Designing HRD Interventions for Employee-Robot Interaction

ERIC Educational Resources Information Center

Heo, Se Jin

2011-01-01

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

Review of critical factors for SEA implementation

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

Zhang Jie, E-mail: jasmine@plan.aau.dk; Christensen, Per; Kornov, Lone

The implementation process involved in translating Strategic Environmental Assessment (SEA) intention into action is vital to an effective SEA. Many factors influence implementation and thus the effectiveness of an SEA. Empirical studies have identified and documented some factors influencing the implementation of an SEA. This research is fragmented, however, and it is still not clear what are the most critical factors of effective SEA performance, and how these relate to different stages of the implementation process or other contextual circumstances. The paper takes its point of departure in implementation theory. Firstly, we introduce implementation theory, and then use it inmore » practice to establish a more comprehensive model related to the stages in the implementation process. Secondly, we identify the critical factors in order to see how they are related to the different stages of SEA or are more general in character. Finally we map the different critical factors and how they influence the overall results of an SEA. Based on a literature review, we present a comprehensive picture of the critical factors and where they are found in the process. We conclude that most of the critical factors identified are of a more general character influencing the SEA process as such, while only one out of four of these factors relates to the specific stages of the SEA. Based on this mapping we can sketch a picture of the totality of critical factors. In this study 266 notions of critical factors were identified. Seen at the level of notions of critical factors, only 24% of these relate to specific stages while for 76% the critical factors are of a more general nature. These critical factors interact in complex ways and appear in different combinations in different stages of the implementation process so tracing the cause and effect is difficult. The pervasiveness of contextual and general factors also clearly suggests that there is no single way to put SEA into practice. The paper identifies some of the critical factors for effective SEA implementation, but further research is still needed to conclude which factors are more critical than others, just as the contingencies on which they depend are not easy to unravel. - Highlights: Black-Right-Pointing-Pointer The research on critical factors influencing SEA implementation is fragmented. Black-Right-Pointing-Pointer The critical factors are used to discuss 'hot-spots' in the implementation process. Black-Right-Pointing-Pointer Critical factors are just as broad as the concept of effectiveness. Black-Right-Pointing-Pointer Both stage and general factors are relevant in explaining the effectiveness of SEA.« less

Critical Thinking among Post-Graduate Diploma in Education Students in Higher Education: Reality or Fuss?

ERIC Educational Resources Information Center

Moeti, Bakadzi; Mgawi, Rabson Killion; Moalosi, Waitshega Tefo Smitta

2017-01-01

Critical thinking is recognised as an influential attribute to achieve quality learning and teaching in higher education institutions world over. This interpretive research study explored the critical thinking among PGDE students at the University of Botswana. The aim of the study was to identify factors contributing to the application of critical…

Critical Thinking as Related to PSSC and Non-PSSC Physics Programs.

ERIC Educational Resources Information Center

Poel, Robert Herman

The three purposes of this study were (1) to evaluate a paper-pencil test of critical thinking skills using physical science content, (2) to compare the effectiveness of Physical Science Study Committee (PSSC) and non-PSSC physics programs in developing critical thinking skills, and (3) to identify teacher-pupil verbal interaction behaviors that…

Space tug propulsion system failure mode, effects and criticality analysis

NASA Technical Reports Server (NTRS)

Boyd, J. W.; Hardison, E. P.; Heard, C. B.; Orourke, J. C.; Osborne, F.; Wakefield, L. T.

1972-01-01

For purposes of the study, the propulsion system was considered as consisting of the following: (1) main engine system, (2) auxiliary propulsion system, (3) pneumatic system, (4) hydrogen feed, fill, drain and vent system, (5) oxygen feed, fill, drain and vent system, and (6) helium reentry purge system. Each component was critically examined to identify possible failure modes and the subsequent effect on mission success. Each space tug mission consists of three phases: launch to separation from shuttle, separation to redocking, and redocking to landing. The analysis considered the results of failure of a component during each phase of the mission. After the failure modes of each component were tabulated, those components whose failure would result in possible or certain loss of mission or inability to return the Tug to ground were identified as critical components and a criticality number determined for each. The criticality number of a component denotes the number of mission failures in one million missions due to the loss of that component. A total of 68 components were identified as critical with criticality numbers ranging from 1 to 2990.

Nuclear criticality safety: 5-day training course

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

Schlesser, J.A.

1992-11-01

This compilation of notes is presented as a source reference for the criticality safety course. It represents the contributions of many people, particularly Tom McLaughlin, the course's primary instructor. At the completion of this training course, the attendee will: be able to define terms commonly used in nuclear criticality safety; be able to appreciate the fundamentals of nuclear criticality safety; be able to identify factors which affect nuclear criticality safety; be able to identify examples of criticality controls as used at Los Alamos; be able to identify examples of circumstances present during criticality accidents; be able to identify examples ofmore » computer codes used by the nuclear criticality safety specialist; be able to identify examples of safety consciousness required in nuclear criticality safety.« less

Using the case study teaching method to promote college students' critical thinking skills

NASA Astrophysics Data System (ADS)

Terry, David Richard

2007-12-01

The purpose of this study was to examine general and domain-specific critical thinking skills in college students, particularly ways in which these skills might be increased through the use of the case study method of teaching. General critical thinking skills were measured using the Watson-Glaser Critical Thinking Appraisal (WGCTA) Short Form, a forty-item paper-and-pencil test designed to measure important abilities involved in critical thinking, including inference, recognition of assumptions, deduction, interpretation, and evaluation of arguments. The ability to identify claims and support those claims with evidence is also an important aspect of critical thinking. I developed a new instrument, the Claim and Evidence Assessment Tool (CEAT), to measure these skills in a domain-specific manner. Forty undergraduate students in a general science course for non-science majors at a small two-year college in the northeastern United States experienced positive changes in general critical thinking according to results obtained using the Watson-Glaser Critical Thinking Appraisal (WGCTA). In addition, the students showed cumulative improvement in their ability to identify claims and evidence, as measured by the Claim and Evidence Assessment Tool (CEAT). Mean score on the WGCTA improved from 22.15 +/- 4.59 to 23.48 +/- 4.24 (out of 40), and the mean CEAT score increased from 14.98 +/- 3.28 to 16.20 +/- 3.08 (out of 24). These increases were modest but statistically and educationally significant. No differences in claim and evidence identification were found between students who learned about specific biology topics using the case study method of instruction and those who were engaged in more traditional instruction, and the students' ability to identify claims and evidence and their factual knowledge showed little if any correlation. The results of this research were inconclusive regarding whether or not the case study teaching method promotes college students' general or domain-specific critical thinking skills, and future research addressing this issue should probably utilize larger sample sizes and a pretest-posttest randomized experimental design.

Critical Issues in Evaluating National-Level Health Data Warehouses in LMICs: Kenya Case Study.

PubMed

Gesicho, Milka B; Babic, Ankica; Were, Martin C

2017-01-01

Low-Middle-Income-Countries (LMICs) are beginning to adopt national health data warehousing (NHDWs) for making strategic decisions and for improving health outcomes. Given the numerous challenges likely to be faced in establishment of NHDWs by LMICs, it is prudent that evaluations are done in relation to the data warehouses (DWs), in order to identify and mitigate critical issues that arise. When critic issues are not identified, DWs are prone to suboptimal implementation with compromised outcomes. Despite the fact that several publications exist on evaluating DWs, evaluations specific to health data warehouses are scanty, with almost none evaluating NHDWs more so in LMICs. This paper uses a systematic approach guided by an evaluation framework to identify critical issues to be considered in evaluating Kenya's NHDW.

Exploration of critical thinking in dental hygiene education.

PubMed

Beistle, Kimberly S; Palmer, Louann Bierlein

2014-12-01

This qualitative study explores the perceptions of dental hygiene faculty regarding issues surrounding critical thinking skills integration within their associate degree dental hygiene programs. Twenty faculty participated in the study, as drawn from 11 accredited associate degree dental hygiene programs in one Midwest state. Multiple sources of data were collected, including email questionnaires, individual follow-up phone interviews and artifacts. Interpretive analysis was conducted. Data analysis revealed that faculty generally understood critical thinking, but interpretations varied. Most do not use varied teaching strategies to promote critical thinking skills, and focus on one particular strategy--that of case studies. The participants identified the need for allied health-focused faculty development opportunities, and noted that calibration of instruction was needed. Despite challenges, faculty felt responsible for teaching critical thinking skills, and identified the need for time to build critical thinking skills into the curriculum. This study was conducted in response to the American Dental Education Association Commission on Change and Innovation's challenge for dental hygiene educators to comprehend their own knowledge on the concept of critical thinking related to research-based pedagogical approaches to teaching and learning. Findings revealed a strong desire among the dental hygiene faculty in this study to incorporate critical thinking into their work. They want to do what they believe is the right thing, but their actual knowledge of the definitional and application theories about critical thinking is still in the early stages of development. Regular and targeted faculty development opportunities are needed. Copyright © 2014 The American Dental Hygienists’ Association.

The Identification, Implementation, and Evaluation of Critical User Interface Design Features of Computer-Assisted Instruction Programs in Mathematics for Students with Learning Disabilities

ERIC Educational Resources Information Center

Seo, You-Jin; Woo, Honguk

2010-01-01

Critical user interface design features of computer-assisted instruction programs in mathematics for students with learning disabilities and corresponding implementation guidelines were identified in this study. Based on the identified features and guidelines, a multimedia computer-assisted instruction program, "Math Explorer", which delivers…

Body image of patients with burns sequellae: evaluation through the critical incident technique.

PubMed

Bergamasco, E C; Rossi, L A; da C G Amancio, A; de Carvalho, E C

2002-02-01

The present investigation is a descriptive study, with a retrospective, ex-post facto, design. The objectives of this study were to characterize the body image changes in patients with burn sequellae, through the critical incident technique and to identify and categorize critical incidents, comparing them to the characteristics defined by the Taxonomy of the North American Nursing Diagnoses Association (NANDA) for the body image disturbance nursing diagnosis. Thirty-five patients were interviewed. Two types of critical incidents were identified: 'facing the mirror'--the moment the patient looks at himself/herself and notices the changes in his/her body, and 'facing other people'--the moment the patient becomes aware that he/she calls the attention of others. Associated with the perceptions of changes in their bodies, the patients reported feelings of fear (19), rebellion (18) and shame (12). They also presented coping mechanisms of denial (12), rationalization (7), minimization (7) and repression (2). NANDA's body image disturbance diagnosis was identified in all patients.

Support Services in Social Studies Courses for Students with Hearing Loss

ERIC Educational Resources Information Center

Akay, Elif

2018-01-01

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

Review of teaching methods and critical thinking skills.

PubMed

Kowalczyk, Nina

2011-01-01

Critical information is needed to inform radiation science educators regarding successful critical thinking educational strategies. From an evidence-based research perspective, systematic reviews are identified as the most current and highest level of evidence. Analysis at this high level is crucial in analyzing those teaching methods most appropriate to the development of critical thinking skills. To conduct a systematic literature review to identify teaching methods that demonstrate a positive effect on the development of students' critical thinking skills and to identify how these teaching strategies can best translate to radiologic science educational programs. A comprehensive literature search was conducted resulting in an assessment of 59 full reports. Nineteen of the 59 reports met inclusion criteria and were reviewed based on the level of evidence presented. Inclusion criteria included studies conducted in the past 10 years on sample sizes of 20 or more individuals demonstrating use of specific teaching interventions for 5 to 36 months in postsecondary health-related educational programs. The majority of the research focused on problem-based learning (PBL) requiring standardized small-group activities. Six of the 19 studies focused on PBL and demonstrated significant differences in student critical thinking scores. PBL, as described in the nursing literature, is an effective teaching method that should be used in radiation science education. ©2011 by the American Society of Radiologic Technologists.

