Structures and geriatrics from a failure analysis experience viewpoint

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

Hopper, D.M.

In a failure analysis consulting engineering practice one sees a variety of structural failures from which observations may be made concerning geriatric structures. Representative experience with power plants, refineries, offshore structures, and forensic investigations is summarized and generic observations are made regarding the maintenance of fitness for purpose of structures. Although it is important to optimize the engineering design for a range of operational and environmental variables, it is essential that fabrication and inspection controls exist along with common sense based ongoing monitoring and operations procedures. 18 figs.

Organizational Processes and Patient Experiences in the Patient-centered Medical Home.

PubMed

Aysola, Jaya; Schapira, Marilyn M; Huo, Hairong; Werner, Rachel M

2018-06-01

There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. We analyzed visit data from patients (n=8356) at adult primary care practices (n=22) in a large health system. We evaluated the associations between practice organizational processes and patient experience using generalized estimating equations (GEE) with an exchangeable correlation structure to account for patient clustering by practice in multivariate models, adjusting for several practice-level and patient-level characteristics. We evaluated if these associations varied by race/ethnicity, insurance type, and the degree of patient comorbidity MEASURES:: Predictors include overall PCMH adoption and adoption of six organizational processes: access and communications, patient tracking and registry, care management, test referral tracking, quality improvement and external coordination. Primary outcome was overall patient experience. In our full sample, overall PCMH adoption score was not significantly associated with patient experience outcomes. However, among subpopulations with higher comorbidities, the overall PCMH adoption score was positively associated with overall patient experience measures [0.2 (0.06, 0.4); P=0.006]. Differences by race/ethnicity and insurance type in associations between specific organizational processes and patient experience were noted. Although some organizational processes relate to patients' experiences with care irrespective of the background of the patient, further efforts are needed to align practice efforts with patient experience.

Virtual deposition plant

NASA Astrophysics Data System (ADS)

Tikhonravov, Alexander

2005-09-01

A general structure of the software for computational manufacturing experiments is discussed. It is shown that computational experiments can be useful for checking feasibility properties of theoretical designs and for finding the most practical theoretical design for a given production environment.

Culture Wires the Brain: A Cognitive Neuroscience Perspective

PubMed Central

Park, Denise C.; Huang, Chih-Mao

2012-01-01

There is clear evidence that sustained experiences may affect both brain structure and function. Thus, it is quite reasonable to posit that sustained exposure to a set of cultural experiences and behavioral practices will affect neural structure and function. The burgeoning field of cultural psychology has often demonstrated the subtle differences in the way individuals process information—differences that appear to be a product of cultural experiences. We review evidence that the collectivistic and individualistic biases of East Asian and Western cultures, respectively, affect neural structure and function. We conclude that there is limited evidence that cultural experiences affect brain structure and considerably more evidence that neural function is affected by culture, particularly activations in ventral visual cortex—areas associated with perceptual processing. PMID:22866061

How to get the most out of your orthopaedic fellowship: thinking about practice-based learning.

PubMed

Templeman, David

2012-09-01

Practice-based learning and improvement is an important skill set to develop during an orthopaedic trauma fellowship and is 1 of the 6 core competencies stated by the ACGME. The review of clinic cases is best done using a few simple models to develop a structured approach for studying cases. Three common sense and easy-to-use strategies to improve clinical practice are as follows: performing each case three times, studying the 4 quadrants of patient outcomes, and the application of the Pareto 80/20 rule. These principles help to develop a structured approach for analyzing and thinking about practice-based experiences.

Computer Programming and Biomolecular Structure Studies: A Step beyond Internet Bioinformatics

ERIC Educational Resources Information Center

Likic, Vladimir A.

2006-01-01

This article describes the experience of teaching structural bioinformatics to third year undergraduate students in a subject titled "Biomolecular Structure and Bioinformatics." Students were introduced to computer programming and used this knowledge in a practical application as an alternative to the well established Internet bioinformatics…

Bidirectional associations in multiplication memory: conditions of negative and positive transfer.

PubMed

Campbell, Jamie I D; Robert, Nicole D

2008-05-01

A variety of experimental evidence indicates that the memory representation for multiplication facts (e.g., 6 x 9 = 54) incorporates bidirectional links with a forward association from factors to product and a reverse association from product to factors. Surprisingly, the authors did not find evidence in Experiment 1 of facilitative transfer-of-practice from multiplication (6 x 9 = ?) to factoring (54 = ? x ?); in fact, multiplication practice produced item-specific interference with factoring. Similarly, the authors found no evidence in Experiment 2 that repetition of specific factoring problems (54 = ? x ?) facilitated performance of corresponding multiplication problems (6 x 9 = ?). In Experiment 3, participants practiced both multiplication and factoring and presented facilitative transfer in both directions. Thus, bidirectional facilitation occurred if both operations were practiced, but interference occurred when only one operation was practiced. We propose that this seemingly paradoxical behavior occurs because it is adaptive for the bidirectional retrieval structure to retain operational flexibility in the context of practicing both operations, whereas it is adaptive to specialize the memory representation for the practiced operation (i.e., factoring or multiplication) when only one operation is practiced.

Communicating a diagnosis of Autism Spectrum Disorder - a qualitative study of parents' experiences.

PubMed

Abbott, Mandy; Bernard, Paul; Forge, Jenny

2013-07-01

Not enough is known about parents' experiences of receiving the news that their child warrants a diagnosis of Autism Spectrum Disorder (ASD). Sharing this information with parents is an important and difficult part of Child and Adolescent Mental Health (CAMH) practice. Qualitative methodology was used to explore the experiences of the 'feedback session' with nine sets of parents in a community Child and Adolescent Mental Health Service (CAMHS) in North East England. Parents gave vivid accounts of their experiences and described issues relating to the structure, style and content of the session. The experiences of CAMHS users should inform the development of good practice in this important area.

Culture Wires the Brain: A Cognitive Neuroscience Perspective.

PubMed

Park, Denise C; Huang, Chih-Mao

2010-07-01

There is clear evidence that sustained experiences may affect both brain structure and function. Thus, it is quite reasonable to posit that sustained exposure to a set of cultural experiences and behavioral practices will affect neural structure and function. The burgeoning field of cultural psychology has often demonstrated the subtle differences in the way individuals process information-differences that appear to be a product of cultural experiences. We review evidence that the collectivistic and individualistic biases of East Asian and Western cultures, respectively, affect neural structure and function. We conclude that there is limited evidence that cultural experiences affect brain structure and considerably more evidence that neural function is affected by culture, particularly activations in ventral visual cortex-areas associated with perceptual processing. © The Author(s) 2010.

Modeling Human Serum Albumin Tertiary Structure to Teach Upper-Division Chemistry Students Bioinformatics and Homology Modeling Basics

ERIC Educational Resources Information Center

Petrovic, Dus?an; Zlatovic´, Mario

2015-01-01

A homology modeling laboratory experiment has been developed for an introductory molecular modeling course for upper-division undergraduate chemistry students. With this experiment, students gain practical experience in homology model preparation and assessment as well as in protein visualization using the educational version of PyMOL…

Students' Experiences of Attending an Innovative Occupational Therapy Professional Practice Placement in a Childcare Setting

ERIC Educational Resources Information Center

Yu, Mong-lin; Brown, Ted; Etherington, Jamie

2018-01-01

This study investigated occupational therapy students' experiences of their alternative fieldwork placement at one childcare center where there was no established occupational therapy service. A semi-structured focus group interview explored four students' placement experiences. The interview was audio-recorded, transcribed verbatim, and content…

Teaching Students to Deconstruct Life Experience with Addictions: A Structured Reflection Exercise

ERIC Educational Resources Information Center

Lay, Kathy; McGuire, Lisa

2008-01-01

Students come to the classroom with life experience that may reinforce stigmatization of those who struggle with addiction. Educators must address this dynamic directly if addiction practitioners are to move beyond their personal experiences and come to understand the neuroscience of addiction, evidence-based practices, and the human potential for…

How do general practice registrars learn from their clinical experience? A critical incident study.

PubMed

Holmwood, C

1997-01-01

This preliminary study of RACGP registrars in the period of subsequent general practice experience examines the types of clinical experiences from which registrars learn, what they learn from the experiences and the process of learning from such experiences. A critical incident method was used on a semi structured interview process. Registrars were asked to recall clinical incidents where they had learnt something of importance. Data were sorted and categorised manually. Nine registrars were interviewed before new categories of data ceased to develop. Registrars learnt from the opportunity to follow up patients. An emotional response to the interaction was an important part of the learning process. Learning from such experiences is haphazard and unstructured. Registrars accessed human resources in response to their clinical difficulties rather than text or electronic based information sources. Registrars should be aware of their emotional responses to interactions with patients; these emotional responses often indicate important learning opportunities. Clinical interactions and resultant learning could be made less haphazard by structuring consultations with patients with specific problems. These learning opportunities should be augmented by the promotion of follow up of patients.

Probabilistic cross-link analysis and experiment planning for high-throughput elucidation of protein structure.

PubMed

Ye, Xiaoduan; O'Neil, Patrick K; Foster, Adrienne N; Gajda, Michal J; Kosinski, Jan; Kurowski, Michal A; Bujnicki, Janusz M; Friedman, Alan M; Bailey-Kellogg, Chris

2004-12-01

Emerging high-throughput techniques for the characterization of protein and protein-complex structures yield noisy data with sparse information content, placing a significant burden on computation to properly interpret the experimental data. One such technique uses cross-linking (chemical or by cysteine oxidation) to confirm or select among proposed structural models (e.g., from fold recognition, ab initio prediction, or docking) by testing the consistency between cross-linking data and model geometry. This paper develops a probabilistic framework for analyzing the information content in cross-linking experiments, accounting for anticipated experimental error. This framework supports a mechanism for planning experiments to optimize the information gained. We evaluate potential experiment plans using explicit trade-offs among key properties of practical importance: discriminability, coverage, balance, ambiguity, and cost. We devise a greedy algorithm that considers those properties and, from a large number of combinatorial possibilities, rapidly selects sets of experiments expected to discriminate pairs of models efficiently. In an application to residue-specific chemical cross-linking, we demonstrate the ability of our approach to plan experiments effectively involving combinations of cross-linkers and introduced mutations. We also describe an experiment plan for the bacteriophage lambda Tfa chaperone protein in which we plan dicysteine mutants for discriminating threading models by disulfide formation. Preliminary results from a subset of the planned experiments are consistent and demonstrate the practicality of planning. Our methods provide the experimenter with a valuable tool (available from the authors) for understanding and optimizing cross-linking experiments.

Development and participant assessment of a practical quality improvement educational initiative for surgical residents.

PubMed

Sellers, Morgan M; Hanson, Kristi; Schuller, Mary; Sherman, Karen; Kelz, Rachel R; Fryer, Jonathan; DaRosa, Debra; Bilimoria, Karl Y

2013-06-01

As patient-safety and quality efforts spread throughout health care, the need for physician involvement is critical, yet structured training programs during surgical residency are still uncommon. Our objective was to develop an extended quality-improvement curriculum for surgical residents that included formal didactics and structured practical experience. Surgical trainees completed an 8-hour didactic program in quality-improvement methodology at the start of PGY3. Small teams developed practical quality-improvement projects based on needs identified during clinical experience. With the assistance of the hospital's process-improvement team and surgical faculty, residents worked through their selected projects during the following year. Residents were anonymously surveyed after their participation to assess the experience. During the first 3 years of the program, 17 residents participated, with 100% survey completion. Seven quality-improvement projects were developed, with 57% completing all DMAIC (Define, Measure, Analyze, Improve, Control) phases. Initial projects involved issues of clinical efficiency and later projects increasingly focused on clinical care questions. Residents found the experience educationally important (65%) and believed they were well equipped to lead similar initiatives in the future (70%). Based on feedback, the timeline was expanded from 12 to 24 months and changed to start in PGY2. Developing an extended curriculum using both didactic sessions and applied projects to teach residents the theory and implementation of quality improvement is possible and effective. It addresses the ACGME competencies of practice-based improvement and learning and systems-based practice. Our iterative experience during the past 3 years can serve as a guide for other programs. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Domain analysis for the reuse of software development experiences

NASA Technical Reports Server (NTRS)

Basili, V. R.; Briand, L. C.; Thomas, W. M.

1994-01-01

We need to be able to learn from past experiences so we can improve our software processes and products. The Experience Factory is an organizational structure designed to support and encourage the effective reuse of software experiences. This structure consists of two organizations which separates project development concerns from organizational concerns of experience packaging and learning. The experience factory provides the processes and support for analyzing, packaging, and improving the organization's stored experience. The project organization is structured to reuse this stored experience in its development efforts. However, a number of questions arise: What past experiences are relevant? Can they all be used (reused) on our current project? How do we take advantage of what has been learned in other parts of the organization? How do we take advantage of experience in the world-at-large? Can someone else's best practices be used in our organization with confidence? This paper describes approaches to help answer these questions. We propose both quantitative and qualitative approaches for effectively reusing software development experiences.

Associations between structural capabilities of primary care practices and performance on selected quality measures.

PubMed

Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Zaslavsky, Alan M; Schneider, Eric C

2009-10-06

Recent proposals to reform primary care have encouraged physician practices to adopt such structural capabilities as performance feedback and electronic health records. Whether practices with these capabilities have higher performance on measures of primary care quality is unknown. To measure associations between structural capabilities of primary care practices and performance on commonly used quality measures. Cross-sectional analysis. Massachusetts. 412 primary care practices. During 2007, 1 physician from each participating primary care practice (median size, 4 physicians) was surveyed about structural capabilities of the practice (responses representing 308 practices were obtained). Data on practice structural capabilities were linked to multipayer performance data on 13 Healthcare Effectiveness Data and Information Set (HEDIS) process measures in 4 clinical areas: screening, diabetes, depression, and overuse. Frequently used multifunctional electronic health records were associated with higher performance on 5 HEDIS measures (3 in screening and 2 in diabetes), with statistically significant differences in performance ranging from 3.1 to 7.6 percentage points. Frequent meetings to discuss quality were associated with higher performance on 3 measures of diabetes care (differences ranging from 2.3 to 3.1 percentage points). Physician awareness of patient experience ratings was associated with higher performance on screening for breast cancer and cervical cancer (1.9 and 2.2 percentage points, respectively). No other structural capabilities were associated with performance on more than 1 measure. No capabilities were associated with performance on depression care or overuse. Structural capabilities of primary care practices were assessed by physician survey. Among the investigated structural capabilities of primary care practices, electronic health records were associated with higher performance across multiple HEDIS measures. Overall, the modest magnitude and limited number of associations between structural capabilities and clinical performance suggest the importance of continuing to measure the processes and outcomes of care for patients. The Commonwealth Fund.

Drama Education in New Zealand: A Coming of Age? A Conceptualisation of the Development and Practice of Drama in the Curriculum as a Structured Improvisation, with New Zealand's Experience as a Case Study

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,…

Observation of multipactor suppression in a dielectric-loaded accelerating structure using an applied axial magnetic field

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

Jing, C.; Konecny, R.; Antipov, S.

2013-11-18

Efforts by a number of institutions to develop a Dielectric-Loaded Accelerating (DLA) structure capable of supporting high gradient acceleration when driven by an external radio frequency source have been ongoing over the past decade. Single surface resonant multipactor has been previously identified as one of the major limitations on the practical application of DLA structures in electron accelerators. In this paper, we report the results of an experiment that demonstrated suppression of multipactor growth in an X-band DLA structure through the use of an applied axial magnetic field. This represents an advance toward the practical use of DLA structures inmore » many accelerator applications.« less

Suggested Guidelines for Writing Reflective Case Narratives: Structure and Indicators

ERIC Educational Resources Information Center

Becker, Karin L.; Renger, Ralph

2017-01-01

Reflective case narratives are a practical mechanism for conveying lessons learned for practice improvement. Their ability to transform experience into knowledge in a colloquial, narrative style positions reflective case narratives as a powerful learning tool with pedagogical benefits for the evaluation community. However, one criticism of…

Teacher Education and Inclusionary Practices: Sharing Delhi University Experiences

ERIC Educational Resources Information Center

Raina, Jyoti

2016-01-01

Teacher agency is a dynamic catalyst in the process of inclusion, emancipation and social change through school education. This article highlights three key curricular practices in the structure, content and method of a process-based elementary teacher education curriculum aimed at enabling the emergence of this agency that characterise the…

Capturing Teachers' Experience of Learning Design through Case Studies

ERIC Educational Resources Information Center

Masterman, Elizabeth; Jameson, Jill; Walker, Simon

2009-01-01

This article distinguishes three dimensions to learning design: a technological infrastructure, a conceptual framework for practice that focuses on the creation of structured sequences of learning activities, and a way to represent and share practice through the use of mediating artefacts. Focusing initially on the second of these dimensions, the…

Inclusion Practices in Elementary Physical Education: A Social-Cognitive Perspective

ERIC Educational Resources Information Center

An, Jihoun; Meaney, Karen S.

2015-01-01

This study explored inclusion practices in general physical education (GPE) from the experiences and perspectives of elementary physical education teachers. The stories of four teachers (two females, two males) between 27 and 57 years of age were gathered using the phenomenological methods of semi-structured interviews, photographs, school…

High School Academics: Increasing the Standard

ERIC Educational Resources Information Center

Gard, Ashley N.

2017-01-01

Beyond heightened academic requirements, student athletes face a multitude of tasks including weight training, practice, film review, and travel for competition. This makes the student's life complex. As student athletes progress through their educational experience, they experience higher structured time demands in regard to their sport…

Cultural Beliefs and Instructional Intentions: Do Experiences in Teacher Education Institutions Matter?

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…

Diagnoses, labels and stereotypes: Supporting children with intellectual disabilities in the hospital.

PubMed

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.

Examining clinicians’ experiences providing sexual health services for LGBTQ youth: considering social and structural determinants of health in clinical practice

PubMed Central

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

Identification challenges for large space structures

NASA Technical Reports Server (NTRS)

Pappa, Richard S.

1990-01-01

The paper examines the on-orbit modal identification of large space structures, stressing the importance of planning and experience, in preparation for the Space Station Structural Characterization Experiment (SSSCE) for the Space Station Freedom. The necessary information to foresee and overcome practical difficulties is considered in connection with seven key factors, including test objectives, dynamic complexity of the structure, data quality, extent of exploratory studies, availability and understanding of software tools, experience with similar problems, and pretest analytical conditions. These factors affect identification success in ground tests. Comparisons with similar ground tests of assembled systems are discussed, showing that the constraints of space tests make these factors more significant. The absence of data and experiences relating to on-orbit modal identification testing is shown to make identification a uniquely mathematical problem, although all spacecraft are constructed and verified by proven engineering methods.

General practitioners' and students' experiences with feedback during a six-week clerkship in general practice: a qualitative study.

PubMed

Gran, Sarah Frandsen; Brænd, Anja Maria; Lindbæk, Morten; Frich, Jan C

2016-06-01

Feedback may be scarce and unsystematic during students' clerkship periods. We wanted to explore general practitioners' (GPs) and medical students' experiences with giving and receiving supervision and feedback during a clerkship in general practice, with a focus on their experiences with using a structured tool (StudentPEP) to facilitate feedback and supervision. Qualitative study. Teachers and students from a six-week clerkship in general practice for fifth year medical students were interviewed in two student and two teacher focus groups. 21 GPs and nine medical students. We found that GPs first supported students' development in the familiarization phase by exploring the students' expectations and competency level. When mutual trust had been established through the familiarization phase GPs encouraged students to conduct their own consultations while being available for supervision and feedback. Both students and GPs emphasized that good feedback promoting students' professional development was timely, constructive, supportive, and focused on ways to improve. Among the challenges GPs mentioned were giving feedback on behavioral issues such as body language and insensitive use of electronic devices during consultations or if the student was very insecure, passive, and reluctant to take action or lacked social or language skills. While some GPs experienced StudentPEP as time-consuming and unnecessary, others argued that the tool promoted feedback and learning through mandatory observations and structured questions. Mutual trust builds a learning environment in which supervision and feedback may be given during students' clerkship in general practice. Structured tools may promote feedback, reflection and learning. Key Points Observing the teacher and being supervised are essential components of Medical students' learning during general practice clerkships. Teachers and students build mutual trust in the familiarization phase. Good feedback is based on observations, is timely, encouraging, and instructive. StudentPEP may create an arena for structured feedback and reflection.

Educating new graduate nurses in their first year of practice: The perspective and experiences of the new graduate nurses and the director of nursing.

PubMed

Doughty, Lesley; McKillop, Ann; Dixon, Robyn; Sinnema, Claire

2018-05-01

New graduate nurses are the future of nursing and the education they receive as they transition into the workforce as a newly registered nurse is critical for building a suitably qualified nursing workforce that will adequately serve the future population. Variation exists in education programmes for new graduate nurses in their first year of practice which is known to impact on transition experience. A qualitative study using focus groups and semi-structured interviews was undertaken to explore the experiences and perceptions of New Graduate Nurses undertaking a new graduate programme and Directors of Nursing supporting them to complete the programme which may or may not have been inclusive of a postgraduate course (Masters Level). The findings of this study are in line with previous research and support the value of new graduate programmes but did reveal a lack of consensus in regards to the structure and content of such programmes. This study revealed some commonalities and challenges between the differing programmes but has identified the need for further research to establish the impact of postgraduate education in the first year of practice and how this impacts on nursing practice and patient care. There are numerous terms in the literature with reference to new graduate programmes; transition to practice programme, nurse entry to practice programme, first year of clinical practice programme, new graduate programme and early career nursing programme. For the purpose of this article the term Nurse Entry to Practice (NETP) will be used in reference to any form of new graduate programme. Copyright © 2018 Elsevier Ltd. All rights reserved.

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…

Staff Nurses’ Perceptions and Experiences about Structural Empowerment: A Qualitative Phenomenological Study

PubMed Central

Van Bogaert, Peter; Peremans, Lieve; Diltour, Nadine; Van heusden, Danny; Dilles, Tinne; Van Rompaey, Bart; Havens, Donna Sullivan

2016-01-01

The aim of the study reported in this article was to investigate staff nurses’ perceptions and experiences about structural empowerment and perceptions regarding the extent to which structural empowerment supports safe quality patient care. To address the complex needs of patients, staff nurse involvement in clinical and organizational decision-making processes within interdisciplinary care settings is crucial. A qualitative study was conducted using individual semi-structured interviews of 11 staff nurses assigned to medical or surgical units in a 600-bed university hospital in Belgium. During the study period, the hospital was going through an organizational transformation process to move from a classic hierarchical and departmental organizational structure to one that was flat and interdisciplinary. Staff nurses reported experiencing structural empowerment and they were willing to be involved in decision-making processes primarily about patient care within the context of their practice unit. However, participants were not always fully aware of the challenges and the effect of empowerment on their daily practice, the quality of care and patient safety. Ongoing hospital change initiatives supported staff nurses’ involvement in decision-making processes for certain matters but for some decisions, a classic hierarchical and departmental process still remained. Nurses perceived relatively high work demands and at times viewed empowerment as presenting additional. Staff nurses recognized the opportunities structural empowerment provided within their daily practice. Nurse managers and unit climate were seen as crucial for success while lack of time and perceived work demands were viewed as barriers to empowerment. PMID:27035457

Staff Nurses' Perceptions and Experiences about Structural Empowerment: A Qualitative Phenomenological Study.

PubMed

Van Bogaert, Peter; Peremans, Lieve; Diltour, Nadine; Van heusden, Danny; Dilles, Tinne; Van Rompaey, Bart; Havens, Donna Sullivan

2016-01-01

The aim of the study reported in this article was to investigate staff nurses' perceptions and experiences about structural empowerment and perceptions regarding the extent to which structural empowerment supports safe quality patient care. To address the complex needs of patients, staff nurse involvement in clinical and organizational decision-making processes within interdisciplinary care settings is crucial. A qualitative study was conducted using individual semi-structured interviews of 11 staff nurses assigned to medical or surgical units in a 600-bed university hospital in Belgium. During the study period, the hospital was going through an organizational transformation process to move from a classic hierarchical and departmental organizational structure to one that was flat and interdisciplinary. Staff nurses reported experiencing structural empowerment and they were willing to be involved in decision-making processes primarily about patient care within the context of their practice unit. However, participants were not always fully aware of the challenges and the effect of empowerment on their daily practice, the quality of care and patient safety. Ongoing hospital change initiatives supported staff nurses' involvement in decision-making processes for certain matters but for some decisions, a classic hierarchical and departmental process still remained. Nurses perceived relatively high work demands and at times viewed empowerment as presenting additional. Staff nurses recognized the opportunities structural empowerment provided within their daily practice. Nurse managers and unit climate were seen as crucial for success while lack of time and perceived work demands were viewed as barriers to empowerment.

An Advanced Professional Pharmacy Experience in a Community Setting Using an Experiential Manual

PubMed Central

Lee, Karen W.; Machado, Matthew R.; Wenzel, Marie M.; Gagnon, James M.; Calomo, Joseph M.

2006-01-01

Objectives To determine the usefulness of a teaching and learning tool used to create structure for advanced pharmacy practice experiences (APPEs) in community pharmacy settings, and to identify differences between respondents' perspectives on the relevance and practicality of implementing specific community pharmacy-related topics during the experience. Design Community practice faculty members designed a manual that outlined a week-by-week schedule of student activities, consistent with the Center for the Advancement of Pharmaceutical Education (CAPE) outcome-based goals, and included associated teaching, documentation, and assessment tools. The manual was distributed to site preceptors and students. Assessment Eighty-six PharmD students responded to a questionnaire upon completion of their community APPE. Student feedback concerning the impact of the manual relative to interactions with site preceptors and their overall learning experience was relatively positive. Conclusion The manual was an effective teaching and learning tool for students completing a community APPE. PMID:17149421

International practice experiences in pharmacy education.

PubMed

Cisneros, Robert M; Jawaid, Sarah Parnapy; Kendall, Debra A; McPherson, Charles E; Mu, Keli; Weston, Grady Scott; Roberts, Kenneth B

2013-11-12

To identify reasons for inclusion of international practice experiences in pharmacy curricula and to understand the related structure, benefits, and challenges related to the programs. A convenience sample of 20 colleges and schools of pharmacy in the United States with international pharmacy education programs was used. Telephone interviews were conducted by 2 study investigators. University values and strategic planning were among key driving forces in the development of programs. Global awareness and cultural competency requirements added impetus to program development. Participants' advice for creating an international practice experience program included an emphasis on the value of working with university health professions programs and established travel programs. Despite challenges, colleges and schools of pharmacy value the importance of international pharmacy education for pharmacy students as it increases global awareness of health needs and cultural competencies.

Locum doctors in general practice: motivation and experiences.

PubMed Central

McKevitt, C; Morgan, M; Hudson, M

1999-01-01

BACKGROUND: There is evidence of dissatisfaction with locum doctors' performance, but little is known about doctors who work as locums in general practice or about their experiences of this work. AIM: To describe the motivations and experiences of doctors providing locum cover in general practices. METHOD: A postal questionnaire survey distributed to locums through organizations such as locum groups, commercial agencies, and general practices. RESULTS: Questionnaires were returned by 111 doctors currently working as locums in general practice. Four main reasons for working as a locum GP were: as a short-term option while between posts, to gain experience of different practices before commitment to one practice, to balance work and family or other commitments, to continue part-time work after retirement. One-quarter of responders intended to continue working as a locum indefinitely. The drawbacks of locum work included frustration with low status, lack of security, and difficulty accessing structured training and education. CONCLUSION: Locum doctors in general practice are a heterogeneous group that includes those who have chosen this type of work. The doctors who intend to continue as locums indefinitely represent a useful resource in primary care whose ability to provide short-term cover could be maximized. The need to control the quality of 'freelance' doctors should not overshadow the need to control the quality of their working environments. PMID:10621983

Committed, Face-Value, Hybrid or Mutual Adaptation? The Experiences of International Students in Australian Higher Education

ERIC Educational Resources Information Center

Tran, Ly Thi

2011-01-01

This paper explores the adaptation patterns of international Chinese and Vietnamese students in relation to academic writing practices in a higher education context. The study utilises a trans-disciplinary framework for interpreting students' and lecturers' practices within institutional structures. This framework has been developed by infusing a…

Best Practices for Young Children's Music Education: Guidance from Brain Research

ERIC Educational Resources Information Center

Flohr, John W.

2010-01-01

This article reviews best practices for young children's music experiences in light of developments in brain research. The first section reviews research music and brain topics including neuromyths, effect of music on structural brain changes and general intelligence, plasticity, critical and optimal periods, and at-risk student populations. The…

Medical home implementation: a sensemaking taxonomy of hard and soft best practices.

PubMed

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.

Examining Clinicians' Experiences Providing Sexual Health Services for LGBTQ Youth: Considering Social and Structural Determinants of Health in Clinical Practice

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…

Medical students, early general practice placements and positive supervisor experiences.

PubMed

Henderson, Margaret; Upham, Susan; King, David; Dick, Marie-Louise; van Driel, Mieke

2018-03-01

Introduction Community-based longitudinal clinical placements for medical students are becoming more common globally. The perspective of supervising clinicians about their experiences and processes involved in maximising these training experiences has received less attention than that of students. Aims This paper explores the general practitioner (GP) supervisor perspective of positive training experiences with medical students undertaking urban community-based, longitudinal clinical placements in the early years of medical training. Methods Year 2 medical students spent a half-day per week in general practice for either 13 or 26 weeks. Transcribed semi-structured interviews from a convenience sample of participating GPs were thematically analysed by two researchers, using a general inductive approach. Results Identified themes related to the attributes of participating persons and organisations: GPs, students, patients, practices and their supporting institution; GPs' perceptions of student development; and triggers enhancing the experience. A model was developed to reflect these themes. Conclusions Training experiences were enhanced for GPs supervising medical students in early longitudinal clinical placements by the synergy of motivated students and keen teachers with support from patients, practice staff and academic institutions. We developed an explanatory model to better understand the mechanism of positive experiences. Understanding the interaction of factors enhancing teaching satisfaction is important for clinical disciplines wishing to maintain sustainable, high quality teaching.

Medical home capabilities of primary care practices that serve sociodemographically vulnerable neighborhoods.

PubMed

Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Schneider, Eric C

2010-06-14

Under current medical home proposals, primary care practices using specific structural capabilities will receive enhanced payments. Some practices disproportionately serve sociodemographically vulnerable neighborhoods. If these practices lack medical home capabilities, their ineligibility for enhanced payments could worsen disparities in care. Via survey, 308 Massachusetts primary care practices reported their use of 13 structural capabilities commonly included in medical home proposals. Using geocoded US Census data, we constructed racial/ethnic minority and economic disadvantage indices to describe the neighborhood served by each practice. We compared the structural capabilities of "disproportionate-share" practices (those in the most sociodemographically vulnerable quintile on each index) and others. Racial/ethnic disproportionate-share practices were more likely than others to have staff assisting patient self-management (69% vs 55%; P = .003), on-site language interpreters (54% vs 26%; P < .001), multilingual clinicians (80% vs 51%; P < .001), and multifunctional electronic health records (48% vs 29%; P = .01). Similarly, economic disproportionate-share practices were more likely than others to have physician awareness of patient experience ratings (73% vs 65%; P = .03), on-site language interpreters (56% vs 25%; P < .001), multilingual clinicians (78% vs 51%; P < .001), and multifunctional electronic health records (40% vs 31%; P = .03). Disproportionate-share practices were larger than others. After adjustment for practice size, only language capabilities continued to have statistically significant relationships with disproportionate-share status. Contrary to expectations, primary care practices serving sociodemographically vulnerable neighborhoods were more likely than other practices to have structural capabilities commonly included in medical home proposals. Payments tied to these capabilities may aid practices serving vulnerable populations.

Design and implementation of robust decentralized control laws for the ACES structure at Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

Collins, Emmanuel G., Jr.; Phillips, Douglas J.; Hyland, David C.

1990-01-01

Many large space system concepts will require active vibration control to satisfy critical performance requirements such as line-of-sight accuracy. In order for these concepts to become operational it is imperative that the benefits of active vibration control be practically demonstrated in ground based experiments. The results of the experiment successfully demonstrate active vibration control for a flexible structure. The testbed is the Active Control Technique Evaluation for Spacecraft (ACES) structure at NASA Marshall Space Flight Center. The ACES structure is dynamically traceable to future space systems and especially allows the study of line-of-sight control issues.

Health and Masculinities Shaped by Agency within Structures among Young Unemployed Men in a Northern Swedish Context.

PubMed

Hammarström, Anne; Lundman, Berit; Ahlgren, Christina; Wiklund, Maria

2015-01-01

The aim of our paper was to explore expressions of life choices and life chances (aspects of agency within structures) related to power and experiences of health among early unemployed adolescent young men during the transition period to adulthood. These expressions of agency within structure were interpreted in the light of Cockerham's Health Lifestyles Theory. Furthermore, social constructions of masculinities were addressed in our analysis. Repeated interviews with ten young men in a cohort of school leavers were analyzed with qualitative content analysis. Cockerham's model was useful for interpreting our findings and we found disposition to act to be a crucial theoretical tool to capture the will and intentions of participants in relation to health. We developed the model in the following ways: structure and socialization were visualized as surrounding the whole model. Analyses of what enhances or restricts power are important. In addition to practices of health lifestyles, we added experiences of health as outcome as well as emotional aspects in disposition to act. We interpret our findings as constructions of masculinities within certain structures, in relation to choices, habitus and practices. Qualitative research could contribute to develop the understanding of the agency within structure relationships. Future studies need to pay attention to experiences of health among young people at the margin of the labor market in various milieus--and to analyze these in relation to gender constructions and within the frame-work of agency within structure.

Las experiencias clinicas de los estudiantes de enfermeria: Estudio de caso hacia la integracion de la mentoria

NASA Astrophysics Data System (ADS)

Rivera Rodriguez, Ivelisse

Clinical experiences are an essential part of the training of future nursing professionals. The period of clinical experience aims to develop in the student the necessary skills to practice as a nursing professional, when the academic program ends. This case study aimed to understand the opinion and explore the perception of faculty, clinical instructors, and nursing students on the meaning, contributions and challenges presented during clinical experiences. Among the themes explored in the focus groups were the meaning and importance to learning about the profession of clinical experiences, teaching strategies used during the practice scenarios, didactic relationships developed among students, clinical instructors, and teachers. The goal was to learn from all participants about what they do, their expectations, and the challenges presented during the clinical experiences. A qualitative, descriptive and contextual research design was followed, which required conducting six focus groups to collect the information from the perspective of all the participants. Faculty, clinical instructors, and nursing students participated each in two focus groups. Collected data were transcribed, coded and analyzed in order to organize it under themes related to the research framework. The qualitative analysis of the focus groups revealed that nursing faculty and clinical instructors perceived clinical experiences as a very important element in the training of nursing students, but that coordination between the academy and practice scenarios is disconnected and needs improvement. They also expressed that they use various learning strategies during the clinical experiences, however, they recognize it needs more structure and suggested mentoring as a strategy to consider. They affirmed that mentoring could contribute positively to enhance the teaching-learning process. Clinical instructors understand they perform mentoring roles, but they would like to have a more defined role and structured process. Nursing students, also, recognized the importance of clinical experiences in their professional training. They expressed the need to improve the communication between the academy and the practice scenarios in order to reduce the levels of anxiety they experience when entering the clinical experiences. Nursing students also expressed the need to consider the use of different teaching strategies, such as mentoring, to improve clinical experiences.

Creating Information Structures That Work for the New Millennium.

ERIC Educational Resources Information Center

Gordon, Heather

This paper discusses the impact of globalization and new information and communication technologies on the structures and practices of higher education. The first section addresses the integration of library and information technology services, focusing on experiences at the University of the Sunshine Coast (Queensland, Australia). The second…

Preregistration nursing students' perspectives on the learning, teaching and application of bioscience knowledge within practice.

PubMed

Molesworth, Mark; Lewitt, Moira

2016-03-01

This paper aims to explore student nurses' experiences of bioscience learning, teaching and application within the practice setting. It draws upon the social learning theory of communities of practice to consider the issues raised. The teaching of bioscience within many nursing curricula has shifted from traditional to more integrated approaches. Student nurses recognise bioscience as a valuable component of their studies, but many find it challenging. The focus of previous research in this area has often focussed on bioscience learning in theoretical rather than practice settings. A phenomenological study. Data were collected via focus group or interview with a total of seven students across two campuses in a Scottish university. Participants were offered the opportunity to share their experiences at both the end of year one and year two of their studies. A thematic analysis was undertaken independently then jointly by the authors. The findings suggest that although participants recognise the value of bioscience within practice settings, they found that opportunities for learning were often limited. Bioscience-related learning, teaching and application was perceived to have been given less legitimacy by the practice setting than other aspects of placement activity. To enhance bioscience approaches participants expressed a desire for more structured and integrated approaches within both practice and university along with further peer learning opportunities. Students recognise that bioscience knowledge is important in relation to the provision of safe and effective care. They request greater structure and consistency in relation to the learning, teaching and application of this topic during their placements. Those with a stake in educating nurses within clinical settings may find the views of student nurses on the topic of bioscience learning useful when planning and facilitating placement experiences. © 2015 John Wiley & Sons Ltd.

The lived experience of feeling sad.

PubMed

Bunkers, Sandra Schmidt

2010-07-01

The purpose of this study was to enhance understanding of the lived experience of feeling sad. Parse's phenomenological-hermeneutic research method was used to answer the research question: What is the structure of the lived experience of feeling sad? Participants were 7 elders who had lost a pet. Data were collected with dialogical engagement. The major finding of the study is the structure: Feeling sad is penetrating anguish surfacing with contemplating absent-yet present intimacies, while prevailing amid misfortune. Feeling sad is discussed in relation to the principles of humanbecoming and in relation to how it can inform future nursing research and nursing practice.

Medical Home Implementation Gaps for Seniors: Perceptions and Experiences of Primary Care Medical Practices.

PubMed

Hoff, Timothy; DePuccio, Matthew

2018-07-01

The study objective was to better understand specific implementation gaps for various aspects of patient-centered medical home (PCMH) care delivered to seniors. The study illuminates the physician and staff experience by focusing on how individuals make sense of and respond behaviorally to aspects of PCMH implementation. Qualitative data from 51 in-depth, semi-structured interviews across six different National Committee for Quality Assurance (NCQA)-accredited primary care practices were collected and analyzed. Physicians and staff identified PCMH implementation gaps for their seniors: (a) performing in-depth clinical assessments, (b) identifying seniors' life needs and linking them with community resources, and (c) care management and coordination, in particular self-management support for seniors. Prior experiences trying to perform these aspects of PCMH care for older adults produced collective understandings that led to inaction and avoidance by medical practices around the first two gaps, and proactive behavior that took strategic advantage of external incentives for addressing the third gap. Greater understanding of physician and staff's PCMH implementation experiences, and the learning that accumulates from these experiences, allows for a deeper understanding of how primary care practices choose to enact the medical home model for seniors on an everyday basis.

The testing effect and analogical problem-solving.

PubMed

Peterson, Daniel J; Wissman, Kathryn T

2018-06-25

Researchers generally agree that retrieval practice of previously learned material facilitates subsequent recall of same material, a phenomenon known as the testing effect. There is debate, however, about when such benefits transfer to related (though not identical) material. The current study examines the phenomenon of transfer in the domain of analogical problem-solving. In Experiments 1 and 2, learners were presented a source text describing a problem and solution to read which was subsequently either restudied or recalled. Following a short (Experiment 1) or long (Experiment 2) delay, learners were given a new target text and asked to solve a problem. The two texts shared a common structure such that the provided solution for the source text could be applied to solve the problem in the target text. In a combined analysis of both experiments, learners in the retrieval practice condition were more successful at solving the problem than those in the restudy condition. Experiment 3 explored the degree to which retrieval practice promotes cued versus spontaneous transfer by manipulating whether participants were provided with an explicit hint that the source and target texts were related. Results revealed no effect of retrieval practice.

Astronauts Shepard and Mitchell practice using Active Seismic Experiment

NASA Image and Video Library

1970-10-30

S71-15273 (October 1970) --- Apollo 14 astronauts Alan B. Shepard Jr., commander (right); and Edgar D. Mitchell, lunar module pilot, practice using the Active Seismic Experiment (ASE) to set off explosions on the lunar surface and arm a mortar to launch four grenades after they leave. Measurements of the ensuing vibrations of the moon, radioed to Earth, will give scientists new information on the shape, structure and thickness of the outer lunar crust. ASE will be deployed during one of two Apollo 14 extravehicular activity (EVA) periods.

Examining clinicians' experiences providing sexual health services for LGBTQ youth: considering social and structural determinants of health in clinical practice.

PubMed

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.

Practice-based learning experience to develop residents as clinical faculty members.

PubMed

Slazak, Erin M; Zurick, Gina M

2009-07-01

A practice-based learning experience designed to expose postgraduate year 1 (PGY1) and 2 (PGY2) residents to and prepare them for a career as clinical faculty is described. A practice-based learning experience was designed to give PGY1 and PGY2 residents exposure to the responsibilities of a clinical faculty member, integrating clinical practice, preceptor duties, and other academia-related responsibilities. The learning experience is a four-week, elective rotation for PGY1 and PGY2 residents. The rotation is designed to correspond to a four-week advanced pharmacy practice experience (APPE) rotation, allowing the resident to work continuously with the same one or two APPE students for the entire rotation. The resident is required to design and implement a rotation for the students and provide clinical services while integrating students into daily tasks, facilitating topic and patient discussions, evaluating assignments, providing constructive feedback, and assigning a final rotation grade. The resident also attends all academic and committee meetings and teaching obligations with his or her residency director, if applicable. The resident is mentored by the residency director throughout all phases of the rotation and is evaluated using goals and objectives tailored to this experience. The development of a formal, structured rotation to give postgraduate residents experience as a preceptor provided an opportunity for residents to further explore their interests in academia and allowed them to serve as a primary preceptor while being guided and evaluated by a mentor.

Deliberate Practice in Medicine: The Motivation to Engage in Work-Related Learning and Its Contribution to Expertise

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…

THE NEGRO AND EQUAL EMPLOYMENT OPPORTUNITIES, A REVIEW OF MANAGEMENT EXPERIENCES IN TWENTY COMPANIES.

ERIC Educational Resources Information Center

FERMAN, LOUIS A.

TO STUDY THE APPLICATION OF EQUAL EMPLOYMENT PRACTICES IN COMPANY SETTINGS AND TO ASSESS THE IMPACT OF THESE PRACTICES ON MINORITY GROUP EMPLOYMENT, 20 COMPANIES WITH VARYING EMPLOYMENT STRUCTURE, INDUSTRY, SIZE, NUMBER OF BRANCH UNITS, GEOGRAPHICAL SPREAD, AND PRODUCT OR SERVICE WERE STUDIED. ALL WERE TRYING TO PROMOTE EQUAL OPPORTUNITIES IN…

Helping Pre-Service Mathematics Teachers Connect Theory and Practice: Using Reading, Writing, and Observation Protocols to Structure Field Experiences

ERIC Educational Resources Information Center

Cross, Stephanie Behm; Bayazit, Nermin Tosmur

2014-01-01

The authors designed the project described her in order to address their students' expressed frustrations at the perceived disconnect between theory and practice. The project combined course readings, journaling, collaboratively created observation protocols, and classroom observation into a semester-long iterative assignment. The students' work…

Dis(en)abled: Legitimating Discriminatory Practice in the Name of Inclusion?

ERIC Educational Resources Information Center

Atkins, Liz

2016-01-01

This article explores tensions between the policies and practice of inclusion and the lived experiences of disabled young people in education. Drawing on the narratives of two young men who participated in a small pilot study, it utilises theoretical concepts related to disability, structure and agency, and power and control, as it explores the…

Vibration-based monitoring for performance evaluation of flexible civil structures in Japan.

PubMed

Fujino, Yozo

2018-01-01

The vibration-based monitoring of flexible civil structures and performance evaluation from this monitoring are reviewed, with an emphasis on research and practice in Japan and the author's experiences. Some new findings and unexpected vibrations from the monitoring of real bridges and buildings are reported to emphasize the importance of monitoring. Future developments and applications of vibration-based monitoring to civil infrastructure management are also described. Many examples are taken from the author's past 30 years' experience of research on bridge dynamics.

The Experience of Feeling Disrespected: A Humanbecoming Perspective.

PubMed

Hawkins, Kim

2017-04-01

The concept of feeling disrespected was explored using the Parse research method. Ten women living with embodied largeness were asked, "What is the experience of feeling disrespected?" The structure of the living experience was feeling disrespected is mortifying disheartenment arising with disquieting irreverence, as distancing affiliations surface while enduring hardship. The findings provided new knowledge of living quality, advanced nursing practice, and presented future direction for research.

Free-decay time-domain modal identification for large space structures

NASA Technical Reports Server (NTRS)

Kim, Hyoung M.; Vanhorn, David A.; Doiron, Harold H.

1992-01-01

Concept definition studies for the Modal Identification Experiment (MIE), a proposed space flight experiment for the Space Station Freedom (SSF), have demonstrated advantages and compatibility of free-decay time-domain modal identification techniques with the on-orbit operational constraints of large space structures. Since practical experience with modal identification using actual free-decay responses of large space structures is very limited, several numerical and test data reduction studies were conducted. Major issues and solutions were addressed, including closely-spaced modes, wide frequency range of interest, data acquisition errors, sampling delay, excitation limitations, nonlinearities, and unknown disturbances during free-decay data acquisition. The data processing strategies developed in these studies were applied to numerical simulations of the MIE, test data from a deployable truss, and launch vehicle flight data. Results of these studies indicate free-decay time-domain modal identification methods can provide accurate modal parameters necessary to characterize the structural dynamics of large space structures.

Learning Communities: New Structures, New Partnerships for Learning. The First-Year Experience. Monograph Series, No. 26.

ERIC Educational Resources Information Center

Levine, Jodi H., Ed.

This monograph on learning communities and the first-year college experience presents 12 chapters which combine theory with examples of good practice and recommendations for building and sustaining effective learning communities. Following an introduction by the editor, the included chapters are: (1) "What Are Learning Communities?"…

Becoming-Nomadic through Experimental Art Making with Children

ERIC Educational Resources Information Center

Clark, Vanessa

2012-01-01

The author draws on her own experiences through art, along with her experiences with children, to inform her understanding of art making as nomadic thinking, a means to disrupt the power structures and boundaries that developmental psychology imposes on early childhood practice. The author altered the classrooms of two early childhood centres with…

Transitional Experiences of Post-16 Sports Education: Jack's Story

ERIC Educational Resources Information Center

Aldous, David C. R.; Sparkes, Andrew C.; Brown, David H. K.

2014-01-01

This paper explores the layered transitional experiences of a semi-professional athlete named Jack (a pseudonym) between the fields of professional sport and further and higher education. Our analysis is framed by the quadripartite framework of structuration and focuses on Jack's "in-situ" practices at his college and university in order…

General practitioners’ experiences using cognitive behavioural therapy in general practice: A qualitative study

PubMed Central

Aschim, Bente; Lundevall, Sverre; Martinsen, Egil W.; Frich, Jan C.

2011-01-01

Objective To explore GPs’ experiences using cognitive behavioural therapy (CBT), with a focus on factors that promote or limit the use of CBT in general practice. Design Qualitative study using data from written evaluation reports and focus-group interviews. Setting Norwegian general practice. Subjects GPs who participated in a longitudinal CBT course in the continuous medical education (CME) programme for GPs in Norway, of whom 19 filled in evaluation forms and 15 participated in focus-group interviews. Main outcome measures Experiences with the use of CBT in general practice. Results GPs used CBT mainly in the treatment of patients with anxiety disorders and depression. Factors that promoted the use of CBT in general practice were structured supervision and group counselling, receiving feedback on individual video-recorded consultations, and experiencing that one mastered the therapeutic techniques. Limiting factors were that it took some time before one mastered the techniques, lack of eligible patients, constraints related to attending group supervision during office hours, and the lack of financial incentives to use CBT in general practice. Conclusion Tailored training programmes in CBT for GPs may contribute to more frequent use of CBT in general practice. A formal recognition of CBT in the reimbursement scheme for GPs might counter limiting factors to an increased use of CBT in general practice. PMID:21861599

Capturing the Integration of Practice-Based Learning with Beliefs, Values, and Attitudes using Modified Concept Mapping.

PubMed

Mcnaughton, Susan; Barrow, Mark; Bagg, Warwick; Frielick, Stanley

2016-01-01

Practice-based learning integrates the cognitive, psychomotor, and affective domains and is influenced by students' beliefs, values, and attitudes. Concept mapping has been shown to effectively demonstrate students' changing concepts and knowledge structures. This article discusses how concept mapping was modified to capture students' perceptions of the connections between the domains of thinking and knowing, emotions, behavior, attitudes, values, and beliefs and the specific experiences related to these, over a period of eight months of practice-based clinical learning. The findings demonstrate that while some limitations exist, modified concept mapping is a manageable way to gather rich data about students' perceptions of their clinical practice experiences. These findings also highlight the strong integrating influence of beliefs and values on other areas of practice, suggesting that these need to be attended to as part of a student's educational program.

Capturing the Integration of Practice-Based Learning with Beliefs, Values, and Attitudes using Modified Concept Mapping

PubMed Central

Mcnaughton, Susan; Barrow, Mark; Bagg, Warwick; Frielick, Stanley

2016-01-01

Practice-based learning integrates the cognitive, psychomotor, and affective domains and is influenced by students’ beliefs, values, and attitudes. Concept mapping has been shown to effectively demonstrate students’ changing concepts and knowledge structures. This article discusses how concept mapping was modified to capture students’ perceptions of the connections between the domains of thinking and knowing, emotions, behavior, attitudes, values, and beliefs and the specific experiences related to these, over a period of eight months of practice-based clinical learning. The findings demonstrate that while some limitations exist, modified concept mapping is a manageable way to gather rich data about students’ perceptions of their clinical practice experiences. These findings also highlight the strong integrating influence of beliefs and values on other areas of practice, suggesting that these need to be attended to as part of a student's educational program. PMID:29349311

Masculinity and undocumented labor migration: injured latino day laborers in San Francisco

PubMed Central

Walter, Nicholas; Bourgois, Philippe; Loinaz, H. Margarita

2009-01-01

Drawing on data collected through clinical practice and ethnographic fieldwork, this study examines the experience of injury, illness and disability among undocumented Latino day laborers in San Francisco. We demonstrate how constructions of masculine identity organize the experience of embodied social suffering among workers who are rendered vulnerable by the structural conditions of undocumented immigrant status. Theoretical concepts from critical medical anthropology and gender studies extend the scholarly analysis of structural violence beyond the primarily economic to uncover how it is embodied at the intimate level as a gendered experience of personal and familial crisis, involving love, respect, betrayal and patriarchal failure. A clinical ethnographic focus on socially structured patriarchal suffering elucidates the causal relationship between macro-forces and individual action with a fuller appreciation of the impact of culture and everyday lived experience. PMID:15210088

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.…

A tale of four practices.

PubMed

Miller-Day, Michelle; Applequist, Janelle; Zabokrtsky, Keri; Dalton, Alexandra; Kellom, Katherine; Gabbay, Robert; Cronholm, Peter F

2017-09-18

Purpose The Patient-Centered Medical Home (PCMH) has become a dominant model of primary care re-design. This transformation presents a challenge to many care delivery organizations. The purpose of this paper is to describe attributes shaping successful and unsuccessful practice transformation within four medical practice groups. Design/methodology/approach As part of a larger study of 25 practices transitioning into a PCMH, the current study focused on diabetes care and identified high- and low-improvement medical practices in terms of quantitative patient measures of glycosylated hemoglobin and qualitative assessments of practice performance. A subset of the top two high-improvement and bottom two low-improvement practices were identified as comparison groups. Semi-structured interviews were conducted with diverse personnel at these practices to investigate their experiences with practice transformation and data were analyzed using analytic induction. Findings Results show a variety of key attributes facilitating more successful PCMH transformation, such as empanelment, shared goals and regular meetings, and a clear understanding of PCMH transformation purposes, goals, and benefits, providing care/case management services, and facilitating patient reminders. Several barriers also exist to successful transformation, such as low levels of resources to handle financial expense, lack of understanding PCMH transformation purposes, goals, and benefits, inadequate training and management of technology, and low team cohesion. Originality/value Few studies qualitatively compare and contrast high and low performing practices to illuminate the experience of practice transformation. These findings highlight the experience of organizational members and their challenges in practice transformation while providing quality diabetes care.

Space Construction Experiment Definition Study (SCEDS), part 1. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1981-01-01

Definition was completed on a basic flight experiment which will provide data on the construction of large space systems from the orbiter which could not be practicably obtained from ground tests. Dynamic behavior of a representative large structure was predicted. On-orbit construction operations were studied. Orbiter control during and after construction was investigated. Evolutionary or supplemental flight experiments for the development of augmentation of a basic flight experiment were identified and defined.

Identifiability of large-scale non-linear dynamic network models applied to the ADM1-case study.

PubMed

Nimmegeers, Philippe; Lauwers, Joost; Telen, Dries; Logist, Filip; Impe, Jan Van

2017-06-01

In this work, both the structural and practical identifiability of the Anaerobic Digestion Model no. 1 (ADM1) is investigated, which serves as a relevant case study of large non-linear dynamic network models. The structural identifiability is investigated using the probabilistic algorithm, adapted to deal with the specifics of the case study (i.e., a large-scale non-linear dynamic system of differential and algebraic equations). The practical identifiability is analyzed using a Monte Carlo parameter estimation procedure for a 'non-informative' and 'informative' experiment, which are heuristically designed. The model structure of ADM1 has been modified by replacing parameters by parameter combinations, to provide a generally locally structurally identifiable version of ADM1. This means that in an idealized theoretical situation, the parameters can be estimated accurately. Furthermore, the generally positive structural identifiability results can be explained from the large number of interconnections between the states in the network structure. This interconnectivity, however, is also observed in the parameter estimates, making uncorrelated parameter estimations in practice difficult. Copyright © 2017. Published by Elsevier Inc.

The Meaning Structures of Muslim Bereavements in Israel: Religious Traditions, Mourning Practices, and Human Experience

ERIC Educational Resources Information Center

Yasien-Esmael, Hend; Rubin, Simon Shimshon

2005-01-01

The grief and mourning of Muslim citizens in Israel are considered. First, a series of mourning customs spanning the period from notification of death until post-mourning are presented from 3 perspectives: (a) the requirements of the Islamic Sunni tradition; (b) the manner in which Islamic mourning rituals are practiced; and (c) the authors'…

Influence of Problem-Based Learning Strategy on Enhancing Student's Industrial Oriented Competences Learned: An Action Research on Learning Weblog Analysis

ERIC Educational Resources Information Center

Chung, Pansy; Yeh, Ron Chuen; Chen, Yi-Cheng

2016-01-01

In order to respond to the ever-changing global economic environment, the technological and vocational education system in Taiwan needs to be dramatically reformed to the changing needs of the domestic industrial structure. Integrating practical talents with practical industrial experiences and competences can help avoid discrepancy and close the…

Identifying clinical learning needs using structured group feedback: first year evaluation of pre-registration nursing and midwifery degree programmes.

PubMed

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.

On the optimal degree of fluctuations in practice for motor learning.

