on screening and early detection are the corner stones to reduce the morbidity and mortality resulting from breast cancer. The aim of the study is to assess the effectiveness of planned teaching program on knowledge and practice of breast self-examination among first year female midwifery students in Hawassa health Sciences College. A pre-experimental one group pre-posttest design was used among 61 students who were selected by systematic random sampling technique. Data was collected using structured questionnaire and adapted and approved checklist. Data was entered using Epi-Info and analyzed using SPSS version 20. Pre-and post-intervention results were calculated using paired t-test. The mean age of the study participants was 20.13(±2.27) and 77% of the study participants were single. Before the intervention 14(23%) of respondents had information and practiced breast self-examination, only 8(13.1%) performed breast self -examination on a regular monthly basis. The number and percentage of the knowledgeable respondents pre-post intervention is 23(37.7%) and 35(57.4%), respectively. The mean knowledge difference for the pre-post intervention is 0.18±0.695 (P < 0.05). The respondents' pre- post interventions score of satisfactory practical competency were 10(16.4%) and 43(70.5%), respectively as well. The mean net gain for the pre-post breast self-examination intervention is 0.51± 0.62 (P < 0.001). Both the knowledge and practical competency scores showed highly significant increment after the intervention, showing that the research hypothesis was accepted. Planned teaching intervention on knowledge and Breast self-examination of students has resulted in an increment of both knowledge and the practice of breast self-examination. Teaching breast self-examination with demonstration to all at risk groups as a secondary prevention for breast cancer and large scale studies on heterogeneous groups is important.
Teaching and breast self-examination: an insufficiency of instruction.
Turnbull, Beverley J; Roberts, Kathryn
2004-01-01
Client teaching is recognised as an essential component of nursing and midwifery care, and all clinical areas provide opportunities for informal client teaching. This qualitative study aimed to explore registered nurses' professional practices with regard to teaching breast self-examination (BSE), and to identify factors that influenced their participation or non-participation in teaching about breast health. Participants' views were obtained using individual semi-structured interviews. The data were analysed inductively, that is, without imposing structure from the interview questions. Findings revealed that participants' perspectives of BSE and breast health, the dual symbolism of breasts, and the time constraints of clinical practice, were significant factors that impacted on participants' personal BSE practices and on their level of participation in teaching BSE. The results indicate that that nurses and midwives do not view teaching breast health as part of their role in client interaction, particularly in an acute care setting. Although nursing literature identifies midwives and nurses as ideally placed to promote health promotion activities, the image of BSE as linked to breast cancer, the dominant illness oriented model of care and a task orientated culture in health care facilities do not facilitate this.
NASA Astrophysics Data System (ADS)
Cullipher, Steven Gene
Green chemistry is a philosophy of chemistry that emphasizes a decreasing dependence on limited non-renewable resources and an increasing focus on preventing pollution byproducts of the chemical industry. In short, it is the discipline of chemistry practiced through the lens of environmental stewardship. In an effort to advance the practice of green chemistry, three studies will be described that have ramifications for the practice. The first study examines the atmospheric oxidation of a hydrofluorinated ether, a third-generation CFC replacement compound with primarily unknown atmospheric degradation products. Determination of these products has the potential to impact decisions on refrigerant usage in the future. The second study examines chemistry students' development of understanding benefits-costs-risks analysis when presented with two real-world scenarios: refrigerant choice and fuel choice. By studying how benefits-costs-risks thinking develops, curricular materials and instructional approaches can be designed to better foster the development of an ability that is both necessary for green chemists and important in daily decision-making for non-chemists. The final study uses eye tracking technology to examine students' abilities to interpret molecular properties from structural information in the context of global warming. Such abilities are fundamental if chemists are to appropriately assess risks and hazards of chemistry practice.
A Practical Engineering Approach to Predicting Fatigue Crack Growth in Riveted Lap Joints
NASA Technical Reports Server (NTRS)
Harris, Charles E.; Piascik, Robert S.; Newman, James C., Jr.
1999-01-01
An extensive experimental database has been assembled from very detailed teardown examinations of fatigue cracks found in rivet holes of fuselage structural components. Based on this experimental database, a comprehensive analysis methodology was developed to predict the onset of widespread fatigue damage in lap joints of fuselage structure. Several computer codes were developed with specialized capabilities to conduct the various analyses that make up the comprehensive methodology. Over the past several years, the authors have interrogated various aspects of the analysis methods to determine the degree of computational rigor required to produce numerical predictions with acceptable engineering accuracy. This study led to the formulation of a practical engineering approach to predicting fatigue crack growth in riveted lap joints. This paper describes the practical engineering approach and compares predictions with the results from several experimental studies.
A Practical Engineering Approach to Predicting Fatigue Crack Growth in Riveted Lap Joints
NASA Technical Reports Server (NTRS)
Harris, C. E.; Piascik, R. S.; Newman, J. C., Jr.
2000-01-01
An extensive experimental database has been assembled from very detailed teardown examinations of fatigue cracks found in rivet holes of fuselage structural components. Based on this experimental database, a comprehensive analysis methodology was developed to predict the onset of widespread fatigue damage in lap joints of fuselage structure. Several computer codes were developed with specialized capabilities to conduct the various analyses that make up the comprehensive methodology. Over the past several years, the authors have interrogated various aspects of the analysis methods to determine the degree of computational rigor required to produce numerical predictions with acceptable engineering accuracy. This study led to the formulation of a practical engineering approach to predicting fatigue crack growth in riveted lap joints. This paper describes the practical engineering approach and compares predictions with the results from several experimental studies.
2017-01-01
Objective Anticipation of opponent actions, through the use of advanced (i.e., pre-event) kinematic information, can be trained using video-based temporal occlusion. Typically, this involves isolated opponent skills/shots presented as trials in a random order. However, two different areas of research concerning representative task design and contextual (non-kinematic) information, suggest this structure of practice restricts expert performance. The aim of this study was to examine the effect of a sequential structure of practice during video-based training of anticipatory behavior in tennis, as well as the transfer of these skills to the performance environment. Methods In a pre-practice-retention-transfer design, participants viewed life-sized video of tennis rallies across practice in either a sequential order (sequential group), in which participants were exposed to opponent skills/shots in the order they occur in the sport, or a non-sequential (non-sequential group) random order. Results In the video-based retention test, the sequential group was significantly more accurate in their anticipatory judgments when the retention condition replicated the sequential structure compared to the non-sequential group. In the non-sequential retention condition, the non-sequential group was more accurate than the sequential group. In the field-based transfer test, overall decision time was significantly faster in the sequential group compared to the non-sequential group. Conclusion Findings highlight the benefits of a sequential structure of practice for the transfer of anticipatory behavior in tennis. We discuss the role of contextual information, and the importance of representative task design, for the testing and training of perceptual-cognitive skills in sport. PMID:28355263
Four Structures for Marketing in the American Public Community College.
ERIC Educational Resources Information Center
Bogart, Quentin J.
Prepared for college officials considering the development of marketing programs, this paper examines the distinctive marketing practices for four geographically separated, public community college districts: Coastline Community College (CCC), California; Metropolitan Community College District (MCCD), Missouri; Triton College (TC), Illinois; and…
Cropp, Carola; Salzer, Simone; Häusser, Leonard F; Streeck-Fischer, Annette
2013-01-01
The axis structure of the Operationalized Psychodynamic Diagnostics in childhood and adolescence (OPD-CA) has proven to be a reliable and valid diagnostic tool under research conditions. However, corresponding data regarding the integration of OPD-CA axis structure into clinical practice is still lacking. Hence, this aspect was examined as part of a randomized controlled clinical trial realized at Asklepios Fachklinikum Tiefenbrunn. Here, the OPD-CA axis structure has been applied to assess the structural level of 42 adolescent patients (15-19 years). In contrast to previous studies, the assessment was not carried out by independent raters using a videotaped OPD-CA interview, but the rating was part of clinical routine procedures. Also under these conditions, inter-rater reliability was high, in particular regarding the four subscales of the OPD-CA axis structure. With respect to construct validity, the results of our study supported a two-factor solution, which is in accordance with the findings of two previous works. One factor corresponded to the dimension "self-regulation" while the other factor included both the dimension "self-perception and object perception" as well as the dimension "communication skills". Implications of the findings for research and practice are discussed.
Bartlett, Maggie; Pritchard, Katie; Lewis, Leo; Hays, Richard B; Mckinley, Robert K
2016-01-01
One approach to facilitating student interactions with patient pathways at Keele University School of Medicine, England, is the placement of medical students for 25% of their clinical placement time in general practices. The largest component is a 15-week 'student attachment' in primary care during the final year, which required the development of a new network of teaching practices in a rural district of England about 90 km (60 mi) from the main campus in North Staffordshire. The new accommodation and education hub was established in 2011-2012 to enable students to become immersed in those communities and learn about medical practice within a rural and remote context. Objectives were to evaluate the rural teaching from the perspectives of four groups: patients, general practice tutors, community hospital staff and students. Learning outcomes (as measured by objective structured clinical examinations) of students learning in rural practices in the final year were compared with those in other practices. Data were gathered from a variety of sources. Students' scores in cohort-wide clinical assessment were compared with those in other locations. Semi-structured interviews were conducted with general practice tutors and community hospital staff. Serial focus groups explored the perceptions of the students, and questionnaires were used to gather the views of patients. Patients reported positive experiences of students in their consultations, with 97% expressing willingness to see students. The majority of patients considered that teaching in general practice was a good thing. They also expressed altruistic ideas about facilitating learning. The tutors were enthusiastic and perceived that teaching had positive impacts on their practices despite negative effects on their workload. The community hospital staff welcomed students and expressed altruistic ideas about helping them learn. There was no significant difference between the rurally placed students' objective structured clinical examination performance and that of their peers in other locations. Some students had difficulty with the isolation from peers and academic activities, and travel was a problem despite their accommodation close to the practices. Students valued the learning opportunities offered by the rural practice placements. The general practice tutors, patients and community hospital staff found teaching to be a positive experience overall and perceived a value to the health system and broader community in students learning locally for substantial periods of time. The evaluation has identified some student concerns about transport times and costs, social isolation, and access to resources and administrative tasks, and these are being addressed.
The FAMULATUR PLUS as an innovative approach for teaching physical examination skills.
Jerg, Achim; Öchsner, Wolfgang; Wander, Henriette; Traue, Harald C; Jerg-Bretzke, Lucia
2016-01-01
The FAMULATUR PLUS is an innovative approach to teaching physical examination skills. The concept is aimed at medical students during the clinical part of their studies and includes a clinical traineeship (English for "Famulatur") extended to include various courses ("PLUS"). The courses are divided into clinical examination courses and problembased-learning (PBL) seminars. The concept's special feature is the full integration of these courses into a 30-day hospital traineeship. The aim is to facilitate the transfer of knowledge from the courses into daily practice. Each week of the FAMULATUR PLUS is structured in line with the courses and focuses on a particular part of the body (e.g., abdomen). A physical examination course under the supervision of a physician is offered at the beginning of the week. Here, medical students learn the relevant examination techniques by practicing on each other (partner exercises). Subsequently, the techniques taught are applied independently during everyday work on the ward, corrected by the supervisor, if necessary, and thereby reinforced. The final POL seminar takes place towards the end of the week. Possible differential diagnoses are developed based on a clinical case study. The goal is to check these by taking a fictitious medical history and performing a physical examination, as well as to make a preliminary diagnosis. Finally, during the PBL seminar, medical students will be shown how physical examination techniques can be efficiently applied in the diagnosis of common cardinal symptoms (e.g., abdominal pain). The initial implementation of the FAMULATUR PLUS proved the practical feasibility of the concept. In addition, the accompanying evaluation showed that the participants of the pilot project improved with regard to their practical physical examination skills.
The FAMULATUR PLUS as an innovative approach for teaching physical examination skills
Jerg, Achim; Öchsner, Wolfgang; Wander, Henriette; Traue, Harald C.; Jerg-Bretzke, Lucia
2016-01-01
The FAMULATUR PLUS is an innovative approach to teaching physical examination skills. The concept is aimed at medical students during the clinical part of their studies and includes a clinical traineeship (English for “Famulatur”) extended to include various courses (“PLUS”). The courses are divided into clinical examination courses and problembased-learning (PBL) seminars. The concept’s special feature is the full integration of these courses into a 30-day hospital traineeship. The aim is to facilitate the transfer of knowledge from the courses into daily practice. Each week of the FAMULATUR PLUS is structured in line with the courses and focuses on a particular part of the body (e.g., abdomen). A physical examination course under the supervision of a physician is offered at the beginning of the week. Here, medical students learn the relevant examination techniques by practicing on each other (partner exercises). Subsequently, the techniques taught are applied independently during everyday work on the ward, corrected by the supervisor, if necessary, and thereby reinforced. The final POL seminar takes place towards the end of the week. Possible differential diagnoses are developed based on a clinical case study. The goal is to check these by taking a fictitious medical history and performing a physical examination, as well as to make a preliminary diagnosis. Finally, during the PBL seminar, medical students will be shown how physical examination techniques can be efficiently applied in the diagnosis of common cardinal symptoms (e.g., abdominal pain). The initial implementation of the FAMULATUR PLUS proved the practical feasibility of the concept. In addition, the accompanying evaluation showed that the participants of the pilot project improved with regard to their practical physical examination skills. PMID:26958652
Adaptive change in corporate control practices.
Alexander, J A
1991-03-01
Multidivisional organizations are not concerned with what structure to adopt but with how they should exercise control within the divisional form to achieve economic efficiencies. Using an information-processing framework, I examined control arrangements between the headquarters and operating divisions of such organizations and how managers adapted control practices to accommodate increasing environmental uncertainty. Also considered were the moderating effects of contextual attributes on such adaptive behavior. Analyses of panel data from 97 multihospital systems suggested that organizations generally practice selective decentralization under conditions of increasing uncertainty but that organizational age, dispersion, and initial control arrangements significantly moderate the direction and magnitude of such changes.
Patient satisfaction constructs.
Rahman, Muhammad Sabbir; Osmangani, Aahad M
2015-01-01
The purpose of this paper is to examine the five-factor structure of patients' satisfaction constructs toward private healthcare service providers. This research is a cross-sectional study. A questionnaire-based survey was conducted with previous and current Bangladeshi patients. Exploratory factor analysis was employed to extract the underlying constructs. Five underlying dimensions that play a significant role in structuring the satisfaction perceived by Bangladeshi private healthcare patients are identified in this study. Practical implications - The main contribution of this study is identifying the dimensions of satisfaction perceived by Bangladeshi patients regarding private healthcare service providers. Healthcare managers adopt the five identified underlying construct items in their business practices to improve their respective healthcare efficiency while ensuring overall customer satisfaction.
Sanghera, Balihar
2016-01-01
This article examines how individuals are reflexive beings who interpret the world in relation to things that matter to them, and how charitable acts are evaluated and embedded in their lives with different degrees of meaning and importance. Rather than framing the discussion of charitable practices in terms of an altruism/egoism binary or imputing motivations and values to social structures, the article explains how reflexivity is an important and neglected dimension of social practices, and how it interacts with sympathy, sentiments and discourses to shape giving. The study also shows that there are different modes of reflexivity, which have varied effects on charity and volunteering. PMID:28232772
Knight, R E; Shoveller, J A; Carson, A M; Contreras-Whitney, J G
2014-08-01
Although barriers related to lesbian, gay, bisexual, transgender and queer (LGBTQ) youth's experiences accessing sexual health services have been examined in detail, research into the experiences and perceptions of clinicians providing these services has been conspicuously absent. The aim of this article is to explore the perceptions and experiences of clinicians providing sexual health services for LGBTQ youth. Drawing on in-depth, semi-structured interviews, this study examines 24 clinicians' experiences providing sexual health services to LGBTQ youth in five communities in British Columbia, Canada. Our findings reveal how many clinicians provide services to LGBTQ youth with a lack of cultural competency-either implicitly (e.g., by describing heteronormative practices) or explicitly (e.g., by expressing frustration that they had not been sufficiently provided with appropriate training related to LGBTQ youth sexual health). Institutional norms and values were identified as the dominant barriers in the effective provision of LGBTQ-tailored services. Many clinicians find themselves unprepared to provide culturally competent sexual health services that have both the capacity to address individual-level issues (e.g. promoting condom use) while considering (and adapting services to) the broader socio-cultural and structural conditions that can render LGBTQ youth socially vulnerable. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
ERIC Educational Resources Information Center
Goldstein, Morris
This paper examines the co-existence of online and CD-ROM technologies in terms of their existing pricing structures, marketing strategies, functionality, and future roles. "Fixed Price Unlimited Usage" (FPUU) pricing and flat-rate pricing are discussed as viable alternatives to current pricing practices. In addition, it is argued that the…
Information Structure, Information Technology, and the Human Services Organizational Environment.
ERIC Educational Resources Information Center
Semke, Jeanette I.; Nurius, Paula S.
1991-01-01
Examines current trends in data collection and information use in human services organizations. Describes issues for managers who are planning information systems, including practitioner resistance to automation. Proposes that conceptual integration of agendas for human services automation, practice evaluation, and service effectiveness enables…
Closer to Learning: Social Networks, Trust, and Professional Communities
ERIC Educational Resources Information Center
Liou, Yi-Hwa; Daly, Alan J.
2014-01-01
Researchers, educators, and policymakers suggest the use of professional learning communities as one important approach to the improvement of teaching and learning. However, relatively little research examines the interplay of professional interactions (structural social capital) around instructional practices and key elements of professional…
ERIC Educational Resources Information Center
Kumar, Revathy; Lauermann, Fani
2018-01-01
This cross-sectional study examines associations between preservice teachers' experiences in teacher education (n = 2,129), their beliefs about culturally diverse students, and their endorsed instructional practices within social reconstructionist and achievement goal theory frameworks. Structural equation modeling confirmed significant…
Daniels, Lia M.; Radil, Amanda I.; Goegan, Lauren D.
2017-01-01
Pre-service and practicing teachers feel responsible for a range of educational activities. Four domains of personal responsibility emerging in the literature are: student achievement, student motivation, relationships with students, and responsibility for ones own teaching. To date, most research has used variable-centered approaches to examining responsibilities even though the domains appear related. In two separate samples we used cluster analysis to explore how pre-service (n = 130) and practicing (n = 105) teachers combined personal responsibilities and their impact on three professional cognitions and their wellbeing. Both groups had low and high responsibility clusters but the third cluster differed: Pre-service teachers combined responsibilities for relationships and their own teaching in a cluster we refer to as teacher-based responsibility; whereas, practicing teachers combined achievement and motivation in a cluster we refer to as student-outcome focused responsibility. These combinations affected outcomes for pre-service but not practicing teachers. Pre-service teachers in the low responsibility cluster reported less engagement, less mastery approaches to instruction, and more performance goal structures than the other two clusters. PMID:28620332
Daniels, Lia M; Radil, Amanda I; Goegan, Lauren D
2017-01-01
Pre-service and practicing teachers feel responsible for a range of educational activities. Four domains of personal responsibility emerging in the literature are: student achievement, student motivation, relationships with students, and responsibility for ones own teaching. To date, most research has used variable-centered approaches to examining responsibilities even though the domains appear related. In two separate samples we used cluster analysis to explore how pre-service ( n = 130) and practicing ( n = 105) teachers combined personal responsibilities and their impact on three professional cognitions and their wellbeing. Both groups had low and high responsibility clusters but the third cluster differed: Pre-service teachers combined responsibilities for relationships and their own teaching in a cluster we refer to as teacher-based responsibility; whereas, practicing teachers combined achievement and motivation in a cluster we refer to as student-outcome focused responsibility. These combinations affected outcomes for pre-service but not practicing teachers. Pre-service teachers in the low responsibility cluster reported less engagement, less mastery approaches to instruction, and more performance goal structures than the other two clusters.
Aston, Megan; Breau, Lynn; MacLeod, Emily
2014-12-01
Children with intellectual disabilities (IDs) and their parents continue to experience stigma within health-care systems. Whilst some research studies have examined the stigma associated with children who have IDs, there continues to be a gap in understanding how the experiences of these children, their parents and nurses have been constructed personally, socially and institutionally. Face-to-face semi-structured interviews were conducted with 17 mothers, 12 nurses and 8 children. Feminist post-structuralism and discourse analysis were used to examine the experiences of children, parents and nurses with the intent of understanding the dominant taken-for-granted everyday practices as well as hidden or marginalized practices. Four main themes emerged, which included the theme of Diagnoses, Labels and Stereotypes, which will be discussed in this article. Participants provided rich detail about their experiences in the hospital and how they addressed and often attempted to challenge the stigma associated with children with IDs. © The Author(s) 2014.
Challenges in Scale-Resolving Simulations of turbulent wake flows with coherent structures
NASA Astrophysics Data System (ADS)
Pereira, Filipe S.; Eça, Luís; Vaz, Guilherme; Girimaji, Sharath S.
2018-06-01
The objective of this work is to investigate the challenges encountered in Scale-Resolving Simulations (SRS) of turbulent wake flows driven by spatially-developing coherent structures. SRS of practical interest are expressly intended for efficiently computing such flows by resolving only the most important features of the coherent structures and modelling the remainder as stochastic field. The success of SRS methods depends upon three important factors: i) ability to identify key flow mechanisms responsible for the generation of coherent structures; ii) determine the optimum range of resolution required to adequately capture key elements of coherent structures; and iii) ensure that the modelled part is comprised nearly exclusively of fully-developed stochastic turbulence. This study considers the canonical case of the flow around a circular cylinder to address the aforementioned three key issues. It is first demonstrated using experimental evidence that the vortex-shedding instability and flow-structure development involves four important stages. A series of SRS computations of progressively increasing resolution (decreasing cut-off length) are performed. An a priori basis for locating the origin of the coherent structures development is proposed and examined. The criterion is based on the fact that the coherent structures are generated by the Kelvin-Helmholtz (KH) instability. The most important finding is that the key aspects of coherent structures can be resolved only if the effective computational Reynolds number (based on total viscosity) exceeds the critical value of the KH instability in laminar flows. Finally, a quantitative criterion assessing the nature of the unresolved field based on the strain-rate ratio of mean and unresolved fields is examined. The two proposed conditions and rationale offer a quantitative basis for developing "good practice" guidelines for SRS of complex turbulent wake flows with coherent structures.
Roche, Victoria F
2009-12-17
To describe a receptor-based approach to promote learning about nonsteroidal anti-inflammatory drug (NSAID) chemistry, structure-activity relationships, and therapeutic decision-making. Three lessons on cyclooxygenase (COX) and NSAID chemistry, and NSAID therapeutic utility, were developed using text-based resources and primary medicinal chemistry and pharmacy practice literature. Learning tools were developed to assist students in content mastery. Student learning was evaluated via performance on quizzes and examinations that measured understanding of COX and NSAID chemistry, and the application of that knowledge to therapeutic problem solving. Student performance on NSAID-focused quizzes and examinations documented the success of this approach.
Leung, Tiffany I; Dumontier, Michel
2015-01-01
Clinical practice guidelines (CPGs) and structured product labels (SPLs) are both intended to promote evidence-based medical practices and guide clinicians' prescribing decisions. However, it is unclear how well CPG recommendations about pharmacologic therapies for certain diseases match SPL indications for recommended drugs. In this study, we use publicly available data and text mining methods to examine drug-disease associations in CPG recommendations and SPL treatment indications for 15 common chronic conditions. Preliminary results suggest that there is a mismatch between guideline-recommended pharmacologic therapies and SPL indications. Conflicting or inconsistent recommendations and indications may complicate clinical decision making and implementation or measurement of best practices.
Patterns in PARTNERing across Public Health Collaboratives.
Bevc, Christine A; Retrum, Jessica H; Varda, Danielle M
2015-10-05
Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162), to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG) models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships.
Boamah, Sheila
2018-03-01
Background While improving patient safety requires strong nursing leadership, there has been little empirical research that has examined the mechanisms by which leadership influences patient safety outcomes. Aim To test a model examining relationships among transformational leadership, structural empowerment, staff nurse clinical leadership, and nurse-assessed adverse patient outcomes. Methods A cross-sectional survey was conducted with a randomly selected sample of 378 registered nurses working in direct patient care in acute care hospitals across Ontario, Canada. Structural equation modeling was used to test the hypothesized model. Results The model had an acceptable fit, and all paths were significant. Transformational leadership was significantly associated with decreased adverse patient outcomes through structural empowerment and staff nurse clinical leadership. Discussion This study highlights the importance of transformational leadership in creating empowering practice environments that foster high-quality care. The findings indicate that a more complete understanding of what drives desired patient outcomes warrants the need to focus on how to empower nurses and foster clinical leadership practices at the point of care. Conclusion In planning safety strategies, managers must demonstrate transformational leadership behaviors in order to modify the work environment to create better defenses for averting adverse events.
Trajectories of Family Management Practices and Early Adolescent Behavioral Outcomes
Wang, Ming-Te; Dishion, Thomas J.; Stormshak, Elizabeth A.; Willett, John B.
2013-01-01
Stage– environment fit theory was used to examine the reciprocal lagged relations between family management practices and early adolescent problem behavior during the middle school years. In addition, the potential moderating roles of family structure and of gender were explored. Hierarchical linear modeling was used to describe patterns of growth in family management practices and adolescents’ behavioral outcomes and to detect predictors of interindividual differences in initial status and rate of change. The sample comprised approximately 1,000 adolescents between ages 11 years and 15 years. The results indicated that adolescents’ antisocial behaviors and substance use increased and their positive behavioral engagement decreased over time. As adolescent age increased, parental knowledge of their adolescent’s activities decreased, as did parental rule making and support. The level and rate of change in family management and adolescent behavioral outcomes varied by family structure and by gender. Reciprocal longitudinal associations between parenting practices and adolescent problem behavior were found. Specifically, parenting practices predicted subsequent adolescent behavior, and adolescent behavior predicted subsequent parenting practices. In addition, parental warmth moderated the effects of parental knowledge and rule making on adolescent antisocial behavior and substance use over time. PMID:21688899
2013-01-01
Background Translating knowledge from research into clinical practice has emerged as a practice of increasing importance. This has led to the creation of new organizational entities designed to bridge knowledge between research and practice. Within the UK, the Collaborations for Leadership in Applied Health Research and Care (CLAHRC) have been introduced to ensure that emphasis is placed in ensuring research is more effectively translated and implemented in clinical practice. Knowledge translation (KT) can be accomplished in various ways and is affected by the structures, activities, and coordination practices of organizations. We draw on concepts in the innovation literature—namely exploration, exploitation, and ambidexterity—to examine these structures and activities as well as the ensuing tensions between research and implementation. Methods Using a qualitative research approach, the study was based on 106 semi-structured, in-depth interviews with the directors, theme leads and managers, key professionals involved in research and implementation in nine CLAHRCs. Data was also collected from intensive focus group workshops. Results In this article we develop five archetypes for organizing KT. The results show how the various CLAHRC entities work through partnerships to create explorative research and deliver exploitative implementation. The different archetypes highlight a range of structures that can achieve ambidextrous balance as they organize activity and coordinate practice on a continuum of exploration and exploitation. Conclusion This work suggests that KT entities aim to reach their goals through a balance between exploration and exploitation in the support of generating new research and ensuring knowledge implementation. We highlight different organizational archetypes that support various ways to maintain ambidexterity, where both exploration and exploitation are supported in an attempt to narrow the knowledge gaps. The KT entity archetypes offer insights on strategies in structuring collaboration to facilitate an effective balance of exploration and exploitation learning in the KT process. PMID:24007259
Oborn, Eivor; Barrett, Michael; Prince, Karl; Racko, Girts
2013-09-05
Translating knowledge from research into clinical practice has emerged as a practice of increasing importance. This has led to the creation of new organizational entities designed to bridge knowledge between research and practice. Within the UK, the Collaborations for Leadership in Applied Health Research and Care (CLAHRC) have been introduced to ensure that emphasis is placed in ensuring research is more effectively translated and implemented in clinical practice. Knowledge translation (KT) can be accomplished in various ways and is affected by the structures, activities, and coordination practices of organizations. We draw on concepts in the innovation literature--namely exploration, exploitation, and ambidexterity--to examine these structures and activities as well as the ensuing tensions between research and implementation. Using a qualitative research approach, the study was based on 106 semi-structured, in-depth interviews with the directors, theme leads and managers, key professionals involved in research and implementation in nine CLAHRCs. Data was also collected from intensive focus group workshops. In this article we develop five archetypes for organizing KT. The results show how the various CLAHRC entities work through partnerships to create explorative research and deliver exploitative implementation. The different archetypes highlight a range of structures that can achieve ambidextrous balance as they organize activity and coordinate practice on a continuum of exploration and exploitation. This work suggests that KT entities aim to reach their goals through a balance between exploration and exploitation in the support of generating new research and ensuring knowledge implementation. We highlight different organizational archetypes that support various ways to maintain ambidexterity, where both exploration and exploitation are supported in an attempt to narrow the knowledge gaps. The KT entity archetypes offer insights on strategies in structuring collaboration to facilitate an effective balance of exploration and exploitation learning in the KT process.
NASA Astrophysics Data System (ADS)
Kurland, Shelley Chih-Hsian
Community college faculty members educate almost half of all U.S. undergraduates, who are often more diverse and more academically underprepared when compared to undergraduate students who attend four-year institutions. In addition, faculty members in community colleges are facing increased accountability for meeting student learning outcomes, expectations to adjust their teaching practices to include active learning practices, and expectations to incorporate more technologies into the classroom. Faculty developers are one of the support structures that faculty members can look to in order to meet those challenges. A survey of literature in faculty development suggests that instructional consultation can play an important role in shaping and transforming teaching practices. Hence, this action research study examined my work using instructional consulting with four full-time STEM faculty colleagues in order to examine and shape their teaching practices with and without the use of digital technologies. The two foci of the research, examining shifts in faculty participants' teaching practices, and my instructional consulting practices, were informed by Thomas and Brown's (2011) social view of learning and the concept of teaching and learning in a "co-learning" environment. Two dominant factors emerged regarding faculty participants' shift in teaching practices. These factors concerned: 1) the perception of control and 2) individual faculty participant's comfort level, expectations, and readiness. In addition to these two dominant factors, the instructional consultation process also supported a range of shifts in either mindset and/or teaching practices. My analysis showed that the use of digital technologies was not an essential factor in shifting faculty participant mindset and/or teaching practices, instead digital technologies were used to enhance the teaching process and students' learning experiences.
Tomer, Mark D; James, David E; Sandoval-Green, Claudette M J
2017-05-01
Conservation planning information is important for identifying options for watershed water quality improvement and can be developed for use at field, farm, and watershed scales. Translation across scales is a key issue impeding progress at watershed scales because watershed improvement goals must be connected with implementation of farm- and field-level conservation practices to demonstrate success. This is particularly true when examining alternatives for "trap and treat" practices implemented at agricultural-field edges to control (or influence) water flows through fields, landscapes, and riparian corridors within agricultural watersheds. We propose that database structures used in developing conservation planning information can achieve translation across conservation-planning scales, and we developed the Agricultural Conservation Planning Framework (ACPF) to enable practical planning applications. The ACPF comprises a planning concept, a database to facilitate field-level and watershed-scale analyses, and an ArcGIS toolbox with Python scripts to identify specific options for placement of conservation practices. This paper appends two prior publications and describes the structure of the ACPF database, which contains land use, crop history, and soils information and is available for download for 6091 HUC12 watersheds located across Iowa, Illinois, Minnesota, and parts of Kansas, Missouri, Nebraska, and Wisconsin and comprises information on 2.74 × 10 agricultural fields (available through /). Sample results examining land use trends across Iowa and Illinois are presented here to demonstrate potential uses of the database. While designed for use with the ACPF toolbox, users are welcome to use the ACPF watershed data in a variety of planning and modeling approaches. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.