Methods for Detecting Early Warnings of Critical Transitions in Time Series Illustrated Using Simulated Ecological Data

PubMed Central

Dakos, Vasilis; Carpenter, Stephen R.; Brock, William A.; Ellison, Aaron M.; Guttal, Vishwesha; Ives, Anthony R.; Kéfi, Sonia; Livina, Valerie; Seekell, David A.; van Nes, Egbert H.; Scheffer, Marten

2012-01-01

Many dynamical systems, including lakes, organisms, ocean circulation patterns, or financial markets, are now thought to have tipping points where critical transitions to a contrasting state can happen. Because critical transitions can occur unexpectedly and are difficult to manage, there is a need for methods that can be used to identify when a critical transition is approaching. Recent theory shows that we can identify the proximity of a system to a critical transition using a variety of so-called ‘early warning signals’, and successful empirical examples suggest a potential for practical applicability. However, while the range of proposed methods for predicting critical transitions is rapidly expanding, opinions on their practical use differ widely, and there is no comparative study that tests the limitations of the different methods to identify approaching critical transitions using time-series data. Here, we summarize a range of currently available early warning methods and apply them to two simulated time series that are typical of systems undergoing a critical transition. In addition to a methodological guide, our work offers a practical toolbox that may be used in a wide range of fields to help detect early warning signals of critical transitions in time series data. PMID:22815897

Safety Hazards During Intrahospital Transport: A Prospective Observational Study.

PubMed

Bergman, Lina M; Pettersson, Monica E; Chaboyer, Wendy P; Carlström, Eric D; Ringdal, Mona L

2017-10-01

To identify, classify, and describe safety hazards during the process of intrahospital transport of critically ill patients. A prospective observational study. Data from participant observations of the intrahospital transport process were collected over a period of 3 months. The study was undertaken at two ICUs in one university hospital. Critically ill patients transported within the hospital by critical care nurses, unlicensed nurses, and physicians. None. Content analysis was performed using deductive and inductive approaches. We detected a total of 365 safety hazards (median, 7; interquartile range, 4-10) during 51 intrahospital transports of critically ill patients, 80% of whom were mechanically ventilated. The majority of detected safety hazards were assessed as increasing the risk of harm, compromising patient safety (n = 204). Using the System Engineering Initiative for Patient Safety, we identified safety hazards related to the work system, as follows: team (n = 61), tasks (n = 83), tools and technologies (n = 124), environment (n = 48), and organization (n = 49). Inductive analysis provided an in-depth description of those safety hazards, contributing factors, and process-related outcomes. Findings suggest that intrahospital transport is a hazardous process for critically ill patients. We have identified several factors that may contribute to transport-related adverse events, which will provide the opportunity for the redesign of systems to enhance patient safety.

Nurses' perceptions of involvement in Thunder Project. American Association of Critical-Care Nurses Thunder Project task force.

PubMed

1995-03-01

The American Association of Critical-Care Nurse's (AACN) Thunder Project was conceptualized and developed to provide critical-care nurses with a research protocol ready for institutional review and implementation. Project goals included providing a research package (protocol, educational, and data collection materials) and a topic of clinical significance to critical-care nurses. Site coordinators and research associates were identified at participating institutions to coordinate and implement all study activities. In this article, an evaluation study undertaken to recount perceptions of site coordinators and research associates in relation to project goals and research experience is described. Data demonstrated that study goals were achieved, and research experience was considered professionally enhancing. Written comments described barriers to project implementation at participating sites. Obtaining informed consent and physician approval and/or cooperation were identified as significant barriers to implementation at some sites.

"In the Middle of Difficulty Lies Opportunity"--Using a Case Study to Identify Critical Success Factors Contributing to the Initiation of International Collaborative Projects

ERIC Educational Resources Information Center

Johnson, Ian M.

2005-01-01

This paper identifies factors that contribute to the successful initiation of international collaborative projects intended to support the development of education for librarianship and information sciences. It discusses the widespread failure to analyse the Critical Success Factors in international collaborative projects and proposes a case study…

Triage: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

Christian, Michael D; Sprung, Charles L; King, Mary A; Dichter, Jeffrey R; Kissoon, Niranjan; Devereaux, Asha V; Gomersall, Charles D

2014-10-01

Pandemics and disasters can result in large numbers of critically ill or injured patients who may overwhelm available resources despite implementing surge-response strategies. If this occurs, critical care triage, which includes both prioritizing patients for care and rationing scarce resources, will be required. The suggestions in this chapter are important for all who are involved in large-scale pandemics or disasters with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. The Triage topic panel reviewed previous task force suggestions and the literature to identify 17 key questions for which specific literature searches were then conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. Suggestions from the previous task force that were not being updated were also included for validation by the expert panel. The suggestions from the task force outline the key principles upon which critical care triage should be based as well as a path for the development of the plans, processes, and infrastructure required. This article provides 11 suggestions regarding the principles upon which critical care triage should be based and policies to guide critical care triage. Ethical and efficient critical care triage is a complex process that requires significant planning and preparation. At present, the prognostic tools required to produce an effective decision support system (triage protocol) as well as the infrastructure, processes, legal protections, and training are largely lacking in most jurisdictions. Therefore, critical care triage should be a last resort after mass critical care surge strategies.

A 5-year retrospective audit of prescribing by a critical care outreach team.

PubMed

Wilson, Mark

2018-05-01

UK prescribing legislation changes made in 2006 and 2012 enabled appropriately qualified nurses to prescribe any licensed medication, and all controlled drugs in schedule 2-5 of the Misuse of Drugs Regulations 2001, for any medical condition within their clinical competence. Critical Care Outreach nurses who are independent nurse prescribers are ideally placed to ensure that acutely ill patients receive treatment without delay. The perceived challenge was how Critical Care Outreach nurses would be able to safely prescribe for a diverse patient group. This study informs this developing area of nurse prescribing in critical care practice. The aims of the audit were to: identify which medications were prescribed; develop a critical care outreach formulary; identify the frequency, timing and number of prescribing decisions being made; identify if prescribing practice changed over the years and provide information for our continuing professional development. This article reports on data collected from a 5-year retrospective audit; of prescribing activity undertaken by nine independent nurse prescribers working in a 24/7 Critical Care Outreach team of a 600-bedded district general hospital in the UK. In total, 8216 medication items were prescribed, with an average of 2·6 prescribed per shift. The most commonly prescribed items were intravenous fluids and analgesia, which were mostly prescribed at night and weekends. The audit has shown that Critical Care Outreach nurse prescribing is feasible in a whole hospital patient population. The majority of prescribing occurred after 16:00 and at night. Further research would be beneficial, particularly looking at patient outcomes following reviews from prescribing critical care outreach nurses. The audit is one of the only long-term studies that describes prescribing practice in Critical Care Outreach teams in the UK. © 2017 British Association of Critical Care Nurses.

Evidence of Critical Thinking in High School Humanities Classrooms (Evidencias del Pensamiento Crítico en las Clases de Ciencias Humanas en Bachillerato)

ERIC Educational Resources Information Center

Alfonso, David Vargas

2015-01-01

Critical thinking skills (CTS) are a group of higher order thinking abilities related with complex processes of learning like contextualization or problem solving. This exploratory research study identified whether critical thinking skills were present in high school humanities classrooms. The study was carried out in a private school in Bogotá,…

A Baseline Study of Strategies to Promote Critical Thinking in the Preschool Classroom (Un Estudio de Base sobre Estrategias para la Promoción de Pensamiento Critico en las Aulas de Preescolar)

ERIC Educational Resources Information Center

León, Jenny Melo

2015-01-01

The purpose of this study was to identify the different incidents of critical thinking in five preschool classrooms in one school, and the instructional strategies preschool teachers employed in the development of children's critical thinking. The participants in this study were five self-contained preschool teachers and their corresponding…

Clustering analysis of water distribution systems: identifying critical components and community impacts.

PubMed

Diao, K; Farmani, R; Fu, G; Astaraie-Imani, M; Ward, S; Butler, D

2014-01-01

Large water distribution systems (WDSs) are networks with both topological and behavioural complexity. Thereby, it is usually difficult to identify the key features of the properties of the system, and subsequently all the critical components within the system for a given purpose of design or control. One way is, however, to more explicitly visualize the network structure and interactions between components by dividing a WDS into a number of clusters (subsystems). Accordingly, this paper introduces a clustering strategy that decomposes WDSs into clusters with stronger internal connections than external connections. The detected cluster layout is very similar to the community structure of the served urban area. As WDSs may expand along with urban development in a community-by-community manner, the correspondingly formed distribution clusters may reveal some crucial configurations of WDSs. For verification, the method is applied to identify all the critical links during firefighting for the vulnerability analysis of a real-world WDS. Moreover, both the most critical pipes and clusters are addressed, given the consequences of pipe failure. Compared with the enumeration method, the method used in this study identifies the same group of the most critical components, and provides similar criticality prioritizations of them in a more computationally efficient time.

Implementation of quality by design principles in the development of microsponges as drug delivery carriers: Identification and optimization of critical factors using multivariate statistical analyses and design of experiments studies.

PubMed

Simonoska Crcarevska, Maja; Dimitrovska, Aneta; Sibinovska, Nadica; Mladenovska, Kristina; Slavevska Raicki, Renata; Glavas Dodov, Marija

2015-07-15

Microsponges drug delivery system (MDDC) was prepared by double emulsion-solvent-diffusion technique using rotor-stator homogenization. Quality by design (QbD) concept was implemented for the development of MDDC with potential to be incorporated into semisolid dosage form (gel). Quality target product profile (QTPP) and critical quality attributes (CQA) were defined and identified, accordingly. Critical material attributes (CMA) and Critical process parameters (CPP) were identified using quality risk management (QRM) tool, failure mode, effects and criticality analysis (FMECA). CMA and CPP were identified based on results obtained from principal component analysis (PCA-X&Y) and partial least squares (PLS) statistical analysis along with literature data, product and process knowledge and understanding. FMECA identified amount of ethylcellulose, chitosan, acetone, dichloromethane, span 80, tween 80 and water ratio in primary/multiple emulsions as CMA and rotation speed and stirrer type used for organic solvent removal as CPP. The relationship between identified CPP and particle size as CQA was described in the design space using design of experiments - one-factor response surface method. Obtained results from statistically designed experiments enabled establishment of mathematical models and equations that were used for detailed characterization of influence of identified CPP upon MDDC particle size and particle size distribution and their subsequent optimization. Copyright © 2015 Elsevier B.V. All rights reserved.

Personal Epistemology and Mathematics: A Critical Review and Synthesis of Research

ERIC Educational Resources Information Center

Muis, Krista R.

2004-01-01

This review critically examines 33 studies on students' epistemological beliefs about mathematics. Five categories were identified: beliefs about mathematics, development of beliefs, effects of beliefs on behavior, domain differences, and changing beliefs. Studies examining beliefs about mathematics revealed consistent patterns of nonavailing…

A critical tryptophan and Ca2+ in activation and catalysis of TPPI, the enzyme deficient in classic late-infantile neuronal ceroid lipofuscinosis.