PubMed

Hossner, Ernst-Joachim; Käch, Boris; Enz, Jonas

2016-06-01

In human movement science, it is widely accepted that random practice generally enhances complex motor-skill learning compared to repetitive practice. In two experiments, a particular variability-related concept is put to empirical test, namely the concept of differencial learning (DL), which assumes (i) that learners should not be distracted from task-space exploration by corrections, and (ii) that learning is facilitated by large inter-trial fluctuations. In both experiments, the advantage of DL over repetitive learning was not statistically significant. Moreover, learning was more pronounced when participants either received corrections in addition to DL (Exp. 1) or practiced in an order in which differences between consecutive trials were relatively small (Exp. 2). These findings suggest that the positive DL effects reported in literature cannot be attributed to the reduction of feedback or to the increase of inter-trial fluctuations. These results are discussed in the light of the structural-learning approach and the two-state model of motor learning in which structure-related learning effects are distinguished from the capability to adapt to current changes. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Inclusive university experience in Australia: Perspectives of students with intellectual disability and their mentors.

PubMed

Rillotta, Fiona; Arthur, Jillian; Hutchinson, Claire; Raghavendra, Parimala

2018-01-01

Inclusive post-secondary education (PSE) delivers positive personal, social and academic outcomes. However, there is limited support for students with intellectual disability (ID) to participate in higher education, particularly in Australia. This study investigated the expectations and experiences of students with ID in an inclusive individual support PSE programme. Semi-structured interviews were conducted with students ( n = 4) and peer mentors ( n = 6) at the beginning and end of one academic semester. Participants were asked about inclusive practices, goal attainment, mentoring experiences and skill development. Thematic analysis was used to analyse data. Four major themes and several subthemes were identified: self-determination (e.g. self-confidence), social development (e.g. social networks), intellectual development (e.g. subject knowledge) and inclusive practices. The results emphasized the value of inclusive PSE for students with ID. Recommendations regarding future practices of inclusive PSE for people with ID are provided.

Teachers' Perceptions and Students' Lived Experiences in Vocational-Technical Subjects in a Rural High School in Zimbabwe

ERIC Educational Resources Information Center

Masinire, Alfred

2015-01-01

This paper explores the construction of dominant models of gender among students in the Vocational-Technical. In the backdrop of dominant narratives that structure gender policies and practices in schooling in Zimbabwe, the paper elaborates upon how students' daily experiences in workrooms perpetuate the feminisation and masculinisation of fields…

Multimodal Teaching and Learning with the Use of Technology: Meanings, Practices and Discourses

ERIC Educational Resources Information Center

Papageorgiou, Vasiliki; Lameras, Petros

2017-01-01

The aim of this paper is to report on teachers' experiences of, and approaches to, multimodality in teaching and learning. A small-scale online survey with closed and semi-structured questions has been deployed to school and university teachers (n = 68) for eliciting their experiences in multimodal teaching and learning. Thematic analysis has been…

Genetic Counsellors and Private Practice: Professional Turbulence and Common Values.

PubMed

Collis, Sarah; Gaff, Clara; Wake, Samantha; McEwen, Alison

2017-12-27

Genetic counsellors face tensions between past and future identities: between established values and goals, and a broadening scope of settings and activities. This study examines the advent of genetic counsellors in private practice in Australia and New Zealand from the perspectives of the small numbers working in this sector and those who have only worked in public practice. Semi-structured interviews were conducted with 16 genetic counsellors who had experience in private practice, and 14 genetic counsellors without private sector experience. Results demonstrated that circumstantial and personal factors can mitigate the challenges experienced and the amount of support desired by those who had established a private practice, and those who were employed by private companies. Notably, most participants with private sector experience perceived themselves to be viewed negatively by other genetic counsellors. Most participants without private sector experience expressed concern that the challenges they believed genetic counsellors face in private practice may impact service quality, but wished to address such concerns by providing appropriate support. Together, our results reinforce that participants in private and public sectors are strong advocates for peer support, multidisciplinary team work, and professional development. These core values, and seeking understanding of different circumstances and support needs, will enable genetic counsellors in different sectors to move forward together. Our results suggest supports that may be acted upon by members of the profession, professional groups, and training programs, in Australia, New Zealand, and overseas.

Exploring nursing students’ experience of peer learning in clinical practice

PubMed Central

Ravanipour, Maryam; Bahreini, Masoud; Ravanipour, Masoumeh

2015-01-01

Background: Peer learning is an educational process wherein someone of the same age or level of experience level interacts with other students interested in the same topic. There is limited evidence specifically focusing on the practical use of peer learning in Iran. The aim of this study was to explore nursing students’ experiences of peer learning in clinical practice. Materials and Methods: A qualitative content analysis was conducted. Focus groups were used to find the students’ experiences about peerlearning. Twenty-eight baccalaureate nursing students at Bushehr University of Medical Sciences were selected purposively, and were arranged in four groups of seven students each. The focus group interviews were conducted using a semi-structured interview schedule. All interviews were tape-recorded, transcribed verbatim, and analyzed using conventional content analysis method. Results: The analysis identified four themes: Paradoxical dualism, peer exploitation, first learning efficacy, and socialization practice. Gained advantages and perceived disadvantages created paradoxical dualism, and peer exploitation resulted from peer selection and peer training. Conclusion: Nursing students reported general satisfaction concerning peer learning due to much more in-depth learning with little stress than conventional learning methods. Peer learning is a useful method for nursing students for practicing educational leadership and learning the clinical skills before they get a job. PMID:26097860

An international capstone experience for pharmacy students.

PubMed

Gourley, Dick R; Vaidya, Varun A; Hufstader, Meghan A; Ray, Max D; Chisholm-Burns, Marie A

2013-04-12

This report describes the experiences of the University of Tennessee College of Pharmacy over 20 years with an international capstone educational experience for students. Although the university provides reciprocal opportunities to international students, this report focuses on the experiences of the college's pharmacy students who have participated in the program. This capstone course is offered as an elective course in the advanced pharmacy practice experience (APPE) component of the college's experiential program. Goals of the program and a brief description of its organizational structure are provided. Results of a structured student satisfaction survey and a survey covering the most recent 3 years of the program are presented. This program has greatly broadened participants' cultural horizons and expanded their global view and understanding of the contributions of pharmacy to health care.

Medical Home Implementation: A Sensemaking Taxonomy of Hard and Soft Best Practices

PubMed Central

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

A reverse engineering approach to optimize experiments for the construction of biological regulatory networks.

PubMed

Zhang, Xiaomeng; Shao, Bin; Wu, Yangle; Qi, Ouyang

2013-01-01

One of the major objectives in systems biology is to understand the relation between the topological structures and the dynamics of biological regulatory networks. In this context, various mathematical tools have been developed to deduct structures of regulatory networks from microarray expression data. In general, from a single data set, one cannot deduct the whole network structure; additional expression data are usually needed. Thus how to design a microarray expression experiment in order to get the most information is a practical problem in systems biology. Here we propose three methods, namely, maximum distance method, trajectory entropy method, and sampling method, to derive the optimal initial conditions for experiments. The performance of these methods is tested and evaluated in three well-known regulatory networks (budding yeast cell cycle, fission yeast cell cycle, and E. coli. SOS network). Based on the evaluation, we propose an efficient strategy for the design of microarray expression experiments.

Computer-Supplemented Structural Drill Practice Versus Computer-Supplemented Semantic Drill Practice by Beginning College German Students: A Comparative Experiment

DTIC Science & Technology

1979-01-01

language education in recent years can be seen in the movement from a teacher- to a learner -centered approach. The best evidence of a teacher-centered...most dramatic effect on how the learner is viewed. The learner now is recognized as an active participant in the learning process rather than as a... best , is optional. Cognitive psychologists, such as Ausubel, and many foreign language educators (Rivers, 1976; Grittner, 1977) believe that practice

Vibration-based monitoring for performance evaluation of flexible civil structures in Japan

PubMed Central

FUJINO, Yozo

2018-01-01

The vibration-based monitoring of flexible civil structures and performance evaluation from this monitoring are reviewed, with an emphasis on research and practice in Japan and the author’s experiences. Some new findings and unexpected vibrations from the monitoring of real bridges and buildings are reported to emphasize the importance of monitoring. Future developments and applications of vibration-based monitoring to civil infrastructure management are also described. Many examples are taken from the author’s past 30 years’ experience of research on bridge dynamics. PMID:29434082

A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers.

PubMed

Prior, Yeliz; Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison

2015-08-01

Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey - Rheumatic Conditions. Face-to-face semi-structured interviews were conducted with occupational therapists ( n  = 9), followed by telephone interviews with their line managers ( n  = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. The main themes emerging from the occupational therapists' interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers' interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. The Work Experience Survey - Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased.

A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers

PubMed Central

Amanna, Evangeline A; Bodell, Sarah J; Hammond, Alison

2015-01-01

Introduction Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey – Rheumatic Conditions. Method Face-to-face semi-structured interviews were conducted with occupational therapists (n = 9), followed by telephone interviews with their line managers (n = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. Results The main themes emerging from the occupational therapists’ interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers’ interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. Conclusion The Work Experience Survey – Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased. PMID:26321786

Using a shared governance structure to evaluate the implementation of a new model of care: the shared experience of a performance improvement committee.

PubMed

Myers, Mary; Parchen, Debra; Geraci, Marilla; Brenholtz, Roger; Knisely-Carrigan, Denise; Hastings, Clare

2013-10-01

Sustaining change in the behaviors and habits of experienced practicing nurses can be frustrating and daunting, even when changes are based on evidence. Partnering with an active shared governance structure to communicate change and elicit feedback is an established method to foster partnership, equity, accountability, and ownership. Few recent exemplars in the literature link shared governance, change management, and evidence-based practice to transitions in care models. This article describes an innovative staff-driven approach used by nurses in a shared governance performance improvement committee to use evidence-based practice in determining the best methods to evaluate the implementation of a new model of care.

Using a Shared Governance Structure to Evaluate the Implementation of a New Model of Care: The Shared Experience of a Performance Improvement Committee

PubMed Central

Myers, Mary; Parchen, Debra; Geraci, Marilla; Brenholtz, Roger; Knisely-Carrigan, Denise; Hastings, Clare

2013-01-01

Sustaining change in the behaviors and habits of experienced practicing nurses can be frustrating and daunting, even when changes are based on evidence. Partnering with an active shared governance structure to communicate change and elicit feedback is an established method to foster partnership, equity, accountability and ownership. Few recent exemplars in the literature link shared governance, change management and evidence-based practice to transitions in care models. This article describes an innovative staff-driven approach used by nurses in a shared governance performance improvement committee to use evidence based practice in determining the best methods to evaluate the implementation of a new model of care. PMID:24061583

Significant Learning Experiences and Ignatian Pedagogy: A Case Study of Curricula, Academic Practices, and Graduate Outcomes in Jesuit Universities' Honors Programs

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…

Structural Exclusion through School Mathematics: Using Bourdieu to Understand Mathematics as a Social Practice

ERIC Educational Resources Information Center

Jorgensen, Robyn; Gates, Peter; Roper, Vanessa

2014-01-01

In this paper, we explore a sociological approach to mathematics education and offer a theoretical lens through which we can come to understand mathematics education as part of a wider set of social practices. Many studies of children's experiences in school show that a child's academic success is a product of many factors, some of which…

Recovery orientation in mental health inpatient settings: Inpatient experiences?

PubMed

Waldemar, Anna Kristine; Esbensen, Bente Appel; Korsbek, Lisa; Petersen, Lone; Arnfred, Sidse

2018-06-01

Offering mental health treatment in line with a recovery-oriented practice has become an objective in the mental health services in many countries. However, applying recovery-oriented practice in inpatient settings seems challenged by unclear and diverging definitions of the concept in and the organization of these settings. In Denmark, educational and organizational efforts have been made to organize inpatient services with a recovery-oriented approach. Hence, we aimed to explore whether and how these efforts are reflected in the inpatients' experiences of their care and treatment. Semi-structured interviews were conducted with 14 inpatients from two mental health inpatient wards using an interview guide based on factors from the Recovery Self-Assessment. Qualitative content analysis was applied in the analysis. Six themes covering the participants' experiences were identified. The participants felt accepted and protected in the ward and found comfort in being around other people but missed talking and engaging with health professionals. They described limited choice and influence on the course of their treatment, and low information levels regarding their treatment, which they considered to consist predominantly of medication. Furthermore, they described feeling continuously observed and assessed from a distance by health professionals. Like the sparse previous research among inpatients, the results highlight ambivalent experiences of health professionals' support and ward structure as well as the medical treatment hegemony. As such, the educational and organizational efforts of introducing recovery-oriented practices in the wards seemed not very well reflected in the participants' experiences of their stay. © 2018 Australian College of Mental Health Nurses Inc.

Practicing What We Teach: A Self-Study in Implementing an Inquiry-Based Curriculum in a Middle Grades Classroom

NASA Astrophysics Data System (ADS)

Dias, Michael; Eick, Charles J.; Brantley-Dias, Laurie

2011-02-01

A science teacher educator returned to teaching adolescents after more than 10 years in the professoriate. We studied his beliefs, practice and daily use of inquiry pedagogy while implementing a reform-based curriculum. Reflection on practice was evidenced by a weekly journal, classroom observations and debriefings, and extensive interviews. Newly developed practical knowledge from this experience shifted the science teacher educator's beliefs away from the Piagetian structuralism espoused in prescribed curricula towards a more culturally responsive, student-driven approach to teaching science to middle grades students. The merits and limitations of curricula attempting to follow traditional scientific practices are discussed.

Beyond Education and Employment: Exploring Youth Experiences of Their Communities, Place Attachment and Reasons for Migration

ERIC Educational Resources Information Center

Eacott, Chelsea; Sonn, Christopher C.

2006-01-01

The population in rural areas of Australia has been declining for many decades and it has become common practice to blame this decline on the migration of young people due to structural limitations (e.g. education and employment). This study explores factors associated with migration of youth from rural Victoria looking at their experience of…

A Mixed Methods Examination of Structural Bigenderism and the Consequences for Transgender and Gender Variant People

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…

Incremental Progress: Re-Examining Field Experiences in K-12 Online Learning Contexts in the United States

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…

Lack of support structures in prioritization decision making concerning patients and resources. Interviews with Swedish physicians.

PubMed

Werntoft, Elisabet; Edberg, Anna-Karin

2011-08-01

To investigate physicians' experiences in relation to prioritization and financing in health care in order to gain a deeper understanding of the reasons behind their standpoints. Eighteen physicians, seven women and eleven men, aged 30 to 69 years were interviewed and the text was analyzed using an inductive approach, also described as conventional qualitative content analysis. Experience of setting healthcare priorities and difficult decision making differed widely among the physicians and seemed to be related to the number of years in professional practice. Their view of how resources should be allocated between disciplines/patients showed that they wanted politicians to make the decisions, with support from medical professions. The overwhelming impression of their reasoning showed that they lacked support structures for their decision making and could be understood under the following categories: prioritisation, easier in theory than in practice, and increasing costs threaten the Swedish welfare model. The findings of this study highlight the importance of practical national guidelines concerning vertical prioritization, also as an important measure to make prioritization more distinct and transparent. The physicians further had a need for tools to increase patients' awareness of their health. The findings of this study also showed that an awareness of the actual costs involved might increase the responsibility among both physicians and patients. The physicians' lack of support structures implies an urgent need for practical national guidelines, especially concerning vertical prioritization. This will also make prioritization appear clear and transparent for citizens.

Fellowships in Community Pharmacy Research: Experiences of Five Schools and Colleges of Pharmacy

PubMed Central

Snyder, Margie E.; Frail, Caitlin K.; Gernant, Stephanie A.; Bacci, Jennifer L.; Coley, Kim C.; Colip, Lauren M.; Ferreri, Stefanie P.; Hagemeier, Nicholas E.; McGivney, Melissa Somma; Rodis, Jennifer L.; Smith, Megan G.; Smith, Randall B.

2017-01-01

Objective To describe common facilitators, challenges, and lessons learned of five schools and colleges of pharmacy in establishing community pharmacy research fellowships. Setting Five schools and colleges of pharmacy in the United States. Practice Description Schools and colleges of pharmacy with existing community partnerships identified a need and ability to develop opportunities for pharmacists to engage in advanced research training. Practice Innovation Community pharmacy fellowships, each structured as two years in length and in combination with graduate coursework, have been established at the University of Pittsburgh, Purdue University, East Tennessee State University, University of North Carolina at Chapel Hill and The Ohio State University. Evaluation Program directors from each of the five community pharmacy research fellowships identified common themes pertaining to program structure, outcomes, and lessons learned to assist others planning similar programs. Results Common characteristics across the programs include length of training, pre-requisites, graduate coursework, mentoring structure, and immersion into a pharmacist patient care practice. Common facilitators have been the existence of strong community pharmacy partnerships, creating a fellowship advisory team, and networking. A common challenge has been recruitment, with many programs experiencing at least one year without filling the fellowship position. All program graduates (n=4) have been successful in securing pharmacy faculty positions. Conclusion Five schools and colleges of pharmacy share similar experiences in implementing community pharmacy research fellowships. Early outcomes show promise for this training pathway in growing future pharmacist-scientists focused on community pharmacy practice. PMID:27083852

Provider Experiences with Chronic Care Management (CCM) Services and Fees: A Qualitative Research Study.

PubMed

O'Malley, Ann S; Sarwar, Rumin; Keith, Rosalind; Balke, Patrick; Ma, Sai; McCall, Nancy

2017-12-01

Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward. Semi-structured telephone interviews from January to April 2016 with 71 respondents. Sixty billing and non-billing providers and practice staff knowledgeable about their practices' CCM services, and 11 professional society representatives. Practice respondents noted that most patients expressed positive views of CCM services. Practice respondents also perceived several patient benefits, including improved adherence to treatment, access to care team members, satisfaction, care continuity, and care coordination. Facilitators of CCM provision included having an in-practice care manager, patient-centered medical home recognition, experience developing care plans, patient trust in their provider, and supplemental insurance to cover CCM copayments. Most billing practices reported few problems obtaining patients' consent for CCM, though providers felt that CMS could better facilitate consent by marketing CCM's goals to beneficiaries. Barriers reported by professional society representatives and by billing and non-billing providers included inadequacy of CCM payments to cover upfront investments for staffing, workflow modification, and time needed to manage complex patients. Other barriers included inadequate infrastructure for health information exchange with other providers and limited electronic health record capabilities for documenting and updating care plans. Practices owned by hospital systems and large medical groups faced greater bureaucracy in implementing CCM than did smaller, independent practices. Improving providers' experiences with and uptake of CCM will require addressing several challenges, including the upfront investment for CCM set-up and the time required to provide CCM to more complex patients.

'We have to put up with it--don't we?' The experience of being the registered nurse on duty, managing a violent incident involving an elderly patient: a phenomenological study.

PubMed

Chambers, N

1998-02-01

The incidence of violence directed towards nurses is well known. However, despite guidelines and training aimed at preventing or minimizing these incidents, recent reports indicate an increase in their occurrence. This phenomenological study investigated the experiences of five registered nurses who had to manage a violent incident involving an elderly patient. The purpose of this was to discover what these nurses 'know' about the structure of such an experience and, through the use of Colaizzi's method of data analysis, present this knowledge in the form of an exhaustive description of the experience. Taped interviews were used to collect the data. The analytical process revealed that the experience is structured around five themes: professional competence, nursing identity, powerlessness and oppression, loss (neglected and deserted) and strategies for survival. The discussion analyses these themes and the relationships between them, highlighting the issues of nurse autonomy and exercising accountability. The implications for nursing practice, education and research include recognition of nurses as a professional group to enable autonomous practice, the ways in which nurses' perceptions of nursing knowledge may affect their educative role and the need to extend this study further to provide answers to the questions raised therein.

The experience of discrimination by US and Internationally educated nurses in hospital practice in the USA: a qualitative study.

PubMed

Wheeler, Rebecca M; Foster, Jennifer W; Hepburn, Kenneth W

2014-02-01

To document experiences of nurses educated abroad and in the USA in 2 urban hospitals in the southeastern USA. Nurses are responsible for providing quality patient care. Discrimination against nurses in the workplace may create hostile environments, potentially affecting patient care and leading to higher nurse attrition rates. Structuration theory posits that agents' interactions create structures. Agents' use of resources and rules shapes interactions, potentially changing the structures. In this study, nurses described interactions with patients and their families and other healthcare personnel, their strategies for managing interactions and rationales behind their selected strategy. This study employed a qualitative, explorative approach using structuration theory. In 2011, 42 internationally educated and 40 USA-educated nurses practising in two urban hospitals in the southeastern USA were interviewed about their experiences in the workplace. Forty-one nurses were re-interviewed to explore the issues raised in the preliminary round: 21 internationally educated and 20 USA. Transcripts were analysed using the constant comparative method. Although internationally educated nurses experienced more explicit discrimination, all nurses experienced discrimination from their patients, their nurse colleagues and/or other hospital personnel. Internationally educated nurses and USA nurses shared similar coping strategies. The prevalence of nurses' experiences of discrimination suggests that healthcare institutions need to strengthen policies to effectively address this harmful practice. More research is needed about discrimination against nurses in the workplace because discrimination may have serious psychological effects that impact nurse retention and the quality of patient care. © 2013 John Wiley & Sons Ltd.

Politics, Policy, Practice and Personal Responsibility: Adult Education in an Era of Welfare Reform. NCSALL Reports #10A.

ERIC Educational Resources Information Center

D'Amico, Deobrah

The relationship of literacy to work should be considered in terms of the political and economic conditions that structure the experiences of the working and non-working poor with respect to education and work. Research shows welfare-to-work programs constitute behavioral solutions to what are structural economic problems; literacy alone cannot…

Effective teaching in the contexts of Internet science projects: American and Russian teachers' perspectives of best practices

NASA Astrophysics Data System (ADS)

Mumma, Brian

Statement of the problem. Science education literature had agreed that an important goal in students' learning is the development of scientific and technological literacy. One effort that teachers have integrated into their practices for addressing this goal has been teaching within the contexts of Internet Science Projects. Greater awareness of teachers' perspectives of their best practices and their beliefs and reasons for these practices in the contexts of Internet Science Projects can improve the quality of science education programs. Methods. A series of pilot interviews was conducted during the 2000--2001 school year to develop the guiding questions for inquiring into teachers' perspectives of their best practices within the contexts of Internet Science Projects. This series of interviews resulted in the understanding of the need to select teachers with experiences with Internet Science Projects and to conduct in-depth phenomenological interviews for learning from their voices. Two teachers were purposefully selected as the participant-informants for this study, one an American elementary teacher from Walker County, Georgia, and one a Russian teacher from St. Petersburg, Russia. The study was conducted from October through December 2001. The data collected for this qualitative study consisted of a series of in-depth phenomenological interviews, classroom observations, and the collection and analysis of various artifacts including teacher journals, student products, and e-mail/bulletin board transcripts. The interview structure was based upon a modification of expanding Seidman's (1998) three interview series into multiple interviews concluded upon the determination of saturation of the topic. The series of interviews were composed of (1) life history focus; (2) the details of the experience of teaching within the contexts of Internet Science Projects; and (3) reflection on the meanings. The data analysis consisted of applying Strauss & Corbin's (1990) open coding structure. Results. The results of this study revealed that these teachers carried their best practices from traditional teaching into their practices in the contexts of Internet Science Projects. The teachers created student-centered learning environments by focusing upon their classroom structure over that of the Internet Science Project. The teachers created strong local learning experiences inside an outside of their classroom environments where students were able to build strong understandings of the topic area before becoming engaged in virtual collaborations and Internet communications. This engagement allowed success in the face of any contingencies that might prevent or limit the ability for the teachers' classrooms to actively collaborate across the Internet. The teachers built their practices in Internet Science Projects upon questions prompted by their students' real world experiences, developed local understandings before progressing into exchanges for global collaborations, and built worldview perspectives.

Repeated Structural Imaging Reveals Nonlinear Progression of Experience-Dependent Volume Changes in Human Motor Cortex.

PubMed

Wenger, Elisabeth; Kühn, Simone; Verrel, Julius; Mårtensson, Johan; Bodammer, Nils Christian; Lindenberger, Ulman; Lövdén, Martin

2017-05-01

Evidence for experience-dependent structural brain change in adult humans is accumulating. However, its time course is not well understood, as intervention studies typically consist of only 2 imaging sessions (before vs. after training). We acquired up to 18 structural magnetic resonance images over a 7-week period while 15 right-handed participants practiced left-hand writing and drawing. After 4 weeks, we observed increases in gray matter of both left and right primary motor cortices relative to a control group; 3 weeks later, these differences were no longer reliable. Time-series analyses revealed that gray matter in the primary motor cortices expanded during the first 4 weeks and then partially renormalized, in particular in the right hemisphere, despite continued practice and increasing task proficiency. Similar patterns of expansion followed by partial renormalization are also found in synaptogenesis, cortical map plasticity, and maturation, and may qualify as a general principle of structural plasticity. Research on human brain plasticity needs to encompass more than 2 measurement occasions to capture expansion and potential renormalization processes over time. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Structure of "Ventilation and Warming" in Notes on Nursing Written by Florence Nightingale in 19th Century: Introduction of Basic Physics to Nursing Students

NASA Astrophysics Data System (ADS)

Ogoh, Kazutoshi

"Basic Natural Science" for freshmen at Miyazaki Prefectural Nursing University has a component including physics. Here students learn three principles of thermal transfer; conduction, radiation, and convection through a series of experiments. The purpose of these experiments is to understand the structure of a method for the caring of breathing and temperature of patients as written in "Ventilation and Warming", the first chapter of F. Nightingale's Notes on Nursing. Students can then apply this structure to retain fresh air in today's hospital rooms, and can then appreciate studying real physics incorporated into fundamental knowledge for nursing practice.

Objective structured practical examination (OSPE) in Forensic Medicine: students' point of view.

PubMed

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.

Structural risk and limits on agency among exotic dancers: HIV risk practices in the exotic dance club.

PubMed

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.

Health visitor views on consultation using the Solihull approach: a grounded theory study.

PubMed

Stefanopoulou, Evgenia; Coker, Sian; Greenshields, Maria; Pratt, Richard

2011-07-01

Consultation is integral to maintaining competence for health professionals and involves a collaborative relationship between specialist and primary care services. Although consultation aims to support them in their work, existing literature exploring health visitors' experiences of consultation is limited. This study explored health visitors' experiences of consultation in relation to their clinical practice, their experience of their work and its impact on the wider service. In all, 10 health visitors were interviewed using a semi-structured guide and analysis was subjected to a grounded theory framework. Participants' views were influenced by a combination of factors--consultants' training specific to their role, their communication and engagement, consultation's support of joint-working and/or transitions, and its relevance to and impact upon practice. Findings suggest that such interface activities require effective co-ordination, communication and structuring strategies, highlighting the importance of future initiatives in developing health visitors' mental health role further. Given the comparative lack of evaluation of such activities, these findings may inform policy-making and service development to ensure high quality of service delivery.

A non-uniformly sampled 4D HCC(CO)NH-TOCSY experiment processed using maximum entropy for rapid protein sidechain assignment

PubMed Central

Mobli, Mehdi; Stern, Alan S.; Bermel, Wolfgang; King, Glenn F.; Hoch, Jeffrey C.

2010-01-01

One of the stiffest challenges in structural studies of proteins using NMR is the assignment of sidechain resonances. Typically, a panel of lengthy 3D experiments are acquired in order to establish connectivities and resolve ambiguities due to overlap. We demonstrate that these experiments can be replaced by a single 4D experiment that is time-efficient, yields excellent resolution, and captures unique carbon-proton connectivity information. The approach is made practical by the use of non-uniform sampling in the three indirect time dimensions and maximum entropy reconstruction of the corresponding 3D frequency spectrum. This 4D method will facilitate automated resonance assignment procedures and it should be particularly beneficial for increasing throughput in NMR-based structural genomics initiatives. PMID:20299257

Writing on Your Feet: Reflective Practices in City as Text™. A Tribute to the Career of Bernice Braid. National Collegiate Honors Council Monograph Series

ERIC Educational Resources Information Center

Long, Ada, Ed.

2014-01-01

City as Text™ (CAT) is one of the earliest structural forms of experiential learning created and practiced in the United States. This monograph explores the centrality of writing in the process of active learning, focusing primarily on the Faculty Institutes and Honors Semesters that foster CAT experiences. All manifestations of this pedagogical…

Nurses' perceptions of research utilization in a corporate health care system.

PubMed

McCloskey, Donna Jo

2008-01-01

To explore selected characteristics of nurses based upon educational level (masters, baccalaureate, associate degree/diploma), years of experience, and hospital position (management, advanced practice, staff nurse) that might affect perceived availability of research resources, attitude towards research, support, and research use in practice. A descriptive nonexperimental mailed survey design was used for this study. Nurses in five hospitals within a corporate hospital system were surveyed using the Research Utilization Questionnaire (RUQ). The RUQ was used to measure nurses' perceptions of research utilization in the four dimensions of perceived use of research, attitude toward research, availability of research resources, and perceived support for research activities. ANOVA was used to analyze the data. Statistically significant differences (p<.001) were found in the perceived use of research, attitude toward research, availability of research resources, and perceived support for research activities based on educational level and organizational position. No significant differences were found in the perception of nurses based on years of experience. The results of this study have implications for staff nurses, administrators, advanced practice nurses, and educators working in hospital systems. The different perceptions based upon educational level and hospital position can be integrated and used at all levels of nursing practice to promote research utilization and evidence-based practice initiatives within the organizational structure. The results of this study have nursing implications within administration and for nursing practice. The different perceptions that were found based upon educational level and hospital position can be positively integrated and used by administrators and by nurses all levels of nursing practice to promote research utilization and evidence based practice initiatives within the organizational structure.

Addressing the “Risk Environment” for Injection Drug Users: The Mysterious Case of the Missing Cop

PubMed Central

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

Changes in Convictions and Attitudes to the Teaching Profession and Classroom Management Due to Practical Teaching Experience

ERIC Educational Resources Information Center

Gawlitza, Gaby; Perels, Franziska

2014-01-01

The aim of this study is to analyze changes in beliefs and attitudes to the teaching profession and to classroom management as a result of teaching experience. The structure of this study is based partly on the COACTIV-model of professional competence of teachers. The COACTIV-model is divided into motivational orientations, convictions and basic…

Experience of light thin-walled structures improvement in construction

NASA Astrophysics Data System (ADS)

Frolovskaia, A. V.; Deordiev, S. V.; Falk, A.; Klinduh, N. Y.; Terehova, I. I.

2018-05-01

The authors on the basis of practical experience have analyzed low-rise construction with the use of energy-saving technologies. Characteristic features of possible variants of frame construction are looked at and described. The relevance of the paper consists in the improvement of the building frame design solution based on the analysis and elimination of disadvantages taking into account consumers’ point of view.

The Dependence of Strength in Plastics upon Polymer Chain Length and Chain Orientation: An Experiment Emphasizing the Statistical Handling and Evaluation of Data.

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.…

Effect of practical training on the learning motivation profile of Japanese pharmacy students using structural equation modeling.

PubMed

Yamamura, Shigeo; Takehira, Rieko

2017-01-01

To establish a model of Japanese pharmacy students' learning motivation profile and investigate the effects of pharmaceutical practical training programs on their learning motivation. The Science Motivation Questionnaire II was administered to pharmacy students in their 4th (before practical training), 5th (before practical training at clinical sites), and 6th (after all practical training) years of study at Josai International University in April, 2016. Factor analysis and multiple-group structural equation modeling were conducted for data analysis. A total of 165 students participated. The learning motivation profile was modeled with 4 factors (intrinsic, career, self-determination, and grade motivation), and the most effective learning motivation was grade motivation. In the multiple-group analysis, the fit of the model with the data was acceptable, and the estimated mean value of the factor of 'self-determination' in the learning motivation profile increased after the practical training programs (P= 0.048, Cohen's d = 0.43). Practical training programs in a 6-year course were effective for increasing learning motivation, based on 'self-determination' among Japanese pharmacy students. The results suggest that practical training programs are meaningful not only for providing clinical experience but also for raising learning motivation.

The experience of 'mental trauma' and its transcultural application.

PubMed

von Peter, Sebastian

2008-12-01

Approaches to the mental health care of refugees and disaster survivors have recently been subject to sustained critique. This article critically examines the notion of ;mental trauma' as it has been used by psychosocial intervention programmes addressing the aftermath of the 2004 Asian tsunami. The objective is to shed light on the guidelines' implicit and explicit assumptions about how people are expected to act and feel after a disaster, thereby implying a certain 'metaphysic' of emotional experience. It will be argued that feelings can not be separated from intersubjective and public spheres, for they shape and motivate expression and experience. Instead, it is necessary to explore the particular ways in which cultural meaning and social structure relate to discourses and practices through which suffering is produced and represented. To conclude, a method is outlined to operationalize particular experiences of suffering and the institutionalized discourses and practices in which they obtain social meaning and force.

A Conceptual Model for Understanding Academic Physicians' Performances of Identity: Findings From the University of Utah.

PubMed

Chow, Candace J; Byington, Carrie L; Olson, Lenora M; Ramirez, Karl Paulo Garcia; Zeng, Shiya; López, Ana María

2018-05-22

To explore how academic physicians perform social and professional identities and how their personal experiences inform professional identity formation. Semi-structured interviews and observations were conducted with 25 academic physicians of diverse gender and racial/ethnic backgrounds at the University of Utah School of Medicine from 2015-2016. Interviews explored the domains of social identity, professional identity, and relationships with patients and colleagues. Patient interactions were observed. Interviews and observations were audio-recorded, transcribed, and analyzed using grounded theory. Three major themes emerged: physicians' descriptions of identity differed based on social identities, as women and racially/ethnically minoritized participants linked their gender and racial/ethnic identities, respectively, to their professional roles more than men and White, non-Latino/a participants; physicians' descriptions of professional practice differed based on social identities, as participants who associated professional practices with personal experiences often drew from events connected to their minoritized identities; and physicians' interactions with patients corresponded to their self-described actions. Professional identity formation is an ongoing process and the negotiation of personal experiences is integral to this process. This negotiation may be more complex for physicians with minoritized identities. Implications for medical education include providing students, trainees, and practicing physicians with intentional opportunities for reflection and instruction on connecting personal experiences and professional practice.

Leaving

ERIC Educational Resources Information Center

Jones, Robyn L.

2011-01-01

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

From recovery programs to recovery-oriented practice? A qualitative study of mental health professionals' experiences when facilitating a recovery-oriented rehabilitation program.

PubMed

Dalum, Helle Stentoft; Pedersen, Inge Kryger; Cunningham, Harry; Eplov, Lene Falgaard

2015-12-01

The recovery model has influenced mental health services and fostered new standards for best practice. However, knowledge about how mental health care professionals (HCPs) experience recovery-oriented programs is sparse. This paper explores HCPs' experiences when facilitating a recovery-oriented rehabilitation program. The research question is how do HCPs experience a change in their attitude and practice when applying recovery-oriented programs? This paper draws on semi-structured in-depth qualitative interviews conducted with 16 HCPs experienced in facilitating a recovery-oriented rehabilitation program in either the USA or Denmark. Three themes emerged from the HCPs' reflections on changes in attitudes and practices: "Hopeful Attitude" captures a change in the HCPs' attitude toward a more positive view on the future for clients' living with mental illness; "A New Focus in the Dialogue With Clients" thematizes how the HCPs focus more on the individual's own goal for recovery rather than disease-induced goals in the dialog with clients; "A Person-Centered Role" comprises a shift in the professional role whereby the HCPs value the client's own ideas in addition to the professional's standards. This study supports the theory of the recovery model by its empirical findings and indications that when facilitating a recovery-oriented program, HCPs experience recovery-oriented changes in their attitude toward life with mental illness, and it alters their professional practice toward a stronger focus on client's own goals during treatment. More studies are needed to further clarify how changes in HCPs' attitudes translate into changes in mental health practices. Copyright © 2015 Elsevier Inc. All rights reserved.

Building the Nonuniversity, Tertiary Care Center Hepatobiliary and Pancreatic Surgery Practice: Structural and Financial Considerations.

PubMed

Baker, Erin H; Siddiqui, Imran; Vrochides, Dionisios; Iannitti, David A; Martinie, John B; Rorabaugh, Lauren; Jeyarajah, D Rohan; Swan, Ryan Z

2016-12-01

Early in their careers, many new surgeons lack the background and experience to understand essential components needed to build a surgical practice. Surgical resident education is often devoid of specific instruction on the business of medicine and practice management. In particular, hepatobiliary and pancreatic (HPB) surgeons require many key components to build a successful practice secondary to significant interdisciplinary coordination and a scope of complex surgery, which spans challenging benign and malignant disease processes. In the following, we describe the required clinical and financial components for developing a successful HPB surgery practice in the nonuniversity tertiary care center. We discuss significant financial considerations for understanding community need and hospital investment, contract establishment, billing, and coding. We summarize the structural elements and key personnel necessary for establishing an effectual HPB surgical team. This article provides useful, essential information for a new HPB surgeon looking to establish a surgical practice. It also provides insight for health-care administrators as to the value an HPB surgeon can bring to a hospital or health-care system.

Structured Reflection Breaks Embedded in an Online Course--Effects on Learning Experience, Time on Task and Performance

ERIC Educational Resources Information Center

Verpoorten, Dominique; Westera, Wim

2016-01-01

The purpose of this article is to gain an insight into the effects of practicing short, frequent, and structured reflection breaks interspersed with the learning material in a computer-based course. To that end, the study sets up a standardized control trial with two groups of secondary school pupils. The study shows that while performance is not…

Mechanisms which help explain implementation of evidence-based practice in residential aged care facilities: a grounded theory study.

PubMed

Masso, Malcolm; McCarthy, Grace; Kitson, Alison

2014-07-01

The context for the study was a nation-wide programme in Australia to implement evidence-based practice in residential aged care, in nine areas of practice, using a wide range of implementation strategies and involving 108 facilities. The study drew on the experiences of those involved in the programme to answer the question: what mechanisms influence the implementation of evidence-based practice in residential aged care and how do those mechanisms interact? The methodology used grounded theory from a critical realist perspective, informed by a conceptual framework that differentiates between the context, process and content of change. People were purposively sampled and invited to participate in semi-structured interviews, resulting in 44 interviews involving 51 people during 2009 and 2010. Participants had direct experience of implementation in 87 facilities, across nine areas of practice, in diverse locations. Sampling continued until data saturation was reached. The quality of the research was assessed using four criteria for judging trustworthiness: credibility, transferability, dependability and confirmability. Data analysis resulted in the identification of four mechanisms that accounted for what took place and participants' experiences. The core category that provided the greatest understanding of the data was the mechanism On Common Ground, comprising several constructs that formed a 'common ground' for change to occur. The mechanism Learning by Connecting recognised the ability to connect new knowledge with existing practice and knowledge, and make connections between actions and outcomes. Reconciling Competing Priorities was an ongoing mechanism whereby new practices had to compete with an existing set of constantly shifting priorities. Strategies for reconciling priorities ranged from structured approaches such as care planning to more informal arrangements such as conversations during daily work. The mechanism Exercising Agency bridged the gap between agency and action. It was the human dimension of change, both individually and collectively, that made things happen. The findings are consistent with the findings of others, but fit together in a novel way and add to current knowledge about how to improve practices in residential aged care. Each of the four mechanisms is necessary but none are sufficient for implementation to occur. Copyright © 2013 Elsevier Ltd. All rights reserved.

Decreasing barriers for nurse practitioner social entrepreneurship.

PubMed

Sharp, Dayle B; Monsivais, Diane

2014-10-01

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

Opening the Black Box: Cognitive Strategies in Family Practice

PubMed Central

Christensen, Robert E.; Fetters, Michael D.; Green, Lee A.

2005-01-01

PURPOSE We wanted to describe the cognitive strategies used by family physicians when structuring the decision-making tasks of an outpatient visit. METHODS This qualitative study used cognitive task analysis, a structured interview method in which a trained interviewer works individually with expert decision makers to capture their stages and elements of information processing. RESULTS Eighteen family physicians of varying levels of experience participated. Three dominant themes emerged: time pressure, a high degree of variation in task structuring, and varying degrees of task automatization. Based on these data and previous research from the cognitive sciences, we developed a model of novice and expert approaches to decision making in primary care. The model illustrates differences in responses to unexpected opportunity in practice, particularly the expert’s use of attentional surplus (reserve capacity to handle problems) vs the novice’s choice between taking more time or displacing another task. CONCLUSIONS Family physicians have specific, highly individualized cognitive task-structuring approaches and show the decision behavior features typical of expert decision makers in other fields. This finding places constraints on and suggests useful approaches for improving practice. PMID:15798041

Reflective journal writing in nurse education: whose interests does it serve?

PubMed

Wellard, S J; Bethune, E

1996-11-01

The use of reflective journal writing has become popularized in the past decade. This paper uses the experience of two university lecturers to problematize this practice. The practice of journal writing in nursing courses is explored firstly through the lens of critical theory and secondly that of post-structuralism. This paper challenges nurse academics to confront the power relationships established by the adoption of journal writing uncritically into courses.

Learner-centred teaching in a non-learner-centred world: An interpretive phenomenological study of the lived experience of clinical nursing faculty.

PubMed

Oyelana, Olabisi; Martin, Donna; Scanlan, Judith; Temple, Beverley

2018-08-01

With the growing complexities in the contemporary health care system, there is a challenge of preparing nurses for the practice demands. To this end, learner-centred teaching has emerged in many nursing curricula in Canada and evidence indicates its effectiveness in developing the essential practice skills in nursing students. It is important to examine the experience of the clinical faculty members who implement learner-centred teaching, as doing so would provide an insight to the factors that may hinder the implementation of learner-centred teaching in the practice settings. This phenomenological study aimed to address two research questions: what does learner-centred teaching mean to clinical nurse faculty? What is the lived experience of clinical nursing faculty who incorporate learner-centred teaching? Ten clinical nurse faculty members who had at least two years of clinical teaching experience volunteered to participate in the study. Data were collected using a semi-structured interview guide and audio recorder. Additional data sources included a demographic survey and a reflective journal. Multiple sub-themes emerged from this study from which three significant themes were consolidated: diversity of meanings, facilitators of LCT, and barriers to LCT. However, an overarching theme of "learner-centred teaching in a non-learner-centred world" was coined from participants' accounts of their experiences of barriers in incorporating LCT in the practice settings. A collaborative effort between faculty and the stakeholders is paramount to a successful implementation of learner-centred teaching in practice settings. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Shopper marketing: a new challenge for Spanish community pharmacies.

PubMed

Gavilan, Diana; Avello, Maria; Abril, Carmen

2014-01-01

Changes that have occurred over the past few decades in retailing and in the health care sector--namely, a drastic reduction in drug profit-margins, and a more critical use of health services by patients--have created a scenario characterized by rising competitiveness. This new context is necessitating community pharmacies (hereafter, pharmacies) to improve their business model through new strategies. Shopper marketing has proven invaluable in other retail settings and therefore, could be a critical element for new practices in pharmacies. First, to analyze how shopping experiences in pharmacies based on new practices in shopper marketing affect shopping behavior. Second, to study the mediating effect of customer satisfaction on the relationship between shopping experiences and shopping behavior. A self-reported questionnaire was developed to measure four concepts: hedonic experience (enjoyable), functional experience (goal-oriented), customer satisfaction and shopping behavior. Data were collected from 28 different pharmacies dispersed throughout Spain. Structural equation modeling (SEM) was used to test the relationships in the theoretical model. First, the measurement model was estimated to assess model fit, reliability, convergent and discriminant validity. Then, the parameters of the structural model were estimated and the mediation effects were subsequently tested. Functional experience and hedonic experience each significantly and positively correlate with consumer satisfaction and with customer shopping behavior (purchases and loyalty). Moreover, the effects of each type of experience on shopping behavior are partially mediated by customer satisfaction. The results suggest that even in Spanish pharmacies, which have traditionally been considered as strictly functional retailers, ensuring customer satisfaction and enhancing shopping behavior now demand more than just functional experiences. Moreover, a customer's experience at a pharmacy can itself trigger a shopping cycle; therefore, pharmacists should consider prioritizing investments in hedonic experiences. Copyright © 2014 Elsevier Inc. All rights reserved.

Applying 3-PG, a simple process-based model designed to produce practical results, to data from loblolly pine experiments

Treesearch

Joe J. Landsberg; Kurt H. Johnsen; Timothy J. Albaugh; H. Lee Allen; Steven E. McKeand

2001-01-01

3-PG is a simple process-based model that requires few parameter values and only readily available input data. We tested the structure of the model by calibrating it against loblolly pine data from the control treatment of the SETRES experiment in Scotland County, NC, then altered the fertility rating to simulate the effects of fertilization. There was excellent...

Silviculture affects composition, growth, and yield in mixed northern conifers: 40-year results from the Penobscot Experimental Forest

Treesearch

Paul E. Sendak; John C. Brissette; Robert M. Frank

2003-01-01

This long-term experiment in Maine, U.S.A., was designed to provide information on the best silvicultural practices for managing stands of mixed northern conifers in northeastern U.S.A. We evaluated growth and yield and changes in species composition, quality, and structure during the first 40 years of the experiment. Replicated treatments include the selection system...

Making framing of uncertainty in water management practice explicit by using a participant-structured approach.

PubMed

Isendahl, Nicola; Dewulf, Art; Pahl-Wostl, Claudia

2010-01-01

By now, the need for addressing uncertainty in the management of water resources is widely recognized, yet there is little expertise and experience how to effectively deal with uncertainty in practice. Uncertainties in water management practice so far are mostly dealt with intuitively or based on experience. That way decisions can be quickly taken but analytic processes of deliberate reasoning are bypassed. To meet the desire of practitioners for better guidance and tools how to deal with uncertainty more practice-oriented systematic approaches are needed. For that purpose we consider it important to understand how practitioners frame uncertainties. In this paper we present an approach where water managers developed criteria of relevance to understand and address uncertainties. The empirical research took place in the Doñana region of the Guadalquivir estuary in southern Spain making use of the method of card sorting. Through the card sorting exercise a broad range of criteria to make sense of and describe uncertainties was produced by different subgroups, which were then merged into a shared list of criteria. That way framing differences were made explicit and communication on uncertainty and on framing differences was enhanced. In that, the present approach constitutes a first step to enabling reframing and overcoming framing differences, which are important features on the way to robust decision-making. Moreover, the elaborated criteria build a basis for the development of more structured approaches to deal with uncertainties in water management practice. Copyright 2009 Elsevier Ltd. All rights reserved.

Transition from child and adolescent to adult mental health services in the Republic of Ireland: an investigation of process and operational practice.

PubMed

McNamara, Niamh; McNicholas, Fiona; Ford, Tamsin; Paul, Moli; Gavin, Blanaid; Coyne, Imelda; Cullen, Walter; O'Connor, Karen; Ramperti, Nicolas; Dooley, Barbara; Barry, Siobhan; Singh, Swaran P

2014-08-01

Ensuring a seamless transition from child to adult mental health services poses challenges for services worldwide. This is an important process in the ongoing care of young people with mental illness; therefore, it is incumbent on all countries to probe their individual structures to assess the quality of mental health service delivery to this vulnerable cohort. To date, there have been no published studies on the transition from Child to Adult Mental Health Services in the Republic of Ireland. To this end, a nationwide survey of transition policies of community mental health teams in both services was conducted in order to compare best practice guidelines for transition with current process and experience in clinical practice. Structured interviews were conducted with 57 consultant psychiatrists (representing 32 CAMHS teams and 25 AMHS teams) to obtain information on annual transition numbers, existing transition policies and operational practice from the professional perspective. Numbers of young people considered suitable for transfer to adult services (M = 7.73, SD = 9.86, n = 25) were slightly higher than numbers who actually transferred (M = 4.50, SD = 3.33, n = 20). There is a lack of standardized practice nationwide regarding the service transition boundary, an absence of written transition policies and protocols, and minimal formal interaction between child and adult services. The findings suggest that there are critical gaps between current operational practice and best practice guidelines. Future studies will investigate the impact this has on the transition experiences of young people, their carers and health-care professionals. © 2013 Wiley Publishing Asia Pty Ltd.

Learning beyond graduation: exploring newly qualified specialists' entrance into daily practice from a learning perspective.

PubMed

Cuyvers, Katrien; Donche, Vincent; Van den Bossche, Piet

2016-05-01

The entrance of newly qualified medical specialists into daily practice is considered to be a stressful period in which curriculum support is absent. Although engaging in both personal and professional learning and development activities is recognized fundamental for lifelong professional competence, research on medical professionals' entrance into practice is scarce. This research aims to contribute to the framework of medical professionals' informal learning and outlines the results of an exploratory study on the nature of learning in daily practice beyond postgraduate training. Eleven newly qualified physicians from different specialized backgrounds participated in a phenomenographic study, using a critical incident method and a grounded theory approach. Results demonstrated that learning in the workplace is, to a large extent, informal and associated with a variety of learning experiences. Analysis shows that experiences related to diagnostics and treatments are important sources for learning. Furthermore, incidents related to communication, changing roles, policy and organization offer learning opportunities, and therefore categorized as learning experiences. A broad range of learning activities are identified in dealing with these learning experiences. More specifically, actively engaging in actions and interactions, especially with colleagues of the same specialty, are the most mentioned. Observing others, consulting written sources, and recognizing uncertainties, are also referred to as learning activities. In the study, interaction, solely or combined with other learning activities, are deemed as very important by specialists in the initial entrance into practice. These insights can be used to develop workplace structures to support the entrance into practice following postgraduate training.

Perceptions of Indonesian general practitioners in maintaining standards of medical practice at a time of health reform.

PubMed

Syah, Nur A; Roberts, Chris; Jones, Alison; Trevena, Lyndal; Kumar, Koshila

2015-10-01

There is little research on how GPs experience the demands of maintaining standards of medical practice in developing countries and what strategies might improve their capability to provide high-quality primary health care (PHC). This study aims to explore the underlying factors, which shape GPs' experience within the Indonesian PHC system and impact on their experience of professional practice. A grounded theory approach was applied using semi-structured interviews of 25 purposively selected GPs in West Sumatra, Indonesia. The interviews were analysed inductively through an iterative process of the interplay between empirical data, emerging analysis and theory development. Three major health care systems attribute shaped GPs' experiences of professional practice, including (i) a restricted concept of the PHC system, (ii) lack of regulation of private primary care practice conducted by GPs, midwives, nurses and specialists and (iii) low coverage and inappropriate policy of the health insurance system. The findings indicate that a major revision of current health care system is required with a focus on promoting the concept of PHC services to the population, redefining the role of the GP to deliver recognised best practice within available resources, changing the way GPs are remunerated by the public health system and the health insurance industry, policing of the regulations related to the scope of practice of other health care professionals, particularly midwives and nurses, and regulation of prescribing. GPs can be the champions of the PHC service that Indonesia needs, but it requires sustained systematic change. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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.

A study of structure of phenomenology of consciousness in meditative and non-meditative states.

PubMed

Venkatesh, S; Raju, T R; Shivani, Y; Tompkins, G; Meti, B L

1997-04-01

Twelve senior Kundalini (Chakra) meditators were assessed during meditation session and non-meditation or control session using Phenomenology of Consciousness Inventory. The data has been analyzed using structural analysis to measure the altered state of consciousness and the identity state by comparing meditative state with non-meditative state. The structural analysis of pattern of consciousness during the meditative state revealed altered experience in perception (percentile rank PR = 90), meaning (PR = 82) and time sense (PR = 87), while positive affect dimension showed increased joy (PR = 73) and love (PR = 67). The imagery vividness (PR = 72), self-awareness (PR = 77), rationality (PR = 73) and arousal (PR = 69) were found to be structurally different from the ordinary state. With regards to identity state meditative experience was found to produce statistically significant changes in terms of intensity in meaning (P < 0.05), time sense (P < 0.05), joy (P < 0.05), love (P < 0.05) and state of awareness (P < 0.01). Our results indicate that long term practice of meditation appears to produce structural as well as intensity changes in phenomenological experiences of consciousness.

A descriptive qualitative examination of knowledge translation practice among health researchers in Manitoba, Canada.

PubMed

Sibley, Kathryn M; Roche, Patricia L; Bell, Courtney P; Temple, Beverley; Wittmeier, Kristy D M

2017-09-06

The importance of effective translation of health research findings into action has been well recognized, but there is evidence to suggest that the practice of knowledge translation (KT) among health researchers is still evolving. Compared to research user stakeholders, researchers (knowledge producers) have been under-studied in this context. The goals of this study were to understand the experiences of health researchers in practicing KT in Manitoba, Canada, and identify their support needs to sustain and increase their participation in KT. Qualitative semi-structured interviews were conducted with 26 researchers studying in biomedical; clinical; health systems and services; and social, cultural, environmental and population health research. Interview questions were open-ended and probed participants' understanding of KT, their experiences in practicing KT, barriers and facilitators to practicing KT, and their needs for KT practice support. KT was broadly conceptualized across participants. Participants described a range of KT practice experiences, most of which related to dissemination. Participants also expressed a number of negative emotions associated with the practice of KT. Many individual, logistical, and systemic or organizational barriers to practicing KT were identified, which included a lack of institutional support for KT in both academic and non-academic systems. Participants described the presence of good relationships with stakeholders as a critical facilitator for practicing KT. The most commonly identified needs for supporting KT practice were access to education and training, and access to resources to increase awareness and promotion of KT. While there were few major variations in response trends across most areas of health research, the responses of biomedical researchers suggested a unique KT context, reflected by distinct conceptualizations of KT (such as commercialization as a core component), experiences (including frustration and lack of support), and barriers to practicing KT (for example, intellectual property concerns). The major findings of this study were the continued variations in conceptualization of KT, and persisting support needs that span basic individual to comprehensive systemic change. Expanding the study to additional regions of Canada will present opportunities to compare and contrast the state of KT practice and its influencing factors.

'It gave me a new lease of life … ': GPs' views and experiences of supervising foundation doctors in general practice.

PubMed

Sabey, Abigail; Harris, Michael; van Hamel, Clare

2016-03-01

General practice is a popular placement in the second year of Foundation training. Evaluations suggest this is a positive experience for most trainee doctors and benefits their perceptions of primary care, but the impact on primary care supervisors has not been considered. At a time when placements may need to increase, understanding the experience of the GP supervisors responsible for these placements is important. To explore the views, experiences and needs of GPs who supervise F2 doctors in their practices including their perceptions of the benefits to individuals and practices. A qualitative approach with GPs from across Severn Postgraduate Medical Education who supervise F2 doctors. Semi-structured interviews with 15 GPs between December 2012 and April 2013. GP supervisors are enthusiastic about helping F2 doctors to appreciate the uniqueness of primary care. Workload and responsibility around supervision is considerable making a supportive team important. Working with young, enthusiastic doctors boosts morale in the team. The presence of freshly trained minds prompts GPs to consider their own learning needs. Being a supervisor can increase job satisfaction; the teaching role gives respite from the demanding nature of GP work. Supervisors are positive about working with F2s, who lift morale in the team and challenge GPs in their own practice and learning. This boosts job and personal satisfaction. Nonetheless, consideration should be given to managing teaching workload and team support for supervision.

Factors Associated With the Perception of Family Nursing Practice Among Mental Health Nurses in Taiwan.