Poduska, Jeanne; Kellam, Sheppard; Brown, C Hendricks; Ford, Carla; Windham, Amy; Keegan, Natalie; Wang, Wei
2009-09-02
While a number of preventive interventions delivered within schools have shown both short-term and long-term impact in epidemiologically based randomized field trials, programs are not often sustained with high-quality implementation over time. This study was designed to support two purposes. The first purpose was to test the effectiveness of a universal classroom-based intervention, the Whole Day First Grade Program (WD), aimed at two early antecedents to drug abuse and other problem behaviors, namely, aggressive, disruptive behavior and poor academic achievement. The second purpose--the focus of this paper--was to examine the utility of a multilevel structure to support high levels of implementation during the effectiveness trial, to sustain WD practices across additional years, and to train additional teachers in WD practices. The WD intervention integrated three components, each previously tested separately: classroom behavior management; instruction, specifically reading; and family-classroom partnerships around behavior and learning. Teachers and students in 12 schools were randomly assigned to receive either the WD intervention or the standard first-grade program of the school system (SC). Three consecutive cohorts of first graders were randomized within schools to WD or SC classrooms and followed through the end of third grade to test the effectiveness of the WD intervention. Teacher practices were assessed over three years to examine the utility of the multilevel structure to support sustainability and scaling-up. The design employed in this trial appears to have considerable utility to provide data on WD effectiveness and to inform the field with regard to structures required to move evidence-based programs into practice. NCT00257088.
A Close Look in to Role of ICT in Education
ERIC Educational Resources Information Center
Kaffash, Hamid Reza; Kargiban, Zohreh Abedi; Kargiban, Sodabeh Abedi; Ramezani, Mehrdad Talesh
2010-01-01
Theoretical approaches and frameworks which are helpful to understand the use of information and communication technology (ICT) in the formal education sector are reviewed and examined. The structured literature review and documentary research techniques are applied. Relationships between ICT, curriculum development, pedagogy, and practice in…
Aspiring Educational Leaders and the Internship: Voices from the Field
ERIC Educational Resources Information Center
Clayton, Jennifer Karyn
2012-01-01
This study examined the experiences of administrative interns at the completion of their experience, using a phenomenological framework, document analysis, semi-structured interviews and a survey. Findings indicate a disparity between theory espoused in programmes and actual practice of sitting administrators, ideological dissonance between…
Evidence-Based Teaching in Higher Education: Application to Counselor Education
ERIC Educational Resources Information Center
Malott, Krista M.; Hall, K. Hridaya; Sheely-Moore, Angela; Krell, Megan M.; Cardaciotto, LeeAnn
2014-01-01
The authors examined best practices in university-level teaching, as premised on the evidence-based teaching (EBT) literature found in fields external to counselor education. Findings were reported in relation to 3 areas: developing an effective learning environment, structuring intentional learning experiences, and assessing teaching…
Understanding Latino Families: Scholarship, Policy, and Practice.
ERIC Educational Resources Information Center
Zambrana, Ruth E., Ed.
This anthology examines the contemporary status of Latino families, especially their great racial and ethnic diversity. The book focuses on the strengths of Latino/Hispanic groups, structural processes that impede their progress, and cultural and familial processes that enhance their intergenerational adaptation and resiliency. Chapter 1,…
Practical Exercises for the Study of Community Ecology at Advanced Level.
ERIC Educational Resources Information Center
Putman, R. J.
1984-01-01
Describes a series of short-term modular experiments which focus on community structure (standing crop biomass) and function (system energy flow). One exercise examines decomposers while another shows energy use by individuals. Equipment needed, procedures used, and results obtained are included. (Author/DH)
Sizing of complex structure by the integration of several different optimal design algorithms
NASA Technical Reports Server (NTRS)
Sobieszczanski, J.
1974-01-01
Practical design of large-scale structures can be accomplished with the aid of the digital computer by bringing together in one computer program algorithms of nonlinear mathematical programing and optimality criteria with weight-strength and other so-called engineering methods. Applications of this approach to aviation structures are discussed with a detailed description of how the total problem of structural sizing can be broken down into subproblems for best utilization of each algorithm and for efficient organization of the program into iterative loops. Typical results are examined for a number of examples.
Allen, Brian; Hoskowitz, Natalie Armstrong
2017-05-01
Structured, trauma-focused cognitive-behavioral therapy (CBT) techniques are widely considered an effective intervention for children who experienced sexual abuse. However, unstructured (i.e., nondirective) play/experiential techniques have a longer history of widespread promotion and are preferred by many practicing clinicians. No evidence is available, however, to determine how the integration of these techniques impacts treatment outcome. In this study, community-based clinicians who received training in a structured, trauma-focused cognitive-behavioral intervention administered pretreatment and posttreatment evaluations to 260 sexually abused children presenting with elevated posttraumatic stress. In addition, they completed a questionnaire describing the treatment techniques implemented with each child. Overall, significant improvement was observed for each of the six clinical outcomes. Regression analyses indicated that technique selection was a significant factor in posttreatment outcome for posttraumatic stress, dissociation, anxiety, and anger/aggression. In general, a greater utilization of the structured CBT techniques was related to lower posttreatment scores, whereas a higher frequency of play/experiential techniques was associated with higher posttreatment scores. However, no interaction effects were observed. The implication of these findings for clinical practice and future research are examined.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Onoufriou, T.; Simpson, R.J.; Protopapas, M.
This paper presents the development and application of reliability based inspection planning techniques for floaters. Based on previous experience from jacket structure applications optimized inspection planning (OIP) techniques for floaters are developed. The differences between floaters and jacket structures in relation to fatigue damage, redundancy levels and inspection practice are examined and reflected in the proposed methodology. The application and benefits of these techniques is demonstrated through representative analyses and important trends are highlighted through the results of a parametric sensitivity study.
Hybrid rendering of the chest and virtual bronchoscopy [corrected].
Seemann, M D; Seemann, O; Luboldt, W; Gebicke, K; Prime, G; Claussen, C D
2000-10-30
Thin-section spiral computed tomography was used to acquire the volume data sets of the thorax. The tracheobronchial system and pathological changes of the chest were visualized using a color-coded surface rendering method. The structures of interest were then superimposed on a volume rendering of the other thoracic structures, thus producing a hybrid rendering. The hybrid rendering technique exploit the advantages of both rendering methods and enable virtual bronchoscopic examinations using different representation models. Virtual bronchoscopic examinations with a transparent color-coded shaded-surface model enables the simultaneous visualization of both the airways and the adjacent structures behind of the tracheobronchial wall and therefore, offers a practical alternative to fiberoptic bronchoscopy. Hybrid rendering and virtual endoscopy obviate the need for time consuming detailed analysis and presentation of axial source images.
Lessons from the Tao for birthing practice.
Overman, B
1994-06-01
The metaphysics of the Tao Te Ching, as the basic structure of the universe, is used to examine birthing as creation. Lessons from the Tao regarding cultivating naturalness are drawn upon to provide suggestions for women in preparation for birthing, as well as for the nurses and midwives who attend them. Compatibility of this metaphysical view of birthing with Rogers's and Newman's nursing theories is identified, and the importance of honoring the metaphysical and spiritual aspects of birthing in nursing practice is stressed.
Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szecsenyi, Joachim
2015-01-01
Objectives To examine the effectiveness of the quality management programme—European Practice Assessment—in primary care in Switzerland. Design Longitudinal study with three points of measurement. Setting Primary care practices in Switzerland. Participants In total, 45 of 91 primary care practices completed European Practice Assessment three times. Outcomes The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: ‘infrastructure’, ‘information’, ‘finance’, and ‘quality and safety’ to examine changes over time. Results Significant improvements were found in three of four domains: ‘quality and safety’ (F=22.81, p<0.01), ‘information’ (F=27.901, p<0.01) and ‘finance’ (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01). Conclusions The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care. PMID:25900466
Marx, Marcia
2014-11-01
This study examined the structural barriers to communication for first-line nurse managers with their staff nurses. The delivery of quality care depends on effective communication in hospital units. First-line nurse managers are central figures in networks whose responsibility is to communicate information from the senior management to staff nurses. The data were collected using face-to-face interviews with first-line managers at two US hospitals The interviews were transcribed and coded with limited use of the qualitative software atlas Interview questions focused on work experiences of managers with special emphases on communication. Structural barriers that influenced managers' communication included the amount of face-to-face interaction with nurses, the amount of information to communicate, levels of formalization, outreach to all nurses, time constraints and nurses' subcultural networks These factors compromised managers' ability to communicate effectively with nurses. Managers should carefully examine how structure affects communication recognizing that some dynamics of structure cannot be changed but that they can influence others, such as formalization and communication networks. Managers should examine their own positioning within nurses' networks and demonstrate to nurses that their expertise contributes to the collaborative capital upon which nursing practice depends. © 2013 John Wiley & Sons Ltd.
Health Beliefs and Practices of African Immigrants in Canada.
Cooper Brathwaite, Angela; Lemonde, Manon
2016-12-01
A purposive sample of 14 immigrants living in Ontario, Canada, participated in two focus groups. The researchers used semi-structured interviews to collect data and five themes emerged from the data: beliefs about diabetes were centered on diverse factors, preserving culture through food preferences and preparation, cultural practices to stay healthy, cultural practices determined number of servings of fruit and vegetables per day, and engaging in physical activity to stay healthy. Findings indicated how health beliefs and cultural practices influenced behavior in preventing type 2 diabetes (T2D). Future research should focus on other high-risk minority groups (South Asian, Caribbean, and Latin American) to examine their health beliefs and cultural practices and use these finding to develop best practice guidelines, which should be incorporated into culturally tailored interventions. © The Author(s) 2015.
Dickinson, L Miriam; Dickinson, W Perry; Nutting, Paul A; Fisher, Lawrence; Harbrecht, Marjie; Crabtree, Benjamin F; Glasgow, Russell E; West, David R
2015-04-01
Efforts to improve primary care diabetes management have assessed strategies across heterogeneous groups of patients and practices. However, there is substantial variability in how well practices implement interventions and achieve desired outcomes. To examine practice contextual features that moderate intervention effectiveness. Secondary analysis of data from a cluster randomized trial of three approaches for implementing the Chronic Care Model to improve diabetes care. Forty small to mid-sized primary care practices participated, with 522 clinician and staff member surveys. Outcomes were assessed for 822 established patients with a diagnosis of type 2 diabetes who had at least one visit to the practice in the 18 months following enrollment. The primary outcome was a composite measure of diabetes process of care, ascertained by chart audit, regarding nine quality measures from the American Diabetes Association Physician Recognition Program: HgA1c, foot exam, blood pressure, dilated eye exam, cholesterol, nephropathy screen, flu shot, nutrition counseling, and self-management support. Data from practices included structural and demographic characteristics and Practice Culture Assessment survey subscales (Change Culture, Work Culture, Chaos). Across the three implementation approaches, demographic/structural characteristics (rural vs. urban + .70(p = .006), +2.44(p < .001), -.75(p = .004)); Medicaid: < 20 % vs. ≥ 20 % (-.20(p = .48), +.75 (p = .08), +.60(p = .02)); practice size: < 4 clinicians vs. ≥ 4 clinicians (+.56(p = .02), +1.96(p < .001), +.02(p = .91)); practice Change Culture (high vs. low: -.86(p = .048), +1.71(p = .005), +.34(p = .22)), Work Culture (high vs. low: -.67(p = .18), +2.41(p < .001), +.67(p = .005)) and variability in practice Change Culture (high vs. low: -.24(p = .006), -.20(p = .0771), -.44(p = .0019) and Work Culture (high vs. low: +.56(p = .3160), -1.0(p = .008), -.25 (p = .0216) were associated with trajectories of change in diabetes process of care, either directly or differentially by study arm. This study supports the need for broader use of methodological approaches to better examine contextual effects on implementation and effectiveness of quality improvement interventions in primary care settings.
Structural properties and magic structures in hydrogenated finite and infinite silicon nanowires
NASA Astrophysics Data System (ADS)
Zdetsis, A. D.; Koukaras, E. N.; Garoufalis, C. S.
2007-11-01
Unusual effects such as bending and "canting," related with the stability, have been identified by ab initio real-space calculations for hydrogenated silicon nanowires. We have examined in detail the electronic and structural properties of finite and infinite nanowires as a function of length (and width) and have developed stability and bending rules, demonstrating that "magic" wires do not bend. Reconstructed 2×1 nanowires are practically as stable as the magic ones. Our calculations are in good agreement with the experimental data of Ma et al. [Science 299, 1874 (2003).].
Roley, Susanne Smith; Mailloux, Zoe; Parham, L. Diane; Koomar, Jane; Schaaf, Roseann C.; Van Jaarsveld, Annamarie; Cohn, Ellen
2014-01-01
This study examined the reliability and validity of the structural section of the Ayres Sensory Integration® Fidelity Measure© (ASIFM), which provides a method for monitoring the extent to which an intervention was implemented as conceptualized in studies of occupational therapy using sensory integration intervention methods (OT–SI). We examined the structural elements of the measure, including content of assessment reports, availability of specific equipment and adequate space, safety monitoring, and integration of communication with parents and other team members, such as collaborative goal setting with parents or family and teacher education, into the intervention program. Analysis of self-report ratings by 259 occupational therapists from 185 different facilities indicated that the structural section of the ASIFM has acceptable interrater reliability (r ≥ .82) and significantly differentiates between settings in which therapists reportedly do and do not practice OT–SI (p < .001). PMID:25184462
Spence Laschinger, Heather K; Nosko, Amanda; Wilk, Piotr; Finegan, Joan
2014-12-01
Recruitment and retention strategies have emphasized the importance of positive work environments that support professional nursing practice for sustaining the nursing workforce. Unit leadership that creates empowering workplace conditions plays a key role in establishing supportive practice environments that increase work effectiveness, and, ultimately, improves job satisfaction. To test a multi-level model examining the effect of both contextual and individual factors on individual nurse job satisfaction. At the unit level, structural empowerment and support for professional nursing practice (organizational resources) were hypothesized to be predictors of unit level effectiveness. At the individual level, core self-evaluation, and psychological empowerment (intrapersonal resources) were modeled as predictors of nurse job satisfaction one year later. Cross-level unit effects on individual nurses' job satisfaction were also examined. This study employed a longitudinal survey design with 545 staff nurses from 49 hospital units in Ontario, Canada. Participants completed a survey at two points in time (response rate of 40%) with standardized measures of the major study variables in the hypothesized model. Multilevel structural equation modeling was used to test the model. Nurses shared perceptions of structural empowerment on their units indirectly influenced their shared perceptions of unit effectiveness (Level 2) through perceived unit support for professional nursing practice, which in turn, had a significant positive direct effect on unit effectiveness (Level 2). Unit effectiveness was also strongly related to individual nurse job satisfaction one year later. At Level 1, higher core self-evaluation had a direct and indirect effect on job satisfaction through increased psychological empowerment. The results suggest that nurses' job satisfaction is influenced by a combination of individual and contextual factors demonstrating utility in considering both sources of nurses' satisfaction with their work in creating effective nursing work environments. Copyright © 2014 Elsevier Ltd. All rights reserved.
Medical and pharmacy students' perceptions of the grading and assessment practices.
Kasanda, C D; Mitonga, K H; Veii, K; Zimba, R F
2013-01-01
Many students at the University of Namibia have frequently complained about ineffective assessment practices used at the institution. On many occasions, these complaints have not been substantiated with evidence of any kind. The purpose of this study was to obtain some empirical evidence that would ascertain undergraduate students' perceptions of the University of Namibia's grading and assessment practices. Using a structured scaled questionnaire, data were obtained from a representative sample of the University's undergraduate students studying for Medical and Pharmacy degrees. The questionnaire items covered matters related to students' experiences of assessment practices, feedback on assessment tasks, reliability and validity of assessment tools used by lecturers, efficacy of processes of administering examinations, perceptions of irregular and unfair assessment practices, impact of assessment regimes on students' cost of studies, motivation, morale, rate of progression in studies and graduation, the degree of compliance with assessment ethics and on academic quality assurance. According to the data reported in this article, the majority of the respondents perceived that the Schools of Medicine and Pharmacy at the University of Namibia applied assessment practices that yielded reliable and valid results. This was the case because most lecturers in the two schools used appropriate assessment tools and provided their students with prompt and informative feedback on the results of assignments, tests and examinations. In addition, most respondents reported that whereas examination procedures used in the two schools were efficient and effective, lecturers graded examination scripts fairly. These and other results are discussed in the article to communicate the message that the assessment procedures used in the Schools of Medicine and Pharmacy at the University of Namibia would promote effective learning and understanding amongst students as they were of high quality.
Chutuape, Kate S.; Muyeed, Adaline Z.; Willard, Nancy; Greenberg, Lauren; Ellen, Jonathan M.
2015-01-01
Opportunities to control risk factors that contribute to HIV transmission and acquisition extend far beyond individuals and include addressing social and structural determinants of HIV risk, such as inadequate housing, poor access to healthcare and economic insecurity. The infrastructure within communities, including the policies and practices that guide institutions and organizations, should be considered crucial targets for change. This paper examines the extent to which 13 community coalitions across the U.S. and Puerto Rico were able to achieve “structural change” objectives (i.e., new or modified practices or policies) as an intermediate step toward the long-term goal of reducing HIV risk among adolescents and young adults (12-24 years old). The study resulted in the completion of 245 objectives with 70% categorized as structural in nature. Coalitions targeted social services, education and government as primary community sectors to adopt structural changes. A median of 12 key actors and six new key actors contributed to accomplishing structural changes. Structural change objectives required a median of seven months to complete. The structural changes achieved offer new ideas for community health educators and practitioners seeking to bolster their HIV prevention agenda. PMID:25632407
The Burden of Leadership: Exploring the Principal's Role in Teacher Collaboration
ERIC Educational Resources Information Center
Szczesiul, Stacy; Huizenga, Jessica
2014-01-01
Based on qualitative data collected over a 6-month period, this article examines how teachers' experiences of principal leadership practice influence their capacity to engage in meaningful collegial interactions during structured collaboration. Similar to previous studies, our findings confirm the limitations of leadership that relies primarily on…
How Principals and Peers Influence Teaching and Learning
ERIC Educational Resources Information Center
Supovitz, Jonathan; Sirinides, Philip; May, Henry
2010-01-01
This paper examines the effects of principal leadership and peer teacher influence on teachers' instructional practice and student learning. Using teacher survey and student achievement data from a mid-sized urban southeastern school district in the United States in 2006-2007, the study employs multilevel structural equation modeling to examine…
Effects of Organizational Role and Culture on Participation in Continuing Professional Education.
ERIC Educational Resources Information Center
Grzyb, Stanley W.; And Others
This study extends the investigation of professionals' reasons for participation in continuing education beyond personal and practice-based factors into the arena of organizational structure and culture. The Participation Reasons Scale (PRS) and the Respondent Information Form (RIF) were used to examine the motives influencing Army Engineers…
ERIC Educational Resources Information Center
Osborn, Debra S.; Peterson, Gary W.; Hale, Rebecca R.
2015-01-01
The advent of virtual schools opens doors to opportunity for delivery of student services via the Internet. Through the use of structured interviews with four practicing Florida virtual school counselors, and a follow-up survey, the authors examined the experiences and reflections of school counselors who are employed full time in a statewide…
A "Top-Down" Analysis of High School Teacher Motivation
ERIC Educational Resources Information Center
Ciani, Keith D.; Summers, Jessica J.; Easter, Matthew A.
2008-01-01
Classroom instruction may be affected by school contexts that are increasingly performance-driven because of legislative demands. Interpreting this as a need to investigate the relationships between school context and classroom practice, this study took a "top-down" approach by examining contextual elements of school goal structure and teacher…
Structure, Features, and Faculty Content in ARL Member Repositories
ERIC Educational Resources Information Center
Mercer, Holly; Koenig, Jay; McGeachin, Robert B.; Tucker, Sandra L.
2011-01-01
Questions about the optimal way to present repository content to authors, submitters, and end-users, prompted this study. The authors examined, through an observation and a survey, the institutional repositories of peer institutions in the ARL for good practices related to the presentation and organization of faculty-authored institutional…
Clinical Assessment Using the Clinical Rating Scale: Thomas and Olson Revisited.
ERIC Educational Resources Information Center
Lee, Robert E.; Jager, Kathleen Burns; Whiting, Jason B.; Kwantes, Catherine T.
2000-01-01
Examines whether the Clinical Rating Scale retains its validity when used by psychotherapists in their clinical practice. Confirmatory factor analysis reveals that data provides a reasonable approximation of the underlying factor structure. Concludes that although primarily considered a research instrument, the scale may have a role in clinical…
Dominant Discourses of Teachers in Early Childhood Education
ERIC Educational Resources Information Center
Ebrahim, H. B.
2010-01-01
This article examines the dominant discourses teachers in early childhood education (ECE) used to produce understandings of children and educational practice for them. Seven teachers from two early childhood centres in urban KwaZulu-Natal participated in this qualitative study. Data were produced through semi-structured interviews and…
J.J. Rykken; A.R. Moldenke; D.H. Olson
2007-01-01
Invertebrate communities were characterized in unmanaged headwaters, and the effects of clearcutting without buffers and with buffers of approximately 30 m was examined. A near-stream community was distinct and largely retained by the buffers. Elevation, location, and microclimate were predictors of community structure.
Teacher Well-Being: Exploring Its Components and a Practice-Oriented Scale
ERIC Educational Resources Information Center
Collie, Rebecca J.; Shapka, Jennifer D.; Perry, Nancy E.; Martin, Andrew J.
2015-01-01
This study examined the psychometric properties of the Teacher Well-Being Scale, which assesses three factors of teachers' work-related well-being: workload, organizational, and student interaction well-being. With a sample of Canadian teachers, results confirmed the reliability, approximate normality, and factor structure of the scale; provided…
Investing in American Higher Education: An Argument for Restructuring.
ERIC Educational Resources Information Center
Eaton, Judith S.
This background paper examines the current state of higher education finance--the scope of the higher education enterprise, challenges to its funding base, and undesirable consequences of current financing practices--and describes what is meant by a "restructuring" of higher education finance. It demonstrates that the structures and practices…
ERIC Educational Resources Information Center
Aspin, David, Ed.; Chapman, Judith, Ed.; Hatton, Michael, Ed.; Sawano, Yukiko, Ed.
These volumes contain 40 papers examining the principles, policies, structure, and practice of lifelong learning worldwide. The following are among the papers included: "Towards a Philosophy of Lifelong Learning" (David Aspin, Judith Chapman); "Locating Lifelong Learning and Education in Contemporary Currents of Thought and…
ERIC Educational Resources Information Center
Lake, Robin; Dusseault, Brianna; Bowen, Melissa; Demeritt, Allison; Hill, Paul
2010-01-01
The National Study of CMO (charter management organizations) Effectiveness is a national, longitudinal research effort designed to measure how nonprofit charter school management organizations (CMOs) affect student achievement, and to examine the internal structures, practices, and policy contexts that may influence these outcomes. The study began…
In Search of Rationality: The Purposes behind the Use of Formal Analysis in Organizations.
ERIC Educational Resources Information Center
Langley, Ann
1989-01-01
Examines how formal analysis is actually practiced in 3 different organizations. Identifies 4 main groups of purposes for formal analysis and relates them to various hierarchical relationships. Formal analysis and social interaction seem inextricably linked in organizational decision-making. Different structural configurations may generate…
The Incorporation of Animal-Assisted Interventions in Social Work Education
ERIC Educational Resources Information Center
Tedeschi, Philip; Fitchett, Jennifer; Molidor, Christian E.
2005-01-01
Successful social work practice requires orientation to diverse social and cultural characteristics which structure the framework for our communities and families. This paper explores the necessity of incorporating the connection between people and non-human relationships in our understanding of social support systems. Specifically, we examine our…
Redefining the WISC-R: Implications for Professional Practice and Public Policy.
ERIC Educational Resources Information Center
Macmann, Gregg M.; Barnett, David W.
1992-01-01
The factor structure of the Wechsler Intelligence Scale for Children (Revised) was examined in the standardization sample using new methods of factor analysis. The substantial overlap across factors was most parsimoniously represented by a single general factor. Implications for public policy regarding the purposes and outcomes of special…
Teachers' Engagement at Work: An International Validation Study
ERIC Educational Resources Information Center
Klassen, Robert M.; Aldhafri, Said; Mansfield, Caroline F.; Purwanto, Edy; Siu, Angela F. Y.; Wong, Marina W.; Woods-McConney, Amanda
2012-01-01
This study explored the validity of the Utrecht Work Engagement Scale in a sample of 853 practicing teachers from Australia, Canada, China (Hong Kong), Indonesia, and Oman. The authors used multigroup confirmatory factor analysis to test the factor structure and measurement invariance across settings, after which they examined the relationships…
Teacher Selection: Legal, Practical, and Theoretical Aspects. UCEA Monograph Series.
ERIC Educational Resources Information Center
Young, I. Philip; Ryerson, Dean
This monograph, structured for administrative use in analyzing and building systems for selecting teachers, outlines the legal, applied, and theoretical issues of teacher selection. This overview is presented in five sections. "Legal Aspects of Teacher Selection" examines individual rights and employer reactions in relation to federal and state…
Special Education Policies and Practices in the Pacific Rim Region.
ERIC Educational Resources Information Center
Mitchell, David R.
This paper examines both the emerging consensus among Pacific Rim countries, especially East and Southeast Asian countries, as to current and future directions of special education and the many differences among these countries in economics, cultural perspectives on disability, concepts of education, and administrative structures. The paper…
Secondary Schools in Canada: The National Report of the Exemplary Schools Project.
ERIC Educational Resources Information Center
Gaskell, Jane
The Exemplary Schools Project was a national cooperative project that identified successful Canadian secondary schools and analyzed their practices to suggest policy implications. Five issues were examined: the meaning and recognition of success; interactions between the school and its context; the influence of school structures, processes, and…
Teachers' Use of Psycho-Educational Reports in Mainstream Classrooms
ERIC Educational Resources Information Center
Lindelauf, Joanne; Reupert, Andrea; Jacobs, Kate E.
2018-01-01
This study investigated how teachers who support children with learning difficulties utilise psychologists' reports in their teaching practice. Previous research has examined teachers' preferences for how reports should be written, rather than how they might be used. Semi-structured, qualitative interviews with 12 teachers (seven primary, four…
The "Only" Solution: Education, Youth, and Social Change in Afghanistan
ERIC Educational Resources Information Center
Holland, Dana G.; Yousofi, Mohammad Hussain
2014-01-01
This article draws on practice theory to examine aspiring youths' pursuit of higher education in Afghanistan. It finds that plans and actions are mediated through youths' families, communities, and solidarity networks. As a result, the personal improvement and enhanced reputational status that aspiring youth seek is structurally connected to…
Foster, Helen; Kay, Lesley; May, Carl; Rapley, Tim
2011-11-01
Competent examination of the pediatric musculoskeletal (MSK) system is a vital component of clinical assessment of children with MSK presentations. The aim was to develop a regional MSK examination for school-age children that is age appropriate and reflects clinical practice. Qualitative and quantitative analyses involving video observation of clinical examination technique, systematic review, and expert consensus were employed to reveal descriptions, frequencies, and variations in technique for joint regions in various clinical scenarios. Systematic review and data from clinical observation were combined with feedback from a group of pediatric MSK experts through a web-based survey. All results were collated and discussed by consensus development groups to derive the pediatric Regional Examination of the Musculoskeletal System (pREMS). A total of 48 pediatric MSK expert clinicians were involved to derive pREMS. Systematic review revealed a paucity of evidence about regional pediatric MSK examination. Video observations of MSK examinations (a total of 2,901 maneuvers) performed by pediatric MSK experts (n = 11 doctors and 8 therapists) of 89 school-age children attending outpatient clinics in 7 UK pediatric rheumatology centers were followed by semistructured interviews with 14 of 19 clinicians. Video observation showed variation in examination techniques, most frequently at the hip and knee in the context of mechanical and inflammatory clinical scenarios. pREMS is the first practice- and consensus-based regional pediatric MSK examination for school-age children. The structured approach is an important step toward improved pediatric MSK clinical skills relevant to clinical training. Copyright © 2011 by the American College of Rheumatology.
de la Fuente, Jaime; Garrett, C Gaelyn; Ossoff, Robert; Vinson, Kim; Francis, David O; Gelbard, Alexander
2017-11-01
To examine the distribution of clinic and operative pathology in a tertiary care laryngology practice. Probability density and cumulative distribution analyses (Pareto analysis) was used to rank order laryngeal conditions seen in an outpatient tertiary care laryngology practice and those requiring surgical intervention during a 3-year period. Among 3783 new clinic consultations and 1380 operative procedures, voice disorders were the most common primary diagnostic category seen in clinic (n = 3223), followed by airway (n = 374) and swallowing (n = 186) disorders. Within the voice strata, the most common primary ICD-9 code used was dysphonia (41%), followed by unilateral vocal fold paralysis (UVFP) (9%) and cough (7%). Among new voice patients, 45% were found to have a structural abnormality. The most common surgical indications were laryngotracheal stenosis (37%), followed by recurrent respiratory papillomatosis (18%) and UVFP (17%). Nearly 55% of patients presenting to a tertiary referral laryngology practice did not have an identifiable structural abnormality in the larynx on direct or indirect examination. The distribution of ICD-9 codes requiring surgical intervention was disparate from that seen in clinic. Application of the Pareto principle may improve resource allocation in laryngology, but these initial results require confirmation across multiple institutions.
NASA Astrophysics Data System (ADS)
González-Howard, María; McNeill, Katherine L.; Marco-Bujosa, Lisa M.; Proctor, C. Patrick
2017-03-01
Reform initiatives around the world are reconceptualising science education by stressing student engagement in science practices. Yet, science practices are language-intensive, requiring students to have strong receptive and productive language proficiencies. It is critical to address these rigorous language demands to ensure equitable learning opportunities for all students, including English language learners (ELLs). Little research has examined how to specifically support ELL students' engagement in science practices, such as argumentation. Using case-study methodology, we examined one middle school science teacher's instructional strategies as she taught an argumentation-focused curriculum in a self-contained ELL classroom. Findings revealed that three trends characterized the teacher's language supports for the structural and dialogic components of argumentation: (1) more language supports focused on argument structure, (2) dialogic interactions were most often facilitated by productive language supports, and (3) some language supports offered a rationale for argumentation. Findings suggest a need to identify and develop supports for the dialogic aspects of argumentation. Furthermore, engaging students in argumentation through productive language functions could be leveraged to support dialogic interactions. Lastly, our work points to the need for language supports that make the rationale for argumentation explicit since such transparency could further increase access for all students.
Urteaga, Elizabeth M; Attridge, Rebecca L; Tovar, John M; Witte, Amy P
2015-10-25
Objective. To evaluate how effectively pharmacy students and practicing pharmacists communicate and apply knowledge to simulations of commonly encountered patient scenarios using an objective structured clinical examination (OSCE). Design. Second-, third-, and fourth-year pharmacy students completed an OSCE as part of their required courses in 2012 and 2013. All students in both years completed identical OSCE cases. Licensed pharmacists were recruited to complete the OSCE and serve as controls in 2012. A survey assessed student perception and acceptance of the OSCE as well as student confidence in performance. Assessment. Licensed pharmacists had significantly higher clinical and communication skills scores than did pharmacy students. Student progression in communication and clinical skills improved significantly over time. Survey results indicated that students felt the OSCE was well-structured and assessed clinical skills taught in pharmacy school; 86% of students felt confident they could provide these skills. Conclusion. Objective structured clinical examinations can evaluate clinical competence and communication skills among professional students. Implementation of OSCEs may be an effective tool for assessment of the Center for the Advancement of Pharmacy Education domains.