PubMed

Kuizon, Salomon; DiMaiuta, Kathleen; Walus, Marius; Jenkins, Edmund C; Kuizon, Marisol; Kida, Elizabeth; Golabek, Adam A; Espinoza, Daniel O; Pullarkat, Raju K; Junaid, Mohammed A

2010-08-03

Tripeptidyl aminopeptidase I (TPPI) is a crucial lysosomal enzyme that is deficient in the fatal neurodegenerative disorder called classic late-infantile neuronal ceroid lipofuscinosis (LINCL). It is involved in the catabolism of proteins in the lysosomes. Recent X-ray crystallographic studies have provided insights into the structural/functional aspects of TPPI catalysis, and indicated presence of an octahedrally coordinated Ca(2+). Purified precursor and mature TPPI were used to study inhibition by NBS and EDTA using biochemical and immunological approaches. Site-directed mutagenesis with confocal imaging technique identified a critical W residue in TPPI activity, and the processing of precursor into mature enzyme. NBS is a potent inhibitor of the purified TPPI. In mammalian TPPI, W542 is critical for tripeptidyl peptidase activity as well as autocatalysis. Transfection studies have indicated that mutants of the TPPI that harbor residues other than W at position 542 have delayed processing, and are retained in the ER rather than transported to lysosomes. EDTA inhibits the autocatalytic processing of the precursor TPPI. We propose that W542 and Ca(2+) are critical for maintaining the proper tertiary structure of the precursor proprotein as well as the mature TPPI. Additionally, Ca(2+) is necessary for the autocatalytic processing of the precursor protein into the mature TPPI. We have identified NBS as a potent TPPI inhibitor, which led in delineating a critical role for W542 residue. Studies with such compounds will prove valuable in identifying the critical residues in the TPPI catalysis and its structure-function analysis.

Nurse's perceptions of physiotherapists in critical care team: Report of a qualitative study.

PubMed

Gupte, Pranati; Swaminathan, Narasimman

2016-03-01

Interprofessional relationship plays a major role in effective patient care. Specialized units such as critical care require multidisciplinary care where perception about every members role may affect the delivery of patient care. The objective of this study was to find out nurses' perceptions of the role of physiotherapists in the critical care team. Qualitative study by using semi-structured interview was conducted among the qualified nurses working in the Intensive Care Unit of a tertiary care hospital. The interview consisted of 19 questions divided into 3 sections. Interviews were audio recorded and transcribed. In-depth content analysis was carried out to identify major themes in relation to the research question. Analysis identified five major issues which included role and image of a physiotherapist, effectiveness of treatment, communications, teamwork, and interprofessional relations. Physiotherapists were perceived to be an important member of the critical team with the role of mobilizing the patients. The respondents admitted that there existed limitations in interprofessional relationship. Nurses perceived the role of physiotherapist in the critical care unit as an integral part and agreed on the need for inclusion of therapist multidisciplinary critical care team.

The Influence of State Policies on Critical Infrastructure Resilience: An Approach for Analyzing Transportation and Capital Investment

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

Wall, Thomas; Trail, Jessica; Gevondyan, Erna

During times of crisis, communities and regions rely heavily on critical infrastructure systems to support their emergency management response and recovery activities. Therefore, the resilience of critical infrastructure systems to crises is a pivotal factor to a community’s overall resilience. Critical infrastructure resilience can be influenced by many factors, including State policies – which are not always uniform in their structure or application across the United States – were identified by the U.S. Department of Homeland Security as an area of particular interest with respect to their the influence on the resilience of critical infrastructure systems. This study focuses onmore » developing an analytical methodology to assess links between policy and resilience, and applies that methodology to critical infrastructure in the Transportation Systems Sector. Specifically, this study seeks to identify potentially influential linkages between State transportation capital funding policies and the resilience of bridges located on roadways that are under the management of public agencies. This study yielded notable methodological outcomes, including the general capability of the analytical methodology to yield – in the case of some States – significant results connecting State policies with critical infrastructure resilience, with the suggestion that further refinement of the methodology may be beneficial.« less

Harnessing Information Technology to Improve the Process of Students' Evaluations of Teaching: An Exploration of Students' Critical Success Factors of Online Evaluations

ERIC Educational Resources Information Center

Nevo, Dorit; McClean, Ron; Nevo, Saggi

2010-01-01

This paper discusses the relative advantage offered by online Students' Evaluations of Teaching (SET) and describes a study conducted at a Canadian university to identify critical success factors of online evaluations from students' point of view. Factors identified as important by the students include anonymity, ease of use (of both SET survey…

A Critical Analysis of Bloom's Taxonomy in Teaching Creative and Critical Thinking Skills in Malaysia through English Literature

ERIC Educational Resources Information Center

Rahman, Shukran Abdul; Manaf, Nor Faridah Abdul

2017-01-01

Purpose: The study aims to (1) review the literature that analyses the relevance of Bloom's Taxonomy of Educational Objectives in the teaching of creative and critical thinking among students in Malaysia, and (2) identify missing aspects in Bloom's Taxonomy vis a vis the indigenous context, important to promote creative and critical thinking among…

Oral intake evaluation in patients following critical illness: an ICU cohort study.

PubMed

Jarden, Rebecca J; Sutton-Smith, Lynsey; Boulton, Catherine

2018-04-16

Timely and adequate nutrition improves health outcomes for the critically ill patient. Despite clinical guidelines recommending early oral nutrition, survivors of critical illness experience significant nutritional deficits. This cohort study evaluates the oral nutrition intake in intensive care unit (ICU) patients who have experienced recent critical illness. The oral nutrition intake of a convenience sample of ICU patients post-critical illness was observed during a 1-month period. Data pertaining to both the amount of oral nutrition intake and factors impacting optimal oral nutrition intake were collected and analysed. Inadequate oral intake was identified in 62% of the 79 patients assessed (n = 49). This was noted early in the ICU stay, around day 1-2, for most of the patients. A significant proportion (25%) of patients remained in the hospital with poor oral intake that persisted beyond ICU day 5. Unsurprisingly, these were the patients who had longer ICU stays. Critical illness weakness was a factor in the assessment of poor oral intake. To conclude, patients who have experienced critical illness also experience suboptimal oral nutrition. The three key factors that were identified as impacting optimal oral nutrition were early removal of nasogastric tubes, critical illness weakness and poor appetite post-critical illness. Seven key recommendations are made based on this cohort study. These recommendations are related to patient assessment, monitoring, documentation and future guidelines. Future research opportunities are highlighted, including the investigation of strategies to improve the transition of patients' post-critical illness to oral nutrition. © 2018 British Association of Critical Care Nurses.

Effect of hypercapnia on respiratory and peripheral skeletal muscle loss during critical illness - A pilot study.

PubMed

Twose, Paul; Jones, Una; Wise, Matt P

2018-06-01

Critical illness has profound effects on muscle strength and long-term physical morbidity. However, there remains a paucity of evidence for the aetiology of critical illness related weakness. Recent animal model research identified that hypercapnia may reduce the rate of muscle loss. The aim of this study was to determine the effect of hypercapnia on respiratory and peripheral skeletal muscle in patients with critical illness. A pilot observational study of mechanically ventilated critically ill patients at a tertiary critical care unit who were retrospectively categorised as: 1) Respiratory failure with normocapnia; 2) Respiratory failure with hypercapnia; and 3) brain injury. Diaphragm thickness and quadriceps rectus femoris cross-sectional area (RFCSA) were measured using ultrasound imaging at baseline and at days 3, 5, 7 and 10 of mechanical ventilation. Significant reductions in RFCSA muscle loss were observed for all time-points when compared to baseline [day 10: -14.9%±8.2 p< 0.001], and in diaphragm thickness between baseline and day 7 [day 7: -5.8%±9.5 p=0.029). No correlation was identified between the rate of muscle mass loss in the diaphragm and RFCSA. In this pilot study, peripheral skeletal muscle weakness occurred early and rapidly within the critical care population, irrespective of carbon dioxide levels. Copyright © 2018 Elsevier Inc. All rights reserved.

Important considerations in lesion-symptom mapping: Illustrations from studies of word comprehension.

PubMed

Shahid, Hinna; Sebastian, Rajani; Schnur, Tatiana T; Hanayik, Taylor; Wright, Amy; Tippett, Donna C; Fridriksson, Julius; Rorden, Chris; Hillis, Argye E

2017-06-01

Lesion-symptom mapping is an important method of identifying networks of brain regions critical for functions. However, results might be influenced substantially by the imaging modality and timing of assessment. We tested the hypothesis that brain regions found to be associated with acute language deficits depend on (1) timing of behavioral measurement, (2) imaging sequences utilized to define the "lesion" (structural abnormality only or structural plus perfusion abnormality), and (3) power of the study. We studied 191 individuals with acute left hemisphere stroke with MRI and language testing to identify areas critical for spoken word comprehension. We use the data from this study to examine the potential impact of these three variables on lesion-symptom mapping. We found that only the combination of structural and perfusion imaging within 48 h of onset identified areas where more abnormal voxels was associated with more severe acute deficits, after controlling for lesion volume and multiple comparisons. The critical area identified with this methodology was the left posterior superior temporal gyrus, consistent with other methods that have identified an important role of this area in spoken word comprehension. Results have implications for interpretation of other lesion-symptom mapping studies, as well as for understanding areas critical for auditory word comprehension in the healthy brain. We propose that lesion-symptom mapping at the acute stage of stroke addresses a different sort of question about brain-behavior relationships than lesion-symptom mapping at the chronic stage, but that timing of behavioral measurement and imaging modalities should be considered in either case. Hum Brain Mapp 38:2990-3000, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Teaching and Understanding the Concept of Critical Thinking Skills within Michigan Accredited Associate Degree Dental Hygiene Programs

ERIC Educational Resources Information Center

Beistle, Kimberly S.

2012-01-01

This study explores dental hygiene faculty's perceptions regarding the issues surrounding the concept of critical thinking skills integration within Michigan accredited associate degree dental hygiene programs. The primary research goals are to determine faculty understanding of the concept of critical thinking, identify personal and departmental…

Development of Critical Thinking with Metacognitive Regulation and Toulmin Model

ERIC Educational Resources Information Center

Gotoh, Yasushi

2017-01-01

Developing critical thinking is an important factor in education. In this study, the author defines critical thinking as the set of skills and dispositions which enable one to solve problems logically and to attempt to reflect autonomously by means of metacognitive regulation of one's own problem-solving processes. To identify the validity and…

"Not Half but Double": Exploring Critical Incidents in the Racial Identity of Multiracial College Students

ERIC Educational Resources Information Center

Kellogg, Angela H.; Liddell, Debora L.

2012-01-01

This qualitative study explored how critical incidents shape multiracial students' understanding of race and identity at predominantly White institutions. Participants included 14 multiracial undergraduate students from two institutions in the Midwest. Four categories of critical incidents were identified from the data: (a) confronting race and…

Global Perspectives: Developing Media Literacy Skills to Advance Critical Thinking

ERIC Educational Resources Information Center

Radeloff, Cheryl L.; Bergman, Barbara J.

2009-01-01

Women's studies and feminist curricula have been lauded for the development and application of critical thinking skills for social and political change in its students (Fisher; Kellner and Share; Mayberry). Critical thinking can be defined as the ability to identify and challenge assumptions, to search for alternative ways of thinking, and to…

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

ERIC Educational Resources Information Center

Houston, Clemith J., Jr.

2013-01-01

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

Beyond Mirrors and Windows: A Critical Content Analysis of Latinx Children's Books

ERIC Educational Resources Information Center

Braden, Eliza G.; Rodriguez, Sanjuana C.

2016-01-01

This critical content analysis examines the representation of Latinx characters in 15 picture books published in 2013 and identified by Children's Cooperative Book Center (CCBC) as having significant Latinx content. The theoretical framework undergirding this study is Critical Race Theory (Ladson-Billings, 1998; Solórzano & Yosso, 2002;…

"Theorizing Teacher Mobility": A Critical Review of Literature

ERIC Educational Resources Information Center

Vagi, Robert; Pivovarova, Margarita

2017-01-01

In this critical review of literature, we summarize the major theoretical frameworks that have been used to study teacher mobility. In total we identified 40 teacher mobility studies that met our inclusion criteria. We conclude that relatively few theoretical frameworks have been used to study teacher mobility and those that have been used are…

An Analytic Hierarchy Process-based Method to Rank the Critical Success Factors of Implementing a Pharmacy Barcode System.