PubMed

Hsiao, Chiu-Yueh; Tsai, Yun-Fang

2015-11-01

The aim of this study was to examine factors that influenced the perceptions of mental health nurses about involving families in their nursing practice. A sample of 175 Taiwanese mental health nurses who are employed in both inpatient and community settings completed structured questionnaires designed to measure empathy, attitudes about involving families in care, and perceptions of family nursing practice. Data were analyzed using descriptive statistics, Pearson's product-moment correlation, t test, one-way ANOVA, and a hierarchical multiple regression analysis. Positive perceptions of family nursing practice were correlated with more years of clinical experience in mental health, empathy, supportive attitudes toward the importance of family nursing care, and personal experiences with family members with serious illness in need of professional care. These findings may assist in the development of effective educational programs designed to help nurses integrate family nursing knowledge and skills in the care of patients and families experiencing mental illness. © The Author(s) 2015.

Experiences of mental health nursing staff working with voice hearers in an acute setting: An interpretive phenomenological approach.

PubMed

McMullan, E; Gupta, A; Collins, S C

2018-04-01

WHAT IS KNOWN ON THE SUBJECT?: Community mental health staff and their service users have reported mixed views on the importance of talking about the content of voices. Community staff have reported feeling that they do not have the skills to explore voice content and worry about making things worse. Voice hearers experiencing extreme distress due to the content of their voices can access support through acute inpatient mental health services. No previous studies have focused on the experiences of staff who nurse voice hearers at a time of acute distress. WHAT DOES THIS STUDY ADD TO EXISTING KNOWLEDGE?: MHNs and HSWs working with voice hearers in acute distress report feeling powerless and helpless, as they feel that they cannot lessen the distress experienced by the voice hearer. Despite these difficult feelings, staff report finding ways of coping, including using structured tools to help make sense of their service users' voice-hearing experiences and accessing reflective practice forums. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Due to the current context of increased acuity and limited resources in acute services, there may be a need to further protect time for staff to access reflective practice groups and supervision forums to help them manage the difficult feelings arising from their work with voice hearers. Introduction Mental health nursing (MHN) staff in acute settings work with voice hearers at times of crises when they experience high levels of distress. Previous research has focused on community mental health staff's experiences and their service users views on exploring the content of voices. No studies have explored this from an acute mental health service perspective. Aim This study therefore sought to explore the experiences of staff working with voice hearers in an acute mental health service. Method Due to the exploratory nature of the research, a qualitative design was chosen. Three MHNs and five healthcare support workers (HSWs) were interviewed. The data were analysed using Interpretative Phenomenological Analysis. Results A group analysis elicited three master themes: "It's quite scary really, not unlike a horror movie;" "I can only influence what's in front of me;" and "Just chipping away". Discussion Staff working with voice hearers in acute settings experience feelings of powerlessness and helplessness, as they feel unable to reduce the distress experienced by voice hearers in their care. Staff employ coping strategies to help manage these difficult feelings, including using structured tools in their work with voice hearers and attending reflective practice forums. Implications for Practice Acute mental health services may need to protect time for staff to access regular reflective practice and other supervision forums to help manage their feelings of powerlessness and helplessness arising from their work with voice hearers. © 2017 John Wiley & Sons Ltd.

What makes a good GP? An empirical perspective on virtue in general practice

PubMed Central

Braunack-Mayer, A

2005-01-01

This paper takes a virtuist approach to medical ethics to explore, from an empirical angle, ideas about settled ways of living a good life. Qualitative research methods were used to analyse the ways in which a group of 15 general practitioners (GPs) articulated notions of good doctoring and the virtues in their work. I argue that the GPs, whose talk is analysed here, defined good general practice in terms of the ideals of accessibility, comprehensiveness, and continuity. They regarded these ideals significant both for the way they dealt with morally problematic situations and for how they conducted their professional lives more generally. In addition, I argue that the GPs who articulated these ideals most clearly were able to, in part, because they shared the experience of working in rural areas. This experience helped them to develop an understanding of the nature of general practice that their urban colleagues were less able to draw on. In that sense, the structural and organisational framework of general practice in rural areas provided the context for their understanding of ideals in general practice. PMID:15681671

Resisting vulnerability: the experiences of families who have kin in hospital-a feminist ethnography.

PubMed

Perry, Joann; Judith Lynam, M; Anderson, Joan M

2006-02-01

Health care restructuring, in an effort to control costs, has resulted in marked organizational change with concomitant influences on nursing practice in the hospital and community contexts. Such changes have resulted in increased levels of acuity among patients and shorter hospital stays. As a consequence, families are being asked to assume greater roles in illness care of family members. At the same time societies and therefore patient populations are becoming increasingly culturally and linguistically diverse. Yet, little is known about hospitalization and help-seeking practices of family caregivers in an ethnoculturally diverse context and the nature of support they require from the health care system. This paper addresses this gap in knowledge. Here we draw upon data gathered in two ethnographic studies of illness care and help-seeking practices in an enthoculturally diverse community. Analysis of family data identified 'resisting vulnerability' as a process central to the families' experiences. This paper examines the process of resisting vulnerability and how it was influenced by the practices of health care professionals and structures of the health system. Implications for practice are discussed.

Data-analysis issues in a phenomenographic investigation of information literacy in nursing.

PubMed

Forster, Marc

2013-11-01

To explore two contrasting methods of phenomenographic data analysis. Phenomenography is a still-uncommon but increasingly used methodology based on qualitative interviews that allows experiences to be categorised and put into a descriptive structure for use in developing educational interventions. There are two different approaches in the literature to analysing data: the Marton and Åkerlind methods. A doctoral research project investigating the role of information literacy in evidence-based practice in nursing. The phenomenographic study involves open-ended interviews in which participants are asked to describe their 'life-world' where the phenomenon is experienced, covering the contexts in which it is experienced and how it is experienced. The researcher attempts to develop statements from the interview transcripts that describe representative ways of experiencing the phenomenon in the form of 'categories of description'. A category of description represents a qualitatively different way of experiencing a phenomenon. This article discusses the reasons for adopting phenomenography, phenomenography's epistemological assumptions, and the strengths and weaknesses of the two different data-analysis methods. Phenomenography's strength is its ability to develop logical structures that give a picture of the experience of a phenomenon while being able to read into the structure as much of the complexity of that experience as is consciously and practically possible. One method, described as the 'Åkerlind' method, emerged as the appropriate method for phenomenographic studies in nursing.

Teaching undergraduate students in rural general practice: an evaluation of a new rural campus in England.

PubMed

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.

A narrative inquiry into novice science mentor teachers' mentoring practices

NASA Astrophysics Data System (ADS)

Naseem, Samina

Many teacher education programs hire new mentors every year to work with their student teacher population. The literature about teacher mentoring suggests the importance of relevant and ongoing professional development (PD) for teacher mentors at all levels. However, it is much more commonly the case that most teacher mentors volunteer and do not have access to PD. Past research about mentoring provides a descriptive sense of the practices of experienced mentors, especially within a PD context, but little is known about how novice mentors, who are mentoring for the first or the second time, with no prior PD related to mentoring articulate their work as mentors. Using the telling form of narrative inquiry, my study documented how four novice science mentors (NSMs) who had no prior mentoring-related PD articulated the work of mentoring through the stories they told about their past experiences as learners and teachers. The term learner included experiences that the NSMs had before school through K-12 and in their teacher education programs. The experiences as a teacher referred to NSMs' in-service experiences -- teaching, coaching, and mentoring (if any). Each NSM was interviewed once a month for a period of five months. The interviews captured experiences of the NSMs since their childhood to present day experiences as teachers to summarize the experiences that informed their current mentoring practices; to document salient mentoring practices they employed; to identify sources and factors that shaped those practices, and to understand mentoring from mentor teachers' perspectives. Clandinin and Connelly's (2000) three commonplaces (temporality- sociality- place ) framework was used for structuring interview questions and analyzing data. The NSMs employed number of practices discussed in the literature. The study found that the most influential life experiences were upbringing, student teaching, teaching, prior mentoring, and coaching. By taking temporality into account, the study revealed that each NSM had a core practice, which was based on their preferred teaching and learning styles, such as hands-on, lecture, etc. Given the core of their practice, the NSMs approached mentoring situations differently, thus making mentoring individualistic in nature. Sociality revealed that beliefs, relationships, and context as the major factors to inform the NSMs' mentoring practices. Place as a factor was significant only in one NSM's stories. These findings suggested a relationship between the NSMs' mentoring practices and professional identity. The study was concluded with an emphasis on the importance of taking in to account the biographies of teacher mentors and their professional identity to understand mentoring practices and the process of mentoring. Based on the findings, it was recommended to offer teacher mentor - centered professional development opportunities to help novice mentors build on their strengths and ways to use their skills to mentor interns in productive ways.

Grieving a loss: the lived experience for elders residing in an institution.

PubMed

Pilkington, F Beryl

2005-07-01

Grieving a loss is a profound and universal human experience. This phenomenological-hermeneutic study was an inquiry into the lived experience of grieving a loss. The nursing perspective was Parse's human becoming theory. Participants were 10 elderly persons residing in a long-term care facility. The study finding specifies the structure of the lived experience of grieving a loss as aching solitude amid enduring cherished affiliations, as serene acquiescence arises with sorrowful curtailments. Findings are discussed in relation to the guiding theoretical perspective and related literature. Recommendations for additional research and insights for practice are presented.

Filtrates and Residues: Ice Cream: Delicious Chemistry.

ERIC Educational Resources Information Center

Martino, James

1983-01-01

An experiment involving preparation of ice cream is conducted after students complete units on solutions, atomic structure, molecular architecture, and bonding. The laboratory gives practical illustration of relation of physical properties to bond type and solution theory developed. Materials needed, procedures used, and questions asked are…

Non-destructive and destructive investigation of aged-in-the field carbon FRP-wrapped columns.

DOT National Transportation Integrated Search

2011-06-01

The common practice of applying deicing salts on highway bridges increases the potential of reinforcing steel in these structures to experience extensive corrosion in the decks as well as the substructure. A new rehabilitation method which is believe...

Mutuality at the center: health promotion with Cape Verdean immigrant women.

PubMed

De Jesus, Maria

2009-02-01

Public health care researchers, policy makers, and providers are increasingly interested in developing more effective and culturally responsive health promotion theories and interventions for diverse immigrant populations. The purpose of this study was to develop health promotion theory that validates the local knowledge and experiences of Cape Verdean women health promoters who work with immigrant women in their community. In-depth, semi-structured interviews were conducted with nine culturally savvy, community-based Cape Verdean women health promoters about their perspectives and daily experiences of health promotion practice with Cape Verdean immigrant women. This study used Glaserian grounded theory to analyze the interviews. This approach identified concepts and developed an integrated process through which to theorize about the practice of health promoters. For Cape Verdean women health promoters, a process of creating relationships was a key to promoting women's health. The relational theory of health promotion practice reflects these dynamic processes, properties, and stages through which Cape Verdean women health promoters develop mutually engaging relationships with immigrant women. CONCLUSION. These findings challenge health care professionals to broaden the repertoire of health promotion strategies to include relationship-building between health promoters and community women. Through these relationships health promoters can understand the complex structural, cultural, and community factors that influence immigrant women's health and incorporate that knowledge into more effective health promotion practices.

Reimagining publics and (non)participation: Exploring exclusion from science communication through the experiences of low-income, minority ethnic groups.

PubMed

Dawson, Emily

2018-01-01

This article explores science communication from the perspective of those most at risk of exclusion, drawing on ethnographic fieldwork. I conducted five focus groups and 32 interviews with participants from low-income, minority ethnic backgrounds. Using theories of social reproduction and social justice, I argue that participation in science communication is marked by structural inequalities (particularly ethnicity and class) in two ways. First, participants' involvement in science communication practices was narrow (limited to science media consumption). Second, their experiences of exclusion centred on cultural imperialism (misrepresentation and 'Othering') and powerlessness (being unable to participate or change the terms of their participation). I argue that social reproduction in science communication constructs a narrow public that reflects the shape, values and practices of dominant groups, at the expense of the marginalised. The article contributes to how we might reimagine science communication's publics by taking inclusion/exclusion and the effects of structural inequalities into account.

Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home

PubMed Central

Flieger, Signe Peterson

2017-01-01

Background This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. Purpose The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Methodology/Approach Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Findings Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. Practice Implications (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking the time to reflect will facilitate greater sensemaking and learning and will ultimately help foster a relationship-centered PCMH. PMID:26939031

Contexts, concepts and cognition: principles for the transfer of basic science knowledge.

PubMed

Kulasegaram, Kulamakan M; Chaudhary, Zarah; Woods, Nicole; Dore, Kelly; Neville, Alan; Norman, Geoffrey

2017-02-01

Transfer of basic science aids novices in the development of clinical reasoning. The literature suggests that although transfer is often difficult for novices, it can be optimised by two complementary strategies: (i) focusing learners on conceptual knowledge of basic science or (ii) exposing learners to multiple contexts in which the basic science concepts may apply. The relative efficacy of each strategy as well as the mechanisms that facilitate transfer are unknown. In two sequential experiments, we compared both strategies and explored mechanistic changes in how learners address new transfer problems. Experiment 1 was a 2 × 3 design in which participants were randomised to learn three physiology concepts with or without emphasis on the conceptual structure of basic science via illustrative analogies and by means of one, two or three contexts during practice (operationalised as organ systems). Transfer of these concepts to explain pathologies in familiar organ systems (near transfer) and unfamiliar organ systems (far transfer) was evaluated during immediate and delayed testing. Experiment 2 examined whether exposure to conceptual analogies and multiple contexts changed how learners classified new problems. Experiment 1 showed that increasing context variation significantly improved far transfer performance but there was no difference between two and three contexts during practice. Similarly, the increased conceptual analogies led to higher performance for far transfer. Both interventions had independent but additive effects on overall performance. Experiment 2 showed that such analogies and context variation caused learners to shift to using structural characteristics to classify new problems even when there was superficial similarity to previous examples. Understanding problems based on conceptual structural characteristics is necessary for successful transfer. Transfer of basic science can be optimised by using multiple strategies that collectively emphasise conceptual structure. This means teaching must focus on conserved basic science knowledge and de-emphasise superficial features. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Exploring the learning experiences of nursing students with dyslexia.

PubMed

Child, J; Langford, E

To examine the learning experiences of nursing students with dyslexia during clinical placements to establish ways of improving support in practice, A phenomenological lifeworld approach was adopted using semi-structured interviews. Students reflected on their experiences during clinical placements, allowing the researcher to gain an in-depth knowledge of the students' lived experience of dyslexia. Twelve student nurses, six with dyslexia and six without, were interviewed using a standard set of questions, and the data were collated and analysed. Using a comparison group of students without dyslexia was felt to be important to contextualise and compare the students' experiences. Three main themes emerged: the value of work-based learning days, the importance of the clinical placement mentor role and the need for advocacy. Both groups of nursing students contributed to recommendations relating to support in practice and those with dyslexia also shared their individual coping strategies, Nursing students with dyslexia may benefit from sharing placement experiences with colleagues outside the clinical environment. They may also benefit from receiving support from their placement mentor and a representative from the university who knows about dyslexia.

A simplified design of the staggered herringbone micromixer for practical applications

PubMed Central

Du, Yan; Zhang, Zhiyi; Yim, ChaeHo; Lin, Min; Cao, Xudong

2010-01-01

We demonstrated a simple method for the device design of a staggered herringbone micromixer (SHM) using numerical simulation. By correlating the simulated concentrations with channel length, we obtained a series of concentration versus channel length profiles, and used mixing completion length Lm as the only parameter to evaluate the performance of device structure on mixing. Fluorescence quenching experiments were subsequently conducted to verify the optimized SHM structure for a specific application. Good agreement was found between the optimization and the experimental data. Since Lm is straightforward, easily defined and calculated parameter for characterization of mixing performance, this method for designing micromixers is simple and effective for practical applications. PMID:20697584

A simplified design of the staggered herringbone micromixer for practical applications.

PubMed

Du, Yan; Zhang, Zhiyi; Yim, Chaeho; Lin, Min; Cao, Xudong

2010-05-07

We demonstrated a simple method for the device design of a staggered herringbone micromixer (SHM) using numerical simulation. By correlating the simulated concentrations with channel length, we obtained a series of concentration versus channel length profiles, and used mixing completion length L(m) as the only parameter to evaluate the performance of device structure on mixing. Fluorescence quenching experiments were subsequently conducted to verify the optimized SHM structure for a specific application. Good agreement was found between the optimization and the experimental data. Since L(m) is straightforward, easily defined and calculated parameter for characterization of mixing performance, this method for designing micromixers is simple and effective for practical applications.

Assessment of photoselective vaporization of prostate skills during Urology Objective Structured Clinical Examinations (OSCE)

PubMed Central

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

Hierarchical mutual information for the comparison of hierarchical community structures in complex networks

NASA Astrophysics Data System (ADS)

Perotti, Juan Ignacio; Tessone, Claudio Juan; Caldarelli, Guido

2015-12-01

The quest for a quantitative characterization of community and modular structure of complex networks produced a variety of methods and algorithms to classify different networks. However, it is not clear if such methods provide consistent, robust, and meaningful results when considering hierarchies as a whole. Part of the problem is the lack of a similarity measure for the comparison of hierarchical community structures. In this work we give a contribution by introducing the hierarchical mutual information, which is a generalization of the traditional mutual information and makes it possible to compare hierarchical partitions and hierarchical community structures. The normalized version of the hierarchical mutual information should behave analogously to the traditional normalized mutual information. Here the correct behavior of the hierarchical mutual information is corroborated on an extensive battery of numerical experiments. The experiments are performed on artificial hierarchies and on the hierarchical community structure of artificial and empirical networks. Furthermore, the experiments illustrate some of the practical applications of the hierarchical mutual information, namely the comparison of different community detection methods and the study of the consistency, robustness, and temporal evolution of the hierarchical modular structure of networks.

How nurse-led practices perceive implementation of the patient-centered medical home.

PubMed

Frasso, Rosemary; Golinkoff, A; Klusaritz, Heather; Kellom, Katherine; Kollar-McArthur, Helen; Miller-Day, Michelle; Gabbay, Robert; Cronholm, Peter F

2017-04-01

The Affordable Care Act (ACA) promotes the Patient-Centered Medical Home (PCMH) model as a way to improve healthcare quality, the patient experience, and has identified nurse-led primary care as a mechanism meeting the increasing demand for quality primary care. The purpose of this study was to investigate the implementation of a PCMH model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model. Data were collected through in-depth interviews with providers and staff in nurse-led practices. These data suggest two categories of processes that facilitate the integration of PCMH in the nurse-led practice setting: patient-oriented facilitators and organizational facilitators. In addition, a number of barriers were identified to implementing the PCMH model. Overall, these practices creatively engaged in the transformation process by structuring themselves as a complex adaptive system and building upon the core principles of nurse-led care. Since the core principles of nurse-led care map onto many of the same principles of the PCMH model, this study discusses the possibility that nurse-led practices may experience fewer barriers when transitioning into PCMHs. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of practical training on the learning motivation profile of Japanese pharmacy students using structural equation modeling

PubMed Central

2017-01-01

Purpose To establish a model of Japanese pharmacy students’ learning motivation profile and investigate the effects of pharmaceutical practical training programs on their learning motivation. Methods The Science Motivation Questionnaire II was administered to pharmacy students in their 4th (before practical training), 5th (before practical training at clinical sites), and 6th (after all practical training) years of study at Josai International University in April, 2016. Factor analysis and multiple-group structural equation modeling were conducted for data analysis. Results A total of 165 students participated. The learning motivation profile was modeled with 4 factors (intrinsic, career, self-determination, and grade motivation), and the most effective learning motivation was grade motivation. In the multiple-group analysis, the fit of the model with the data was acceptable, and the estimated mean value of the factor of ‘self-determination’ in the learning motivation profile increased after the practical training programs (P= 0.048, Cohen’s d= 0.43). Conclusion Practical training programs in a 6-year course were effective for increasing learning motivation, based on ‘self-determination’ among Japanese pharmacy students. The results suggest that practical training programs are meaningful not only for providing clinical experience but also for raising learning motivation. PMID:28167812

Mountain bicycle frame testing as an example of practical implementation of hybrid simulation using RTFEM

NASA Astrophysics Data System (ADS)

Mucha, Waldemar; Kuś, Wacław

2018-01-01

The paper presents a practical implementation of hybrid simulation using Real Time Finite Element Method (RTFEM). Hybrid simulation is a technique for investigating dynamic material and structural properties of mechanical systems by performing numerical analysis and experiment at the same time. It applies to mechanical systems with elements too difficult or impossible to model numerically. These elements are tested experimentally, while the rest of the system is simulated numerically. Data between the experiment and numerical simulation are exchanged in real time. Authors use Finite Element Method to perform the numerical simulation. The following paper presents the general algorithm for hybrid simulation using RTFEM and possible improvements of the algorithm for computation time reduction developed by the authors. The paper focuses on practical implementation of presented methods, which involves testing of a mountain bicycle frame, where the shock absorber is tested experimentally while the rest of the frame is simulated numerically.

Stanislavsky's system as an enactive guide to embodied cognition?

NASA Astrophysics Data System (ADS)

Clare, Ysabel

2017-01-01

This paper presents a model of the structure of subjective experience derived from the work of Konstantin Stanislavsky, and demonstrates its usefulness as a functional framework of enacted cognitive embodiment by using it to articulate his approach to the process of acting. Research into Stanislavsky's training exercises reveals that they evoke a spatial adpositional conceptualisation of experience. When reflected back onto the practice from which it emerges, this situates the choices made by actors as contributing towards the construction of a stable attention field with which they enter into relationship during performance. It is suggested that the resulting template might clarify conceptual distinctions between practices at the unconscious level, and a brief illustrative comparison between Stanislavsky's and Meisner's practices is essayed. A parallel is drawn throughout with the basic principles of embodied cognition, and correlations found with aspects of Dynamic Field Theory and Wilson's notions of "on-" and "off-line" processing.

Insights from industry: a quantitative analysis of engineers' perceptions of empathy and care within their practice

NASA Astrophysics Data System (ADS)

Hess, Justin L.; Strobel, Johannes; Pan, Rui Celia; Wachter Morris, Carrie A.

2017-11-01

This study focuses on two seldom-investigated skills or dispositions aligned with engineering habits of mind - empathy and care. In order to conduct quantitative research, we designed, explored the underlying structure of, validated, and tested the reliability of the Empathy and Care Questionnaire (ECQ), a new psychometric instrument. In the second part, we used the ECQ to explore the perceptions of empathy and care of alumni/ae of an internationally ranked US institution, along with how perceptions differed by work experience and gender. Results show that participants perceived empathy and care to be important in multiple respects, most notably in relational aspects of engineering practice. Engineers with more engineering experience were more likely to perceive empathy and care as existing in engineering practice and as important to their work. While these phenomena are sometimes depicted as feminine qualities, we found no gender differences among our respondents.

Women, Poverty, and Trauma: An Empowerment Practice Approach.

PubMed

East, Jean Francis; Roll, Susan J

2015-10-01

This article describes an empowerment approach for working with diverse women who experience poverty, trauma, and multiple structural oppressions. The approach is the result of 20 years of experience developing, implementing, and evaluating this practice in a metropolitan community, and is grounded in women's empowerment theory and relational-cultural theory. The interventions combine social work's clinical interventions with community organizing strategies to promote personal and collective empowerment, supporting the "personal is political" tenet of feminist practice. The interventions, including nonclinical interviews, story circles, and leadership and advocacy education and training, can guide practitioners in providing services and programs that create a space for women to make changes in their personal lives and in their community. Program outcomes report successful changes for women in improving symptoms, increasing self-efficacy, and engaging in community advocacy. Women who participated also reported an increased sense of power, balancing commonality and difference among women, and a sense of hope for their future.

Reframing masculinity: structural vulnerability and HIV among black men who have sex with men and women.

PubMed

Mackenzie, Sonja

2018-04-19

This paper calls for a critical reframing of masculinity as an intersectional construct in the HIV epidemic and in public health. In-depth qualitative interviews were conducted with a sample of 56 Black men who have sex with men and women in the San Francisco Bay Area. Men described their sexual identities and practices via complex narratives of masculinity that drew on subordinated and resourceful adaptations to the structural effects of racism, economic marginalisation and homophobia. By focusing on men whose experience of masculinity operates outside fixed identity categories, the paper draws attention to the intersectionality that is, by necessity, constitutive of men's lived experiences. Findings suggest the value of an integrative framework for understanding Black masculinities as processes and practices simultaneously informed by structural inequalities (racism, economic marginalisation and/or homophobia, in particular) and cultural meanings of gender. By utilising an intersectional approach, public health and sociology can better understand the concurrent resilience and vulnerability of masculinities, while building an interdisciplinary understanding of the symbolic role of Black masculinities in the USA, as well as a means by which to promote health and well-being in and through these gendered contexts.

Obstructions to Bell CMB experiments

NASA Astrophysics Data System (ADS)

Martin, Jérôme; Vennin, Vincent

2017-09-01

We present a general and systematic study of how a Bell experiment on the cosmic microwave background could be carried out. We introduce different classes of pseudo-spin operators and show that, if the system is placed in a two-mode squeezed state as inflation predicts, they all lead to a violation of the Bell inequality. However, we also discuss the obstacles that one faces in order to realize this program in practice and show that they are probably insurmountable. We suggest alternative methods that could reveal the quantum origin of cosmological structures without relying on Bell experiments.

Student perception of travel service learning experience in Morocco.

PubMed

Puri, Aditi; Kaddoura, Mahmoud; Dominick, Christine

2013-08-01

This study explores the perceptions of health profession students participating in academic service learning in Morocco with respect to adapting health care practices to cultural diversity. Authors utilized semi-structured, open-ended interviews to explore the perceptions of health profession students. Nine dental hygiene and nursing students who traveled to Morocco to provide oral and general health services were interviewed. After interviews were recorded, they were transcribed verbatim to ascertain descriptive validity and to generate inductive and deductive codes that constitute the major themes of the data analysis. Thereafter, NVIVO 8 was used to rapidly determine the frequency of applied codes. The authors compared the codes and themes to establish interpretive validity. Codes and themes were initially determined independently by co-authors and applied to the data subsequently. The authors compared the applied codes to establish intra-rater reliability. International service learning experiences led to perceptions of growth as a health care provider among students. The application of knowledge and skills learned in academic programs and service learning settings were found to help in bridging the theory-practice gap. The specific experience enabled students to gain an understanding of diverse health care and cultural practices in Morocco. Students perceived that the experience gained in international service learning can heighten awareness of diverse cultural and health care practices to foster professional growth of health professionals.

Learning professional ethics: Student experiences in a health mentor program.

PubMed

Langlois, Sylvia; Lymer, Erin

2016-01-01

The use of patient centred approaches to healthcare education is evolving, yet the effectiveness of these approaches in relation to professional ethics education is not well understood. The aim of this study was to explore the experiences and learning of health profession students engaged in an ethics module as part of a Health Mentor Program at the University of Toronto. Students were assigned to interprofessional groups representing seven professional programs and matched with a health mentor. The health mentors, individuals living with chronic health conditions, shared their experiences of the healthcare system through 90 minute semi-structured interviews with the students. Following the interviews, students completed self-reflective papers and engaged in facilitated asynchronous online discussions. Thematic analysis of reflections and discussions was used to uncover pertaining to student experiences and learning regarding professional ethics. Five major themes emerged from the data: (1) Patient autonomy and expertise in care; (2) ethical complexity and its inevitable reality in the clinical practice setting; (3) patient advocacy as an essential component of day-to-day practice; (4) qualities of remarkable clinicians that informed personal ideals for future practice; (5) patients' perspectives on clinician error and how they enabled suggestions for improving future practice. The findings of a study in one university context suggest that engagement with the health mentor narratives facilitated students' critical reflection related to their understanding of the principles of healthcare ethics.

Embodiment and aging in contemporary physiotherapy.

PubMed

Hay, Melissa E; Connelly, Denise M; Kinsella, Elizabeth Anne

2016-05-01

Contemporary discourses in the health sciences vary in their treatment of aging bodies and the mind-body relationship, yet our understanding of aging experiences and health care practices can be limited by an overreliance on biomedical or social constructionist approaches alone. This paper offers a conceptual exploration of embodiment as an innovative approach to enhance our understandings of aging bodies and health in physiotherapy practice. Embodiment attends to body and mind, nature and culture, structure and agency, while appreciating differences in aging bodies and health in aging. Conclusions consider embodiment in the practice and disciplinary discourse of contemporary physiotherapy, specifically, considering the ways embodied perspectives can support therapists in their health care practice and relationships with people with aging bodies.

Presumed fair: ironic effects of organizational diversity structures.

PubMed

Kaiser, Cheryl R; Major, Brenda; Jurcevic, Ines; Dover, Tessa L; Brady, Laura M; Shapiro, Jenessa R

2013-03-01

This research tests the hypothesis that the presence (vs. absence) of organizational diversity structures causes high-status group members (Whites, men) to perceive organizations with diversity structures as procedurally fairer environments for underrepresented groups (racial minorities, women), even when it is clear that underrepresented groups have been unfairly disadvantaged within these organizations. Furthermore, this illusory sense of fairness derived from the mere presence of diversity structures causes high-status group members to legitimize the status quo by becoming less sensitive to discrimination targeted at underrepresented groups and reacting more harshly toward underrepresented group members who claim discrimination. Six experiments support these hypotheses in designs using 4 types of diversity structures (diversity policies, diversity training, diversity awards, idiosyncratically generated diversity structures from participants' own organizations) among 2 high-status groups in tests involving several types of discrimination (discriminatory promotion practices, adverse impact in hiring, wage discrimination). Implications of these experiments for organizational diversity and employment discrimination law are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved

Professional Identity Formation: Considerations for Athletic Training Education

ERIC Educational Resources Information Center

Peer, Kimberly S.

2016-01-01

Clinical education is a complex element of educational programs in health care. Understanding identity is important because how educators structure learning experiences and foster the development of professionals within these programs impacts students as they emerge into professional practice. This article discusses five cultural dimensions of…

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…

Water and Plant Cells: Notes on a Teaching Scheme for O-Level.

ERIC Educational Resources Information Center

Grenville, H. W.

1983-01-01

Offers suggestions for teaching some aspects of water economy in plants. These include diffusion/osmosis, water transport, the part played by turgor in structural support, and its implications for plant organs or whole plants. Several practical demonstrations/experiments are also described. (JN)

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)

Faculty Descriptions of Simulation Debriefing in Traditional Baccalaureate Nursing Programs.

PubMed

Waznonis, Annette R

A study was conducted to describe simulation debriefing practices of faculty in accredited, traditional, baccalaureate nursing programs in the United States. Best debriefing practices include debriefing by a competent facilitator in a safe environment using a structured framework. Yet, structured frameworks and evaluation of debriefing are lacking in nursing education. This article reports the interview findings from the qualitative component of a large-scale mixed-methods study. Twenty-three full-time faculty members with an average of 6 years of simulation debriefing experience participated in interviews. Three themes emerged with subthemes: a) having the student's best interest at heart, b) getting over the emotional hurdle, and c) intentional debriefing evolves into learning. Gaps were found in faculty development, use of a structured framework, and evaluation. Research is warranted on use of video, postdebriefing assignments, cofacilitation, and debriefing effectiveness.

Increased gray matter density in the parietal cortex of mathematicians: a voxel-based morphometry study.

PubMed

Aydin, K; Ucar, A; Oguz, K K; Okur, O O; Agayev, A; Unal, Z; Yilmaz, S; Ozturk, C

2007-01-01

The training to acquire or practicing to perform a skill, which may lead to structural changes in the brain, is called experience-dependent structural plasticity. The main purpose of this cross-sectional study was to investigate the presence of experience-dependent structural plasticity in mathematicians' brains, which may develop after long-term practice of mathematic thinking. Twenty-six volunteer mathematicians, who have been working as academicians, were enrolled in the study. We applied an optimized method of voxel-based morphometry in the mathematicians and the age- and sex-matched control subjects. We assessed the gray and white matter density differences in mathematicians and the control subjects. Moreover, the correlation between the cortical density and the time spent as an academician was investigated. We found that cortical gray matter density in the left inferior frontal and bilateral inferior parietal lobules of the mathematicians were significantly increased compared with the control subjects. Furthermore, increase in gray matter density in the right inferior parietal lobule of the mathematicians was strongly correlated with the time spent as an academician (r = 0.84; P < .01). Left-inferior frontal and bilateral parietal regions are involved in arithmetic processing. Inferior parietal regions are also involved in high-level mathematic thinking, which requires visuospatial imagery, such as mental creation and manipulation of 3D objects. The voxel-based morphometric analysis of mathematicians' brains revealed increased gray matter density in the cortical regions related to mathematic thinking. The correlation between cortical density increase and the time spent as an academician suggests experience-dependent structural plasticity in mathematicians' brains.

A Virtual Practice Environment to Develop Communication Skills in Pharmacy Students

PubMed Central

Styles, Kim; Duncan, Greg

2012-01-01

Objective. To develop communication skills in second-year pharmacy students using a virtual practice environment (VPE) and to assess students’ and tutors’ (instructors’) experiences. Design. A VPE capable of displaying life-sized photographic and video images and representing a pharmacy setting was constructed. Students viewed prescriptions and practiced role-playing with each other and explored the use of nonverbal communication in patient-pharmacist interactions. The VPE experiences were complemented with lectures, reflective journaling, language and learning support, and objective structured clinical examinations (OSCEs). Assessment. Most students believed the VPE was a useful teaching resource (87%) and agreed that the video component enabled them to contextualize patient problems (73%). While 45% of students questioned the usefulness of watching the role plays between students after they were video recorded, most (90%) identified improvement in their own communication as a result of participating in the tutorials. Most tutors felt comfortable using the technology. Focus group participants found the modified tutorials more engaging and aesthetically positive than in their previous experience. Conclusion. The VPE provided an effective context for communication skills development classes. PMID:23275667

Intercultural education of nurses and health professionals in Europe (IENE).

PubMed

Taylor, G; Papadopoulos, I; Dudau, V; Maerten, M; Peltegova, A; Ziegler, M

2011-06-01

The study aimed to explore the perceived learning and teaching needs of students and practitioners of health-care professions in relation to preparation for working in another European country and/or in a multicultural environment. The participating countries were: Belgium, Bulgaria, Germany, Romania and the UK. Questionnaires, consisting of open questions, were completed by a total of 118 participants. Data analysis adopted both a priori and inductive approaches. The predetermined constructs of cultural awareness, cultural knowledge, cultural sensitivity and cultural competence were used to structure suggestions for theoretical input and practical activities and experiences. Inductive analysis revealed other emergent themes that underpin all four of these constructs. Practical experiences form a fundamental part of preparation for labour mobility and/or for practice within a multicultural environment. However, health-care practitioners need to be adequately prepared for such experiences and value the opportunity to learn about culture, to explore values and beliefs, and to practise intercultural skills within the safe environment of an educational establishment, facilitated by skilled teachers. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Computerisation of general practice in the Republic of Croatia: experience gained in general practice use.

PubMed

Bergman-Marković, Biserka; Katić, Milica; Kern, Josipa

2007-01-01

Well-organised medical records are the prerequisite for achieving a high level of performance in primary healthcare settings. Recording balanced structured and coded data as well as free text can improve both quality and organisation of work in the office. It provides a more substantiated support of financial transactions and accountancy, allows better communication with other facilities and institutions, and is a source of valuable scientific research material. This article is the result of an individual experience gained in general practice use of various programs/systems employed within the family medicine frame, and the frame of evaluation of available and commonly-exploited program solutions. The use of various programs allows for systematic adjustments as to the increasingly complex requirements imposed on electronic medical records (EMRs). The experience of a general practitioner, presented in this paper, confirms the assumption that an adequate program to be employed with EMRs should be developed, provided that family medicine practitioners, that is, the final users, have been involved in each and every stage of its development, adjustment, implementation and evaluation.

Oncology nurses and the experience of participation in an evidence-based practice project.

PubMed

Fridman, Mary; Frederickson, Keville

2014-07-01

To illuminate the experiences of oncology nurses who participated in an evidence-based practice (EBP) project in an institution with an EBP organizational structure. A descriptive phenomenologic approach and in-depth interviews with each participant. An oncology-focused academic medical center with an established organizational infrastructure for EBP. 12 RNs working in an oncology setting who participated in an EBP project. Descriptive, qualitative phenomenologic approach through use of interviews and analysis of interview text. Four essential themes (i.e., support, challenges, evolution, and empowerment) and 11 subthemes emerged that reflected nurses' professional and personal growth, as well as the creation of a culture of EBP in the workplace. The participants described the EBP project as a positive, empowering personal and professional evolutionary experience with supports and challenges that resulted in improvements in patient care. To the authors' knowledge, the current study is the first qualitative study to demonstrate improved nursing outcomes (e.g., professional growth, improved nursing performance) and nurses' perception of improved patient outcomes (e.g., ongoing healthcare collaboration, evidence-based changes in practice).

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.

Analysis of defects of overhead facade systems and other light thin-walled structures

NASA Astrophysics Data System (ADS)

Endzhievskiy, L.; Frolovskaia, A.; Petrova, Y.

2017-04-01

This paper analyzes the defects and the causes of contemporary design solutions with an example of overhead facade systems with ventilated air gaps and light steel thin-walled structures on the basis of field experiments. The analysis is performed at all stages of work: design, manufacture, including quality, construction, and operation. Practical examples are given. The main causes of accidents and the accident rate prediction are looked upon and discussed.

Educational area for learning of optics and technologies: union of open laboratories of ideas, methods and practices (OLIMP)

NASA Astrophysics Data System (ADS)

Ivashchenko, Maksim; Bodrov, Kirill; Tolstoba, Nadezhda

2016-09-01

The paper deals with the concept of creating the union of Open Laboratories of Ideas, Methods and Practices (OLIMP). It describes the structure designed to simplify the relationship, such as business incubators, start-up accelerators, small innovative enterprises, fabrication laboratories and student centers. We consider their advantages and disadvantages for the specific audience of students and enthusiasts who do not have funding for their own projects. The experience of interaction between the Open Laboratories of Ideas, Methods and Practices and the Student Research Laboratory for Optical Engineering shows the relative impact of structures on each other and the value of using such interaction in the learning process. The paper also addresses issues such as: the motivation of students, enthusiasm for the direction the lab participants identify and maintain the initiatives, profiling in the design, scientific, commercial, social sphere.

Development of Laboratory Seismic Exploration Experiment for Education and Demonstration

NASA Astrophysics Data System (ADS)

Kuwano, O.; Nakanishi, A.

2016-12-01

We developed a laboratory experiment to simulate a seismic refraction survey for educational purposes. The experiment is tabletop scaled experiment using the soft hydrogel as an analogue material of a layered crust. So, we can conduct the seismic exploration experiment in a laboratory or a classroom. The softness and the transparency of the gel material enable us to observe the wave propagation with our naked eyes, using the photoelastic technique. By analyzing the waveforms obtained by the image analysis of the movie of the experiment, one can estimate the velocities and the structure of the gel specimen in the same way as an actual seismic survey. We report details of the practical course and the public outreach activities using the experiment.

Failing securely: The processes and support which underpin English nurse mentors' assessment decisions regarding under-performing students.

PubMed

Hunt, Louise A; McGee, Paula; Gutteridge, Robin; Hughes, Malcolm

2016-04-01

This study was undertaken in response to concerns that mentors who assessed practical competence were reluctant to fail student nurses which generated doubts about the fitness to practise of some registered nurses. Limited evidence was available about the experiences of mentors who had failed underperforming students and what had helped them to do this. To investigate what enabled some mentors to fail underperforming students when it was recognised that many were hesitant to do so. An ethically approved, grounded theory approach was used to explore thirty-one nurses' experiences of failing student nurses in practical assessments in England. Participants were recruited using theoretical sampling techniques. Semi-structured interviews were conducted. Analysis was undertaken using iterative, constant comparative techniques and reflexive processes. The theoretical framework which emerged had strong resonance with professionals. Five categories emerged from the findings: (1) Braving the assessment vortex; (2) Identifying the 'gist' of underperformance; (3) Tempering Reproach; (4) Standing up to scrutiny; and (5) Drawing on an interpersonal network. These categories together revealed that mentors needed to feel secure to fail a student nurse in a practical assessment and that they used a three stage decision making process to ascertain if this was the case. Many of the components which helped mentors to feel secure were informal in nature and functioned on goodwill and local arrangements rather than on timely, formal, organisational systems. The mentor's partner/spouse and practice education facilitator or link lecturer were identified as the key people who provided essential emotional support during this challenging experience. This study contributes to understanding of the combined supportive elements required for robust practical assessment. It presents a new explanatory framework about how mentors formulate the decision to fail a student nurse and the supportive structures which are necessary for this to occur. Copyright © 2016 Elsevier Ltd. All rights reserved.

Analysis of the connection of the timber-fiber concrete composite structure

NASA Astrophysics Data System (ADS)

Holý, Milan; Vráblík, Lukáš; Petřík, Vojtěch

2017-09-01

This paper deals with an implementation of the material parameters of the connection to complex models for analysis of the timber-fiber concrete composite structures. The aim of this article is to present a possible way of idealization of the continuous contact model that approximates the actual behavior of timber-fiber reinforced concrete structures. The presented model of the connection was derived from push-out shear tests. It was approved by use of the nonlinear numerical analysis, that it can be achieved a very good compliance between results of numerical simulations and results of the experiments by a suitable choice of the material parameters of the continuous contact. Finally, an application for an analytical calculation of timber-fiber concrete composite structures is developed for the practical use in engineering praxis. The input material parameters for the analytical model was received using data from experiments.

Autoethnography and cognitive adaptation: two powerful buffers against the negative consequences of workplace bullying and academic mobbing.

PubMed

Pheko, Mpho M

2018-12-01

Work is undoubtedly fundamental to human life, social development and the economic development of individuals, organizations and nations. However, the experience of working is not always pleasant as there are many instances where relationships between workers could deteriorate, leading to practices and behaviours that could be characterized as workplace bullying and/or mobbing. The current study is an exploratory study which used autoethnography to investigate experiences of academic bullying and mobbing, and relates the practices to power structures in academic institutions. Specifically, the author shares personal experiences and explores the physical and emotional pain of being bullied and mobbed. The author also outlines how both autoethnography and meaning in life strategies were used to cope with the physical and emotional distresses associated with the negative experiences. By outlining the success of the meaning in life strategies, the author hopes to inspire other "victims" to move from victims to being survivors of bullying and mobbing.

Autoethnography and cognitive adaptation: two powerful buffers against the negative consequences of workplace bullying and academic mobbing

PubMed Central

Pheko, Mpho M.

2018-01-01

ABSTRACT Work is undoubtedly fundamental to human life, social development and the economic development of individuals, organizations and nations. However, the experience of working is not always pleasant as there are many instances where relationships between workers could deteriorate, leading to practices and behaviours that could be characterized as workplace bullying and/or mobbing. The current study is an exploratory study which used autoethnography to investigate experiences of academic bullying and mobbing, and relates the practices to power structures in academic institutions. Specifically, the author shares personal experiences and explores the physical and emotional pain of being bullied and mobbed. The author also outlines how both autoethnography and meaning in life strategies were used to cope with the physical and emotional distresses associated with the negative experiences. By outlining the success of the meaning in life strategies, the author hopes to inspire other “victims” to move from victims to being survivors of bullying and mobbing. PMID:29667923

Visibility and Voice: Aboriginal People Experience Culturally Safe and Unsafe Health Care.

PubMed

Hole, Rachelle D; Evans, Mike; Berg, Lawrence D; Bottorff, Joan L; Dingwall, Carlene; Alexis, Carmella; Nyberg, Jessie; Smith, Michelle L

2015-12-01

In Canada, cultural safety (CS) is emerging as a theoretical and practice lens to orient health care services to meet the needs of Aboriginal people. Evidence suggests Aboriginal peoples' encounters with health care are commonly negative, and there is concern that these experiences can contribute to further adverse health outcomes. In this article, we report findings based on participatory action research drawing on Indigenous methods. Our project goal was to interrogate practices within one hospital to see whether and how CS for Aboriginal patients could be improved. Interviews with Aboriginal patients who had accessed hospital services were conducted, and responses were collated into narrative summaries. Using interlocking analysis, findings revealed a number of processes operating to produce adverse health outcomes. One significant outcome is the production of structural violence that reproduces experiences of institutional trauma. Positive culturally safe experiences, although less frequently reported, were described as interpersonal interactions with feelings visibility and therefore, treatment as a "human being." © The Author(s) 2015.

Professional Identity Formation in an Advanced Pharmacy Practice Experience Emphasizing Self-Authorship.

PubMed

Johnson, Jessica L; Chauvin, Sheila

2016-12-25

Objective. To examine the extent to which reflective essays written by graduating pharmacy students revealed professional identity formation and self-authorship development. Design. Following a six-week advanced pharmacy practice experience (APPE) grounded in Baxter-Magolda's Learning Partnerships Model of self-authorship development, students completed a culminating reflective essay on their rotation experiences and professional identity formation. Assessment. Thematic and categorical analysis of 41 de-identified essays revealed nine themes and evidence of all Baxter-Magolda's domains and phases of self-authorship. Analysis also suggested relationships between self-authorship and pharmacist professional identity formation. Conclusion. Results suggest that purposeful structuring of learning experiences can facilitate professional identity formation. Further, Baxter-Magolda's framework for self-authorship and use of the Learning Partnership Model seem to align well with pharmacist professional identify formation. Results of this study could be used by pharmacy faculty members when considering how to fill gaps in professional identity formation in future course and curriculum development.

Professional Identity Formation in an Advanced Pharmacy Practice Experience Emphasizing Self-Authorship

PubMed Central

Chauvin, Sheila

2016-01-01

Objective. To examine the extent to which reflective essays written by graduating pharmacy students revealed professional identity formation and self-authorship development. Design. Following a six-week advanced pharmacy practice experience (APPE) grounded in Baxter-Magolda’s Learning Partnerships Model of self-authorship development, students completed a culminating reflective essay on their rotation experiences and professional identity formation. Assessment. Thematic and categorical analysis of 41 de-identified essays revealed nine themes and evidence of all Baxter-Magolda’s domains and phases of self-authorship. Analysis also suggested relationships between self-authorship and pharmacist professional identity formation. Conclusion. Results suggest that purposeful structuring of learning experiences can facilitate professional identity formation. Further, Baxter-Magolda’s framework for self-authorship and use of the Learning Partnership Model seem to align well with pharmacist professional identify formation. Results of this study could be used by pharmacy faculty members when considering how to fill gaps in professional identity formation in future course and curriculum development. PMID:28179721

Feeling safe and motivated to achieve better health: Experiences with a partnership-based nursing practice programme for in-home patients with chronic obstructive pulmonary disease.

PubMed

Leine, Marit; Wahl, Astrid Klopstad; Borge, Christine Råheim; Hustavenes, Magne; Bondevik, Hilde

2017-09-01

To explore chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme in the home setting. Patients with chronic obstructive pulmonary disease suffer from psychological and physiological problems, especially when they return home after hospitalisation from exacerbation. Many express a need for information and knowledge about chronic obstructive pulmonary disease. Partnership as practice is a patient-centred framework providing an individualised practice for each patient. This study intends to achieve a nuanced and improved understanding of chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme comprising home visits from a respiratory nurse after hospital discharge, alongside interdisciplinary collaboration. This study has a qualitative design with interviews. Six individual semi-structured interviews collected in 2012-2013 constitute the material. Interviews were recorded, transcribed to written text and analysed using systematic text condensation. Three key themes were identified: to be seen, talked with and understood; healthcare support at home-continuity, practical support and facilitation; and exchange of knowledge. However, there were two generic themes that permeated the material: feeling safe and comforted, and motivation to achieve better health. Patients with chronic obstructive pulmonary disease can experience feeling safe and comforted, and be motivated to make changes in order to achieve better health after participating in a partnership-based nursing practice programme that includes home visits from a respiratory nurse and interdisciplinary cooperation after hospital discharge. To feel safe is of great importance, and how this relates to the patient's ability to cope with illness should be explored in further research. The results suggest that the partnership-based nursing practice programme that includes home visits and interdisciplinary collaboration can be a good approach to meeting the complexity of the chronic obstructive pulmonary disease patient's health needs. © 2017 John Wiley & Sons Ltd.

Status of Pharmacy Practice Experience Education Programs

PubMed Central

Eccles, Dayl; Kwasnik, Abigail; Craddick, Karen; Heinz, Andrew K.; Harralson, Arthur F.

2014-01-01

Objective. To assess financial, personnel, and curricular characteristics of US pharmacy practice experiential education programs and follow-up on results of a similar survey conducted in 2001. Methods. Experiential education directors at 118 accredited US pharmacy colleges and schools were invited to participate in a blinded, Web-based survey in 2011. Aggregate responses were analyzed using descriptive statistics and combined with data obtained from the American Association of Colleges of Pharmacy to assess program demographics, faculty and administrative organizational structure, and financial support. Results. The number of advanced pharmacy practice experience (APPE) sites had increased by 24% for medium, 50% for large, and 55% for very large colleges and schools. Introductory pharmacy practice experience (IPPE) sites outnumbered APPEs twofold. The average experiential education team included an assistant/associate dean (0.4 full-time equivalent [FTE]), a director (1.0 FTE), assistant/associate director (0.5 FTE), coordinator (0.9 FTE), and multiple administrative assistants (1.3 FTE). Most faculty members (63%-75%) were nontenure track and most coordinators (66%) were staff members. Estimated costs to operate an experiential education program represented a small percentage of the overall expense budget of pharmacy colleges and schools. Conclusion. To match enrollment growth, pharmacy practice experiential education administrators have expanded their teams, reorganized responsibilities, and found methods to improve cost efficiency. These benchmarks will assist experiential education administrators to plan strategically for future changes. PMID:24850934

Status of pharmacy practice experience education programs.

PubMed

Danielson, Jennifer; Eccles, Dayl; Kwasnik, Abigail; Craddick, Karen; Heinz, Andrew K; Harralson, Arthur F

2014-05-15

To assess financial, personnel, and curricular characteristics of US pharmacy practice experiential education programs and follow-up on results of a similar survey conducted in 2001. Experiential education directors at 118 accredited US pharmacy colleges and schools were invited to participate in a blinded, Web-based survey in 2011. Aggregate responses were analyzed using descriptive statistics and combined with data obtained from the American Association of Colleges of Pharmacy to assess program demographics, faculty and administrative organizational structure, and financial support. The number of advanced pharmacy practice experience (APPE) sites had increased by 24% for medium, 50% for large, and 55% for very large colleges and schools. Introductory pharmacy practice experience (IPPE) sites outnumbered APPEs twofold. The average experiential education team included an assistant/associate dean (0.4 full-time equivalent [FTE]), a director (1.0 FTE), assistant/associate director (0.5 FTE), coordinator (0.9 FTE), and multiple administrative assistants (1.3 FTE). Most faculty members (63%-75%) were nontenure track and most coordinators (66%) were staff members. Estimated costs to operate an experiential education program represented a small percentage of the overall expense budget of pharmacy colleges and schools. To match enrollment growth, pharmacy practice experiential education administrators have expanded their teams, reorganized responsibilities, and found methods to improve cost efficiency. These benchmarks will assist experiential education administrators to plan strategically for future changes.

Influences on final year medical students' attitudes to general practice as a career.

PubMed

Parker, Johanna E; Hudson, Ben; Wilkinson, Tim J

2014-03-01

General practice is under-represented in student career choices. This study aimed to identify and explore factors that influence the attitudes of final year medical students to general practice as a career. This qualitative study used semi-structured interviews of focus groups of final year undergraduate medical students at the University of Otago, Christchurch, New Zealand. Thematic analysis and grounded theory were used to interpret the data. General practitioners (GPs) play a key role in influencing medical students' attitudes to general practice as a career. Students identified their general practice placement during medical school training and personal contact with their own GP as principal factors. The media portrayal of general practice and the attitudes of friends and family were also influential. Students were positively influenced when they were made to feel part of the team, involved with consultations, allowed to carry out practical procedures under supervision, and witnessed what they perceived as good medical practice during clinical placements. Positive experiences often occurred later in training, when students felt more confident of their clinical abilities. While students reported occasional negative comments about general practice by some hospital doctors, these had a lesser role in influencing their perceptions of general practice compared with their own experiences, both as students and patients. GPs have a strong influence, positively and negatively, on the attitudes of medical students to general practice as a career. Effective influences include being made to feel welcome, involved, valued, and given legitimate roles during clinical placements.

'Seeking authorization': a grounded theory exploration of mentors' experiences of assessing nursing students on the borderline of achievement of competence in clinical practice.

PubMed

Cassidy, Simon; Coffey, Michael; Murphy, Fiona

2017-09-01

To develop a substantive theoretical explanation of how mentors make sense of their experiences where nursing students are on the borderline of achievement of competence in clinical practice. The reluctance of Registered Nurse mentors to fail nursing students in clinical practice despite concerns about competence remains a contemporary issue in international healthcare education. Mentors' assessment decisions have considerable impact for a variety of key stakeholders, not least for students in these circumstances. Grounded theory qualitative study. Phase one involved 20 individual semi-structured interviews with nurse mentors in one United Kingdom National Health Service Health Board (July-October 2009). Phase two included eight individual semi-structured interviews and seven focus groups with mentors and practice educators (n = 38) in four further Health Boards (June 2011-February 2012). Data were analysed using open, axial and selective coding consistent with grounded theory method. Three categories 'the conundrum of practice competence,' 'the intensity of nurturing hopefulness,' and 'managing assessment impasse,' led to the study's substantive theoretical explanation - 'Seeking authorization: Establishing collective accountability for mentorship.' This demonstrates how mentors are dependent on key sources of support and feedback to validate their assessment decision-making, notwithstanding substantial personal, professional and organizational pressures. We conclude that management of borderline assessment situations is considerably developed by recognition of the authorizing effects of a wider community of assessors. Consequently, we identify the personal, professional and organizational implications involved in the preparation, support and regulation of mentors specifically during borderline assessment circumstances. © 2017 John Wiley & Sons Ltd.

Importance of dowels in transversal joints in concrete pavements

NASA Astrophysics Data System (ADS)

Grosek, Jiri; Chupik, Vladimir; Stryk, Josef; Brezina, Ilja

2017-09-01

Concrete pavements are designed for heavy loaded road structures. Their usage brings a number of specific issues. It is necessary to solve them all to ensure that concrete pavements will fulfil their function along the whole design period. One of these issues concerns dowels, which are located in transversal joints. Modelling of load, caused by heavy vehicles, with the use of the finite element method, provides valuable information about the stress condition of concrete pavement. The results of modelling can be verified by measurements or experiments in practice. Dowels and tie bars in jointed unreinforced concrete pavements and the importance of their correct placement, dimensions and material quality on pavement behaviour and lifespan were studied as a part of R&D projects of Technology Agency of the Czech Republic Nos. TA02031195 and TE01020168. The paper presents the experience from the modelling and performed experiments and makes conclusions which are important for the use in practice.