NASA Astrophysics Data System (ADS)
Vollmers, Burkhard
1997-01-01
Piaget's theory of genetic recognition has a number of pedagogical implications. With the swing from structuralism to constructivism, Piaget created one of the first constructivist learning theories around the middle of this century. After this has been briefly presented, its relationship to present-day teaching and learning research, pedagogical practice and other forms of constructivism is examined critically. Although Piaget's theory does not embrace all forms of human learning, it does contain some significant pointers for pedagogical practice. An appropriate practical application of Piaget's learning theory would be to teach by encouraging spontaneous activity and the interests of the pupils.
The complexity of implementing culture change practices in nursing homes.
Sterns, Samantha; Miller, Susan C; Allen, Susan
2010-09-01
The culture change (CC) movement aims to transform the traditional nursing home (NH) that is institutional in design with hierarchical management structure into a homelike environment that empowers residents and frontline staff. This study examines differences in adoption of CC practices according to a NH's self-reported extent of CC implementation and its duration of CC adoption. Furthermore, it examines differences in adoption by whether a CC practice is considered less versus more complex, using complexity theory as the theoretical framework for this classification. Using data from a 2007 Commonwealth-funded study, we analyzed a national sample of 291 US nursing homes that identified as being "for the most part" or "completely" CC facilities for "1 to 3 years" or "3+ years." Also, using a complexity theory framework, we ranked 16 practices commonly associated with CC as low, moderately, or highly complex based on level of agreement needed to actuate the process (number of parties involved) and the certainty of intended outcomes. We then examined the prevalence of CC-associated practices in relation to their complexity and the extent and duration of a NH's CC adoption. We found practices ranked as less complex were implemented more frequently in NHs with both shorter and longer durations of CC adoption. However, more complex CC practices were more prevalent among NHs reporting "complete" adoption for 3+ years versus 1 to 3 years. This was not observed in NHs reporting having CC "for the most part." Less complex practices may be more economical and easier to implement. These early successes may result in sufficient momentum so that more complex change can follow. A nursing home that more completely embraces the culture change movement may be more likely to attempt these complex changes. Copyright 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
Meo, Sultan Ayoub
2013-09-01
This study aimed to assess knowledge and skills in a respiratory physiology course in traditional versus problem-based learning (PBL) groups in two different medical schools. Two different undergraduate medical schools were selected for this study. The first medical school followed the traditional [lecture-based learning (LBL)] curriculum, and the second medical school followed the PBL curriculum. Sixty first-year male medical students (30 students from each medical school) volunteered; they were apparently healthy and of the same age, sex, nationality, and regional and cultural background. Students were taught respiratory physiology according to their curriculum for a period of 2 wk. At the completion of the study period, knowledge was measured based on a single best multiple-choice question examination, and skill was measured based on the objective structured practical examination in the lung function laboratory (respiratory physiology). A Student's t-test was applied for the analysis of the data, and the level of significance was set at P < 0.05. Students belonging to the PBL curriculum obtained a higher score in the multiple-choice question examination (P = 0.001) and objective structured practical examination (P = 0.0001) compared with traditional (LBL) students. Students in the PBL group obtained significantly higher knowledge and skill scores in the respiratory physiology course compared with students in the traditional (LBL) style of medical schools.
Malhotra, Neha; Poolton, Jamie M; Wilson, Mark R; Leung, Gilberto; Zhu, Frank; Fan, Joe K M; Masters, Rich S W
2015-01-01
Surgical educators have encouraged the investigation of individual differences in aptitude and personality in surgical performance. An individual personality difference that has been shown to influence laparoscopic performance under time pressure is movement specific reinvestment. Movement specific reinvestment has 2 dimensions, movement self-consciousness (MS-C) (i.e., the propensity to consciously monitor movements) and conscious motor processing (CMP) (i.e., the propensity to consciously control movements), which have been shown to differentially influence laparoscopic performance in practice but have yet to be investigated in the context of psychological stress (e.g., the objective structured clinical examination [OSCE]). This study investigated the role of individual differences in propensity for MS-C and CMP in practice of a fundamental laparoscopic skill and in laparoscopic performance during the OSCE. Furthermore, this study examined whether individual differences during practice of a fundamental laparoscopic skill were predictive of laparoscopic performance during the OSCE. Overall, 77 final-year undergraduate medical students completed the movement specific reinvestment scale, an assessment tool that quantifies the propensity for MS-C and CMP. Participants were trained to proficiency on a fundamental laparoscopic skill. The number of trials to reach proficiency was measured, and completion times were recorded during early practice, later practice, and the OSCE. There was a trend for CMP to be negatively associated with the number of trials to reach proficiency (p = 0.064). A higher propensity for CMP was associated with fewer trials to reach proficiency (β = -0.70, p = 0.023). CMP and MS-C did not significantly predict completion times in the OSCE (p > 0.05). Completion times in early practice (β = 0.05, p = 0.016) and later practice (β = 0.47, p < 0.001) and number of trials to reach proficiency (β = 0.23, p = 0.003) significantly predicted completion times in the OSCE. It appears that a higher propensity for CMP predicts faster rates of learning of a fundamental laparoscopic skill. Furthermore, laparoscopic performance during practice is indicative of laparoscopic performance in the challenging conditions of the OSCE. The lack of association between the 2 dimensions of movement specific reinvestment and performance during the OSCE is explained using the theory of reinvestment as a framework. Overall, consideration of personality differences and individual differences in ability during practice could help inform the development of individualized surgical training programs. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Factor structure of a standards-based inventory of competencies in social work with groups.
Macgowan, Mark J; Dillon, Frank R; Spadola, Christine E
2018-01-01
This study extends previous findings on a measure of competencies based on Standards for Social Work Practice with Groups. The Inventory of Competencies in Social Work with Groups (ICSWG) measures confidence in performing the Standards. This study examines the latent structure of the Inventory, while illuminating the underlying structure of the Standards. A multinational sample of 586 persons completed the ICSWG. Exploratory factor analysis (EFA), reliability estimates, standard error of measurement estimates, and a range of validity tests were conducted. The EFA yielded a six-factor solution consisting of core values, mutuality/connectivity, collaboration, and three phases of group development (planning, beginnings/middles, endings). The alphas were .98 for the scale and ranged from .85 to .95 for the subscales. Correlations between the subscales and validators supported evidence of construct validity. The findings suggest key group work domains that should be taught and practiced in social work with groups.
Handwerker, Sarah M
2012-09-12
Current societal and healthcare system trends highlight the need to transform nursing education to prepare nurses capable of outstanding practice in the 21st century. Patricia Benner and colleagues urged nurse educators to transform their practice in the 2010 publication Educating Nurses, A Call to Radical Transformation. Frequently utilized pedagogical frameworks in nursing education include behaviorism and constructivism. Much of the structure and basis for instruction and evaluation can be found rooted in these philosophies. By first exploring both behaviorism and constructivism and then relating their use in nursing education to the call to transform, educators can be encourage to examine current practice and possibly modify aspects to include more rich experiential learning.
Yonas, Michael A; Nowalk, Mary Patricia; Zimmerman, Richard K; Ahmed, Faruque; Albert, Steven M
2012-01-01
A proven method to increase vaccination rates in primary care is a standing orders program (SOP) for nonphysician staff to assess and vaccinate eligible individuals without a specific written physician order. This study describes a mixed methods approach to examining physicians' beliefs and attitudes about and adoption of SOPs for adult immunizations, specifically, influenza and pneumococcal polysaccharide vaccine. Focus groups and in-depth interviews of physicians, nurses, practice managers, and the medical director of a managed care health plan were conducted. Results were used to enrich a concise survey based on the Awareness-to-Adherence model of physician behavior and previous research, which was mailed to 1,640 general internists and family physicians nationwide. Barriers to SOPs identified through qualitative methods were lack of interest in changing the status quo, a physician-dominated hierarchy, and fear of malpractice. Facilitators included having an electronic medical record and a practice culture that was open to change. The survey (response rate 67%) confirmed the facilitators and further identified patient, physician, and practice factors that served as barriers to establishing and maintaining SOPs. This mixed methods approach provided the opportunity to develop a tailored and practice-oriented survey for examining the contextual factors influencing clinical providers' decisions to implement SOPs for adult immunization. © 2011 National Association for Healthcare Quality.
Vaughn, Amber E; Dearth-Wesley, Tracy; Tabak, Rachel G; Bryant, Maria; Ward, Dianne S
2017-02-01
Parents' food parenting practices influence children's dietary intake and risk for obesity and chronic disease. Understanding the influence and interactions between parents' practices and children's behavior is limited by a lack of development and psychometric testing and/or limited scope of current measures. The Home Self-Administered Tool for Environmental Assessment of Activity and Diet (HomeSTEAD) was created to address this gap. This article describes development and psychometric testing of the HomeSTEAD family food practices survey. Between August 2010 and May 2011, a convenience sample of 129 parents of children aged 3 to 12 years were recruited from central North Carolina and completed the self-administered HomeSTEAD survey on three occasions during a 12- to 18-day window. Demographic characteristics and child diet were assessed at Time 1. Child height and weight were measured during the in-home observations (following Time 1 survey). Exploratory factor analysis with Time 1 data was used to identify potential scales. Scales with more than three items were examined for scale reduction. Following this, mean scores were calculated at each time point. Construct validity was assessed by examining Spearman rank correlations between mean scores (Time 1) and children's diet (fruits and vegetables, sugar-sweetened beverages, snacks, sweets) and body mass index (BMI) z scores. Repeated measures analysis of variance was used to examine differences in mean scores between time points, and single-measure intraclass correlations were calculated to examine test-retest reliability between time points. Exploratory factor analysis identified 24 factors and retained 124 items; however, scale reduction narrowed items to 86. The final instrument captures five coercive control practices (16 items), seven autonomy support practices (24 items), and 12 structure practices (46 items). All scales demonstrated good internal reliability (α>.62), 18 factors demonstrated construct validity (significant association with child diet, P<0.05), and 22 demonstrated good reliability (intraclass correlation coefficient>0.61). The HomeSTEAD family food practices survey provides a brief, yet comprehensive and psychometrically sound assessment of food parenting practices. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Epistemological beliefs and epistemological practices in elementary science
NASA Astrophysics Data System (ADS)
Kittleson, Julie M.
In this study, I examined the reciprocal relationship between third graders' epistemological beliefs and practices in the context of science instruction. Epistemological beliefs describe students' ideas about the nature of knowledge. Epistemological practices describe how students interact with dimensions of scientific knowledge. Examining the intersection between beliefs and practices involves describing how participating in science learning activities influences and is influenced by ideas about science. To examine beliefs and practices, I used interviews and classroom observations. Interview data were analyzed to ascertain students' ideas about the purpose of science and the justification, certainty, and structure/coherence of scientific knowledge. Additionally, lessons in the FOSS Human Body unit and the STC Chemical Tests unit were video taped. These data were analyzed to examine epistemological practices. Interview and classroom data were used in combination to explore the intersection between beliefs and practices. Students held multifaceted ideas about science. They indicated that science involves description, but they also indicated that science involves generating evidence and drawing conclusions. Students indicated that ideas can change in relation to new evidence. Epistemological practices, in contrast, revealed that the investigation strategies invoked in these units underestimated students' ideas about science. Students used matching strategies to complete investigations. In the Chemical Tests unit, the teacher helped students move beyond matching by introducing the idea of molecules. Students discussed molecules in relation to their empirical investigations, indicating that when elementary students are provided with appropriate scaffolds they can expand their range of practices which also potentially expands their beliefs. Students approached science as a repertoire of tests. They recalled ideas about the purpose of a test in one context and applied those ideas to another context. Additionally, they suggested that certain tests are appropriate for certain situations. Although students understood the purpose of the tests, they did not seem to recognize the full range of purposes underlying scientific investigations. This study highlights the challenge of designing learning environments that scaffold productive epistemological beliefs. This study also highlights the complexity of the relationship between beliefs and practices, particularly in terms of understanding the role instruction might play in mediating this relationship.
Beliefs and practices surrounding postpartum period among Myanmar women.
Sein, Kyi Kyi
2013-11-01
to examine the postpartum beliefs and practices among young women (15-24 years) both quantitative and qualitative approaches were used: a cross-sectional comparative study using a semi-structured questionnaire and focus group discussions (FGDs). Kyimyindaing Township in the western district of Yangon, Myanmar. young women (15-24 years) who had experience of at least one live birth were included. A total of 196 women for a quantitative survey and 31 women for FGDs were recruited. postpartum beliefs and practices at the last childbirth were explored by a pretested semi-structured questionnaire and four FGDs (two in urban and two in rural areas). The survey questionnaire covered socio-demographic data, food and behavioural restrictions and observances during the last postpartum period and underlying reasons for those practices. Majority of participants followed the traditional postpartum practices regardless of the area of residence and education level. Notion of 'dirty lochia' was identified. traditional beliefs and practices surrounding post partum were highly prevalent among young women. Variation in degree and duration of adherence to postpartum taboos was noted. These beliefs and practices were imparted and perpetuated by women's close social network. the findings point out the importance of awareness of postpartum beliefs and practices among health staff for providing culturally sensitive health care and gaining better co-operation and mutual understanding in giving health care. Copyright © 2012 Elsevier Ltd. All rights reserved.
Does responsibility drive learning? Lessons from intern rotations in general practice.
Cantillon, Peter; Macdermott, Maeve
2008-01-01
The intern (or pre-registration) year has been criticised in the past for its emphasis on service delivery at the expense of educational achievement. It is hoped that new approaches to early postgraduate training such as the foundation programmes in the UK, will make clinical education more structured and effective. Intern placements in non-traditional settings such as general practice have been shown in the past to improve the quality of learning. Little is known however about which features of the general practice learning environment contribute most to the perception of improved learning. This aim of this study was to examine the learning environment in general practice from the perspective of interns, (the learners), to determine the factors that contribute most to motivating effective learning in a general practice setting. This study used a qualitative case study approach to explore the effects of two different learning environments, (general practice and hospital) on learner motivation amongst a small group of interns. We found that the biggest difference between the hospital and general practice learning environments was the increased individual responsibility for patient care experienced by interns in general practice. Greater responsibility was associated with greater motivation for learning. Increased intern responsibility for patient care does appear to motivate learning. More work needs to be done on providing interns in hospital posts with greater patient responsibility within an effective supervisory structure.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kuz'micheva, T.N.; Mazurenok, A.M.; Eliseev, V.P.
The problem of using the chemical method for checking the airtightness of ventilation systems and containment structures with the use of indicator materials on a base of Congo red and an air-ammonia mixture as the test medium was examined. The methods and results of experimental investigations of leaks characteristic for containment structures and ventilation systems are given. Suggestions are given on a determination of the parameters of local leaks and on the practical use of the given method for evaluating the quality of sealing.
2009-01-01
Objective To describe a receptor-based approach to promote learning about nonsteroidal anti-inflammatory drug (NSAID) chemistry, structure-activity relationships, and therapeutic decision-making. Design Three lessons on cyclooxygenase (COX) and NSAID chemistry, and NSAID therapeutic utility, were developed using text-based resources and primary medicinal chemistry and pharmacy practice literature. Learning tools were developed to assist students in content mastery. Assessment Student learning was evaluated via performance on quizzes and examinations that measured understanding of COX and NSAID chemistry, and the application of that knowledge to therapeutic problem solving. Conclusion Student performance on NSAID-focused quizzes and examinations documented the success of this approach. PMID:20221336
Structured Smoking Cessation Training for Medical Students: A Prospective Study
Herold, Ronja; Schiekirka, Sarah; Brown, Jamie; Bobak, Alex; McEwen, Andy
2016-01-01
Introduction: Physician adherence to guideline recommendations regarding the provision of counseling and support for smokers willing to quit is low. A lack of training during undergraduate medical education has been identified as a potential cause. This prospective intervention study evaluated a novel teaching module for medical students. Methods: As part of a 6-week cardiovascular course, 125 fourth-year undergraduate medical students received a multimodal and interactive teaching module on smoking cessation, including online learning material, lectures, seminars, and practical skills training. Short- and medium-term effects on knowledge, skills, attitudes, and self-reported practice were measured using written examinations and an objective structured clinical examination at the end of the module and 6 months later. Results were compared to data obtained from a historical control cohort (n = 70) unexposed to the intervention. Results: At the 6-month follow-up, scores in the knowledge test were significantly higher in the intervention than the control group (61.1% vs. 51.7%; p < .001). A similar pattern was observed in the objective structured clinical examination (71.5% vs. 60.5%; p < .001). More students in the intervention than control group agreed that smoking was a chronic disease (83.1% vs. 68.1%; p = .045). The control group was more likely to report recording smoking status (p = .018), but no group difference was detected regarding the report of advising to quit (p = .154). Conclusions: A novel teaching module for undergraduate medical students produced a sustained learning outcome in terms of knowledge, skills, and attitudes but not self-reported practice. Implications: Studies across the world have identified considerable knowledge gaps and deficits in practical training with regard to smoking cessation counseling in undergraduate medical students. This paper describes a teaching intervention informed by current recommendations for the design of educational activities aimed at enabling medical students to deliver adequate behavior change counseling. The teaching module was tailored to the needs of a specific healthcare system. Given its effectiveness as demonstrated in this prospective study, a rollout of this intervention in medical schools might have the potential to substantially improve medical students’ knowledge, skills, and attitudes in relation to smoking cessation counseling. PMID:27613926
Davies, Alicia; Wong, Carol A; Laschinger, Heather
2011-07-01
The purpose of this study was to test Kanter's theory by examining relationships among structural empowerment, leader-member exchange (LMX) quality and nurses' participation in personal knowledge transfer activities. Despite the current emphasis on evidence-based practice in health care, research suggests that implementation of research findings in everyday clinical practice is unsystematic at best with mixed outcomes. This study was a secondary analysis of data collected using a non-experimental, predictive mailed survey design. A random sample of 400 registered nurses who worked in urban tertiary care hospitals in Ontario yielded a final sample of 234 for a 58.5% response rate. Hierarchical multiple linear regression analysis revealed that the combination of LMX and structural empowerment accounted for 9.1% of the variance in personal knowledge transfer but only total empowerment was a significant independent predictor of knowledge transfer (β=0.291, t=4.012, P<0.001). Consistent with Kanter's Theory, higher levels of empowerment and leader-member exchange quality resulted in increased participation in personal knowledge transfer in practice. The results reinforce the pivotal role of nurse managers in supporting empowering work environments that are conducive to transfer of knowledge in practice to provide evidence-based care. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
Medical home implementation: a sensemaking taxonomy of hard and soft best practices.
Hoff, Timothy
2013-12-01
The patient-centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care. I used a multicase, comparative study design that relied on a sensemaking approach and fifty-one in-depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care. I found two distinct taxonomies of implementation best practices, which I labeled "hard" and "soft" because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices. The results suggest that there may be no standardized, one-size-fits-all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on building structural supports for medical home work. Further study of these softer implementation practices and a continued call for qualitative methodological approaches that gain insight into everyday practice behavior are warranted. © 2013 Milbank Memorial Fund.
Kong, Linghua; Liu, Yun; Li, Guopeng; Fang, Yueyan; Kang, Xiaofei; Li, Ping
2016-11-01
To examine the positive association between emotional intelligence and clinical communication ability among practice nursing students, and to determine whether resilience plays a moderating role in the relationship between emotional intelligence and clinical communication ability among Chinese practice nursing students. Three hundred and seventy-seven practice nursing students from three hospitals participated in this study. They completed questionnaires including the Emotional Intelligence Inventory (EII), Connor-Davidson Resilience Scale (CD-RISC-10), and Clinical Communication Ability Scale (CCAS). Structural equation modeling was used to analyze the relationships among emotional intelligence, resilience, and clinical communication ability. Emotional intelligence was positively associated with clinical communication ability (P<0.01). Resilience significantly affected clinical communication ability (P<0.01) and moderated the relationship between emotional intelligence and clinical communication ability (P<0.01). Emotional intelligence is positively related to clinical communication ability among Chinese practice nursing students, and resilience moderates the relationship between emotional intelligence and clinical communication ability, which may provide scientific evidence to aid in developing intervention strategies to improve clinical communication ability. Copyright © 2016 Elsevier Ltd. All rights reserved.
Eisenberg, Marisa C; Jain, Harsh V
2017-10-27
Mathematical modeling has a long history in the field of cancer therapeutics, and there is increasing recognition that it can help uncover the mechanisms that underlie tumor response to treatment. However, making quantitative predictions with such models often requires parameter estimation from data, raising questions of parameter identifiability and estimability. Even in the case of structural (theoretical) identifiability, imperfect data and the resulting practical unidentifiability of model parameters can make it difficult to infer the desired information, and in some cases, to yield biologically correct inferences and predictions. Here, we examine parameter identifiability and estimability using a case study of two compartmental, ordinary differential equation models of cancer treatment with drugs that are cell cycle-specific (taxol) as well as non-specific (oxaliplatin). We proceed through model building, structural identifiability analysis, parameter estimation, practical identifiability analysis and its biological implications, as well as alternative data collection protocols and experimental designs that render the model identifiable. We use the differential algebra/input-output relationship approach for structural identifiability, and primarily the profile likelihood approach for practical identifiability. Despite the models being structurally identifiable, we show that without consideration of practical identifiability, incorrect cell cycle distributions can be inferred, that would result in suboptimal therapeutic choices. We illustrate the usefulness of estimating practically identifiable combinations (in addition to the more typically considered structurally identifiable combinations) in generating biologically meaningful insights. We also use simulated data to evaluate how the practical identifiability of the model would change under alternative experimental designs. These results highlight the importance of understanding the underlying mechanisms rather than purely using parsimony or information criteria/goodness-of-fit to decide model selection questions. The overall roadmap for identifiability testing laid out here can be used to help provide mechanistic insight into complex biological phenomena, reduce experimental costs, and optimize model-driven experimentation. Copyright © 2017. Published by Elsevier Ltd.
Akhtari-Zavare, Mehrnoosh; Lattif, Latiffah A; Juni, Muhamad Hanafiah; Md Said, Salmiah; Ismail, Irmi Zarina
2015-12-01
Breast cancer is the most common cancer among women worldwide, including Malaysia. In developing countries, predictors affecting breast self-examination (BSE) practice are different. This cross-sectional study was conducted to determine the prevalence of BSE practice and the predictors affecting BSE practice among undergraduate female students in Klang Valley, Malaysia. A cross-sectional study was conducted among 820 female undergraduate students to assess the BSE performance and related determinants of BSE practice in Klang Valley, Malaysia. Data were collected via a self-administered structured questionnaire that was developed for this study. The mean age of the respondents was 21.7 ± 1.2 years old. Most of them were single (96.8%), Malay (91.9%) and 19.6% of the participants performed BSE regularly. Multivariate logistic regression modeling revealed that BSE performance was more likely among women who have checked their breast with a doctor (odds ratio = 2.04, P = 0.00), and women who have personal history of breast disease (odds ratio = 4.43, P = 0.03). The findings showed a low BSE practice rate among young Malaysian women. Hence, the community's breast health awareness is needed to improve breast cancer prevention among young Malaysian women. © 2015 Japan Society of Obstetrics and Gynecology.
Spot-checks to measure general hygiene practice.
Sonego, Ina L; Mosler, Hans-Joachim
2016-01-01
A variety of hygiene behaviors are fundamental to the prevention of diarrhea. We used spot-checks in a survey of 761 households in Burundi to examine whether something we could call general hygiene practice is responsible for more specific hygiene behaviors, ranging from handwashing to sweeping the floor. Using structural equation modeling, we showed that clusters of hygiene behavior, such as primary caregivers' cleanliness and household cleanliness, explained the spot-check findings well. Within our model, general hygiene practice as overall concept explained the more specific clusters of hygiene behavior well. Furthermore, the higher general hygiene practice, the more likely children were to be categorized healthy (r = 0.46). General hygiene practice was correlated with commitment to hygiene (r = 0.52), indicating a strong association to psychosocial determinants. The results show that different hygiene behaviors co-occur regularly. Using spot-checks, the general hygiene practice of a household can be rated quickly and easily.
Altered resting brain function and structure in professional badminton players.
Di, Xin; Zhu, Senhua; Jin, Hua; Wang, Pin; Ye, Zhuoer; Zhou, Ke; Zhuo, Yan; Rao, Hengyi
2012-01-01
Neuroimaging studies of professional athletic or musical training have demonstrated considerable practice-dependent plasticity in various brain structures, which may reflect distinct training demands. In the present study, structural and functional brain alterations were examined in professional badminton players and compared with healthy controls using magnetic resonance imaging (MRI) and resting-state functional MRI. Gray matter concentration (GMC) was assessed using voxel-based morphometry (VBM), and resting-brain functions were measured by amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity. Results showed that the athlete group had greater GMC and ALFF in the right and medial cerebellar regions, respectively. The athlete group also demonstrated smaller ALFF in the left superior parietal lobule and altered functional connectivity between the left superior parietal and frontal regions. These findings indicate that badminton expertise is associated with not only plastic structural changes in terms of enlarged gray matter density in the cerebellum, but also functional alterations in fronto-parietal connectivity. Such structural and functional alterations may reflect specific experiences of badminton training and practice, including high-capacity visuo-spatial processing and hand-eye coordination in addition to refined motor skills.
NASA Astrophysics Data System (ADS)
Seda Cetin, Pinar; Eymur, Guluzar; Southerland, Sherry A.; Walker, Joi; Whittington, Kirby
2018-03-01
This study examines the influence of laboratory instruction that engages students in a wide range of the practices of science on Turkish high-school students' chemistry learning. In this mixed methods study, student learning in two different laboratory settings was compared, one that featured an instruction that engaged students in a wide range of disciplinary practices (through Argument-driven Inquiry - ADI) and similar laboratories in which a more traditional Structured Inquiry (SI) approach was employed. The data sources included a Chemistry Concept test, an Argumentative Writing Assessment, and Semi-structured interviews. After seven weeks of chemistry instruction, students experiencing ADI instruction scored higher on the Chemistry Concept test and the Argumentative Writing Assessment than students experiencing SI instruction. Furthermore, girls who experienced ADI instruction scored higher on the assessments than their majority peers in the same class. The results suggest that Turkish students can substantially improve their chemistry proficiency if they have an opportunity to engage in instruction featuring a broad array of the practices of science.
NASA Astrophysics Data System (ADS)
Martin, Anita; Park, Soonhye; Hand, Brian
2017-08-01
This qualitative case study examined the process of change in an experienced elementary teacher's belief structure during implementation of an inquiry-based science program. Difficulties generally associated with ascertaining beliefs were minimized by using Leatham's (Journal of Mathematics Teacher Education, 9, 91-102 (2006) Sensible System Framework, enabling researchers to obtain rich descriptions of the teacher's belief structure by focusing on words (professed beliefs), intentions (intended beliefs), and actions (enacted beliefs). Models were constructed of the teacher's belief structure before and after implementation of the Science Writing Heuristic (SWH) approach (Hand et al. International Journal of Science Education, 26(2), 131-149, 2004), an inquiry-based approach to teaching science. Key beliefs for this teacher were related to how students learn, goals for teaching science, focus of instruction, and roles of teacher and student. Ultimately, the teacher shifted her professed, intended, and enacted beliefs resulting in a shift from a teacher-centered to a student-centered classroom. Findings support Thagard's Coherence Theory of Justification (2002), positing that change in one belief creates a state of disequilibrium that must be alleviated by changing/realigning other beliefs in order to re-establish coherence in the overall belief structure. This research focus is distinct from the general trend in teacher beliefs research in important ways. Most significant is that this study was not focused on the traditional two lists—those beliefs that were consistent with practice and those that were inconsistent with practice—but instead focused on the entwined nature of beliefs and practice and have shown that a teacher's practice can be viewed as their enacted beliefs, an integral part of the teacher's overall belief structure.
Development and psychometric evaluation of the Professional Practice Environment (PPE) scale.
Erickson, Jeanette Ives; Duffy, Mary E; Gibbons, M Patricia; Fitzmaurice, Joan; Ditomassi, Marianne; Jones, Dorothy
2004-01-01
To describe the Professional Practice Environment (PPE) scale, its conceptual development and psychometric evaluation, and its uses in measuring eight characteristics of the professional practice environment in an acute care setting. The 38-item PPE Scale was validated on a sample of 849 professional practice staff at the Massachusetts General Hospital in Boston. Psychometric analysis included: item analysis, principal components analysis (PCA) with varimax rotation and Kaiser normalization, and internal consistency reliability using Cronbach's alpha coefficient. Eight components were shown, confirming the original conceptually derived model's structure and accounting for 61% of explained variance. Cronbach's alpha coefficients for the eight PPE subscales ranged from .78 to .88. Findings showed the 38-item PPE Scale was reliable and valid for use in health outcomes research to examine the professional practice environment of staff working in acute care settings.
NASA Astrophysics Data System (ADS)
White, J. C.; Hill, M. J.; Bickerton, M. A.; Wood, P. J.
2017-09-01
The widespread degradation of lotic ecosystems has prompted extensive river restoration efforts globally, but many studies have reported modest ecological responses to rehabilitation practices. The functional properties of biotic communities are rarely examined within post-project appraisals, which would provide more ecological information underpinning ecosystem responses to restoration practices and potentially pinpoint project limitations. This study examines macroinvertebrate community responses to three projects which aimed to physically restore channel morphologies. Taxonomic and functional trait compositions supported by widely occurring lotic habitats (biotopes) were examined across paired restored and non-restored (control) reaches. The multivariate location (average community composition) of taxonomic and functional trait compositions differed marginally between control and restored reaches. However, changes in the amount of multivariate dispersion were more robust and indicated greater ecological heterogeneity within restored reaches, particularly when considering functional trait compositions. Organic biotopes (macrophyte stands and macroalgae) occurred widely across all study sites and supported a high alpha (within-habitat) taxonomic diversity compared to mineralogical biotopes (sand and gravel patches), which were characteristic of restored reaches. However, mineralogical biotopes possessed a higher beta (between-habitat) functional diversity, although this was less pronounced for taxonomic compositions. This study demonstrates that examining the functional and structural properties of taxa across distinct biotopes can provide a greater understanding of biotic responses to river restoration works. Such information could be used to better understand the ecological implications of rehabilitation practices and guide more effective management strategies.
Situated Teacher Quality: A Case Study of an Experienced Elementary School Teacher
ERIC Educational Resources Information Center
Kolman, Joni S.
2017-01-01
This case study examines how an experienced teacher's practice and pedagogy differs across two high-accountability urban charter schools in the United States of America (USA). Drawing on semi-structured interviews and participant observations, the findings describe variances in Rebecca's planning, use of classroom time, and curriculum flexibility,…
Supporting Fourth-Grade Students' Word Identification Using Application Software
ERIC Educational Resources Information Center
Moser, Gary P.; Morrison, Timothy G.; Wilcox, Brad
2017-01-01
A quasi-experimental study examined effects of a 10-week word structure intervention with fourth-grade students. During daily 10-15-minute practice periods, students worked individually with mobile apps focused on specific aspects of word identification. Pre- and post-treatment assessments showed no differences in rate and accuracy of oral reading…
Politics First: Examining the Practice of the Multi-District Superintendent
ERIC Educational Resources Information Center
Hall, Daniella; McHenry-Sorber, Erin
2017-01-01
Over the past decade, multiple states have implemented a form of regional school district consolidation referred to as multi-district unions. Their organizational structure enables districts to retain individual school boards within regional local education agencies, all of which are overseen by a superintendent and a central board. However, no…
ERIC Educational Resources Information Center
Griffin, Penny
2007-01-01
This article examines the World Bank's discourse of neoliberalism with a view to understanding how this informs and sustains the Bank's policies and practices in particularly gendered ways. "Neoliberalism" is, here, a discursive structure that constitutes a powerful and pervasive contemporary model of economic development, resting on assumptions…
ERIC Educational Resources Information Center
Heafner, Tina L.; Plaisance, Michelle
2016-01-01
Background/Context: Current research addresses the marginalization of social studies and trends in teaching English learners (ELs) in monolingual schools; however, few studies have examined the way in which support services provided to ELs impact their exposure to social studies instruction. Purpose/Objective/Research Question/Focus of Study:…
ERIC Educational Resources Information Center
Dantley, Michael E.