PubMed

Alharthi, Hana; Sultana, Nahid; Al-Amoudi, Amjaad; Basudan, Afrah

2015-01-01

Pharmacy barcode scanning is used to reduce errors during the medication dispensing process. However, this technology has rarely been used in hospital pharmacies in Saudi Arabia. This article describes the barriers to successful implementation of a barcode scanning system in Saudi Arabia. A literature review was conducted to identify the relevant critical success factors (CSFs) for a successful dispensing barcode system implementation. Twenty-eight pharmacists from a local hospital in Saudi Arabia were interviewed to obtain their perception of these CSFs. In this study, planning (process flow issues and training requirements), resistance (fear of change, communication issues, and negative perceptions about technology), and technology (software, hardware, and vendor support) were identified as the main barriers. The analytic hierarchy process (AHP), one of the most widely used tools for decision making in the presence of multiple criteria, was used to compare and rank these identified CSFs. The results of this study suggest that resistance barriers have a greater impact than planning and technology barriers. In particular, fear of change is the most critical factor, and training is the least critical factor.

Confidence in critical care nursing.

PubMed

Evans, Jeanne; Bell, Jennifer L; Sweeney, Annemarie E; Morgan, Jennifer I; Kelly, Helen M

2010-10-01

The purpose of the study was to gain an understanding of the nursing phenomenon, confidence, from the experience of nurses in the nursing subculture of critical care. Leininger's theory of cultural care diversity and universality guided this qualitative descriptive study. Questions derived from the sunrise model were used to elicit nurses' perspectives about cultural and social structures that exist within the critical care nursing subculture and the influence that these factors have on confidence. Twenty-eight critical care nurses from a large Canadian healthcare organization participated in semistructured interviews about confidence. Five themes arose from the descriptions provided by the participants. The three themes, tenuously navigating initiation rituals, deliberately developing holistic supportive relationships, and assimilating clinical decision-making rules were identified as social and cultural factors related to confidence. The remaining two themes, preserving a sense of security despite barriers and accommodating to diverse challenges, were identified as environmental factors related to confidence. Practice and research implications within the culture of critical care nursing are discussed in relation to each of the themes.

Analysis of the critical thinking process of junior high school students in solving geometric problems by utilizing the v-a-k learning styles model

NASA Astrophysics Data System (ADS)

Hananto, R. B.; Kusmayadi, T. A.; Riyadi

2018-05-01

The research aims to identify the critical thinking process of students in solving geometry problems. The geometry problem selected in this study was the building of flat side room (cube). The critical thinking process was implemented to visual, auditory and kinesthetic learning styles. This research was a descriptive analysis research using qualitative method. The subjects of this research were 3 students selected by purposive sampling consisting of visual, auditory, and kinesthetic learning styles. Data collection was done through test, interview, and observation. The results showed that the students' critical thinking process in identifying and defining steps for each learning style were similar in solving problems. The critical thinking differences were seen in enumerate, analyze, list, and self-correct steps. It was also found that critical thinking process of students with kinesthetic learning style was better than visual and auditory learning styles.

Critical appraisal of nonrandomized studies-A review of recommended and commonly used tools.

PubMed

Quigley, Joan M; Thompson, Juliette C; Halfpenny, Nicholas J; Scott, David A

2018-02-27

When randomized controlled trial data are limited or unavailable, or to supplement randomized controlled trial evidence, health technology assessment (HTA) agencies may rely on systematic reviews of nonrandomized studies (NRSs) for evidence of the effectiveness of health care interventions. NRS designs may introduce considerable bias into systematic reviews, and several methodologies by which to evaluate this risk of bias are available. This study aimed to identify tools commonly used to assess bias in NRS and determine those recommended by HTA bodies. Appraisal tools used in NRS were identified through a targeted search of systematic reviews (January 2013-March 2017; MEDLINE and EMBASE [OVID SP]). Recommendations for the critical appraisal of NRS by expert review groups and HTA bodies were reviewed. From the 686 studies included in the narrative synthesis, 48 critical appraisal tools were identified. Commonly used tools included the Newcastle-Ottawa Scale, the methodological index for NRS, and bespoke appraisal tools. Neither the Cochrane Handbook nor the Centre for Reviews and Dissemination recommends a particular instrument for the assessment of risk of bias in NRS, although Cochrane has recently developed their own NRS critical appraisal tool. Among HTA bodies, only the Canadian Agency for Drugs and Technologies in Health recommends use of a specific critical appraisal tool-SIGN 50 (for cohort or case-control studies). Several criteria including reporting, external validity, confounding, and power were examined. There is no consensus between HTA groups on the preferred appraisal tool. Reviewers should select from a suite of tools on the basis of the design of studies included in their review. © 2018 John Wiley & Sons, Ltd.

Psychosocial Interventions for Women with HIV/AIDS: A Critical Review

ERIC Educational Resources Information Center

Hernandez, Julieta P.; Macgowan, Mark J.

2015-01-01

Objective: Recent research on psychosocial interventions addressing the well-being of women with HIV/AIDS has brought new options for practitioners. This study critically reviews the treatment features, methodological quality, and efficacy of these interventions. Methods: A comprehensive search between 2000 and 2011 identified 19 studies employing…

Critical Thinking Skills for Language Students

ERIC Educational Resources Information Center

Djiwandono, Patrisius Istiarto

2013-01-01

Recent developments in language teaching increasingly put a stronger importance on critical thinking skills. While studies in this area have begun to emerge, it is believed that a probe into the learners' mind when they process information can contribute significantly to the effort of identifying exactly how our learners think. This study was…

Critical Technology Accessibility

ERIC Educational Resources Information Center

National Academies Press, 2006

2006-01-01

In 2003, the Defense Intelligence Agency asked the NRC to form a standing committee to help develop study topics about technology warning. One issue that was identified was the growing dependence on foreign suppliers of critical technology as a result of the increase in globalization of economic activity. Two important questions emerged for study:…

Risk factors for invasive fungal disease in critically ill adult patients: a systematic review.

PubMed

Muskett, Hannah; Shahin, Jason; Eyres, Gavin; Harvey, Sheila; Rowan, Kathy; Harrison, David

2011-01-01

Over 5,000 cases of invasive Candida species infections occur in the United Kingdom each year, and around 40% of these cases occur in critical care units. Invasive fungal disease (IFD) in critically ill patients is associated with increased morbidity and mortality at a cost to both the individual and the National Health Service. In this paper, we report the results of a systematic review performed to identify and summarise the important risk factors derived from published multivariable analyses, risk prediction models and clinical decision rules for IFD in critically ill adult patients to inform the primary data collection for the Fungal Infection Risk Evaluation Study. An internet search was performed to identify articles which investigated risk factors, risk prediction models or clinical decisions rules for IFD in critically ill adult patients. Eligible articles were identified in a staged process and were assessed by two investigators independently. The methodological quality of the reporting of the eligible articles was assessed using a set of questions addressing both general and statistical methodologies. Thirteen articles met the inclusion criteria, of which eight articles examined risk factors, four developed a risk prediction model or clinical decision rule and one evaluated a clinical decision rule. Studies varied in terms of objectives, risk factors, definitions and outcomes. The following risk factors were found in multiple studies to be significantly associated with IFD: surgery, total parenteral nutrition, fungal colonisation, renal replacement therapy, infection and/or sepsis, mechanical ventilation, diabetes, and Acute Physiology and Chronic Health Evaluation II (APACHE II) or APACHE III score. Several other risk factors were also found to be statistically significant in single studies only. Risk factor selection process and modelling strategy also varied across studies, and sample sizes were inadequate for obtaining reliable estimates. This review shows a number of risk factors to be significantly associated with the development of IFD in critically ill adults. Methodological limitations were identified in the design and conduct of studies in this area, and caution should be used in their interpretation.

Risk factors for invasive fungal disease in critically ill adult patients: a systematic review

PubMed Central

2011-01-01

Introduction Over 5,000 cases of invasive Candida species infections occur in the United Kingdom each year, and around 40% of these cases occur in critical care units. Invasive fungal disease (IFD) in critically ill patients is associated with increased morbidity and mortality at a cost to both the individual and the National Health Service. In this paper, we report the results of a systematic review performed to identify and summarise the important risk factors derived from published multivariable analyses, risk prediction models and clinical decision rules for IFD in critically ill adult patients to inform the primary data collection for the Fungal Infection Risk Evaluation Study. Methods An internet search was performed to identify articles which investigated risk factors, risk prediction models or clinical decisions rules for IFD in critically ill adult patients. Eligible articles were identified in a staged process and were assessed by two investigators independently. The methodological quality of the reporting of the eligible articles was assessed using a set of questions addressing both general and statistical methodologies. Results Thirteen articles met the inclusion criteria, of which eight articles examined risk factors, four developed a risk prediction model or clinical decision rule and one evaluated a clinical decision rule. Studies varied in terms of objectives, risk factors, definitions and outcomes. The following risk factors were found in multiple studies to be significantly associated with IFD: surgery, total parenteral nutrition, fungal colonisation, renal replacement therapy, infection and/or sepsis, mechanical ventilation, diabetes, and Acute Physiology and Chronic Health Evaluation II (APACHE II) or APACHE III score. Several other risk factors were also found to be statistically significant in single studies only. Risk factor selection process and modelling strategy also varied across studies, and sample sizes were inadequate for obtaining reliable estimates. Conclusions This review shows a number of risk factors to be significantly associated with the development of IFD in critically ill adults. Methodological limitations were identified in the design and conduct of studies in this area, and caution should be used in their interpretation. PMID:22126425

Palliative Care in Critical Care Settings: A Systematic Review of Communication-Based Competencies Essential for Patient and Family Satisfaction.

PubMed

Schram, Andrew W; Hougham, Gavin W; Meltzer, David O; Ruhnke, Gregory W

2017-11-01

There is an emerging literature on the physician competencies most meaningful to patients and their families. However, there has been no systematic review on physician competency domains outside direct clinical care most important for patient- and family-centered outcomes in critical care settings at the end of life (EOL). Physician competencies are an essential component of palliative care (PC) provided at the EOL, but the literature on those competencies relevant for patient and family satisfaction is limited. A systematic review of this important topic can inform future research and assist in curricular development. Review of qualitative and quantitative empirical studies of the impact of physician competencies on patient- and family-reported outcomes conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines for systematic reviews. The data sources used were PubMed, MEDLINE, Web of Science, and Google Scholar. Fifteen studies (5 qualitative and 10 quantitative) meeting inclusion and exclusion criteria were identified. The competencies identified as critical for the delivery of high-quality PC in critical care settings are prognostication, conflict mediation, empathic communication, and family-centered aspects of care, the latter being the competency most frequently acknowledged in the literature identified. Prognostication, conflict mediation, empathic communication, and family-centered aspects of care are the most important identified competencies for patient- and family-centered PC in critical care settings. Incorporation of education on these competencies is likely to improve patient and family satisfaction with EOL care.

Study Abroad Information in the New Media

ERIC Educational Resources Information Center

Teng, Shasha; Khong, Kok Wei; Chong, Alain Yee Loong

2015-01-01

Few studies have been conducted to identify what kinds of online information are provided by institutions and needed by international students in social media. This study aims to identify critical constructs of study abroad information (SAI) that can generate positive attitudes toward the university. Specifically, this study attempts to…

Talking Back to the Media Ideal: The Development and Validation of the Critical Processing of Beauty Images Scale

ERIC Educational Resources Information Center

Engeln-Maddox, Renee; Miller, Steven A.