Structural geology practice and learning, from the perspective of cognitive science

NASA Astrophysics Data System (ADS)

Shipley, Thomas F.; Tikoff, Basil; Ormand, Carol; Manduca, Cathy

2013-09-01

Spatial ability is required by practitioners and students of structural geology and so, considering spatial skills in the context of cognitive science has the potential to improve structural geology teaching and practice. Spatial thinking skills may be organized using three dichotomies, which can be linked to structural geology practice. First, a distinction is made between separating (attending to part of a whole) and combining (linking together aspects of the whole). While everyone has a basic ability to separate and combine, experts attend to differences guided by experiences of rock properties in context. Second, a distinction is made between seeing the relations among multiple objects as separate items or the relations within a single object with multiple parts. Experts can flexibly consider relations among or between objects to optimally reason about different types of spatial problems. Third, a distinction is made between reasoning about stationary and moving objects. Experts recognize static configurations that encode a movement history, and create mental models of the processes that led to the static state. The observations and inferences made by a geologist leading a field trip are compared with the corresponding observations and inferences made by a cognitive psychologist interested in spatial learning. The presented framework provides a vocabulary for discussing spatial skills both within and between the fields of structural geology and cognitive psychology.

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…

Transforming Professional Healthcare Narratives into Structured Game-Informed-Learning Activities

ERIC Educational Resources Information Center

Begg, Michael; Ellaway, Rachel; Dewhurst, David; Macleod, Hamish

2007-01-01

Noting the dependency of healthcare education on practice-based learning, Michael Begg, Rachel Ellaway, David Dewhurst, and Hamish Macleod suggest that creating a virtual clinical setting for students to interact with virtual patients can begin to address educational demands for clinical experience. They argue that virtual patient simulations that…

A Model for Teaching Information Design

ERIC Educational Resources Information Center

Pettersson, Rune

2011-01-01

The author presents his views on the teaching of information design. The starting point includes some general aspects of teaching and learning. The multidisciplinary structure and content of information design as well as the combined practical and theoretical components influence studies of the discipline. Experiences from working with a model for…

Derivation of Electronic Course Templates for Use in Higher Education

ERIC Educational Resources Information Center

Hill, Robin K.; Fresen, Jill W.; Geng, Fawei

2012-01-01

Lecturers in higher education often consider the incorporation of web technologies into their teaching practice. Partially structured and populated course site templates could aid them in getting started with creating and deploying web-based materials and activities to enrich the teaching and learning experience. Discussions among instructional…

Annual Research Review: Parenting and Children's Brain Development--The End of the Beginning

ERIC Educational Resources Information Center

Belsky, Jay; de Haan, Michelle

2011-01-01

After questioning the practical significance of evidence that parenting influences brain development--while highlighting the scientific importance of such work for understanding "how" family experience shapes human development--this paper reviews evidence suggesting that brain structure and function are "chiselled" by parenting. Although the…

Basic Comfort Heating Principles.

ERIC Educational Resources Information Center

Dempster, Chalmer T.

The material in this beginning book for vocational students presents fundamental principles needed to understand the heating aspect of the sheet metal trade and supplies practical experience to the student so that he may become familiar with the process of determining heat loss for average structures. Six areas covered are: (1) Background…

Virtual School Counseling

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…

Creative Grammar and Art Education

ERIC Educational Resources Information Center

Cunliffe, Leslie

2011-01-01

The grammar of creative practices is described by George Steiner as the "articulate organisation of perception, reflection and experience, the nerve structure of consciousness when it communicates with itself and with others." Steiner's description of creative grammar is consistent with Lev Vygotsky's comment that "art is the social within us, and…

Parent Experience of Implementing Effective Home Programs

ERIC Educational Resources Information Center

Novak, Iona

2011-01-01

The aim of this preliminary study was to describe parent views about implementing effective home programs to inform practice recommendations. Semi-structured interviews were conducted with 10 parents of children with cerebral palsy (2 fathers and 8 mothers) who had participated in a home program by using a partnership-based approach. Transcripts…

Transforming School Climate: Educational and Psychoanalytic Perspectives: Introduction

ERIC Educational Resources Information Center

Cohen, Jonathan

2009-01-01

School climate refers to the character and quality of school life. It is based on these patterns and reflects norms, goals, values, interpersonal relationships, teaching, learning, leadership practices, and organizational structures. School climate is at the nexus of individual and group experience. School climate is based on the individual's…

The Ethics of Interpretation: The Signifying Chain from Field to Analysis

ERIC Educational Resources Information Center

Lapping, Claudia

2008-01-01

This paper attempts to describe the relationship between the embodied practice of fieldwork and the written articulation of this experience. Starting from Valerie Hey's conceptualization of "rapport" as form of "intersubjective synergy", a moment of recognition of similarity within difference--similar in structure to Laclau and Moufffe's…

Suffolk Community College Early Childhood Program Review.

ERIC Educational Resources Information Center

Hochman, Darlene; Kaplan, Paul

The Early Childhood Program (ECP) at Suffolk County Community College (SCCC) was established to train students in the instruction of young children by providing them with theoretical knowledge, skills training, and practical experience. This report provides information on the philosophy, structure, and outcomes of the ECP. The first section…

Narrative-Based Interactive Learning Environments from Modelling Reasoning

ERIC Educational Resources Information Center

Yearwood, John; Stranieri, Andrew

2007-01-01

Narrative and story telling has a long history of use in structuring, organising and communicating human experience. This paper describes a narrative based interactive intelligent learning environment which aims to elucidate practical reasoning using interactive emergent narratives that can be used in training novices in decision making. Its…

STEM High School Communities: Common and Differing Features

ERIC Educational Resources Information Center

Tofel-Grehl, Colby; Callahan, Carolyn M.

2014-01-01

Using observations and interviews, the researchers explore the experiences and perspectives of students, teachers, and administrators at six specialized high schools with a focus on science, technology, engineering, and mathematics (STEM) as they pertain to the practices and structures affecting student outcomes. Four themes were found to be…

Putting Nature to the Rack: Narrative Studies as Research.

ERIC Educational Resources Information Center

Thomas, David

Narrative study of teachers and teaching is seen as sited at the intersection of many current intellectual and professional concerns. These include not only classroom practice and professional careers, but also the Self, Experience, Memory, Identity, Autobiography, Life History, Agency, and Structure. Narrative as genre presents post-modernist…

Connecting Instances to Promote Children's Relational Reasoning

ERIC Educational Resources Information Center

Son, Ji Y.; Smith, Linda B.; Goldstone, Robert L.

2011-01-01

The practice of learning from multiple instances seems to allow children to learn about relational structure. The experiments reported here focused on two issues regarding relational learning from multiple instances: (a) what kind of perceptual situations foster such learning and (b) how particular object properties, such as complexity and…

Emotional Pedagogy and the Gendering of Social and Emotional Learning

ERIC Educational Resources Information Center

Evans, Rhiannon

2017-01-01

Social and emotional learning (SEL) has predominantly been conceptualised as a neurological process, which has precluded understanding of how social, cultural and material discourses inform the expression of emotional experiences. Gender remains a notable omission. This article explores the micro-practices through which gender structures the…

Vibration isolation by exploring bio-inspired structural nonlinearity.

PubMed

Wu, Zhijing; Jing, Xingjian; Bian, Jing; Li, Fengming; Allen, Robert

2015-10-08

Inspired by the limb structures of animals/insects in motion vibration control, a bio-inspired limb-like structure (LLS) is systematically studied for understanding and exploring its advantageous nonlinear function in passive vibration isolation. The bio-inspired system consists of asymmetric articulations (of different rod lengths) with inside vertical and horizontal springs (as animal muscle) of different linear stiffness. Mathematical modeling and analysis of the proposed LLS reveal that, (a) the system has very beneficial nonlinear stiffness which can provide flexible quasi-zero, zero and/or negative stiffness, and these nonlinear stiffness properties are adjustable or designable with structure parameters; (b) the asymmetric rod-length ratio and spring-stiffness ratio present very beneficial factors for tuning system equivalent stiffness; (c) the system loading capacity is also adjustable with the structure parameters which presents another flexible benefit in application. Experiments and comparisons with existing quasi-zero-stiffness isolators validate the advantageous features above, and some discussions are also given about how to select structural parameters for practical applications. The results would provide an innovative bio-inspired solution to passive vibration control in various engineering practice.

Negotiating the transition between different teaching contexts through shared responsibility and shared reflection

NASA Astrophysics Data System (ADS)

Beers, Jennifer S.

2009-06-01

This paper draws on my personal experiences with coteaching and my participation in the research described by Wassell and LaVan (2009). It examines the role of coteaching in the development of structures that afforded opportunities for shared reflection and shared responsibility between stakeholders in the classroom. It also describes how the schema and practices developed through coteaching and cogenerative dialogue helped mediate the transition between my preservice and inservice teaching experiences.

Teaching at the United States Army War College. Philosophy, Practice, and Resources AY 2000

DTIC Science & Technology

2000-01-01

side stands the teacher as unquestioning dolt, duped into an uncritical acceptance of structural oppression, eco- nomic inequity, racism , sexism ...is all about. The ILP and the Core courses should take into account the three elements of inquiry-driven study ( theory , experience and application...that students bring with them an abundance of prior knowledge and experience. • Theory . All learning at the USAWC is supported by theory . Theory is the

Hospice nurses' views on single nurse administration of controlled drugs.

PubMed

Taylor, Vanessa; Middleton-Green, Laura; Carding, Sally; Perkins, Paul

2015-07-01

The involvement of two nurses to dispense and administer controlled drugs is routine practice in most clinical areas despite there being no legal or evidence-based rationale. Indeed, evidence suggests this practice enhances neither safety nor care. Registered nurses at two hospices agreed to change practice to single nurse dispensing and administration of controlled drugs (SNAD). Participants' views on SNAD were evaluated before and after implementation. The aim of this study was to explore the views and experiences of nurses who had implemented SNAD and to identify the views and concerns of those who had not yet experienced SNAD. Data was obtained through semi-structured interviews. Qualitative thematic analysis of interview transcripts identified three key themes: practice to enhance patient benefit and care; practice to enhance nursing care and satisfaction; and practice to enhance organisational safety. The findings have implications for the understanding of influences on medicines safety in clinical practice and for hospice policy makers.

'Do You Practice What You Preach?' A Qualitative Exploration of Therapists' Personal Practice of Compassion Focused Therapy.

PubMed

Gale, Corinne; Schröder, Thomas; Gilbert, Paul

2017-01-01

Therapists' personal practice of therapy techniques can impact on a range of areas, including: empathy for the client, therapeutic understanding, therapist skills and self-awareness. Compassion Focused Therapy (CFT) draws extensively on personal practice during training, and on-going personal practice is encouraged. However, the impact of this has not been examined. To explore therapists' experiences of personal practice in relation to CFT, and the impact this has upon them and their therapeutic work. A qualitative approach was adopted, using inductive thematic analysis. Ten therapists, who had trained in CFT, took part in a semi-structured interview to explore their experiences of personal practice. Five main themes were identified. These highlighted that: (1) experiences of personal practice often felt strange to start with but were surprisingly powerful; (2) with practice, the exercises became more automatic and could be adopted as a 'way of life'; (3) personal practice was felt to increase both self-compassion and compassion for others; (4) personal practice often helped participants to feel more present for their clients; and (5) participants were more aware of what they were bringing to therapy. This exploratory study demonstrated that personal practice is an important part of CFT training and can have a positive impact upon therapists both personally and professionally. It is concluded that the results justify further research in order to establish the applicability of these findings with a larger sample. Copyright © 2015 John Wiley & Sons, Ltd. Personal practice facilitates experiential learning and is an important element of CFT training, which impacts on both personal and professional development. CFT trainers need to ensure that sufficient time is provided for both personal practice and reflection. CFT trainees should be aware that initial reactions to personal practice can be powerful and sometimes unsettling. As for therapy itself, working through fears, blocks and resistances is important. Personal practice is a valuable self-care strategy, and therapists are encouraged to engage in personal practice after training. Copyright © 2015 John Wiley & Sons, Ltd.

Review: To be or not to be an identifiable model. Is this a relevant question in animal science modelling?

PubMed

Muñoz-Tamayo, R; Puillet, L; Daniel, J B; Sauvant, D; Martin, O; Taghipoor, M; Blavy, P

2018-04-01

What is a good (useful) mathematical model in animal science? For models constructed for prediction purposes, the question of model adequacy (usefulness) has been traditionally tackled by statistical analysis applied to observed experimental data relative to model-predicted variables. However, little attention has been paid to analytic tools that exploit the mathematical properties of the model equations. For example, in the context of model calibration, before attempting a numerical estimation of the model parameters, we might want to know if we have any chance of success in estimating a unique best value of the model parameters from available measurements. This question of uniqueness is referred to as structural identifiability; a mathematical property that is defined on the sole basis of the model structure within a hypothetical ideal experiment determined by a setting of model inputs (stimuli) and observable variables (measurements). Structural identifiability analysis applied to dynamic models described by ordinary differential equations (ODEs) is a common practice in control engineering and system identification. This analysis demands mathematical technicalities that are beyond the academic background of animal science, which might explain the lack of pervasiveness of identifiability analysis in animal science modelling. To fill this gap, in this paper we address the analysis of structural identifiability from a practitioner perspective by capitalizing on the use of dedicated software tools. Our objectives are (i) to provide a comprehensive explanation of the structural identifiability notion for the community of animal science modelling, (ii) to assess the relevance of identifiability analysis in animal science modelling and (iii) to motivate the community to use identifiability analysis in the modelling practice (when the identifiability question is relevant). We focus our study on ODE models. By using illustrative examples that include published mathematical models describing lactation in cattle, we show how structural identifiability analysis can contribute to advancing mathematical modelling in animal science towards the production of useful models and, moreover, highly informative experiments via optimal experiment design. Rather than attempting to impose a systematic identifiability analysis to the modelling community during model developments, we wish to open a window towards the discovery of a powerful tool for model construction and experiment design.

A Characterization of Student Reflections in an Introductory Pharmacy Practice Experience Discussion Course.

PubMed

Dinkins, Melissa M; Haltom, Wesley R

2018-04-01

Objective. To characterize weekly student reflections in an introductory pharmacy practice experience (IPPE) discussion course meeting concurrently with IPPE rotations in institutional pharmacy. Methods. A qualitative analysis was conducted to identify themes within weekly reflective statements submitted by second year pharmacy students (P2) enrolled in an IPPE rotation and concurrent discussion course. Weekly reflections from the 2015-2016 offering of the course were reviewed by investigators to identify common themes via an iterative process. Subsequently, investigators coded each submission into one of the identified categories. Initial agreement between investigators was assessed using the Cohen kappa coefficient. Discrepancies between coding were resolved through discussion to reach consensus. Results. A total of 402 reflection assignments were reviewed from 85 P2 students enrolled in the IPPE course. Ten themes were identified, with the most common themes being interprofessional teamwork, pharmacist and technician roles and responsibilities, and policies and procedures. Substantial initial agreement between investigators was found, with the most discrepancies arising within the themes of medication distribution and pharmacy administration/organizational structure. Conclusion. Student reflections on IPPEs centered on 10 key topics, primarily related to distributive, legal, and regulatory functions of institutional pharmacy practice. Structuring an IPPE rotation longitudinally in an academic term, with a concurrent discussion course, builds a framework for regular student reflection.

Capturing patient experience: a qualitative study of implementing real-time feedback in primary care

PubMed Central

Carter, Mary; Davey, Antoinette; Wright, Christine; Elmore, Natasha; Newbould, Jenny; Roland, Martin; Campbell, John; Burt, Jenni

2016-01-01

Background In recent years, hospitals have made use of new technologies, such as real-time feedback, to collect patient experience information. This approach is currently rarely used in primary care settings, but may provide practices with a useful tool that enables them to take prompt, focused action to improve their services. Aim To identify the factors inhibiting and enabling the implementation of real-time feedback in general practices. Design and setting Qualitative study embedded within an exploratory trial (July 2014 to February 2015) of a real-time feedback intervention targeting patient experience in general practices in south-west England and Cambridgeshire. Method Semi-structured interviews (n = 22) and focus groups (n = 4, total of 28 attendees) with practice staff were audiorecorded, transcribed, and analysed thematically, using a framework based on constructs from normalisation process theory. Results Staff engagement with real-time feedback varied considerably, and staff made sense of real-time feedback by comparing it with more familiar feedback modalities. Effective within-team communication was associated with positive attitudes towards real-time feedback. Timing of requests for feedback was important in relation to patient engagement. Real-time feedback may offer potential as a means of informing practice development, perhaps as a component of a wider programme of capturing and responding to patients’ comments. Conclusion Successful implementation of real-time feedback requires effective communication across the practice team to engender thorough engagement. Feedback processes should be carefully introduced to fit with existing patient and practice routines. Future studies should consider making real-time feedback content relevant to specific practice needs, and support participation by all patient groups. PMID:27621292

The impact of a Role Emerging Placement while a student occupational therapist, on subsequent qualified employability, practice and career path.

PubMed

Thew, Miranda; Thomas, Yvonne; Briggs, Michelle

2018-06-01

Although Role Emerging Placements (REP) are now a common feature in pre-registration occupational therapy curricula, there is a need to expand the understanding of the impact of this experience on employability, practice and career path of qualified occupational therapists. A case finding online survey was used to create a purposive sample for Thematic Analysis of semi-structured interviews with practising occupational therapists from one UK Masters' level pre-registration occupational therapy program. The case finding survey (n = 19) led to recruitment of six participants to be interviewed. The qualitative findings reflected the impact of a REP experience on occupational therapists' employability, practice and career path. The complementary features of the more traditional placement and the role emergent type of placement were considered as being useful and beneficial to qualified practice regardless of setting. However, the REP additionally, had an internal and outward impact. Internally, the therapist gains a passion for occupation-focussed practice and builds confidence to promote both self and the profession. Outwardly, the therapist can offer extra skills in qualified practice, particularly in innovative service development and delivery, thereby offering added value for employability. A REP experience as an occupational therapy student, can develop additional skills for qualified professional practice than traditional practice placements alone. The impact of such a placement matches with the 'Generation Y' traits of young adults who are now starting to emerge into training and the work place, translates well into a variety of working environments and lasts into career development. The placement model of occupation-focussed project development and the less apprentice style learning of a REP may be influential, and could be a suitable model within traditional placements. © 2018 Occupational Therapy Australia.

Qualitative analysis of heterosexual women's experience of sexual pain and discomfort.

PubMed

Sutherland, Olga

2012-01-01

In this qualitative analysis, the author explored heterosexual women's accounts of the lived experience of sexual pain and discomfort. The author's aim was to expand theoretical and empirical knowledge in the area of female sexual dysfunction by providing a detailed description of the subjective experience of female sexual concerns. The author used empirical phenomenological methodology to analyze the data generated during semi-structured in-depth interviews conducted with 9 women and generated 42 themes that were woven into a common story of the experience, its preconditions, coping strategies, and aftereffects. The limitations of the study and implications for research and clinical practice are discussed.

"My view that disability is okay sometimes clashes": experiences of two disabled occupational therapists.

PubMed

Chacala, Aneta; McCormack, Cathy; Collins, Bethan; Beagan, Brenda L

2014-03-01

While disability is the focus of much attention in occupational therapy, there has been little attention paid to disability within the profession. Disabled therapists not only bring valuable perspectives on disability, but also pose important challenges to taken-for-granted assumptions about impairment and disability within the profession. At the same time, their cultural beliefs and values may clash with core assumptions of the profession. This study analyses interview data from two disabled occupational therapists, part of a larger study with cultural minority therapists. Semi-structured interviews explored their experiences of professional practice in the context of societal belief in the superiority of non-disabled and "normal" ways of doing and being. Some cultural values of participants clashed with the values and beliefs of their profession, particularly concerning independence. Negative attitudes of colleagues and managers were the key barriers to practice. The responsibility for bridging the disabled/non-disabled cultural divide rested with the disabled therapists, exacerbating inequity. Nonetheless, these therapists believed their disability experiences had advantages for practice. Disabled therapists may be required to engage in invisible work to communicate across cultural differences, and to educate others. Respectful openness to difference could enhance the practice competence of both disabled therapists and their non-disabled colleagues. This demands critical reflexive attention to ableism within the profession.

The attitudes and beliefs of a female science teacher: Implications in relation to gender and pedagogical practice

NASA Astrophysics Data System (ADS)

Zapata, Mara

In this case study of a female science teacher named Laura, numerous observations, field notes, researcher interpretations, and assertions were developed. As meanings were negotiated, intent of actions was defined using significant statements, clustered to produce invariant meaning units. Both the participant's intents and how she interpreted her experiences were central to the understandings sought in this study. Whenever Laura planned for teaching science, taught, or otherwise interacted with students, the following four themes seemed to frame her actions: (1) Responsibility to Nurture/Mother/Mentor (2) Connecting to and Relating (3) Meeting Gender-Specific Expectations (4) Promoting the Fighter/Survivor Within. Each theme is examined in relation to attitudes and beliefs about teaching and learning science, and conclusions and assertions are expressed. The findings of this study point to the tensions between Laura's attitudes and beliefs and her pedagogical practices, disconfirming these as they pertain to gender in relation to teaching and learning science. It was not evident as part of her daily practice that student experiences were used in an attempt to create connections between their lives and science, although Laura always emphasized that science is a way of life. The findings support questioning the role of intentionality and a teacher's perceived ability to adhere to intentions while practicing within the norms established by the social institution of schools operating within the larger structures of society. The major findings and implications are relevant to the manner teachers are prepared and encouraged to enact their practice by departments and boards of education, prepared by institutions of higher education and subsequent participation in professional development. Specifically, calling attention to how these educational frameworks emphasize or de-emphasize the role of teachers and promote cognizance in terms of the culture of schools, reflective of the larger structures of society. Understanding the larger social structures and manner in which science in particular is formally packaged with its hegemonic reality and power arrangements reflective of such society is important if teachers are going to enact their practice in ways that facilitate this understanding to students. A lack of this understanding implicates that teachers enter the classroom without having developed a critical consciousness about societal structures and about schools as reproducers of the social and gender inequalities pervasive in society. (Abstract shortened by UMI.)

Orbital construction demonstration study

NASA Technical Reports Server (NTRS)

1976-01-01

A conceptual design and program plan for an Orbital Construction Demonstration Article (OCDA) was developed that can be used for evaluating and establishing practical large structural assembly operations. A flight plan for initial placement and continued utility is presented as a basic for an entirely new shuttle payload line-item having great future potential benefit for space applications. The OCDA is a three-axis stabilized platform in low-earth orbit with many structural nodals for mounting large construction and fabrication equipments. This equipment would be used to explore methods for constructing the large structures for future missions. The OCDA would be supported at regular intervals by the shuttle. Construction experiments and consumables resupply are performed during shuttle visit periods. A 250 kw solar array provides sufficient power to support the shuttle while attached to the OCDA and to run construction experiments at the same time. Wide band communications with a Telemetry and Data Relay Satellite compatible high gain antenna can be used between shuttle revisits to perform remote controlled, TV assisted construction experiments.

Special populations: telehealth advance practice nursing: the lived experiences of individuals with acute infections transitioning in the home.

PubMed

Marineau, Michelle L

2007-01-01

This paper aims to describe the "lived experience" of individuals with acute infections transitioning in the home with support by an advance practice nurse using telehealth. The use of telehealth in individuals' homes in the United States is increasing in an effort to cut cost by limiting admissions to hospitals and/or reducing length of stay. This increase has not been driven by conclusive research findings in support of this technology; furthermore, the majority of research conducted has been in the area of chronic disease management. A qualitative approach was used to describe the essential structure of the lived experience as told during taped interviews by individuals who had been enrolled in a pilot quantitative telehealth study over the past 2 years. Major findings consisted of three theme categories: Initial response, Engaging in care, and Experiencing the downside. The transition that occurred when an individual with an acute infection was discharged from the hospital to the home supported by telehealth technology revealed an overall positive experience from the 10 participants. There was one negative experience in a participant who had two separate telehealth enrollments. The findings add valuable insight for advanced practice nurses into the experience of participants with acute illness who are receiving telehealth as they transition from hospital care to home care. The findings highlighted the importance of the participants having a sense of control when recovering from their illness, which could be achieved at home with a family member acting as a substitute nurse. The participants shared that the hospital environment may not be optimal for recovering from an illness. This provides the advanced practice nurse with information on risk and benefits of telehealth from the individuals' perspective.

Quantification of network structural dissimilarities.

PubMed

Schieber, Tiago A; Carpi, Laura; Díaz-Guilera, Albert; Pardalos, Panos M; Masoller, Cristina; Ravetti, Martín G

2017-01-09

Identifying and quantifying dissimilarities among graphs is a fundamental and challenging problem of practical importance in many fields of science. Current methods of network comparison are limited to extract only partial information or are computationally very demanding. Here we propose an efficient and precise measure for network comparison, which is based on quantifying differences among distance probability distributions extracted from the networks. Extensive experiments on synthetic and real-world networks show that this measure returns non-zero values only when the graphs are non-isomorphic. Most importantly, the measure proposed here can identify and quantify structural topological differences that have a practical impact on the information flow through the network, such as the presence or absence of critical links that connect or disconnect connected components.

Nurse managers' perceptions and experiences regarding staff nurse empowerment: a qualitative study.

PubMed

Van Bogaert, Peter; Peremans, Lieve; de Wit, Marlinde; Van Heusden, Danny; Franck, Erik; Timmermans, Olaf; Havens, Donna S

2015-01-01

To study nurse managers' perceptions and experiences of staff nurse structural empowerment and its impact on the nurse manager leadership role and style. Nurse managers' leadership roles may be viewed as challenging given the complex needs of patients and staff nurses' involvement in both clinical and organizational decision-making processes in interdisciplinary care settings. Qualitative phenomenological study. Individual semi-structured interviews were conducted with 8 medical or surgical nurse managers in a 600-bed Belgian university hospital between December 2013 and June 2014. This hospital was undergoing conversion from a classical hierarchical, departmental structure to a flat, interdisciplinary model. Nurse managers were found to be familiar with the structural empowerment of clinical nurses in the hospital and to hold positive attitudes toward it. They confirmed the positive impact of empowerment on their staff nurses, as evidenced by increased responsibility, autonomy, critical reflection and enhanced communication skills that in turn improved the quality and safety of patient care. Structural empowerment was being supported by several change initiatives at both the unit and hospital levels. Nurse managers' experiences with these initiatives were mixed, however, because of the changing demands with regard to their manager role and leadership style. In addition, pressure was being experienced by both staff nurses and nurse managers as a result of direct patient care priorities, tightly scheduled projects and miscommunication. Nurse managers reported that structural empowerment was having a favorable impact on staff nurses' professional attitudes and the safety and quality of care in their units. However, they also reported that the empowerment process had led to changes in the managers' roles as well as daily practice dilemmas related to the leadership styles needed. Clear organizational goals and dedicated support for both clinical nurses and nursing unit managers are imperative to maintaining an empowering practice environment which can ensure the best care and healthy, engaged staff.

Developmental Structural Tooth Defects in Dogs – Experience From Veterinary Dental Referral Practice and Review of the Literature

PubMed Central

Boy, Sonja; Crossley, David; Steenkamp, Gerhard

2016-01-01

Developmental tooth abnormalities in dogs are uncommon in general veterinary practice but understanding thereof is important for optimal management in order to maintain masticatory function through preservation of the dentition. The purpose of this review is to discuss clinical abnormalities of the enamel and general anatomy of dog teeth encountered in veterinary dental referral practice and described in the literature. More than 900 referral cases are seen annually between the two referral practices. The basis of the pathogenesis, resultant clinical appearance, and the principles of management for each anomaly will be described. Future research should be aimed toward a more detailed analysis of these conditions so rarely described in the literature. PMID:26904551

Occupational therapy practitioners' perspectives regarding international cross-cultural work.

PubMed

Humbert, Tamera Keiter; Burket, Allison; Deveney, Rebecca; Kennedy, Katelyn

2011-08-01

The purpose of this study was to investigate the perspectives of occupational therapy practitioners who have engaged in cross-cultural work experiences. The research question was how do occupational therapy practitioners make meaning of their lived cross-cultural experiences.   This study utilised a qualitative, phenomenological design. Eleven open-ended, semi-structured interviews were conducted with occupational therapy practitioners educated in the United States and who engaged in international practice. The interviews were then coded and analysed using a constant comparative analysis approach. Three central themes emerged from the completed interviews and data analysis, including connectedness, cultural awareness and complexity. Connectedness is the process of forming relationships with others while engaging in cross-cultural experiences. Cultural awareness is the recognition and understanding of a different culture, comparing these insights with one's own culture and then responding to those differences. Complexity is the idea that cross-cultural experiences are dynamic, multi-faceted and intricate. This study helps provide an understanding of cross-cultural work experiences from the practitioners' perspective. The demands of such work require practitioners to go beyond developing basic skills related to cultural sensitivity and cultural awareness. Instead, practitioners need to embrace and integrate the ability to incorporate layers of cultural awareness, complexity and connectedness into practice. Further research is needed to understand how this is actually developed and utilised within practice. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

Quantitative structural MRI for early detection of Alzheimer’s disease

PubMed Central

McEvoy, Linda K; Brewer, James B

2011-01-01

Alzheimer’s disease (AD) is a common progressive neurodegenerative disorder that is not currently diagnosed until a patient reaches the stage of dementia. There is a pressing need to identify AD at an earlier stage, so that treatment, when available, can begin early. Quantitative structural MRI is sensitive to the neurodegeneration that occurs in mild and preclinical AD, and is predictive of decline to dementia in individuals with mild cognitive impairment. Objective evidence of ongoing brain atrophy will be critical for risk/benefit decisions once potentially aggressive, disease-modifying treatments become available. Recent advances have paved the way for the use of quantitative structural MRI in clinical practice, and initial clinical use has been promising. However, further experience with these measures in the relatively unselected patient populations seen in clinical practice is needed to complete translation of the recent enormous advances in scientific knowledge of AD into the clinical realm. PMID:20977326

A survey validation and analysis of undergraduate medical biochemistry practical curriculum in maharashtra, India.

PubMed

Dandekar, Sucheta P; Maksane, Shalini N; McKinley, Danette

2012-01-01

In order to review the strengths and weaknesses of medical biochemistry practical curriculum for undergraduates and to generate ideas to improve it, a questionnaire was sent to 50 biochemistry faculty members selected (through simple random sampling method) from 42 medical colleges of Maharashtra, India. 39 responded to the questionnaire, representing a 78% response rate. The internal consistency of the questionnaire sections was found to be satisfactory (>0.7). The respondents did not agree that the ongoing curriculum was in alignment with learning outcomes (8%), that it encouraged active learning (28%), helped to apply knowledge to clinical situations (18%) and promoted critical thinking and problem solving skills (28%). There were a number of qualitative experiments that were rated 'irrelevant'. Qualitative and quantitative experiments related to recent advances were suggested to be introduced by the respondents. Checklists for the practicals and new curriculum objectives provided in the questionnaire were also approved. The results of the curriculum evaluation suggest a need for re-structuring of practical biochemistry curriculum and introduction of a modified curriculum with more clinical relevance.

Therapist correlates of attitudes toward sexual minority individuals, affirmative counseling self-efficacy, and beliefs about affirmative practice.

PubMed

Alessi, Edward J; Dillon, Frank R; Kim, Hillary Mi-Sung

2016-07-01

The purpose of this study was to examine the influence of training in sexual minority issues, professional identification, and gender on attitudes toward lesbian, gay, and bisexual individuals, affirmative counseling self-efficacy, and beliefs about affirmative practice among mental health practitioners in the USA. We used the Internet to recruit a nationwide sample of 443 heterosexual psychologists (n = 270), clinical social workers (n = 110), and marriage and family therapists (n = 63) residing in the USA. When controlling for years of practice experience and age, results from structural equation modeling analysis showed that training was associated with more affirmative attitudes, higher levels of affirmative counseling self-efficacy, and more positive beliefs. Female therapists reported more affirmative attitudes and higher levels of affirmative counseling self-efficacy than male therapists. Professional identification did not predict any criterion variables, when controlling for years of practice experience and age. Findings suggest that it will be important for educational and training initiatives to consider the effect of gender role socialization on attitudes and affirmative counseling self-efficacy, especially among beginning male therapists.

Effects of electronic and lattice polarization on the band structure of delafossite transparent conductive oxides.

PubMed

Vidal, Julien; Trani, Fabio; Bruneval, Fabien; Marques, Miguel A L; Botti, Silvana

2010-04-02

We use hybrid functionals and restricted self-consistent GW, state-of-the-art theoretical approaches for quasiparticle band structures, to study the electronic states of delafossite Cu(Al,In)O2, the first p-type and bipolar transparent conductive oxides. We show that a self-consistent GW approximation gives remarkably wider band gaps than all the other approaches used so far. Accounting for polaronic effects in the GW scheme we recover a very nice agreement with experiments. Furthermore, the modifications with respect to the Kohn-Sham bands are strongly k dependent, which makes questionable the common practice of using a scissor operator. Finally, our results support the view that the low energy structures found in optical experiments, and initially attributed to an indirect transition, are due to intrinsic defects in the samples.

Modeling the Skills and Practices of Scientists through an “All-Inclusive” Comparative Planetology Student Research Investigation

NASA Technical Reports Server (NTRS)

Graff, Paige; Bandfield, J.; Stefanov, W.; Vanderbloemen, L.; Willis, K.; Runco, S.

2013-01-01

To effectively prepare the nation's future Science, Technology, Engineering, and Mathematics (STEM) workforce, students in today's classrooms need opportunities to engage in authentic experiences that model skills and practices used by STEM professionals. Relevant, real-world authentic research experiences allow students to behave as scientists as they model the process of science. This enables students to get a true sense of STEM-related professions and also allows them to develop the requisite knowledge, skills, curiosity, and creativity necessary for success in STEM careers. Providing professional development and opportunities to help teachers infuse research in the classroom is one of the primary goals of the Expedition Earth and Beyond (EEAB) program. EEAB, facilitated by the Astromaterials Research and Exploration Science (ARES) Directorate at the NASA Johnson Space Center, is an Earth and planetary science education program designed to inspire, engage, and educate teachers and students in grades 5-12 by getting them actively involved with exploration, discovery, and the process of science. The program combines the expertise of scientists and educators to ensure the professional development provided to classroom teachers is scientifically valid and also recognizes classroom constraints. For many teachers, facilitating research in the classroom can be challenging. In addition to addressing required academic standards and dealing with time constraints, challenges include structuring a research investigation the entire class can successfully complete. To build educator confidence, foster positive classroom research experiences, and enable teachers to help students model the skills and practices of scientists, EEAB has created an "allinclusive" comparative planetology research investigation activity. This activity addresses academic standards while recognizing students (and teachers) potentially lack experience with scientific practices involved in conducting research. Designed as an entry level research engagement investigation, the activity introduces, illustrates, and teaches the skills involved in each step of the research process. Students use astronaut photos, provided through the ARES Crew Earth Observations (CEO) payload on the International Space Station (ISS) as well as remote sensing imagery of other planetary worlds. By including all the necessary tools to complete the investigation, students can focus on gaining experience in the process of science. Additionally, students are able to extend their experience of modeling the skills and practices of scientists through the opportunity to request new data of Earth from the ISS. Professional development offered through in-person and webinar trainings, along with the resources provided, enable educators to gain first-hand experience implementing a structured research investigation in the classroom. Through data and feedback collected from teachers, this type of "all-inclusive" investigation activity aims to become a model that can be utilized for other research topics and STEM disciplines.

Modeling the Skills and Practices of Scientists through an 'All-Inclusive' Comparative Planetology Student Research Investigation

NASA Astrophysics Data System (ADS)

Graff, P. V.; Bandfield, J. L.; Stefanov, W. L.; Vanderbloemen, L.; Willis, K. J.; Runco, S.

2013-12-01

To effectively prepare the nation's future Science, Technology, Engineering, and Mathematics (STEM) workforce, students in today's classrooms need opportunities to engage in authentic experiences that model skills and practices used by STEM professionals. Relevant, real-world authentic research experiences allow students to behave as scientists as they model the process of science. This enables students to get a true sense of STEM-related professions and also allows them to develop the requisite knowledge, skills, curiosity, and creativity necessary for success in STEM careers. Providing professional development and opportunities to help teachers infuse research in the classroom is one of the primary goals of the Expedition Earth and Beyond (EEAB) program. EEAB, facilitated by the Astromaterials Research and Exploration Science (ARES) Directorate at the NASA Johnson Space Center, is an Earth and planetary science education program designed to inspire, engage, and educate teachers and students in grades 5-12 by getting them actively involved with exploration, discovery, and the process of science. The program combines the expertise of scientists and educators to ensure the professional development provided to classroom teachers is scientifically valid and also recognizes classroom constraints. For many teachers, facilitating research in the classroom can be challenging. In addition to addressing required academic standards and dealing with time constraints, challenges include structuring a research investigation the entire class can successfully complete. To build educator confidence, foster positive classroom research experiences, and enable teachers to help students model the skills and practices of scientists, EEAB has created an 'all-inclusive' comparative planetology research investigation activity. This activity addresses academic standards while recognizing students (and teachers) potentially lack experience with scientific practices involved in conducting research. Designed as an entry level research engagement investigation, the activity introduces, illustrates, and teaches the skills involved in each step of the research process. Students use astronaut photos, provided through the ARES Crew Earth Observations (CEO) payload on the International Space Station (ISS) as well as remote sensing imagery of other planetary worlds. By including all the necessary tools to complete the investigation, students can focus on gaining experience in the process of science. Additionally, students are able to extend their experience of modeling the skills and practices of scientists through the opportunity to request new data of Earth from the ISS. Professional development offered through in-person and webinar trainings, along with the resources provided, enable educators to gain first-hand experience implementing a structured research investigation in the classroom. Through data and feedback collected from teachers, this type of 'all-inclusive' investigation activity aims to become a model that can be utilized for other research topics and STEM disciplines.

Beliefs and practices surrounding postpartum period among Myanmar women.

PubMed

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.

Contextualizing immigrants' lived experience: story of Taiwanese immigrants in the United States.

PubMed

Tsai, Jenny Hsin-Chun

2003-01-01

Immigration involves extensive changes in living environments. Nonetheless, the predominant approach in the health science literature has been to utilize individual characteristics (including ethnic background) to explain and predict immigrants' lived experiences and health outcomes. Contexts, particularly the larger societal contexts by which immigrants are constituted, are generally ignored. Data from a critical ethnography regarding immigrants' experiences with language, occupation, and economic survival in the United States are utilized to illustrate that immigrants' lives are inseparable from the larger societal contexts, such as immigration policy, Western imperialism, and structural discrimination. The implications for practice, education, and research are discussed.

[Philosophy of psychiatry and phenomenology of everyday life: The disruptions of ordinary experience in schizophrenia].

PubMed

Troubé, Sarah

2016-12-01

The paper considers the philosophy of psychiatry from the perspective of everyday life, as a particular structure of experience. We outline some questions raised by disturbances typical of psychotic disorders with regard to a phenomenology of the everyday and common sense. As a link between philosophy and clinical psychopathology, this phenomenology implies a transcendental point of view, embedded in concrete and practical forms of ordinary experience, along with social norms. This opens the possibility of a mutual questioning between philosophy and psychiatry, drawing on its clinical, epistemological, and ethical dimensions.

The insight and challenge of reflexive practice in an ethnographic study of black traumatically injured patients in Philadelphia.

PubMed

Jacoby, Sara F

2017-07-01

The integrity of critical ethnography requires engagement in reflexive practice at all phases of the research process. In this discussion paper, I explore the insights and challenges of reflexive practice in an ethnographic study of the recovery experiences of black trauma patients in a Philadelphia hospital. Observation and interviews were conducted with twelve patients who were admitted to trauma-designated units of the hospital over the course of a year. During fieldwork, I learned the ways that my background as a professional nurse structured my way of being in clinical space and facilitated a particular interpretation of clinical culture. In analysis, reflection on subjectivities through which I designed this ethnographic research allowed me to see beyond my preconceived and theoretically informed perspective to permit unexpected features of the field to emerge. Reflexive practice also guided my reconciliation of key practical and epistemological differences between clinical ethnographic research and the anthropologic tradition in which it is rooted. I conclude that with careful reflection to the subjectivities that influence the research process, interdisciplinary clinically relevant applied interpretations of critical ethnographic work can be used to generate detailed knowledge across contexts in clinical care, nursing practice, and patient experiences. © 2016 John Wiley & Sons Ltd.

Theory-guided Therapeutic Function of Music to facilitate emotion regulation development in preschool-aged children.

PubMed

Sena Moore, Kimberly; Hanson-Abromeit, Deanna

2015-01-01

Emotion regulation (ER) is an umbrella term to describe interactive, goal-dependent explicit, and implicit processes that are intended to help an individual manage and shift an emotional experience. The primary window for appropriate ER development occurs during the infant, toddler, and preschool years. Atypical ER development is considered a risk factor for mental health problems and has been implicated as a primary mechanism underlying childhood pathologies. Current treatments are predominantly verbal- and behavioral-based and lack the opportunity to practice in-the-moment management of emotionally charged situations. There is also an absence of caregiver-child interaction in these treatment strategies. Based on behavioral and neural support for music as a therapeutic mechanism, the incorporation of intentional music experiences, facilitated by a music therapist, may be one way to address these limitations. Musical Contour Regulation Facilitation (MCRF) is an interactive therapist-child music-based intervention for ER development practice in preschoolers. The MCRF intervention uses the deliberate contour and temporal structure of a music therapy session to mirror the changing flow of the caregiver-child interaction through the alternation of high arousal and low arousal music experiences. The purpose of this paper is to describe the Therapeutic Function of Music (TFM), a theory-based description of the structural characteristics for a music-based stimulus to musically facilitate developmentally appropriate high arousal and low arousal in-the-moment ER experiences. The TFM analysis is based on a review of the music theory, music neuroscience, and music development literature and provides a preliminary model of the structural characteristics of the music as a core component of the MCRF intervention.

Theory-guided Therapeutic Function of Music to facilitate emotion regulation development in preschool-aged children

PubMed Central

Sena Moore, Kimberly; Hanson-Abromeit, Deanna

2015-01-01

Emotion regulation (ER) is an umbrella term to describe interactive, goal-dependent explicit, and implicit processes that are intended to help an individual manage and shift an emotional experience. The primary window for appropriate ER development occurs during the infant, toddler, and preschool years. Atypical ER development is considered a risk factor for mental health problems and has been implicated as a primary mechanism underlying childhood pathologies. Current treatments are predominantly verbal- and behavioral-based and lack the opportunity to practice in-the-moment management of emotionally charged situations. There is also an absence of caregiver–child interaction in these treatment strategies. Based on behavioral and neural support for music as a therapeutic mechanism, the incorporation of intentional music experiences, facilitated by a music therapist, may be one way to address these limitations. Musical Contour Regulation Facilitation (MCRF) is an interactive therapist-child music-based intervention for ER development practice in preschoolers. The MCRF intervention uses the deliberate contour and temporal structure of a music therapy session to mirror the changing flow of the caregiver–child interaction through the alternation of high arousal and low arousal music experiences. The purpose of this paper is to describe the Therapeutic Function of Music (TFM), a theory-based description of the structural characteristics for a music-based stimulus to musically facilitate developmentally appropriate high arousal and low arousal in-the-moment ER experiences. The TFM analysis is based on a review of the music theory, music neuroscience, and music development literature and provides a preliminary model of the structural characteristics of the music as a core component of the MCRF intervention. PMID:26528171

'It sounds like a great idea but…': a qualitative study of GPs' attitudes towards the development of a national diabetes register.

PubMed

Mc Hugh, Sheena M; O'Mullane, Monica; Perry, Ivan J; Bradley, Colin

2014-11-01

The aim of this study was to investigate the attitudes of general practitioners (GPs) to the development of a national diabetes register as a way of improving the quality of care. Qualitative study using semistructured interviews. General practice, Ireland. Purposive sample of 29 GPs and two practice nurses. Participants' practices varied by (a) location (rural/urban), (b) size (single-handed/group practice) and (c) extent of computerisation. The semistructured topic guide focused on experiences of change in the health system at a local and national level and attitudes towards the development of a national diabetes register. Analysis was conducted using the Framework approach. Participants were sceptical about the development of a national diabetes register. The main advantage was 'knowing the numbers' for epidemiological and policy purposes. However, participants questioned the benefits for their practice and patients. There were concerns that it would drain resources from other priorities and distract from patient management. These attitudes were strongly influenced by previous experience of change in the health system. Participants felt that remuneration would be necessary to ensure full engagement, reflecting wider frustrations with payment structures for general practice. There was a sense of wariness towards health service administration which was not specific to diabetes care but which coloured some participants' attitudes towards a national register. In contrast, participants referred to positive experiences of change at a local level, facilitated by a 'practice ethos' and professional leadership. This study highlights the growing sense of scepticism and inertia towards change within the health system. This inertia stems from previous experience and the competing demands of maintaining versus improving care in a system with dwindling resources. 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.

Moving research tools into practice: the successes and challenges in promoting uptake of classification tools.

PubMed

Cunningham, Barbara Jane; Hidecker, Mary Jo Cooley; Thomas-Stonell, Nancy; Rosenbaum, Peter

2018-05-01

In this paper, we present our experiences - both successes and challenges - in implementing evidence-based classification tools into clinical practice. We also make recommendations for others wanting to promote the uptake and application of new research-based assessment tools. We first describe classification systems and the benefits of using them in both research and practice. We then present a theoretical framework from Implementation Science to report strategies we have used to implement two research-based classification tools into practice. We also illustrate some of the challenges we have encountered by reporting results from an online survey investigating 58 Speech-language Pathologists' knowledge and use of the Communication Function Classification System (CFCS), a new tool to classify children's functional communication skills. We offer recommendations for researchers wanting to promote the uptake of new tools in clinical practice. Specifically, we identify structural, organizational, innovation, practitioner, and patient-related factors that we recommend researchers address in the design of implementation interventions. Roles and responsibilities of both researchers and clinicians in making implementations science a success are presented. Implications for rehabilitation Promoting uptake of new and evidence-based tools into clinical practice is challenging. Implementation science can help researchers to close the knowledge-to-practice gap. Using concrete examples, we discuss our experiences in implementing evidence-based classification tools into practice within a theoretical framework. Recommendations are provided for researchers wanting to implement new tools in clinical practice. Implications for researchers and clinicians are presented.

Restructuring the rotor analysis program C-60

NASA Technical Reports Server (NTRS)

1985-01-01

The continuing evolution of the rotary wing industry demands increasing analytical capabilities. To keep up with this demand, software must be structured to accommodate change. The approach discussed for meeting this demand is to restructure an existing analysis. The motivational factors, basic principles, application techniques, and practical lessons from experience with this restructuring effort are reviewed.

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…

Using Critical Race Theory to Analyze Science Teachers Culturally Responsive Practices

ERIC Educational Resources Information Center

Wallace, Tamara; Brand, Brenda R.

2012-01-01

Culturally responsive science teaching is using knowledge about the culture and life experiences of students to structure learning that is conducive to their needs. Understanding what teachers need to prepare them to be culturally responsive is a matter of continuous debate. As the focus of multicultural education ventures farther away from its…

Doctoral Students as Journal Editors: Non-Formal Learning through Academic Work

ERIC Educational Resources Information Center

Hopwood, Nick

2010-01-01

Much attention has been paid to formal pedagogic elements of the doctorate--supervision and other structured institutional provisions--but we know less about the role played by non-formal practices in doctoral students' learning. This paper explores the experiences of eight doctoral students involved in editing student-run journals. Editorship and…

Structural Model of the Effects of Poverty on Externalizing and Internalizing Behaviors of Four- to Five-Year-Old Children.

ERIC Educational Resources Information Center

Eamon, Mary Keegan

2000-01-01

Identifies the parenting practices that mediate relations between persistent, recent, and transitional poverty and the externalizing and internalizing behaviors of children four to five years old. Results reveal that lower-quality physical environment, maternal emotional unresponsiveness, and fewer stimulating experiences contribute significantly…

NASA Earth Resources Survey Symposium. Volume 1-B: Geology, Information Systems and Services

NASA Technical Reports Server (NTRS)

1975-01-01

A symposium was conducted on the practical applications of earth resources survey technology including utilization and results of data from programs involving LANDSAT, the Skylab earth resources experiment package, and aircraft. Topics discussed include geological structure, landform surveys, energy and extractive resources, and information systems and services.

The Powers of Literacy: A Genre Approach to Teaching Writing.

ERIC Educational Resources Information Center

Cope, Bill, Ed.; Kalantzis, Mary, Ed.

Documenting an educational experiment that began in Sydney, Australia, this book presents essays by theorists and practitioners in the genre literacy movement that describe this approach to literacy instruction in a clear, practical, and accessible way. The book notes that the genre approach to literacy teaching emphasizes content, structure, and…

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…

A Biographical Experience of Teacher Education in Aotearoa New Zealand

ERIC Educational Resources Information Center

O'Neill, John

2017-01-01

The article analyses initial teacher education (ITE) policy and practice in Aotearoa New Zealand over forty years. Central to the local ITE context was the incorporation of the "monotechnic" colleges of teacher education into the university sector in the 1990s and 2000s, following New Zealand's structural adjustments to the state…

The Narrative Process of Improving Vocational Classroom Practice

ERIC Educational Resources Information Center

Sharman, Kathleen Y.

2011-01-01

This research inquires into the use of stories by vocational teachers. These stories are of interest because they are a fundamental feature of both the subject content and the social structures of vocational classrooms. The trade experiences of vocational teachers are brought to the classroom through stories. These stories have a secondary effect…

Teaching Values in Everything We Do: The Nativity Experience.

ERIC Educational Resources Information Center

Daly, Jennifer Grumhaus

1996-01-01

Nativity Prep, a small, inner-city Roman Catholic middle school seeks to provide an environment that helps students excel in their studies and their personal development. The school has few discipline problems due to its small size; its strict, highly structured academic climate; its underpaid and devoted faculty; and its practice of praying…

Making Data-Driven Decisions: Silent Reading

ERIC Educational Resources Information Center

Trudel, Heidi

2007-01-01

Due in part to conflicting opinions and research results, the practice of sustained silent reading (SSR) in schools has been questioned. After a frustrating experience with SSR, the author of this article began a data-driven decision-making process to gain new insights on how to structure silent reading in a classroom, including a comparison…

Social Media Adoption and Use among Information Technology Professionals and Implications for Leadership

ERIC Educational Resources Information Center

Lundahl Philpot, Eva

2013-01-01

This sequential, mixed methods research addressed emerging social media use practices among IT professionals and explored lived experiences of senior IT leaders relative to successful organizational social media adoption and use. The study was informed by structuration theory and elements from the universal technology adoption and use (UTAUT)…

Elaborating on systems thinking in health promotion practice.

PubMed

Naaldenberg, Jenneken; Vaandrager, Lenneke; Koelen, Maria; Wagemakers, Anne-Marie; Saan, Hans; de Hoog, Kees

2009-03-01

Health and well-being are the result of a series of complex processes in which an individual interacts with other people and the environment. A systematic approach ensures incorporation of individual, ecological, social and political factors. However, interactions between these factors can be overlooked within a systematical approach. A systemic approach can provide additional information by incorporating interactions and communication. The opportunities of a systems thinking perspective for health promotion were investigated for this paper. Although others have also made attempts to explore systems thinking in the field of health promotion, the implications of systems thinking in practice need attention. Other fields such as agricultural extension studies, organizational studies and development studies provide useful experiences with the use of a systems thinking perspective in practice. Building on experiences from these fields, we give a theoretical background in which processes of social learning and innovation play an important role. From this background, we derive an overview of important concepts for the practical application of a systems thinking perspective. These concepts are the structure of the system, meanings attached to actions, and power relations between actors. To make these concepts more explicit and reduce the theoretical character of systems thinking, we use an illustration to elaborate on these concepts in practice. For this purpose, we describe a health promotion partnership in The Netherlands using the concepts structure, meaning and power relations. We show how a systems perspective increases insight in the functioning of a partnership and how this can facilitate processes of social learning and innovation. This article concludes by identifying future opportunities and challenges in adopting systems thinking for health promotion practice. A systems perspective towards health promotion can help projects reaching a more integral and sustainable approach in which the complex nature of health promotion processes is supported. Practical applications of systems thinking are necessary to adapt this perspective.

Practical experience with full-scale structured sheet media (SSM) integrated fixed-film activated sludge (IFAS) systems for nitrification.

PubMed

Li, Hua; Zhu, Jia; Flamming, James J; O'Connell, Jack; Shrader, Michael

2015-01-01

Many wastewater treatment plants in the USA, which were originally designed as secondary treatment systems with no or partial nitrification requirements, are facing increased flows, loads, and more stringent ammonia discharge limits. Plant expansion is often not cost-effective due to either high construction costs or lack of land. Under these circumstances, integrated fixed-film activated sludge (IFAS) systems using both suspended growth and biofilms that grow attached to a fixed plastic structured sheet media are found to be a viable solution for solving the challenges. Multiple plants have been retrofitted with such IFAS systems in the past few years. The system has proven to be efficient and reliable in achieving not only consistent nitrification, but also enhanced bio-chemical oxygen demand removal and sludge settling characteristics. This paper presents long-term practical experiences with the IFAS system design, operation and maintenance, and performance for three full-scale plants with distinct processes; that is, a trickling filter/solids contact process, a conventional plug flow activated sludge process and an extended aeration process.

Teaching and assessing procedural skills: a qualitative study.

PubMed

Touchie, Claire; Humphrey-Murto, Susan; Varpio, Lara

2013-05-14

Graduating Internal Medicine residents must possess sufficient skills to perform a variety of medical procedures. Little is known about resident experiences of acquiring procedural skills proficiency, of practicing these techniques, or of being assessed on their proficiency. The purpose of this study was to qualitatively investigate resident 1) experiences of the acquisition of procedural skills and 2) perceptions of procedural skills assessment methods available to them. Focus groups were conducted in the weeks following an assessment of procedural skills incorporated into an objective structured clinical examination (OSCE). Using fundamental qualitative description, emergent themes were identified and analyzed. Residents perceived procedural skills assessment on the OSCE as a useful formative tool for direct observation and immediate feedback. This positive reaction was regularly expressed in conjunction with a frustration with available assessment systems. Participants reported that proficiency was acquired through resident directed learning with no formal mechanism to ensure acquisition or maintenance of skills. The acquisition and assessment of procedural skills in Internal Medicine programs should move toward a more structured system of teaching, deliberate practice and objective assessment. We propose that directed, self-guided learning might meet these needs.

Controlled trials to improve antibiotic utilization: a systematic review of experience, 1984-2004.

PubMed

Parrino, Thomas A

2005-02-01

To review the effectiveness of interventions designed to improve antibiotic prescribing patterns in clinical practice and to draw inferences about the most practical methods for optimizing antibiotic utilization in hospital and ambulatory settings. A literature search using online databases for the years 1975-2004 identified controlled trials of strategies for improving antibiotic utilization. Due to variation in study settings and design, quantitative meta-analysis was not feasible. Therefore, a qualitative literature review was conducted. Forty-one controlled trials met the search criteria. Interventions consisted of education, peer review and feedback, physician participation, rewards and penalties, administrative methods, and combined approaches. Social marketing directed at patients and prescribers was effective in varying contexts, as was implementation of practice guidelines. Authorization systems with structured order entry, formulary restriction, and mandatory consultation were also effective. Peer review and feedback were more effective when combined with dissemination of relevant information or social marketing than when used alone. Several practices were effective in improving antibiotic utilization: social marketing, practice guidelines, authorization systems, and peer review and feedback. Online systems providing clinical information, structured order entry, and decision support may be the most promising approach. Further studies, including economic analyses, are needed to confirm or refute this hypothesis.