2003-01-01
Examines purposeful leadership, a concept grounded in "prophetic spirituality." Suggests that educational leaders who build their professional practice in purpose-driven leadership clearly understand the multidimensional aspects of their daily challenges yet find the inner strength to resist hegemonic structures and forms of oppression and…
Remote Practice and Culture Shock: Social Workers Moving to Isolated Northern Regions.
ERIC Educational Resources Information Center
Zapf, Michael Kim
1993-01-01
Examined adjustment patterns of social workers (n=85) who relocated to remote Yukon Territory. Social workers recruited from southern Canada reported overall experience of culture shock followed by recovery. Structural variables related to job itself were associated with culture shock but not recovery. Individual variables of personal history and…
Swimming Between: An Examination of the Inherent Complexity within Social Justice
ERIC Educational Resources Information Center
Aguilar, Israel; Nelson, Sarah; Niño, Juan Manuel
2016-01-01
Classrooms tend to be absolute spaces, places where fluidity is rejected and nearly everything--from people, to ideas, to practices and policies--is viewed and organized through binary logic. Because binary logic is implicitly accepted as the natural order in schools and the structures resulting from it are highly unmalleable, individuals who…
Examining Mathematics Teachers' Beliefs through Multiple Lenses.
ERIC Educational Resources Information Center
Mewborn, Denise S.
This paper presents a longitudinal study of an elementary mathematics teacher and describes her beliefs system in terms of Green's (1971) metaphor and provides examples of how her beliefs were enacted in her classroom practices. Dewey's (1933) notion of reflective thinking is used to explain the changes in the structure of the teacher's belief…
Network Structural Influences on the Adoption of Evidence-Based Prevention in Communities
ERIC Educational Resources Information Center
Fujimoto, Kayo; Valente, Thomas W.; Pentz, Mary Ann
2009-01-01
This study examined the impact of key variables in coalition communication networks, centralization and density, on the adoption of evidence-based substance abuse prevention. Data were drawn from a network survey and a corresponding community leader survey that measured leader attitudes and practices toward substance abuse prevention programs. Two…
Preschool Movement Education in Turkey: Perceptions of Preschool Administrators and Parents
ERIC Educational Resources Information Center
Sevimli-Celik, Serap; Kirazci, Sadettin; Ince, Mustafa Levent
2011-01-01
The purpose of this study was to examine the perceptions of preschool administrators and parents about preschool movement education and movement practices in preschools. Participants were 8 preschool administrators and 21 parents from 8 randomly selected private preschools in one of the municipalities in Ankara, Turkey. Semi-structured interviews,…
Ethics Considerations with Diameter Limit-Cutting
Victor L. Ford; Victor L. Ford
2006-01-01
High grading is a poor management practice by definition. It has serious long-term implications to stand structure and function. The use of this management technique creates some ethical dilemmas. By examining the codes of ethics for the Forest Stewards Guild, Association of Consulting Foresters, and Society of American Foresters, only the Society of American Foresters...
Taking It Down: Notetaking Practices of L1 and L2 Students.
ERIC Educational Resources Information Center
Clerehan, Rosemary
1995-01-01
This study examined notes taken by 29 undergraduate native and non-native speakers of English during a lecture on commercial law. It found that native speakers took more detailed notes and more accurately recorded the hierarchical structure and principal elements of the lecture than non-native speakers. (48 references) (MDM)
Information Retrieval System Design Issues in a Microcomputer-Based Relational DBMS Environment.
ERIC Educational Resources Information Center
Wolfram, Dietmar
1992-01-01
Outlines the file structure requirements for a microcomputer-based information retrieval system using FoxPro, a relational database management system (DBMS). Issues relating to the design and implementation of such systems are discussed, and two possible designs are examined in terms of space economy and practicality of implementation. (15…
WhichWayNC: A Model for Mobile Media Development
ERIC Educational Resources Information Center
Clark, Meredith D.
2015-01-01
This student newsroom ethnography examines the emergent culture and values of a group-created news and information content with a mobile-first focus. Using semi-structured interviews from 12 participants working on a mobile-optimized summer news project, the study provides insights on the work practices of the digital student newsroom. Validated…
ERIC Educational Resources Information Center
Welk, Dorette Sugg
2002-01-01
Sophomore nursing students (n=162) examined scenarios depicting typical and atypical signs of heart attack. Examples were structured to include essential and nonessential symptoms, enabling pattern recognition and improved performance. The method provides a way to prepare students to anticipate and recognize life-threatening situations. (Contains…
African American Male Superintendents in Urban School Districts: National Stories of Success
ERIC Educational Resources Information Center
Carrier, Isaac Charles
2017-01-01
The purpose of this study is to examine and interpret the life experiences and leadership practices of four African American male superintendents leading urban school districts across the nation. The research approach adopted in this dissertation used semi-structured interviews with four African American male superintendents that consisted of…
ERIC Educational Resources Information Center
Mordal-Moen, Kjersti; Green, Ken
2014-01-01
This paper examines the place of reflexivity in the "philosophies" and practices of physical education (PE) teacher educators in Norway. Using a case study approach to one quite typical institution delivering physical education teacher education (PETE) in Norway, semi-structured interviews were conducted with 15 teacher educators.…
ERIC Educational Resources Information Center
Ayers, David F.
2015-01-01
Objective: To examine the discursive strategies deployed by community colleges to sustain legitimacy in an evolving and contradictory institutional environment. Method: Using corpus linguistics software, I compared 1,009 mission statements from 2012-2013 with a reference corpus of 427 mission statements from 2004. Results: Keywords analysis,…
ERIC Educational Resources Information Center
Kraft, Matthew A.; Marinell, William H.; Yee, Darrick
2016-01-01
During the last decade, education research and policy have generated considerable momentum behind efforts to remake teacher evaluation systems and place an effective teacher in every classroom. But schools are not simply collections of individual teachers; they are also organizations, with structures, practices, and norms that may impede or…
Organisational Conditions to Boost or Limit Professional Development in the Cypriot Primary School
ERIC Educational Resources Information Center
Loizou, Florentia
2014-01-01
In this article, I examine which organisational conditions can promote or limit the professional development of teachers in the Cypriot primary school. The discussion builds on findings from a study I conducted about Cypriot primary school teachers' reflective practices (Loizou 2011). The study was qualitative and used semi-structured interviews…
ERIC Educational Resources Information Center
Stringfield, Sam
Current theorizing in education, as in industry, is largely devoted to explaining trial-and-error, failure-tolerant, low-reliability organizations. This article examines changing societal demands on education and argues that effective responses to those demands require new and different organizational structures. Schools must abandon industrial…
Ego Boundaries and Attainments in FL Pronunciation
ERIC Educational Resources Information Center
Baran-Lucarz, Malgorzata
2012-01-01
The paper reports on a study designed to examine the relationship between the thickness of ego boundaries and attainments in FL pronunciation after a clearly structured form-focused practical course of phonetics. The research involved 45 first-year students of the Institute of English Studies in Wroclaw, Poland, who had attended around thirty…
ERIC Educational Resources Information Center
Chung, He Len; Steinberg, Laurence
2006-01-01
The present study examined relations among neighborhood structural and social characteristics, parenting practices, peer group affiliations, and delinquency among a group of serious adolescent offenders. The sample of 14-18-year-old boys (N = 488) was composed primarily of economically disadvantaged, ethnic-minority youth living in urban…
A Review of Technical Communication Programs Outside the United States.
ERIC Educational Resources Information Center
Alred, Gerald J.
2001-01-01
Examines technical communication programs outside the United States and comments on such features as their location in the university structure, links with public relations, the inclusion of internships or practicums, the balance of theory and practice, and typical course offerings. Lists a dozen major programs in seven countries. Concludes that…
Culture and Commitment: The Key to the Creation of an Action Learning Organization
ERIC Educational Resources Information Center
Hind, Matthew; Koenigsberger, John
2007-01-01
This article examines the introduction and practice of action learning into a highly volatile, commercial environment. During nine years of action learning projects, the impact on individuals, the action learning sets into which they were formed, the organization and its structure and the organizational culture were evaluated. The article…
A Study of the Subject Headings Practices of Fifteen Small Liberal Arts College Libraries.
ERIC Educational Resources Information Center
Kissel, Laura J.
This research was conducted in order to examine whether libraries are maintaining consistent and complete subject authority control and creating syndetic reference structure for popular topics. A descriptive study of 15 private liberal arts college libraries was conducted to determine whether the Library of Congress (LC) prescribed "see"…
ERIC Educational Resources Information Center
Klockare, Ellinor; Gustafsson, Henrik; Nordin-Bates, Sanna M.
2011-01-01
The aim of this study was to examine how dance teachers work with psychological skills with their students in class. Semi-structured interviews were conducted with six female professional teachers in jazz, ballet and contemporary dance. The interview transcripts were analyzed using interpretative phenomenological analysis (Smith 1996). Results…
ERIC Educational Resources Information Center
Shimura, Takashi
2015-01-01
This paper examines the status and relevant challenges in Japan's primary geography education system, from the perspectives of curriculum and levels of teachers' expertise. Japanese elementary schools adopted the subject Social Studies in the National Curriculum Standards. These emphasize geographical content and the curriculum structure utilizing…
Valued social roles and measuring mental health recovery: examining the structure of the tapestry.
Hunt, Marcia G; Stein, Catherine H
2012-12-01
The complexity of the concept of mental health recovery often makes it difficult to systematically examine recovery processes and outcomes. The concept of social role is inherent within many acknowledged dimensions of recovery such as community integration, family relationships, and peer support and can deepen our understanding of these dimensions when social roles are operationalized in ways that directly relate to recovery research and practice. This paper reviews seminal social role theories and operationalizes aspects of social roles: role investment, role perception, role loss, and role gain. The paper provides a critical analysis of the ability of social role concepts to inform mental health recovery research and practice. PubMed and PsychInfo databases were used for the literature review. A more thorough examination of social role aspects allows for a richer picture of recovery domains that are structured by the concept social roles. Increasing understanding of consumers' investment and changes in particular roles, perceptions of consumers' role performance relative to peers, and consumers' hopes for the future with regards to the different roles that they occupy could generate tangible, pragmatic approaches in addressing complex recovery domains. This deeper understanding allows a more nuanced approach to recovery-related movements in mental health system transformation.
[A Multimedia Tutorial to Train Ultrasonography of the Thyroid for Medical Students].
Ritter, Julia; Wolfram, Maximilian; Schuler, Stefan; Guntinas-Lichius, Orlando
2017-11-01
Physicians in education often have poor experience in practice and assessment of ultrasonography on entering their profession, due to a deficiency of training offers during their study of medicine. Hence, a multimedia device for stepwise learning and training ultrasonography of the thyroid was developed. A software for a portable ultrasonography system was used to design a multimedia device for ultrasonography of the thyroid. It allows the user to illustrate texts and pictorial material simultaneously with ultrasound examination in order to compare own findings with examples from a database. The device was evaluated by 8 medical students and compared to a tutor-guided training. A structured, stepwise manual for ultrasonography of the thyroid with a large content of examples in different sectional images was designed for simultaneous reconstruction with the ultrasonography device. The informative content of the device and the replicability of the examination procedure were evaluated positively. Assessment respecting clarity, eligibility for users without experience and learning success was varying. The tutorial to learn and train ultrasonography of the thyroid is an instrument for self-learning and improving practical education in ultrasonography in medical education. In the next version, the manual for the examination will be structured in greater detail. © Georg Thieme Verlag KG Stuttgart · New York.
Tokunaga, Jin; Takamura, Norito; Ogata, Kenji; Setoguchi, Nao; Sato, Keizo
2013-01-01
Bedside training for fourth-year students, as well as seminars in hospital pharmacy (vital sign seminars) for fifth-year students at the Department of Pharmacy of Kyushu University of Health and Welfare have been implemented using patient training models and various patient simulators. The introduction of simulation-based pharmaceutical education, where no patients are present, promotes visually, aurally, and tactilely simulated learning regarding the evaluation of vital signs and implementation of physical assessment when disease symptoms are present or adverse effects occur. A patient simulator also promotes the creation of training programs for emergency and critical care, with which basic as well as advanced life support can be practiced. In addition, an advanced objective structured clinical examination (OSCE) trial has been implemented to evaluate skills regarding vital signs and physical assessments. Pharmacists are required to examine vital signs and conduct physical assessment from a pharmaceutical point of view. The introduction of these pharmacy clinical skills will improve the efficacy of drugs, work for the prevention or early detection of adverse effects, and promote the appropriate use of drugs. It is considered that simulation-based pharmaceutical education is essential to understand physical assessment, and such education will ideally be applied and developed according to on-site practices.
de Montbrun, Sandra L; Roberts, Patricia L; Lowry, Ann C; Ault, Glenn T; Burnstein, Marcus J; Cataldo, Peter A; Dozois, Eric J; Dunn, Gary D; Fleshman, James; Isenberg, Gerald A; Mahmoud, Najjia N; Reznick, Richard K; Satterthwaite, Lisa; Schoetz, David; Trudel, Judith L; Weiss, Eric G; Wexner, Steven D; MacRae, Helen
2013-12-01
To develop and evaluate an objective method of technical skills assessment for graduating subspecialists in colorectal (CR) surgery-the Colorectal Objective Structured Assessment of Technical Skill (COSATS). It may be reasonable for the public to assume that surgeons certified as competent have had their technical skills assessed. However, technical skill, despite being the hallmark of a surgeon, is not directly assessed at the time of certification by surgical boards. A procedure-based, multistation technical skills examination was developed to reflect a sample of the range of skills necessary for CR surgical practice. These consisted of bench, virtual reality, and cadaveric models. Reliability and construct validity were evaluated by comparing 10 graduating CR residents with 10 graduating general surgery (GS) residents from across North America. Expert CR surgeons, blinded to level of training, evaluated performance using a task-specific checklist and a global rating scale. The mean global rating score was used as the overall examination score and a passing score was set at "borderline competent for CR practice." The global rating scale demonstrated acceptable interstation reliability (0.69) for a homogeneous group of examinees. Both the overall checklist and global rating scores effectively discriminated between CR and GS residents (P < 0.01), with 27% of the variance attributed to level of training. Nine CR residents but only 3 GS residents were deemed competent. The Colorectal Objective Structured Assessment of Technical Skill effectively discriminated between CR and GS residents. With further validation, the Colorectal Objective Structured Assessment of Technical Skill could be incorporated into the colorectal board examination where it would be the first attempt of a surgical specialty to formally assess technical skill at the time of certification.
Kwok, Cannas; Endrawes, Gihane; Lee, Chun Fan
2016-02-01
The aim of the study was to report the psychometric properties of the Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). A convenience sample of 251 Arabic-Australian women was recruited from a number of Arabic community organizations. Construct validity was examined by Cuzick's non-parametric test while Cronbach α was used to assess internal consistency reliability. Explanatory factor analysis was conducted to study the factor structure. The results indicated that the Arabic version of the BCSBQ had satisfactory validity and internal consistency. The Cronbach's alpha of the three subscales ranged between 0.810 and 0.93. The frequency of breast cancer screening practices (breast awareness, clinical breast-examination and mammography) were significantly associated with attitudes towards general health check-up and perceived barriers to mammographic screening. Exploratory factor analysis showed a similar fit for the hypothesized three-factor structure with our data set. The Arabic version of the BCBSQ is a culturally appropriate, valid and reliable instrument for assessing the beliefs, knowledge and attitudes to breast cancer and breast cancer screening practices among Arabic-Australian women. Copyright © 2015 Elsevier Ltd. All rights reserved.
Structured data quality reports to improve EHR data quality.
Taggart, Jane; Liaw, Siaw-Teng; Yu, Hairong
2015-12-01
To examine whether a structured data quality report (SDQR) and feedback sessions with practice principals and managers improve the quality of routinely collected data in EHRs. The intervention was conducted in four general practices participating in the Fairfield neighborhood electronic Practice Based Research Network (ePBRN). Data were extracted from their clinical information systems and summarised as a SDQR to guide feedback to practice principals and managers at 0, 4, 8 and 12 months. Data quality (DQ) metrics included completeness, correctness, consistency and duplication of patient records. Information on data recording practices, data quality improvement, and utility of SDQRs was collected at the feedback sessions at the practices. The main outcome measure was change in the recording of clinical information and level of meeting Royal Australian College of General Practice (RACGP) targets. Birth date was 100% and gender 99% complete at baseline and maintained. DQ of all variables measured improved significantly (p<0.01) over 12 months, but was not sufficient to comply with RACGP standards. Improvement was greatest with allergies. There was no significant change in duplicate records. SDQRs and feedback sessions support general practitioners and practice managers to focus on improving the recording of patient information. However, improved practice DQ, was not sufficient to meet RACGP targets. Randomised controlled studies are required to evaluate strategies to improve data quality and any associated improved safety and quality of care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Following the funding trail: Financing, nurses and teamwork in Australian general practice
2011-01-01
Background Across the globe the emphasis on roles and responsibilities of primary care teams is under scrutiny. This paper begins with a review of general practice financing in Australia, and how nurses are currently funded. We then examine the influence on funding structures on the role of the nurse. We set out three dilemmas for policy-makers in this area: lack of an evidence base for incentives, possible untoward impacts on interdisciplinary functioning, and the substitution/enhancement debate. Methods This three year, multimethod study undertook rapid appraisal of 25 general practices and year-long studies in seven practices where a change was introduced to the role of the nurse. Data collected included interviews with nurses (n = 36), doctors (n = 24), and managers (n = 22), structured observation of the practice nurse (51 hours of observation), and detailed case studies of the change process in the seven year-long studies. Results Despite specific fee-for-service funding being available, only 6% of nurse activities generated such a fee. Yet the influence of the funding was to focus nurse activity on areas that they perceived were peripheral to their roles within the practice. Conclusions Interprofessional relationships and organisational climate in general practices are highly influential in terms of nursing role and the ability of practices to respond to and utilise funding mechanisms. These factors need to be considered, and the development of optimal teamwork supported in the design and implementation of further initiatives that financially support nursing in general practice. PMID:21329506
Chulach, Teresa; Gagnon, Marilou
2016-03-01
Nurse practitioners (NPs), as advanced practice nurses, have evolved over the years to become recognized as an important and growing trend in Canada and worldwide. In spite of sound evidence as to the effectiveness of NPs in primary care and other care settings, role implementation and integration continue to pose significant challenges. This article utilizes postcolonial theory, as articulated by Homi Bhabha, to examine and challenge traditional ideologies and structures that have shaped the development, implementation and integration of the NP role to this day. Specifically, we utilize Bhabha's concepts of third space, hybridity, identity and agency in order to further conceptualize the nurse practitioner role, to examine how the role challenges some of the inherent assumptions within the healthcare system and to explore how development of each to these concepts may prove useful in integration of nurse practitioners within the healthcare system. Our analysis casts light on the importance of a broader, power structure analysis and illustrates how colonial assumptions operating within our current healthcare system entrench, expand and re-invent, as well as mask the structures and practices that serve to impede nurse practitioner full integration and contributions. Suggestions are made for future analysis and research. © 2015 John Wiley & Sons Ltd.
Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szecsenyi, Joachim
2015-04-21
To examine the effectiveness of the quality management programme--European Practice Assessment--in primary care in Switzerland. Longitudinal study with three points of measurement. Primary care practices in Switzerland. In total, 45 of 91 primary care practices completed European Practice Assessment three times. The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: 'infrastructure', 'information', 'finance', and 'quality and safety' to examine changes over time. Significant improvements were found in three of four domains: 'quality and safety' (F=22.81, p<0.01), 'information' (F=27.901, p<0.01) and 'finance' (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01). The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Miner Gearin, Kimberly J; Thrash, Allison M Rick; Frauendienst, Renee; Myhre, Julie; Gyllstrom, M Elizabeth; Riley, William J; Schroeder, Janelle
2012-11-01
Studies have reported a relationship between the organization of public health services and variability in public health practice at the local and state levels. A national research agenda has prioritized practice-based research to understand pathways that lead to this variation and examine the impact of these differences on outcomes. To measure the extent to which Minnesota local health directors report having key authorities and examine the relationship between organizational structure and authority of local health directors. : Multimodal. Minnesota local health departments. Directors of Minnesota local health departments. Director authorities. Most Minnesota local health directors reported having 6 key authorities related to budget preparation and modification and interaction with local elected officials (n = 51, 71%). Twelve directors (16%) reported that they have 4 or fewer of the 6 authorities. The authority most commonly reported as lacking was the authority to initiate communication with locally elected officials (n = 15, 21%). The percentage of directors who reported having all 6 authorities was higher among those in stand-alone departments (82%) than those in combined organizations (50%). This descriptive study illustrates that emerging practice-based research networks can successfully collaborate on small-scale research projects with immediate application for systems development. Study findings are being used by local public health officials to help articulate their role, aid in succession planning, and inform elected officials, who need to consider the public health implications of potential changes to local public health governance and organization. More studies are needed to refine measurement of authority and structure.
Vogel, Daniela; Harendza, Sigrid
2016-01-01
Practical skills are an essential part of physicians' daily routine. Nevertheless, medical graduates' performance of basic skills is often below the expected level. This review aims to identify and summarize teaching approaches of basic practical skills in undergraduate medical education which provide evidence with respect to effective students' learning of these skills. Basic practical skills were defined as basic physical examination skills, routine skills which get better with practice, and skills which are also performed by nurses. We searched PubMed with different terms describing these basic practical skills. In total, 3467 identified publications were screened and 205 articles were eventually reviewed for eligibility. 43 studies that included at least one basic practical skill, a comparison of two groups of undergraduate medical students and effects on students' performance were analyzed. Seven basic practical skills and 15 different teaching methods could be identified. The most consistent results with respect to effective teaching and acquisition of basic practical skills were found for structured skills training, feedback, and self-directed learning. Simulation was effective with specific teaching methods and in several studies no differences in teaching effects were detected between expert or peer instructors. Multimedia instruction, when used in the right setting, also showed beneficial effects for basic practical skills learning. A combination of voluntary or obligatory self-study with multimedia applications like video clips in combination with a structured program including the possibility for individual exercise with personal feedback by peers or teachers might provide a good learning opportunity for basic practical skills.
Vogel, Daniela; Harendza, Sigrid
2016-01-01
Objective: Practical skills are an essential part of physicians’ daily routine. Nevertheless, medical graduates’ performance of basic skills is often below the expected level. This review aims to identify and summarize teaching approaches of basic practical skills in undergraduate medical education which provide evidence with respect to effective students’ learning of these skills. Methods: Basic practical skills were defined as basic physical examination skills, routine skills which get better with practice, and skills which are also performed by nurses. We searched PubMed with different terms describing these basic practical skills. In total, 3467 identified publications were screened and 205 articles were eventually reviewed for eligibility. Results: 43 studies that included at least one basic practical skill, a comparison of two groups of undergraduate medical students and effects on students’ performance were analyzed. Seven basic practical skills and 15 different teaching methods could be identified. The most consistent results with respect to effective teaching and acquisition of basic practical skills were found for structured skills training, feedback, and self-directed learning. Simulation was effective with specific teaching methods and in several studies no differences in teaching effects were detected between expert or peer instructors. Multimedia instruction, when used in the right setting, also showed beneficial effects for basic practical skills learning. Conclusion: A combination of voluntary or obligatory self-study with multimedia applications like video clips in combination with a structured program including the possibility for individual exercise with personal feedback by peers or teachers might provide a good learning opportunity for basic practical skills. PMID:27579364
[Controlling instruments in radiology].
Maurer, M
2013-10-01
Due to the rising costs and competitive pressures radiological clinics and practices are now facing, controlling instruments are gaining importance in the optimization of structures and processes of the various diagnostic examinations and interventional procedures. It will be shown how the use of selected controlling instruments can secure and improve the performance of radiological facilities. A definition of the concept of controlling will be provided. It will be shown which controlling instruments can be applied in radiological departments and practices. As an example, two of the controlling instruments, material cost analysis and benchmarking, will be illustrated.
Bullock, Justin B; Bradford, W David
2016-03-01
Adequate access to primary care is not universally achieved in many countries, including the United States, particularly for vulnerable populations. In this paper we use multiple years of the U.S.-based Community Tracking Survey to examine whether a variety of physician compensation structures chosen by practices influence the likelihood that the practice takes new patients from a variety of different types of insurance. Specifically, we examine the roles of customer satisfaction and quality measures on the one hand, and individual physician productivity measures on the other hand, in determining whether or not firms are more likely to accept patients who have private insurance, Medicare, or Medicaid. In the United States these different types of insurance mechanisms cover populations with different levels of vulnerability. Medicare (elderly and disabled individuals) and Medicaid (low income households) enrollees commonly have lower ability to pay any cost sharing associated with care, are more likely to have multiple comorbidities (and so be more costly to treat), and may be more sensitive to poor access. Further, these two insurers also generally reimburse less generously than private payors. Thus, if lower reimbursements interact with compensation mechanisms to discourage physician practices from accepting new patients, highly vulnerable populations may be at even greater risk than generally appreciated. We control for the potential endogeneity of incentive choice using a multi-level propensity score method. We find that the compensation incentives chosen by practices are statistically and economically significant predictors for the types of new patients that practices accept. These findings have important implications for both policy makers and private health care systems.
Leung, Mei-Kei; Chan, Chetwyn C H; Yin, Jing; Lee, Chack-Fan; So, Kwok-Fai; Lee, Tatia M C
2013-01-01
Previous voxel-based morphometry (VBM) studies have revealed that meditation is associated with structural brain changes in regions underlying cognitive processes that are required for attention or mindfulness during meditation. This VBM study examined brain changes related to the practice of an emotion-oriented meditation: loving-kindness meditation (LKM). A 3 T magnetic resonance imaging (MRI) scanner captured images of the brain structures of 25 men, 10 of whom had practiced LKM in the Theravada tradition for at least 5 years. Compared with novices, more gray matter volume was detected in the right angular and posterior parahippocampal gyri in LKM experts. The right angular gyrus has not been previously reported to have structural differences associated with meditation, and its specific role in mind and cognitive empathy theory suggests the uniqueness of this finding for LKM practice. These regions are important for affective regulation associated with empathic response, anxiety and mood. At the same time, gray matter volume in the left temporal lobe in the LKM experts appeared to be greater, an observation that has also been reported in previous MRI meditation studies on meditation styles other than LKM. Overall, the findings of our study suggest that experience in LKM may influence brain structures associated with affective regulation.
Practice and Age-Related Loss of Adaptability in Sensorimotor Performance
Sosnoff, Jacob J.; Voudrie, Stefani J.
2009-01-01
The purpose of the present investigation was to examine whether the ability to adapt to task constraints is influenced by short-term practice in older adults. Young (18–29 years old) and old (65–75 years old) adults produced force output to a constant force target and a 1-Hz sinusoidal force target by way of the index finger flexion. Participants completed each task 5 times per session for 5 concurrent sessions. The amount and structure of force variability was calculated using linear and nonlinear analyses. As expected, there was a decrease in the magnitude of variability (coefficient of variation) in both tasks and task-related change in the structure of force variability (approximate entropy) with training across groups. The authors found older adults to have a greater amount of variability than their younger counterparts in both tasks. Older adults also demonstrated an increase in the structure of force output in the constant task but a decrease in structure in the sinusoidal task. Age differences in the adaptability to task constraints persisted throughout practice. The authors propose that older adults' ability to adapt sensorimotor output to task demands is not a result of lack of familiarity with the task but that it is, instead, characteristic of the aging process. PMID:19201684
Sandwich Structure Risk Reduction in Support of the Payload Adapter Fitting
NASA Technical Reports Server (NTRS)
Nettles, A. T.; Jackson, J. R.; Guin, W. E.
2018-01-01
Reducing risk for utilizing honeycomb sandwich structure for the Space Launch System payload adapter fitting includes determining what parameters need to be tested for damage tolerance to ensure a safe structure. Specimen size and boundary conditions are the most practical parameters to use in damage tolerance inspection. The effect of impact over core splices and foreign object debris between the facesheet and core is assessed. Effects of enhanced damage tolerance by applying an outer layer of carbon fiber woven cloth is examined. A simple repair technique for barely visible impact damage that restores all compression strength is presented.
Steele, Maureen; Silins, Edmund; Flaherty, Ian; Hiley, Sarah; van Breda, Nick; Jauncey, Marianne
2018-01-01
Wheel-filtration of pharmaceutical opioid tablets is a recognised harm reduction strategy, but uptake of the practice among people who inject drugs is low. The study aimed to: (i) examine perceptions of filtration practices; (ii) provide structured education on wheel-filtration; and (iii) assess uptake of the practice. Frequent opioid tablet injectors (n = 30) attending a supervised injecting facility in Sydney, Australia, received hands-on instruction on wheel-filtration based on recommended practice. Pre-education, post-education and follow-up questionnaires were administered. Wheel-filtration was generally regarded as better than cotton-filtration (the typical method) in terms of perceived effects on health, ease of use and overall drug effect. Sixty-eight percent of those who said they would try wheel-filtration after the education had actually done so. Of those who usually used cotton-filtration, over half (60%) had used wheel-filtration two weeks later. Uptake of safer preparation methods for pharmaceutical opioid tablets increases after structured education in wheel-filtration. Findings suggest that SIFs are an effective site for this kind of education. Supervised injecting facility workers are uniquely positioned to provide harm reduction education at the time of injection. [Steele M, Silins E, Flaherty I, Hiley S, van Breda N, Jauncey M. Uptake of wheel-filtration among clients of a supervised injecting facility: Can structured education work? Drug Alcohol Rev 2018;37:116-120]. © 2017 Australasian Professional Society on Alcohol and other Drugs.
Sonne, Carolin; Vogelmann, Roger; Lesevic, H; Bott-Flügel, Lorenz; Ott, I; Seyfarth, Melchior
2013-01-01
Regular student evaluations at the Technical University Munich indicate the necessity for improvement of the clinical examination course. The aim of this study was to examine if targeted measures to restructure and improve a clinical examination course session lead to a higher level of student satisfaction as well as better self-assessment of the acquired techniques of clinical examination. At three medical departments of the Technical University Munich during the 2010 summer semester, the quantitative results of 49 student evaluations (ratings 1-6, German scholastic grading system) of the clinical examination course were compared for a course before and a course after structured measures for improvement. These measures included structured teaching instructions, handouts and additional material from the Internet. 47 evaluations were completed before and 34 evaluations after the measures for improvement. The measures named above led to a significant improvement of the evaluative ratings in the following areas: short introduction to the topic of each clinical examination course (from 2.4±1.2 to1.7±1.0; p=0.0020) and to basic measures of hygiene (from 3.8±1.9 to 2.5±1.8; p=0.004), structured demonstration of each clinical examination step (from 2.9±1.5 to 1.8±1.0; p=0.001), sufficient practice of each clinical examination step (from 3.1±1.8 to 2.2±1.4; p=0.030) structured feedback on each clinical examination step (from 3.0±1.4 to 2.3±1.0; p=0.0070), use of handouts (from 5.2±1.4 to 1.8±1.4; p<0.001), advice on additional learning material (from 5.0±1.4 to 3.4±2.0; p<0.001), general learning experience (from 2.4±0.9 to 1.9±0.8; p=0.017), and self-assessment of the acquired techniques of clinical examination (from 3.5±1.3 to 2.5±1.1; p<0.01). Structured changes led to significant improvement in the evaluative ratings of a clinical examination course session concerning preparation of the tutors, structure of the course, and confidence in performing physical examinations.