2008-01-01

This article details the development of the Critical Processing of Beauty Images Scale (CPBI) and studies demonstrating the psychometric soundness of this measure. The CPBI measures women's tendency to engage in critical processing of media images featuring idealized female beauty. Three subscales were identified using exploratory factor analysis…

A Genre-Specific Reading Comprehension Strategy to Enhance Struggling Fifth-Grade Readers' Ability to Critically Analyze Argumentative Text

ERIC Educational Resources Information Center

Haria, Priti D.; Midgette, Ekaterina

2014-01-01

This study examined the effectiveness of instruction in a genre-specific reading comprehension strategy, "critical analysis of argumentative text," which was designed to help students to identify, summarize, and critically analyze parts of an argumentative text. The investigators hypothesized that reading instruction would improve the…

The Impacts of a National Internship Program on Interns' Perceived Leadership, Critical Thinking, and Communication Skills

ERIC Educational Resources Information Center

Duncan, Dennis W.; Birdsong, Victoria; Fuhrman, Nicholas; Borron, Abigail

2017-01-01

At perhaps all levels of education, strong leadership skills are often equated with the ability to engage in critical thinking, and effective oral and written communication. The purpose of this study was to identify the self-perceived expansion of animal health interns' leadership, critical thinking and communication competencies using the…

Critical Thinking and Its Relationship to Motivation, Learning Strategies, and Classroom Experience.

ERIC Educational Resources Information Center

Garcia, Teresa; Pintrich, Paul R.

Critical thinking has important implications for classic learning issues such as transfer of knowledge and application of problem-solving skills to novel situations. The goal of this study was to identify some of the important correlates of critical thinking, in terms of motivation, use of cognitive learning strategies, and classroom experiences.…

Evaluation of Critical Thinking in Higher Education in Oman

ERIC Educational Resources Information Center

Kumar.R, Renjith; James, Rajani

2015-01-01

The study aims to identify the critical level thinking of students in higher education. It is focused to evaluate the level of critical thinking variables among the students in Nizwa College of Technology and to determine whether these variables are influenced by gender and department. The data for the research is collected from 281 diploma…

Peer-to-Peer Teaching in Higher Education: A Critical Literature Review

ERIC Educational Resources Information Center

Stigmar, Martin

2016-01-01

The aim of my critical literature review is to identify studies where students are engaged as partners in teaching in higher education and to analyze how tutors and tutees benefit from peer teaching. Thirty studies were included for review. Thirteen countries are represented and two thirds of the studies conducted in the United States of America…

Smartness as Property: A Critical Exploration of Intersections between Whiteness and Disability Studies

ERIC Educational Resources Information Center

Leonardo, Zeus; Broderick, Alicia A.

2011-01-01

Background/Context: Two scholars who each primarily identify as a scholar of critical race/whiteness studies and a scholar of disability studies, respectively, engage in this article in a purposeful dialogue that responds to the invitation put forth by Baglieri, Bejoian, Broderick, Connor, and Valle to engage with the construct of inclusive…

Self-Perceived Gains in Communication and Critical Thinking Skills: Are There Disciplinary Differences? AIR 1998 Annual Forum Paper.

ERIC Educational Resources Information Center

Li, Guihua; Long, Shawna; Simpson, Mary Ellen

This study sought to identify similarities and differences influencing students' self-perceived gains in communication and critical thinking skills. The study examined students' background characteristics and general college experiences, as well as their experiences in their major field of study. Structural equation modeling was used to examine…

A Critical Tryptophan and Ca2+ in Activation and Catalysis of TPPI, the Enzyme Deficient in Classic Late-Infantile Neuronal Ceroid Lipofuscinosis

PubMed Central

Kuizon, Salomon; DiMaiuta, Kathleen; Walus, Marius; Jenkins, Edmund C.; Kuizon, Marisol; Kida, Elizabeth; Golabek, Adam A.; Espinoza, Daniel O.; Pullarkat, Raju K.; Junaid, Mohammed A.

2010-01-01

Background Tripeptidyl aminopeptidase I (TPPI) is a crucial lysosomal enzyme that is deficient in the fatal neurodegenerative disorder called classic late-infantile neuronal ceroid lipofuscinosis (LINCL). It is involved in the catabolism of proteins in the lysosomes. Recent X-ray crystallographic studies have provided insights into the structural/functional aspects of TPPI catalysis, and indicated presence of an octahedrally coordinated Ca2+. Methodology Purified precursor and mature TPPI were used to study inhibition by NBS and EDTA using biochemical and immunological approaches. Site-directed mutagenesis with confocal imaging technique identified a critical W residue in TPPI activity, and the processing of precursor into mature enzyme. Principal Findings NBS is a potent inhibitor of the purified TPPI. In mammalian TPPI, W542 is critical for tripeptidyl peptidase activity as well as autocatalysis. Transfection studies have indicated that mutants of the TPPI that harbor residues other than W at position 542 have delayed processing, and are retained in the ER rather than transported to lysosomes. EDTA inhibits the autocatalytic processing of the precursor TPPI. Conclusions/Significance We propose that W542 and Ca2+ are critical for maintaining the proper tertiary structure of the precursor proprotein as well as the mature TPPI. Additionally, Ca2+ is necessary for the autocatalytic processing of the precursor protein into the mature TPPI. We have identified NBS as a potent TPPI inhibitor, which led in delineating a critical role for W542 residue. Studies with such compounds will prove valuable in identifying the critical residues in the TPPI catalysis and its structure-function analysis. PMID:20689811

A Critical Case Study of Selected United States History Textbooks from a Tribal Critical Race Theory Perspective

ERIC Educational Resources Information Center

Padgett, Gary

2012-01-01

The purpose of this study was to describe and explain the portrayal of American Indians in U.S. textbooks selected for review in Hillsborough County, Florida's 2012 textbook adoption. The study identified which of the textbooks under consideration contained the greatest amount of information dedicated to American Indians. The study then analyzed…

A Systematic Approach of Employing Quality by Design Principles: Risk Assessment and Design of Experiments to Demonstrate Process Understanding and Identify the Critical Process Parameters for Coating of the Ethylcellulose Pseudolatex Dispersion Using Non-Conventional Fluid Bed Process.

PubMed

Kothari, Bhaveshkumar H; Fahmy, Raafat; Claycamp, H Gregg; Moore, Christine M V; Chatterjee, Sharmista; Hoag, Stephen W

2017-05-01

The goal of this study was to utilize risk assessment techniques and statistical design of experiments (DoE) to gain process understanding and to identify critical process parameters for the manufacture of controlled release multiparticulate beads using a novel disk-jet fluid bed technology. The material attributes and process parameters were systematically assessed using the Ishikawa fish bone diagram and failure mode and effect analysis (FMEA) risk assessment methods. The high risk attributes identified by the FMEA analysis were further explored using resolution V fractional factorial design. To gain an understanding of the processing parameters, a resolution V fractional factorial study was conducted. Using knowledge gained from the resolution V study, a resolution IV fractional factorial study was conducted; the purpose of this IV study was to identify the critical process parameters (CPP) that impact the critical quality attributes and understand the influence of these parameters on film formation. For both studies, the microclimate, atomization pressure, inlet air volume, product temperature (during spraying and curing), curing time, and percent solids in the coating solutions were studied. The responses evaluated were percent agglomeration, percent fines, percent yield, bead aspect ratio, median particle size diameter (d50), assay, and drug release rate. Pyrobuttons® were used to record real-time temperature and humidity changes in the fluid bed. The risk assessment methods and process analytical tools helped to understand the novel disk-jet technology and to systematically develop models of the coating process parameters like process efficiency and the extent of curing during the coating process.

Web-based resources for critical care education.

PubMed

Kleinpell, Ruth; Ely, E Wesley; Williams, Ged; Liolios, Antonios; Ward, Nicholas; Tisherman, Samuel A

2011-03-01

To identify, catalog, and critically evaluate Web-based resources for critical care education. A multilevel search strategy was utilized. Literature searches were conducted (from 1996 to September 30, 2010) using OVID-MEDLINE, PubMed, and the Cumulative Index to Nursing and Allied Health Literature with the terms "Web-based learning," "computer-assisted instruction," "e-learning," "critical care," "tutorials," "continuing education," "virtual learning," and "Web-based education." The Web sites of relevant critical care organizations (American College of Chest Physicians, American Society of Anesthesiologists, American Thoracic Society, European Society of Intensive Care Medicine, Society of Critical Care Medicine, World Federation of Societies of Intensive and Critical Care Medicine, American Association of Critical Care Nurses, and World Federation of Critical Care Nurses) were reviewed for the availability of e-learning resources. Finally, Internet searches and e-mail queries to critical care medicine fellowship program directors and members of national and international acute/critical care listserves were conducted to 1) identify the use of and 2) review and critique Web-based resources for critical care education. To ensure credibility of Web site information, Web sites were reviewed by three independent reviewers on the basis of the criteria of authority, objectivity, authenticity, accuracy, timeliness, relevance, and efficiency in conjunction with suggested formats for evaluating Web sites in the medical literature. Literature searches using OVID-MEDLINE, PubMed, and the Cumulative Index to Nursing and Allied Health Literature resulted in >250 citations. Those pertinent to critical care provide examples of the integration of e-learning techniques, the development of specific resources, reports of the use of types of e-learning, including interactive tutorials, case studies, and simulation, and reports of student or learner satisfaction, among other general reviews of the benefits of utilizing e-learning. Review of the Web sites of relevant critical care organizations revealed the existence of a number of e-learning resources, including online critical care courses, tutorials, podcasts, webcasts, slide sets, and continuing medical education resources, some requiring membership or a fee to access. Respondents to listserve queries (>100) and critical care medicine fellowship director and advanced practice nursing educator e-mail queries (>50) identified the use of a number of tutorials, self-directed learning modules, and video-enhanced programs for critical care education and practice. In all, >135 Web-based education resources exist, including video Web resources for critical care education in a variety of e-learning formats, such as tutorials, self-directed learning modules, interactive case studies, webcasts, podcasts, and video-enhanced programs. As identified by critical care educators and practitioners, e-learning is actively being integrated into critical care medicine and nursing training programs for continuing medical education and competency training purposes. Knowledge of available Web-based educational resources may enhance critical care practitioners' ongoing learning and clinical competence, although this has not been objectively measured to date.

A method for identifying EMI critical circuits during development of a large C3

NASA Astrophysics Data System (ADS)

Barr, Douglas H.

The circuit analysis methods and process Boeing Aerospace used on a large, ground-based military command, control, and communications (C3) system are described. This analysis was designed to help identify electromagnetic interference (EMI) critical circuits. The methodology used the MIL-E-6051 equipment criticality categories as the basis for defining critical circuits, relational database technology to help sort through and account for all of the approximately 5000 system signal cables, and Macintosh Plus personal computers to predict critical circuits based on safety margin analysis. The EMI circuit analysis process systematically examined all system circuits to identify which ones were likely to be EMI critical. The process used two separate, sequential safety margin analyses to identify critical circuits (conservative safety margin analysis, and detailed safety margin analysis). These analyses used field-to-wire and wire-to-wire coupling models using both worst-case and detailed circuit parameters (physical and electrical) to predict circuit safety margins. This process identified the predicted critical circuits that could then be verified by test.

Building Evidence in Early Childhood Special Education: A Systematic Review of Replication Intervention Studies

ERIC Educational Resources Information Center

Banerjee, Rashida; Movahedazarhouligh, Sara; Millen, Kaitlyn; Luckner, John L.