Mentoring medical students in your general practice.

PubMed

Fraser, John

2016-05-01

Mentoring medical students in general practices is becoming more common in Australia due to formalised scholarship programs and informal approaches by students. This paper defines mentoring in Australian general practice. Practical suggestions are made on how to structure a mentorship program in your practice. Mentoring differs from leadership and teaching. It is a long-term relationship between a student and an experienced general practitioner. Avoiding summative assessment in mentorship is important to its success. Mentoring is about forming a safe place to confidentially discuss personal and professional issues between a mentor and student. This is based on defining roles and mutual trust. At the same time, students crave formative feedback. Unfortunately, present feedback models are based on teaching principles that can blur the differences between assessor, teacher and mentor. Mentorship can provide students with orientation and learning experiences so that they are prepared for practice as an intern.

Technology of civil usage of composites. [in commercial aircraft structures

NASA Technical Reports Server (NTRS)

Kemp, D. E.

1977-01-01

The paper deals with the use of advanced composites in structural components of commercial aircraft. The need for testing the response of a material system to service environment is discussed along with methods for evaluating design and manufacturing aspects of a built-up structure under environmental conditions and fail-safe (damage-tolerance) evaluation of structures. Crashworthiness aspects, the fire-hazard potential, and electrical damage of composite structures are considered. Practical operational experience with commercial aircraft is reviewed for boron/epoxy foreflaps, Kevlar/epoxy fillets and fairings, graphite/epoxy spoilers, graphite/polysulfone spoilers, graphite/epoxy floor posts, boron/aluminum aft pylon skin panels, graphite/epoxy engine nose cowl outer barrels, and graphite/epoxy upper aft rudder segments.

‘On the same level’: facilitators’ experiences running a drug user-led safer injecting education campaign

PubMed Central

2013-01-01

Background Unsafe injection practices play a major role in elevated rates of morbidity and mortality among people who inject drugs (IDU). There is growing interest in the direct involvement of IDU in interventions that seek to address unsafe injecting. This study describes a drug user-led safer injecting education campaign, and explores facilitators’ experiences delivering educational workshops. Methods We conducted semi-structured qualitative interviews with 8 members of the Injection Support (IS) Team who developed and facilitated a series of safer injecting education workshops. Interviews explored facilitator’s perceptions of the workshops, experiences being a facilitator, and perspectives on the educational campaign. Interviews were transcribed verbatim and a thematic analysis was conducted. Results IS Team facilitators described how the workshop’s structure and content enabled effective communication of information about safer injecting practices, while targeting the unsafe practices of workshop participants. Facilitators’ identity as IDU enhanced their ability to relate to workshop participants and communicate educational messages in language accessible to workshop participants. Facilitators reported gaining knowledge and skills from their involvement in the campaign, as well as positive feelings about themselves from the realization that they were helping people to protect their health. Overall, facilitators felt that this campaign provided IDU with valuable information, although facilitators also critiqued the campaign and suggested improvements for future efforts. Conclusions This study demonstrates the feasibility of involving IDU in educational initiatives targeting unsafe injecting. Findings illustrate how IDU involvement in prevention activities improves relevance and cultural appropriateness of interventions while providing individual, social, and professional benefits to those IDU delivering education. PMID:23497293

Structure and Soot Formation Properties of Laminar Flames

NASA Technical Reports Server (NTRS)

El-Leathy, A. M.; Xu, F.; Faeth, G. M.

2001-01-01

Soot formation within hydrocarbon-fueled flames is an important unresolved problem of combustion science for several reasons: soot emissions are responsible for more deaths than any other combustion-generated pollutant, thermal loads due to continuum radiation from soot limit the durability of combustors, thermal radiation from soot is mainly responsible for the growth and spread of unwanted fires, carbon monoxide emissions associated with soot emissions are responsible for most fire deaths, and limited understanding of soot processes in flames is a major impediment to the development of computational combustion. Motivated by these observations, soot processes within laminar premixed and nonpremixed (diffusion) flames are being studied during this investigation. The study is limited to laminar flames due to their experimental and computational tractability, noting the relevance of these results to practical flames through laminar flamelet concepts. Nonbuoyant flames are emphasized because buoyancy affects soot processes in laminar diffusion flames whereas effects of buoyancy are small for most practical flames. This study involves both ground- and space-based experiments, however, the following discussion will be limited to ground-based experiments because no space-based experiments were carried out during the report period. The objective of this work was to complete measurements in both premixed and nonpremixed flames in order to gain a better understanding of the structure of the soot-containing region and processes of soot nucleation and surface growth in these environments, with the latter information to be used to develop reliable ways of predicting soot properties in practical flames. The present discussion is brief, more details about the portions of the investigation considered here can be found in refs. 8-13.

Experiment study on RC frame retrofitted by the external structure

NASA Astrophysics Data System (ADS)

Liu, Chunyang; Shi, Junji; Hiroshi, Kuramoto; Taguchi, Takashi; Kamiya, Takashi

2016-09-01

A new retrofitting method is proposed herein for reinforced concrete (RC) structures through attachment of an external structure. The external structure consists of a fiber concrete encased steel frame, connection slab and transverse beams. The external structure is connected to the existing structure through a connection slab and transverse beams. Pseudostatic experiments were carried out on one unretrofitted specimen and three retrofitted frame specimens. The characteristics, including failure mode, crack pattern, hysteresis loops behavior, relationship of strain and displacement of the concrete slab, are demonstrated. The results show that the load carrying capacity is obviously increased, and the extension length of the slab and the number of columns within the external frame are important influence factors on the working performance of the existing structure. In addition, the displacement difference between the existing structure and the outer structure was caused mainly by three factors: shear deformation of the slab, extraction of transverse beams, and drift of the conjunction part between the slab and the existing frame. Furthermore, the total deformation determined by the first two factors accounted for approximately 80% of the damage, therefore these factors should be carefully considered in engineering practice to enhance the effects of this new retrofitting method.

High-throughput crystallization screening.

PubMed

Skarina, Tatiana; Xu, Xiaohui; Evdokimova, Elena; Savchenko, Alexei

2014-01-01

Protein structure determination by X-ray crystallography is dependent on obtaining a single protein crystal suitable for diffraction data collection. Due to this requirement, protein crystallization represents a key step in protein structure determination. The conditions for protein crystallization have to be determined empirically for each protein, making this step also a bottleneck in the structure determination process. Typical protein crystallization practice involves parallel setup and monitoring of a considerable number of individual protein crystallization experiments (also called crystallization trials). In these trials the aliquots of purified protein are mixed with a range of solutions composed of a precipitating agent, buffer, and sometimes an additive that have been previously successful in prompting protein crystallization. The individual chemical conditions in which a particular protein shows signs of crystallization are used as a starting point for further crystallization experiments. The goal is optimizing the formation of individual protein crystals of sufficient size and quality to make them suitable for diffraction data collection. Thus the composition of the primary crystallization screen is critical for successful crystallization.Systematic analysis of crystallization experiments carried out on several hundred proteins as part of large-scale structural genomics efforts allowed the optimization of the protein crystallization protocol and identification of a minimal set of 96 crystallization solutions (the "TRAP" screen) that, in our experience, led to crystallization of the maximum number of proteins.

Altered resting brain function and structure in professional badminton players.

PubMed

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.

A Review of Distributed Optical Fiber Sensors for Civil Engineering Applications.

PubMed

Barrias, António; Casas, Joan R; Villalba, Sergi

2016-05-23

The application of structural health monitoring (SHM) systems to civil engineering structures has been a developing studied and practiced topic, that has allowed for a better understanding of structures' conditions and increasingly lead to a more cost-effective management of those infrastructures. In this field, the use of fiber optic sensors has been studied, discussed and practiced with encouraging results. The possibility of understanding and monitor the distributed behavior of extensive stretches of critical structures it's an enormous advantage that distributed fiber optic sensing provides to SHM systems. In the past decade, several R & D studies have been performed with the goal of improving the knowledge and developing new techniques associated with the application of distributed optical fiber sensors (DOFS) in order to widen the range of applications of these sensors and also to obtain more correct and reliable data. This paper presents, after a brief introduction to the theoretical background of DOFS, the latest developments related with the improvement of these products by presenting a wide range of laboratory experiments as well as an extended review of their diverse applications in civil engineering structures.

Operationalizing Dynamic Ocean Management (DOM): Understanding the Incentive Structure, Policy and Regulatory Context for DOM in Practice

NASA Astrophysics Data System (ADS)

Lewison, R. L.; Saumweber, W. J.; Erickson, A.; Martone, R. G.

2016-12-01

Dynamic ocean management, or management that uses near real-time data to guide the spatial distribution of commercial activities, is an emerging approach to balance ocean resource use and conservation. Employing a wide range of data types, dynamic ocean management in a fisheries context can be used to meet multiple objectives - managing target quota, bycatch reduction, and reducing interactions with species of conservation concern. There is a growing list of DOM applications currently in practice in fisheries around the world, yet the approach is new enough that both fishers and fisheries managers are unclear how DOM can be applied to their fishery. Here, we use the experience from dynamic ocean management applications that are currently in practice to address the commonly asked question "How can dynamic management approaches be implemented in a traditionally managed fishery?". Combining knowledge from the DOM participants with a review of regulatory frameworks and incentive structures, stakeholder participation, and technological requirements of DOM in practice, we identify ingredients that have supported successful implementation of this new management approach.

Healing environments in cancer treatment and care. Relations of space and practice in hematological cancer treatment.

PubMed

Høybye, Mette Terp

2013-02-01

Given the growing attention to the importance of design in shaping healing hospital environments this study extends the understanding of healing environments, beyond causal links between environmental exposure and health outcome by elucidating how environments and practices interrelate. The study was conducted as an ethnographic fieldwork from March 2011 to September 2011 at the Department of Haematology at Odense University Hospital, Denmark, systematically using participant observation and interviews as research strategies. It included 20 patients, four of who were followed closely over an extended time period. Through thematic analysis five key concepts emerged about the social dynamics of hospital environments: practices of self; creating personal space; social recognition; negotiating space; and ambiguity of space and care. Through these concepts, the study demonstrates how the hospital environment is a flow of relations between space and practice that changes and challenges a structural idea of design and healing. Patients' sense of healing changes with the experience of progression in treatment and the capacity of the hospital space to incite an experience of homeliness and care. Furthermore, cancer patients continuously challenge the use and limits of space by individual objects and practices of privacy and home. Healing environments are complex relations between practices, space and care, where recognition of the individual patient's needs, values and experiences is key to developing the environment to support the patient quality of life. The present study holds implications for practice to inform design of future hospital environments for cancer treatment. The study points to the importance for being attentive to the need for flexible spaces in hospitals that recognize the dynamics of healing, by providing individualized care, relating to the particular and changing needs of patients supporting their potential and their challenged condition with the best care possible.

Nurse's Awareness on Ethico-legal Aspects of Nursing Profession.

PubMed

Paudel Subedi, Krishna Kumari; Timalsina, Kalpana; Bhele, Raja Laxmi

2018-03-13

Nursing practice amicably includes practical efficacy and ethics. Now a days legal and ethical problems associated with client care are arising day by day. Therefore, nurses should have adequate understanding of basic legal concepts and issues relevant to nursing profession in order to protect the rights of the clients and the nurses. A cross sectional descriptive design was adopted for the study. 142 nurses were included by using purposive sampling technique. Data was collected with self-administered structured questionnaire. Descriptive statistics was used to reveal demographic information. Kruskal Wallis and Mann Whitney test were used to find out association of selected demographic variables and ethico legal aspects of nursing. Majority of participants were belonging to 20-29 years of age. More than half nurses had complete bachelor's degree and had less than 10 year's experiences. Majority of participants reported that they did not encounter any legal issues in their professional life till date. Similarly, majority of participants had average level knowledge and equate level of practice. Years of experiences and education level did not affect in knowledge level and existing practice related to ethico legal aspect of nursing. There was no significant relationship between level of knowledge and existing practice. Nurses have average knowledge and practice on ethico legal aspects. There is positive relationship between knowledge and practice though it is not statistically significant.

Outcomes of newly practicing nurses who applied principles of holistic comfort theory during the transition from school to practice: a qualitative study.

PubMed

Goodwin, Miki; Candela, Lori

2013-06-01

The aim of this qualitative study was to explore if newly practicing nurses benefited from learning holistic comfort theory during their baccalaureate education, and to provide a conceptual framework to support the transition from school to practice. The study was conducted among graduates of an accelerated baccalaureate nursing program where holistic comfort theory was embedded as a learner-centered philosophy across the curriculum. A phenomenological process using van Manen's qualitative methodology in education involving semi-structured interviews and thematic analysis was used. The nurses recalled what holistic comfort meant to them in school, and described the lived experience of assimilating holistic comfort into their attitudes and behaviors in practice. Themes were established and a conceptual framework was developed to better understand the nurses' lived experiences. Results showed that holistic comfort was experienced as a constructive approach to transcend unavoidable difficulties during the transition from school to practice. Participants described meaningful learning and acquisition of self-strengthening behaviors using holistic comfort theory. Holistic comfort principles were credited for easing nurses into the realities of work and advocating for best patient outcomes. Patient safety and pride in patient care were incidental positive outcomes. The study offers new insights about applying holistic comfort to prepare nurses for the realities of practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Using a Guided Journal Club as a Teaching Strategy to Enhance Learning Skills for Evidence-Based Practice.

PubMed

Szucs, Kimberly A; Benson, Jeryl D; Haneman, Brianne

2017-04-01

Journal clubs are used in both clinical and academic settings in order for clinicians and students to utilize current best-practices, become competent in evidence based practice and develop critical appraisal skills. Journal clubs encourage students to practice searching for relevant research, critically appraising articles, and contributing to open discussions with peers. Establishing the practice of reading and critiquing literature in the classroom can enable the creation of a habit of using current evidence when students enter practice. This article describes a strategy for delivering a structured academic journal club to support the learning of evidence based practice skills and students' perception of the journal club, including their overall satisfaction, knowledge base skills, and presentation skills. Students had an overall positive experience and perception of the guided journal club activity. From the instructor's perspective, this assignment was an excellent opportunity to engage students in learning the process of evidence based practice.

Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home.

PubMed

Flieger, Signe Peterson

This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking the time to reflect will facilitate greater sensemaking and learning and will ultimately help foster a relationship-centered PCMH.

Ward nurses' experiences of the discharge process between intensive care unit and general ward.

PubMed

Kauppi, Wivica; Proos, Matilda; Olausson, Sepideh

2018-05-01

Intensive care unit (ICU) discharges are challenging practices that carry risks for patients. Despite the existing body of knowledge, there are still difficulties in clinical practice concerning unplanned ICU discharges, specifically where there is no step-down unit. The aim of this study was to explore general ward nurses' experiences of caring for patients being discharged from an ICU. Data were collected from focus groups and in-depth interviews with a total of 16 nurses from three different hospitals in Sweden. An inductive qualitative design was chosen. The analysis revealed three themes that reflect the challenges in nursing former ICU patients: a vulnerable patient, nurses' powerlessness and organizational structure. The nurses described the challenge of nursing a fragile patient based on several aspects. They expressed feeling unrealistic demands when caring for a fragile former ICU patient. The demands were related to their own profession and knowledge regarding how to care for this group of patients. The organizational structure had an impact on how the nurses' caring practice could be realized. This evoked ethical concerns that the nurses had to cope with as the organization's care guidelines did not always favour the patients. The structure of the organization and its leadership appear to have a significant impact on the nurses' ability to offer patients the care they need. This study sheds light on the need for extended outreach services and intermediate care in order to meet the needs of patients after the intensive care period. © 2018 British Association of Critical Care Nurses.

Patients' experiences of continuity in the care of type 2 diabetes: a focus group study in primary care

PubMed Central

Alazri, Mohammed H; Neal, Richard D; Heywood, Phil; Leese, Brenda

2006-01-01

Background Continuity of care is fundamental to general practice and type 2 diabetes is a common chronic disease with major health and social impacts. Nevertheless continuity, as experienced by patients with type 2 diabetes, remains a neglected area. Aim To explore perceptions and experiences of continuity of care in general practice from the perspectives of patients with type 2 diabetes, focusing on the advantages and disadvantages of different types of continuity. Design of study Focus groups with patients. Setting Seven practices with different organisational structures in Leeds, UK. Method Seventy-nine patients with type 2 diabetes were recruited. Focus group interviews were conducted with 79 patients with type 2 diabetes from seven practices in Leeds, UK. Results Patients experienced three different types of continuity: relational (or longitudinal) continuity, cross-boundary (or team) continuity, and continuity of information. Patients' perceptions of continuity were influenced by several factors including a personal relationship between themselves and their healthcare professional, their own beliefs and behaviours, presence of diabetes, and the systems and structures of general practices. Patients identified the advantages and disadvantages of two types of continuity. Relational or longitudinal continuity was important in providing psychosocial care, but with a risk of misdiagnosis. The advantages of cross-boundary or team continuity were to provide physical care, whereas the main disadvantages were the absence of personal care and patient confusion. Conclusion Perceptions of continuity by patients with type 2 diabetes were influenced by several factors; they perceived several advantages and disadvantages associated with different types of continuity. Patients might expect certain healthcare benefits by following certain types of continuity. PMID:16834874

Instructional and Career Guidance in STEM: An Improvement Initiative to Create Opportunities for Female High School Students

NASA Astrophysics Data System (ADS)

Belcher, Aaron Heath

The purpose of this disquisition is to disseminate an improvement initiative in a public high school that addressed female Science, Technology, Engineering and Math (STEM) disparity in STEM classes. In this high school current instructional and career guidance practices were inadequate in providing female STEM students opportunities to experience relevant instruction in STEM through the application of real world practices. The improvement initiative identified four interventions using qualitative research that addressed the question, how do instructional and career guidance practices that emphasize the real world application of STEM impact the academic choices and career aspirations of female STEM students? The interventions include (1) instructional feedback (2) instructional resources, (3) career coaching, and (4) community college partnership. These interventions were chosen as a result of insider research methods that followed a scan, focus, summarize framework for understanding the problem. The aim of the improvement initiative was to develop structured protocols that impact STEM classroom and career guidance practices. An intervention team intended to identify opportunities for female STEM students to experience the real world application of STEM. First, the research context is explained. Then, a review of the literature explains foundation knowledge that led to the conceptual and leadership framework. Next, the research methodology is outlined including design and participants, survey instruments, procedures, timeline, and measures. The research methodology is followed by an analysis of data for instructional and career guidance practice efficacy. Finally, a discussion of the initiative and its outcome are illustrated through the stories of three female STEM students. As a result of these stories, the intervention team developed STEM classroom observation protocols. These protocols can be used by school leaders as a structure for STEM instruction and career guidance.

Thermo-optic characteristics and switching power limit of slow-light photonic crystal structures on a silicon-on-insulator platform.

PubMed

Chahal, Manjit; Celler, George K; Jaluria, Yogesh; Jiang, Wei

2012-02-13

Employing a semi-analytic approach, we study the influence of key structural and optical parameters on the thermo-optic characteristics of photonic crystal waveguide (PCW) structures on a silicon-on-insulator (SOI) platform. The power consumption and spatial temperature profile of such structures are given as explicit functions of various structural, thermal and optical parameters, offering physical insight not available in finite-element simulations. Agreement with finite-element simulations and experiments is demonstrated. Thermal enhancement of the air-bridge structure is analyzed. The practical limit of thermo-optic switching power in slow light PCWs is discussed, and the scaling with key parameters is analyzed. Optical switching with sub-milliwatt power is shown viable.

Digital Tools to Enhance Clinical Reasoning.

PubMed

Manesh, Reza; Dhaliwal, Gurpreet

2018-05-01

Physicians can improve their diagnostic acumen by adopting a simulation-based approach to analyzing published cases. The tight coupling of clinical problems and their solutions affords physicians the opportunity to efficiently upgrade their illness scripts (structured knowledge of a specific disease) and schemas (structured frameworks for common problems). The more times clinicians practice accessing and applying those knowledge structures through published cases, the greater the odds that they will have an enhanced approach to similar patient-cases in the future. This article highlights digital resources that increase the number of cases a clinician experiences and learns from. Copyright © 2017 Elsevier Inc. All rights reserved.

Solid, Cystic, and Tubular: Novice Ultrasound Skills Training Using a Versatile, Affordable Practice Model.

PubMed

Sevak, Shruti; Lurvey, Benjamin; Woodfin, Ashley A; Hothem, Zachary; Callahan, Rose E; Robbins, James; Ziegler, Kathryn

2018-04-09

In spite of the recognized benefits of ultrasound, many physicians have little experience with using ultrasound to perform procedures. Many medical schools and residency programs lack a formal ultrasound training curriculum. We describe an affordable ultrasound training curriculum and versatile, inexpensive practice model. Participants underwent a didactic session to teach the theory required to perform ultrasound-guided procedures. Motor skills were taught using a practice model incorporating analogs of common anatomic and pathologic structures into an opacified gelatin substrate. The Marcia and Eugene Applebaum Simulation Learning Institute, Beaumont Hospital, Royal Oak, MI; a private nonprofit tertiary care hospital associated with the OUWB School of Medicine, Rochester, MI. The model was tested in a cohort of 50 medical students and general surgery residents. The gelatin model can be constructed for $1.03 per learner. The solid, cystic, and vascular structural analogs were readily identifiable on ultrasound and easily differentiated based on their echotextures. Eighty-four percent of participants successfully aspirated the cystic structure, 88% successfully biopsied a portion of the solid structure, and 76% successfully cannulated the tubular structure. Overall, 82% of participants achieved a passing score for the exercise based on a validated Objective Structured Assessment of Technical Skill instrument. There were no significant differences between the medical students and residents. This model can be used to teach basic ultrasound skills such as aspiration, biopsy, and vessel cannulation, providing a foundation for the use of ultrasound in a broad range of clinical procedures, as well as providing practice opportunities for medical students and residents to gain increased ultrasound competency and confidence. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

From Guide to Practice: Improving Your After School Science Program to Increase Student Academic Achievement

NASA Astrophysics Data System (ADS)

Taylor, J.

2013-12-01

Numerous science organizations, such as NASA, offer educational outreach activities geared towards after school. For some programs, the primary goal is to grow students' love of science. For others, the programs are also intended to increase academic achievement. For those programs looking to support student learning in out-of-school time environments, aligning the program with learning during the classroom day can be a challenge. The Institute for Education Sciences, What Works Clearinghouse, put together a 'Practice Guide' for maximizing learning time beyond the regular school day. These practice guides provide concrete recommendations for educators supported by research. While this guide is not specific to any content or subject-area, the recommendations provided align very well with science education. After school science is often viewed as a fun, dynamic environment for students. Indeed, one of the recommendations to ensure time is structured according to students' needs is to provide relevant and interesting experiences. Given that our after school programs provide such creative environments for students, what other components are needed to promote increased academic achievement? The recommendations provided to academic achievement, include: 1. Align Instruction, 2. Maximize Attendance and Participation, 3. Adapt Instruction, 4. Provide Engaging Experiences, and 5. Evaluate Program. In this session we will examine these five recommendations presented in the Practice Guide, discuss how these strategies align with science programs, and examine what questions each program should address in order to provide experiences that lend themselves to maximizing instruction. Roadblocks and solutions for overcoming challenges in each of the five areas will be presented. Jessica Taylor will present this research based on her role as an author on the Practice Guide, 'Improving Academic Achievement in Out-of-School Time' and her experience working in various informal science programs for NASA.

What are community nurses experiences of assessing frailty and assisting in planning subsequent interventions?

PubMed

Britton, Hannah

2017-09-02

With an ageing population and increasing focus on community care, this study aimed to explore the experiences of community nurses in assessing frailty and planning interventions around frailty. Six community nurses were recruited for face-to-face semi-structured interviews as part of this qualitative study which was underpinned by a competence framework ( Royal College of Nursing, 2009 ). Thematic analysis was used and frailty was identified as an emerging topic within practice. Participants discussed several aspects associated with frailty; however, some uncertainty around the concept of frailty and its definition was noted, particularly for staff who had received limited frailty training. Participants had a growing awareness of frailty in practice, but challenges-including time constraints and staffing within some roles, a perception of limited services to support older people, and for some a lack of confidence and training-presented barriers to frailty assessment. The Rockwood frailty scale was used by participants within practice, but evidence suggested it was felt to lack validity within the community setting.

Exercise prescription for non-specific chronic low back pain (NSCLBP): a qualitative study of patients' experiences of involvement in decision making.

PubMed

Stenner, Rob; Swinkels, Annette; Mitchell, Theresa; Palmer, Shea

2016-12-01

The culture of current clinical practice calls for collaboration between therapists and patients, sharing power and responsibility. This paper reports on the findings of a qualitative study of exercise prescription for patients with NSCLBP, taking into account issues such as decision making and how this accords with patient preferences and experiences. To understand the treatment decision making experiences, information and decision support needs of patients with NSCLBP who have been offered exercise as part of their management plan. A qualitative study using a philosophical hermeneutic approach. Semi-structured interviews with eight patients (including use of brief patient vignettes) was undertaken to explore their personal experiences of receiving exercise as part of the management of their NSCLBP, and their involvement in decisions regarding their care. The findings provide a detailed insight into patients' perceptions and experiences of receiving exercise-based management strategies. Four themes were formed from the texts: (1) patients' expectations and patients' needs are not synonymous, (2) information is necessary but often not sufficient, (3) not all decisions need to be shared, and (4) wanting to be treated as an individual. Shared decision making did not appear to happen in physiotherapy clinical practice, but equally may not be what every patient wants. The overall feeling of the patients was that the therapist was dominant in structuring the interactions, leaving the patients feeling disempowered to question and contribute to the decision making. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Organisational support for evidence-based practice: occupational therapists perceptions.

PubMed

Bennett, Sally; Allen, Shelley; Caldwell, Elizabeth; Whitehead, Mary; Turpin, Merrill; Fleming, Jennifer; Cox, Ruth

2016-02-01

Barriers to the use of evidence-based practice extend beyond the individual clinician and often include organisational barriers. Adoption of systematic organisational support for evidence-based practice in health care is integral to its use. This study aimed to explore the perceptions of occupational therapy staff regarding the influence of organisational initiatives to support evidence-based practice on workplace culture and clinical practice. This study used semi-structured interviews with 30 occupational therapists working in a major metropolitan hospital in Brisbane, Australia regarding their perceptions of organisational initiatives designed to support evidence-based practice. Four themes emerged from the data: (i) firmly embedding a culture valuing research and EBP, (ii) aligning professional identity with the Research and Evidence in Practice model, (iii) experiences of change: pride, confidence and pressure and (iv) making evidence-based changes to clinical practices. Organisational initiatives for evidence-based practice were perceived as influencing the culture of the workplace, therapists' sense of identity as clinicians, and as contributing to changes in clinical practice. It is therefore important to consider organisational factors when attempting to increase the use of evidence in practice. © 2016 Occupational Therapy Australia.

Arts, literature and reflective writing as educational strategies to promote narrative reasoning capabilities among physiotherapy students.

PubMed

Caeiro, Carmen; Cruz, Eduardo Brazete; Pereira, Carla Mendes

2014-11-01

The use of arts, literature and reflective writing has becoming increasingly popular in health professionals education. However, research examining its contribution as an educational strategy to promote narrative reasoning capabilities is limited, particularly from the students' perspective. This study aimed to explore the final year physiotherapy students' perspectives about the contribution of arts, literature and reflective writing in facilitating narrative reasoning capabilities. Three focus group meetings using a semi-structured interview schedule were carried out to collect data. Focus group sessions were audiotaped and transcribed verbatim. Interpretative phenomenological analysis was used to conduct the study and analyze the transcripts. Three themes emerged: (1) developmental understanding of the patients' experiences; (2) developmental understanding about the self; and (3) embedding reflection in clinical practice. Students emphasized an increasing capability to be sensitive and vicariously experience the patient's experience. Through reflective writing, students reported they became more capable of thinking critically about their practice and learning needs for continuous professional development. Finally, students highlighted the contribution of these strategies in making reflection part of their practice. Final year physiotherapy students reported enhanced skills of narrative reasoning. The findings support the inclusion of these strategies within the undergraduate physiotherapy curricula.

From cooperation to conflict? Swedish rehabilitation professionals' experiences of interorganizational cooperation.

PubMed

Ståhl, Christian; Svensson, Tommy; Ekberg, Kerstin

2011-09-01

This article analyses Swedish rehabilitation professionals' experiences of interorganizational cooperation in return-to-work and labour market reintegration. Two groups (n = 15) from different organizations met on a regular basis to discuss their practice from a cooperation perspective. The participants had experience of cooperation in the organizational setting of Coordination Associations. The groups worked with a tutor according to a problem-based methodology, to discuss how their practice is influenced by new structures for cooperation. The material was analysed inductively using qualitative content analysis. Interorganizational cooperation in rehabilitation is generally perceived as promoting coherence and communication. Nevertheless, there are several contradictory factors in the implementation of such work forms, primarily inflexible sickness insurance regulations and inability of managers to implement cooperation in regular practice. While interorganizational cooperation promotes professional discretion and tailored solutions, the insurance system contradicts such ambitions through increased governance. Ultimately, the contradictory tendencies of cooperative initiatives and the stricter governance of sickness insurance regulations are political matters. If political attempts to promote interorganizational cooperation are to succeed, the increasing sectorization that results from strict governance of sickness insurance regulations needs to be targeted on a system level.

Increased gray matter volume in the right angular and posterior parahippocampal gyri in loving-kindness meditators.

PubMed

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.

Developing an approach for teaching and learning about Lewis structures

NASA Astrophysics Data System (ADS)

Kaufmann, Ilana; Hamza, Karim M.; Rundgren, Carl-Johan; Eriksson, Lars

2017-08-01

This study explores first-year university students' reasoning as they learn to draw Lewis structures. We also present a theoretical account of the formal procedure commonly taught for drawing these structures. Students' discussions during problem-solving activities were video recorded and detailed analyses of the discussions were made through the use of practical epistemology analysis (PEA). Our results show that the formal procedure was central for drawing Lewis structures, but its use varied depending on situational aspects. Commonly, the use of individual steps of the formal procedure was contingent on experiences of chemical structures, and other information such as the characteristics of the problem given. The analysis revealed a number of patterns in how students constructed, checked and modified the structure in relation to the formal procedure and the situational aspects. We suggest that explicitly teaching the formal procedure as a process of constructing, checking and modifying might be helpful for students learning to draw Lewis structures. By doing so, the students may learn to check the accuracy of the generated structure not only in relation to the octet rule and formal charge, but also to other experiences that are not explicitly included in the formal procedure.

Proposal for probing energy transfer pathway by single-molecule pump-dump experiment.

PubMed

Tao, Ming-Jie; Ai, Qing; Deng, Fu-Guo; Cheng, Yuan-Chung

2016-06-09

The structure of Fenna-Matthews-Olson (FMO) light-harvesting complex had long been recognized as containing seven bacteriochlorophyll (BChl) molecules. Recently, an additional BChl molecule was discovered in the crystal structure of the FMO complex, which may serve as a link between baseplate and the remaining seven molecules. Here, we investigate excitation energy transfer (EET) process by simulating single-molecule pump-dump experiment in the eight-molecules complex. We adopt the coherent modified Redfield theory and non-Markovian quantum jump method to simulate EET dynamics. This scheme provides a practical approach of detecting the realistic EET pathway in BChl complexes with currently available experimental technology. And it may assist optimizing design of artificial light-harvesting devices.

Proposal for probing energy transfer pathway by single-molecule pump-dump experiment

NASA Astrophysics Data System (ADS)

Tao, Ming-Jie; Ai, Qing; Deng, Fu-Guo; Cheng, Yuan-Chung

2016-06-01

The structure of Fenna-Matthews-Olson (FMO) light-harvesting complex had long been recognized as containing seven bacteriochlorophyll (BChl) molecules. Recently, an additional BChl molecule was discovered in the crystal structure of the FMO complex, which may serve as a link between baseplate and the remaining seven molecules. Here, we investigate excitation energy transfer (EET) process by simulating single-molecule pump-dump experiment in the eight-molecules complex. We adopt the coherent modified Redfield theory and non-Markovian quantum jump method to simulate EET dynamics. This scheme provides a practical approach of detecting the realistic EET pathway in BChl complexes with currently available experimental technology. And it may assist optimizing design of artificial light-harvesting devices.

Proposal for probing energy transfer pathway by single-molecule pump-dump experiment

PubMed Central

Tao, Ming-Jie; Ai, Qing; Deng, Fu-Guo; Cheng, Yuan-Chung

2016-01-01

The structure of Fenna-Matthews-Olson (FMO) light-harvesting complex had long been recognized as containing seven bacteriochlorophyll (BChl) molecules. Recently, an additional BChl molecule was discovered in the crystal structure of the FMO complex, which may serve as a link between baseplate and the remaining seven molecules. Here, we investigate excitation energy transfer (EET) process by simulating single-molecule pump-dump experiment in the eight-molecules complex. We adopt the coherent modified Redfield theory and non-Markovian quantum jump method to simulate EET dynamics. This scheme provides a practical approach of detecting the realistic EET pathway in BChl complexes with currently available experimental technology. And it may assist optimizing design of artificial light-harvesting devices. PMID:27277702

Development pathways in learning to be a physiotherapist.

PubMed

Lindquist, Ingrid; Engardt, Margareta; Garnham, Liz; Poland, Fiona; Richardson, Barbara

2006-09-01

Few studies have examined the experiences of students' professional socialization in physiotherapy. This international longitudinal study aimed to study experiences of situated learning and change in a student cohort during a physiotherapy education programme. A phenomenographic design with semi-structured interviews was carried out with a cohort of physiotherapy students from two sites, strategically selected for variation in gender, age, educational background, work experience and academic level. Interviews were carried out after each of the first five semesters in the programme by a team of researchers. Seventy-six interviews explored students' learning experiences. Analysis identified the variation in experiences seen as important to becoming a physiotherapist. Distinct perceptions of professional growth and progression are identified in four pathways of development: 'Reflecting on Practice'; 'Communicating with Others'; 'Performing Skills'; and 'Searching Evidence'. These pathways demonstrate qualitative differences in the focus of learning experiences and preferred learning context, and include learning in a context which supports reflection, learning as agreed by others in a context with patients and other professionals, learning physiotherapy skills in a practice context and learning formal knowledge in a context where theory can be linked with practice. In a cohort of students professional growth can be seen in a variety of development pathways. Each shows progress of professional growth in the 'what' as changes in experiences and the 'how' as ways of learning from them. In addition, the pattern of pathways in a cohort may change from one semester to another suggesting individuals may adopt different learning pathways throughout their education. Teaching staff are challenged to consider how they recognize a variation in development pathways in their student cohorts and how they purposefully ensure experiences to guide students through different learning pathways in socialization to become a physiotherapist.

The personal is professional: Connecting white urban middle school science teachers' biographies to their teaching of all students

NASA Astrophysics Data System (ADS)

Oey, Esther Ruth

The purpose of this study was to examine if and in what ways white, urban middle school science teachers use experiences of being marginalized or feeling different to connect to students coming from backgrounds unlike their own---especially students who are racially, culturally, linguistically and otherwise different from them, the school culture and the dominant society. Personal biography was used to frame this study. Data consisted of structured and semi-structured interviews and classroom observations of one female and two male science teachers gathered over one academic year. Results indicated that experiences with difference may be used to inform teachers' practices, but personal biography alone was insufficient to enable the teachers to reflect on their experiences with race, class, gender, and difference. Also, attending to emotions appeared to be an important factor in helping students develop cognitive skills in science classrooms.

Ambiguity in knowledge transfer: The role of theory-practice gap.

PubMed

Cheraghi, Mohammad Ali; Salsali, Mahvash; Safari, Mahmoud

2010-01-01

In spite of much literature written about the theory-practice gap in the international nursing journals, there is evidence that indicates this subject has not been probed comprehensively since nursing education was transferred to universities in Iran. In the recent years, the public and the government have criticized Iranian nurses because of poor quality of patient care. Although this subject has been lamented by some researchers, there is no comprehensive work on how this gap resulted. In the process of a larger study on "nursing knowledge translation to practice", of one PhD thesis, this process was explored. Using grounded theory analysis, indepth interviews were undertaken with a purposive sample of 29 nurses, with different levels of experience, from the school of nursing in Tehran University of Medical Sciences in 2006 from January to August. Data were analyzed using the constant comparative method. Three main themes emerging from this study included clinical behavior structure, paradoxical knowledge and practice, and divergent nursing organization. It seems that nursing education with some praxis and paradoxes in the realm of nursing knowledge and practice, along with divergent organizational structure have decreased nurses' ability in applying their professional knowledge and skills in order to bridge the gap between theory and practice. Moreover, in spite of increased academic input into nursing education, clinical behaviors of both education and practice settings was perceived as "traditional routine-based".

A Thematic Inquiry into the Burnout Experience of Australian Solo-Practicing Clinical Psychologists.

PubMed

Hammond, Trent E; Crowther, Andrew; Drummond, Sally

2017-01-01

Objective: Burnout is conceptualized as a syndrome that consists of emotional exhaustion, depersonalization, and decreased personal accomplishment. Despite the increased frequency and severity of burnout in the Western world, there is limited published research regarding the experiences of clinical psychologists who have had burnout. The present study examines clinical psychologists' different experiences of burnout in Australia. Design and Methods: In the year 2015, six privately practicing and solo-employed clinical psychologists provided rich qualitative data by participating in semi-structured interviews. Thematic analysis was the method used to analyze clinical psychologists' natural accounts of their burnout experiences. Using NVivo, emerging themes were identified through coding 'first order constructs' and then axial code 'second order constructs.' Findings: Clinical psychologists indicated that their roles are demanding and a diverse range of symptoms, including the enduring effects of burnout, mental stress, fatigue, decreased personal accomplishment, negative affect, depersonalization, reduced productivity and motivation, and insomnia. They identified precursors of burnout, including excessive workload and hours of work, life stresses, mismanaged workload, and transference. Clinical psychologists suggested that protective factors of burnout include knowledge and years worked in direct care, and trusting and long-term relationships. They indicated that the barriers to overcoming burnout include the fallacy that their clients' expectations and needs are more important than their own, the financial cost of working in private practice, contemporary knowledge and inadequate education regarding self-care, and time constraints. Discussion and Conclusion: The findings presented in this study provide psychologists and other health professionals with an insight about the burnout experience and inform professionals of the mental shortcomings of working as a solo-practicing clinical psychologist. Findings from this study should lead to an increased understanding of the complexities of burnout, and ultimately reduced cases of burnout, absenteeism, and staff disengagement.

Organizing the public health-clinical health interface: theoretical bases.

PubMed

St-Pierre, Michèle; Reinharz, Daniel; Gauthier, Jacques-Bernard

2006-01-01

This article addresses the issue of the interface between public health and clinical health within the context of the search for networking approaches geared to a more integrated delivery of health services. The articulation of an operative interface is complicated by the fact that the definition of networking modalities involves complex intra- and interdisciplinary and intra- and interorganizational systems across which a new transversal dynamics of intervention practices and exchanges between service structures must be established. A better understanding of the situation is reached by shedding light on the rationale underlying the organizational methods that form the bases of the interface between these two sectors of activity. The Quebec experience demonstrates that neither the structural-functionalist approach, which emphasizes remodelling establishment structures and functions as determinants of integration, nor the structural-constructivist approach, which prioritizes distinct fields of practice in public health and clinical health, adequately serves the purpose of networking and integration. Consequently, a theoretical reframing is imperative. In this regard, structuration theory, which fosters the simultaneous study of methods of inter-structure coordination and inter-actor cooperation, paves the way for a better understanding of the situation and, in turn, to the emergence of new integration possibilities.

Preliminary experimental investigation of an X-band Cerenkov-type high power microwave oscillator without guiding magnetic field.

PubMed

Guo, Liming; Shu, Ting; Li, Zhiqiang; Ju, Jinchuan; Fang, Xiaoting

2017-02-01

Among high power microwave (HPM) generators without guiding magnetic field, Cerenkov-type oscillator is expected to achieve a relatively high efficiency, which has already been realized in X-band in our previous simulation work. This paper presents the preliminary experimental investigations into an X-band Cerenkov-type HPM oscillator without guiding magnetic field. Based on the previous simulation structure, some modifications regarding diode structure were made. Different cathode structures and materials were tested in the experiments. By using a ring-shaped graphite cathode, microwave of about one hundred megawatt level was generated with a pure center frequency of 9.14 GHz, and an efficiency of about 1.3%. As analyzed in the paper, some practical issues reduce the efficiency in experiments, such as real features of the electron beam, probable breakdown regions on the cathode surface which can damage the diode, and so forth.

Disclosing clinical adverse events to patients: can practice inform policy?

PubMed Central

Sorensen, Ros; Iedema, Rick; Piper, Donella; Manias, Elizabeth; Williams, Allison; Tuckett, Anthony

2009-01-01

Abstract Objectives  To understand patients’ and health professionals’ experience of Open Disclosure and how practice can inform policy. Background  Open Disclosure procedures are being implemented in health services worldwide yet empirical evidence on which to base models of patient–clinician communication and policy development is scant. Design, setting and participants  A qualitative method was employed using semi‐structured open‐ended interviews with 154 respondents (20 nursing, 49 medical, 59 clinical/administrative managerial, 3 policy coordinators, 15 patients and 8 family members) in 21 hospitals and health services in four Australian states. Results  Both patients and health professionals were positive about Open Disclosure, although each differed in their assessments of practice effectiveness. We found that five major elements influenced patients’ and professionals’ experience of openly disclosing adverse events namely: initiating the disclosure, apologizing for the adverse event, taking the patient’s perspective, communicating the adverse event and being culturally aware. Conclusions  Evaluating the impact of Open Disclosure refines policy implementation because it provides an evidence base to inform policy. Health services can use specific properties relating to each of the five Open Disclosure elements identified in this study as training standards and to assess the progress of policy implementation. However, health services must surmount their sensitivity to revealing the extent of error so that research into patient experiences can inform practice and policy development. PMID:19804555

Comparison of private versus academic practice for general surgeons: a guide for medical students and residents.

PubMed

Schroen, Anneke T; Brownstein, Michelle R; Sheldon, George F

2003-12-01

Medical students and residents often make specialty and practice choices with limited exposure to aspects of professional and personal life in general surgery. The purpose of this study was to portray practice composition, career choices, professional experiences, job satisfaction, and personal life characteristics specific to practicing general surgeons in the United States. A 131-question survey was mailed to all female members (n = 1,076) and a random 2:1 sample of male members (n = 2,152) of the American College of Surgeons in three mailings between September 1998 and March 1999. Respondents who were not actively practicing general surgery in the United States and both trainees and surgeons who did not fit the definition of private or academic practice were excluded. Detailed questions regarding practice attributes, surgical training, professional choices, harassment, malpractice, career satisfaction, and personal life characteristics were included. Separate five-point Likert scales were designed to measure influences on career choices and satisfaction with professional and personal matters. Univariate analyses were used to analyze responses by surgeon age, gender, and practice type. A response rate of 57% resulted in 1,532 eligible responses. Significant differences between private and academic practice were noted in case composition, practice structure, and income potential; no major differences were seen in malpractice experience. Propensity for marriage and parenthood differed significantly between men and women surgeons. Overall career satisfaction was very high regardless of practice type. Some differences by surgeon gender in perceptions of equal career advancement opportunities and of professional isolation were noted. This study offers a comprehensive view of general surgery to enable more informed decisions among medical students and residents regarding specialty choice or practice opportunities.

Health-care sector and complementary medicine: practitioners' experiences of delivering acupuncture in the public and private sectors.

PubMed

Bishop, Felicity L; Amos, Nicola; Yu, He; Lewith, George T

2012-07-01

The aim was to identify similarities and differences between private practice and the National Health Service (NHS) in practitioners' experiences of delivering acupuncture to treat pain. We wished to identify differences that could affect patients' experiences and inform our understanding of how trials conducted in private clinics relate to NHS clinical practice. Acupuncture is commonly used in primary care for lower back pain and is recommended in the National Institute for Health and Clinical Excellence's guidelines. Previous studies have identified differences in patients' accounts of receiving acupuncture in the NHS and in the private sector. The major recent UK trial of acupuncture for back pain was conducted in the private sector. Semi-structured qualitative interviews were conducted with 16 acupuncturists who had experience of working in the private sector (n = 7), in the NHS (n =3), and in both the sectors (n = 6). The interviews lasted between 24 and 77 min (median=49 min) and explored acupuncturists' experiences of treating patients in pain. Inductive thematic analysis was used to identify similarities and differences across private practice and the NHS. The perceived effectiveness of acupuncture was described consistently and participants felt they did (or would) deliver acupuncture similarly in NHS and in private practice. In both the sectors, patients sought acupuncture as a last resort and acupuncturist-patient relationships were deemed important. Acupuncture availability differed across sectors: in the NHS it was constrained by Trust policies and in the private sector by patients' financial resources. There were greater opportunities for autonomous practice in the private sector and regulation was important for different reasons in each sector. In general, NHS practitioners had Western-focussed training and also used conventional medical techniques, whereas private practitioners were more likely to have Traditional Chinese training and to practise other complementary therapies in addition to acupuncture. Future studies should examine the impact of these differences on patients' clinical outcomes.

Specialty training and the personal use of benzodiazepines by physicians affect their proneness to prescribe tranquilizers.

PubMed

Linden, M; Gothe, H

1998-03-01

The decision on how to treat a patient does not depend on clinical matters or illness characteristics alone, but also on patient, physician and setting variables such as personality, training, or reimbursement. No research has yet been carried out to answer the question whether personal experience with medications also influences prescribing behavior. In this study, 124 physicians stratified according to specialty (neuropsychiatrists vs. general practitioners), type of institution (private practice vs. hospital), years of professional experience (young vs. old), and region (rural vs. urban) participated in a structured interview to evaluate their proneness to prescribe benzodiazepines for sleep disorders as well as their personal experience in taking benzodiazepines for their own sleep problems. Both specialty and personal experience were significantly related to proneness to prescribe. Other variables tested (region, institution, age, gender) did not help to explain the variance in benzodiazepine prescribing practice. Thus physician variables and, importantly, their own personal experience in taking the medication significantly influence treatment choice. Rational medical decision making and treatment guidelines must therefore take into account medical knowledge as well as knowledge of personal treatment preferences and professional biases.

The effect of a science work experience program for teachers on the classroom environment: A qualitative program evaluation

NASA Astrophysics Data System (ADS)

Frazier, Wendy Michelle

Science Work Experience Programs for Teachers (SWEPTs) provide an opportunity for science and math teachers to work in research laboratories during the summer to experience science as it is practiced in the laboratory-setting. Through the use of interviews with teachers and students, classroom observations, and an analysis of printed student sheets and student work, the lived experience of a cohort of program participants in Columbia University's Summer Research Program for Secondary School Science Teachers was recorded in an effort to describe the effect of experience in a SWEPT on the classroom environment of teacher participants and student outcomes. Relying on Social Learning Theory and science education reform documentation as a theoretical framework the following dimensions of the classroom were examined: (1) emergent themes that include the participants' perceptions of the importance of technology in the classroom, (2) interpersonal relationships with the teachers at the participants' schools, fellow program participants, research scientists, and students, and (3) changes in epistemological structure, curriculum, instructional strategies, and classroom practices. Methodological and theoretical implications are addressed with respect to future studies, and suggestions for refinement of SWEPTs are provided.

Practicing the practice: Learning to guide elementary science discussions in a practice-oriented science methods course

NASA Astrophysics Data System (ADS)

Shah, Ashima Mathur

University methods courses are often criticized for telling pre-service teachers, or interns, about the theories behind teaching instead of preparing them to actually enact teaching. Shifting teacher education to be more "practice-oriented," or to focus more explicitly on the work of teaching, is a current trend for re-designing the way we prepare teachers. This dissertation addresses the current need for research that unpacks the shift to more practice-oriented approaches by studying the content and pedagogical approaches in a practice-oriented, masters-level elementary science methods course (n=42 interns). The course focused on preparing interns to guide science classroom discussions. Qualitative data, such as video records of course activities and interns' written reflections, were collected across eight course sessions. Codes were applied at the sentence and paragraph level and then grouped into themes. Five content themes were identified: foregrounding student ideas and questions, steering discussion toward intended learning goals, supporting students to do the cognitive work, enacting teacher role of facilitator, and creating a classroom culture for science discussions. Three pedagogical approach themes were identified. First, the teacher educators created images of science discussions by modeling and showing videos of this practice. They also provided focused teaching experiences by helping interns practice the interactive aspects of teaching both in the methods classroom and with smaller groups of elementary students in schools. Finally, they structured the planning and debriefing phases of teaching so interns could learn from their teaching experiences and prepare well for future experiences. The findings were analyzed through the lens of Grossman and colleagues' framework for teaching practice (2009) to reveal how the pedagogical approaches decomposed, represented, and approximated practice throughout course activities. Also, the teacher educators' purposeful use of both pedagogies of investigation (to study teaching) and pedagogies of enactment (to practice enacting teaching) was uncovered. This work provides insights for the design of courses that prepare interns to translate theories about teaching into the interactive work teachers actually do. Also, it contributes to building a common language for talking about the content of practice-oriented courses and for comparing the affordances and limitations of pedagogical approaches across teacher education settings.

Implicit Sequence Learning and Contextual Cueing Do Not Compete for Central Cognitive Resources

ERIC Educational Resources Information Center

Jimenez, Luis; Vazquez, Gustavo A.

2011-01-01

Sequence learning and contextual cueing explore different forms of implicit learning, arising from practice with a structured serial task, or with a search task with informative contexts. We assess whether these two learning effects arise simultaneously when both remain implicit. Experiments 1 and 2 confirm that a cueing effect can be observed…

TRANSFORMATIONAL SENTENCE-COMBINING, A METHOD FOR ENHANCING THE DEVELOPMENT OF SYNTACTIC FLUENCY IN ENGLISH COMPOSITION. FINAL REPORT.

ERIC Educational Resources Information Center

MELLON, JOHN C.

THIS STUDY REPORTS AN EXPERIMENT ON THE HYPOTHESIS THAT GRAMMAR-RELATED SENTENCE-COMBINING PRACTICE WILL MEANINGFULLY ENHANCE THE NORMAL GROWTH OF SYNTACTIC FLUENCY. TRADITIONAL STUDIES ON ERROR THERAPY AND SENTENCE STRUCTURE ARE REVIEWED, AND DESIGN AND RATIONALE ARE INFERRED FROM THE RESEARCH OF BATEMAN AND ZIDONIS. RULE LEARNING, PATTERN…

Performing an Archive of Resistance: Challenging Normative Life Narratives through Literary Reading and Memoir Writing Research

ERIC Educational Resources Information Center

Robson, Claire; Sumara, Dennis; Luce-Kapler, Rebecca

2011-01-01

This research explores the ways in which normative structures organize experiences and representations of identities. It reports on two groups, one in which the members identified as rural and heterosexual and the other as urban and lesbian. Both participated in literary reading and response practices organized by a literary anthropological…

Teaching Health Education. A Thematic Analysis of Early Career Teachers' Experiences Following Pre-Service Health Training

ERIC Educational Resources Information Center

Pickett, Karen; Rietdijk, Willeke; Byrne, Jenny; Shepherd, Jonathan; Roderick, Paul; Grace, Marcus

2017-01-01

Purpose: The purpose of this paper is to understand early career teachers' perceptions of the impact of a pre-service health education programme on their health promotion practice in schools and the contextual factors that influence this. Design/methodology/approach: Semi-structured interviews were conducted with 14 primary and secondary trainee…

How Do Professional Learning Communities Foster Strong Career and Technical Education Programs of Study in Illinois Public High Schools?

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…

Narrative Abilities of Monolingual and Bilingual Children with and without Language Impairment: Implications for Clinical Practice

ERIC Educational Resources Information Center

Boerma, Tessel; Leseman, Paul; Timmermeister, Mona; Wijnen, Frank; Blom, Elma

2016-01-01

Background: Understanding and expressing a narrative's macro-structure is relatively independent of experience in a specific language. A narrative task is therefore assumed to be a less biased method of language assessment for bilingual children than many other norm-referenced tests and may thus be particularly valuable to identify language…

Doctoral Education as Social Practice for Knowledge Development: Conditions and Demands Encountered by Industry PhD Students

ERIC Educational Resources Information Center

Wallgren, Lillemor; Dahlgren, Lars Owe

2005-01-01

This article reports on an empirical study of industry PhD students in the Swedish Graduate School for Applied IT and Software Engineering. The students were questioned in semi-structured interviews about their experiences of sharing their postgraduate studies between industrial and academic environments. The results from the first analysis…

Increasing Physical Activity in Preschool: A Pilot Study to Evaluate Animal Trackers

ERIC Educational Resources Information Center

Williams, Christine L.; Carter, Betty Jean; Kibbe, Debra L.; Dennison, David

2009-01-01

Objective: This report describes a pilot study to evaluate Animal Trackers (AT), a preschool program designed to (1) increase structured physical activity (PA) during the preschool day; (2) increase practice of gross motor skills; (3) provide teachers with an easy-to-use PA program regardless of teacher experience; and (4) implement a teacher…

From Science to Fiction: Measurement and Representation of an Idea. No. 78.

ERIC Educational Resources Information Center

Bierschenk, Inger

Two scientific ideas have been discerned in 20th century thinking: the structuralism common in Europe and the functionalism apparent in the United States. This paper presents two experiments in text analysis. One discusses the behaviorist writing style of Ernest Hemingway. It hypothesizes that since he is a behaviorist in practice, he should be a…

Mathematics and Culture in Micronesia: The Structure and Function of a Capacity Building Project

ERIC Educational Resources Information Center

Dawson, A. J. Sandy

2013-01-01

The first goal of this Project is the development of elementary school mathematics curricula sensitive to indigenous mathematical thought and experience. A necessary prerequisite for the achievement of this goal is to recapture and honor the mathematics developed and practiced in the Micronesian communities. This is the Project's second goal. The…

A Computer Simulation Comparing the Incentive Structures of Dictatorships and Democracies

ERIC Educational Resources Information Center

Nishikawa, Katsuo A.; Jaeger, Joseph

2011-01-01

The draw of simulations is that by replicating a simplified version of reality they can illustrate the repercussions that individual choices create. Students can play the role of a judge, an ambassador, or a parliamentarian and can experience first hand how their decisions play out. As a discipline, we assume that such practices are an improvement…

Teachers' Racialised Habitus in School Knowledge Construction: A Bourdieusian Analysis of Social Inequality beyond Class

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…

Collage Life Story Elicitation Technique: A Representational Technique for Scaffolding Autobiographical Memories

ERIC Educational Resources Information Center

van Schalkwyk, Gertina J.