Implementing a Structured Reporting Initiative Using a Collaborative Multistep Approach.
Goldberg-Stein, Shlomit; Walter, William R; Amis, E Stephen; Scheinfeld, Meir H
To describe the successful implementation of a structured reporting initiative in a large urban academic radiology department. We describe our process, compromises, and top 10 lessons learned in overhauling traditional reporting practices and comprehensively implementing structured reporting at our institution. To achieve our goals, we took deliberate steps toward consensus building, undertook multistep template refinement, and achieved close collaboration with the technical staff, department coders, and hospital information technologists. Following institutional review board exemption, we audited radiologist compliance by evaluating 100 consecutive cases of 12 common examination types. Fisher exact test was applied to determine significance of association between trainee initial report drafting and template compliance. We produced and implemented structured reporting templates for 95% of all departmental computed tomography, magnetic resonance, and ultrasound examinations. Structured templates include specialized reports adhering to the American College of Radiology's Reporting and Data Systems (ACR's RADS) recommendations (eg, Lung-RADS and Li-RADS). We attained 94% radiologist compliance within 2 years, without any financial incentives. We provide a blueprint of how to successfully achieve structured reporting using a collaborative multistep approach. Copyright © 2017 Elsevier Inc. All rights reserved.
Determinants of environmental audit frequency: the role of firm organizational structure.
Earnhart, Dietrich; Leonard, J Mark
2013-10-15
This study empirically examines the extent of environmental management practiced by US chemical manufacturing facilities, as reflected in the number of environmental internal audits conducted annually. As its focus, this study analyzes the effects of firm-level organizational structure on facility-level environmental management practices. For this empirical analysis, the study exploits unique data from a survey distributed to all U.S. chemical manufacturing permitted to discharge wastewater in 2001; the data reflect internal audits conducted during the years 1999-2001. Empirical results reveal differences in auditing behavior based on whether facilities are owned by publicly held or non-publicly held firms, owned by U.S.-based or non-U.S.-based firms, and owned by larger or smaller firms. Copyright © 2013 Elsevier Ltd. All rights reserved.
Expedite random structure searching using objects from Wyckoff positions
NASA Astrophysics Data System (ADS)
Wang, Shu-Wei; Hsing, Cheng-Rong; Wei, Ching-Ming
2018-02-01
Random structure searching has been proved to be a powerful approach to search and find the global minimum and the metastable structures. A true random sampling is in principle needed yet it would be highly time-consuming and/or practically impossible to find the global minimum for the complicated systems in their high-dimensional configuration space. Thus the implementations of reasonable constraints, such as adopting system symmetries to reduce the independent dimension in structural space and/or imposing chemical information to reach and relax into low-energy regions, are the most essential issues in the approach. In this paper, we propose the concept of "object" which is either an atom or composed of a set of atoms (such as molecules or carbonates) carrying a symmetry defined by one of the Wyckoff positions of space group and through this process it allows the searching of global minimum for a complicated system to be confined in a greatly reduced structural space and becomes accessible in practice. We examined several representative materials, including Cd3As2 crystal, solid methanol, high-pressure carbonates (FeCO3), and Si(111)-7 × 7 reconstructed surface, to demonstrate the power and the advantages of using "object" concept in random structure searching.
Doctorate of Nursing Practice Students' Impressions of Uses for Visual Thinking Strategies.
Hensel, Desiree; Moorman, Margaret
2017-08-01
Visual Thinking Strategies (VTS) is a structured art-viewing technique designed to teach critical thinking and aesthetic appreciation. Literature on how VTS might be used in nursing is just emerging. This qualitative descriptive study examined written responses to how 14 doctorate of nursing practice students thought they might use VTS in their practice after engaging in a classroom session. Three themes emerged for how nurses might use VTS: Facilitating Interpersonal Relationships, Changing Thinking in Practice, and As a Teaching Tool. This study contributes to the growing body of literature that suggests that art and VTS and can be used in nursing with practitioners of all levels to promote conversations that involve listening intently and considering other possibilities. J Contin Educ Nurs. 2017;48(8):365-368. Copyright 2017, SLACK Incorporated.
Warren, Carol; Visser, Leontine
The local turn in good governance theory and practice responded to critiques of the ineffectiveness of state management and the inequity of privatization alternatives in natural resource management. Confounding expectations of greater effectiveness from decentralised governance, including community-based natural resource management, however, critics argue that expanded opportunities for elite capture have become widely associated with program failures. This overview of theoretical controversies on leadership, patronage and elite capture is part of a themed section in this issue that challenges assumptions across a wide range of current policy literature. It introduces a set of Indonesian case studies that examine practices of local leaders and elites and seek to account in structural terms for appropriations both by ('elite capture') and of ('captured elites') these key figures. These studies explore the structural factors and co-governance practices most likely to promote effective participation of the full spectrum of local interests in pursuit of better local natural resource governance.
Shih, P; Worth, H; Travaglia, J; Kelly-Hanku, A
2017-11-01
In his conceptualisation of pastoral power, Michel Foucault argues that modern healthcare practices derive a specific power technique from pastors of the early Christian church. As experts in a position of authority, pastors practise the care of others through implicitly guiding them towards thoughts and actions that effect self-care, and towards a predefined realm of acceptable conduct, thus having a regulatory effect. This qualitative study of healthcare workers from two Christian faith-based organisations in Papua New Guinea examines the pastoral rationalities of HIV prevention practices which draw together globally circulated modern medical knowledge and Christian teachings in sexual morality for implicit social regulation. Community-based HIV awareness education, voluntary counselling and testing services, mobile outreach, and economic empowerment programs are standardised by promoting behavioural choice and individual responsibility for health. Through pastoral rationalities of care, healthcare practices become part of the social production of negative differences, and condemn those who become ill due to perceived immorality. This emphasis assumes that all individuals are equal in their ability to make behavioural choices, and downplays social inequality and structural drivers of HIV risk that are outside individual control. Given healthcare workers' recognition of the structural drivers of HIV, yet the lack of language and practical strategies to address these issues, political commitment is needed to enhance structural competency among HIV prevention programs and healthcare workers. Copyright © 2017 Elsevier Ltd. All rights reserved.
Hilton, S; Rink, E; Fletcher, J; Sibbald, B; Freeling, P; Szczepura, A; Davies, C; Stilwell, J
1994-01-01
BACKGROUND. The evaluation of near patient testing in British general practice has largely been confined to studies examining individual tests or comparing equipment. AIM. This study set out to determine the attitudes of practice staff to near patient testing, and the extent to which staff undertook quality assessment. METHOD. Four types of near patient testing machines were introduced into 12 general practices in two regions of England, south west Thames and west Midlands. General practitioner and practice nurse attitudes to near patient testing were assessed by semi-structured interview before and six months after the introduction of the machines. The extent to which routine quality assurance procedures were carried out within the surgery and as part of local and national schemes was examined. RESULTS. Although 80% of general practitioners anticipated changing patient management with near patient testing, only two fifths reported having done so after six months. Nurses generally were enthusiastic at the outset, although one third were unhappy about incorporating near patient testing into their work schedules. Time pressure was the most important factor restricting uptake of near patient testing. Nurses performed quality control regularly but complete local external quality assurance procedures were established in only half the practices. All the practices participated in a national scheme for cholesterol assays. CONCLUSION. General practitioners in this study did not find near patient testing a very useful addition to their resources. Pressure on nurses' time was the most frequently reported limitation. PMID:7748669
Final year MBBS students' perception for observed structured clinical examination.
Siddiqui, Faisal Ghani
2013-01-01
To determine perceptions of final year students about observed structured clinical examination (OSCE) and to determine its acceptance among these students. Sequential mixed method design using survey questionnair and in-depth interviews. The study constituted a one-time survey and in-depth interviews conducted over a period of three consecutive days during final year MBBS annual examination at OSCE centre, from April 04, 2010 to April 06, 2010. Three hundred and fifty final year MBBS students, selected through non-probability convenience sampling, were asked to fill the 12-item questionnaire. Three hundred and thirty one students returned the forms. In-depth, structured interviews with 22 students, selected by non-probability purposive sampling, were conducted. The interviews were tape recorded for subsequent transcription. The statistical analysis was done using SPSS 17. The qualitative data was analyzed through content analysis techniques. Three hundred and thirty one final year MBBS students (50.6% females) filled the questionnaire (response rate 94.6%). Fifty three percent respondents agreed that the OSCE tasks were taught during clinical rotations. The experience was stressful for 67.9% respondents. Inadequate prior guidelines, inadequate time for stations, newness of the assessment format and vague instructions were the main causes for stress. Over 70% of the students felt that OSCE helped them identify areas of weakness in their practical and clinical skills; 56.5% felt that the stations dealt with practical skills. Seventy nine percent students were happy with the attitude of the examiners while 19% students felt that the facilitators were uncooperative; failure of the examiners to observe the students during performance of the tasks was the major cause for dissatisfaction. Nearly thirty percent (29.9%) respondent felt that the stations were difficult to understand. Over forty nine percent (49.7%) complained that adequate guidelines were not given prior to the examination. Overall, 67% students were satisfied with this new method of assessment. The overall acceptance of the students for OSCE was low. Reforms such as redesigning of curriculum and learning objectives, training the faculty in conduct of OSCE, involving more external examiners and establishment of a skill's lab would help improve this assessment tool.
Tu, Andrew W; O'Connor, Teresia M; Beauchamp, Mark R; Hughes, Sheryl O; Baranowski, Tom; Mâsse, Louise C
2017-12-01
Parents have the potential to substantively influence their child's physical activity. This study identified the parenting practices of US and Canadian parents to encourage or discourage their 5-12 year-old child's physical activity and to examine differences in parenting practices by country, parental sex, age of child, and income. The sample consisted of 134 US and Canadian parents (54.5% US; 60.4% female) recruited from a web-based panel by a polling firm. The parents answered open-ended questions about what they and other parents do to encourage or discourage their child to be active. Responses were coded using a scheme previously developed to code items used in the published literature. Coded responses were summarized by domain and dimension with differences in responses by country, parental sex, age of child, or household income assessed with a log-linear analysis. The 134 parents provided 649 and 397 responses to ways that parents encourage or discourage their child's physical activity, respectively. Over 70% of responses for practices that encourage physical activity were related to structure of the environment, parental encouragement, and co-participation. The most common response was co-participation in activity with the child. Of the practices that discourage physical activity, 67% were related to structure of the environment, lack of parental control, and modeling poor behaviors. The most common response was allowing screen time. There were no differences in response by country, parental sex, child age, or household income. Parents most often encouraged physical activity through structure and emotional support and discouraged physical activity through lack of structure and control. Understanding how parents influence their child's physical activity may help improve intervention strategies. The current results will inform the development of a physical activity parenting practices instrument.
Dynamic analysis of periodic vibration suppressors with multiple secondary oscillators
NASA Astrophysics Data System (ADS)
Ma, Jiangang; Sheng, Meiping; Guo, Zhiwei; Qin, Qi
2018-06-01
A periodic vibration suppressor with multiple secondary oscillators is examined in this paper to reduce the low-frequency vibration. The band-gap properties of infinite periodic structure and vibration transmission properties of finite periodic structure attached with secondary oscillators with arbitrary degree of freedom are thoroughly analyzed by the plane-wave-expansion method. A simply supported plate with a periodic rectangular array of vibration suppressors is considered. The dynamic model of this periodic structure is established and the equation of harmonic vibration response is theoretically derived and numerically examined. Compared with the simply supported plate without attached suppressors, the proposed plate can obtain better vibration control, and the vibration response can be effectively reduced in several frequency bands owing to the multiple band-gap property. By analyzing the modal properties of the periodic vibration suppressors, the relationship between modal frequencies and the parameters of spring stiffness and mass is established. With the numerical results, the design guidance of the locally resonant structure with multiple secondary oscillators is proposed to provide practical guidance for application. Finally, a practical periodic specimen is designed and fabricated, and then an experiment is carried out to validate the effectiveness of periodic suppressors in the reality. The results show that the experimental band gaps have a good coincidence with those in the theoretical model, and the low-frequency vibration of the plate with periodic suppressors can be effectively reduced in the tuned band gaps. Both the theoretical results and experimental results prove that the design method is effective and the structure with periodic suppressors has a promising application in engineering.
The development and evaluation of a new coding system for medical records.
Papazissis, Elias
2014-01-01
The present study aims to develop a simple, reliable and easy tool enabling clinicians to codify the major part of individualized medical details (patient history and findings of physical examination) quickly and easily in routine medical practice, by entering data to a purpose-built software application, using structure data elements and detailed medical illustrations. We studied medical records of 9,320 patients and we extracted individualized medical details. We recorded the majority of symptoms and the majority of findings of physical examination into the system, which was named IMPACT® (Intelligent Medical Patient Record and Coding Tool). Subsequently the system was evaluated by clinicians, based on the examination of 1206 patients. The evaluation results showed that IMPACT® is an efficient tool, easy to use even under time-pressing conditions. IMPACT® seems to be a promising tool for illustration-guided, structured data entry of medical narrative, in electronic patient records.
Lee, Edmund W J; Shin, Mincheol; Kawaja, Ariffin; Ho, Shirley S
2016-05-01
As knowledge acquisition is an important component of health communication research, this study examines factors associated with Singaporean women's breast cancer knowledge using an augmented cognitive mediation model. We conducted a nationally representative study that surveyed 802 women between the ages of 30 and 70 using random-digit dialing. The results supported the augmented cognitive mediation model, which proposes the inclusion of risk perception as a motivator of health information seeking and structural knowledge as an additional knowledge dimension. There was adequate support for the hypothesized paths in the model. Risk perception was positively associated with attention to newspaper, television, Internet, and interpersonal communication. Attention to the three media channels was associated with interpersonal communication, but only newspaper and television attention were associated with elaboration. Interpersonal communication was positively associated with structural knowledge, whereas elaboration was associated with both factual and structural knowledge. Differential indirect effects between media attention and knowledge dimensions via interpersonal communication and elaboration were found. Theoretical and practical implications are discussed.
Robertson, A; Norén, J G
2001-02-01
Dental trauma in children and adolescents is a common problem, and the prevalence of these injuries has increased in the last 10-20 years. A dental injury should always be considered an emergency and, thus, be treated immediately to relieve pain, facilitate reduction of displaced teeth, reconstruct lost hard tissue, and improve prognosis. Rational therapy depends upon a correct diagnosis, which can be achieved with the aid of various examination techniques. It must be understood that an incomplete examination can lead to inaccurate diagnosis and less successful treatment. Good knowledge of traumatology and models of treatments can also reduce stress and anxiety for both the patient and the dental team. Knowledge-based Systems (KBS) are a practical implementation of Artificial Intelligence. In complex domains which humans find difficult to understand, KBS can assist in making decisions and can also add knowledge. The aim of this paper is to describe the structure of a knowledge-based system for structured examination, diagnosis and therapy for traumatised primary and permanent teeth. A commercially available program was used as developmental tool for the programming (XpertRule, Attar, London, UK). The paper presents a model for a computerised decision support system for traumatology.
Patterson, Fiona; Lievens, Filip; Kerrin, Máire; Munro, Neil; Irish, Bill
2013-01-01
Background The selection methodology for UK general practice is designed to accommodate several thousand applicants per year and targets six core attributes identified in a multi-method job-analysis study Aim To evaluate the predictive validity of selection methods for entry into postgraduate training, comprising a clinical problem-solving test, a situational judgement test, and a selection centre. Design and setting A three-part longitudinal predictive validity study of selection into training for UK general practice. Method In sample 1, participants were junior doctors applying for training in general practice (n = 6824). In sample 2, participants were GP registrars 1 year into training (n = 196). In sample 3, participants were GP registrars sitting the licensing examination after 3 years, at the end of training (n = 2292). The outcome measures include: assessor ratings of performance in a selection centre comprising job simulation exercises (sample 1); supervisor ratings of trainee job performance 1 year into training (sample 2); and licensing examination results, including an applied knowledge examination and a 12-station clinical skills objective structured clinical examination (OSCE; sample 3). Results Performance ratings at selection predicted subsequent supervisor ratings of job performance 1 year later. Selection results also significantly predicted performance on both the clinical skills OSCE and applied knowledge examination for licensing at the end of training. Conclusion In combination, these longitudinal findings provide good evidence of the predictive validity of the selection methods, and are the first reported for entry into postgraduate training. Results show that the best predictor of work performance and training outcomes is a combination of a clinical problem-solving test, a situational judgement test, and a selection centre. Implications for selection methods for all postgraduate specialties are considered. PMID:24267856
Patterson, Fiona; Lievens, Filip; Kerrin, Máire; Munro, Neil; Irish, Bill
2013-11-01
The selection methodology for UK general practice is designed to accommodate several thousand applicants per year and targets six core attributes identified in a multi-method job-analysis study To evaluate the predictive validity of selection methods for entry into postgraduate training, comprising a clinical problem-solving test, a situational judgement test, and a selection centre. A three-part longitudinal predictive validity study of selection into training for UK general practice. In sample 1, participants were junior doctors applying for training in general practice (n = 6824). In sample 2, participants were GP registrars 1 year into training (n = 196). In sample 3, participants were GP registrars sitting the licensing examination after 3 years, at the end of training (n = 2292). The outcome measures include: assessor ratings of performance in a selection centre comprising job simulation exercises (sample 1); supervisor ratings of trainee job performance 1 year into training (sample 2); and licensing examination results, including an applied knowledge examination and a 12-station clinical skills objective structured clinical examination (OSCE; sample 3). Performance ratings at selection predicted subsequent supervisor ratings of job performance 1 year later. Selection results also significantly predicted performance on both the clinical skills OSCE and applied knowledge examination for licensing at the end of training. In combination, these longitudinal findings provide good evidence of the predictive validity of the selection methods, and are the first reported for entry into postgraduate training. Results show that the best predictor of work performance and training outcomes is a combination of a clinical problem-solving test, a situational judgement test, and a selection centre. Implications for selection methods for all postgraduate specialties are considered.
Contradictions and dilemmas within the practice of immigration medicine.
Bisaillon, Laura
2013-01-08
To identify, explore and critique features of how practices associated with immigration medicine are socially organized. Specifically, how the work of designated medical practitioners (DMP) - physicians who conduct immigration medical examinations of prospective immigrants to Canada as contractors to the Canadian government department of Citizenship and Immigration Canada - is organized to occur in interactions with applicants who are diagnosed with the human immunodeficiency virus during the immigration medical examination. Findings from a theoretically informed empirical study using institutional and political activist ethnography inform this article. Data collection and analytic activities spanning 18 months included observational work in institutional settings, textual review, 61 interviews, and 2 focus groups in three Canadian cities. The medical examination of prospective immigrants to Canada is not organized as a therapeutic relation of care and has little to do with medicine per se. The rationale structuring the work of DMPs is actually administrative responsibilities. The work achieved by the DMP positions her/him as a key figure and important decision-maker within the Canadian immigration system. The work of doctors who practice immigration medicine gives rise to contradictions and ethical problems. These are largely unresolvable because of the way in which the labour process in which the DMP is implicated is coordinated. The social organization of immigration doctoring practices has serious consequences for prospective immigrants to Canada, for doctors themselves, and for the Canadian immigration system more broadly.
Seismology in civil engineering
NASA Astrophysics Data System (ADS)
Dvorak, A.
Properties of soils and rocks exposed to vibrations in the practice of civil engineering are examined. Seismic and dynamic field investigations, determination of seismic and dynamic modulus of elasticity, coefficients of damping and absorption are studied. Seismic effects of blasting and of other sources of vibrations on structures and persons, application of rock-noise and dynamic tests of piles are studied.
ERIC Educational Resources Information Center
Lichte, Rainer; And Others
Training in the motor vehicle repair and sales sector in Germany was examined in a study that included the following approaches: review of the sector's structure/characteristics, institutional and social context, employment practices/trends, changes in the type of work and employment/training requirements, and available initial and continuing…
Influence of woodland expansion (1942 to 2000) on the establishment of Phytophthora ramorum
Ross K. Meentemeyer; Nathan E. Rank; Brian L. Anacker; David M. Rizzo; Hall J. Cushman
2008-01-01
Human land-use practices have resulted in dramatic alterations of forest ecosystems worldwide. By modifying transmission pathways and habitat structure, land use changes are being increasingly implicated in the emergence of infectious plant disease. In this research, we examined the effects of human-related land-cover change on the establishment of the invasive plant...
ERIC Educational Resources Information Center
Eubanks, Eugene; Parish, Ralph
The relationship between effective schools research and the cultural aspect of school organizations are examined in this paper. The first part discusses how effective schools projects are designed and implemented as opposed to what is actually practiced. Differences between "tinkering" with existing structures, a strategy to maintain the status…
ERIC Educational Resources Information Center
Portes, Pedro R.; Salas, Spencer
2010-01-01
In this article, we draw from cultural historical theory to examine the assimilationist forces embodied by English as a Second Language (ESOL) identification and programming practices in and outside of Georgia. We argue that the categorization of Spanish-speaking schoolchildren as Limited English Proficient is an extension of historical…
ERIC Educational Resources Information Center
Gregory, Anne; Cornell, Dewey; Fan, Xitao; Sheras, Peter; Shih, Tse-Hua; Huang, Francis
2010-01-01
In this study we examined authoritative discipline theory, which posits that 2 complementary aspects of school climate--structure and support--are important for adolescents' safety in school. Using a statewide sample of over 7,300 ninth-grade students and 2,900 teachers randomly selected from 290 high schools, we showed, using hierarchical linear…
ERIC Educational Resources Information Center
Custable, Wendy
2013-01-01
This research study examines how Illinois public high school Career and Technical Education educational leaders employ best practices in providing all students rigorous, relevant, and equitable learning experiences within a professional learning community structure. This study utilized a mixed method two-tier case study methodology. Tier one…
The Dinosaur in the Classroom: What We Stand to Lose through Ability-Grouping in the Primary School
ERIC Educational Resources Information Center
Marks, Rachel
2014-01-01
Embedding setting (subject-based ability-grouping) into the primary school environment creates structural conflict--physically and culturally--fundamentally changing the nature of primary schools through the imposition of secondary practices and cultures and the loss of pastoral care. This article examines the hidden implications for teachers and…
Negotiating the Rub between Cultures: Teacher Talk and Sustained Shifts in Practice
ERIC Educational Resources Information Center
Meth, Jessica Matthews; Azano, Amy
2012-01-01
This article examines the outcomes of an eight-month professional development initiative, designed to support six Writing Project teachers' classroom inquiry projects, each focused on improving an aspect of student writing. We begin by introducing the genesis of these classroom research projects as well as the structure and content of the support…
Playing the (Sexual) Field: The Interactional Basis of Systems of Sexual Stratification
ERIC Educational Resources Information Center
Green, Adam Isaiah
2011-01-01
Recently, scholars have used a Bourdieusian theory of practice to analyze systems of sexual stratification, including an examination of sexual fields and sexual (or erotic) capital. While the broad structural features of the sexual field have been a point of focus in this latter research, a systematic analysis of the interactional processes that…
The Differential Valuation of Women's Work: A New Look at the Gender Gap in Lawyers' Incomes
ERIC Educational Resources Information Center
Dinovitzer, Ronit; Reichman, Nancy; Sterling, Joyce
2009-01-01
This article seeks to identify the mechanisms underlying the gender wage gap among new lawyers. Relying on nationally representative data to examine the salaries of lawyers working fulltime in private practice, we find a gender gap of about 5 percent. Identifying four mechanisms--work profiles, opportunity paths and structures, credentials, and…
ERIC Educational Resources Information Center
Gyogi, Eiko
2015-01-01
This paper examines how children exercise their agency vis-à-vis their mother's beliefs and practices of bilingualism, especially code-switching, at home and elsewhere. The data were mainly collected through audio-recordings of family conversations both with and without the presence of the researcher and semi-structured interviews conducted during…
Human Resource Development Practices in Russia: A Structured Literature Review
ERIC Educational Resources Information Center
Plakhotnik, Maria S.
2005-01-01
This literature review aimed to investigate the literature on HRD in Russian enterprises, U.S. firms in Russia, or U.S.-Russian joint ventures to determine the role and function of HRD practitioners in creating a successful economic transition. Thirty-three articles were selected through a database search and examined using content analysis. Three…
Nurse Aide Empowerment Strategies and Staff Stability: Effects on Nursing Home Resident Outcomes
ERIC Educational Resources Information Center
Barry, Theresa; Brannon, Diane; Mor, Vincent
2005-01-01
Purpose: This study examines the moderating effect of staff stability on the relationship between management practices used to empower nurse aides and resident outcomes in a multistate sample of nursing homes. An adaptation of Kanter's theory of structural power in organizations guided the framework for the model used in this study. Design and…
ERIC Educational Resources Information Center
Evans, Emily; Ching, Cynthia Carter; Ballard, Heidi L.
2012-01-01
In the following case study, we examine the interplay between self-perception, environmental perception, and the interests and practice of volunteer trail guides who were recruited to provide educational services for visitors to a natural reserve in Northern California. Through semi-structured interviews with 15 guides and observations of training…
ERIC Educational Resources Information Center
Thomas-Brown, Karen A.; Sepetys, Peggy
2011-01-01
This research explores using participant ethnography, the theoretical and practical underpinnings of the combination pedagogical approach of co-teaching and embedded professional development within the Co-teaching Professional Development Approach (CoPD). The structure of this approach is presented and the research findings examine the outcomes of…
The Negro in the Furniture Industry. The Racial Policies of American Industry Series.
ERIC Educational Resources Information Center
Fulmer, William E.
This is the twenty-eighth of a series of studies conducted to determine variances in industrial employment practices of Negroes and to develop appropriate hiring policies. This particular study sought to examine current racial employment policies in the furniture industry within the context of the industry's structure and history. Interviews with…
ERIC Educational Resources Information Center
Cui, Dan
2017-01-01
This article examines the school experiences of Chinese Canadian youth, a population often ignored by the academy under the model minority discourse. Drawing on Bourdieu's theoretical insights, I raise and discuss the concept of teachers' racialised habitus. I explore how teachers' racialised habitus structures their practices of knowledge…
Redefining Our Mission: What Does Higher Education Need from Student Affairs?
ERIC Educational Resources Information Center
Porterfield, Kent T.; Roper, Larry D.; Whitt, Elizabeth J.
2011-01-01
In this article, the authors argue that the relevance of student affairs depends on the will to redefine the mission, structures, and practices to provide the leadership that institutions require. They begin with an overview of challenges to higher education and student affairs, examine the implications of those challenges for student affairs, and…
William G. Luppold; Matthew S. Bumgardner
2018-01-01
Timber harvesting is a major disturbance agent influencing the composition and structure of eastern hardwood forests. To better understand timber harvesting practices, we examined roundwood harvesting patterns in 13 eastern states in the Central, Mid-Atlantic, and Northern regions that contained high proportional volumes of hardwood in their forest inventories. Nearly...
Beijing In-Service Teachers' Self-Efficacy and Attitudes towards Inclusive Education
ERIC Educational Resources Information Center
Malinen, Olli-Pekka; Savolainen, Hannu; Xu, Jiacheng
2012-01-01
Four-hundred-and-fifty-one in-service teachers from the Beijing municipality filled in a questionnaire containing a Teacher Efficacy for Inclusive Practices (TEIP) scale. The aim was to examine the factor structure of the TEIP scale among mainland Chinese in-service teachers, and to investigate the relationship between self-efficacy for inclusive…
The Prevalence of ADHD, ODD, Depression, and Anxiety in a Community Sample of 4-Year-Olds
ERIC Educational Resources Information Center
Lavigne, John V.; LeBailly, Susan A.; Hopkins, Joyce; Gouze, Karen R.; Binns, Helen J.
2009-01-01
Few studies have examined the epidemiology of preschoolers' psychopathology. This study included 796 4-year-old children recruited from schools and pediatric practices in a diverse, urban area. Psychiatric disorder was assessed by a structured interview adapted for preschool children and by questionnaire. The most common disorders were…
ERIC Educational Resources Information Center
Howley, Craig; Howley, Aimee; Telfer, Deborah
2017-01-01
Multimethod study examined the 50 U.S. states' preparation and licensure practices regarding students with low-incidence sensory disabilities (LISD). The researchers used document review and structured interviews with state education agency representatives. It was found that institutions of higher education (IHEs) in 38 states offer at least one…
Good Readers Make Good Historians: "Can We Just Settle It on "a Lot of People Died"?"
ERIC Educational Resources Information Center
Barksdale, Scott T.
2013-01-01
Teachers can engage students in historical thinking by intentionally structuring close reading tasks. This article provides a practical and theoretical examination of the learning and teaching during a 30-minute social studies class in which students studied colonization by reading a primary source text from the Jamestown Colony. Students used…
ERIC Educational Resources Information Center
Cravens, Xiu; Drake, Timothy A.; Goldring, Ellen; Schuermann, Patrick
2017-01-01
Purpose: The purpose of this paper is to study the viability of implementing a protocol-guided model designed to provide structure and focus for teacher collaboration from Shanghai in today's US public schools. The authors examine whether the new model, Teacher Peer Excellence Group (TPEG), fosters the desired key features of productive…
ERIC Educational Resources Information Center
Jones, Stephanie
2012-01-01
Drawing from a larger ethnographic study, this article engages post-structural theories of language and critical feminist theories of social class to examine two fourth-grade, White, working-poor girls' narratives about their urban neighbourhood in the United States. The author argues that young girls should be perceived as social theorists…
Exploring Novice and Experienced Iranian EFL Teachers' Beliefs Representations: A More Vivid Picture
ERIC Educational Resources Information Center
Mehrpour, Saeed; Moghaddam, Meisam
2018-01-01
As part of a larger scale research on teachers' beliefs and practices, the present study examined the categories of pedagogical beliefs of novice and experienced EFL teachers (gleaned from the administration of 'Importance of Pedagogical Knowledge Scale' (IPKS)) and their verbal reports through semi structured interviews and stimulated recall, and…
Durocher, Evelyne; Kinsella, Elizabeth Anne; McCorquodale, Lisa; Phelan, Shanon
2016-09-03
Ethical tensions arise daily in health care practice and are frequently related to health care system structures or policies. Collective case study methodology was adopted to examine ethical tensions reported by occupational therapists practicing in different settings in Southwestern Ontario, Canada. Inductive analysis involving multiple layers of coding was conducted. This article focuses on tensions related to systemic constraints. Participants reported ethical tensions related to balancing client priorities with those of health care services. Four themes related to systemic constraints were identified including imposed practices, ineffective processes, resource limitations, and lack of services. Therapists' aims could be seen to align with an "ethic of care" and were seen to be in tension in light of systemic constraints. The findings raise issues related to occupational justice, particularly related to occupational alienation in occupational therapy practice, and open conversations related to neoliberalist health care agendas. © The Author(s) 2016.
Perceptions of Interdisciplinary Communication Among Correctional Health Care Providers.
Costa, Christine; Lusk, Pamela
2017-01-01
Collaborative practice is a health care standard that improves patient outcomes through maximizing the use of resources and mutual work of all health care providers. Since collaborative practice depends on interdisciplinary communication, effective communication training for health care participants is imperative for success. This article presents the results of research that studied perceptions of interdisciplinary communication and collaborative practice among 24 health care personnel in three correctional facilities in Orange County, California. The research explored different approaches in terms of team structure, mutual support, situation monitoring, leadership, and communication practices. The study used questionnaires to examine the perceptions of teamwork and interdisciplinary communication and how they can be impacted by one educational session. The study results are discussed in terms of modern approaches to health care, including evidence-based practice, along with nationwide initiatives for improving the health of inmates with psychiatric issues.