2018-01-01

Valid and evidence-informed practices are critical to help young children with disabilities and their families with highly effective interventions and instruction to reach their potentials. Replication research is critical for appraising research and identifying evidence-based practices. The purpose of this study was to replicate the methods used…

User Acceptance Of Commercial Vehicle Operations (CVO) Services, Critical Issues Relating To Acceptance Of CVO Services By Interstate Truck And Bus Drivers, Final Report, Task B Report

DOT National Transportation Integrated Search

1995-08-08

PENN + SCHOEN ASSOCIATES HAS BEEN COMMISSIONED BY THE FEDERAL HIGHWAY ADMINISTRATION TO CONDUCT A STUDY ENTITLED "USER ACCEPTANCE OF COMMERCIAL VEHICLE OPERATIONS (CVO) SERVICES." THE PURPOSE OF THIS STUDY IS TO IDENTIFY AND EVALUATE CRITICAL ISSUES ...

Teaching Critical Thinking Using High-Impact Practices: A Quantitative Study

ERIC Educational Resources Information Center

Rosfeld, Kimberlina

2017-01-01

Many American college students lack the academic skills to be successful. College faculty members struggle to help these disadvantaged students excel in a college environment. There is a need for identified strategies to help college students develop academic skills such as critical thinking. The purpose of this study was to determine if…

Using cognitive task analysis to identify critical decisions in the laparoscopic environment.

PubMed

Craig, Curtis; Klein, Martina I; Griswold, John; Gaitonde, Krishnanath; McGill, Thomas; Halldorsson, Ari

2012-12-01

The aim of this study was to identify the critical decisions surgeons need to make regarding laparoscopic surgery, the information these decisions are based on, the strategies employed by surgeons to reach their objectives, and the difficulties experienced by novices. Laparoscopic training focuses on the development of technical skills. However, successful surgical outcomes are also dependent on appropriate decisions made during surgery, which are influenced by critical cues and the use of appropriate strategies. Novices might not be as adept at cue detection and strategy use. Participants were eight attending surgeons. The authors employed task-analytic techniques to identify critical decisions inherent in laparoscopy and the cues, strategies, and novice traps associated with these decisions. The authors used decision requirements tables to organize the data into the key decisions made during the preoperative, operative, and postoperative phases as well as the cues, strategies, and novice traps associated with these decisions. Key decisions identified for the preoperative phase included but were not limited to the decision of performing a laparoscopic versus open surgery, necessity to review the literature, practicing the procedure, and trocar placement. Some key decisions identified for the operative phase included converting to open surgery, performing angiograms, cutting tissue or organs, and reevaluation of the approach. Only one key decision was identified for the postoperative phrase: whether the surgeon's technique needs to be evaluated and revised. The laparoscopic environment requires complex decision making, and novices are prone to errors in their decisions. The information elicited in this study is applicable to laparoscopic training.

Structural identification of a real-world shear-critical prestressed concrete highway bridge.

DOT National Transportation Integrated Search

2012-08-01

A typical span of the Little River overflow bridge located in McCurtain County, Oklahoma, a shear-critical prestressed concrete bridge identified by the Oklahoma Department of Transportation (ODOT) Bridge Division, is studied using a multidisciplinar...

Critical mass of public goods and its coevolution with cooperation

NASA Astrophysics Data System (ADS)

Shi, Dong-Mei; Wang, Bing-Hong

2017-07-01

In this study, the enhancing parameter represented the value of the public goods to the public in public goods game, and was rescaled to a Fermi-Dirac distribution function of critical mass. Public goods were divided into two categories, consumable and reusable public goods, and their coevolution with cooperative behavior was studied. We observed that for both types of public goods, cooperation was promoted as the enhancing parameter increased when the value of critical mass was not very large. An optimal value of critical mass which led to the best cooperation was identified. We also found that cooperations emerged earlier for reusable public goods, and defections became extinct earlier for the consumable public goods. Moreover, we observed that a moderate depreciation rate for public goods resulted in an optimal cooperation, and this range became wider as the enhancing parameter increased. The noise influence on cooperation was studied, and it was shown that cooperation density varied non-monotonically as noise amplitude increased for reusable public goods, whereas decreased monotonically for consumable public goods. Furthermore, existence of the optimal critical mass was also identified in other three regular networks. Finally, simulation results were utilized to analyze the provision of public goods in detail.

What the Tweets Say: A Critical Analysis of Twitter Research in Language Learning from 2009 to 2016

ERIC Educational Resources Information Center

Hattem, David; Lomicka, Lara

2016-01-01

This study presents an overview and critical analysis of the literature related to Twitter and language learning published from 2009 to 2016. Seventeen studies were selected for inclusion based on a four-phase identification procedure, which helped us to identify published studies that resulted in a content analysis of themes in the articles…

Geographic Hotspots of Critical National Infrastructure.

PubMed

Thacker, Scott; Barr, Stuart; Pant, Raghav; Hall, Jim W; Alderson, David

2017-12-01

Failure of critical national infrastructures can result in major disruptions to society and the economy. Understanding the criticality of individual assets and the geographic areas in which they are located is essential for targeting investments to reduce risks and enhance system resilience. Within this study we provide new insights into the criticality of real-life critical infrastructure networks by integrating high-resolution data on infrastructure location, connectivity, interdependence, and usage. We propose a metric of infrastructure criticality in terms of the number of users who may be directly or indirectly disrupted by the failure of physically interdependent infrastructures. Kernel density estimation is used to integrate spatially discrete criticality values associated with individual infrastructure assets, producing a continuous surface from which statistically significant infrastructure criticality hotspots are identified. We develop a comprehensive and unique national-scale demonstration for England and Wales that utilizes previously unavailable data from the energy, transport, water, waste, and digital communications sectors. The testing of 200,000 failure scenarios identifies that hotspots are typically located around the periphery of urban areas where there are large facilities upon which many users depend or where several critical infrastructures are concentrated in one location. © 2017 Society for Risk Analysis.

Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients.

PubMed

Gosselink, R; Bott, J; Johnson, M; Dean, E; Nava, S; Norrenberg, M; Schönhofer, B; Stiller, K; van de Leur, H; Vincent, J L

2008-07-01

The Task Force reviewed and discussed the available literature on the effectiveness of physiotherapy for acute and chronic critically ill adult patients. Evidence from randomized controlled trials or meta-analyses was limited and most of the recommendations were level C (evidence from uncontrolled or nonrandomized trials, or from observational studies) and D (expert opinion). However, the following evidence-based targets for physiotherapy were identified: deconditioning, impaired airway clearance, atelectasis, intubation avoidance, and weaning failure. Discrepancies and lack of data on the efficacy of physiotherapy in clinical trials support the need to identify guidelines for physiotherapy assessments, in particular to identify patient characteristics that enable treatments to be prescribed and modified on an individual basis. There is a need to standardize pathways for clinical decision-making and education, to define the professional profile of physiotherapists, and increase the awareness of the benefits of prevention and treatment of immobility and deconditioning for critically ill adult patients.

[Failure mode and effects analysis (FMEA) of insulin in a mother-child university-affiliated health center].

PubMed

Berruyer, M; Atkinson, S; Lebel, D; Bussières, J-F

2016-01-01

Insulin is a high-alert drug. The main objective of this descriptive cross-sectional study was to evaluate the risks associated with insulin use in healthcare centers. The secondary objective was to propose corrective measures to reduce the main risks associated with the most critical failure modes in the analysis. We conducted a failure mode and effects analysis (FMEA) in obstetrics-gynecology, neonatology and pediatrics. Five multidisciplinary meetings occurred in August 2013. A total of 44 out of 49 failure modes were analyzed. Nine out of 44 (20%) failure modes were deemed critical, with a criticality score ranging from 540 to 720. Following the multidisciplinary meetings, everybody agreed that an FMEA was a useful tool to identify failure modes and their relative importance. This approach identified many corrective measures. This shared experience increased awareness of safety issues with insulin in our mother-child center. This study identified the main failure modes and associated corrective measures. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

DEVELOPMENT OF PROTOCOLS TO STUDY TO IDENTIFY CRITICAL ECOSYSTEMS

EPA Science Inventory

Healthy, functioning ecosystems are critical to the sustainability of human and natural communities, but the identification of areas of healthy ecosystems in an area as large as Region 5 is difficult due to time and information constraints. Geographic Information Systems (GIS) a...

A Systematic Review of Postgraduate Teaching in Evidence-Based Medicine and Critical Appraisal.

ERIC Educational Resources Information Center

Coomarasamy, Aravinthan; Taylor, Rod; Khan, Khalid S.

2003-01-01

Examines the effectiveness of evidence-based medicine and critical appraisal teaching at the postgraduate level. Conducts a comprehensive search and identifies 17 studies. Shows a significant improvement in knowledge but not in attitude, skills, or behavior. (Author/KHR)

Healthcare Disparities in Critical Illness

PubMed Central

Soto, Graciela J.; Martin, Greg S.; Gong, Michelle Ng

2013-01-01

Objective To summarize the current literature on racial and gender disparities in critical care and the mechanisms underlying these disparities in the course of acute critical illness. Data Sources MEDLINE search on the published literature addressing racial, ethnic, or gender disparities in acute critical illness such as sepsis, acute lung injury, pneumonia, venous thromboembolism, and cardiac arrest. Study Selection Clinical studies that evaluated general critically ill patient populations in the United States as well as specific critical care conditions were reviewed with a focus on studies evaluating factors and contributors to health disparities. Data Extraction Study findings are presented according to their association with the incidence, clinical presentation, management, and outcomes in acute critical illness. Data Synthesis This review presents potential contributors for racial and gender disparities related to genetic susceptibility, comorbidities, preventive health services, socioeconomic factors, cultural differences, and access to care. The data is organized along the course of acute critical illness. Conclusions The literature to date shows that disparities in critical care are most likely multifactorial involving individual, community, and hospital-level factors at several points in the continuum of acute critical illness. The data presented identify potential targets as interventions to reduce disparities in critical care and future avenues for research. PMID:24121467

Leptospirosis Outbreaks in Nicaragua: Identifying Critical Areas and Exploring Drivers for Evidence-Based Planning

PubMed Central

Schneider, Maria Cristina; Nájera, Patricia; Aldighieri, Sylvain; Bacallao, Jorge; Soto, Aida; Marquiño, Wilmer; Altamirano, Lesbia; Saenz, Carlos; Marin, Jesus; Jimenez, Eduardo; Moynihan, Matthew; Espinal, Marcos

2012-01-01

Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide. In Central America, leptospirosis outbreaks have been reported in almost all countries; Nicaragua in particular has faced several outbreaks. The objective of this study was to stratify the risk and identify “critical areas” for leptospirosis outbreaks in Nicaragua, and to perform an exploratory analysis of potential “drivers”. This ecological study includes the entire country (153 municipalities). Cases from 2004 to 2010 were obtained from the country’s health information system, demographic and socioeconomic variables from its Census, and environmental data from external sources. Criteria for risk stratification of leptospirosis were defined. Nicaragua reported 1,980 cases of leptospirosis during this period, with the highest percentage of cases (26.36%) in León, followed by Chinandega (15.35%). Among the 153 municipalities, 48 were considered critical areas, 85 were endemic and 20 silent. Using spatial and statistical analysis, the variable presenting the most evident pattern of association with critical areas defined by top quintile of incidence rate is the percentage of municipal surface occupied by the soil combination of cambisol (over pyroclastic and lava bedrock) and andosol (over a volcanic ashes foundation). Precipitation and percentage of rural population are also associated with critical areas. This methodology and findings could be used for Nicaragua’s Leptospirosis Intersectoral Plan, and to identify possible risk areas in other countries with similar drivers. PMID:23202822

Teacher Perceptions of High School Student Failure in the Classroom: Identifying Preventive Practices of Failure Using Critical Incident Technique

ERIC Educational Resources Information Center

Kalahar, Kory G.