2010-01-01

A basic premise in narrative therapy and inquiry is that life story telling is a mechanism by which experiences are rendered meaningful within some form of structure. However, narrative inquiry has to take cognisance of difficulties ensuing from discursive practices for different populations when eliciting their life stories. In this article I…

The Doctoral "Viva Voce" as a Cultural Practice: The Gendered Production of Academic Subjects

ERIC Educational Resources Information Center

Crossouard, Barbara

2011-01-01

This article reports on a recent small-scale phenomenological study into the student experience of the doctoral "viva voce". It was prompted by strong concerns about "viva voce" processes on the part of a Director of Graduate Studies in an English university. The study involved semi-structured interviews with 20 respondents…

A Practical Hybrid Model of Application, Integration, and Competencies at Interactive Table Conferences in Histology (ITCH)

ERIC Educational Resources Information Center

Ettarh, Rajunor

2016-01-01

Significant changes have been implemented in the way undergraduate medical education is structured. One of the challenges for component courses such as histology in medical and dental curricula is to restructure and deliver training within new frameworks. This article describes the process of aligning the purpose and experience in histology…

Qualitative Analysis of Sexually Experienced Adolescent Females: Attitudes about Vaginal Health

PubMed Central

Francis, Jenny K R; Fraiz, Lauren Dapena; Catallozzi, Marina; Rosenthal, Susan L

2016-01-01

Structured Abstract Study Objective To explore adolescent’s perceptions of vaginal health, practices, and vaginally-placed products. Design Semi-structured interviews were audio-recorded and transcribed until achieving theoretical saturation. Setting Adolescent medicine clinics in NYC. Participants Adolescent females (n = 22) who were sexually experienced, predominately Hispanic (73%) with a mean age of 17.7 years (range 15–20 years). Interventions None Main Outcome Measures Interviews assessed perspectives on vaginal health, specific vaginal hygiene practices and attitudes about vaginally-placed products (contraceptive rings, intrauterine devices (IUDs), and proposed multi-purpose technologies (MPTs) administered as ring or gel). The interviews were transcribed and coded for relevant themes. Results Overlapping themes included young women’s view of their vagina as a space that needed to be healthy for sexual partners and future fertility. The vagina could not be presumed to be healthy and conversations about vaginal health were limited to only include specific individuals. All reported a variety of practices to maintain their vaginal health, including showering 1 to 5 times a day and using soaps specifically for the vagina. Attitudes about vaginally-placed products revealed concerns about the sensory experience of having a product in the vagina, safety concerns and interest in the product’s objective (prevention of pregnancy or infection). Conclusions Adolescents have very specific views and practices about their vaginas. Clinicians should initiate conversations about vaginal health and hygiene with adolescents and focus on the normalcy of the vagina. Development of vaginally-placed products should focus on the sensory experience, safety and purpose of the product. PMID:27133374

Propagation of Computational Uncertainty Using the Modern Design of Experiments

NASA Technical Reports Server (NTRS)

DeLoach, Richard

2007-01-01

This paper describes the use of formally designed experiments to aid in the error analysis of a computational experiment. A method is described by which the underlying code is approximated with relatively low-order polynomial graduating functions represented by truncated Taylor series approximations to the true underlying response function. A resource-minimal approach is outlined by which such graduating functions can be estimated from a minimum number of case runs of the underlying computational code. Certain practical considerations are discussed, including ways and means of coping with high-order response functions. The distributional properties of prediction residuals are presented and discussed. A practical method is presented for quantifying that component of the prediction uncertainty of a computational code that can be attributed to imperfect knowledge of independent variable levels. This method is illustrated with a recent assessment of uncertainty in computational estimates of Space Shuttle thermal and structural reentry loads attributable to ice and foam debris impact on ascent.

Transequatorial Propagation and Depletion Precursors

NASA Astrophysics Data System (ADS)

Miller, E. S.; Bust, G. S.; Kaeppler, S. R.; Frissell, N. A.; Paxton, L. J.

2014-12-01

The bottomside equatorial ionosphere in the afternoon and evening sector frequently evolves rapidly from smoothly stratified to violently unstable with large wedges of depleted plasma growing through to the topside on timescales of a few tens of minutes. These depletions have numerous practical impacts on radio propagation, including amplitude scintillation, field-aligned irregularity scatter, HF blackouts, and long-distance transequatorial propagation at frequencies above the MUF. Practical impacts notwithstanding, the pathways and conditions under which depletions form remain a topic of vigorous inquiry some 80 years after their first report. Structuring of the pre-sunset ionosphere---morphology of the equatorial anomalies and long-wavelength undulations of the isodensity contours on the bottomside---are likely to hold some clues to conditions that are conducive to depletion formation. The Conjugate Depletion Experiment is an upcoming transequatorial forward-scatter HF/VHF experiment to investigate pre-sunset undulations and their connection with depletion formation. We will present initial results from the Conjugate Depletion Experiment, as well as a companion analysis of a massive HF propagation data set.

Self-practice and self-reflection in cognitive behaviour therapy training: what factors influence trainees' engagement and experience of benefit?

PubMed

Bennett-Levy, James; Lee, Nicole K

2014-01-01

Previous studies of self-practice/self-reflection (SP/SR) CBT training have found that trainees report significant benefits from practising CBT techniques on themselves (self-practice) and reflecting on their experience (self-reflection) as a formal part of their CBT training. However, not all trainees experience the same level of benefit from SP/SR and not all types of training course produce benefits to the same extent. This paper examines the question: What factors influence trainees' reported benefit from SP/SR? The aim was to develop a model to maximize the value of SP/SR training. The authors used a grounded theory analysis of four SP/SR training courses, varying along several dimensions, to derive a model that could account for the data. A model was derived comprising of seven elements: Two outcomes - "Experience of Benefit" and "Engagement with the Process" - that mutually influence one another; and five other influencing factors - "Course Structure and Requirements", "Expectation of Benefit", "Feeling of Safety with the Process", "Group Process", and "Available Personal Resources" - that mediate the impact on Engagement with the Process and Experience of Benefit from SP/SR. A model that provides guidance about the best ways to set up and develop SP/SR programs has been developed. This model may now be subject to empirical testing by trainers and researchers. Implications and recommendations for the design and development of future SP/SR programs are discussed.

Older men's experiences of sleep in the hospital.

PubMed

Lee, Chau Yuen; Low, Lisa Pau Le; Twinn, Sheila

2007-02-01

The aim of this study was to examine the sleep experiences of older patients during a period of hospitalization on an extended care ward. Hospital wards have been demonstrated as environments that are not conducive to sleep for patients. Findings highlight the difficulties of falling asleep and getting insufficient sleep as the major causes of sleep disturbances. Such studies limit themselves to patients of Intensive Care Units and acute care settings. Relatively little is known about understanding the sleep experiences of older patients whilst hospitalized on extended care wards. An exploratory qualitative design was used with a convenience sample of six Chinese male informants, recruited from an extended care ward of a Rehabilitation Hospital in Hong Kong. Multiple data collection methods were used, including repeated semi-structured interviews and a one-week sleep diary. The findings demonstrated that all informants experienced dynamic changes in their sleeping patterns during hospitalization, resulting in sleep disruption and deprivation. The public nature of the ward environment and perceived sense of helplessness significantly interfered with sleep. Some cultural beliefs and practices were perceived by older patients to be associated with the quality of their sleep experiences. The findings contributed to an understanding of the sleep experiences of older patients during hospitalization. Implications for nursing practice indicate the significance of including focused sleep assessment of patients during admission into the ward, so strategies perceived by older patients as being able to improve sleep would be included as part of the usual ward routine and nursing practice, where possible.

Using Technological Advances to Improve Surgery Curriculum: Experience With a Mobile Application.

PubMed

Green, Courtney A; Kim, Edward H; O'Sullivan, Patricia S; Chern, Hueylan

2018-01-31

Our previous home-video basic surgical skills curriculum required substantial faculty time and resources, and was limited by delayed feedback and technical difficulties. Consequently, we integrated that curriculum with a mobile application platform. Our purpose is to describe this application and learner satisfaction. The mobile platform incorporates a patented pedagogical design based on Ericsson's deliberate practice and Bandura's social learning theory. Instructors built step-wise skills modules. During the challenge phase, learners watched a video of surgical tasks completed by experts and uploaded a video of themselves performing the same task. In the Peer Review phase, they used a grading rubric to provide feedback. In the Recap stage, learners received individual feedback and could review their own videos. Two groups of learners, graduating medical students and matriculating surgical residents, participated in this independent learning platform, along with 2 to 4 laboratory sessions, and completed a survey about their experience. Survey responses were summarized descriptively and comments analyzed using content analysis. Fifty learners submitted videos of assigned tasks and completed peer reviews. Learners reported positive experiences specifically for the Peer Review Stage, structured home practice, ease of mobile access to submit and review videos, and ongoing immediate feedback. Over half of the learners reported spending at least 10 to 30 minute practicing skills before recording their videos and over 80% rerecorded at least 2 times before submission. Content analysis revealed learners engaged with the educational concepts designed into the platform. Learners easily used and were satisfied with a mobile-technology teaching platform that maintained the fundamental content, educational theories, and organizational structure of our previously effective surgical skills curriculum. Prior challenges were directly addressed through the mobile application's ease of use, support of deliberate practice, and improved timeliness of feedback. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Exception reporting in the Quality and Outcomes Framework: views of practice staff - a qualitative study.

PubMed

Campbell, Stephen; Hannon, Kerin; Lester, Helen

2011-04-01

Exception reporting allows practices to exclude eligible patients from indicators or an entire clinical domain of the Quality and Outcomes Framework (QOF). It is a source of contention, viewed by some as a 'gaming' mechanism. To explore GP and practice staff views and experiences of exception reporting in the QOF. Qualitative semi-structured interviews. Interviews with 24 GPs, 20 practice managers, 13 practice nurses, and nine other staff were conducted in 27 general practices in the UK. Semi-structured interviews, analysed using open explorative thematic coding. Exception reporting was seen as a clinically necessary part of the QOF. Exempting patients, particularly for discretionary reasons, was seen as an 'exception to the rule' that was justified either in terms of practising patient-centred care within a framework of population-based health measures or because of the poor face validity of the indicators. Rates in all practices were described as minimal and the threat of external scrutiny from primary care trusts kept rates low. However, GPs were happy to defend using discretionary exception codes for individual patients. Exception reporting was used, particularly at the end of the payment year, to meet unmet targets and to prevent the practice being penalised financially. Overt gaming was seen as something done by 'other' practices. Only two GPs admitted to occasional inappropriate exception reporting. Exception reporting is seen by most GPs and practice staff as an important and defensible safeguard against inappropriate treatment or over-treatment of patients. However, a minority of practitioners also saw it as a gaming mechanism.

A thematic analysis of the experience of UK mental health nurses who have trained in Solution Focused Brief Therapy.

PubMed

Smith, S; Macduff, C

2017-03-01

WHAT IS KNOWN ON THE SUBJECT?: Solution Focused Brief Therapy (SFBT) is an effective model of brief psychotherapy. Evidence suggests that nurses can be trained to deliver SFBT with only a few days training. It has been argued that SFBT reflects the core values of nursing practice, but no empirical research has been undertaken to validate this assertion. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This is the first time the impact of such training on nurses' sense of professional and personal identity has been explored. Drawing upon data derived from twenty interviews, this paper explores the key themes reported by nurses in relation to their personal experience of training in SFBT. This paper extends our understanding of the lived experience of mental health nurses and facilitates discussion on the preparation and practice of their role. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Training in SFBT can provide a framework for nurses to empower their clients/patients to take control of their own recovery in a shared and trusting relationship. Training in SFBT can enhance nurses' sense of trust in their clients. Training in solution-focused interactions may provide a framework for many nurses to provide the type of collaborative, patient-led care they aspire to. Introduction SFBT is a psychotherapeutic model that aims to 'build solutions' rather than 'solve problems'. It has evolved into a structured communication framework utilized across a range of disciplines, focusing on the future, as opposed to the past, and on participant's strengths and abilities, as opposed to their problems and deficits. There have been no studies exploring the experience of training in SFBT from the perspective of the nurses being trained. Aim This study sought to explore the experience of nurses who had completed a six-month training course in SFBT. Methods Using a qualitative methodology, 20 nurses who had undertaken SFBT training were interviewed at various locations across Scotland. Results Five main themes emerged from analysis of the 20 interviews. Many of the participants reported increased trust in their clients and enhanced role satisfaction. Implications for Practice Training in SFBT provides nurses with an alternative model of practice to the dominant 'medical' and 'psychological' models of contemporary practice. The experiences of the participants in this study suggest that SFBT can be a useful intervention in nursing practice and that nurses can easily incorporate SFBT into their practice. © 2017 John Wiley & Sons Ltd.

Equilibrium high entropy alloy phase stability from experiments and thermodynamic modeling

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

Saal, James E.; Berglund, Ida S.; Sebastian, Jason T.

Long-term stability of high entropy alloys (HEAs) is a critical consideration for the design and practical application of HEAs. It has long been assumed that many HEAs are a kinetically-stabilized metastable structure, and recent experiments have confirmed this hypothesis by observing HEA ecomposition after long-termequilibration. In the presentwork,we demonstrate the use of the CALculation of PHAse Diagrams (CALPHAD) approach to predict HEA stability and processing parameters, comparing experimental long-term annealing observations to CALPHAD phase diagrams from a commercially-available HEA database. As a result, we find good agreement between single- and multi-phase predictions and experiments.

Equilibrium high entropy alloy phase stability from experiments and thermodynamic modeling

DOE PAGES

Saal, James E.; Berglund, Ida S.; Sebastian, Jason T.; ...

2017-10-29

Long-term stability of high entropy alloys (HEAs) is a critical consideration for the design and practical application of HEAs. It has long been assumed that many HEAs are a kinetically-stabilized metastable structure, and recent experiments have confirmed this hypothesis by observing HEA ecomposition after long-termequilibration. In the presentwork,we demonstrate the use of the CALculation of PHAse Diagrams (CALPHAD) approach to predict HEA stability and processing parameters, comparing experimental long-term annealing observations to CALPHAD phase diagrams from a commercially-available HEA database. As a result, we find good agreement between single- and multi-phase predictions and experiments.

New models to support the professional education of health visitors: A qualitative study of the role of space and place in creating 'community of learning hubs'.

PubMed

Donetto, Sara; Malone, Mary; Sayer, Lynn; Robert, Glenn

2017-07-01

In response to a policy-driven workforce expansion in England new models of preparing health visitors for practice have been implemented. 'Community of Learning hubs' (COLHs) are one such model, involving different possible approaches to student support in clinical practice placements (for example, 'long arm mentoring' or 'action learning set' sessions). Such models present opportunities for studying the possible effects of spatiality on the learning experiences of students and newly qualified health visitors, and on team relationships more broadly. To explore a 'community of learning hub' model in health visitor education and reflect on the role of space and place in the learning experience and professional identity development of student health visitors. Qualitative research conducted during first year of implementation. Three 'community of learning hub' projects based in two NHS community Trusts in London during the period 2013-2015. Managers and leads (n=7), practice teachers and mentors (n=6) and newly qualified and student health visitors (n=16). Semi-structured, audio-recorded interviews analysed thematically. Participants had differing views as to what constituted a 'hub' in their projects. Two themes emerged around the spaces that shape the learning experience of student and newly qualified health visitors. Firstly, a generalised need for a 'quiet place' which allows pause for reflection but also for sharing experiences and relieving common anxieties. Secondly, the role of physical arrangements in open-plan spaces to promote access to support from more experienced practitioners. Attention to spatiality can shed light on important aspects of teaching and learning practices, and on the professional identities these practices shape and support. New configurations of time and space as part of educational initiatives can surface new insights into existing practices and learning models. Copyright © 2017. Published by Elsevier Ltd.

The benefits of working abroad for British General Practice trainee doctors: the London deanery out of programme experience in South Africa.

PubMed

Reardon, Candice; George, Gavin; Enigbokan, Oluwatobi

2015-10-14

The value of international health experience for doctors from developed nations is well recognised. Provisions have been made for medical staff in the United Kingdom to embark on work experiences abroad during their careers in the National Health Service. The London Deanery and Africa Health Placements provide an Out of Programme Experience for British General Practice trainee doctors wanting to work for a year in rural hospitals in South Africa. A qualitative study was conducted among fifteen British General Practice trainees who participated in the programme. The research aim was to understand the perceived benefit and value of their experience and their opinions about the structure of the programme. The data was analysed using thematic analysis. Their experience provided an accelerated year of learning and development that contributed to their professional and personal development. In addition to their general development, their improved ability to work in resource limited settings, enhancement of soft skills, a greater appreciation for the National Health Service and a better understanding of working within foreign health care systems were important gains. The timing of the experience, the security of re-employment on their return, assistance with administrative requirements of destination countries and the opportunity to gain varied, hands-on experience were highly valued components of the Out of Programme Experience. The value and benefits derived from the doctors' experience in South Africa are discussed in relation to another evaluation of the Out of Programme Experience, as well as issues of transferability of skills and competencies and future impacts on career decisions. This study provides evidence to suggest programmes such as the OOPE have the potential to create substantial benefits for trainee doctors, both in terms of their medical skills and competencies and through the development of softer skills. This programme, through the supply of scarce skills, further benefits the host country and specifically the health facilities and communities served by these trainee doctors.

Structural engineering masters level education framework of knowledge for the needs of initial professional practice

NASA Astrophysics Data System (ADS)

Balogh, Zsuzsa Enriko

For at least the last decade, engineering, civil engineering, along with structural engineering as a profession within civil engineering, have and continue to face an emerging need for "Raising the Bar" of preparedness of young engineers seeking to become practicing professional engineers. The present consensus of the civil engineering profession is that the increasing need for broad and in-depth knowledge should require the young structural engineers to have at least a Masters-Level education. This study focuses on the Masters-Level preparedness in the structural engineering area within the civil engineering field. It follows much of the methodology used in the American Society of Civil Engineers (ASCE) Body of Knowledge determination for civil engineering and extends this type of study to better define the portion of the young engineers preparation beyond the undergraduate program for one specialty area of civil engineering. The objective of this research was to create a Framework of Knowledge for the young engineer which identifies and recognizes the needs of the profession, along with the profession's expectations of how those needs can be achieved in the graduate-level academic setting, in the practice environment, and through lifelong learning opportunities with an emphasis on the initial five years experience past completion of a Masters program in structural engineering. This study applied a modified Delphi method to obtain the critical information from members of the structural engineering profession. The results provide a Framework of Knowledge which will be useful to several groups seeking to better ensure the preparedness of the future young structural engineers at the Masters-Level.

Deliberate acquisition of competence in physiological breech birth: A grounded theory study.

PubMed

Walker, Shawn; Scamell, Mandie; Parker, Pam

2018-06-01

Research suggests that the skill and experience of the attendant significantly affect the outcomes of vaginal breech births, yet practitioner experience levels are minimal within many contemporary maternity care systems. Due to minimal experience and cultural resistance, few practitioners offer vaginal breech birth, and many practice guidelines and training programmes recommend delivery techniques requiring supine maternal position. Fewer practitioners have skills to support physiological breech birth, involving active maternal movement and choice of birthing position, including upright postures such as kneeling, standing, squatting, or on a birth stool. How professionals learn complex skills contrary to those taught in their local practice settings is unclear. How do professionals develop competence and expertise in physiological breech birth? Nine midwives and five obstetricians with experience facilitating upright physiological breech births participated in semi-structured interviews. Data were analysed iteratively using constructivist grounded theory methods to develop an empirical theory of physiological breech skill acquisition. Among the participants in this research, the deliberate acquisition of competence in physiological breech birth included stages of affinity with physiological birth, critical awareness, intention, identity and responsibility. Expert practitioners operating across local and national boundaries guided less experienced practitioners. The results depict a specialist learning model which could be formalised in sympathetic training programmes, and evaluated. It may also be relevant to developing competence in other specialist/expert roles and innovative practices. Deliberate development of local communities of practice may support professionals to acquire elusive breech skills in a sustainable way. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Secure software practices among Malaysian software practitioners: An exploratory study

NASA Astrophysics Data System (ADS)

Mohamed, Shafinah Farvin Packeer; Baharom, Fauziah; Deraman, Aziz; Yahya, Jamaiah; Mohd, Haslina

2016-08-01

Secure software practices is increasingly gaining much importance among software practitioners and researchers due to the rise of computer crimes in the software industry. It has become as one of the determinant factors for producing high quality software. Even though its importance has been revealed, its current practice in the software industry is still scarce, particularly in Malaysia. Thus, an exploratory study is conducted among software practitioners in Malaysia to study their experiences and practices in the real-world projects. This paper discusses the findings from the study, which involved 93 software practitioners. Structured questionnaire is utilized for data collection purpose whilst statistical methods such as frequency, mean, and cross tabulation are used for data analysis. Outcomes from this study reveal that software practitioners are becoming increasingly aware on the importance of secure software practices, however, they lack of appropriate implementation, which could affect the quality of produced software.

In-space fabrication of thin-film structures

NASA Technical Reports Server (NTRS)

Lippman, M. E.

1972-01-01

A conceptual study of physical vapor-deposition processes for in-space fabrication of thin-film structures is presented. Potential advantages of in-space fabrication are improved structural integrity and surface reflectivity of free-standing ultra-thin films and coatings. Free-standing thin-film structures can find use as photon propulsion devices (solar sails). Other applications of the concept involve free-standing shadow shields, or thermal control coatings of spacecraft surfaces. Use of expendables (such as booster and interstage structures) as source material for the physical vapor deposition process is considered. The practicability of producing thin, textured, aluminum films by physical vapor deposition and subsequent separation from a revolving substrate is demonstrated by laboratory experiments. Heating power requirement for the evaporation process is estimated for a specific mission.

Use of after action reports (AARs) to promote organizational and systems learning in emergency preparedness.

PubMed

Savoia, Elena; Agboola, Foluso; Biddinger, Paul D

2012-08-01

Many public health and healthcare organizations use formal knowledge management practices to identify and disseminate the experiences gained over time. The "lessons-learned" approach is one such example of knowledge management practice applied to the wider concept of organizational learning. In the field of emergency preparedness, the lessons-learned approach stands on the assumption that learning from experience improves practice and minimizes avoidable deaths and negative economic and social consequences of disasters. In this project, we performed a structured review of AARs to analyze how lessons learned from the response to real-incidents may be used to maximize knowledge management and quality improvement practices such as the design of public health emergency preparedness (PHEP) exercises. We chose as a source of data the "Lessons Learned Information Sharing (LLIS.gov)" system, a joined program of the U.S. Department of Homeland Security DHS and FEMA that serves as the national, online repository of lessons learned, best practices, and innovative ideas. We identified recurring challenges reported by various states and local public health agencies in the response to different types of incidents. We also strove to identify the limitations of systematic learning that can be achieved due to existing weaknesses in the way AARs are developed.

The experience of Australian project leaders in encouraging practitioners to adopt research evidence in their clinical practice.

PubMed

Henderson, Amanda J; Davies, Jan; Willet, Michaela R

2006-11-01

This paper describes a qualitative program evaluation which sought to identify factors that either assist or impede the adoption of clinical evidence in everyday practice. Thirteen Australian projects were funded in a competitive grant program to adopt innovative strategies to improve the uptake of research evidence in everyday clinical practice. Project leaders' reports were analysed to collate common themes related to 1) critical elements in successful application of research knowledge, 2) barriers to implementing evidence, and 3) lessons for other organisations that might implement a similar project. Despite the diversity of the methods used to establish projects and the range of topics and clinical settings, many similarities were identified in the perceived critical success elements, barriers, and lessons for adopting clinical evidence. Eighteen themes emerged across the data including: leadership support; key stakeholder involvement; practice changes; communication; resources; education of staff; evaluation of outcomes; consumers; knowledge gaps; adoption/implementing staff; access to knowledge; risk assessment; collaboration; effectiveness of clinical research evidence; structure/organisation; cultural barriers; previous experiences; and information technology. Leaders of projects to adopt evidence in clinical practice identified barriers, critical success elements and lessons that impacted on their projects. A range of influences on the adoption of evidence were identified, and this knowledge can be used to assist others undertaking similar projects.

Use of After Action Reports (AARs) to Promote Organizational and Systems Learning in Emergency Preparedness

PubMed Central

Savoia, Elena; Agboola, Foluso; Biddinger, Paul D.

2012-01-01

Many public health and healthcare organizations use formal knowledge management practices to identify and disseminate the experiences gained over time. The “lessons-learned” approach is one such example of knowledge management practice applied to the wider concept of organizational learning. In the field of emergency preparedness, the lessons-learned approach stands on the assumption that learning from experience improves practice and minimizes avoidable deaths and negative economic and social consequences of disasters. In this project, we performed a structured review of AARs to analyze how lessons learned from the response to real-incidents may be used to maximize knowledge management and quality improvement practices such as the design of public health emergency preparedness (PHEP) exercises. We chose as a source of data the “Lessons Learned Information Sharing (LLIS.gov)” system, a joined program of the U.S. Department of Homeland Security DHS and FEMA that serves as the national, online repository of lessons learned, best practices, and innovative ideas. We identified recurring challenges reported by various states and local public health agencies in the response to different types of incidents. We also strived to identify the limitations of systematic learning that can be achieved due to existing weaknesses in the way AARs are developed. PMID:23066408

Lessons learned from the implementation of an online infertility community into an IVF clinic's daily practice.

PubMed

Aarts, Johanna W M; Faber, Marjan J; Cohlen, Ben J; Van Oers, Anne; Nelen, WillianNe L D M; Kremer, Jan A M

2015-01-01

The Internet is expected to innovate healthcare, in particular patient-centredness of care. Within fertility care, information provision, communication with healthcare providers and support from peers are important components of patient-centred care. An online infertility community added to an in vitro fertilisation or IVF clinic's practice provides tools to healthcare providers to meet these. This study's online infertility community facilitates peer-to-peer support, information provision to patients and patient provider communication within one clinic. Unfortunately, these interventions often fail to become part of clinical routines. The analysis of a first introduction into usual care can provide lessons for the implementation in everyday health practice. The aim was to explore experiences of professionals and patients with the implementation of an infertility community into a clinic's care practice. We performed semi-structured interviews with both professionals and patients to collect these experiences. These interviews were analyzed using the Normalisation Process Model. Assignment of a community manager, multidisciplinary division of tasks, clear instructions to staff in advance and periodical evaluations could contribute to the integration of this online community. Interviews with patients provided insights into the possible impact on daily care. This study provides lessons to healthcare providers on the implementation of an online infertility community into their practice.

A novel constant-force scanning probe incorporating mechanical-magnetic coupled structures.

PubMed

Wang, Hongxi; Zhao, Jian; Gao, Renjing; Yang, Yintang

2011-07-01

A one-dimensional scanning probe with constant measuring force is designed and fabricated by utilizing the negative stiffness of the magnetic coupled structure, which mainly consists of the magnetic structure, the parallel guidance mechanism, and the pre-stressed spring. Based on the theory of material mechanics and the equivalent surface current model for computing the magnetic force, the analytical model of the scanning probe subjected to multi-forces is established, and the nonlinear relationship between the measuring force and the probe displacement is obtained. The practicability of introducing magnetic coupled structure in the constant-force probe is validated by the consistency of the results in numerical simulation and experiments.

Costs associated with data collection and reporting for diabetes quality improvement in primary care practices: a report from SNOCAP-USA.

PubMed

West, David R; Radcliff, Tiffany A; Brown, Tiffany; Cote, Murray J; Smith, Peter C; Dickinson, W Perry

2012-01-01

Information about the costs and experiences of collecting and reporting quality measure data are vital for practices deciding whether to adopt new quality improvement initiatives or monitor existing initiatives. Six primary care practices from Colorado's Improving Performance in Practice program participated. We conducted structured key informant interviews with Improving Performance in Practice coaches and practice managers, clinicians, and staff and directly observed practices. Practices had 3 to 7 clinicians and 75 to 300 patients with diabetes, half had electronic health records, and half were members of an independent practice association. The estimated per-practice cost of implementation for the data collection and reporting for the diabetes quality improvement program was approximately $15,552 per practice (about $6.23 per diabetic patient per month). The first-year maintenance cost for this effort was approximately $9,553 per practice ($3.83 per diabetic patient per month). The cost of implementing and maintaining a diabetes quality improvement effort that incorporates formal data collection, data management, and reporting is significant and quantifiable. Policymakers must become aware of the financial and cultural impact on primary care practices when considering value-based purchasing initiatives.

General practitioners' views on leadership roles and challenges in primary health care: a qualitative study.

PubMed

Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C

2017-03-01

To explore general practitioners' (GPs) views on leadership roles and leadership challenges in general practice and primary health care. We conducted focus groups (FGs) with 17 GPs. Norwegian primary health care. 17 GPs who attended a 5 d course on leadership in primary health care. Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical and leadership role. GPs recognized the need to take on leadership roles in primary care, but their lack of leadership training and credentials, and the way in which their practices were organized and financed were barriers towards their involvement. GPs experience tensions between the clinical and leadership role and note a lack of leadership training and awareness. There is a need for a more structured educational and career path for GPs, in which doctors are offered training and preparation in advance. KEY POINTS Little is known about doctors' experiences and views about leadership in general practice and primary health care. Our study suggests that: There is a lack of preparation and formal training for the leadership role. GPs experience tensions between the clinical and leadership role. GPs recognize leadership challenges at a system level and that doctors should take on leadership roles in primary health care.

Nurses' experiences of practice and political reform in long-term aged care in Australia: implications for the retention of nursing personnel.

PubMed

Venturato, Lorraine; Kellett, Ursula; Windsor, Carol

2007-01-01

The aim of the study was to explore registered nurses' experiences in long-term aged care in light of the political reform of aged care services in Australia. In Australia, the aged care industry has undergone a lengthy period of political and structural reform. Despite reviews into various aspects of these reforms, there has been little consideration of the effect these are having on the practice experiences and retention of nursing staff in long-term care. In this critical hermeneutic study, 14 nurses from long-term care facilities in Australia were interviewed about their experiences during the reform period. The data revealed a sense of tension and conflict between nurses' traditional values, roles and responsibilities and those supported by the reforms. Nurses struggled to re-negotiate both their practice roles and values as the reforms were implemented and the system evolved. Nursing management support was an important aspect in mediating the effect of reforms on nursing staff. This research highlights both the tensions experienced by nurses in long-term aged care in Australia and the need to re-negotiate nursing roles, responsibilities and values within an evolving care system. This research supports a role for sensitive and proactive nursing management during periods of industry reform as a retention strategy for qualified nursing personnel.

General practitioners’ views on leadership roles and challenges in primary health care: a qualitative study

PubMed Central

Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C.

2017-01-01

Objective To explore general practitioners’ (GPs) views on leadership roles and leadership challenges in general practice and primary health care. Design We conducted focus groups (FGs) with 17 GPs. Setting Norwegian primary health care. Subjects 17 GPs who attended a 5 d course on leadership in primary health care. Results Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical and leadership role. GPs recognized the need to take on leadership roles in primary care, but their lack of leadership training and credentials, and the way in which their practices were organized and financed were barriers towards their involvement. Conclusions GPs experience tensions between the clinical and leadership role and note a lack of leadership training and awareness. There is a need for a more structured educational and career path for GPs, in which doctors are offered training and preparation in advance. Key points Little is known about doctors’ experiences and views about leadership in general practice and primary health care. Our study suggests that: There is a lack of preparation and formal training for the leadership role. GPs experience tensions between the clinical and leadership role. GPs recognize leadership challenges at a system level and that doctors should take on leadership roles in primary health care. PMID:28277051

Establishing the boundaries and building bridges: a literature review on ecological theory: implications for research into the refugee parenting experience.

PubMed

Williams, Nombasa

2010-03-01

Currently an ecological model for conceptualizing and capturing the refugee parenting experience is lacking. After an extensive review of the literature related to the usages of Bronfenbrenner's ecological model of child development, a gap was found in knowledge and research centred on describing the environment of pre-resettlement (i.e. pre-flight, flight, migration, camp) contexts and their impact on refugee parents and carer experiences. The culture of the refugee parenting experience may be characterized by disruptions in and alterations to family structure and organization; values and norms; and gender roles. This paper begins by examining the definition and usages of existing ecological frameworks in the 20th and 21st century. Particular attention is drawn to the gaps in the existing literature and an ecological model is offered. The paper concludes with a discussion of the implications for practice. The outcomes of this paper suggest the need for practitioners, policymakers and researchers to engage and develop culturally competent, relevant and appropriate interventions (i.e. reconciling differing beliefs and behaviours concerning child-rearing practices; affirming positive parenting practices of these families during engagement protocols and processes; adopting a strengths-based orientation) in the area of child protection whilst at the same time safeguarding and promoting the welfare of children within pre- and post-resettlement contexts.

Faculty internships in environmental health: planning and implementation.

PubMed

Bermúdez, Eliezer

2005-12-01

Faculty internships, in which a faculty member works temporarily for a government organization or a private business, are a concept that is becoming popular at universities. This paper discusses how a faculty internship can be developed and implemented, and it reports on the advantages of the internship for academia, the sponsoring institution, and the professor. In addition, suggestions on structuring and implementing the internship are offered. The major objective of the paper is to encourage environmental health educators to seriously consider faculty internships as a means of bridging the gaps between academia and the business world. Faculty internships should be beneficial primarily for two groups of professors. First are those professors who, after earning doctorates, enter the teaching profession without any environmental health practicum experience. Second are those who once worked full time as environmental health practitioners but have been out of the field for a significant number of years with little or no contact with the "real world" of environmental health practice. The information presented is based on the experience of the author, who served as a faculty intern for the environmental health division of a county health department in rural west-central Indiana, Some of the benefits of faculty internships are improved teaching methods, practical experience, community contacts, and increased internship opportunities for students. The experience can enhance classroom theory for students, and the implementation of practice can be clarified for the educator.

Alternatives to the face-to-face consultation in general practice: focused ethnographic case study.

PubMed

Atherton, Helen; Brant, Heather; Ziebland, Sue; Bikker, Annemieke; Campbell, John; Gibson, Andy; McKinstry, Brian; Porqueddu, Tania; Salisbury, Chris

2018-04-01

NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the 'one sheet of paper' mind-map method to identify the line of argument in each thematic report. Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other's practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal. Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team. © British Journal of General Practice 2018.

Water quality, health, and human occupations.

PubMed

Blakeney, Anne B; Marshall, Amy

2009-01-01

To introduce evidence of the critical link between water quality and human occupations. A participatory action research design was used to complete a three-phase project. Phase 1 included mapping the watershed of Letcher County, Kentucky. Phase 2 consisted of surveying 122 Letcher County health professionals. Phase 3, the primary focus of this article, consisted of interviews with Letcher County adults regarding their lived experiences with water. The Occupational Therapy Practice Framework: Domain and Process (American Occupational Therapy Association, 2002) was used to structure questions. The Model of Occupational Justice provided the theoretical framework for presentation of the results. The watershed in Letcher County, Kentucky, is polluted as a result of specific coal mining practices and a lack of adequate infrastructure. As a result, citizens experience occupational injustice in the forms of occupational imbalance, occupational deprivation, and occupational alienation.

The quest for better quality-of-life - learning from large-scale shaking table tests

NASA Astrophysics Data System (ADS)

Nakashima, M.; Sato, E.; Nagae, T.; Kunio, F.; Takahito, I.

2010-12-01

Earthquake engineering has its origins in the practice of “learning from actual earthquakes and earthquake damages.” That is, we recognize serious problems by witnessing the actual damage to our structures, and then we develop and apply engineering solutions to solve these problems. This tradition in earthquake engineering, i.e., “learning from actual damage,” was an obvious engineering response to earthquakes and arose naturally as a practice in a civil and building engineering discipline that traditionally places more emphasis on experience than do other engineering disciplines. But with the rapid progress of urbanization, as society becomes denser, and as the many components that form our society interact with increasing complexity, the potential damage with which earthquakes threaten the society also increases. In such an era, the approach of ”learning from actual earthquake damages” becomes unacceptably dangerous and expensive. Among the practical alternatives to the old practice is to “learn from quasi-actual earthquake damages.” One tool for experiencing earthquake damages without attendant catastrophe is the large shaking table. E-Defense, the largest one we have, was developed in Japan after the 1995 Hyogoken-Nanbu (Kobe) earthquake. Since its inauguration in 2005, E-Defense has conducted over forty full-scale or large-scale shaking table tests, applied to a variety of structural systems. The tests supply detailed data on actual behavior and collapse of the tested structures, offering the earthquake engineering community opportunities to experience and assess the actual seismic performance of the structures, and to help society prepare for earthquakes. Notably, the data were obtained without having to wait for the aftermaths of actual earthquakes. Earthquake engineering has always been about life safety, but in recent years maintaining the quality of life has also become a critical issue. Quality-of-life concerns include nonstructural damage, business continuity, public health, quickness of damage assessment, infrastructure, data and communication networks, and other issues, and not enough useful empirical data have emerged about these issues from the experiences of actual earthquakes. To provide quantitative data that can be used to reduce earthquake risk to our quality of life, E-Defense recently has been implementing two comprehensive research projects in which a base-isolated hospital and a steel high-rise building were tested using the E-Defense shaking table and their seismic performance were examined particularly in terms of the nonstructural damage, damage to building contents and furniture, and operability, functionality, and business-continuity capability. The paper presents the overview of the two projects, together with major findings obtained from the projects.

Faculty development through simulation-based education in physical therapist education.

PubMed

Greenwood, Kristin Curry; Ewell, Sara B

2018-01-01

The use of simulation-based education (SBE) in health professions, such as physical therapy, requires faculty to expand their teaching practice and development. The impact of this teaching on the individual faculty member, and how their teaching process changes or develops, is not fully understood. The purpose of this study was to explore individual physical therapist faculty members' experience with SBE and how those experiences may have transformed their teaching practice to answer the research questions: How do physical therapist faculty develop through including SBE and are there commonalities among educators? An interpretive phenomenological analysis approach was used with a small sample of subjects who participated in three individual semi-structured interviews. Interview questions were created through the lens of transformative learning theory to allow faculty transformations to be uncovered. A two-step thematic coding process was conducted across participants to identify commonalities of faculty experiences with SBE in physical therapist education. Credibility and trustworthiness were achieved through member checking and expert external review. Thematic findings were validated with transcript excerpts and research field notes. Eight physical therapist faculty members (25% male) with a range of 3 to 16 years of incorporating SBE shared their individual experiences. Four common themes related to faculty development were identified across the participants. Themes identified are the following: faculty strengthen their professional identity as physical therapists, faculty are affected by their introduction and training with simulation, faculty develop their interprofessional education through SBE, and faculty experiences with SBE facilitate professional growth. Physical therapist educators had similarities in their experiences with SBE that transformed their teaching practice and professional development. This study provides insight into what physical therapist faculty may experience when adopting SBE.

Bridging the gap between guidelines and practice in the management of emerging infectious diseases: a qualitative study of emergency nurses.

PubMed

Lam, Stanley Kk; Kwong, Enid Wy; Hung, Maria Sy; Pang, Samantha Mc

2016-10-01

To explore the difficulties and strategies regarding guideline implementation among emergency nurses. Emerging infectious diseases remain an underlying source of global health concern. Guidelines for accident and emergency departments would require adjustments for infectious disease management. However, disparities between guidelines and nurses' practice are frequently reported, which undermines the implementation of these guidelines into practice. This article explores the experience of frontline emergency nurses regarding guideline implementation and provides an in-depth account of their strategies in bridging guideline-practice gaps. A qualitative descriptive design was used. Semi-structured, face-to-face, individual interviews were conducted between November 2013-May 2014. A purposive sample of 12 frontline emergency nurses from five accident and emergency departments in Hong Kong were recruited. The audio-recorded interviews were transcribed verbatim and analysed with a qualitative content analysis approach. Four key categories associated with guideline-practice gaps emerged, including getting work done, adapting to accelerated infection control measures, compromising care standards and resolving competing clinical judgments across collaborating departments. The results illustrate that the guideline-practice gaps could be associated with inadequate provision of corresponding organisational supports after guidelines are established. The nurses' experiences have uncovered the difficulties in the implementation of guidelines in emergency care settings and the corresponding strategies used to address these problems. The nurses' experiences reflect their endeavour in adjusting accordingly and adapting themselves to their circumstances in the face of unfeasible guidelines. It is important to customise guidelines to the needs of frontline nurses. Maintaining cross-departmental consensus on guideline interpretation and operation is also indicated as an important component for effective guideline implementation. © 2016 John Wiley & Sons Ltd.

The application and improvement of Fourier transform spectrometer experiment

NASA Astrophysics Data System (ADS)

Liu, Zhi-min; Gao, En-duo; Zhou, Feng-qi; Wang, Lan-lan; Feng, Xiao-hua; Qi, Jin-quan; Ji, Cheng; Wang, Luning

2017-08-01

According to teaching and experimental requirements of Optoelectronic information science and Engineering, in order to consolidate theoretical knowledge and improve the students practical ability, the Fourier transform spectrometer ( FTS) experiment, its design, application and improvement are discussed in this paper. The measurement principle and instrument structure of Fourier transform spectrometer are introduced, and the spectrums of several common Laser devices are measured. Based on the analysis of spectrum and test, several possible improvement methods are proposed. It also helps students to understand the application of Fourier transform in physics.

Teaching 'origins of depth psychology': overview and candidate-members' experience.

PubMed

Hinton, Ladson

2008-02-01

In 2002 the North Pacific Institute inaugurated a new seminar series on the 'origins of depth psychology' for incoming candidate-members. This approach emphasized the historical and cultural embeddedness of analytic theory, practice and institutions. The seminar was experienced as enlightening and freeing, as well as sometimes painfully disillusioning. The overall feedback indicated that it fostered an opening of creative space for their education as analysts. This paper describes the structure, and some of the rationale and process of the seminar. It includes firsthand expressions of the candidate-members' experiences.

A conceptual framework for international service-learning course planning: promoting a foundation for ethical practice in the physical therapy and occupational therapy professions.

PubMed

Lattanzi, Jill Black; Pechak, Celia

2011-01-01

As physical therapy (PT) and occupational therapy (OT) educational programs endeavor to foster core values of social responsibility, justice, and altruism in an increasingly global community, the incorporation of local and international service-learning (ISL) into the curriculum is growing. Much of the research has focused on the measurement of student learning, with little written about the impact on the host community. Proponents of global health initiatives are calling for consideration of all stakeholders to ensure ethical practice. This paper explores the current literature related to PT and OT ISL and builds a conceptual framework for ISL course planning. The essential phases in the framework include: 1) pre-experience planning/preparation stage, 2) field immersion experience stage, and 3) postexperience stage. The essential elements are: 1) cultural competency training, 2) communication and coordination with community, 3) comprehensive assessment, and 4) strategic planning. The authors suggest this framework as a practical tool to structure ISL courses with an explicit emphasis on ethical concerns. Additionally, they seek to foster more dialogue and action related to the promotion of ethical practices in ISL in PT and OT education programs.

Learning about general practice through qualitative interviews: lessons from a seminar course with medical students.

PubMed

von Unger, Hella; Werwick, Katrin; Lichte, Thomas; Herrmann, Markus

2010-01-01

A seminar course was developed in order to train medical students in qualitative research methods, while providing an introduction to the field of General Practice. Students were enabled to conduct semi-structured interviews with general practitioners (GPs), during which they learned about the prevention, diagnosis, and treatment of frequently encountered medical problems. The course was carried out four times at two universities in Germany. The study explores the students' learning experiences focusing on their research experience. Data were collected in four focus groups and analyzed. The students perceived the course as very different from their usual medical education. This was appreciated, but also caused some difficulties. Three themes emerged: (1) Missing 'facts', (2) New horizons: 'Thinking outside the box', and (3) The challenge of interpretation: 'Reading between the lines'. Learning qualitative research methods can be particularly challenging for medical students as the tasks and epistemology of qualitative research run counter to the usual learning formats and research paradigms in medical education. When teaching qualitative research, special care should be taken to address the cognitive dissonance experienced by students and to explain the unique contribution of qualitative research to medical practice and the field of General Practice especially.

Knowledge, experience and practice of SLTs regarding (re)habilitation in deaf children with cochlear implants.

PubMed

Okalidou, Areti; Kitsona, Mariana; Anagnostou, Flora; Tsoukala, Marinella; Santzakli, Stella; Gouda, Stamatia; Nikolopoulos, Thomas P

2014-07-01

To assess the knowledge, experience and practices of speech and language therapists (SLTs) in Greece regarding children with cochlear implants. A special designed questionnaire was originally completed electronically by 313 SLTs via surveymonkey platform. From the 313 respondents 35% had worked with implanted children, 37% received course training and 44% had participated in post-graduate seminars. Although 96% believe that there are differences in the management of these children, almost 47% of the participants did not have adequate knowledge on the candidacy criteria for implantation and 70% regarding the available technology for implanted children. Knowledge and skills on CI were better for those SLTs who worked with hearing-impairment. Diverse practice models were noted. Interestingly, more than 87% of the participants advocated toward further training and supervision in the field, even the ones who had less than extensive knowledge in working with CI. As for practice, a lack of organizational interdisciplinary structure became evident. There is a growing need for well organized professional training and team networks for SLTs in order for them to further improve their knowledge and service delivery to implanted children. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Drama as a pedagogical tool for practicing death notification-experiences from Swedish medical students.

PubMed

Nordström, Anna; Fjellman-Wiklund, Anncristine; Grysell, Tomas

2011-09-28

One of the toughest tasks in any profession is the deliverance of death notification. Marathon Death is an exercise conducted during the fourth year of medical school in northern Sweden to prepare students for this responsibility. The exercise is designed to enable students to gain insight into the emotional and formal procedure of delivering death notifications. The exercise is inspired by Augusto Boal's work around Forum Theatre and is analyzed using video playback. The aim of the study was to explore reflections, attitudes and ideas toward training in delivering death notifications among medical students who participate in the Marathon Death exercise based on forum play. After participation in the Marathon Death exercise, students completed semi-structured interviews. The transcribed interviews were analyzed using the principles of qualitative content analysis including a deductive content analysis approach with a structured matrix based on Bloom's taxonomy domains. The Marathon Death exercise was perceived as emotionally loaded, realistic and valuable for the future professional role as a physician. The deliverance of a death notification to the next of kin that a loved one has died was perceived as difficult. The exercise conjured emotions such as positive expectations and sheer anxiety. Students perceived participation in the exercise as an important learning experience, discovering that they had the capacity to manage such a difficult situation. The feedback from the video playback of the exercise and the feedback from fellow students and teachers enhanced the learning experience. The exercise, Marathon Death, based on forum play with video playback is a useful pedagogical tool that enables students to practice delivering death notification. The ability to practice under realistic conditions contributes to reinforce students in preparation for their future professional role.

A Review of Distributed Optical Fiber Sensors for Civil Engineering Applications

PubMed Central

Barrias, António; Casas, Joan R.; Villalba, Sergi

2016-01-01

The application of structural health monitoring (SHM) systems to civil engineering structures has been a developing studied and practiced topic, that has allowed for a better understanding of structures’ conditions and increasingly lead to a more cost-effective management of those infrastructures. In this field, the use of fiber optic sensors has been studied, discussed and practiced with encouraging results. The possibility of understanding and monitor the distributed behavior of extensive stretches of critical structures it’s an enormous advantage that distributed fiber optic sensing provides to SHM systems. In the past decade, several R & D studies have been performed with the goal of improving the knowledge and developing new techniques associated with the application of distributed optical fiber sensors (DOFS) in order to widen the range of applications of these sensors and also to obtain more correct and reliable data. This paper presents, after a brief introduction to the theoretical background of DOFS, the latest developments related with the improvement of these products by presenting a wide range of laboratory experiments as well as an extended review of their diverse applications in civil engineering structures. PMID:27223289

The scope of private practice nursing in an Australian sample.

PubMed

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.

The field of medical anthropology in Social Science & Medicine.

PubMed

Panter-Brick, Catherine; Eggerman, Mark

2018-01-01

Conceptually and methodologically, medical anthropology is well-positioned to support a "big-tent" research agenda on health and society. It fosters approaches to social and structural models of health and wellbeing in ways that are critically reflective, cross-cultural, people-centered, and transdisciplinary. In this review article, we showcase these four main characteristics of the field, as featured in Social Science & Medicine over the last fifty years, highlighting their relevance for an international and interdisciplinary readership. First, the practice of critical inquiry in ethnographies of health offers a deep appreciation of sociocultural viewpoints when recording and interpreting lived experiences and contested social worlds. Second, medical anthropology champions cross-cultural breadth: it makes explicit local understandings of health experiences across different settings, using a fine-grained, comparative approach to develop a stronger global platform for the analysis of health-related concerns. Third, in offering people-centered views of the world, anthropology extends the reach of critical enquiry to the lived experiences of hard-to-reach population groups, their structural vulnerabilities, and social agency. Finally, in developing research at the nexus of cultures, societies, biologies, and health, medical anthropologists generate new, transdisciplinary conversations on the body, mind, person, community, environment, prevention, and therapy. As featured in this journal, scholarly contributions in medical anthropology seek to debate human health and wellbeing from many angles, pushing forward methodology, social theory, and health-related practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mobile Devices and Apps as Scaffolds to Science Learning in the Primary Classroom

NASA Astrophysics Data System (ADS)

Falloon, Garry

2017-12-01

Considerable work over many years has explored the contribution technology can make to science learning, at all levels of education. In the school sector, historically this has focused on the use of fixed, desktop-based or semi-mobile laptop systems for purposes such as experiment data collection or analysis, or as a means of engaging or motivating interest in science. However, the advent of mobile devices such as iPads supported by a huge array of low or no cost apps, means that new opportunities are becoming available for teachers to explore how these resources may be useful for supporting `hands on' science learning. This article reports outcomes from a study of primary (elementary) school students' use of a series of apps integrated with practical science activities, in a topic exploring Energy concepts. It used an innovative display capture tool to examine how the students used the apps and features of their iPads to scaffold their practical work at different stages during the experiments. Results identify device functions and app-based scaffolds that assisted these students to structure their experiments, understand procedures, think about the influence of variables and communicate and share outcomes. However, they also discovered limitations in the apps' ability to support conceptual knowledge development, identifying the critical role of teachers and the importance of task structure and design to ensuring conceptual knowledge objectives are met.

What happens when doctors are patients? Qualitative study of GPs.

PubMed

Fox, Fiona; Harris, Michael; Taylor, Gordon; Rodham, Karen; Sutton, Jane; Robinson, Brian; Scott, Jenny

2009-11-01

Current evidence about the experiences of doctors who are unwell is limited to poor quality data. To investigate GPs' experiences of significant illness, and how this affects their own subsequent practice. Qualitative study using interpretative phenomenological analysis to conduct and analyse semi-structured interviews with GPs who have experienced significant illness. Two primary care trusts in the West of England. A total of 17 GPs were recruited to take part in semi-structured interviews which were conducted and analysed using interpretative phenomenological analysis Results: Four main categories emerged from the data. The category, 'Who cares when doctors are ill?' embodies the tension between perceptions of medicine as a 'caring profession' and as a 'system'. 'Being a doctor-patient' covers the role ambiguity experienced by doctors who experience significant illness. The category 'Treating doctor-patients' reveals the fragility of negotiating shared medical care. 'Impact on practice' highlights ways in which personal illness can inform GPs' understanding of being a patient and their own consultation style. Challenging the culture of immunity to illness among GPs may require interventions at both individual and organisational levels. Training and development of doctors should include opportunities to consider personal health issues as well as how to cope with role ambiguity when being a patient and when treating doctor-patients. Guidelines about being and treating doctor-patients need to be developed, and GPs need easy access to an occupational health service.

Aspects of design, structure, performance and operation of reed beds--eight years' experience in northeastern New South Wales, Australia.

PubMed

Davison, L; Headley, T; Pratt, K

2005-01-01

Reed beds (horizontal subsurface flow constructed wetlands) have been employed as secondary treatment devices in on-site and decentralised wastewater management systems in the northeast of the Australian state of New South Wales (NSW) for over a decade. This paper summarises some of the practical and research findings that have come to light in that time. Experience with various aspects of reed bed structure is discussed. A study of the evaporative performance of four small beds planted with Phragmites australis yielded an annual crop factor of 2.6. A total of 28 studies on reed beds treating a variety of commonly encountered wastewater streams yielded the following mean pollutant removal efficiencies: total suspended solids (TSS) 83%, biochemical oxygen demand (BOD) 81%, total nitrogen (TN) 57%, total phosphorus (TP) 35% and faecal coliforms (FC) 1.9 logs. The reed bed is becoming the preferred on-site technology for removing TN and BOD and polishing TSS from primary settled domestic wastewater. Sizing beds for a residence time of approximately five days has become standard practice. A study of six reed beds found six different species of earthworm present, mainly Perionyx excavatus (Indian Blue). A mesocosm experiment subsequently showed that the worms were translocating clogging material from the substrate interstices to the surface of the bed thereby indicating a possible method for prolonging reed bed life.

Subjective experience or objective process: understanding the gap between values and practice for involving patients in designing patient-centred care.

PubMed

Lord, Laura; Gale, Nicola

2014-01-01

Patient-centred care and patient involvement are increasingly central concepts in health policy in the UK and elsewhere. However, there is little consensus regarding their definition or how to achieve "patient-centred" care in everyday practice or how to involve patients in service redesign initiatives. The purpose of this paper is to explore these issues from the perspective of key stakeholders within National Health Service (NHS) hospitals in the UK. Semi-structured interviews, covering a range of topics related to service redesign, were conducted with 77 key stakeholders across three NHS Trusts in the West Midlands. In total, 20 of these stakeholders were re-interviewed 18 months later. Data were managed and analysed using the Framework Method. While patient-centred care and patient involvement were regularly cited as important to the stakeholders, a gap persisted between values and reported practice. This gap is explained through close examination of the ways in which the concepts were used by stakeholders, and identifying the way in which they were adapted to fit other organizational priorities. The value placed on positive subjective experience changed to concerns about objective measurement of the patients as they move through the system. Increased awareness and reflection on the conceptual tensions between objective processes and subjective experiences could highlight reasons why patient-centred values fail to translate into improved practice. The paper describes and explains a previously unarticulated tension in health organisations between values and practice in patient centred care and patient involvement in service redesign.

Superresolution microscopy for microbiology

PubMed Central

Coltharp, Carla; Xiao, Jie

2014-01-01

Summary This review provides a practical introduction to superresolution microscopy from the perspective of microbiological research. Because of the small sizes of bacterial cells, superresolution methods are particularly powerful and suitable for revealing details of cellular structures that are not resolvable under conventional fluorescence light microscopy. Here we describe the methodological concepts behind three major categories of super-resolution light microscopy: photoactivated localization microscopy (PALM) and stochastic optical reconstruction microscopy (STORM), structured illumination microscopy (SIM) and stimulated emission-depletion (STED) microscopy. We then present recent applications of each of these techniques to microbial systems, which have revealed novel conformations of cellular structures and described new properties of in vivo protein function and interactions. Finally, we discuss the unique issues related to implementing each of these superresolution techniques with bacterial specimens and suggest avenues for future development. The goal of this review is to provide the necessary technical background for interested microbiologists to choose the appropriate super-resolution method for their biological systems, and to introduce the practical considerations required for designing and analysing superresolution imaging experiments. PMID:22947061

The Framing of Women and Health Disparities: A Critical Look at Race, Gender, and Class from the Perspectives of Grassroots Health Communicators.