A nurse-led model of chronic disease management in general practice: Patients' perspectives.
Young, Jacqueline; Eley, Diann; Patterson, Elizabeth; Turner, Catherine
2016-12-01
Evidence suggests that current models of chronic disease management within general practice are not effective in meeting the needs of the community. The objective of this article is to examine patients' perceptions of a nurse-led collaborative model of care trialled in three general practices in Australia. This article reports on the second phase of a mixed-methods study in which semi-structured interviews with purposively selected patients were conducted to elicit information about their perceptions of nurse-led care. Three themes emerged from the data - time, ambiance and dimensions of the nurse role. The results suggest that general practice nurses had a positive impact on patients' ability to manage their chronic disease. This infers that there is scope for general practice nurses to expand their role in chronic disease management to assist patients to better self-manage their chronic diseases.
Parametric Stiffness Control of Flexible Structures
NASA Technical Reports Server (NTRS)
Moon, F. C.; Rand, R. H.
1985-01-01
An unconventional method for control of flexible space structures using feedback control of certain elements of the stiffness matrix is discussed. The advantage of using this method of configuration control is that it can be accomplished in practical structures by changing the initial stress state in the structure. The initial stress state can be controlled hydraulically or by cables. The method leads, however, to nonlinear control equations. In particular, a long slender truss structure under cable induced initial compression is examined. both analytical and numerical analyses are presented. Nonlinear analysis using center manifold theory and normal form theory is used to determine criteria on the nonlinear control gains for stable or unstable operation. The analysis is made possible by the use of the exact computer algebra system MACSYMA.
NASA Technical Reports Server (NTRS)
Gorman, D.; Grant, C.; Kyrias, G.; Lord, C.; Rombach, J. P.; Salis, M.; Skidmore, R.; Thomas, R.
1975-01-01
A sound, practical approach for the assembly and maintenance of very large structures in space is presented. The methods and approaches for assembling two large structures are examined. The maintenance objectives include the investigation of methods to maintain five geosynchronous satellites. The two assembly examples are a 200-meter-diameter radio astronomy telescope and a 1,000-meter-diameter microwave power transmission system. The radio astronomy telescope operates at an 8,000-mile altitude and receives RF signals from space. The microwave power transmission system is part of a solar power satellite that will be used to transmit converted solar energy to microwave ground receivers. Illustrations are included.
Mitchell, Marion L; Henderson, Amanda; Jeffrey, Carol; Nulty, Duncan; Groves, Michele; Kelly, Michelle; Knight, Sabina; Glover, Pauline
2015-05-01
Objective Structured Clinical Examinations (OSCEs) are widely used in health professional education and should be based on sound pedagogical foundations. The aim of this study is to evaluate the feasibility and utility of using Best Practice Guidelines (BPGs) within an OSCE format in a broad range of tertiary education settings with under-graduate and post-graduate nursing and midwifery students. We evaluated how feasible it was to apply the BPGs to modify OSCEs in a course; students' perspective of the OSCE; and finally, if the BPG-revised OSCEs better prepared students for clinical practice when compared with the original OSCEs. A mixed method with surveys, focus groups and semi-structured interviews evaluated the BPGs within an OSCE. Four maximally different contexts across four sites in Australia were used. Participants included lecturers and undergraduate nursing students in high and low fidelity simulation settings; under-graduate midwifery students; and post-graduate rural and remote area nursing students. 691 students participated in revised OSCEs. Surveys were completed by 557 students; 91 students gave further feedback through focus groups and 14 lecturers participated in interviews. At all sites the BPGs were successfully used to modify and implement OSCEs. Students valued the realistic nature of the modified OSCEs which contributed to students' confidence and preparation for clinical practice. The lecturers considered the revised OSCEs enhanced student preparedness for their clinical placements. The BPGs have a broad applicability to OSCEs in a wide range of educational contexts with improved student outcomes. Students and lecturers identified the revised OSCEs enhanced student preparation for clinical practice. Subsequent examination of the BPGs saw further refinement to a set of eight BPGs that provide a sequential guide to their application in a way that is consistent with best practice curriculum design principles. Copyright © 2015 Elsevier Ltd. All rights reserved.
Innovation characteristics and intention to adopt sustainable facilities management practices.
Lee, So Young; Kang, Mihyun
2013-01-01
Sustainable facilities management (SFM) is important because typical buildings consume more resources and energy than necessary, negatively impact the environment and generate lots of waste (US Department of Energy, 2003, Green Buildings). This study examined innovation characteristics that relate to facility managers' intention to adopt SFM practices. Based on the diffusion of innovations theory (Rogers 1962, 1995, Diffusion of Innovations. 4th ed. New York: The Free Press), an SFM innovation and adoption model was proposed. A survey was conducted with a convenience sample of 240 public facilities managers in 25 facilities management divisions in Seoul, Korea, and its metropolitan areas. Structural equation modelling was employed to analyse the data. The results showed that economic advantage and human comfort aspects are predictors for the intention of SFM adoption. Observability is positively relevant to the intention of SFM adoption. Complexity, however, is not a significant predictor for the intention of SFM adoption. Practical implications for sustainable products and systems and the built environment are suggested. To incorporate an innovation like sustainable practices, it is required to meet the needs of potential adopters. Innovation characteristics that influence facility managers' intention to adopt sustainable facilities management were examined. A survey was conducted. Economic advantage, human comfort and observability are predictors for the intention of adoption of sustainable practice.
Aziz, Mirette M; Abd El-Megeed, Hosnia S; Abd Ellatif, Mennat Allah M
2018-04-22
to assess the health seeking practices and their determinants among Umrah pilgrims departing from Assiut international Airport. We interviewed 300 pilgrims departing from Assiut International Airport while they were in the departure lounge, using a semi-structured questionnaire. Only 60%, 46.3% and 46.3% of Umrah pilgrims believed in importance of pre-travel vaccination, seeking health information, and health examination, respectively. The most frequently practiced pre-travel health related behaviour was getting vaccinated (56.3%), as compared to much lower frequencies of seeking health information (24%) or having a clinical health examination (26.7%). Private clinics, internet and the tourism companies were the main sources of health information of the pilgrims. Positive attitude of pilgrims about health seeking practices, the perception of health risk of travelling to Hajj/Umrah and having a chronic disease were the predictors of pre-travel health practices. Raising awareness among Hajj/Umrah pilgrims about the importance of seeking professional pre-travel health advice and communicating the risk of exposure to travel-related diseases to pilgrims could be important strategies to improve the uptake of preventive measures. Training of general practitioners in the public health sector about the travel health information would promote the travel health services. Copyright © 2018. Published by Elsevier Ltd.
Significance of Objective Structured Clinical Examinations to Plastic Surgery Residency Training.
Simmons, Brian J; Zoghbi, Yasmina; Askari, Morad; Birnbach, David J; Shekhter, Ilya; Thaller, Seth R
2017-09-01
Objective structured clinical examinations (OSCEs) have proven to be a powerful tool. They possess more than a 30-year track record in assessing the competency of medical students, residents, and fellows. Objective structured clinical examinations have been used successfully in a variety of medical specialties, including surgery. They have recently found their way into the subspecialty of plastic surgery. This article uses a systematic review of the available literature on OSCEs and their recent use in plastic surgery. It incorporates survey results assessing program directors' views on the use of OSCEs. Approximately 40% of programs surveyed use OSCEs to assess the Accreditation Council for Graduate Medical Education core competencies. We found that 40% use OSCEs to evaluate specific plastic surgery milestones. Objective structured clinical examinations are usually performed annually. They cost anywhere between $100 and more than $1000 per resident. Four milestones giving residents the most difficulties on OSCEs were congenital anomalies, noncancer breast surgery, breast reconstruction, and practice-based learning and improvement. It was determined that challenges with milestones were due to lack of adequate general knowledge and surgical ward patient care, as well as deficits in professionalism and system-based problems. Programs were able to remediate weakness found by OSCEs using a variety of methods. Objective structured clinical examinations offer a unique tool to objectively assess the proficiency of residents in key areas of the Accreditation Council for Graduate Medical Education core competencies. In addition, they can be used to assess the specific milestones that plastic surgery residents must meet. This allows programs to identify and improve identified areas of weakness.
Do quality indicators for general practice teaching practices predict good outcomes for students?
Bartlett, Maggie; Potts, Jessica; McKinley, Bob
2016-07-01
Keele medical students spend 113 days in general practices over our five-year programme. We collect practice data thought to indicate good quality teaching. We explored the relationships between these data and two outcomes for students; Objective Structured Clinical Examination (OSCE) scores and feedback regarding the placements. Though both are surrogate markers of good teaching, they are widely used. We collated practice and outcome data for one academic year. Two separate statistical analyses were carried out: (1) to determine how much of the variation seen in the OSCE scores was due to the effect of the practice and how much to the individual student. (2) to identify practice characteristics with a relationship to student feedback scores. (1) OSCE performance: 268 students in 90 practices: six quality indicators independently influenced the OSCE score, though without linear relationships and not to statistical significance. (2) Student satisfaction: 144 students in 69 practices: student feedback scores are not influenced by practice characteristics. The relationships between the quality indicators we collect for practices and outcomes for students are not clear. It may be that neither the quality indicators nor the outcome measures are reliable enough to inform decisions about practices' suitability for teaching.
The scope of private practice nursing in an Australian sample.
Wilson, Anne; Averis, Andrea; Walsh, Ken
2004-01-01
The changing Australian health care system is creating new opportunities for nurses who work directly with clients in private practice settings. This study examines the scope of practice of a cohort of nurses in private practice. In a questionnaire sent to 106 self-employed nurse entrepreneurs, questions were asked pertaining to the participants' scope of practice, their clients, the types of services offered, and their fee structures. Questions about scope of practice were divided into domains of clinical practice, business consultancy, education, and research. Quantitative and qualitative data were collected for a final sample 54 eligible responses. Participants had been in private practice for an average of 7.6 years (range: 1-20) and reported a mean of 21 years of nursing experience (range: 4-42) before entering private practice. Over half held diplomas in specialty areas. Most participants reported clinical practice, consultancy, or education as the primary work domain; research was much less important as a work activity. Nurses reported difficulties with building client base and receiving adequate fees for service, particularly in clinical practice. Increasing awareness within the nursing profession and health sector about various aspects of private practice nursing could improve service quality for their clients.
Ludt, Sabine; Campbell, Stephen M; Petek, Davorina; Rochon, Justine; Szecsenyi, Joachim; van Lieshout, Jan; Wensing, Michel; Ose, Dominik
2013-03-09
Prevention of cardiovascular diseases (CVD) is a major health issue worldwide. Primary care plays an important role in cardiovascular risk management (CVRM). Guidelines and quality of care measures to assess CVRM in primary care practices are available. In this study, we assessed the relationship between structural and organisational practice characteristics and the quality of care provided in individuals at high risk for developing CVD in European primary care. An observational study was conducted in 267 general practices from 9 European countries. Previously developed quality indicators were abstracted from medical records of randomly sampled patients to create a composite quality measure. Practice characteristics were collected by a practice questionnaire and face to face interviews. Data were aggregated using factor analysis to four practice scores representing structural and organisational practice features. A hierarchical multilevel analysis was performed to examine the impact of practice characteristics on quality of CVRM. The final sample included 4223 individuals at high risk for developing CVD (28% female) with a mean age of 66.5 years (SD 9.1). Mean indicator achievement was 59.9% with a greater variation between practices than between countries. Predictors at the patient level (age, gender) had no influence on the outcome. At the practice level, the score 'Preventive Services' (13 items) was positively associated with clinical performance (r = 1.92; p = 0.0058). Sensitivity analyses resulted in a 5-item score (PrevServ_5) that was also positively associated with the outcome (r = 4.28; p < 0.0001). There was a positive association between the quality of CVRM in individuals at high risk for developing CVD and the availability of preventive services related to risk assessment and lifestyle management supported by information technology.
2013-01-01
Background Prevention of cardiovascular diseases (CVD) is a major health issue worldwide. Primary care plays an important role in cardiovascular risk management (CVRM). Guidelines and quality of care measures to assess CVRM in primary care practices are available. In this study, we assessed the relationship between structural and organisational practice characteristics and the quality of care provided in individuals at high risk for developing CVD in European primary care. Methods An observational study was conducted in 267 general practices from 9 European countries. Previously developed quality indicators were abstracted from medical records of randomly sampled patients to create a composite quality measure. Practice characteristics were collected by a practice questionnaire and face to face interviews. Data were aggregated using factor analysis to four practice scores representing structural and organisational practice features. A hierarchical multilevel analysis was performed to examine the impact of practice characteristics on quality of CVRM. Results The final sample included 4223 individuals at high risk for developing CVD (28% female) with a mean age of 66.5 years (SD 9.1). Mean indicator achievement was 59.9% with a greater variation between practices than between countries. Predictors at the patient level (age, gender) had no influence on the outcome. At the practice level, the score ‘Preventive Services’ (13 items) was positively associated with clinical performance (r = 1.92; p = 0.0058). Sensitivity analyses resulted in a 5-item score (PrevServ_5) that was also positively associated with the outcome (r = 4.28; p < 0.0001). Conclusions There was a positive association between the quality of CVRM in individuals at high risk for developing CVD and the availability of preventive services related to risk assessment and lifestyle management supported by information technology. PMID:23510482
Use of an Objective Structured Clinical Examination in Clinical Nurse Specialist Education.
Cuevas, Heather E; Timmerman, Gayle M
2016-01-01
Helping patients maximize their potential using expert coaching to facilitate lifestyle change is an important practice area for clinical nurse specialists (CNSs). The purpose is to determine the usefulness of objective structured clinical examinations (OSCEs) for evaluating CNS students' coaching competencies in the context of facilitating lifestyle change. Despite the use of OSCEs to assess competencies in clinical skills (eg, performance of procedures, decision making), its potential for evaluating coaching competencies for lifestyle change has not been demonstrated. We developed 4 OSCEs dealing with coaching patients in exercise, weight loss, stress reduction, or nonpharmacologic management of hyperlipidemia. Evaluation criteria included (1) approach to the patient, (2) information gathering, (3) motivational interviewing, and (4) management (medical and behavioral strategies). Student performance ranged from highly organized with proficient coaching skills to disorganized and focused solely on clinical management and prescriptive communication. Student responses were positive. Objective structured clinical examinations were highly useful for evaluating CNS students' coaching competencies for lifestyle change. Using OSCEs early in the semester to provide students feedback on their performance and again at the end to determine improvement optimizes use of this teaching strategy.
Ellerton, Cindy; Evans, Cathy
2015-01-01
ABSTRACT Purpose: To identify professional behaviours measured in objective structured clinical examinations (OSCEs) by Canadian university physical therapy (PT) programs. Method: A cross-sectional telephone survey was conducted to review current practice and determine which OSCE items Canadian PT programs are using to measure PT students' professional behaviours. Telephone interviews using semi-structured questions were conducted with individual instructors responsible for courses that included an OSCE as part of the assessment component. Results: Nine PT programmes agreed to take part in the study, and all reported conducting at least one OSCE. The number and characteristics of OSCEs varied both within and across programs. Participants identified 31 professional behaviour items for use in an OSCE; these items clustered into four categories: communication (n=14), respect (n=10), patient safety (n=4), and physical therapists' characteristics (n=3). Conclusions: All Canadian entry-level PT programmes surveyed assess professional behaviours in OSCE-type examinations; however, the content and style of assessment is variable. The local environment should be considered when determining what professional behaviours are appropriate to assess in the OSCE context in individual programmes. PMID:25931656
Fiery Spirits in the context of institutional entrepreneurship in Swedish healthcare.
Eriksson, Nomie; Ujvari, Sandor
2015-01-01
Clinical governance and leadership concepts can lead to more or less successful implementations of new clinical practice. The purpose of this paper is to examine how Fiery Spirits, as institutional entrepreneurs can, working in a team, implement sustained change in hospital clinical practice. This paper describes two case studies, conducted at two Swedish hospitals over a period of two years, in which changes in clinical practice were implemented. In both cases, key-actors, termed Fiery Spirits, played critical roles in these changes. The authors use a qualitative approach and take an intra-organizational perspective with semi-structured in-depth interviews and document analysis. The new clinical practices were successfully implemented with a considerable influence of the Fiery Spirits who played a pivotal role in the change efforts. The Fiery Spirits persuasively, based on their structural and normative legitimacy and the adoption of learning processes, advocated, and supported change. Fiery Spirits, given flexibility and opportunity, can be powerful forces for change outside the trajectory of management-inspired and management-directed change. Team members, when inspired and encouraged by Fiery Spirits, are less resistant to change and more willing to test new clinical practices. The paper complements literature on how the Fiery Spirit concept aligns with concepts of clinical governance and leadership and how change can be achieved. Additionally, the findings show the effects of legitimacy and learning processes on change in clinical practice.
Rohan, Zdeněk; Matěj, Radoslav
2015-01-01
Brain and spinal cord autopsies aimed at neuropathological diagnosis of the causes of dementia and motor abnormalities are of increasing importance. Neuropathological brain examination is often the only diagnostic modality capable of definitive diagnosis of a neurodegenerative disease and thus serves as invaluable feedback for clinicians and biochemical and imaging diagnostics. The brain and spinal cord autopsy is performed following a standardized protocol and its goal is to sample all diagnostically relevant structures. Subsequent diagnostics are then done using standard and special histologic stainings, however state-of-the-art diagnostics can be achieved only using immunohistochemical methods. The purpose of the article is to provide the pathologists with a brief and practical guideline for brain and spinal cord autopsy when diagnosis of a neurodegenerative disease is suspected.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Willenbrock, J.H.; Thomas, H.R. Jr.; Burati, J.J. Jr.
1978-12-01
A summary of two reports, COO/4120-1 and COO/4120-2, is given. A comparative analysis was made of the Quality Assurance practices related to the structural concrete phase on nine nuclear and three fossil fuel power plant projects which are (or have been) under construction in the United States in the past ten years. For the nuclear projects the analysis identified the response of each Quality Assurance program to the applicable criteria of 10 CFR Part 50, Appendix B as well as to the pertinent regulatory requirements and industry standards. For the fossil projects the analysis identified the response of each Qualitymore » Assurance program to criteria similar to those which were applicable in the nuclear situation. The major emphasis was placed on the construction aspects of the structural concrete phase of each project. The engineering and design aspects were examined whenever they interfaced with the construction aspects.« less
Altered Resting Brain Function and Structure in Professional Badminton Players
Di, Xin; Zhu, Senhua; Wang, Pin; Ye, Zhuoer; Zhou, Ke; Zhuo, Yan
2012-01-01
Abstract Neuroimaging studies of professional athletic or musical training have demonstrated considerable practice-dependent plasticity in various brain structures, which may reflect distinct training demands. In the present study, structural and functional brain alterations were examined in professional badminton players and compared with healthy controls using magnetic resonance imaging (MRI) and resting-state functional MRI. Gray matter concentration (GMC) was assessed using voxel-based morphometry (VBM), and resting-brain functions were measured by amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity. Results showed that the athlete group had greater GMC and ALFF in the right and medial cerebellar regions, respectively. The athlete group also demonstrated smaller ALFF in the left superior parietal lobule and altered functional connectivity between the left superior parietal and frontal regions. These findings indicate that badminton expertise is associated with not only plastic structural changes in terms of enlarged gray matter density in the cerebellum, but also functional alterations in fronto-parietal connectivity. Such structural and functional alterations may reflect specific experiences of badminton training and practice, including high-capacity visuo-spatial processing and hand-eye coordination in addition to refined motor skills. PMID:22840241
CPD Aligned to Competency Standards to Support Quality Practice
Nash, Rose; Thompson, Wendy; Stupans, Ieva; Lau, Esther T. L.; Santos, Jose Manuel Serrano; Brown, Natalie; Nissen, Lisa M.; Chalmers, Leanne
2017-01-01
As medication experts, pharmacists are key members of the patient’s healthcare team. Pharmacists must maintain their competence to practice to remain responsive to the increasingly complex healthcare sector. This paper seeks to determine how competence training for pharmacists may enhance quality in their professional development. Results of two separately administered surveys (2012 and 2013) were compared to examine the reported continued professional development (CPD) practices of Australian pharmacists. Examination of results from both studies enabled a focus on how the competency standards inform CPD practice. In the survey administered in 2012, 91% (n = 253/278) pharmacists reported that they knew their current registration requirements. However, in the survey administered in 2013, only 43% (n = 46/107) reported utilization of the National Competency Standards Framework for Pharmacists in Australia (NCS) to self-asses their practice as part of their annual re-registration requirements. Fewer, 23% (n = 25/107), used the NCS to plan their CPD. This may be symptomatic of poor familiarity with the NCS, uncertainty around undertaking self-directed learning as part of a structured learning plan and/or misunderstandings around what CPD should include. This is supported by thematic analysis of pharmacists’ social media comments. Initial and ongoing competence training to support meaningful CPD requires urgent attention in Australia. The competence (knowledge, skills and attributes) required to engage in meaningful CPD practice should be introduced and developed prior to entry into practice; other countries may find they are in a similar position. PMID:28970424
CPD Aligned to Competency Standards to Support Quality Practice.
Nash, Rose; Thompson, Wendy; Stupans, Ieva; Lau, Esther T L; Santos, Jose Manuel Serrano; Brown, Natalie; Nissen, Lisa M; Chalmers, Leanne
2017-02-25
As medication experts, pharmacists are key members of the patient's healthcare team. Pharmacists must maintain their competence to practice to remain responsive to the increasingly complex healthcare sector. This paper seeks to determine how competence training for pharmacists may enhance quality in their professional development. Results of two separately administered surveys (2012 and 2013) were compared to examine the reported continued professional development (CPD) practices of Australian pharmacists. Examination of results from both studies enabled a focus on how the competency standards inform CPD practice.In the survey administered in 2012, 91% ( n = 253/278) pharmacists reported that they knew their current registration requirements. However, in the survey administered in 2013, only 43% ( n = 46/107) reported utilization of the National Competency Standards Framework for Pharmacists in Australia (NCS) to self-asses their practice as part of their annual re-registration requirements. Fewer, 23% ( n = 25/107), used the NCS to plan their CPD. This may be symptomatic of poor familiarity with the NCS, uncertainty around undertaking self-directed learning as part of a structured learning plan and/or misunderstandings around what CPD should include. This is supported by thematic analysis of pharmacists' social media comments. Initial and ongoing competence training to support meaningful CPD requires urgent attention in Australia. The competence (knowledge, skills and attributes) required to engage in meaningful CPD practice should be introduced and developed prior to entry into practice; other countries may find they are in a similar position.
Miedema, Baukje; Easley, Julie; Thompson, Ashley E; Boivin, Antoine; Aubrey-Bassler, Kris; Katz, Alan; Hogg, William E; Breton, Mylaine; Francoeur, Danièle; Wong, Sabrina T; Wodchis, Walter P
2016-01-01
To examine access to primary care in new and traditional models using 2 dimensions of the concept of patient-centred access. An international survey examining the quality and costs of primary health care (the QUALICOPC study) was conducted in 2013 in Canada. This study adopted a descriptive cross-sectional survey method using data from practices across Canada. Each participating practice filled out the Family Physician Survey and the Practice Survey, and patients in each participating practice were asked to complete the Patient Experiences Survey. All 10 Canadian provinces. A total of 759 practices and 7172 patients. Independent t tests were conducted to examine differences between new and traditional models of care in terms of availability and accommodation, and affordability of care. Of the 759 practices, 407 were identified as having new models of care and 352 were identified as traditional. New models of care were distinct with respect to payment structure, opening hours, and having an interdisciplinary work force. Most participating practices were from large cities or suburban areas. There were few differences between new and traditional models of care regarding accessibility and accommodation in primary care. Patients under new models of care reported easier access to other physicians in the same practice, while patients from traditional models reported seeing their regular family physicians more frequently. There was no difference between the new and traditional models of care with regard to affordability of primary care. Patients attending clinics with new models of care reported that their physicians were more involved with them as a whole person than patients attending clinics based on traditional models did. Primary care access issues do not differ strongly between traditional and new models of care; however, patients in the new models of care believed that their physicians were more involved with them as people.
Frazer, Kate; Connolly, Michael; Naughton, Corina; Kow, Veronica
2014-07-01
Facilitating and supporting clinical learning for student nurses and midwives are essential within their practice environments. Clinical placements provide unique opportunities in preparation for future roles. Understanding the experiences of first year student nurses and midwives following clinical exposures and examining the clinical facilitators and barriers can assist in maintaining and developing clinical supports. The study used a structured group feedback approach with a convenience sample of 223 first year nursing and midwifery students in one Irish university in April 2011 to ascertain feedback on the clinical aspects of their degree programme. Approximately 200 students participated in the process. Two key clinical issues were identified by students: facilitating clinical learning and learning experiences and needs. Positive learning environments, supportive staff and increased opportunities for reflection were important issues for first year students. The role of supportive mentoring staff in clinical practice is essential to enhance student learning. Students value reflection in practice and require more opportunities to engage during placements. More collaborative approaches are required to ensure evolving and adapting practice environments can accommodate student learning. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kellett, Peter; Fitton, Chantelle
2017-01-01
Many nursing education programs deserve a failing grade with respect to supporting gender diversity in their interactions with their students and in terms of the curricular content directed toward engaging in the safe and supportive nursing care of transgender clients. This situation contributes to transinvisibility in the nursing profession and lays a foundation for nursing practice that does not recognize the role that gender identity plays in the health and well-being of trans-clients and trans-nurses. This article seeks to raise readers' awareness about the problems inherent to transinvisibility and to propose several curricular and structural-level interventions that may serve to gradually increase the recognition of gender diversity in the planning and delivery of nursing education and practice. Contextualized in gender and intersectionality theory, cultural safety is presented as a viable and appropriate framework for engaging in these upstream approaches to addressing gender diversity in nursing education and practice. Among the structural interventions proposed are as follows: inclusive information systems, creation of gender neutral and safe spaces, lobbying for inclusion of competencies that address care of trans-persons in accreditation standards and licensure examinations and engaging in nursing research in this area. © 2016 John Wiley & Sons Ltd.
Block-structured grids for complex aerodynamic configurations: Current status
NASA Technical Reports Server (NTRS)
Vatsa, Veer N.; Sanetrik, Mark D.; Parlette, Edward B.
1995-01-01
The status of CFD methods based on the use of block-structured grids for analyzing viscous flows over complex configurations is examined. The objective of the present study is to make a realistic assessment of the usability of such grids for routine computations typically encountered in the aerospace industry. It is recognized at the very outset that the total turnaround time, from the moment the configuration is identified until the computational results have been obtained and postprocessed, is more important than just the computational time. Pertinent examples will be cited to demonstrate the feasibility of solving flow over practical configurations of current interest on block-structured grids.
Wong, H S
1996-04-01
This paper applies Panzar and Rosse's (1987) econometric test of market structure to examine two long-debated issues: What is the market structure for physician services? Do more physicians in a market area raise the search cost of obtaining consumer information and increase prices (Satterthwaite, 1979, 1985)? For primary care and general and family practice physicians, the monopolistically competitive model prevailed over the competing hypotheses--monopoly, perfect competition, and monopolistic competition characterized by consumer informational confusion. Although less conclisive, there is some evidence to support the monopolistically competitive model for surgeons and the consumer informational confusion model for internal medicine physicians.
Odoms-Young, Angela; Bruce, Marino A
Food insecurity is defined as "a household-level economic and social condition of limited or uncertain access to adequate food." While, levels of food insecurity in the United States have fluctuated over the past 20 years; disparities in food insecurity rates between people of color and whites have continued to persist. There is growing recognition that discrimination and structural racism are key contributors to disparities in health behaviors and outcomes. Although several promising practices to reduce food insecurity have emerged, approaches that address structural racism and discrimination may have important implications for alleviating racial/ethnic disparities in food insecurity and promoting health equity overall.
Beckers, Stefan K; Timmermann, Arnd; Müller, Michael P; Angstwurm, Matthias; Walcher, Felix
2009-05-12
Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6). Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education in emergency medical care.
Disorders of the neonatal nasal cavity: Fundamentals for practice.
Sohal, Maheep; Schoem, Scott R
2016-08-01
Neonatal nasal obstruction is a well-known clinical entity. Fortunately, it is rarely life-threatening and usually resolves with conservative management. As with most conditions, a systematic history and thorough physical examination are crucial for correct diagnosis and management. The initial diagnosis may be elusive and require either serial or more in-depth evaluations. Occasionally, examination may reveal structural abnormalities necessitating surgical intervention. Fortunately most of these abnormalities are amenable to surgery; however, a select few are notoriously difficult to treat. Copyright © 2016. Published by Elsevier Ltd.
Managed care strategy for mental health services.
Jones, A
In the UK, managed care is beginning to be recognized as a cost effective, quality-driven system which can be used to structure patient care. This article examines the potential use of managed care pathways in mental health services, focusing on clients with schizophrenia. The strengths of managed care include the effective coordination of healthcare resources, the clear accountable audit of mental health practice and the re-engineering of mental health practice to improve patient outcomes. Problems in designing representative care pathways and encouraging healthcare providers to implement care pathways are some of the disadvantages of this system.
[Work in medicine: some issues concerning professional autonomy].
Schraiber, L B
1995-01-01
The author analyzes several issues pertaining to medical practice as related to the technical autonomy characterizing professional activity in this field. She points to the coexistente of a scientific side and an empirical/pragmatic side of medicine, the latter known as the medical art. The article also discusses the complexity of medical command of technological rationality which presides over the practical use of scientific knowledge. The author defines work in medicine as a "tensive structure" and examines its consequences for self-representation by physicians, their daily work, and themselves as agents of professional labor and subjects of action.
Pilot study of six Colorado dental hygiene independent practices.
Astroth, D B; Cross-Poline, G N
1998-01-01
The purpose of this pilot study was to gather demographic data about six Colorado dental hygienists who were practicing independently and their practices as well as assess productivity and service mix, evaluate structure and process, and compare the findings in these practices to those of a study of California Health Manpower Pilot Project #139. A convenience sample of six dental hygiene independent practices was studied. A 21-item survey was distributed by mail to obtain demographic and practice information. Weekly surveys tracking patient visits and services provided were completed for three months. A general office audit to evaluate structure and a record audit of 22 patient records to evaluate process were conducted during visits at each practice site. The overall responses for each phase of this study were tabulated and frequencies were calculated using the SPSS/PC+ statistical package. The dental hygienists had practiced for an average of 13 years prior to establishing their practices. Four of the six practices were office-based, one was institution-based, and one was office- and institution-based. Health history, extraoral/intraoral examination, periodontal probing, adult prophylaxis, and oral hygiene instruction were provided during a majority of patient visits. The general office audit revealed compliance with infection control, office protocols for emergency situations, and practice management protocols. The patient record audit indicated a high standard for process of care for the practice sites. The six practices revealed a variety of backgrounds among the dental hygienists and diverse practice characteristics regarding both the populations served and practice settings. The services provided were consistent with allowable services for unsupervised practice. Compliance with specific guidelines was verified during the general office and patient record audits. Consistent with the findings of California Health Manpower Pilot Project #139, the care provided by the Colorado dental hygiene independent practitioners in this study and the environment in which the care was provided do not exhibit any undue risk to the health and safety of the public.