2011-01-01

Student failure is a prominent issue in many comprehensive secondary schools nationwide. Researchers studying error, reliability, and performance in organizations have developed and employed a method known as critical incident technique (CIT) for investigating failure. Adopting an action research model, this study involved gathering and analyzing…

Transphobia and Cisgender Privilege: Pre-Service Teachers Recognizing and Challenging Gender Rigidity in Schools

ERIC Educational Resources Information Center

Kearns, Laura-Lee; Mitton-Kükner, Jennifer; Tompkins, Joanne

2017-01-01

Our study provides examples of how critical curricula and social justice education can be brought together to inform teacher education. Building upon our ongoing longitudinal study, which investigates the impact of an integrated LGBTQ awareness program, we focus in this article on five pre-service teachers who identified critical incidents in…

Application of ICH Q9 Quality Risk Management Tools for Advanced Development of Hot Melt Coated Multiparticulate Systems.

PubMed

Stocker, Elena; Becker, Karin; Hate, Siddhi; Hohl, Roland; Schiemenz, Wolfgang; Sacher, Stephan; Zimmer, Andreas; Salar-Behzadi, Sharareh

2017-01-01

This study aimed to apply quality risk management based on the The International Conference on Harmonisation guideline Q9 for the early development stage of hot melt coated multiparticulate systems for oral administration. N-acetylcysteine crystals were coated with a formulation composing tripalmitin and polysorbate 65. The critical quality attributes (CQAs) were initially prioritized using failure mode and effects analysis. The CQAs of the coated material were defined as particle size, taste-masking efficiency, and immediate release profile. The hot melt coated process was characterized via a flowchart, based on the identified potential critical process parameters (CPPs) and their impact on the CQAs. These CPPs were prioritized using a process failure mode, effects, and criticality analysis and their critical impact on the CQAs was experimentally confirmed using a statistical design of experiments. Spray rate, atomization air pressure, and air flow rate were identified as CPPs. Coating amount and content of polysorbate 65 in the coating formulation were identified as critical material attributes. A hazard and critical control points analysis was applied to define control strategies at the critical process points. A fault tree analysis evaluated causes for potential process failures. We successfully demonstrated that a standardized quality risk management approach optimizes the product development sustainability and supports the regulatory aspects. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

The Use of Newspaper Articles as a Tool to Develop Critical Thinking in Science Classes

NASA Astrophysics Data System (ADS)

Oliveras, Begoña; Márquez, Conxita; Sanmartí, Neus

2013-04-01

The aim of this research is to identify the difficulties experienced by secondary school students (aged 15-16) with the critical reading of newspaper articles with scientific content. Two newspaper critical reading activities in relation to the study of various scientific contents were designed and carried out in two schools (61 students in total), one with a student population from a medium to high social and economic bracket and the other with students from a medium to low social and economic bracket. These activities were designed taking into account the phases of the reading process: before, during and after reading. In order to analyse the difficulties 'Elements of science critical reading' were identified on the basis of the 'Elements of reasoning' of Paul and Elder and the categories proposed by Bartz C.R.I.T.I.C. questionnaire and a scale was drawn up. The results show that the activities designed were useful in helping students to read critically. We also rated very positively the instrument created to assess the students' answers: the scale based on the performance indicators of Paul and Elder. This instrument enabled us to detect the aspects of critical thinking where students have the most difficulties: identifying the writer's purpose and looking for evidence in a text. It was also shown that the stance taken in the articles also had an influence on the results.

"All in the Family" in Context: A Unified Model of Media Studies Applied to Television Criticism.

ERIC Educational Resources Information Center

Timberg, Bernard

Proposing the use of a single comprehensive communications model, the Circles of Context Model, for all forms of communication, this paper shows how the model can be used to identify different kinds of criticism of the television comedy series "All in the Family" and the ways in which that criticism shifted during the show's nine-year…

The use of source memory to identify one's own episodic confusion errors.

PubMed

Smith, S M; Tindell, D R; Pierce, B H; Gilliland, T R; Gerkens, D R

2001-03-01

In 4 category cued recall experiments, participants falsely recalled nonlist common members, a semantic confusion error. Errors were more likely if critical nonlist words were presented on an incidental task, causing source memory failures called episodic confusion errors. Participants could better identify the source of falsely recalled words if they had deeply processed the words on the incidental task. For deep but not shallow processing, participants could reliably include or exclude incidentally shown category members in recall. The illusion that critical items actually appeared on categorized lists was diminished but not eradicated when participants identified episodic confusion errors post hoc among their own recalled responses; participants often believed that critical items had been on both the incidental task and the study list. Improved source monitoring can potentially mitigate episodic (but not semantic) confusion errors.

Report of the Horizontal Launch Study

NASA Technical Reports Server (NTRS)

Wilhite, Alan W.; Bartolotta, Paul A.

2011-01-01

A study of horizontal launch concepts has been conducted. This study, jointly sponsored by the Defense Advanced Research Projects Agency (DARPA) and the National Aeronautics and Space Administration (NASA) was tasked to estimate the economic and technical viability of horizontal launch approaches. The study team identified the key parameters and critical technologies which determine mission viability and reported on the state of the art of critical technologies, along with objectives for technology development.

Single-Blinded Prospective Implementation of a Preoperative Imaging Checklist for Endoscopic Sinus Surgery.

PubMed

Error, Marc; Ashby, Shaelene; Orlandi, Richard R; Alt, Jeremiah A

2018-01-01

Objective To determine if the introduction of a systematic preoperative sinus computed tomography (CT) checklist improves identification of critical anatomic variations in sinus anatomy among patients undergoing endoscopic sinus surgery. Study Design Single-blinded prospective cohort study. Setting Tertiary care hospital. Subjects and Methods Otolaryngology residents were asked to identify critical surgical sinus anatomy on preoperative CT scans before and after introduction of a systematic approach to reviewing sinus CT scans. The percentage of correctly identified structures was documented and compared with a 2-sample t test. Results A total of 57 scans were reviewed: 28 preimplementation and 29 postimplementation. Implementation of the sinus CT checklist improved identification of critical sinus anatomy from 24% to 84% correct ( P < .001). All residents, junior and senior, demonstrated significant improvement in identification of sinus anatomic variants, including those not directly included in the systematic review implemented. Conclusion The implementation of a preoperative endoscopic sinus surgery radiographic checklist improves identification of critical anatomic sinus variations in a training population.

The Effect of Concept Maps on Undergraduate Nursing Students' Critical Thinking.

PubMed

Garwood, Janet K; Ahmed, Azza H; McComb, Sara A

The aim of the study was to evaluate the effect of using concept maps as a teaching and learning strategy on students' critical thinking abilities and examine students' perceptions toward concept maps utilizing the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Researchers have found that almost two thirds of nurse graduates do not have adequate critical thinking skills for a beginner nurse. Critical thinking skills are required for safe practice and mandated by accrediting organizations. Nursing educators should consider teaching and learning strategies that promote the development of critical thinking skills. A literature review was conducted using "concept maps, nursing education, and critical thinking" as the combined search terms. Inclusion criteria were studies that measured the effects of concept mapping on critical thinking in nursing students. Seventeen articles were identified. Concept maps may be useful tools to promote critical thinking in nursing education and for applying theory to practice.

Sleep Disturbance after Hospitalization and Critical Illness: A Systematic Review.

PubMed

Altman, Marcus T; Knauert, Melissa P; Pisani, Margaret A

2017-09-01

Sleep disturbance during intensive care unit (ICU) admission is common and severe. Sleep disturbance has been observed in survivors of critical illness even after transfer out of the ICU. Not only is sleep important to overall health and well being, but patients after critical illness are also in a physiologically vulnerable state. Understanding how sleep disturbance impacts recovery from critical illness after hospital discharge is therefore clinically meaningful. This Systematic Review aimed to summarize studies that identify the prevalence of and risk factors for sleep disturbance after hospital discharge for critical illness survivors. PubMed (January 4, 2017), MEDLINE (January 4, 2017), and EMBASE (February 1, 2017). Databases were searched for studies of critically ill adult patients after hospital discharge, with sleep disturbance measured as a primary outcome by standardized questionnaire or objective measurement tools. From each relevant study, we extracted prevalence and severity of sleep disturbance at each time point, objective sleep parameters (such as total sleep time, sleep efficiency, and arousal index), and risk factors for sleep disturbance. A total of 22 studies were identified, with assessment tools including subjective questionnaires, polysomnography, and actigraphy. Subjective questionnaire studies reveal a 50-66.7% (within 1 mo), 34-64.3% (>1-3 mo), 22-57% (>3-6 mo), and 10-61% (>6 mo) prevalence of abnormal sleep after hospital discharge after critical illness. Of the studies assessing multiple time points, four of five questionnaire studies and five of five polysomnography studies show improved aspects of sleep over time. Risk factors for poor sleep varied, but prehospital factors (chronic comorbidity, pre-existing sleep abnormality) and in-hospital factors (severity of acute illness, in-hospital sleep disturbance, pain medication use, and ICU acute stress symptoms) may play a role. Sleep disturbance was frequently associated with postdischarge psychological comorbidities and impaired quality of life. Sleep disturbance is common in critically ill patients up to 12 months after hospital discharge. Both subjective and objective studies, however, suggest that sleep disturbance improves over time. More research is needed to understand and optimize sleep in recovery from critical illness.

Assessment of critical thinking in pharmacy students.

PubMed

Cisneros, Robert M

2009-07-10

To determine whether changes occur over 1 academic year in pharmacy students' critical thinking skills and disposition to think critically. First, second, third, and fourth-year pharmacy students completed the California Critical Thinking Skills Test (CCTST) and the California Critical Thinking Disposition Inventory (CCTDI) at the beginning and end of 1 academic year. One hundred thirty-seven students completed the study. No significant changes occurred over the year in total scores on either instrument. However, scores in 3 of 12 subscale scores changed significantly and several significant correlations were found. Pharmacy students' scores on 2 critical thinking instruments showed no major improvements over 1 academic year but most scores were above average. Some areas of possible weakness were identified. Additional studies comparing scores over a longer period of time (eg, admission to graduation) are needed.

Predicting invasive fungal disease due to Candida species in non-neutropenic, critically ill, adult patients in United Kingdom critical care units.