PubMed

Vardeman-Winter, Jennifer

2017-05-01

As women's health has received significant political and media attention recently, I proposed an expanded structural theory of women's communication about health. Women's health communication and critical race and systemic racism research framed this study. I interviewed 15 communicators and community health workers from grass-roots organizations focused on women's health to learn of their challenges of communicating with women from communities experiencing health disparities. Findings suggest that communicators face difficulties in developing meaningful messaging for publics because of disjunctures between medical and community frames, issues in searching for health among women's many priorities, Whiteness discourses imposed on publics' experiences, and practices of correcting for power differentials. A structural theory of women's health communication, then, consists of tenets around geographic, research/funding, academic/industry, and social hierarchies. Six frames suggesting racial biases about women and health disparities are also defined. This study also includes practical solutions in education, publishing, and policy change for addressing structural challenges.

Subinternship in Radiology - A Practical Start to the Specialization?

PubMed

Kasch, R; Wirkner, J; Hosten, N; Hinz, P; Napp, M; Kessler, R

2016-11-01

Purpose: To identify factors influencing medical students to choose radiology in the four-month clinical elective in the final year of medical school following radiology subinternships. Materials and Methods: A subsample of medical students in a nationwide German online survey evaluated a subinternship in radiology (19 items). They were divided into four groups: Students who could imagine doing a clinical elective in radiology in the practical year based on their experiences during the subinternship ("yes, based on subinternship"), students who could not ("no, based on subinternship") and students who had made this decision prior to the subinternship ("yes, prior to subinternship" and "no, prior to subinternship"). Results: 94 medical students evaluated a radiology subinternship (54.4 % females). Based on their experiences during the subinternship, 54 students (57.4 %) intended to do a final year clinical elective in radiology, 39 of them (41.5 %) being encouraged by the subinternship. 40 (42.6 %) reported having a negative attitude towards a clinical elective in radiology, 16 of them (17.0 %) having made this decision based on their subinternship experience. Groups did not differ regarding gender (p = 0.396) and age (p = 0.853). Students motivated to do a final year clinical elective in radiology experienced excellent academic teaching (p = 0.001) and practical involvement (p = 0.003), achieved their learning goals more often (p = 0.001), were better integrated into the team (p = 0.001), and acquired more practical skills (p = 0.003). Overall satisfaction was higher in these groups (p = 0.001). Conclusion: Satisfaction with a radiology subinternship is crucial for motivating medical students to do a final year clinical elective in radiology. A structured subinternship and continuous mentoring should be targeted to keep students connected to radiology. Key Points: • Radiology subinternships influence further interest in the specialization.• The quality and structure of teaching critically influence student satisfaction.• Team integration and practical involvement positively affect the attitude towards a specialization. Citation Format: • Kasch R, Wirkner J, Hosten N et al. Subinternship in Radiology - A Practical Start to the Specialization? Fortschr Röntgenstr 2016; 188: 1024 - 1030. © Georg Thieme Verlag KG Stuttgart · New York.

(abstract) Oblique Insonification Ultrasonic NDE of Composite Materials for Space Applications

NASA Technical Reports Server (NTRS)

Bar-Cohen, Y.; Lih, S. S.; Mal, A. K.

1997-01-01

In recent years, a great deal of research has been exerted to developing NDE methods for the characterization of the material properties of composites as well as other space structural materials. The need for information about such parameters as the elastic properties, density, and thickness are critical to the safe design and operation of such structural materials. Ultrasonics using immersion methods has played an important role in these efforts due to its capability, cost effectiveness, and ease of use. The authors designed a series of ultrasonic oblique insonification experiments in order to develop a practical field applicable NDE method for space structures.

Phenomenological analysis of patient experiences of medical student teaching encounters.

PubMed

McLachlan, Emma; King, Nigel; Wenger, Etienne; Dornan, Tim

2012-10-01

It is important to know how patients are affected by becoming opportunistically involved in medical student education. In previous studies, researchers rather than patients set the research agenda and expert patients or people well known to teachers were more often involved than ordinary people. This study aimed to explore how ordinary patients experience undergraduate medical teaching when they become involved in it opportunistically and to derive practical insights from the lived experiences of these patients. The research was conducted in line with a conceptual orientation towards communities of practice theory and used phenomenology as a way of exploring patients' lived experiences in depth. Minimally structured interviews were carried out with 10 patients following ordinary out-patient or general practice appointments in which students were being taught. Template analysis was used to generate provisional themes and a process of phenomenological reduction was used to distil individual respondents' lived experiences to their essence. The presence of students in ambulatory consultations was normal. Nine respondents described transactional relationships in which they remained outside the community of practice of which the doctor and student were members. Only an intimate problem would engage them deeply enough for a student's presence to 'bother' them. One patient's personal and professional background led her to regard doctors' handling of consultation dynamics as factors contributing to whether teaching consultations were negative or positive experiences. When doctors' sensitive and inclusive behaviour drew her into a triadic relationship with the student and doctor, she experienced mutual benefits with students. When it did not, she felt objectified and alienated. Provided they receive the clinical care for which they are attending a consultation and are treated respectfully, patients may sometimes willingly become 'objects' from which students learn. They may, however, become more deeply engaged in teaching consultations in which they participate actively in a triadic relationship of mutual benefit with a doctor and student. Teaching consultations call for doctors to be sensitive and adaptable. © Blackwell Publishing Ltd 2012.

Emotions in communication skills training - experiences from general practice to Porsche maintenance.

PubMed

Lundeby, Tonje; Jacobsen, Henrik Børsting; Lundeby, Paul Andreas; Loge, Jon Håvard

2017-11-01

The emphasis on skills in communication training of physicians has gained momentum over the last 30 years. Furthermore, a specific focus on skills to address emotions has been suggested and more recently supported by empirical studies. In this paper we use the Expanded Four Habits Model to illustrate how a structured consultation model supplemented with specific skills to address emotions is considered useful in medical and non-medical settings. The primacy of emotions in different types of professional encounters is discussed in relation to education and practice. Copyright © 2017 Elsevier B.V. All rights reserved.

Hospital-based group: ideal practice for the future?

PubMed

Matloff, J M; Denton, T A

1995-11-01

The format for future cardiothoracic surgical practices includes the option of a hospital-based group where provider groups and the hospital share the responsibilities and obligations of clinical care and the cost of that care. Based on personal experience at the Cedars-Sinai Medical Center, Los Angeles, three separate contract relationships during our tenure have reflected the evolution of cardiothoracic surgeons' relationship to our patients and the hospital in which we work. Although other organizational modes may prove equally successful, the hospital-based group practice is a viable structure that supports the preservation of quality in the work performed. This relationship helps to maintain a steady volume of patients enabling research endeavors, which are primarily funded through practice incomes, to continue and it also provides a platform for networking with defined patient referrals, shared services, and bench-marking with other centers.

Education and training column: the learning collaborative.

PubMed

MacDonald-Wilson, Kim L; Nemec, Patricia B

2015-03-01

This column describes the key components of a learning collaborative, with examples from the experience of 1 organization. A learning collaborative is a method for management, learning, and improvement of products or processes, and is a useful approach to implementation of a new service design or approach. This description draws from published material on learning collaboratives and the authors' experiences. The learning collaborative approach offers an effective method to improve service provider skills, provide support, and structure environments to result in lasting change for people using behavioral health services. This approach is consistent with psychiatric rehabilitation principles and practices, and serves to increase the overall capacity of the mental health system by structuring a process for discovering and sharing knowledge and expertise across provider agencies. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Psychometric properties of the questionnaire of cognitive and affective empathy in a Portuguese sample.

PubMed

Queirós, Andreia; Fernandes, Eugénia; Reniers, Renate; Sampaio, Adriana; Coutinho, Joana; Seara-Cardoso, Ana

2018-01-01

Empathy is an important concept in psychology and cognitive neuroscience. Despite the controversy around its definition, most researchers would agree that empathy is a multidimensional phenomenon which involves a vicarious experience of another person's affective state and an understanding of another person's affective experience. Self-report measures of empathy constitute an important tool for both research and clinical practice. The main goal of this study was to adapt and study the psychometric properties of the Questionnaire of Cognitive and Affective Empathy (QCAE), a worldwide used measure of empathy, in a Portuguese community sample (N = 562). Confirmatory factor analyses supported the factor structure of the original QCAE. Results show that the Portuguese version of the QCAE has sound psychometric properties, with good structural validity and internal consistency for both scales (i.e., affective and cognitive) and respective subscales of the instrument (i.e., Emotion Contagion, Proximal Responsivity, Peripheral Responsivity, Perspective Taking and Online Simulation). We tested both a five correlated factor structure (Model 1) and a second-order model that postulates the affective and cognitive dimensions (Model 2). Our results show that while both models present acceptable goodness of fit indices, Model 1 performs slightly better. In conclusion, the Portuguese version of the QCAE may prove a useful tool for future cross-cultural assessments of empathy in both research and clinical practice.

An exploration of student nurses' thoughts and experiences of using a video-recording to assess their performance of cardiopulmonary resuscitation (CPR) during a mock objective structured clinical examination (OSCE).

PubMed

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.

Complexity of Curved Glass Structures

NASA Astrophysics Data System (ADS)

Kosić, T.; Svetel, I.; Cekić, Z.

2017-11-01

Despite the increasing number of research on the architectural structures of curvilinear forms and technological and practical improvement of the glass production observed over recent years, there is still a lack of comprehensive codes and standards, recommendations and experience data linked to real-life curved glass structures applications regarding design, manufacture, use, performance and economy. However, more and more complex buildings and structures with the large areas of glass envelope geometrically complex shape are built every year. The aim of the presented research is to collect data on the existing design philosophy on curved glass structure cases. The investigation includes a survey about how architects and engineers deal with different design aspects of curved glass structures with a special focus on the design and construction process, glass types and structural and fixing systems. The current paper gives a brief overview of the survey findings.

Altered Resting Brain Function and Structure in Professional Badminton Players

PubMed Central

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

Alternatives to the face-to-face consultation in general practice: focused ethnographic case study

PubMed Central

Atherton, Helen; Brant, Heather; Ziebland, Sue; Bikker, Annemieke; Campbell, John; Gibson, Andy; McKinstry, Brian; Porqueddu, Tania; Salisbury, Chris

2018-01-01

Background NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. Aim To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Design and setting Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Method Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the ‘one sheet of paper’ mind-map method to identify the line of argument in each thematic report. Results Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other’s practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal. Conclusion Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team. PMID:29378697

Science Teachers' Pedagogical Discontentment: Its Sources and Potential for Change

NASA Astrophysics Data System (ADS)

Southerland, Sherry A.; Sowell, Scott; Enderle, Patrick

2011-08-01

This research explored science teachers' pedagogical discontentment and described its role in teachers' consideration of new teaching practices. Pedagogical discontentment is an expression of the degree to which one is discontented because one's teaching practices do not achieve one's teaching goals. Through a series of structured interviews conducted with 18 practicing science teachers of various grade levels, content areas, routes of preparation, and amount of experience, areas of commonality in the teachers' pedagogical discontentment were identified. The common areas of pedagogical discontentment include the ability to teach all students science, science content knowledge, balancing depth versus breath of instruction, implementing inquiry instruction, and assessing science learning. We draw implications for using this construct to craft more effective professional development.

Modeling contextual influences on parents with intellectual disability and their children.

PubMed

Wade, Catherine; Llewellyn, Gwynnyth; Matthews, Jan

2011-11-01

Many parents with intellectual disability experience living conditions associated with risk for children and parents. This study used structural equation modeling to test a theoretical model of the relationships among parent, child, family, and contextual variables in 120 Australian families where a parent had an intellectual disability. Findings revealed that parenting practices had a direct effect on children's well being, that social support was associated with children's well being through the mediator of parenting practices, and that access to social support had a direct influence on parenting practices. Implications of the findings for research, intervention, and policy are explored, with the goal of promoting optimal well being for children who are raised by parents with intellectual disability.

A Personalised Needs-Led Group Approach to Induction: Perceptions of Early Academics in a University School of Education

ERIC Educational Resources Information Center

Jarvis, Joy; Dickerson, Claire; Chivers, Leo; Collins, Chris; Lee, Libby; Levy, Roger; Solly, Dianne

2012-01-01

Members of staff joining a school of education often have extensive experience in practice but not in academia and the university setting may present a complex diversity of roles, ways of working, values and goals. Colleagues may face issues of understanding the organisational structure and culture, changing identities, and concerns about their…

Taming "Tyrannosaurus Rex": English Use in the Research and Publication Practices of Humanities Scholars in Sweden

ERIC Educational Resources Information Center

Kuteeva, Maria; McGrath, Lisa

2014-01-01

We investigate the current position of English in the language ecology of Swedish academia, with a special focus on the humanities. Semi-structured interviews with 15 informants from the fields of Anthropology, General Linguistics and History were carried out to explore how non-native speakers of English experience using academic English in their…

Evidence-Based Conclusions Concerning Practice, Curriculum Design and Curriculum Reform in a Civil Engineering Capstone Design Course in Hong Kong

ERIC Educational Resources Information Center

Chan, Cecilia K. Y.; Wong, George C. K.; Law, Ada K. H.; Zhang, T.; Au, Francis T. K.

2017-01-01

This study aimed to provide evidence-based conclusions from students concerning a capstone-design course in a civil engineering programme in Hong Kong. The evidence was generated by designing a student-experience questionnaire. The questionnaire instrument was assessed for internal consistency in four scales (curriculum and structure changes;…

Neoliberalism and Pedagogical Practices of Alienation: A Case Study Research on the Integrated Curriculum in Greek Primary Education

ERIC Educational Resources Information Center

Noula, Ioanna; Govaris, Christos

2018-01-01

In this article, we present insights from an ethnographic research that investigated the concept of citizenship in primary schools in Greece. We explored children's experiences of citizenship in school approaching citizenship as a set of habits that prescribe what is considered 'legitimate' in the public sphere. We focused on structures and agents…

Discipline-Based Art Education and Cultural Diversity. Seminar Proceedings of a National Invitational Seminar (3rd, Austin Texas, August 6-9, 1992).

ERIC Educational Resources Information Center

Getty Center for Education in the Arts, Los Angeles, CA.

This publication contains proceedings of a seminar structured around five basic themes: (1) cultural diversity in education; (2) discipline based art education (DBAE) and cultural diversity; (3) how cultural diversity has affected practices in art history, aesthetics, criticism, and art making; (4) experiences in other disciplines which effect…

The Operation and Impact of Participants' Trans-Expedition Reflective Practice: Structuring and Optimising the Transfer Process

ERIC Educational Resources Information Center

Hickman, Mark; Collins, Dave

2014-01-01

With gap year activities, including expeditions, for young people worth an estimated £2 billion annually, the subject of transfer (or ensuring that outcomes offer positive benefits to participants' general lives) from these experiences is an important topic in outdoor education. This paper argues that many of the claims for a positive behavioural…

Continuous Practice-Based Research on the Use of Standardized Patients: Experience from Shanghai Medical College of Fudan University

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…

Pre-Service Teachers' Shifting Perceptions of Cross-Curricular Practice: The Impact of School Experience in Mediating Professional Insight

ERIC Educational Resources Information Center

Heywood, David; Parker, Joan; Jolley, Nina

2012-01-01

Contemporary educational debate in curriculum organisation and pedagogy has focused on the merits or otherwise of integrating disciplines for more effective learning. A wide range of terms is used to describe the various traditions associated with the presentation and structure of the curriculum and there are various perspectives on the purposes…

Music Memory Following Short-term Practice and Its Relationship with the Sight-reading Abilities of Professional Pianists.

PubMed

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.

Music Memory Following Short-term Practice and Its Relationship with the Sight-reading Abilities of Professional Pianists

PubMed Central

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

Teaching and assessing procedural skills: a qualitative study

PubMed Central

2013-01-01

Background Graduating Internal Medicine residents must possess sufficient skills to perform a variety of medical procedures. Little is known about resident experiences of acquiring procedural skills proficiency, of practicing these techniques, or of being assessed on their proficiency. The purpose of this study was to qualitatively investigate resident 1) experiences of the acquisition of procedural skills and 2) perceptions of procedural skills assessment methods available to them. Methods Focus groups were conducted in the weeks following an assessment of procedural skills incorporated into an objective structured clinical examination (OSCE). Using fundamental qualitative description, emergent themes were identified and analyzed. Results Residents perceived procedural skills assessment on the OSCE as a useful formative tool for direct observation and immediate feedback. This positive reaction was regularly expressed in conjunction with a frustration with available assessment systems. Participants reported that proficiency was acquired through resident directed learning with no formal mechanism to ensure acquisition or maintenance of skills. Conclusions The acquisition and assessment of procedural skills in Internal Medicine programs should move toward a more structured system of teaching, deliberate practice and objective assessment. We propose that directed, self-guided learning might meet these needs. PMID:23672617

An Open-Structure Treadmill Gait Trainer: From Research to Application.

PubMed

Li, Jian; Chen, Diansheng; Fan, Yubo

2017-01-01

Lower limb rehabilitation robots are designed to enhance gait function in individuals with motor impairments. Although numerous rehabilitation robots have been developed, only few of these robots have been used in practical health care, particularly in China. The objective of this study is to construct a lower limb rehabilitation robot and bridge the gap between research and application. Open structure to facilitate practical application was created for the whole robot. Three typical movement patterns of a single leg were adopted in designing the exoskeletons, and force models for patient training were established and analyzed under three different conditions, respectively, and then a control system and security strategy were introduced. After establishing the robot, a preliminary experiment on the actual use of a prototype by patients was conducted to validate the functionality of the robot. The experiment showed that different patients and stages displayed different performances, and results on the trend variations across patients and across stages confirmed the validity of the robot and suggested that the design may lead to a system that could be successful in the treatment of patients with walking disorders in China. Furthermore, this study could provide a reference for a similar application design.

Promoting interprofessional learning with medical students in home care settings.

PubMed

Solomon, Patricia; Risdon, Cathy

2011-01-01

The home care setting is ideal for medical students to learn about the importance of interprofessional collaboration in the community. This project examined the impact of a unique program designed to facilitate medical students' knowledge and awareness of the challenges of interprofessional care in the home. In pairs, medical students participated in two community visits with preceptors from different professions. Students completed a structured personal reflection after their first visit. Students and preceptors participated in focus groups or interviews to identify strengths and challenges of the experiences. The structured reflections and the focus group and interview transcripts were analyzed qualitatively. 164 medical students and 36 preceptors participated in 326 visits. There were high ratings of satisfaction from students and preceptors. Students developed unexpected insights into peoples' lives, developed a greater understanding of the patient's perspective and determinants of health, learned about others' scope of practice, and developed an appreciation of the limitations of their own scope of practice. Preceptors had high expectations for student performance and engagement and enjoyed the opportunity to impart their knowledge to future physicians. Although organizationally complex, the program evaluation suggestions that students and preceptors benefit from interprofessional experiences in the home.

The National Practice Benchmark for oncology, 2014 report on 2013 data.

PubMed

Towle, Elaine L; Barr, Thomas R; Senese, James L

2014-11-01

The National Practice Benchmark (NPB) is a unique tool to measure oncology practices against others across the country in a way that allows meaningful comparisons despite differences in practice size or setting. In today's economic environment every oncology practice, regardless of business structure or affiliation, should be able to produce, monitor, and benchmark basic metrics to meet current business pressures for increased efficiency and efficacy of care. Although we recognize that the NPB survey results do not capture the experience of all oncology practices, practices that can and do participate demonstrate exceptional managerial capability, and this year those practices are recognized for their participation. In this report, we continue to emphasize the methodology introduced last year in which we reported medical revenue net of the cost of the drugs as net medical revenue for the hematology/oncology product line. The effect of this is to capture only the gross margin attributable to drugs as revenue. New this year, we introduce six measures of clinical data density and expand the radiation oncology benchmarks. Copyright © 2014 by American Society of Clinical Oncology.

Embodied experiences for science learning: A cognitive linguistics exploration of middle school students' language in learning about water

NASA Astrophysics Data System (ADS)

Salinas Barrios, Ivan Eduardo

I investigated linguistic patterns in middle school students' writing to understand their relevant embodied experiences for learning science. Embodied experiences are those limited by the perceptual and motor constraints of the human body. Recent research indicates student understanding of science needs embodied experiences. Recent emphases of science education researchers in the practices of science suggest that students' understanding of systems and their structure, scale, size, representations, and causality are crosscutting concepts that unify all scientific disciplinary areas. To discern the relationship between linguistic patterns and embodied experiences, I relied on Cognitive Linguistics, a field within cognitive sciences that pays attention to language organization and use assuming that language reflects the human cognitive system. Particularly, I investigated the embodied experiences that 268 middle school students learning about water brought to understanding: i) systems and system structure; ii) scale, size and representations; and iii) causality. Using content analysis, I explored students' language in search of patterns regarding linguistic phenomena described within cognitive linguistics: image schemas, conceptual metaphors, event schemas, semantical roles, and force-dynamics. I found several common embodied experiences organizing students' understanding of crosscutting concepts. Perception of boundaries and change in location and perception of spatial organization in the vertical axis are relevant embodied experiences for students' understanding of systems and system structure. Direct object manipulation and perception of size with and without locomotion are relevant for understanding scale, size and representations. Direct applications of force and consequential perception of movement or change in form are relevant for understanding of causality. I discuss implications of these findings for research and science teaching.

Assessment of knowledge and practice of health workers towards tuberculosis infection control and associated factors in public health facilities of Addis Ababa, Ethiopia: A cross-sectional study.

PubMed

Demissie Gizaw, Girma; Aderaw Alemu, Zewdie; Kibret, Kelemu Tilahun

2015-01-01

Tuberculosis is the leading causes of mortality among infectious diseases worldwide. The risk of transmission from patients to health workers is doubles that of the general population. The close contact to the infectious case before diagnosis is the major risk for tuberculosis infection. The aim of the study was to assess knowledge and practice of health professionals towards tuberculosis infection control and its associated factors in health facilities of Addis Ababa, Ethiopia. A cross-sectional study was conducted from February 29 to April 15/2014 in selected health facilities in Addis Ababa. Five hundred ninety health workers were included in the study. The sample size was assigned to each health facility proportional to their number of health workers. Study subjects were selected from each stratum by simple random sampling technique. Interviewer administered structured questionnaire was used to collect information. Logistic regression was used to identify factors associated with knowledge and practice of health workers towards tuberculosis infection control. Five hundred eighty two participants with 98.6% response rate were involved in the study. Of these, 36.1% had poor knowledge and 51.7% unsatisfactory practice score towards tuberculosis infection control. Having more than six years working experience in health facility (AOR = 2.51; 95% CI: 1.5-4.1) and tuberculosis related training (AOR = 2.51 95% CI; 1.5, 4.1) were significantly associated with knowledge on tuberculosis infection control. Having experience in tuberculosis clinic (AOR =1.93; 95% CI: 1.12, 3.34) and tuberculosis related training (AOR = 1.48; 95% CI: 1.87, 2.51) were significantly associated with practice on tuberculosis infection control. One third of health workers had relatively poor knowledge and nearly half of them had unsatisfactory practice on tuberculosis infection control. Tuberculosis training and work experiences in health facility are determinant factor to knowledge. Whereas tuberculosis related training and experience in tuberculosis clinic are predictor to practice. So, training of the health professionals, on job orientations of junior health workers, and farther study including private health workers are recommended.

Institutional and structural barriers to HIV testing: elements for a theoretical framework.

PubMed

Meyerson, Beth; Barnes, Priscilla; Emetu, Roberta; Bailey, Marlon; Ohmit, Anita; Gillespie, Anthony

2014-01-01

Stigma is a barrier to HIV health seeking, but little is known about institutional and structural expressions of stigma in HIV testing. This study examines evidence of institutional and structural stigma in the HIV testing process. A qualitative, grounded theory study was conducted using secondary data from a 2011 HIV test site evaluation data in a Midwestern, moderate HIV incidence state. Expressions of structural and institutional stigma were found with over half of the testing sites and at three stages of the HIV testing visit. Examples of structural stigma included social geography, organization, and staff behavior at first encounter and reception, and staff behavior when experiencing the actual HIV test. Institutional stigma was socially expressed through staff behavior at entry/reception and when experiencing the HIV test. The emerging elements demonstrate the potential compounding of stigma experiences with deleterious effect. Study findings may inform future development of a theoretical framework. In practice, findings can guide organizations seeking to reduce HIV testing barriers, as they provide a window into how test seekers experience HIV test sites at first encounter, entry/reception, and at testing stages; and can identify how stigma might be intensified by structural and institutional expressions.

Practical strategies and perceptions from community pharmacists following their experiences with conducting pharmacy practice research: a qualitative content analysis.

PubMed

De Vera, Mary A; Campbell, Natasha K J; Chhina, Harpreet; Galo, Jessica S; Marra, Carlo

2017-10-26

While prior research identified barriers to conducting research in community pharmacies, there remains a need to better understand facilitators to ensure successful collaborations between academic researchers and pharmacists. Our objective was to determine the experiences and perspectives of community pharmacists who have recently conducted a pharmacy practice-based research study to gain in-depth understanding of challenges as well as facilitators and identify strategies and solutions. We conducted a qualitative study involving one-on-one semi-structured telephone interviews with community pharmacists following the completion of a practice-based research study in their pharmacies. Interview transcripts were analysed using inductive content analysis involving open coding, creating categories and abstraction into final themes. Eleven pharmacists participated in the qualitative interviews. We identified six major themes including: (1) barriers (e.g. time constraints); (2) facilitators (e.g. ideal pharmacy layout); (3) support and resources from academic researchers (e.g. helpfulness of training, easy-to-use study materials); (4) pharmacist-initiated strategies for conducting research (beyond prior suggestions from researchers); (5) suggestions for future pharmacy practice research; and (6) motivation for conducting pharmacy practice research. These findings informed practical strategies targeted at academic researchers and pharmacists, respectively, to facilitate the conduct of research in community pharmacists across various stages of the research process. Our study adds to better understanding of community pharmacists' perspectives on conducting research and identifies practical solutions that can be readily implemented by academic researchers and pharmacists participating in research. © 2017 Royal Pharmaceutical Society.

Narrative insight in psychosis: The relationship with spiritual and religious explanatory frameworks.

PubMed

Marriott, Michael R; Thompson, Andrew R; Cockshutt, Graham; Rowse, Georgina

2018-03-25

When considering psychosis, the concept of narrative insight has been offered as an alternative to clinical insight in determining individuals' responses to their difficulties, as it allows for a more holistic and person-centred framework to be embraced within professional practice. This study aims to explore the validity of the narrative insight construct within a group of people who have experienced psychosis. Inductive qualitative methods were used to explore how eight participants utilized spiritual or religious explanatory frameworks for their experiences of psychosis and to consider these in relation to the construct of narrative insight. Semi-structured interviews were undertaken with individuals who identified themselves as interested in spiritual or religious ideas and whose self-reported experiences which were identified as akin to psychosis by experienced academic clinicians. Transcriptions from these interviews were subject to interpretative phenomenological analysis within a broader research question; a selection of themes and data from the resultant phenomenological structure are explored here for their relevance to narrative insight. Participants discussed spiritual and biological explanations for their experiences and were able to hold alternative potential explanations alongside each other. They were reflective regarding the origins of their explanations and would describe a process of testing and proof in relation to them. These findings suggest that the narrative insight construct has the potential to be a valid approach to understanding experiences of psychosis, and challenge the dominance of the clinical insight construct within clinical practice. Clinicians should value the explanatory framework for experiences which are provided by individuals experiencing psychosis, and encourage them to develop a framework which is coherent to their own world view rather than predominantly pursuing a biomedical explanation. Assessments of psychosis should be adapted to include an understanding of the cohesiveness of the individual's explanatory framework and personal value to them, with a reduced focus on their acceptance of biomedical models of 'illness'. Care and care research for individuals experiencing psychosis should consider the value of narrative insight within future developments. © 2018 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of British Psychological Society.

The embodiment of tourism among bisexually-behaving Dominican male sex workers.

PubMed

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.

Measurement of nurses' attitudes and knowledge regarding acute care older patients: Psychometrics of the OPACS-US combined with the KOP-Q.

PubMed

Dikken, Jeroen; Hoogerduijn, Jita G; Lagerwey, Mary D; Shortridge-Baggett, Lillie; Klaassen, Sharon; Schuurmans, Marieke J

In clinical practice, identifying positive and negative attitudes toward older patients is very important to improve quality of care provided to them. The Older People in Acute Care Survey - United States (OPACS-US) is an instrument measuring hospital nurses attitudes regarding older patients. However, psychometrics have never been assessed. Furthermore, knowledge being related to attitude and behavior should also be measured complementing the OPACS-US. The purpose of this study was to assess structural validity and reliability of the OPACS-US and assess whether the OPACS-US can be complemented with the Knowledge about Older Patients-Quiz (KOP-Q). A multicenter cross sectional design was conducted. Registered nurses (n = 130, mean age 39,9 years; working experience 14,6 years) working in four general hospitals were included in the study. Nurses completed the OPACS-US section A: practice experiences, B: general opinion and the KOP-Q online. Findings demonstrated that the OPACS-US is a valid and reliable survey instrument that measures practice experiences and general opinion. Furthermore, the OPACS-US can be combined with the KOP-Q adding a knowledge construct, and is ready for use within education and/or quality improvement programs in the USA. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed

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

2017-07-07

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

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

PubMed Central

Seneviratne, Ruth E.; Bradbury, Helen

2017-01-01

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

Everyday drug diversions: a qualitative study of the illicit exchange and non-medical use of prescription stimulants on a university campus.

PubMed

Vrecko, Scott

2015-04-01

This article investigates everyday experiences and practises that are associated with processes of pharmaceuticalization and with practices of 'drug diversion'--that is, the illicit exchange and non-medical use of prescription drugs. It reports results from a qualitative study that was designed to examine the everyday dimensions of non-medical prescription stimulant use among students on an American university campus, which involved 38 semi-structured interviews with individuals who used prescription stimulants as a means of improving academic performance. While discussions of drug diversion are often framed in terms of broad, population-level patterns and demographic trends, the present analysis provides a complementary sociocultural perspective that is attuned to the local and everyday phenomena. Results are reported in relation to the acquisition of supplies of medications intended for nonmedical use. An analysis is provided which identifies four different sources of diverted medications (friends; family members; black-market vendors; deceived clinicians), and describes particular sets of understandings, practices and experiences that arise in relation to each different source. Findings suggest that at the level of everyday experience and practice, the phenomenon of prescription stimulant diversion is characterised by a significant degree of complexity and heterogeneity. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

Everyday drug diversions: A qualitative study of the illicit exchange and non-medical use of prescription stimulants on a university campus

PubMed Central

Vrecko, Scott

2015-01-01

This article investigates everyday experiences and practises that are associated with processes of pharmaceuticalization and with practices of ‘drug diversion’—that is, the illicit exchange and non-medical use of prescription drugs. It reports results from a qualitative study that was designed to examine the everyday dimensions of non-medical prescription stimulant use among students on an American university campus, which involved 38 semi-structured interviews with individuals who used prescription stimulants as a means of improving academic performance. While discussions of drug diversion are often framed in terms of broad, population-level patterns and demographic trends, the present analysis provides a complementary sociocultural perspective that is attuned to the local and everyday phenomena. Results are reported in relation to the acquisition of supplies of medications intended for nonmedical use. An analysis is provided which identifies four different sources of diverted medications (friends; family members; black-market vendors; deceived clinicians), and describes particular sets of understandings, practices and experiences that arise in relation to each different source. Findings suggest that at the level of everyday experience and practice, the phenomenon of prescription stimulant diversion is characterised by a significant degree of complexity and heterogeneity. PMID:25455480

[Stress in Medical Students: A Cross-Sectional Study on the Relevance of Attachment Style and Structural Integration].

PubMed

Bugaj, Till Johannes; Müksch, Christine; Ehrenthal, Johannes C; Köhl-Hackert, Nadja; Schauenburg, Henning; Huber, Julia; Schmid, Carolin; Erschens, Rebecca; Junne, Florian; Herzog, Wolfgang; Nikendei, Christoph

2016-02-01

From year one of studying medicine an increase of psychological stress is found. The relationship between the occurrence of this stress and attachment patterns or structural personality functions remains unclear. The present study aimed at investigating whether a relationship between the enduring personality variables, attachment style and level of structural integration of the personality, and acute stress experience at the beginning of medical students' studies exists. In this study, all students in the first semester of medicine were invited to participate in a study to identify stress factors via questionnaire (MBI-SS, PSQ, PHQ-9, GAD-7) in the WS 2013/2014. Simultaneously, the predominant attachment style (RQ-2) and structural abilities (OPD-SFK) were evaluated. The study included 293 students (return: 91.3%). Securely attached students experienced significantly less stress than insecurely attached students (p=0.019). Students with a high level of structural integration showed significantly less stress burden (p<0.001) and lower exhaustion- (p<0.001) and cynicism values (p<0.001), while showing a higher experience of self-efficacy (p<0.001). The influence of attachment behavior on stress experience is mediated by the level of the structural integration of the personality. Significant correlations exist between attachment style and the level of structural integration of the personality, and burnout risk as well as stress burden. The level of structural integration of the personality mediates the relationship between the attachment-related "model of self" and stress experience, i. e. a positive "model of self" can have a stress-protective effect when good structural abilities are present. Practical implication: An insecure attachment style and a low level of structural integration may be associated with higher stress experience when transitioning to study. The results suggest that the enduring personality variable attachment style, mediated by the level of structural integration of the personality, leads to higher stress and burnout experience. Affected students could be supported by early preventive measures enabling the sustainable preparation for this transitional period. Longitudinal prospective studies are needed to explore if the assumption is applicable that pre-existing vulnerabilities in school are exacerbated at this transitional stage. © Georg Thieme Verlag KG Stuttgart · New York.

Creating an inclusive leisure space: strategies used to engage children with and without disabilities in the arts-mediated program Spiral Garden.

PubMed

Smart, Eric; Edwards, Brydne; Kingsnorth, Shauna; Sheffe, Sarah; Curran, C J; Pinto, Madhu; Crossman, Shannon; King, Gillian

2018-01-01

This article describes how service providers use a set of practical strategies to create an inclusive leisure space in Spiral Garden, an arts-mediated outdoor summer day program for children with and without disabilities. This study was guided by an interpretive qualitative approach. Fourteen Spiral Garden service providers participated in semi-structured interviews. Nine had extensive experience with the program and had been present during key phases of program development spanning over a 26-year period and five were service providers during the summer of 2013. Transcript data were analyzed using inductive thematic analysis. The analysis produced eight strategies organized under three larger categories that service providers perceived to be essential in creating an inclusive leisure space: (1) engaging children in collective experiences; (2) encouraging peer interactions and friendships; and (3) facilitating collaborative child-directed experiences. Service providers working across different inclusive settings can use findings from this study to contribute to program design and implementation. Presented strategies enable children to experience opportunities for spontaneous free play, individualized structured support, and meaningful social participation. Overall, service providers are encouraged to enhance supportive child and service provider relationships and reciprocal child and environment relationships in group-based programs. Implications for Rehabilitation Exploring and facilitating reciprocal relationships between children and their environment is essential to creating inclusive leisure spaces. Transforming program intentions of meaningful social participation into practice requires learning about and affecting change in children's individual social contexts. Service providers can engage themselves as full participants in inclusive leisure spaces through playful negotiations, internal reflections, and artistic expressions.

Implementation of brief alcohol interventions by nurses in primary care: do non-clinical factors influence practice?

PubMed

Lock, Catherine A; Kaner, Eileen F S

2004-06-01

In the UK, GPs and practice nurses selectively provide brief alcohol interventions to risk drinkers. GPs' provision of a brief alcohol intervention can be predicted by patient characteristics, practitioner characteristics and structural factors such as the features of the practice and how it is organized. However, much less is known about possible modifiers of nurse practice. Our aim was to investigate if patient characteristics, nurse characteristics and practice factors influence provision of a brief alcohol intervention by practice nurses in primary health care. One hundred and twenty-eight practice nurses who had implemented a brief alcohol intervention programme in a previous trial based in the North of England were requested to screen adults presenting to their surgery and follow a structured protocol to give a brief intervention (5 min of advice plus an information booklet) to all 'risk' drinkers. Anonymized carbon copies of 5541 completed Alcohol Use Disorders Identification Test (AUDIT) screening questionnaires were collected after a 3-month implementation period and analysed by logistic regression analysis. Although AUDIT identified 1500 'risk' drinkers, only 926 (62%) received a brief intervention. Logistic regression modelling showed that patients' risk status as measured by AUDIT score was the most influential predictor of a brief intervention by practice nurses. However, risk drinkers who were most likely to receive a brief intervention were male. Patients' age or social class did not independently predict a brief intervention. The multilevel model was unable to identify any independent nurse characteristics that could predict a brief intervention, but indicated significant variation between nurses in their tendency to offer the intervention to patients. No structural factors were found to be positively associated with selective provision. Patient and nurse factors contributed to the selective provision of a brief intervention in primary care. If patients are to experience the beneficial effects of a brief alcohol intervention, then there is a need to improve the accuracy of delivery.

Exploring reforms while learning to teach science: Facilitating exploration of theory-practice relationships in a teacher education study group

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.

Theory versus practice at implementation of inquiry-based approaches into physics education

NASA Astrophysics Data System (ADS)

Pfefferová, Miriam Spodniaková; Raganová, Janka; Hruška, Martin; Holec, Stanislav

2017-01-01

At present a lot of ideas for student inquiry-based activities accompanied with methodical remarks and instructions for teachers exist and can be used at physics lessons at lower and upper secondary levels. A need of the use of the teaching methods that support an independent student work as well as active learning approaches has been reflected also in the Slovak state educational program at various educational levels. Experiences of teachers who have used inquiry-based approaches in the classrooms are often in the contrary with expectations of these didactical trends. The paper aims to compare the theory and the practice of the implementation of inquiry-based activities in physics teaching. Practical experience was gained implementing activities for science education developed within the Chain Reaction project running at Matej Bel University Banska Bystrica. Opinions of teachers were investigated with the help of questionnaires, evaluation meetings and structured interviews. Their analysis identified many problems that the teachers had met during the implementation of the inquiry-based approaches in their teaching, as well as benefits of those activities for development of student competences.

Moored offshore structures - evaluation of forces in elastic mooring lines

NASA Astrophysics Data System (ADS)

Crudu, L.; Obreja, D. C.; Marcu, O.

2016-08-01

In most situations, the high frequency motions of the floating structure induce important effects in the mooring lines which affect also the motions of the structure. The experience accumulated during systematic experimental tests and calculations, carried out for different moored floating structures, showed a complex influence of various parameters on the dynamic effects. Therefore, it was considered that a systematic investigation is necessary. Due to the complexity of hydrodynamics aspects of offshore structures behaviour, experimental tests are practically compulsory in order to be able to properly evaluate and then to validate their behaviour in real sea. Moreover the necessity to carry out hydrodynamic tests is often required by customers, classification societies and other regulatory bodies. Consequently, the correct simulation of physical properties of the complex scaled models becomes a very important issue. The paper is investigating such kind of problems identifying the possible simplification, generating different approaches. One of the bases of the evaluation has been found consideringtheresults of systematic experimental tests on the dynamic behaviour of a mooring chain reproduced at five different scales. Dynamic effects as well as the influences of the elasticity simulation for 5 different scales are evaluated together. The paper presents systematic diagrams and practical results for a typical moored floating structure operating as pipe layer based on motion evaluations and accelerations in waves.

Evidence-based practice curriculum in allied health professions for teaching-research-practice nexus.

PubMed

Asokan, G V

2012-11-01

Allied healthcare workers are from diverse professions and the key skill required is providing evidence-based care but this concept has not permeated enough for using it skillfully in their professions. A well structured curriculum in allied health professions is needed to strengthen concerted teaching, research, and practice to empower their professionals and make considerable differences in the lives of people by adopting evidence-based practice. Information sources for allied health professionals have relied on advice of their supervisors and colleagues, personal experiences, authoritative theory and texts for practice. Because of "research-practice" gap, often the use of evidence is not reflected in an individual day to day professional practice. Although allied health professionals work in resource and evidence challenged settings, there are certain barriers and facilitators, which need to be addressed. To implement practice-related research findings and uptake of evidence requires two essential components, namely, practical component and knowledge component. Research bench marking and research metrics for quality assurance and standardization through evidence-based practice will promote academic status and credibility of allied health profession. © 2012 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

The Obstetric Hemorrhage Initiative (OHI) in Florida: The Role of Intervention Characteristics in Influencing Implementation Experiences among Multidisciplinary Hospital Staff.

PubMed

Vamos, Cheryl A; Cantor, Allison; Thompson, Erika L; Detman, Linda A; Bronson, Emily A; Phelps, Annette; Louis, Judette M; Gregg, Anthony R; Curran, John S; Sappenfield, William M

2016-10-01

Objectives Obstetric hemorrhage is one of the leading causes of maternal mortality. The Florida Perinatal Quality Collaborative coordinates a state-wide Obstetric Hemorrhage Initiative (OHI) to assist hospitals in implementing best practices related to this preventable condition. This study examined intervention characteristics that influenced the OHI implementation experiences among Florida hospitals. Methods Purposive sampling was employed to recruit diverse hospitals and multidisciplinary staff members. A semi-structured interview guide was developed based on the following constructs from the intervention characteristics domain of the Consolidated Framework for Implementation Research: evidence strength; complexity; adaptability; and packaging. Interviews were audio-recorded, transcribed and analyzed using Atlas.ti. Results Participants (n = 50) across 12 hospitals agreed that OHI is evidence-based and supported by various information sources (scientific literature, experience, and other epidemiologic or quality improvement data). Participants believed the OHI was 'average' in complexity, with variation depending on participant's role and intervention component. Participants discussed how the OHI is flexible and can be easily adapted and integrated into different hospital settings, policies and resources. The packaging was also found to be valuable in providing materials and supports (e.g., toolkit; webinars; forms; technical assistance) that assisted implementation across activities. Conclusions for Practice Participants reflected positively with regards to the evidence strength, adaptability, and packaging of the OHI. However, the complexity of the initiative adversely affected implementation experiences and required additional efforts to maximize the initiative effectiveness. Findings will inform future efforts to facilitate implementation experiences of evidence-based practices for hemorrhage prevention, ultimately decreasing maternal morbidity and mortality.

Qualitative evaluation of general practices developing training for a range of health disciplines.

PubMed

Hughes, Lesley A

2014-01-01

This study adopted an interpretative approach, using focus groups and face-to-face interviews to evaluate the development of a five-year pilot project within general practice. The aim of the project is for these practices to offer training to a range of health disciplines from varying academic levels, develop capacity and provide interprofessional education as part of the learning ethos. Eight consortia are involved in the project, which is funded by the workforce and education directorate and the Deanery of the Yorkshire and Humber Strategic Health Authority. The evaluation was undertaken 18 months into the project, to understand the views and experiences of primary care practitioners and university educationalists, in order to identify achievements and barriers to the project's development. The study revealed positive attitudes towards the project, and that steps are being taken to engage in dialogue with universities to increase student numbers, but progress is slow. Early experiences of student nurses taking up placements in the practices reveal incompatible learning outcomes between what is expected for curriculum and learning opportunities within primary care. A common concern is the impact increased students may pose on existing support structures, and that this may compromise student learning. Concern is evident over self-belief and competencies to teach across professions, and the ambiguity over the learning outcomes for IPE and the training required to support this. It is recommended that a systems theory be adopted to provide strategic planning across clinical and education organisations to ensure that structures of communication, leadership and training adequately meet the aims of the project. The paper will be of interest to practitioners in primary care who may be considering expanding services and training, and to educationalists seeking to allocate students to placements in primary care.

Proof-of-principle experiment of measurement-device-independent quantum key distribution with vector vortex beams

NASA Astrophysics Data System (ADS)

Dong, Chen; Zhao, Shang-Hong; Li, Wei; Yang, Jian

2018-03-01

In this paper, by combining measurement-device-independent quantum key distribution (MDI-QKD) scheme with entangled photon sources, we present a modified MDI-QKD scheme with pairs of vector vortex(VV) beams, which shows a structure of hybrid entangled entanglement corresponding to intrasystem entanglement and intersystem entanglement. The former entanglement, which is entangled between polarization and orbit angular momentum within each VV beam, is adopted to overcome the polarization misalignment associated with random rotations in quantum key distribution. The latter entanglement, which is entangled between the two VV beams, is used to perform entangled-based MDI-QKD protocol with pair of VV beams to inherit the merit of long distance. The numerical simulations show that our modified scheme can tolerate 97dB with practical detectors. Furthermore, our modified protocol only needs to insert q-plates in practical experiment.

Assessing the Psychoeducational Approach to Transcendence and Health Program: An Intervention to Foster Self-Transcendence and Well-Being in Community-Dwelling Older Adults.

PubMed

McCarthy, Valerie Lander; Bowland, Sharon; Hall, Lynne A; Connelly, Jennifer

2015-12-01

The late-life developmental process of self-transcendence shapes elders' perspectives on self, others, the nature of this world, and of a dimension beyond the here and now. This qualitative pilot study evaluated the Psychoeducational Approach to Transcendence and Health (PATH) Program, a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling women at a senior center. The intervention involved eight weekly group sessions using group processes, mindfulness practices, creative experiences, and independent at-home practice. The findings supported the underlying theory-based structure and content of the intervention and indicated the intervention may empower elders to attend to self-care, develop acceptance, and learn new skills associated with health and well-being, thus merits further study. Based on insights gained from facilitators' and participants' experiences and perceptions, the intervention will be revised and strengthened. © The Author(s) 2015.

Swedish students' and preceptors' perceptions of what students learn in a six-month advanced pharmacy practice experience.

PubMed

Wallman, Andy; Sporrong, Sofia Kälvemark; Gustavsson, Maria; Lindblad, Asa Kettis; Johansson, Markus; Ring, Lena

2011-12-15

To identify what pharmacy students learn during the 6-month advanced pharmacy practice experience (APPE) in Sweden. Semi-structured interviews were conducted with 18 pharmacy APPE students and 17 pharmacist preceptors and analyzed in a qualitative directed content analysis using a defined workplace learning typology for categories. The Swedish APPE provides students with task performance skills for work at pharmacies and social and professional knowledge, such as teamwork, how to learn while in a work setting, self-evaluation, understanding of the pharmacist role, and decision making and problem solving skills. Many of these skills and knowledge are not accounted for in the curricula in Sweden. Using a workplace learning typology to identify learning outcomes, as in this study, could be useful for curricula development. Exploring the learning that takes place during the APPE in a pharmacy revealed a broad range of skills and knowledge that students acquire.

Experiences of intervertebral motion palpation in osteopathic practice - A qualitative interview study among Swedish osteopaths.

PubMed

Sposato, Niklas S; Bjerså, Kristofer

2017-01-01

Assessment in manual therapy includes quantitative and qualitative procedures, and intervertebral motion palpation (IMP) is one of the core assessment methods in osteopathic practice. The aim of this study was to explore osteopathic practitioners' experiences of clinical decision-making and IMP as a diagnostic tool for planning and evaluation of osteopathic interventions. The study was conducted with semi-structured interviews that included eight informants. Content analysis was used as the analytical procedure. In total, three categories emerged from the analysis: strategic decision-making, diagnostic usability of IMP, and treatment applicability of IMP. The study indicated that IMP was considered relevant and was given particular importance in cases where IMP findings confirmed clinical information attained from other stages in the diagnostic process as a whole. However, IMP findings were experienced as less important if they were not correlated to other findings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Interdisciplinary rural immersion week.

PubMed

Deutchman, Mark E; Nearing, Kathryn; Baumgarten, Brenda; Westfall, John M

2012-01-01

Health professions students interested in future rural practice locations spend a week learning about and investigating all aspects of small town personal, professional and community life. This augments the mainly clinical experience provided by clinical rotations they complete as part of their professional academic training program. Students from professional programs in medicine, physician assistant, pharmacy, nursing, public health and psychology travel to a small community, receive an orientation and in small interprofessional groups investigate health care, education, government, law enforcement, public health, economy and natural resources. Participants report that the experience raises their interest in future rural practice, answers questions they have about rural life and enhances their understanding of the issues they must learn more about before making a career location choice. The interdisciplinary rural immersion program provides students with the time, structure and permission to move out of their clinical 'comfort zone' and think about the cultural, economic and environmental aspects of rural life and work.

[KoMPASS--design, implementation and experiences concerning a structured communication skills training for physicians dealing with oncology].

PubMed

Vitinius, Frank; Sonntag, Bernd; Barthel, Yvette; Brennfleck, Barbara; Kuhnt, Susanne; Werner, Andreas; Schönefuß, Götz; Petermann-Meyer, Andrea; Gutberlet, Susanne; Stein, Barbara; Söllner, Wolfgang; Kruse, Johannes; Keller, Monika

2013-12-01

Goal of the KoMPASS project is to develop and test a training program that effectively improves oncologists' communication skills. The training draws with regard to concept, content and didactic methods to the specific challenges arising in interactions with cancer patients. Concept and didactical methods for an intensive training (KoMPASS Training) are being presented and complemented with experiences gathered during 39 trainings with 335 physicians, as well as findings from the training evaluation by participants. The participants' feedback after 4 months indicates successful transfer into clinical practice along with personal relief, improved self-efficacy, and communicative competencies. Even experienced practitioners ascribe high practical usefulness, and personal learning achievements to the KoMPASS training. The results of the concomitant study concerning self-efficacy, empathy, work-related stress and communicative competence will be published later. © Georg Thieme Verlag KG Stuttgart · New York.

Clinical Knowledge Governance Framework for Nationwide Data Infrastructure Projects.

PubMed

Wulff, Antje; Haarbrandt, Birger; Marschollek, Michael

2018-01-01

The availability of semantically-enriched and interoperable clinical information models is crucial for reusing once collected data across institutions like aspired in the German HiGHmed project. Funded by the Federal Ministry of Education and Research, this nationwide data infrastructure project adopts the openEHR approach for semantic modelling. Here, strong governance is required to define high-quality and reusable models. Design of a clinical knowledge governance framework for openEHR modelling in cross-institutional settings like HiGHmed. Analysis of successful practices from international projects, published ideas on archetype governance and own modelling experiences as well as modelling of BPMN processes. We designed a framework by presenting archetype variations, roles and responsibilities, IT support and modelling workflows. Our framework has great potential to make the openEHR modelling efforts manageable. Because practical experiences are rare, prospectively our work will be predestinated to evaluate the benefits of such structured governance approaches.

Retrieval of past and future positive and negative autobiographical experiences.

PubMed

García-Bajos, Elvira; Migueles, Malen

2017-09-01

We studied retrieval-induced forgetting for past or future autobiographical experiences. In the study phase, participants were given cues to remember past autobiographical experiences or to think about experiences that may occur in the future. In both conditions, half of the experiences were positive and half negative. In the retrieval-practice phase, for past and future experiences, participants retrieved either half of the positive or negative experiences using cued recall, or capitals of the world (control groups). Retrieval practice produced recall facilitation and enhanced memory for the practised positive and negative past and future experiences. While retrieval practice on positive experiences did not impair the recall of other positive experiences, we found inhibition for negative past and future experiences when participants practised negative experiences. Furthermore, retrieval practice on positive future experiences inhibited negative future experiences. These positivity biases for autobiographical memory may have practical implications for treatment of emotional disorders.

Australia's first transition to professional practice in primary care program for graduate registered nurses: a pilot study.

PubMed

Aggar, Christina; Bloomfield, Jacqueline; Thomas, Tamsin H; Gordon, Christopher J

2017-01-01

Increases in ageing, chronic illness and complex co-morbidities in the Australian population are adding pressure to the primary care nursing workforce. Initiatives to attract and retain nurses are needed to establish a sustainable and skilled future primary care nursing workforce. We implemented a transition to professional practice program in general practice settings for graduate nurses and evaluated graduate nurse competency, the graduate nurse experience and program satisfaction. This study aimed to determine whether a transition to professional practice program implemented in the general practice setting led to competent practice nurses in their first year post-graduation. A longitudinal, exploratory mixed-methods design was used to assess the pilot study. Data were collected at three times points (3, 6, 12 months) with complete data sets from graduate nurses ( n =  4) and preceptors ( n =  7). We assessed perceptions of the graduates' nursing competency and confidence, satisfaction with the preceptor/graduate relationship, and experiences and satisfaction with the program. Graduate nurse competency was assessed using the National Competency Standards for Nurses in General Practice. Semi-structured interviews with participants at Time 3 sought information about barriers, enablers, and the perceived impact of the program. Graduate nurses were found to be competent within their first year of clinical practice. Program perceptions from graduate nurses and preceptors were positive and the relationship between the graduate nurse and preceptor was key to this development. With appropriate support registered nurses can transition directly into primary care and are competent in their first year post-graduation. While wider implementation and research is needed, findings from this study demonstrate the potential value of transition to professional practice programs within primary care as a nursing workforce development strategy.

Having a baby in the new land: a qualitative exploration of the experiences of Asian migrants in rural Tasmania, Australia.

PubMed

Hoang, H T; Le, Q; Kilpatrick, S

2009-01-01

Australia is a land of cultural diversity. Cultural differences in maternity care may result in conflict between migrants and healthcare providers, especially when migrants have minimal English language knowledge. The aim of the study was to investigate Asian migrant women's child-birth experiences in a rural Australian context. The study consisted of semi-structured interviews conducted with 10 Asian migrant women living in rural Tasmania to explore their childbirth experiences and the barriers they faced in accessing maternal care in the new land. The data were analysed using grounded theory and three main categories were identified: 'migrants with traditional practices in the new land', 'support and postnatal experiences' and 'barriers to accessing maternal care'. The findings revealed that Asian migrants in Tasmania faced language and cultural barriers when dealing with the new healthcare system. Because some Asian migrants retain traditional views and practices for maternity care, confusion and conflicting expectations may occur. Family and community play an important role in supporting migrant women through their maternity care. Providing interpreting services, social support for migrant women and improving the cross-cultural training for healthcare providers were recommended to improve available maternal care services.

A mixed methods investigation of an online intervention to facilitate student midwives' engagement in effective conversations about weight-related behaviour change with pregnant women.

PubMed

Hart, Jo; Furber, Christine; Chisholm, Anna; Aspinall, Samantha; Lucas, Charlotte; Runswick, Emma; Mann, Karen; Peters, Sarah

2018-05-16

(1) To identify whether an online training intervention could increase midwifery students' knowledge of behaviour change techniques (BCTs) and intentions to use them in practice. (2) To identify students' views and current experiences of talking to women about weight-related behaviour change. Mixed methods study involving pre- and post-training assessments, and qualitative interviews with midwifery students. Online training course delivered at a University in the North of England, UK. Midwifery students in the third year of their undergraduate degree during 2015-2016. Online training focused on equipping students with knowledge of theoretically-informed BCTs, and the skills to use them opportunistically in existing practice settings. Likelihood of discussing obesity with women was assessed via a 12-item, 7-point Likert scale assessing students' attitudes, subjective norms, perceived behavioural control, and intentions. A 14-item checklist was used to assess BCT knowledge whereby students selected recognised BCTs (of 7 correct, 7 false). Students' views and experiences of current practice was explored through in-depth, semi-structured one-on-one interviews with a member of the research team. Students' subjective norms, perceived behavioural control, and knowledge of BCTs increased post-training but intention and attitudes did not. Interviews revealed three themes accounting for students experiences and views of behaviour change practice: (1) 'How training fits with current encounters with maternal obesity in midwifery training' (2) 'TEnT PEGS prepares students for practice', and (3) 'Value of tailored training'. Online BCT training can improve the midwifery students' confidence, knowledge and beliefs that this is part of their role. They also reported finding the training helpful in better preparing them for this challenging element of their routine practice. Online BCT training can be used to prepare undergraduate midwifery students for practice. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

The boundary structure in the analysis of reversibly interacting systems by sedimentation velocity.