Knight, Danica K; Joe, George W; Morse, David T; Smith, Corey; Knudsen, Hannah; Johnson, Ingrid; Wasserman, Gail A; Arrigona, Nancy; McReynolds, Larkin S; Becan, Jennifer E; Leukefeld, Carl; Wiley, Tisha R A
2018-05-18
This study examines associations among organizational context, staff attributes, perceived importance, and use of best practices among staff in community-based, juvenile justice (JJ) agencies. As part of the National Institute on Drug Abuse's Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, 492 staff from 36 JJ agencies were surveyed about the perceived importance and use of best practices within their organization in five substance use practice domains: screening, assessment, standard referral, active referral, and treatment support. Structural equation models indicated that supervisory encouragement and organizational innovation/flexibility were associated with greater individual adaptability. Adaptability (willingness to try new ideas, use new procedures, adjust quickly to change), was positively correlated with importance ratings. Importance ratings were positively associated with reported use of best practices. Organizational climates that support innovation likely affect use of practices through staff attributes and perceptions of the importance of such services.
Aiba, Eriko; Matsui, Toshie
2016-01-01
This study investigated the relationship between the ability to sight-read and the ability to memorize a score using a behavioral experiment. By measuring the amount of memorization following short-term practice, we examined whether better sight-readers not only estimate forthcoming notes but also memorize musical structures and phrases with more practice. Eleven pianists performed the music first by sight-reading. After a 20-minute practice, the participants were asked to perform from memory without any advance notice. The number of mistakes was used as an index of performance. There were no correlations in the numbers of mistakes between sight-reading and memory trial performance. Some pianists memorized almost the entire score, while others hardly remembered it despite demonstrating almost completely accurate performance just before memory trial performance. However, judging from the participants' responses to a questionnaire regarding their practice strategies, we found auditory memory was helpful for memorizing music following short-term practice.
Aiba, Eriko; Matsui, Toshie
2016-01-01
This study investigated the relationship between the ability to sight-read and the ability to memorize a score using a behavioral experiment. By measuring the amount of memorization following short-term practice, we examined whether better sight-readers not only estimate forthcoming notes but also memorize musical structures and phrases with more practice. Eleven pianists performed the music first by sight-reading. After a 20-minute practice, the participants were asked to perform from memory without any advance notice. The number of mistakes was used as an index of performance. There were no correlations in the numbers of mistakes between sight-reading and memory trial performance. Some pianists memorized almost the entire score, while others hardly remembered it despite demonstrating almost completely accurate performance just before memory trial performance. However, judging from the participants’ responses to a questionnaire regarding their practice strategies, we found auditory memory was helpful for memorizing music following short-term practice. PMID:27242576
Medical Home Implementation: A Sensemaking Taxonomy of Hard and Soft Best Practices
Hoff, Timothy
2013-01-01
Context The patient-centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care. Methods I used a multicase, comparative study design that relied on a sensemaking approach and fifty-one in-depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care. Findings I found two distinct taxonomies of implementation best practices, which I labeled “hard” and “soft” because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices. Conclusions The results suggest that there may be no standardized, one-size-fits-all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on building structural supports for medical home work. Further study of these softer implementation practices and a continued call for qualitative methodological approaches that gain insight into everyday practice behavior are warranted. PMID:24320169
Karthaus, Anne; Schmidt, Anita
2016-01-01
In preparation for the state examination, many students have open questions and a need for advice. Tutors of the Skills Lab PERLE-"Praxis ERfahren und Lernen" (experiencing and learning practical skills) have developed a new course concept to provide support and practical assistance for the examinees. The course aims to familiarize the students with the exam situation in order to gain more confidence. This enables the students to experience a confrontation with the specific situation of the exam in a protected environment. Furthermore, soft skills are utilized and trained. Concept of the course: The course was inspired by the OSCE-model (Objective Structured Clinical Examination), an example for case-based learning and controlling. Acquired knowledge can be revised and extended through the case studies. Experienced tutors provide assistance in discipline-specific competencies, and help in organizational issues such as dress code and behaviour. Evaluation of the course: An evaluation was conducted by the attending participants after every course. Based on this assessment, the course is constantly being developed. In March, April and October 2015 six courses, with a total of 84 participants, took place. Overall 76 completed questionnaires (91%) were analysed. Strengths of the course are a good tutor-participants-ratio with 1:4 (1 Tutor provides guidance for 4 participants), the interactivity of the course, and the high flexibility in responding to the group's needs. Weaknesses are the tight schedule, and the currently not yet performed evaluation before and after the course. In terms of "best practise", this article shows an example of how to offer low-cost and low-threshold preparation for the state examination.
Burns, L R; Robinson, J C
1997-01-01
Physician practice management companies (PPMCs) are one of the most visible entrants into the industry of managing physician practices, and anywhere from 100-150 are already in operation. Although PPMCs and hospital-based integrated delivery systems (IDSs) differ from each other in many ways, they share a number of common features, including the pursuit of capitation contracts from payors. As a result, PPMCs pose a growing, direct threat to hospital systems in competing for managed care contracts that cover physician service. PPMCs also provide an alternative to hospital-based IDSs at the local market level for physician group consolidation. This article looks at the structure, operation, and strategy of PPMCs and examines what implications their growth will have for hospital-based IDSs.
"Where can I be deported?" Thinking through the "Foreigner Fetish" in Namibia.
Lorway, Robert
2008-01-01
In "Thinking through the Foreigner Fetish," I examine the safer sex difficulties that form unevenly around class, gender, and ethniciy for a communiy of Namibian township youth involved in a transnationally-mediated queer rights movement. Post-structural notions of "desire" are employed in this article to re-orient poliical economic frameworks that consider "the body" in sex tourism in Marxists terms of "commodification" and "alienation." Through ethnographic account, I emphasize the practices through which local actors reflect on the value and authenticiy of their "self" in relation to the "global gay Other." By examining the moral economies of selfhood generated wihin the relationships between local and foreign males, I attempt to move discussions of "sex tourism" and "HIV-vulnerabiliy" beyond binary notions of "structure" and "agency."
ERIC Educational Resources Information Center
Bogo, Marion; Lee, Barbara; McKee, Eileen; Ramjattan, Roxanne; Baird, Stephanie L.
2017-01-01
To strengthen students' preparation for engaging in field learning, an innovation was implemented to teach and assess foundation-year students' performance prior to entering field education. An Objective Structured Clinical Examination informed the final evaluation of students' performance in two companion courses on practice theory and skills.…
ERIC Educational Resources Information Center
Suzuki, Yuichi
2017-01-01
This study examined optimal learning schedules for second language (L2) acquisition of a morphological structure. Sixty participants studied the simple and complex morphological rules of a novel miniature language system so as to use them for oral production. They engaged in four training sessions in either shorter spaced (3.3-day interval) or…
ERIC Educational Resources Information Center
Pulford, Justin; Black, Stella; Wheeler, Amanda; Sheridan, Janie; Adams, Peter
2010-01-01
This paper examines the post-treatment support practices, attitudes and preferences of outpatient alcohol and other drug (AOD) treatment staff as well as perceived barriers to implementing a post-treatment support service in an outpatient AOD treatment context. Data were collected via semi-structured interview and group discussion (n = 23).…
ERIC Educational Resources Information Center
Sanjakdar, Fida
2009-01-01
This paper reports on a study that examines how a group of teachers at a Victorian Islamic College deliberated on how to develop an appropriate sexual health education curriculum for their Muslim students. Teachers found themselves challenged by the current restrictive curriculum structures, policies and practices at their school. They also found…
ERIC Educational Resources Information Center
Marynchenko, Yevhenii
2017-01-01
The article examines the main approaches to content, forms and methods of training future teachers of vocational education in Europe. It has been found that the structure and content according to national traditions and European standards have led to success of European vocational education. It has been proved that training is practice-oriented,…
ERIC Educational Resources Information Center
Seelman, Kristie L.
2013-01-01
For years, transgender activists and their allies have spoken out about the oppression that transgender and gender non-conforming people experience in relation to societal systems and institutions, due to policies and practices that do not acknowledge non-binary experiences of gender, that do not recognize that one's gender may change over time or…
ERIC Educational Resources Information Center
Warmerdam, John; And Others
Training in the motor vehicle repair and sales sector in the Netherlands was examined in a study that included the following approaches: review of the sector's structure/characteristics, institutional and social context, employment practices, changing conditions, and available education and training; in-depth case studies of four auto repair shops…
ERIC Educational Resources Information Center
Hurn, Christopher J.; Burn, Barbara B.
This comparative evaluation of the differing educational systems in North America, Europe, the USSR, and Japan examines the goals and values of these systems. It is pointed out that Americans value equality, practicality, and utility and that they are both individualistic and suspicious of government authority. Contrasts between these values and…
ERIC Educational Resources Information Center
Putman, R. J.
1984-01-01
Describes an activity (suitable for high school or college) in which the effects of competition in the structuring of ecological communities are examined. The exercise also offers an introduction into species diversity; more advanced classes may be encouraged to seek reasons for differences in insect diversity on different trees. (Author/JN)
ERIC Educational Resources Information Center
Froiland, John Mark; Powell, Douglas R.; Diamond, Karen E.
2014-01-01
In response to increasing research and policy interest in the neighborhood context of early school success, this study examined relations among neighborhood social networks, home literacy practices/resources, and children's expressive vocabulary in a suburban at-risk sample in the USA at the beginning of the school year. In a Structural Equation…
ERIC Educational Resources Information Center
Easterly, R.G., III.; Myers, Brian E.
2017-01-01
Desimone's core features of professional development (PD) guides the PD for teachers. The purpose of this study was to examine the PD practice of School-Based Agricultural Education (SBAE) teachers in the enthusiastic and growing career stage. Semi-structured telephone interviews were conducted with five teachers from five different states. The…
Exploring the Contribution of Workplace Learning to an HRD Strategy in the Scottish Legal Profession
ERIC Educational Resources Information Center
Watson, Sandra; Harmel-Law, Amanda
2010-01-01
Purpose: The purpose of this paper is to explore the relevance of human resource development (HRD) for law firms in the UK. It examines how the characteristics of legal professional practice in the UK, including the partnership structure, long established methods of targeting solicitors and the law society, may act as barriers to the…
ERIC Educational Resources Information Center
Zeng, Yong; Wu, Yan; Lai, Yanni; Lu, Yingqing; Zou, Hejian; Feng, Xueshan
2014-01-01
In the past ten years, the objective structured clinical examination (OSCE) project team of the Shanghai Medical College of Fudan University has continuously conducted further study on the development and maintenance of standardized patients and their application in teaching. The team carried out a series of randomized controlled studies on the…
ERIC Educational Resources Information Center
Gibson, Sandra; Leinster, Samuel
2011-01-01
There are an increasing number of students with learning difficulties attending university, and currently much debate about the suitability and ability of students with dyslexia at both medical school and once they graduate into clinical practice. In this study we describe the performance of students with dyslexia compared to fellow students in…
ERIC Educational Resources Information Center
Sweet, Pauline
A study examined the current policies, practices, and perceived unmet needs of selected organizations involved in employment, training, and education (ETE) for offenders and exoffenders in the Yorkshire and Humberside region of the United Kingdom. Representatives of 63 of the more than 100 probation services, further education (FE) colleges,…
ERIC Educational Resources Information Center
Zhang-Wu, Qianqian
2017-01-01
As a result of increases in immigration, more students from culturally and linguistically diverse backgrounds are entering K-12 classrooms in the United States. Thus, the need to study the education of diverse learners is intensified. Drawing upon semi-structured interviews, observations, and informal conversations, this case study examined how a…
Effectiveness of foot care education among people with type 2 diabetes in rural Puducherry, India.
Saurabh, Suman; Sarkar, Sonali; Selvaraj, Kalaiselvi; Kar, Sitanshu Sekhar; Kumar, S Ganesh; Roy, Gautam
2014-01-01
The burden of diabetes and its foot complications is increasing in India. Prevention of these complications through foot care education should be explored. The objective of our study was to assess the risk factors of poor diabetic foot care and to find the effectiveness of health education in improving foot care practice among diabetes patients. A structured pre-tested questionnaire was administered to the outpatients of a rural health center with type 2 diabetes. Awareness regarding diabetes, care of diabetes and foot care practice ware assessed and scored. Individual and group health education focusing on foot care was performed. Foot care practice was reassessed after 2 weeks of education. Only 54% were aware that diabetes could lead to reduced foot sensation and foot ulcers. Nearly 53% and 41% of the patients had good diabetes awareness and good diabetes care respectively. Only 22% of the patients had their feet examined by a health worker or doctor. The patients with poor, satisfactory and good practice scores were 44.7%, 35.9% and 19.4% respectively. Low education status, old age and low awareness regarding diabetes were the risk factors for poor practice of foot care. Average score for practice of foot care improved from 5.90 ± 1.82 to 8.0 ± 1.30 after 2 weeks of health education. Practice related to toe space examination, foot inspection and foot wear inspection improved maximally. Foot care education for diabetics in a primary care setting improves their foot care practice and is likely to be effective in reducing the burden of diabetic foot ulcer.
Surgical handover in an era of reduced working hours: an audit of current practice.
Shafiq-ur-Rehman; Mehmood, Sajid; Ahmed, Jamil; Razzaq, Muhammad Haroon; Khan, Shakeeb; Perry, Eugene Phillip
2012-06-01
To examine the current practice of handover and to record trainees' assessment of handover process. An audit study. Department of General Surgery, Scarborough General Hospital, Scarborough, United Kingdom, from January to April 2010. A paper-based questionnaire containing instruments pertaining to handover guidelines was disseminated to trainees on surgical on-call rota at the hospital. Trainees' responses regarding handover process including information transferred, designated location, duration, structure, senior supervision, awareness of guidelines, formal training, and rating of current handover practice were analysed. A total of 42 questionnaires were returned (response rate = 100%). The trainees included were; registrars 21% (n=9), core surgical trainees 38 % (n=16), and foundation trainees 41% (n=17). Satisfactory compliance (> 80% handover sessions) to RCS guidelines was observed for only five out of nine components. Ninety-five percent of hand over sessions took place at a designated place and two-third lasted less than 20-minutes. Computer generated handover sheet 57% (n=24) was the most commonly practised method of handover. Specialist registrar 69 % (n=29) remained the supervising person in majority of handover sessions. None of the respondents received formal teaching or training in handover, whereas only half of them 48% (n=20) were aware of handover guidelines. Twenty-one percent of the trainees expressed dissatisfaction with the current practice of handover. Current practice of surgical handover lacks structure despite a fair degree of compliance to RCS handover guidelines. A computerised-sheet based structured handover process, subjected to regular audit, would ensure patient safety and continuity of care.
van Ochten, John M; Mos, Marinka C E; van Putte-Katier, Nienke; Oei, Edwin H G; Bindels, Patrick J E; Bierma-Zeinstra, Sita M A; van Middelkoop, Marienke
2014-09-01
Persistent complaints are very common after a lateral ankle sprain. To investigate possible associations between structural abnormalities on radiography and MRI, and persistent complaints after a lateral ankle sprain. Observational case control study on primary care patients in general practice. Patients were selected who had visited their GP with an ankle sprain 6-12 months before the study; all received a standardised questionnaire, underwent a physical examination, and radiography and MRI of the ankle. Patients with and without persistent complaints were compared regarding structural abnormalities found on radiography and MRI; analyses were adjusted for age, sex, and body mass index. Of the 206 included patients, 98 had persistent complaints and 108 did not. No significant differences were found in structural abnormalities between patients with and without persistent complaints. In both groups, however, many structural abnormalities were found on radiography in the talocrural joint (47.2% osteophytes and 45.1% osteoarthritis) and the talonavicular joint (36.5% sclerosis). On MRI, a high prevalence was found of bone oedema (33.8%) and osteophytes (39.5) in the talocrural joint; osteophytes (54.4%), sclerosis (47.2%), and osteoarthritis (55.4%, Kellgren and Lawrence grade >1) in the talonavicular joint, as well as ligament damage (16.4%) in the anterior talofibular ligament. The prevalence of structural abnormalities is high on radiography and MRI in patients presenting in general practice with a previous ankle sprain. There is no difference in structural abnormalities, however, between patients with and without persistent complaints. Using imaging only will not lead to diagnosis of the explicit reason for the persistent complaint. © British Journal of General Practice 2014.
Inhibition Plasticity in Older Adults: Practice and Transfer Effects Using a Multiple Task Approach.
Wilkinson, Andrea J; Yang, Lixia
2016-01-01
OBJECTIVE. To examine plasticity of inhibition, as indexed by practice effects of inhibition tasks and the associated transfer effects, using a multiple task approach in healthy older adults. METHOD. Forty-eight healthy older adults were evenly assigned to either a practice group or a no-contact control group. All participants completed pretest (2.5 hours) and posttest (2 hours) sessions, with a 2-week interval in between. During the 2-week interval, only the practice group completed six 30-minute practice sessions (three sessions per week for two consecutive weeks) of three lab-based inhibition tasks. RESULTS. All three inhibition tasks demonstrated significant improvement across practice sessions, suggesting practice-induced plasticity. The benefit, however, only transferred to near-near tasks. The results are inconclusive with regard to the near-far and far-far transfer effects. DISCUSSION. This study further extends literature on practice effects of inhibition in older adults by using a multiple task approach. Together with previous work, the current study suggests that older adults are able to improve inhibition performance through practice and transfer the practice gains to tasks that overlap in both target cognitive ability and task structure (i.e., near-near tasks).
Organizational culture influences health care workers' influenza immunization behavior.
Isaacson, Nicole; Roemheld-Hamm, Beatrix; Crosson, Jesse C; Dicicco-Bloom, Barbara; Winston, Carla A
2009-03-01
Low rates of influenza immunization among health care workers (HCWs) pose a potential health risk to patients in primary care practices. Despite previous educational efforts and programs to reduce financial barriers, HCW influenza immunization rates remain low. Variation in practice-level organizational culture may affect immunization rates. To explore this relationship, we examined organizational cultures and HCWs' influenza immunization behaviors in three family medicine practices. We used a multi-method comparative case study. A field researcher used participant observation, in-depth interviews, and key informant interviews to collect data in each practice in November-December 2003. A diverse team used grounded theory to analyze text data. Organizational culture varied among practices and differing HCW immunization rates were observed. The most structured and business-like practice achieved immunization of all HCWs, while the other two practices exhibited greater variation in HCW immunization rates. Physicians in the practices characterized as chaotic/disorganized or divided were immunized at higher rates than other members of the practices. In these practices, organizational culture was associated with varying rates of influenza immunization for HCWs, especially among nonphysicians. Addressing elements of organizational culture such as beliefs regarding influenza immunization and office policies may facilitate the immunization of all staff members.
Inhibition Plasticity in Older Adults: Practice and Transfer Effects Using a Multiple Task Approach
Wilkinson, Andrea J.; Yang, Lixia
2016-01-01
Objective. To examine plasticity of inhibition, as indexed by practice effects of inhibition tasks and the associated transfer effects, using a multiple task approach in healthy older adults. Method. Forty-eight healthy older adults were evenly assigned to either a practice group or a no-contact control group. All participants completed pretest (2.5 hours) and posttest (2 hours) sessions, with a 2-week interval in between. During the 2-week interval, only the practice group completed six 30-minute practice sessions (three sessions per week for two consecutive weeks) of three lab-based inhibition tasks. Results. All three inhibition tasks demonstrated significant improvement across practice sessions, suggesting practice-induced plasticity. The benefit, however, only transferred to near-near tasks. The results are inconclusive with regard to the near-far and far-far transfer effects. Discussion. This study further extends literature on practice effects of inhibition in older adults by using a multiple task approach. Together with previous work, the current study suggests that older adults are able to improve inhibition performance through practice and transfer the practice gains to tasks that overlap in both target cognitive ability and task structure (i.e., near-near tasks). PMID:26885407
Noureldin, Yasser A.; Elkoushy, Mohamed A.; Fahmy, Nader; Carrier, Serge; Elhilali, Mostafa M.; Andonian, Sero
2015-01-01
Introduction: We evaluated the use of the GreenLight Simulator (GL-SIM) (American Medical Systems, Guelph, ON) in the skill assessment of postgraduate trainees (PGTs) in photoselective vaporization of the prostate (PVP). We also sought to determine whether previous PVP experience or GL-SIM practice improved performance. Methods: PGTs in postgraduate years (PGY-3 to PGY-5) from all 4 Quebec urology training programs were recruited during 2 annual Objective Structured Clinical Examinations (OSCEs). During a 20-minute OSCE station, PGTs were asked to perform 2 exercises: (1) identification of endoscopic landmarks and (2) a PVP of a 30-g normal prostate. Grams vaporized, global scores, and number of correct anatomical landmarks were recorded and correlated with PGY level, practice on the GL-SIM, and previous PVP experience. Results: In total, 25 PGTs were recruited at each OSCE, with 13 PGTs participating in both OSCEs. When comparing scores from the first and second OSCEs, there was a significant improvement in the number of grams vaporized (2.9 vs. 4.3 g; p = 0.003) and global score (100 vs. 165; p = 0.03). There was good correlation between the number of previously performed PVPs and the global score (r = 0.4, p = 0.04). Similarly, PGTs with previous practice on the GL-SIM had significantly higher global score (100.6 vs. 162.6; p = 0.04) and grams vaporized (3.1 vs. 4.1 g; p = 0.04) when compared with those who did not practice on GL-SIM. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM (32.7% vs. 10.2%; p = 0.009). PGY level did not significantly affect grams vaporized or global score (p > 0.05). Conclusion: Performance on the GL-SIM at OSCEs significantly correlated with previous practice on the GL-SIM and previous PVP experience rather than PGY level. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM. PMID:25737763
NASA Astrophysics Data System (ADS)
Foster, Jacob G.
This dissertation inserts a new view into an old problem in teacher education. The study explores the theory-practice gap, the large distance between what preservice science teachers experience in schools, are able to enact, and are told they should hold themselves to in their practice. It does so by narrowing the focus of analysis to a secondary science study group and examining how the facilitator uses sociocultural constructivism to promote discussion. The analysis surfaces key communicative moves made by the facilitator and preservice teachers that yield fruitful discussion of theory-practice relationships. Additionally, the study's use of discourse analysis as a methodology and intertextuality as a conceptual framework opens new directions for applied sociolinguistic research and scholarship in science teacher education. Findings from the study focus on what was discussed and how explorations of theory-practice relationships were facilitated. Preservice teachers in the study group engaged in meaningful conversations about constructivist theory and its application to their students and teaching of science. They discussed many science education topics such as planning science lessons that actively engage students, assessment of content understanding, and management of content-based activities. Discussions of broader science education goals, including implementation of inquiry or development of collaborative communities, were not promoted. Examination of the facilitation illuminates a number of strategies found to be helpful in supporting these explorations. This study shows that facilitation can successfully support preservice teachers to construct understanding of social constructivist assumptions underlying the National Science Education Standards (NSES), as well as a few components of the Standards themselves. The focus on the underlying assumptions suggests that science teacher education should focus on these so that preservice teachers can build a strong foundation from which to later implement broader science education reform efforts. The study group serves as a bridging structure between university courses and classroom experiences to support preservice teacher navigation of theory-practice relationships in the context of their classroom teaching. The study group contributes to helping preservice teachers navigate the theory-practice gap by complementing other teacher education structures to achieve this long-standing goal.
Sheehan, Scott E.; Orwin, John F.; Lee, Kenneth S.
2016-01-01
Shoulder pain is one of the most common musculoskeletal conditions encountered in primary care and specialty orthopedic clinic settings. Although magnetic resonance (MR) imaging is typically the modality of choice for evaluating the soft-tissue structures of the shoulder, ultrasonography (US) is becoming an important complementary imaging tool in the evaluation of superficial soft-tissue structures such as the rotator cuff, subacromial-subdeltoid bursa, and biceps tendon. The advantages of US driving its recent increased use include low cost, accessibility, and capability for real-time high-resolution imaging that enables dynamic assessment and needle guidance. As more radiologists are considering incorporating shoulder US into their practices, the development of a standardized approach to performing shoulder US should be a priority to facilitate the delivery of high-quality patient care. Familiarity with and comfort in performing a standardized shoulder US examination, as well as knowledge of the types of anomalies that can be evaluated well with US, will enhance the expertise of those working in musculoskeletal radiology practices and add value in the form of increased patient and health care provider satisfaction. This review describes the utility and benefits of shoulder US as a tool that complements MR imaging in the assessment of shoulder pain. A standardized approach to the shoulder US examination is also described, with a review of the basic technique of this examination, normal anatomy of the shoulder, common indications for shoulder US, and characteristic US findings of common shoulder diseases—with select MR imaging and arthroscopic correlation. Online supplemental material is available for this article. ©RSNA, 2016 PMID:27726738
McLennan, J D
2016-09-01
Point-of-use (POU) strategies to improve drinking water, particularly chlorination, are promoted within cholera epidemics when centrally delivered safe drinking water is lacking. Most studies examining POU practices during cholera epidemics have relied on single cross-sectional studies which are limited for assessing behavioural changes. This study examined POU practices in a community over time during a cholera outbreak. Secondary data analysis of existing dataset. During attendance at well-baby clinics serving a low-income peri-urban community in the Dominican Republic, mothers had been routinely asked, using a structured questionnaire, about POU strategies used for drinking water for their children. Frequency distribution of reported practices was determined over a 21 month period during the cholera outbreak on the island of Hispaniola. An estimated 27.8% of children were reported to have had some exposure to untreated tap water. Unsustained reductions in exposure to untreated tap water were noted early in the epidemic. POU chlorination was infrequent and showed no significant or sustained increases over the study time period. High reliance on bottled water, consistent with national household patterns prior to the cholera outbreak, may have reduced the perceived need for POU chlorination. Examination of the safety of relying on bottled water during cholera outbreaks is needed. Additionally, further inquiries are needed to understand variation in POU practices both during and beyond cholera outbreaks. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Medical humanities and their discontents: definitions, critiques, and implications.
Shapiro, Johanna; Coulehan, Jack; Wear, Delese; Montello, Martha
2009-02-01
The humanities offer great potential for enhancing professional and humanistic development in medical education. Yet, although many students report benefit from exposure to the humanities in their medical education, they also offer consistent complaints and skepticism. The authors offer a pedagogical definition of the medical humanities, linking it to medicine as a practice profession. They then explore three student critiques of medical humanities curricula: (1) the content critique, examining issues of perceived relevance and intellectual bait-and-switch, (2) the teaching critique, which examines instructor trustworthiness and perceived personal intrusiveness, and (3) the structural/placement critique, or how and when medical humanities appear in the curriculum. Next, ways are suggested to tailor medical humanities to better acknowledge and reframe the needs of medical students. These include ongoing cross-disciplinary reflective practices in which intellectual tools of the humanities are incorporated into educational activities to help students examine and, at times, contest the process, values, and goals of medical practice. This systematic, pervasive reflection will organically lead to meaningful contributions from the medical humanities in three specific areas of great interest to medical educators: professionalism, "narrativity," and educational competencies. Regarding pedagogy, the implications of this approach are an integrated required curriculum and innovative concepts such as "applied humanities scholars." In turn, systematic integration of humanities perspectives and ways of thinking into clinical training will usefully expand the range of metaphors and narratives available to reflect on medical practice and offer possibilities for deepening and strengthening professional education.
The value of artefacts in stimulated-recall interviews.
Burden, Sarah; Topping, Annie; O'Halloran, Catherine
2015-09-01
To assess the use of artefacts in semi-structured, stimulated-recall interviews in a study exploring mentors' decisions regarding students' competence in practice. Few empirical studies have examined how mentors reach a decision when assessing students' performance in practice. Concerns have repeatedly been voiced that students may lack essential skills at the point of registration or that mentors may have failed or been reticent to judge students' performance as unsatisfactory. Student practice assessment documents (PADs) were used in stimulated-recall (SR) interviews with mentors to explore decision making. A review of the literature identified that artefacts can play a role in triggering a more comprehensive retrospective examination of decision making, thus helping to capture the essence of a mentor's decision over time and in context. Use of an artefact to stimulate recall can elicit evidence of thought processes, which may be difficult to obtain in a normal, semi-structured interview. PADs proved to be a valuable way to generate naturalistic decision making. In addition, discussion of artefacts created by participants can promote participant-driven enquiry, thereby reducing researcher bias. Identifying an approach that captures post hoc decision making based on sustained engagement and interaction between students and their mentors was a challenge. Artefacts can be used to address the difficulties associated with retrospective introspection about a unique decision. There is the potential to increase the use of artefacts in healthcare research. SR can also help novice mentors develop their skills in making decisions regarding assessments of students.
Baker, James; Dickman, Andrew; Mason, Stephen; Ellershaw, John
2018-01-01
A continuous subcutaneous infusion (CSCI) is an effective method of multiple drug administration commonly encountered in end of life care when the oral route is compromised. At present, current practice is to limit syringe driver infusion time to a maximum of 24 hours as dictated by available chemical stability data. However, the ability to deliver prescribed medication by a CSCI over 48 hours may have numerous benefits in both patient care and health service resource utilisation. To examine and present the current evidence base for the stability of 48-hour multiple-drug CSCIs in current clinical practice. A systematically-structured review following PRISMA guidelines. Three electronic databases and the grey literature were searched with no time limits. Empirical studies reporting data on the chemical stability of continuous subcutaneous infusions or solutions stored in polypropylene syringes were included. Twenty-one empirical studies were included in this review reporting chemical compatibility and stability of 32 discrete combinations of twenty-four drugs tested at a variety of different drug concentrations. The majority of combinations reported were assessed as being chemically compatible. The greatest risk of clinically significant chemical degradation was observed with midazolam. Only one study reported the microbiological stability of the solution examined. There is currently limited evidence for the physical, chemical and microbiological stability of solutions for continuous subcutaneous infusion over a period of 48 hours. More stability data is required before the use of 48-hour CSCIs can be evaluated for use within clinical practice.
Stiers, William; Barisa, Mark; Stucky, Kirk; Pawlowski, Carey; Van Tubbergen, Marie; Turner, Aaron P; Hibbard, Mary; Caplan, Bruce
2015-05-01
This study describes the results of a multidisciplinary conference (the Baltimore Conference) that met to develop consensus guidelines for competency specification and measurement in postdoctoral training in rehabilitation psychology. Forty-six conference participants were chosen to include representatives of rehabilitation psychology training and practice communities, representatives of psychology accreditation and certification bodies, persons involved in medical education practice and research, and consumers of training programs (students). Consensus education and training guidelines were developed that specify the key competencies in rehabilitation psychology postdoctoral training, and structured observation checklists were developed for their measurement. This study continues the development of more than 50 years of thinking about education and training in rehabilitation psychology and builds on the existing work to further advance the development of guidelines in this area. The conference developed aspirational guidelines for competency specification and measurement in rehabilitation psychology postdoctoral training (i.e., for studying the outcomes of these training programs). Structured observation of trainee competencies allows examination of actual training outcomes in relation to intended outcomes and provides a methodology for studying how program outcomes are related to program structures and processes so that program improvement can occur. Best practices in applying program evaluation research methods to the study of professional training programs are discussed. (c) 2015 APA, all rights reserved).
DOE Office of Scientific and Technical Information (OSTI.GOV)
Willenbrock, J.H.; Thomas, H.R. Jr.; Burati, J.L. Jr.
1978-06-01
The basic objective of this research effort was to perform a comparative analysis of the Quality Assurance practices related to the structural concrete phase on nine nuclear power plant projects which are (or have been) under construction in the United States in the past ten years. This analysis identified the response of each Quality Assurance program to the applicable criteria of 10 CFR Part 50, Appendix B as well as to the pertinent regulatory requirements and industry standards. The major emphasis was placed on the construction aspects of the structural concrete phase of each project. The engineering and design aspectsmore » were examined whenever they interfaced with the construction aspects. For those aspects of the Quality Assurance system which can be considered managerial in nature (i.e., organizational relationships, types of Quality Assurance programs, corrective action procedures, etc.) an attempt has been made to present the alternative approaches that were identified. For those aspects of the Quality Assurance system which are technical in nature (i.e., the frequency of testing for slump, compressive strength, etc.) an attempt has been made to present a comparative analysis between projects and in relation to the recommended or mandated practices presented in the appropriate industry codes and standards.« less
AlShammari, Abdullah; Inayah, Aman; Afsar, Nasir Ali; Nurhussen, Akram; Siddiqui, Amna; Anwer, Muhammad Lucman; Obeidat, Sadek; Bakro, Mohammed Khaled; Abu Assale, Tawfik Samer; Almidani, Eyad; Alsonbul, Abdullah; Alhaider, Sami; Hussain, Ibrahim Bin; Khadawardi, Emad; Zafar, Muhammad
2018-02-01
To explore the effects of simulation training on paediatric residents' confidence and skills in managing advanced skills in critical care. The study was conducted at Alfaisal University, Riyadh, Saudi Arabia, from March to June 2016, and comprised junior residents in paediatrics. All paediatric residents (years 1 and 2) were recruited into two workshops, held one week apart. The first workshop covered lumbar puncture/ cerebrospinal fluid interpretation, oral intubation, bone marrow aspiration, and critical airway management. The second workshop covered chest tube insertion, pleural tap, insertion of central line, and arthrocentesis. The participants were surveyed using a 5-point Likert scale survey pre- and post-course, assessing their confidence. Their practical skills were assessed using a pre-objective structured clinical examination on the same day and post-course objective structured clinical examination a week later on selected skills. The outcome measures were: (1) pre-/post-course confidence rating, and (2) pre-/post-course objective structured clinical examination results. Data was analysed using SPSS 20. Of the 16 participants, 8(50%) were boys and 8(50%) girls. Besides, 13(81%) residents were in year-1 and 3(19%) in year-2. Median post-course confidence level ranks for all the skills were higher (p<0.05). There was no improvement in mean pre-objective structured clinical examination scores (2.31±2.66/ 7.46±3.02) and post- objective structured clinical examination scores (22.54±4.39/ 31.85±6.90) in Year 1 residents (p<0.001). Simulation course was significantly successful in improving residents' clinical skills and confidence in performing critical tasks.
McNulty, John A; Espiritu, Baltazar R; Hoyt, Amy E; Ensminger, David C; Chandrasekhar, Arcot J
2015-01-01
Formative practice quizzes have become common resources for self-evaluation and focused reviews of course content in the medical curriculum. We conducted two separate studies to (1) compare the effects of a single or multiple voluntary practice quizzes on subsequent summative examinations and (2) examine when students are most likely to use practice quizzes relative to the summative examinations. In the first study, providing a single on-line practice quiz followed by instructor feedback had no effect on examination average grades compared to the previous year or student performances on similar questions. However, there were significant correlations between student performance on each practice quiz and each summative examination (r = 0.42 and r = 0.24). When students were provided multiple practice quizzes with feedback (second study), there were weak correlations between the frequency of use and performance on each summative examination (r = 0.17 and r = 0.07). The frequency with which students accessed the practice quizzes was greatest the day before each examination. In both studies, there was a decline in the level of student utilization of practice quizzes over time. We conclude that practice quizzes provide some predictive value for performances on summative examinations. Second, making practice quizzes available for longer periods prior to summative examinations does not promote the use of the quizzes as a study strategy because students appear to use them mostly to assess knowledge one to two days prior to examinations. © 2014 American Association of Anatomists.
Williams, Virginia; Deane, Frank P; Oades, Lindsay G; Crowe, Trevor P; Ciarrochi, Joseph; Andresen, Retta
2016-02-02
The implementation and use of evidence-based practices is a key priority for recovery-oriented mental health service provision. Training and development programmes for employees continue to be a key method of knowledge and skill development, despite acknowledged difficulties with uptake and maintenance of behaviour change. Self-determination theory suggests that autonomy, or a sense that behaviour is self-generated, is a key motivator to sustained behaviour change, in this case practices in mental health services. This study examined the utility of values-focused staff intervention as a specific, reproducible method of autonomy support. Mental health workers (n = 146) were assigned via cluster randomisation to either a values clarification condition or an active problem-solving control condition. Results demonstrated that a structured values clarification exercise was useful in promoting integrated motivation for the changed practice and resulted in increased implementation planning. Structured values clarification intervention demonstrates utility as a reproducible means of autonomy support within the workplace. We discuss future directions for the study of autonomous motivation in the field of implementation science. ACTRN12613000353796.
Confronting patriarchal attitudes in the fight for professional recognition.
Carter, H
1994-02-01
Contemporary nursing practice and education belong to a dynamic process which is likely to change the structure of nursing, as well as the relationships that have been established with other professions. This paper is concerned with the professionalization of nursing and examines how nurses and doctors maintain, or challenge, patriarchal relationships in a clinical context. It also examines the wider social climate which upholds the subordination of women in the caring environment. The implementation of alternative therapies, emphasis on patient education, rehabilitation and individualized care all contribute to a climate in which nurses are able to develop an area that can be deemed as their own. Furthermore, the achievement of research-based practice, and the implementation of primary nursing in many areas, indicate a collective approach to patient care. By linking these developments with a feminist discourse nurses are able to challenge their position within the sexual division of labour and highlight the ambiguous position they occupy.
Lessons from America? US magnet hospitals and their implications for UK nursing.
Buchan, J
1994-02-01
This paper examines possible implications of the US 'magnet hospital' concept for the UK nursing labour market. Magnet hospitals have been researched in the US and have been demonstrated to exhibit lower nurse turnover and higher levels of reported job satisfaction than other hospitals. Key characteristics include a decentralized organizational structure, a commitment to flexible working hours, an emphasis on professional autonomy and development, and systematic communication between management and staff. The paper examines the labour market characteristics of UK nurses and US nurses and finds many similarities. Detailed case studies of employment practice in 10 US hospitals and 10 Scottish hospitals are reported, with specific attention to remuneration practice, methods of organizing nursing care, establishment-setting and flexible hours. The paper concludes that there are features of the magnet hospital concept which are of relevance and applicable to the UK nursing labour market, but that piecemeal importation of ideas is unlikely to be beneficial.
Islamic Influence on HIV Risk and Protection Among Central Asian Male Migrant Workers in Kazakhstan.
Shaw, Stacey A; McCrimmon, Tara; Mergenova, Gaukhar; Sultangaliyeva, Alma; El-Bassel, Nabila
2017-08-01
HIV incidence is increasing in Central Asia, where migrant workers experience risks for acquiring sexually transmitted HIV. As a social and structural factor that may influence perceptions and behavior, we examine how Islam shapes HIV risk and protection. Phenomenological qualitative interviews examine religion and contexts of HIV risk among 48 male Central Asian migrant workers residing in Almaty, Kazakhstan. Men described nonvaginal sex, alcohol use, premarital sex, and extramarital sex as forbidden or frowned upon. Religious networks were unlikely to discuss HIV risks, and some men viewed religious affiliation or practices as protective. Marital practices including neke (religious marriage), polygyny, and bride kidnapping may be linked to risk. Findings suggest adhering to Islamic ideals may be protective for some men, but for others, assumptions of protection may enhance risk. HIV prevention strategies among Central Asian migrants may be strengthened by attention to religious and cultural understandings of risk and protection.
Tran, Ulrich S; Cebolla, Ausiàs; Glück, Tobias M; Soler, Joaquim; Garcia-Campayo, Javier; von Moy, Theresa
2014-01-01
To investigate the psychometric and structural properties of the Five Facets Mindfulness Questionnaire (FFMQ) among meditators, to develop a short form, and to examine associations of mindfulness with mental health and the mechanisms of mindfulness. Two independent samples were used, a German (n = 891) and a Spanish (n = 393) meditator sample, practicing various meditation styles. Structural and psychometric properties of the FFMQ were investigated with multigroup confirmatory factor analysis and exploratory structural equation modeling. Associations with mental health and mechanisms of mindfulness were examined with path analysis. The derived short form broadly matched a previous item selection in samples of non-meditators. Self-regulated Attention and Orientation to Experience governed the facets of mindfulness on a higher-order level. Higher-order factors of mindfulness and meditation experience were negatively associated with symptoms of depression and anxiety, and perceived stress. Decentering and nonattachment were the most salient mechanisms of mindfulness. Aspects of emotion regulation, bodily awareness, and nonattachment explained the effects of mindfulness on depression and anxiety. A two-component conceptualization for the FFMQ, and for the study of mindfulness as a psychological construct, is recommended for future research. Mechanisms of mindfulness need to be examined in intervention studies.
Practice of clinical forensic medicine in Sri Lanka: does it need a new era?
Kodikara, Sarathchandra
2012-07-01
Clinical forensic medicine is a sub-specialty of forensic medicine and is intimately associated with the justice system of a country. Practice of clinical forensic medicine is evolving, but deviates from one jurisdiction to another. Most English-speaking countries practice clinical forensic medicine and forensic pathology separately while most non-English-speaking countries practice forensic medicine which includes clinical forensic medicine and forensic pathology. Unlike the practice of forensic pathology, several countries have informal arrangements to deal with forensic patients and there are no international standards of practice or training in this discipline. Besides, this is rarely a topic of discussion. In the adversarial justice system in Sri Lanka, the designated Government Medical Officers practice both clinical forensic medicine and forensic pathology. Practice of clinical forensic medicine, and its teaching and training in Sri Lanka depicts unique features. However, this system has not undergone a significant revision for many decades. In this communication, the existing legal framework, current procedure of practice, examination for drunkenness, investigations, structure of referrals, reports, subsequent legal procedures, undergraduate, in-service, and postgraduate training are discussed with suggestions for reforms. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Leadership by collaboration: Nursing's bold new vision for academic-practice partnerships.
Sebastian, Juliann G; Breslin, Eileen T; Trautman, Deborah E; Cary, Ann H; Rosseter, Robert J; Vlahov, David
In 2016 the American Association of Colleges of Nursing issued a report, Advancing Healthcare Transformation: A New Era for Academic Nursing that included recommendations for more fully integrating nursing education, research, and practice. The report calls for a paradigm shift in how nursing leaders in academia and practice work together and with other leaders in higher education and clinical practice. Only by doing so can we realize the full benefits of academic nursing in this new era in which integration and collaboration are essential to success. In this paper we: 1) examine how academic nursing can contribute to healthcare innovation across environments; 2) explore leadership skills for deans of nursing to advance the goals of academic nursing in collaboration with clinical nursing partners, other health professions and clinical service leaders, academic administrators, and community members; and, 3) consider how governance structures and policy initiatives can advance this work. Copyright © 2017 Elsevier Inc. All rights reserved.
Concept analysis of mentoring.
2013-10-01
The purpose of a concept analysis is to examine the structure and function of a concept by defining its attributes and internal structure. Concept analysis can clarify an overused or vague concept and promote mutual understanding by providing a precise operational definition. Mentoring is a concept more fully used by other fields, such as business, than in nursing and may not always translate well for use in nursing. Therefore, clarifying the meaning of the existing concept of mentoring and developing an operational definition for use in nursing are aims of this concept analysis. Mentoring is broadly based and concentrates on developing areas such as career progression, scholarly achievements, and personal development. Mentoring relationships are based around developing reciprocity and accountability between each partner. Mentoring is seen related to transition in practice, role acquisition, and socialization, as a way to support new colleagues. Mentorship is related to nurses' success in nursing practice linked to professionalism, nursing quality improvement, and self-confidence.
Breaking Boundaries: Complementary and Alternative Medicine Provider Framing of Preventive Care.
Agarwal, Vinita
2017-11-01
This textual examination extends understandings of how complementary and alternative medicine (CAM) providers constitute preventive care in their discourse by identifying the frame of breaking boundaries referencing relational, structural, and philosophical orientations in their practice with their clients. Analysis of semistructured, in-depth interviews with CAM providers ( n = 17) reveals that the frame of breaking boundaries was comprised of three themes: finding one's own strength; I don't prescribe, so I'm exploring; and ground yourself, and have an escape route. The themes describe preventive care by identifying how CAM providers negotiate their relational positionality in connecting with clients, structural positionality within the field of health care, and philosophical positionality within the ontological understandings that guide how health is defined and conceptualized. The study contributes toward enhancing diverse understandings of constituting preventive care in practice and suggests pragmatic implications for addressing biomedical provider communication with their patients seeking CAM care alongside conventional treatments.
Wolle, Patrik; Müller, Matthias P; Rauh, Daniel
2018-03-16
The examination of three-dimensional structural models in scientific publications allows the reader to validate or invalidate conclusions drawn by the authors. However, either due to a (temporary) lack of access to proper visualization software or a lack of proficiency, this information is not necessarily available to every reader. As the digital revolution is quickly progressing, technologies have become widely available that overcome the limitations and offer to all the opportunity to appreciate models not only in 2D, but also in 3D. Additionally, mobile devices such as smartphones and tablets allow access to this information almost anywhere, at any time. Since access to such information has only recently become standard practice, we want to outline straightforward ways to incorporate 3D models in augmented reality into scientific publications, books, posters, and presentations and suggest that this should become general practice.
Shih, Jenny A; Shiow, Sue-Anne Toh Ee; Wee, Hwee-Lin
2015-01-01
Primary care practices in the United States are transforming into patient-centered medical homes (PCMHs) at a rapid pace. Newer PCMH standards have emphasized culturally and linguistically appropriate services (CLAS), but at this time, only some states in the United States have proposed or passed cultural competency training for health care professionals. Other countries are moving to PCMH models. Singapore, a small, ethnically diverse island nation, has national values and social structures that emphasize cultural and linguistic cohesion. In this piece, we examine Singapore’s first PCMH pilot with a national academic center and primary care practice group. Features such as common shared values, self-reliance, racial and religious harmony, patient experience surveillance, and incorporation of CLAS standards in routine health care transactions may predict success for the PCMH in Singapore, with some implications for the United States. PMID:28725822
Alexander, Jeffrey A; Young, Gary J; Weiner, Bryan J; Hearld, Larry R
2008-04-01
Recent investigations into the activities of nonprofit hospitals have pointed to weak or lax governance on the part of some of these organizations. As a result of these events, various federal and state initiatives are now either under way or under discussion to strengthen the governance of hospitals and other nonprofit corporations through mandatory board structures and practices. However, despite policy makers' growing interest in these types of governance reforms, there is in fact little empirical evidence to support their contribution to the effectiveness of hospital boards. The purpose of this article is to report the results of a study examining the relationship between the structure and practices of nonprofit hospital boards relative to the hospital's provision of community benefits. Our results point to modest relationships between these sets of variables, suggesting considerable limitations to what federal and state policy makers can accomplish through legislative initiatives to improve the governance of nonprofit hospitals.
Griffin, Kenneth W.; Botvin, Gilbert J.; Scheier, Lawrence M.; Diaz, Tracy; Miller, Nicole L.
2014-01-01
This study examined how parenting factors were associated with adolescent problem behaviors among urban minority youth and to what extent these relationships were moderated by family structure and gender. Sixth-grade students (N = 228) reported how often they use alcohol, smoke cigarettes, or engage in aggressive or delinquent behaviors; a parent or guardian reported their monitoring and other parenting practices. Findings indicated that boys and those from single-parent families engaged in the highest rates of problem behavior. More parental monitoring was associated with less delinquency overall, as well as less drinking in boys only. Eating family dinners together was associated with less aggression overall, as well as less delinquency in youth from single-parent families and in girls. Unsupervised time at home alone was associated with more smoking for girls only. Implications for prevention interventions are discussed. PMID:10860116
Crume, Peter K
2013-10-01
The National Reading Panel emphasizes that spoken language phonological awareness (PA) developed at home and school can lead to improvements in reading performance in young children. However, research indicates that many deaf children are good readers even though they have limited spoken language PA. Is it possible that some deaf students benefit from teachers who promote sign language PA instead? The purpose of this qualitative study is to examine teachers' beliefs and instructional practices related to sign language PA. A thematic analysis is conducted on 10 participant interviews at an ASL/English bilingual school for the deaf to understand their views and instructional practices. The findings reveal that the participants had strong beliefs in developing students' structural knowledge of signs and used a variety of instructional strategies to build students' knowledge of sign structures in order to promote their language and literacy skills.
Predicting the child-rearing practices of mothers sexually abused in childhood.
Ruscio, A M
2001-03-01
Although empirical investigations have established a relationship between childhood sexual abuse and numerous long-term consequences, surprisingly little research has addressed the possible effects of childhood victimization on the later child-rearing practices of adult survivors. The present study examined hypothesized predictors of three parenting styles among adult survivors of sexual abuse as compared with adult children of alcoholic parents. Forty-five clinical outpatients completed a questionnaire battery assessing experiences of childhood abuse, current economic and social resources, and parenting attitudes and practices. The child-rearing practices of participants were compared with those reported by a community sample of 717 mothers. Additional analyses examined the extent to which sexual abuse and its adult sequelae predicted the parenting behaviors reported by the present sample. Both sexual abuse survivors and children of alcoholics reported significantly higher rates of permissive parenting practices than mothers in the community sample. Multiple regression analyses further revealed unique relationships between sexual abuse and parenting, over and above the variance explained by physical abuse, current socioeconomic status, and the experience of growing up in an alcoholic home. Mothers' sexual abuse severity, social support satisfaction, and dysfunctional parenting attitudes moderated several of these relationships. The present findings suggest that sexual abuse and its adult sequelae may have negative consequences for the parenting practices of survivors, particularly for survivors' ability to provide their children with appropriate structure, consistent discipline, and clear behavioral expectations. Implications for the psychosocial development of survivors' children are discussed.
Exploring deliberate practice in medicine: how do physicians learn in the workplace?
van de Wiel, Margje W J; Van den Bossche, Piet; Janssen, Sandra; Jossberger, Helen
2011-03-01
Medical professionals need to keep on learning as part of their everyday work to deliver high-quality health care. Although the importance of physicians' learning is widely recognized, few studies have investigated how they learn in the workplace. Based on insights from deliberate practice research, this study examined the activities physicians engage in during their work that might further their professional development. As deliberate practice requires a focused effort to improve performance, the study also examined the goals underlying this behaviour. Semi-structured interviews were conducted with 50 internal medicine physicians: 19 residents, 18 internists working at a university hospital, and 13 working at a non-university hospital. The results showed that learning in medical practice was very much embedded in clinical work. Most relevant learning activities were directly related to patient care rather than motivated by competence improvement goals. Advice and feedback were sought when necessary to provide this care. Performance standards were tied to patients' conditions. The patients encountered and the discussions with colleagues about patients were valued most for professional development, while teaching and updating activities were also valued in this respect. In conclusion, physicians' learning is largely guided by practical experience rather than deliberately sought. When professionals interact in diagnosing and treating patients to achieve high-quality care, their experiences contribute to expertise development. However, much could be gained from managing learning opportunities more explicitly. We offer suggestions for increasing the focus on learning in medical practice and further research.
Karthaus, Anne; Schmidt, Anita
2016-01-01
Introduction: In preparation for the state examination, many students have open questions and a need for advice. Tutors of the Skills Lab PERLE-„Praxis ERfahren und Lernen“ (experiencing and learning practical skills) have developed a new course concept to provide support and practical assistance for the examinees. Objectives: The course aims to familiarize the students with the exam situation in order to gain more confidence. This enables the students to experience a confrontation with the specific situation of the exam in a protected environment. Furthermore, soft skills are utilized and trained. Concept of the course: The course was inspired by the OSCE-model (Objective Structured Clinical Examination), an example for case-based learning and controlling. Acquired knowledge can be revised and extended through the case studies. Experienced tutors provide assistance in discipline-specific competencies, and help in organizational issues such as dress code and behaviour. Evaluation of the course: An evaluation was conducted by the attending participants after every course. Based on this assessment, the course is constantly being developed. In March, April and October 2015 six courses, with a total of 84 participants, took place. Overall 76 completed questionnaires (91%) were analysed. Discussion: Strengths of the course are a good tutor-participants-ratio with 1:4 (1 Tutor provides guidance for 4 participants), the interactivity of the course, and the high flexibility in responding to the group's needs. Weaknesses are the tight schedule, and the currently not yet performed evaluation before and after the course. Conclusion: In terms of “best practise”, this article shows an example of how to offer low-cost and low-threshold preparation for the state examination. PMID:27579355
Erlich, Deborah R; Shaughnessy, Allen F
2014-04-01
While most medical schools have students teach other students, few offer formal education in teaching skills, and fewer provide teaching theory together with experiential teaching practice. Furthermore, curriculum evaluation of teaching education is lacking. This study aimed to examine effects of a novel didactic teaching curriculum for students embedded in a practical teaching experience. A longitudinal 12-week curriculum with complementary didactic and practical components for final-year students learning how to teach was developed, implemented and evaluated using a multi-level evaluation based on the Kirkpatrick approach with qualitative and quantitative methods. Thirteen student-teachers acquired measureable knowledge, skills and attitudes necessary for teaching excellence. Confidence in teaching increased (p < 0.001), particularly in four key areas: oral feedback, written feedback, mentoring, and the difficult learner. Student-teachers demonstrated teaching competence as determined by self-assessment, student feedback, and faculty observation. Top teachers impacted their first-year students' performance in patient interviewing as measured by Objective Structured Clinical Examination (OSCE). Reinforcing educational theory with practical teaching experience under direct faculty supervision promotes teaching competency for graduating medical students. The intertwined didactic plus practical model can be applied to various teaching contexts to fulfil the mandate that medical schools train graduates in core teaching knowledge, skills and attitudes in preparation for their future roles as clinical teachers.
Postfire management in forested public lands of the western USA
Beschta, R.L.; Rhodes, J.J.; Kauffman, J.B.; Gresswell, Robert E.; Minshall, G.W.; Frissell, C.A.; Perry, D.A.; Hauer, R.
2004-01-01
Forest ecosystems in the western United States evolved over many millennia in response to disturbances such as wildfires. Land use and management practices have altered these ecosystems, however, including fire regimes in some areas. Forest ecosystems are especially vulnerable to postfire management practices because such practices may influence forest dynamics and aquatic systems for decades to centuries. Thus, there is an increasing need to evaluate the effect of postfire treatments from the perspective of ecosystem recovery. We examined, via the published literature and our collective experience, the ecological effects of some common postfire treatments. Based on this examination, promising postfire restoration measures include retention of large trees, rehabilitation of firelines and roads, and, in some cases, planting of native species. The following practices are generally inconsistent with efforts to restore ecosystem functions after fire: seeding exotic species, livestock grazing, placement of physical structures in and near stream channels, ground-based postfire logging, removal of large trees, and road construction. Practices that adversely affect soil integrity, persistence or recovery of native species, riparian functions, or water quality generally impede ecological recovery after fire. Although research provides a basis for evaluating the efficacy of postfire treatments, there is a continuing need to increase our understanding of the effects of such treatments within the context of societal and ecological goals for forested public lands of the western United States.
The effectiveness of immediate feedback during the objective structured clinical examination.
Hodder, R V; Rivington, R N; Calcutt, L E; Hart, I R
1989-03-01
Using eight different physical examination or technical stations, 400 examinations were conducted to evaluate the effectiveness of immediate feedback during the Objective Structured Clinical Examination (OSCE). The test group comprised 50 medical students who underwent a standard 4-minute examination followed by 2 minutes of feedback. Immediately following feedback the students repeated an identical 4-minute examination scored by the same examiners. The control group consisted of 50 students from the same class who underwent an identical testing sequence, but instead of receiving feedback, they were instructed to continue their examinations for an additional 2 minutes before repeating the stations. Simple repetition of the task did not significantly improve score (mean increase 2.0%, NS). Extending the testing period from 4 to 6 minutes resulted in a small but significant increase in score (mean 6.7%, P less than 0.001). However, there was a much larger increase in the scores obtained following 2 minutes of immediate feedback compared to pre-feedback performance (mean 26.3%, P less than 0.0001). The majority of students and examiners felt that feedback, as administered in this study, was valuable both as a learning and teaching experience. Short periods of immediate feedback during an OSCE are practical and can improve competency in the performance of criterion-based tasks, at least over the short term. In addition, such feedback provides students with valuable self-assessment that may stimulate further learning.
Finn, Natalie K; Torres, Elisa M; Ehrhart, Mark G; Roesch, Scott C; Aarons, Gregory A
2016-08-01
The Implementation Leadership Scale (ILS) is a brief, pragmatic, and efficient measure that can be used for research or organizational development to assess leader behaviors and actions that actively support effective implementation of evidence-based practices (EBPs). The ILS was originally validated with mental health clinicians. This study validates the ILS factor structure with providers in community-based organizations (CBOs) providing child welfare services. Participants were 214 service providers working in 12 CBOs that provide child welfare services. All participants completed the ILS, reporting on their immediate supervisor. Confirmatory factor analyses were conducted to examine the factor structure of the ILS. Internal consistency reliability and measurement invariance were also examined. Confirmatory factor analyses showed acceptable fit to the hypothesized first- and second-order factor structure. Internal consistency reliability was strong and there was partial measurement invariance for the first-order factor structure when comparing child welfare and mental health samples. The results support the use of the ILS to assess leadership for implementation of EBPs in child welfare organizations. © The Author(s) 2016.
ERIC Educational Resources Information Center
Dunbar, Kristina; Ridha, Aala; Cankaya, Ozlem; Jiménez Lira, Carolina; LeFevre, Jo-Anne
2017-01-01
Research Findings: Children who speak English are slower to learn the counting sequence between 11 and 20 compared to children who speak Asian languages. In the present research, we examined whether providing children with spatially relevant information during counting would facilitate their acquisition of the counting sequence. Three-year-olds…
ERIC Educational Resources Information Center
Hodkinson, Alan; Devarakonda, Chandrika
2009-01-01
This paper details the development and operation of a system of inclusive education in India during the latter part of the twentieth and the beginning of the twenty-first century. Through a literature review and the employment of in-depth semi-structured interviews the study sought to determine how inclusion is defined and how the professional…
J. E. Lundquist; R. A. Sommerfeld
2002-01-01
Various disturbances such as disease and management practices cause canopy gaps that change patterns of forest stand structure. This study examined the usefulness of digital image analysis using aerial photos, Fourier Tranforms, and cluster analysis to investigate how different spatial statistics are affected by spatial scale. The specific aims were to: 1) evaluate how...
ERIC Educational Resources Information Center
Keddie, Amanda
2014-01-01
This paper explores issues of equity and group identity at "Hamilton Court," a large comprehensive multi-faith and multi-cultural school located in England. The exploration draws on data gathered from a study that examined the conditions, structures and practices associated with productively addressing issues of justice and cultural…
ERIC Educational Resources Information Center
Spencer, R. Donald
1984-01-01
Describes an experiment (using plastic bags) designed to give students practical understanding on using statistics to evaluate data and how statistical treatment of experimental results can enhance their value in solving scientific problems. Students also gain insight into the orientation and structure of polymers by examining the plastic bags.…
Using Simulation in Assessment and Teaching: OSCE Adapted for Social Work
ERIC Educational Resources Information Center
Bogo, Marion; Rawlings, Mary; Katz, Ellen; Logie, Carmen
2014-01-01
This detailed book by the most experienced authors in the field describes how to develop and implement the objective structured clinical examination (OSCE) for social work education. In addition to a wealth of practical material in the appendices, two videos produced especially for this book (accessible online) show the OSCE process step-by-step.…
ERIC Educational Resources Information Center
Luckman, Elizabeth A.
2017-01-01
This account of practice examines the implementation of and reactions to action learning through the Lean methodology in a unique, cross-cultural context. I review my time spent as a Lean coach; engaging with, training, and using action learning with employees in a garment manufacturing facility located in Bali, Indonesia. This research addresses…
ERIC Educational Resources Information Center
Bloom, Zachary D.; Gutierrez, Daniel; Lambie, Glenn W.
2017-01-01
Researchers performed an exploratory factor analysis on the Attitudes Toward Erotica Questionnaire (ATEQ) and examined the construct and concurrent validity of the ATEQ data with a sample of practicing counselors and marriage and family therapists in the state of Florida (N = 373). The data analyses resulted in a two-factor, 10-item assessment…
Development problem analysis of correlation leak detector’s software
NASA Astrophysics Data System (ADS)
Faerman, V. A.; Avramchuk, V. S.; Marukyan, V. M.
2018-05-01
In the article, the practical application and the structure of the correlation leak detectors’ software is studied and the task of its designing is analyzed. In the first part of the research paper, the expediency of the facilities development of correlation leak detectors for the following operating efficiency of public utilities exploitation is shown. The analysis of the functional structure of correlation leak detectors is conducted and its program software tasks are defined. In the second part of the research paper some development steps of the software package – requirement forming, program structure definition and software concept creation – are examined in the context of the usage experience of the hardware-software prototype of correlation leak detector.
Are Leadership and Management Essential for Good Research? An Interview Study of Genetic Researchers
Antes, Alison L.; Mart, Adelina; DuBois, James M.
2016-01-01
Principal investigators are responsible for a myriad of leadership and management activities in their work. The practices they employ to navigate these responsibilities ultimately influence the quality and integrity of research. However, leadership and management roles in research have received scant empirical examination. Semi-structured interviews with 32 National Institutes of Health (NIH)-funded genetic researchers revealed that they considered leadership and management essential for effective research, but their scientific training inadequately prepared them. We also report management practices that the researchers described employing in their labs, as well as their perceptions of a proposed intervention to enhance laboratory leadership. These findings suggest best practices for the research community, future directions for scientific training, and implications for research on leadership and management in science. PMID:27646401
Antes, Alison L; Mart, Adelina; DuBois, James M
2016-12-01
Principal investigators are responsible for a myriad of leadership and management activities in their work. The practices they use to navigate these responsibilities ultimately influence the quality and integrity of research. However, leadership and management roles in research have received scant empirical examination. Semi-structured interviews with 32 National Institutes of Health (NIH)-funded genetic researchers revealed that they considered leadership and management essential for effective research, but their scientific training inadequately prepared them. We also report management practices that the researchers described using in their labs, as well as their perceptions of a proposed intervention to enhance laboratory leadership. These findings suggest best practices for the research community, future directions for scientific training, and implications for research on leadership and management in science.
Tindana, Paulina O.; Rozmovits, Linda; Boulanger, Renaud F.; Bandewar, Sunita V. S.; Aborigo, Raymond A.; Hodgson, Abraham V. O.; Kolopack, Pamela
2011-01-01
Despite the recognition of its importance, guidance on community engagement practices for researchers remains underdeveloped, and there is little empirical evidence of what makes community engagement effective in biomedical research. We chose to study the Navrongo Health Research Centre in northern Ghana because of its well-established community engagement practices and because of the opportunity it afforded to examine community engagement in a traditional African setting. Our findings suggest that specific preexisting features of the community have greatly facilitated community engagement and that using traditional community engagement mechanisms limits the social disruption associated with research conducted by outsiders. Finally, even in seemingly ideal, small, and homogeneous communities, cultural issues exist, such as gender inequities, that may not be effectively addressed by traditional practices alone. PMID:21852635
The influence of parents' religious practices on young adults' divorce attitudes.
Kapinus, Carolyn A; Pellerin, Lisa A
2008-09-01
This study investigates the intergenerational transmission of parents' religious views and divorce attitudes, paying particular attention to the effect of parent-child closeness. We use structural equation modeling to examine a national longitudinal data set containing information from 455 married individuals and their adult offspring. We find that parent religiosity influences young adults' views of divorce via two pathways: by affecting offspring's religiosity and parents' views of divorce. More religious offspring are less tolerant of divorce, but offspring who do not share their parents' religious practices are nonetheless influenced by their parents' religiously-influenced divorce attitudes. While parent religiosity has no effect on parent-child closeness, religious offspring report having been closer to their parents, suggesting that their current religious practices may affect their perceptions of the parent-child relationship.