PubMed

Zhao, Huaying; Balbo, Andrea; Brown, Patrick H; Schuck, Peter

2011-05-01

Sedimentation velocity (SV) experiments of heterogeneous interacting systems exhibit characteristic boundary structures that can usually be very easily recognized and quantified. For slowly interacting systems, the boundaries represent concentrations of macromolecular species sedimenting at different rates, and they can be interpreted directly with population models based solely on the mass action law. For fast reactions, migration and chemical reactions are coupled, and different, but equally easily discernable boundary structures appear. However, these features have not been commonly utilized for data analysis, for the lack of an intuitive and computationally simple model. The recently introduced effective particle theory (EPT) provides a suitable framework. Here, we review the motivation and theoretical basis of EPT, and explore practical aspects for its application. We introduce an EPT-based design tool for SV experiments of heterogeneous interactions in the software SEDPHAT. As a practical tool for the first step of data analysis, we describe how the boundary resolution of the sedimentation coefficient distribution c(s) can be further improved with a Bayesian adjustment of maximum entropy regularization to the case of heterogeneous interactions between molecules that have been previously studied separately. This can facilitate extracting the characteristic boundary features by integration of c(s). In a second step, these are assembled into isotherms as a function of total loading concentrations and fitted with EPT. Methods for addressing concentration errors in isotherms are discussed. Finally, in an experimental model system of alpha-chymotrypsin interacting with soybean trypsin inhibitor, we show that EPT provides an excellent description of the experimental sedimentation boundary structure of fast interacting systems. Published by Elsevier Inc.

Amplitude spectrum distance: measuring the global shape divergence of protein fragments.

PubMed

Galiez, Clovis; Coste, François

2015-08-14

In structural bioinformatics, there is an increasing interest in identifying and understanding the evolution of local protein structures regarded as key structural or functional protein building blocks. A central need is then to compare these, possibly short, fragments by measuring efficiently and accurately their (dis)similarity. Progress towards this goal has given rise to scores enabling to assess the strong similarity of fragments. Yet, there is still a lack of more progressive scores, with meaningful intermediate values, for the comparison, retrieval or clustering of distantly related fragments. We introduce here the Amplitude Spectrum Distance (ASD), a novel way of comparing protein fragments based on the discrete Fourier transform of their C(α) distance matrix. Defined as the distance between their amplitude spectra, ASD can be computed efficiently and provides a parameter-free measure of the global shape dissimilarity of two fragments. ASD inherits from nice theoretical properties, making it tolerant to shifts, insertions, deletions, circular permutations or sequence reversals while satisfying the triangle inequality. The practical interest of ASD with respect to RMSD, RMSDd, BC and TM scores is illustrated through zinc finger retrieval experiments and concrete structure examples. The benefits of ASD are also illustrated by two additional clustering experiments: domain linkers fragments and complementarity-determining regions of antibodies. Taking advantage of the Fourier transform to compare fragments at a global shape level, ASD is an objective and progressive measure taking into account the whole fragments. Its practical computation time and its properties make ASD particularly relevant for applications requiring meaningful measures on distantly related protein fragments, such as similar fragments retrieval asking for high recalls as shown in the experiments, or for any application taking also advantage of triangle inequality, such as fragments clustering. ASD program and source code are freely available at: http://www.irisa.fr/dyliss/public/ASD/.

Evaluation of the dental curriculum at the University of Basel. Does the Master of Dental Medicine adequately prepare for the professional practice?

PubMed

Zitzmann, Nicola U; Yoon-Büchel, Nadja; Bühler, Julia; Dettwiler, Christian A; Weiger, Roland

The present study reports the results of a structured survey of graduates intending to evaluate the education at the Dental School of the University of Basel in the years from 2006 to 2014. In addition, dentists and practice owners supervising graduates from Basel in daily clinical routine or hiring them as assistant dentists were questioned. The aims of the current survey were (1) to analyze own subjective experiences, (2) to assess potential differences between the cohorts prior to and after the implementation of the Bologna reform, (3) to compare the rating regarding theoretical knowledge and practical skills, and (4) to disclose potential for improvement. It was found that according to both their own assessment and the rating of the practice owners, graduates possess the basic dental expertise. The alumni rated their theoretical knowledge higher than their clinical practical skills and indicated a potential for intensification in the fields of dental surgery and implantology. When comparing the cohorts who had completed their studies according to the old (until 2010) and new study regulations, there were only minor differences; the own skills related to patient information about treatments were better rated by alumni who had been trained according to the new study regulations. The curriculum leading to the Master of Dental Medicine at the University of Basel fundamentally prepares graduates for the professional activity, but the additional acquisition of clinical experience in daily practice is indispensable.

Predicting the child-rearing practices of mothers sexually abused in childhood.

PubMed

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?

PubMed

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.

Moments of speaking and silencing: Nurses share their experiences of manual handling in healthcare.

PubMed

Kay, Kate; Evans, Alicia; Glass, Nel

2015-01-01

Nursing care involves complex patient handling tasks, resulting in high musculoskeletal injury rates. Epidemiological studies from the 1980s estimated a lifetime prevalence of lower back injuries for nurses between 35 and 80%. National and international studies continue to mirror these findings. Despite the development of programs intended to reduce manual handling injuries, sustainable solutions remain elusive. This paper reports on a study of nurses speaking about their perspectives on current manual handling practices. Qualitative research conducted in 2012 investigated nurses' perceptions and experiences relating to manual handling in the healthcare context and their participation in injury prevention programs. There were two research methods: semi-structured interviews and researcher reflective journaling. The research was framed in critical emancipatory methodology. Thirteen nurses from two Australian states participated in the study. Thematic analysis revealed an overarching theme of 'power relations' with a subcategory of '(mis)power' that comprised two subthemes, these being 'how to practice' and 'voicing practice issues'. Specifically, this paper explores nurses verbalising their views in the workplace and responses which left them feeling silenced, punished and disillusioned. The findings suggest that the sociopolitical context within which nurses practice impacts upon their ability to voice concerns or ideas related to manual handling. Inclusion of nurses in the manual handling dialogue may generate an expanded understanding of, and the potential to transform, manual handling practices in healthcare environments.

"Refreshed…reinforced…reflective": A qualitative exploration of interprofessional education facilitators' own interprofessional learning and collaborative practice.

PubMed

Evans, Sherryn; Shaw, Nicole; Ward, Catherine; Hayley, Alexa

2016-11-01

While there is extensive research examining the outcomes of interprofessional education (IPE) for students, minimal research has investigated how facilitating student learning influences the facilitators themselves. This exploratory case study aimed to explore whether and how facilitating IPE influences facilitators' own collaborative practice attitudes, knowledge, and workplace behaviours. Sixteen facilitators of an online pre-licensure IPE unit for an Australian university participated in semi-structured telephone interviews. Inductive thematic analysis revealed three emergent themes and associated subthemes characterising participants' reflexivity as IPE facilitators: interprofessional learning; professional behaviour change; and collaborative practice expertise. Participants experienced interprofessional learning in their role as facilitators, improving their understanding of other professionals' roles, theoretical and empirical knowledge underlying collaborative practice, and the use and value of online communication. Participants also reported having changed several professional behaviours, including improved interprofessional collaboration with colleagues, a change in care plan focus, a less didactic approach to supervising students and staff, and greater enthusiasm impressing the value of collaborative practice on placement students. Participants reported having acquired their prior interprofessional collaboration expertise via professional experience rather than formal learning opportunities and believed access to formal IPE as learners would aid their continuing professional development. Overall, the outcomes of the IPE experience extended past the intended audience of the student learners and positively impacted on the facilitators as well.

A new model of collaborative research: experiences from one of Australia's NHMRC Partnership Centres for Better Health.

PubMed

Wutzke, Sonia; Redman, Sally; Bauman, Adrian; Hawe, Penelope; Shiell, Alan; Thackway, Sarah; Wilson, Andrew

2017-02-15

There is often a disconnection between the creation of evidence and its use in policy and practice. Cross-sectoral, multidisciplinary partnership research, founded on shared governance and coproduction, is considered to be one of the most effective means of overcoming this research-policy-practice disconnect. Similar to a number of funding bodies internationally, Australia's National Health and Medical Research Council has introduced Partnership Centres for Better Health: a scheme explicitly designed to encourage coproduced partnership research. In this paper, we describe our experiences of The Australian Prevention Partnership Centre, established in June 2013 to explore the systems, strategies and structures that inform decisions about how to prevent lifestyle-related chronic disease. We present our view on how the Partnership Centre model is working in practice. We comment on the unique features of the Partnership Centre funding model, how these features enable ways of working that are different from both investigator-initiated and commissioned research, and how these ways of working can result in unique outcomes that would otherwise not have been possible. Although not without challenges, the Partnership Centre approach addresses a major gap in the Australian research environment, whereby large-scale, research-policy-practice partnerships are established with sufficient time, resources and flexibility to deliver highly innovative, timely and accessible research that is of use to policy and practice.

Student-teacher education programme (STEP) by step: transforming medical students into competent, confident teachers.

PubMed

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.

High performance, accelerometer-based control of the Mini-MAST structure at Langley Research Center

NASA Technical Reports Server (NTRS)

Collins, Emmanuel G., Jr.; King, James A.; Phillips, Douglas J.; Hyland, David C.

1991-01-01

Many large space system concepts will require active vibration control to satisfy critical performance requirements such as line of sight pointing accuracy and constraints on rms surface roughness. In order for these concepts to become operational, it is imperative that the benefits of active vibration control be shown to be practical in ground based experiments. The results of an experiment shows the successful application of the Maximum Entropy/Optimal Projection control design methodology to active vibration control for a flexible structure. The testbed is the Mini-Mast structure at NASA-Langley and has features dynamically traceable to future space systems. To maximize traceability to real flight systems, the controllers were designed and implemented using sensors (four accelerometers and one rate gyro) that are actually mounted to the structure. Ground mounted displacement sensors that could greatly ease the control design task were available but were used only for performance evaluation. The use of the accelerometers increased the potential of destabilizing the system due to spillover effects and motivated the use of precompensation strategy to achieve sufficient compensator roll-off.

High performance, accelerometer-based control of the Mini-MAST structure

NASA Technical Reports Server (NTRS)

Collins, Emmanuel G., Jr.; King, James A.; Phillips, Douglas J.; Hyland, David C.

1992-01-01

Many large space system concepts will require active vibration control to satisfy critical performance requirements such as line of sight pointing accuracy and constraints on rms surface roughness. In order for these concepts to become operational, it is imperative that the benefits of active vibration control be shown to be practical in ground based experiments. The results of an experiment shows the successful application of the Maximum Entropy/Optical Projection control design methodology to active vibration control for a flexible structure. The testbed is the Mini-Mast structure at NASA-Langley and has features dynamically traceable to future space systems. To maximize traceability to real flight systems, the controllers were designed and implemented using sensors (four accelerometers and one rate gyro) that are actually mounted to the structure. Ground mounted displacement sensors that could greatly ease the control design task were available but were used only for performance evaluation. The use of the accelerometers increased the potential of destabilizing the system due to spillover effects and motivated the use of precompensation strategy to achieve sufficient compensator roll-off.

Transfer of movement sequences: bigger is better.

PubMed

Dean, Noah J; Kovacs, Attila J; Shea, Charles H

2008-02-01

Experiment 1 was conducted to determine if proportional transfer from "small to large" scale movements is as effective as transferring from "large to small." We hypothesize that the learning of larger scale movement will require the participant to learn to manage the generation, storage, and dissipation of forces better than when practicing smaller scale movements. Thus, we predict an advantage for transfer of larger scale movements to smaller scale movements relative to transfer from smaller to larger scale movements. Experiment 2 was conducted to determine if adding a load to a smaller scale movement would enhance later transfer to a larger scale movement sequence. It was hypothesized that the added load would require the participants to consider the dynamics of the movement to a greater extent than without the load. The results replicated earlier findings of effective transfer from large to small movements, but consistent with our hypothesis, transfer was less effective from small to large (Experiment 1). However, when a load was added during acquisition transfer from small to large was enhanced even though the load was removed during the transfer test. These results are consistent with the notion that the transfer asymmetry noted in Experiment 1 was due to factors related to movement dynamics that were enhanced during practice of the larger scale movement sequence, but not during the practice of the smaller scale movement sequence. The findings that the movement structure is unaffected by transfer direction but the movement dynamics are influenced by transfer direction is consistent with hierarchal models of sequence production.

Home food preparation practices, experiences and perceptions: A qualitative interview study with photo-elicitation

PubMed Central

White, Martin; Wrieden, Wendy; Brown, Heather; Stead, Martine; Adams, Jean

2017-01-01

Food-related choices have an important impact on health. Food preparation methods may be linked to diet and health benefits. However, the factors influencing people’s food choices, and how they are shaped by food preparation experiences, are still not fully understood. We aimed to study home food preparation practices, experiences and perceptions amongst adults in North East England. A matrix was used to purposively sample participants with diverse socio-demographic characteristics. Participants developed photographic food diaries that were used as prompts during semi-structured interviews. Data were analysed using the Framework Method. Interviews were conducted with 18 adults (five men and 13 women), aged approximately 20 to 80 years, to reach data saturation. Participants’ practices varied widely, from reliance on pre-prepared foods, to preparing complex meals entirely from basic ingredients. Key themes emerged regarding the cook (identity), the task (process of cooking), and the context (situational drivers). Resources, in terms of time, money and facilities, were also underpinning influences on food preparation. Participants’ practices were determined by both personal motivations to cook, and the influence of others, and generally reflected compromises between varied competing demands and challenges in life. Most people appeared to be overall content with their food preparation behaviour, though ideally aspired to cook more frequently, using basic ingredients. This often seemed to be driven by social desirability. Home food preparation is complex, with heterogeneous practices, experiences and perceptions both between individuals and within the same individual over time, according to shifting priorities and circumstances. Generalisability of these findings may be limited by the regional participant sample; however the results support and build upon previous research. Focussing interventions on life transition points at which priorities and circumstances change, with careful targeting to stimulate personal motivation and social norms, may prove effective in encouraging home food preparation. PMID:28854196

Home food preparation practices, experiences and perceptions: A qualitative interview study with photo-elicitation.

PubMed

Mills, Susanna; White, Martin; Wrieden, Wendy; Brown, Heather; Stead, Martine; Adams, Jean

2017-01-01

Food-related choices have an important impact on health. Food preparation methods may be linked to diet and health benefits. However, the factors influencing people's food choices, and how they are shaped by food preparation experiences, are still not fully understood. We aimed to study home food preparation practices, experiences and perceptions amongst adults in North East England. A matrix was used to purposively sample participants with diverse socio-demographic characteristics. Participants developed photographic food diaries that were used as prompts during semi-structured interviews. Data were analysed using the Framework Method. Interviews were conducted with 18 adults (five men and 13 women), aged approximately 20 to 80 years, to reach data saturation. Participants' practices varied widely, from reliance on pre-prepared foods, to preparing complex meals entirely from basic ingredients. Key themes emerged regarding the cook (identity), the task (process of cooking), and the context (situational drivers). Resources, in terms of time, money and facilities, were also underpinning influences on food preparation. Participants' practices were determined by both personal motivations to cook, and the influence of others, and generally reflected compromises between varied competing demands and challenges in life. Most people appeared to be overall content with their food preparation behaviour, though ideally aspired to cook more frequently, using basic ingredients. This often seemed to be driven by social desirability. Home food preparation is complex, with heterogeneous practices, experiences and perceptions both between individuals and within the same individual over time, according to shifting priorities and circumstances. Generalisability of these findings may be limited by the regional participant sample; however the results support and build upon previous research. Focussing interventions on life transition points at which priorities and circumstances change, with careful targeting to stimulate personal motivation and social norms, may prove effective in encouraging home food preparation.

Responses of Baltic Sea Ice and Open-Water Natural Bacterial Communities to Salinity Change

PubMed Central

Kaartokallio, Hermanni; Laamanen, Maria; Sivonen, Kaarina

2005-01-01

To investigate the responses of Baltic Sea wintertime bacterial communities to changing salinity (5 to 26 practical salinity units), an experimental study was conducted. Bacterial communities of Baltic seawater and sea ice from a coastal site in southwest Finland were used in two batch culture experiments run for 17 or 18 days at 0°C. Bacterial abundance, cell volume, and leucine and thymidine incorporation were measured during the experiments. The bacterial community structure was assessed using denaturing gradient gel electrophoresis (DGGE) of PCR-amplified partial 16S rRNA genes with sequencing of DGGE bands from initial communities and communities of day 10 or 13 of the experiment. The sea ice-derived bacterial community was metabolically more active than the open-water community at the start of the experiment. Ice-derived bacterial communities were able to adapt to salinity change with smaller effects on physiology and community structure, whereas in the open-water bacterial communities, the bacterial cell volume evolution, bacterial abundance, and community structure responses indicated the presence of salinity stress. The closest relatives for all eight partial 16S rRNA gene sequences obtained were either organisms found in polar sea ice and other cold habitats or those found in summertime Baltic seawater. All sequences except one were associated with the α- and γ-proteobacteria or the Cytophaga-Flavobacterium-Bacteroides group. The overall physiological and community structure responses were parallel in ice-derived and open-water bacterial assemblages, which points to a linkage between community structure and physiology. These results support previous assumptions of the role of salinity fluctuation as a major selective factor shaping the sea ice bacterial community structure. PMID:16085826

Awarding Credit Where Credit Is Due: Effective Practices for the Implementation of Credit by Exam. Adopted Spring 2014

ERIC Educational Resources Information Center

Academic Senate for California Community Colleges, 2014

2014-01-01

Credit by Exam is a mechanism employed in the California community colleges as a means of granting credit for student learning outside of the traditional classroom. In some instances, credit by exam is the means used to award college credit for structured learning experiences in a secondary educational setting, while in other instances knowledge…

Negotiating a Sense of Identity in a Foreign Land: Navigating Public School Structures and Practices that Often Conflict with Haitian Culture and Values

ERIC Educational Resources Information Center

Cone, Neporcha; Buxton, Cory; Lee, Okhee; Mahotiere, Margarette

2014-01-01

As part of a larger investigation into the educational experiences of Haitians in South Florida, this study explores factors that influence the identity development and academic success of Haitian students. Individual and focus group interviews with Haitian students, parents, and teachers provide the context for studying how pressures from both…

Making Waves: Career Development and Public Policy. International Symposium 1999 Papers, Proceedings, and Strategies (Ottawa, Ontario, Canada, May 2-4, 1999).

ERIC Educational Resources Information Center

Hiebert, Bryan, Ed.; Bezanson, Lynne, Ed.

People in many countries are experimenting with solutions to changes in the structure and delivery of career development services. As a result, there is vast opportunity to learn from, and be guided by, exemplary practices from other countries. The International Symposium is designed to provide such opportunities, and to give policymakers and…

Understanding the Theoretical Framework of Technological Pedagogical Content Knowledge: A Collaborative Self-Study to Understand Teaching Practice and Aspects of Knowledge

ERIC Educational Resources Information Center

Fransson, Goran; Holmberg, Jorgen

2012-01-01

This paper describes a self-study research project that focused on our experiences when planning, teaching, and evaluating a course in initial teacher education. The theoretical framework of technological pedagogical content knowledge (TPACK) was used as a conceptual structure for the self-study. Our understanding of the framework in relation to…

Magnetic shielding structure optimization design for wireless power transmission coil

NASA Astrophysics Data System (ADS)

Dai, Zhongyu; Wang, Junhua; Long, Mengjiao; Huang, Hong; Sun, Mingui

2017-09-01

In order to improve the performance of the wireless power transmission (WPT) system, a novel design scheme with magnetic shielding structure on the WPT coil is presented in this paper. This new type of shielding structure has great advantages on magnetic flux leakage reduction and magnetic field concentration. On the basis of theoretical calculation of coil magnetic flux linkage and characteristic analysis as well as practical application feasibility consideration, a complete magnetic shielding structure was designed and the whole design procedure was represented in detail. The simulation results show that the coil with the designed shielding structure has the maximum energy transmission efficiency. Compared with the traditional shielding structure, the weight of the new design is significantly decreased by about 41%. Finally, according to the designed shielding structure, the corresponding experiment platform is built to verify the correctness and superiority of the proposed scheme.

Win-win-win: collaboration advances critical care practice.

PubMed

Spence, Deb; Fielding, Sandra

2002-10-01

Against a background of increasing interest in education post registration, New Zealand nurses are working to advance their professional practice. Because the acquisition of highly developed clinical capabilities requires a combination of nursing experience and education, collaboration between clinicians and nurse educators is essential. However, the accessibility of relevant educational opportunities has been an ongoing issue for nurses outside the country's main centres. Within the framework of a Master of Health Science, the postgraduate certificate (critical care nursing) developed between Auckland University of Technology and two regional health providers is one such example. Students enrol in science and knowledge papers concurrently then, in the second half of the course, are supported within their practice environment to acquire advanced clinical skills and to analyse, critique and develop practice within their specialty. This paper provides an overview of the structure and pr month, distance education course focused on developing the context of critical care nursing.

Essential Elements for a Pharmacy Practice Mentoring Program

PubMed Central

Hardy, Yolanda M.; Jarvis, Courtney; Stoner, Steven C.; Pitlick, Matthew; Hilaire, Michelle L.; Hanes, Scott; Carey, Katherine; Burke, Jack; Lodise, Nicole M.

2013-01-01

Formal guidelines for mentoring faculty members in pharmacy practice divisions of colleges and schools of pharmacy do not exist in the literature. This paper addresses the background literature on mentoring programs, explores the current state of mentoring programs used in pharmacy practice departments, and provides guidelines for colleges and schools instituting formal mentoring programs. As the number of pharmacy colleges and schools has grown, the demand for quality pharmacy faculty members has dramatically increased. While some faculty members gain teaching experience during postgraduate residency training, new pharmacy practice faculty members often need professional development to meet the demands of their academic responsibilities. A mentoring program can be 1 means of improving faculty success and retention. Many US colleges and schools of pharmacy have developed formal mentoring programs, whereas several others have informal processes in place. This paper discusses those programs and the literature available, and makes recommendations on the structure of mentoring programs. PMID:23519448

Registered Nurses’ Patient Education in Everyday Primary Care Practice

PubMed Central

Bergh, Anne-Louise; Friberg, Febe; Persson, Eva; Dahlborg-Lyckhage, Elisabeth

2015-01-01

Nurses’ patient education is important for building patients’ knowledge, understanding, and preparedness for self-management. The aim of this study was to explore the conditions for nurses’ patient education work by focusing on managers’ discourses about patient education provided by nurses. In 2012, data were derived from three focus group interviews with primary care managers. Critical discourse analysis was used to analyze the transcribed interviews. The discursive practice comprised a discourse order of economic, medical, organizational, and didactic discourses. The economic discourse was the predominant one to which the organization had to adjust. The medical discourse was self-evident and unquestioned. Managers reorganized patient education routines and structures, generally due to economic constraints. Nurses’ pedagogical competence development was unclear, and practice-based experiences of patient education were considered very important, whereas theoretical pedagogical knowledge was considered less important. Managers’ support for nurses’ practical- and theoretical-based pedagogical competence development needs to be strengthened. PMID:28462314

Experiences of emergency department care from the perspective of families in which a child has autism spectrum disorder.

PubMed

Nicholas, David B; Zwaigenbaum, Lonnie; Muskat, Barbara; Craig, William R; Newton, Amanda S; Kilmer, Christopher; Greenblatt, Andrea; Roberts, Wendy; Cohen-Silver, Justine

2016-07-01

Care for children with autism spectrum disorder (ASD) in the emergency department (ED) is increasingly recognized as difficult. Communication, sensory and behavioral challenges in a high intensity environment pose risks for negative experiences and outcomes. Through semi-structured interviews, parents (n = 31) and their children (n = 4) with ASD shared their perspectives on ED care. Participants identified issues that negatively affected care experiences, including care processes, communication issues, insufficient staff knowledge about ASD, and inadequate partnership with parents. Elements contributing to an improved ED experience were also cited, including staff knowledge about ASD, child- and family-centered care, and clarity of communication. Findings inform an emerging model of ED care. Recommendations for capacity building and practice development are offered.

Could Values and Social Structures in Singapore Facilitate Attainment of Patient-Focused, Cultural, and Linguistic Competency Standards in a Patient-Centered Medical Home Pilot?

PubMed Central

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

Packaged microsphere-taper coupling system with a high Q factor.

PubMed

Dong, Yongchao; Wang, Keyi; Jin, Xueying

2015-01-10

A novel packaged microsphere-taper coupling system which consists of a glass tube and two glass plates is proposed and demonstrated in this paper. We analyze the impact of the microsphere distortion on the resonant spectrum and it is observed that a very high quality factor (Q) up to 1.08×10(8) can be achieved by optimizing the microsphere position and orientation relative to the fiber taper. The maintenance of Q and a stable spectrum are realized by placing the packaged structure in a sealed organic glass box. Furthermore, to verify the practicability of the sealed device, thermal sensing experiments are carried out, which indicates the excellent convenience of the device with a resolution of 1.12×10(-4)°C. The portability and robustness of the packaged structure make it strikingly attractive and illustrate its potential in practical microcavity sensors and lasers.

Meditation has stronger relationships with mindfulness, kundalini, and mystical experiences than yoga or prayer.

PubMed

de Castro, John M

2015-09-01

Contemplative practices can have profound effects on mindfulness and on physical and sensory and mystical experiences. Individuals who self-reported meditation, yoga, contemplative prayer, or a combination of practices and their patterns of practice were compared for mindfulness, kundalini effects, and mystical experiences. The results suggest that the amount of practice but not the pattern and social conditions of practice influences mindfulness and possibly mystical experiences. Meditation, yoga, contemplative prayer, or a combination of practices all were found to be associated with enhancements of mindfulness, kundalini effects, and mystical experiences, but meditation had particularly strong associations and may be the basis of the associations of yoga and prayer with these outcomes. The results further suggest that the primary association of contemplative practices is with the real time awareness and appreciation of sensory and perceptual experiences which may be the intermediary between disparate practices and mindfulness, kundalini effects, and mystical experiences. Copyright © 2015 Elsevier Inc. All rights reserved.

QSAR Methods.

PubMed

Gini, Giuseppina

2016-01-01

In this chapter, we introduce the basis of computational chemistry and discuss how computational methods have been extended to some biological properties and toxicology, in particular. Since about 20 years, chemical experimentation is more and more replaced by modeling and virtual experimentation, using a large core of mathematics, chemistry, physics, and algorithms. Then we see how animal experiments, aimed at providing a standardized result about a biological property, can be mimicked by new in silico methods. Our emphasis here is on toxicology and on predicting properties through chemical structures. Two main streams of such models are available: models that consider the whole molecular structure to predict a value, namely QSAR (Quantitative Structure Activity Relationships), and models that find relevant substructures to predict a class, namely SAR. The term in silico discovery is applied to chemical design, to computational toxicology, and to drug discovery. We discuss how the experimental practice in biological science is moving more and more toward modeling and simulation. Such virtual experiments confirm hypotheses, provide data for regulation, and help in designing new chemicals.

The impact of training and working conditions on junior doctors’ intention to leave clinical practice

PubMed Central

2014-01-01

Background The shortage of physicians is an evolving problem throughout the world. In this study we aimed to identify to what extent junior doctors’ training and working conditions determine their intention to leave clinical practice after residency training. Methods A prospective cohort study was conducted in 557 junior doctors undergoing residency training in German hospitals. Self-reported specialty training conditions, working conditions and intention to leave clinical practice were measured over three time points. Scales covering training conditions were assessed by structured residency training, professional support, and dealing with lack of knowledge; working conditions were evaluated by work overload, job autonomy and social support, based on the Demand–Control–Support model. Multivariate ordinal logistic regression analyses with random intercept for longitudinal data were applied to determine the odds ratio of having a higher level of intention to leave clinical practice. Results In the models that considered training and working conditions separately to predict intention to leave clinical practice we found significant baseline effects and change effects. After modelling training and working conditions simultaneously, we found evidence that the change effect of job autonomy (OR 0.77, p = .005) was associated with intention to leave clinical practice, whereas for the training conditions, only the baseline effects of structured residency training (OR 0.74, p = .017) and dealing with lack of knowledge (OR 0.74, p = .026) predicted intention to leave clinical practice. Conclusions Junior doctors undergoing specialty training experience high workload in hospital practice and intense requirements in terms of specialty training. Our study indicates that simultaneously improving working conditions over time and establishing a high standard of specialty training conditions may prevent junior doctors from considering leaving clinical practice after residency training. PMID:24942360

Perceptual experience and posttest improvements in perceptual accuracy and consistency.

PubMed

Wagman, Jeffrey B; McBride, Dawn M; Trefzger, Amanda J

2008-08-01

Two experiments investigated the relationship between perceptual experience (during practice) and posttest improvements in perceptual accuracy and consistency. Experiment 1 investigated the potential relationship between how often knowledge of results (KR) is provided during a practice session and posttest improvements in perceptual accuracy. Experiment 2 investigated the potential relationship between how often practice (PR) is provided during a practice session and posttest improvements in perceptual consistency. The results of both experiments are consistent with previous findings that perceptual accuracy improves only when practice includes KR and that perceptual consistency improves regardless of whether practice includes KR. In addition, the results showed that although there is a relationship between how often KR is provided during a practice session and posttest improvements in perceptual accuracy, there is no relationship between how often PR is provided during a practice session and posttest improvements in consistency.

A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners.

PubMed

Boyle, Eileen; Saunders, Rosemary; Drury, Vicki

2016-07-01

To explore patient experiences of type 2 diabetes mellitus care delivered by general practice nurses in collaboration with the general practitioner. Australian general practice nurses are expanding their role in multidisciplinary type 2 diabetes care with limited research on patient perceptions of care provision within this collaborative model. Qualitative interpretive. Purposeful sampling was used to invite the patients (n = 10). Data were collected from semi-structured face-to-face interviews. Braun and Clarke's () inductive coding thematic analysis process was used to interpret the data. All participants experienced their General Practice Nurse consultation as a clinical assessment for their General Practitioner. While they appreciated the extra time with the General Practice Nurse, they were unsure of the purpose of the consultation beyond clinical assessment. They described the ongoing challenge of living with T2DM and identified a need for additional information and advice. The results suggest that the model of general practice nurse type 2 diabetes care has an important role to play in the delivery of effective ongoing care of patients. However, this role requires further development to ensure that it is understood by the patients as a role that not only conducts clinical assessments but also provides relevant education and self-management support as part of a collaborative approach to care delivery with General Practitioners. The findings are relevant to primary health care clinicians providing diabetes care to inform more relevant supportive care by general practice nurses. © 2016 John Wiley & Sons Ltd.

Experiences of using email for general practice consultations: a qualitative study.

PubMed

Atherton, Helen; Pappas, Yannis; Heneghan, Carl; Murray, Elizabeth

2013-11-01

Reports suggest approximately 21-23% of GPs in the UK have consulted with patients using email, but little is known about the nature of this use and what it means for clinicians and patients in general practice. To understand the use of email consultation in general practice by investigating the experiences of existing users and views of experts. A qualitative study conducted in 2010 using purposive sampling and semi-structured interviews in general practice and community settings in some London boroughs. A maximum variation sample of GPs and patients who had used email for consultation in general practice were recruited, as were policy and/or implementation experts. Interviews continued until saturation was achieved. In total 10 GPs, 14 patients, and six experts were interviewed. Consultation by email was often triggered by logistic or practical issues; motivators for ongoing use were the benefits, such as convenience, for GPs and patients. Both GPs and patients reported concerns about safety and lack of guidance about the 'rules of engagement' in email consultations, with GPs also concerned about workload. In response, both groups attempted to introduce their own rules, although this only went some way to addressing uncertainty. Long term, participants felt there was a need for regulation and guidance. Consultations by email in general practice occur in an unregulated and unstructured way. Current UK policy is to promote consultations by email, making it crucial to consider the responsibility and workload faced by clinicians, and the changes required to ensure safe use; not doing so may risk safety breaches and result in suboptimal care for patients.

Virtual temporal bone dissection system: OSU virtual temporal bone system: development and testing.

PubMed

Wiet, Gregory J; Stredney, Don; Kerwin, Thomas; Hittle, Bradley; Fernandez, Soledad A; Abdel-Rasoul, Mahmoud; Welling, D Bradley

2012-03-01

The objective of this project was to develop a virtual temporal bone dissection system that would provide an enhanced educational experience for the training of otologic surgeons. A randomized, controlled, multi-institutional, single-blinded validation study. The project encompassed four areas of emphasis: structural data acquisition, integration of the system, dissemination of the system, and validation. Structural acquisition was performed on multiple imaging platforms. Integration achieved a cost-effective system. Dissemination was achieved on different levels including casual interest, downloading of software, and full involvement in development and validation studies. A validation study was performed at eight different training institutions across the country using a two-arm randomized trial where study subjects were randomized to a 2-week practice session using either the virtual temporal bone or standard cadaveric temporal bones. Eighty subjects were enrolled and randomized to one of the two treatment arms; 65 completed the study. There was no difference between the two groups using a blinded rating tool to assess performance after training. A virtual temporal bone dissection system has been developed and compared to cadaveric temporal bones for practice using a multicenter trial. There was no statistical difference between practice on the current simulator compared to practice on human cadaveric temporal bones. Further refinements in structural acquisition and interface design have been identified, which can be implemented prior to full incorporation into training programs and used for objective skills assessment. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Long-term no-tillage and organic input management enhanced the diversity and stability of soil microbial community.

PubMed

Wang, Yi; Li, Chunyue; Tu, Cong; Hoyt, Greg D; DeForest, Jared L; Hu, Shuijin

2017-12-31

Intensive tillage and high inputs of chemicals are frequently used in conventional agriculture management, which critically depresses soil properties and causes soil erosion and nonpoint source pollution. Conservation practices, such as no-tillage and organic farming, have potential to enhance soil health. However, the long-term impact of no-tillage and organic practices on soil microbial diversity and community structure has not been fully understood, particularly in humid, warm climate regions such as the southeast USA. We hypothesized that organic inputs will lead to greater microbial diversity and a more stable microbial community, and that the combination of no-tillage and organic inputs will maximize soil microbial diversity. We conducted a long-term experiment in the southern Appalachian mountains of North Carolina, USA to test these hypotheses. The results showed that soil microbial diversity and community structure diverged under different management regimes after long term continuous treatments. Organic input dominated the effect of management practices on soil microbial properties, although no-tillage practice also exerted significant impacts. Both no-tillage and organic inputs significantly promoted soil microbial diversity and community stability. The combination of no-tillage and organic management increased soil microbial diversity over the conventional tillage and led to a microbial community structure more similar to the one in an adjacent grassland. These results indicate that effective management through reducing tillage and increasing organic C inputs can enhance soil microbial diversity and community stability. Copyright © 2017 Elsevier B.V. All rights reserved.

"A Very Steep Climb": Therapists' Perspectives on Barriers to Disclosure of Child Sexual Abuse Experiences for Men.

PubMed

Gruenfeld, Elizabeth; Willis, Danny G; Easton, Scott D

2017-01-01

Recent studies indicate that men experience unique barriers to disclosure of child sexual abuse. Blind spots held by mental health providers and social service agencies may inadvertently help produce and sustain these barriers. However, therapists who specialize in treating this population may also hold important insights into the barriers clients face. Because delayed and nondisclosure of child sexual abuse have been associated with negative mental health outcomes for adult survivors, understanding these barriers is critical to improve clinical practice and facilitate help-seeking. Using conventional content analysis, this study examined the perceptions of nine therapists who specialize in the treatment of men who were sexually abused in childhood, many of whom are considered pioneers in the field. Analyses identified nine types of barriers, which were organized into three categories: intrapersonal experience (difficult feelings, lack of language, and self-engagement), social milieu (internalized social stigma, negative responses, social loss or judgment, and masculine identity dissonance), and health care environment (structural barriers, relational challenges with therapists, and unhelpful therapeutic strategies). Implications for future research, clinical training, and clinical practice are discussed.

Plasticity of the postural function to sport and/or motor experience.

PubMed

Paillard, Thierry

2017-01-01

This review addresses the possible structural and functional adaptations of the postural function to motor experience. Evidence suggests that postural performance and strategy evolve after training in inactive subjects. In trained subjects, postural adaptations could also occur, since elite athletes exhibit better postural performance than, and different postural strategy to sub-elite athletes. The postural adaptations induced are specific to the context in which the physical activity is practiced. They appear to be so specific that there would be no or only a very slight effect of transfer to non-experienced motor tasks (apart from in subjects presenting low initial levels of postural performance, such as aged subjects). Yet adaptations could occur as part of the interlimb relationship, particularly when the two legs do not display the same motor experience. Mechanistic explanations as well as conceptual models are proposed to explain how postural adaptations operate according to the nature of physical activities and the context in which they are practiced as well as the level of motor expertise of individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Geographically distributed hybrid testing & collaboration between geotechnical centrifuge and structures laboratories

NASA Astrophysics Data System (ADS)

Ojaghi, Mobin; Martínez, Ignacio Lamata; Dietz, Matt S.; Williams, Martin S.; Blakeborough, Anthony; Crewe, Adam J.; Taylor, Colin A.; Madabhushi, S. P. Gopal; Haigh, Stuart K.

2018-01-01

Distributed Hybrid Testing (DHT) is an experimental technique designed to capitalise on advances in modern networking infrastructure to overcome traditional laboratory capacity limitations. By coupling the heterogeneous test apparatus and computational resources of geographically distributed laboratories, DHT provides the means to take on complex, multi-disciplinary challenges with new forms of communication and collaboration. To introduce the opportunity and practicability afforded by DHT, here an exemplar multi-site test is addressed in which a dedicated fibre network and suite of custom software is used to connect the geotechnical centrifuge at the University of Cambridge with a variety of structural dynamics loading apparatus at the University of Oxford and the University of Bristol. While centrifuge time-scaling prevents real-time rates of loading in this test, such experiments may be used to gain valuable insights into physical phenomena, test procedure and accuracy. These and other related experiments have led to the development of the real-time DHT technique and the creation of a flexible framework that aims to facilitate future distributed tests within the UK and beyond. As a further example, a real-time DHT experiment between structural labs using this framework for testing across the Internet is also presented.

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.

Child maltreatment, parent alcohol and drug-related problems, polydrug problems, and parenting practices: a test of gender differences and four theoretical perspectives.

PubMed

Locke, Thomas F; Newcomb, Michael

2004-03-01

The authors tested how adverse childhood experiences (child maltreatment and parent alcohol- and drug-related problems) and adult polydrug use (as a mediator) predict poor parenting in a community sample (237 mothers and 81 fathers). These relationships were framed within several theoretical perspectives, including observational learning, impaired functioning, self-medication, and parentification-pseudomaturity. Structural models revealed that child maltreatment predicted poor parenting practices among mothers. Parent alcohol- and drug-related problems had an indirect detrimental influence on mothers' parenting and practices through self-drug problems. Among fathers, emotional neglect experienced as a child predicted lack of parental warmth more parental neglect, and sexual abuse experienced as a child predicted a rejecting style of parenting.

Supporting metacognitive development in early science education: Exploring elementary teachers' beliefs and practices in metacognition

NASA Astrophysics Data System (ADS)

Braund, Heather Leigh-Anne

Metacognition is the understanding and control of cognitive processes. Students with high levels of metacognition achieve greater academic success. The purpose of this mixed-methods study was to examine elementary teachers' beliefs about metacognition and integration of metacognitive practices in science. Forty-four teachers were recruited through professional networks to complete a questionnaire containing open-ended questions (n = 44) and Likert-type items (n = 41). Five respondents were selected to complete semi-structured interviews informed by the questionnaire. The selected interview participants had a minimum of three years teaching experience and demonstrated a conceptual understanding of metacognition. Statistical tests (Pearson correlation, t-tests, and multiple regression) on quantitative data and thematic analysis of qualitative data indicated that teachers largely understood metacognition but had some gaps in their understanding. Participants' reported actions (teaching practices) and beliefs differed according to their years of experience but not gender. Hierarchical multiple regression demonstrated that the first block of gender and experience was not a significant predictor of teachers' metacognitive actions, although experience was a significant predictor by itself. Experience was not a significant predictor once teachers' beliefs were added. The majority of participants indicated that metacognition was indeed appropriate for elementary students. Participants consistently reiterated that students' metacognition developed with practice, but required explicit instruction. A lack of consensus remained around the domain specificity of metacognition. More specifically, the majority of questionnaire respondents indicated that metacognitive strategies could not be used across subject domains, whereas all interviewees indicated that they used strategies across subjects. Metacognition was integrated frequently into Ontario elementary classrooms; however, metacognition was integrated less frequently in science lessons. Lastly, participants used a variety of techniques to integrate metacognition into their classrooms. Implications for practice include the need for more professional development aimed at integrating metacognition into science lessons at both the Primary and Junior levels. Further, teachers could benefit from additional clarification on the three main components of metacognition and the need to integrate all three to successfully develop students' metacognition.

A Thematic Inquiry into the Burnout Experience of Australian Solo-Practicing Clinical Psychologists

PubMed Central

Hammond, Trent E.; Crowther, Andrew; Drummond, Sally

2018-01-01

Objective: Burnout is conceptualized as a syndrome that consists of emotional exhaustion, depersonalization, and decreased personal accomplishment. Despite the increased frequency and severity of burnout in the Western world, there is limited published research regarding the experiences of clinical psychologists who have had burnout. The present study examines clinical psychologists’ different experiences of burnout in Australia. Design and Methods: In the year 2015, six privately practicing and solo-employed clinical psychologists provided rich qualitative data by participating in semi-structured interviews. Thematic analysis was the method used to analyze clinical psychologists’ natural accounts of their burnout experiences. Using NVivo, emerging themes were identified through coding ‘first order constructs’ and then axial code ‘second order constructs.’ Findings: Clinical psychologists indicated that their roles are demanding and a diverse range of symptoms, including the enduring effects of burnout, mental stress, fatigue, decreased personal accomplishment, negative affect, depersonalization, reduced productivity and motivation, and insomnia. They identified precursors of burnout, including excessive workload and hours of work, life stresses, mismanaged workload, and transference. Clinical psychologists suggested that protective factors of burnout include knowledge and years worked in direct care, and trusting and long-term relationships. They indicated that the barriers to overcoming burnout include the fallacy that their clients’ expectations and needs are more important than their own, the financial cost of working in private practice, contemporary knowledge and inadequate education regarding self-care, and time constraints. Discussion and Conclusion: The findings presented in this study provide psychologists and other health professionals with an insight about the burnout experience and inform professionals of the mental shortcomings of working as a solo-practicing clinical psychologist. Findings from this study should lead to an increased understanding of the complexities of burnout, and ultimately reduced cases of burnout, absenteeism, and staff disengagement. PMID:29403402

Japanese style total quality control: A first hand experience

NASA Astrophysics Data System (ADS)

Cook, S. C.

1991-11-01

The scope, concepts and practices of Total Quality Control (TQC) as operated in Japan today are described. The following mechanisms and elements are introduced: policy deployment, cross functional management, small group activities, suggestion systems, standardization, the TQC promotion department, and TQC education. It is shown on a practical level, how TQC operates in the research and engineering divisions of the aeroengine and space operation at Ishikawajima Harima Industries in Japan. Japanese style TQC is a well developed, well promoted, well structured, common approach to achieving customer satisfaction through continuous improvements. Furthermore, TQC itself is being continuously improved with the Japanese still refining, extending, and developing TQC.

Promising Practices for Making Recreation Programming Matter for People who Experience Mental Illness.

PubMed

Hutchinson, Susan L; Fenton, Lara

2018-05-01

There is merit in understanding how recreation-oriented programs for adults living with mental illness address barriers to participation and how programming is structured to create safe and inclusive environments, resulting in programming that amplifies the benefits of recreation for mental well-being. Following an environmental scan of programs targeting adults living with mental illness in Canada, ten coordinators in community mental health settings were interviewed. Four themes were constructed to reflect characteristics deemed to be 'promising practices' related to recreation-oriented programming: (a) barriers and solutions to individual participation, (b) characteristics of welcoming and supportive environments, (c) leadership characteristics, and (d) program characteristics.

Factors affecting the innovative practice of nurse managers in health organisations.

PubMed

Williams, Lindy; McMurray, Adela J

This exploratory study reports on two surveys conducted in metropolitan and rural health organisations. Two questionnaires consisting of open and closed questions were distributed to a total of 340 respondents resulting in 176 usable responses, yielding a response rate of 53%. The findings revealed that nurse managers require fairness, trust, recognition, supervisory encouragement, organisational support, and reward for efforts. These are key aspects of organisational climate, which support innovative practice. Experience and innovation were significantly related and other factors such as, management structures and management styles, also had an impact on nurse managers' ability to exhibit innovative behaviour in the 21st Century workplace.

Nursing as a scientific undertaking and the intersection with science in undergraduate studies: implications for nursing management.

PubMed

Logan, Patricia A; Angel, Lyndall

2011-04-01

To explore the science-nursing tension and impact for nursing students studying bioscience. Several studies have examined why nursing students struggle to be successful in bioscience subjects. Undeveloped science background and theory-practice gaps are noted as contributing factors. A qualitative study explored the science-nursing tension with 100 Australian Registered Nurses using focus groups and a survey. The survey response rate was 85 from 550. Of survey respondents, 88% viewed nursing as an applied science. An emphasis on procedural skills and task busyness undermines theoretical understanding of care and can be a negative influence upon the student bioscience experience. Practicum mentors confident in scientific knowledge enhance the student experience of bioscience by providing opportunities for integration with practice. Competing philosophies that reinforce the science-nursing tension have an impact upon student endeavours yet the nexus created by practice can be used to activate student curiosity and scientific understanding. Nurse managers need to structure the student practicum to encompass scientific theory applied to practice with equal emphasis on task efficiency. This improves student attitudes to learning bioscience and potentially minimizes the impact of the science-nursing tension on student learning. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Emotion socialization practices in Italian and Hong Kong-Chinese mothers.

PubMed

Fiorilli, Caterina; De Stasio, Simona; Di Chicchio, Carlo; Chan, Siu Mui

2015-01-01

Parents' emotion socialization practices are their ways of handling their children's emotional experiences in light of cultural expectations surrounding emotions. Such practices are thought to significantly affect children's social adjustment. We compared the parenting practices of Italian and Hong Kong Chinese samples in an ethnological validation study of the maternal responses to children's emotion scale (MRCES). Participants were 71 Italian mothers (M = 39.45) and 71 Hong Kong-Chinese mothers (M = 37.75) with children aged 6-9 years. The results confirmed the two-factor structure identified by the scale's authors, namely coaching/emotion-encouraging and emotion dismissing approaches, respectively. Each of the two factors displayed satisfactory internal consistency. The Chinese mothers obtained higher scores than the Italian mothers on both subscales. Our findings suggested that parents' emotion socialization practices for coping with children's emotions received different degrees of emphasis and were underpinned by different meaning in the Hong Kong and Italian cultural groups. These cultural differences are discussed in relation to their effect on children's socio-emotional development.

The payment for performance model and its influence on British general practitioners' principles and practice.

PubMed

Norman, Armando Henrique; Russell, Andrew J; Macnaughton, Jane

2014-01-01

This article explores some effects of the British payment for performance model on general practitioners' principles and practice, which may contribute to issues related to financial incentive modalities and quality of primary healthcare services in low and middle-income countries. Aiming to investigate what general practitioners have to say about the effect of the British payment for performance on their professional ethos we carried out semi-structured interviews with 13 general practitioner educators and leaders working in academic medicine across the UK. The results show a shift towards a more biomedical practice model and fragmented care with nurse practitioners and other health care staff focused more on specific disease conditions. There has also been an increased medicalisation of the patient experience both through labelling and the tendency to prescribe medications rather than non-pharmacological interventions. Thus, the British payment for performance has gradually strengthened a scientific-bureaucratic model of medical practice which has had profound effects on the way family medicine is practiced in the UK.

Patients' views of pay for performance in primary care: a qualitative study.

PubMed

Hannon, Kerin L; Lester, Helen E; Campbell, Stephen M

2012-05-01

Many countries use pay-for-performance schemes to reward family practices financially for achieving quality indicators. The views of patients on pay for performance remain largely unexplored. To gain the views of family practice patients on the United Kingdom pay-for-performance Quality and Outcomes Framework (QOF). Interviews with 52 patients were conducted in 15 family practices across England. All patients had at least one long-term condition that had been diagnosed before the introduction of the QOF in 2004. Semi-structured interviews analysed using open explorative thematic coding. Few patients had heard of the QOF or had noticed changes to the structure or process of their care. However, where they were noted, changes to consultations such as increased use of computers and health checks initiated by the GP or practice nurse were seen as good practice. The majority of patients were surprised to hear their practice received bonuses for doing 'simple things'. Some patients also raised concerns over potential unintended consequences of pay-for-performance frameworks, such as a reduced focus on non-incentivised areas. This study adds a unique patient perspective to the debate around the impact of pay-for-performance schemes and consequences on patient care. Patients' views, experiences, and concerns about pay for performance mostly chime with previously described opinions of primary care staff. Patient surprise and concern around incentivising basic processes of care shows how patient views are vital when monitoring and evaluating a scheme that is designed to improve patient care.

Overcoming early barriers to PCMH practice improvement in family medicine residencies.

PubMed

Fernald, Douglas H; Deaner, Nicole; O'Neill, Caitlin; Jortberg, Bonnie T; degruy, Frank Verloin; Dickinson, W Perry

2011-01-01

Residency programs face inevitable challenges as they redesign their practices for higher quality care and resident training. Identifying and addressing early barriers can help align priorities and thereby augment the capacity to change. Evaluation of the Colorado Family Medicine Residency PCMH Project included iterative qualitative analysis of field notes, interviews, and documents to identify early barriers to change and strategies to overcome them. Nine common but not universal barriers were identified: (1) a practice's history reflected some negative past experiences with quality improvement or routines incompatible with transformative change, (2) leadership gaps were evident in unprepared practice leaders or hierarchical leadership, (3) resistance and skepticism about change were expressed through cynicism aimed at change or ability to change, (4) unproductive team processes were reflected in patterns of canceled meetings, absentee leaders, or lack of accountability, (5) knowledge gaps about the Patient-centered Medical Home (PCMH) were apparent from incomplete dissemination about the project or planned changes, (6) EHR implementation distracted focus or stalled improvement activity, (7) sponsoring organizations' constraints emerged from staffing rules and differing priorities, (8) insufficient staff participation resulted from traditional role expectations and structures, and (9) communication was hampered by ineffective methods and part-time faculty and residents. Early barriers responded to varying degrees to specific interventions by practice coaches. Some barriers that interfere with practices getting started with cultural and structural transformation can be addressed with persistent attention and reflection from on-site coaches and by realigning the talents, leaders, and priorities already in these residency programs.

Organizing physics teacher professional education around productive habit development: A way to meet reform challenges

NASA Astrophysics Data System (ADS)

Etkina, Eugenia; Gregorcic, Bor; Vokos, Stamatis

2017-06-01

Extant literature on teacher preparation suggests that preservice teachers learn best when they are immersed in a community that allows them to develop dispositions, knowledge, and practical skills and share with the community a strong vision of what good teaching entails. However, even if the requisite dispositions, knowledge, and skills in pursuing the shared vision of good teaching are developed, the professional demands on a teacher's time are so great out of, and so complex during class time that if every decision requires multiple considerations and deliberations with oneself, the productive decisions might not materialize. We argue that the link between intentional decision making and actual teaching practice are teacher's habits (spontaneous responses to situational cues). Teachers unavoidably develop habits with practical experience and under the influence of knowledge and belief structures that in many ways condition the responses of teachers in their practical work. To steer new teachers away from developing unproductive habits directed towards "survival" instead of student learning, we propose that teacher preparation programs (e.g., in physics) strive to develop in preservice teachers strong habits of mind and practice that will serve as an underlying support structure for beginning teachers. We provide examples of physics teacher habits that are to be developed during the program, propose mechanisms for the development of such habits, and outline possible future research agendas around habits.

Pitfalls of implementing acute care surgery.

PubMed

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.

An ontology of scientific experiments

PubMed Central

Soldatova, Larisa N; King, Ross D

2006-01-01

The formal description of experiments for efficient analysis, annotation and sharing of results is a fundamental part of the practice of science. Ontologies are required to achieve this objective. A few subject-specific ontologies of experiments currently exist. However, despite the unity of scientific experimentation, no general ontology of experiments exists. We propose the ontology EXPO to meet this need. EXPO links the SUMO (the Suggested Upper Merged Ontology) with subject-specific ontologies of experiments by formalizing the generic concepts of experimental design, methodology and results representation. EXPO is expressed in the W3C standard ontology language OWL-DL. We demonstrate the utility of EXPO and its ability to describe different experimental domains, by applying it to two experiments: one in high-energy physics and the other in phylogenetics. The use of EXPO made the goals and structure of these experiments more explicit, revealed ambiguities, and highlighted an unexpected similarity. We conclude that, EXPO is of general value in describing experiments and a step towards the formalization of science. PMID:17015305

I don't think general practice should be the front line: Experiences of general practitioners working with refugees in South Australia

PubMed Central

Johnson, David R; Ziersch, Anna M; Burgess, Teresa

2008-01-01

Introduction Many refugees arrive in Australia with complex health needs. In South Australia (SA), providing initial health care to refugees is the responsibility of General Practitioners (GPs) in private practice. Their capacity to perform this work effectively for current newly arrived refugees is uncertain. The aim of this study was to document the challenges faced by GPs in private practice in SA when providing initial care to refugees and to discuss the implications of this for policy relating to optimising health care services for refugees. Methods Semi-structured interviews with twelve GPs in private practice and three Medical Directors of Divisions of General Practice. Using a template analysis approach the interviews were coded and analysed thematically. Results Multiple challenges providing care to refugees were found including those related to: (1) refugee health issues; (2) the GP-refugee interaction; and (3) the structure of general practice. The Divisions also reported challenges assisting GPs to provide effective care related to a lack of funding and awareness of which GPs required support. Although respondents suggested a number of ways that GPs could be assisted to provide better initial care to refugees, strong support was voiced for the initial care of refugees to be provided via a specialist refugee health service. Conclusion GPs in this study were under-resourced, at both an individual GP level as well as a structural level, to provide effective initial care for refugees. In SA, there are likely to be a number of challenges attempting to increase the capacity of GPs in private practice to provide initial care. An alternative model is for refugees with multiple and complex health care needs as well as those with significant resettlement challenges to receive initial health care via the existing specialist refugee health service in Adelaide. PMID:18687150

Long-term prospective teaching effectivity of practical skills training and a first OSCE in cranio maxillofacial surgery for dental students.

PubMed

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.