PubMed

Shahin, Jason; Allen, Elizabeth J; Patel, Krishna; Muskett, Hannah; Harvey, Sheila E; Edgeworth, Jonathan; Kibbler, Christopher C; Barnes, Rosemary A; Biswas, Sharmistha; Soni, Neil; Rowan, Kathryn M; Harrison, David A

2016-09-09

Given the predominance of invasive fungal disease (IFD) amongst the non-immunocompromised adult critically ill population, the potential benefit of antifungal prophylaxis and the lack of generalisable tools to identify high risk patients, the aim of the current study was to describe the epidemiology of IFD in UK critical care units, and to develop and validate a clinical risk prediction tool to identify non-neutropenic, critically ill adult patients at high risk of IFD who would benefit from antifungal prophylaxis. Data on risk factors for, and outcomes from, IFD were collected for consecutive admissions to adult, general critical care units in the UK participating in the Fungal Infection Risk Evaluation (FIRE) Study. Three risk prediction models were developed to model the risk of subsequent Candida IFD based on information available at three time points: admission to the critical care unit, at the end of 24 h and at the end of calendar day 3 of the critical care unit stay. The final model at each time point was evaluated in the three external validation samples. Between July 2009 and April 2011, 60,778 admissions from 96 critical care units were recruited. In total, 359 admissions (0.6 %) were admitted with, or developed, Candida IFD (66 % Candida albicans). At the rate of candidaemia of 3.3 per 1000 admissions, blood was the most common Candida IFD infection site. Of the initial 46 potential variables, the final admission model and the 24-h model both contained seven variables while the end of calendar day 3 model contained five variables. The end of calendar day 3 model performed the best with a c index of 0.709 in the full validation sample. Incidence of Candida IFD in UK critical care units in this study was consistent with reports from other European epidemiological studies, but lower than that suggested by previous hospital-wide surveillance in the UK during the 1990s. Risk modeling using classical statistical methods produced relatively simple risk models, and associated clinical decision rules, that provided acceptable discrimination for identifying patients at 'high risk' of Candida IFD. The FIRE Study was reviewed and approved by the Bolton NHS Research Ethics Committee (reference: 08/H1009/85), the Scotland A Research Ethics Committee (reference: 09/MRE00/76) and the National Information Governance Board (approval number: PIAG 2-10(f)/2005).

A proposed procedure for expressing the behavior of a full engine cycle by identifying its critical load timings

NASA Astrophysics Data System (ADS)

Marius Andrei, Mihalache; Gheorghe, Nagit; Gavril, Musca; Vasile, Merticaru, Jr.; Marius Ionut, Ripanu

2016-11-01

In the present study the authors propose a new algorithm for identifying the right loads that act upon a functional connecting rod during a full engine cycle. The loads are then divided into three categories depending on the results they produce, as static, semi-dynamic and dynamic ones Because an engine cycle extends up to 720°, the authors aim to identify a method of substitution of values that produce the same effect as a previous value of a considered angle did. In other words, the proposed method aims to pin point the critical values that produce an effect different as the one seen before during a full engine cycle. Only those values will then be considered as valid loads that act upon the connecting rod inside FEA analyses. This technique has been applied to each of the three categories mentioned above and did produced different critical values for each one of them. The whole study relies on a theoretical mechanical project which was developed in order to identify the right values that correspond to each degree of the entire engine cycle of a Daewoo Tico automobile.

Leadership Curricula in Nursing Education: A Critical Literature Review and Gap Analysis.

PubMed

Morrow, Kelly J

2015-07-01

The Institute of Medicine's Future of Nursing report advises nursing education programs to integrate and embed leadership content within all areas of prelicensure nursing curriculum. This critical literature review synthesizes the state of the science of leadership curricula in prelicensure baccalaureate nursing education programs from 2008 to 2013. Gaps are identified and discussed. The Academic Search Premier and Health Source databases were searched, using the keywords baccalaureate nursing education and leadership. The CINAHL database was searched, using the keywords leadership, education, nursing, and baccalaureate. The 13 peer-reviewed articles identified for inclusion comprised descriptive articles (n = 8), mixed-methods studies (n = 2), quantitative studies (n = 2), and a qualitative study (n = 1). The underlying theme identified is the study and use of active learning strategies. Subthemes within this context were the use of reflection, peer learning, interdisciplinary teams, organizational partnerships, and curricular reform. Copyright 2015, SLACK Incorporated.

Automatic Identification of Critical Follow-Up Recommendation Sentences in Radiology Reports

PubMed Central

Yetisgen-Yildiz, Meliha; Gunn, Martin L.; Xia, Fei; Payne, Thomas H.

2011-01-01

Communication of follow-up recommendations when abnormalities are identified on imaging studies is prone to error. When recommendations are not systematically identified and promptly communicated to referrers, poor patient outcomes can result. Using information technology can improve communication and improve patient safety. In this paper, we describe a text processing approach that uses natural language processing (NLP) and supervised text classification methods to automatically identify critical recommendation sentences in radiology reports. To increase the classification performance we enhanced the simple unigram token representation approach with lexical, semantic, knowledge-base, and structural features. We tested different combinations of those features with the Maximum Entropy (MaxEnt) classification algorithm. Classifiers were trained and tested with a gold standard corpus annotated by a domain expert. We applied 5-fold cross validation and our best performing classifier achieved 95.60% precision, 79.82% recall, 87.0% F-score, and 99.59% classification accuracy in identifying the critical recommendation sentences in radiology reports. PMID:22195225

Automatic identification of critical follow-up recommendation sentences in radiology reports.

PubMed

Yetisgen-Yildiz, Meliha; Gunn, Martin L; Xia, Fei; Payne, Thomas H

2011-01-01

Communication of follow-up recommendations when abnormalities are identified on imaging studies is prone to error. When recommendations are not systematically identified and promptly communicated to referrers, poor patient outcomes can result. Using information technology can improve communication and improve patient safety. In this paper, we describe a text processing approach that uses natural language processing (NLP) and supervised text classification methods to automatically identify critical recommendation sentences in radiology reports. To increase the classification performance we enhanced the simple unigram token representation approach with lexical, semantic, knowledge-base, and structural features. We tested different combinations of those features with the Maximum Entropy (MaxEnt) classification algorithm. Classifiers were trained and tested with a gold standard corpus annotated by a domain expert. We applied 5-fold cross validation and our best performing classifier achieved 95.60% precision, 79.82% recall, 87.0% F-score, and 99.59% classification accuracy in identifying the critical recommendation sentences in radiology reports.

Identifying the critical physical demanding tasks of paramedic work: Towards the development of a physical employment standard.

PubMed

Fischer, Steven L; Sinden, Kathryn E; MacPhee, Renee S

2017-11-01

Public safety related occupations including police, fire and military commonly apply physical employment standard (PES) to facilitate job matching, an approach to evaluate if candidates demonstrate acceptable physical capabilities as required to perform the job safely and effectively. In Canada, paramedics remain as one of the few public safety occupations without an evidence-based, validated PES. The purpose of this study was to document and describe the physical demands of paramedic work and to identify the most physically demanding tasks. These outcomes are essential to inform the design and development of an evidence-based PES for the paramedic sector. Physical demands of paramedic work were documented and described using a direct observation-based task analysis technique. Five paramedic's were trained to document the physical demands of their work, then applied their training to observe more than 90 calls over the course of 20 full 12-h work shifts. Physical demands data were then listed in a survey, administered service-wide, where 155 frontline paramedics identified critically demanding tasks and rank-ordered physical demands from not physically demanding to very strongly demanding. Critically important and physically demanding tasks were identified such as: transferring a patient; loading or unloading a stretcher in to or out of the ambulance; performing CPR; and, raising and lowering a stretcher. It is important that a paramedic-based PES evaluate a candidate's physical capabilities to perform the critical and physically demanding tasks identified in this study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Use of critical thinking in the diagnostic process.

PubMed

Lunney, Margaret

2010-01-01

To demonstrate use of critical thinking in the diagnostic process in order to achieve accuracy of nursing diagnoses. The 7 cognitive skills and 10 habits of mind identified as important for nursing in a Delphi study by Scheffer and Rubenfeld are applied to the diagnostic process using a published case study of a woman with heart failure. Taking into account all data from the case study and using the concepts of critical thinking, two high-accuracy nursing diagnoses were selected to guide nursing interventions. Because the specific types of critical thinking needed for accurate diagnosing are not known, nurses should develop all 17 of the cognitive skills and habits of mind so these thinking abilities are available when needed. The 17 critical thinking concepts should be combined with domain knowledge, e.g., nursing diagnoses, to think about thinking, which will improve critical thinking processes.

Distributed Leadership: A Study in Knowledge Production

ERIC Educational Resources Information Center

Gunter, Helen; Hall, Dave; Bragg, Joanna

2013-01-01

We have designed and deployed a mapping framework to present and analyse knowledge production and distributed leadership in schools. Positions are identified from within the field: functional (descriptive and normative), critical and socially critical. For each position we examine the purposes, rationales and narratives within selected texts that…

An arthroscopic evaluation of the anatomical "critical zone".

PubMed

Naidoo, N; Lazarus, L; Osman, S A; Satyapal, K S

2017-01-01

The "critical zone", a region of speculated vascularity, is situated approximately 10 mm proximal to the insertion of the supraspinatus tendon. Despite its obvious role as an anatomical landmark demarcator, its patho-anatomic nature has been identified as the source of rotator cuff pathology. Although many studies have attempted to evaluate the vascularity of this region, the architecture regarding the exact length, width and shape of the critical zone, remains unreported. This study aimed to determine the shape and morphometry of the "critical zone" arthroscopically. The sample series, which was comprised of 38 cases (n = 38) specific to pathological types, employed an anatomical investigation of the critical zone during routine real-time arthroscopy. Demographic representation: i) sex: 19 males, 19 females; ii) age range: 18-76 years; iii) race: white (n = 29), Indian (n = 7) and coloured (n = 2). The incidence of shape and the mean lengths and widths of the critical zone were determined in accordance with the relevant demographic factors and patient history. Although the cresenteric shape was predominant, hemispheric and sail-shaped critical zones were also identified. The lengths and widths of the critical zone appeared markedly increased in male individuals. While the increase in age may account for the increased incidence of rotator cuff degeneration due to poor end-vascular supply, the additional factors of height and weight presented as major determinants of the increase in size of the critical zone. In addition, the comparisons of length and width with each other and shape yielded levels of significant difference, therefore indicating a directly proportional relationship between the length and width of the critical zone. This detailed understanding of the critical zone may prove beneficial for the success of post-operative rotator cuff healing.

Critical pedagogy in a health service management development programme: can "critically thinking" managers change the NHS management culture?

PubMed

Sambrook, Sally

2009-01-01

Management development programmes available to NHS managers focus on a performance orientation and sustain a culture of managerial and medical domination. This paper aims to question whether it is possible to consider NHS management development from a critical (empowerment culture) perspective. Features of the critical management studies approach (CMS) are identified. A new MSc is evaluated against these characteristics, examining the teaching and learning processes and students' perceptions of the programme. The aim is to develop critical thinkers who can return to their organizations and challenge existing power structures and practices to change local cultures and enhance health services. Empirical research employed anonymous student questionnaires and a focus group. Student evaluations suggest the MSc can deliver a critical pedagogy and help managers understand issues of power and empowerment, challenge dominant cultures, innovate and effect small, local changes in the NHS culture. There is a need to continue evaluating the programme and include other stakeholders. Longitudinal research should assess the impact of the managers' changed values, attitudes and behaviours on colleagues, clients and the local cultures. The paper identifies some of the tensions of developing "critical" health service managers, and the problems they encounter back in the "uncritical" NHS context, as well as some of the challenges in "facilitating" a critical curriculum. It questions the ethics of developing (or not) a critical perspective in a local context unfamiliar with CMS. Management development in the NHS largely ignores critical pedagogy. This paper makes a small and unique contribution to understanding how developing "critically thinking" managers can challenge the dominant culture. However, the limitations of such a small-scale study and ethical implications are noted.

A systematic review of critical thinking in nursing education.

PubMed

Chan, Zenobia C Y

2013-03-01

This review aimed to explore how critical thinking is perceived in previous studies of nursing education, and analyse the obstacles and strategies in teaching and learning critical thinking mentioned in these studies. Systematic review. This review was based on the following five databases: The British Nursing Index, Ovid Medline, CINAHL, PsycINFO and Scopus. After the screening process and evaluation through using the Critical Appraisal Skills Programme tool, 17 studies were identified that met the inclusion and quality criteria. The studies were read through several times and analysed through thematic synthesis. A total of three themes were developed. The first theme, components for critical thinkers, suggests the abilities and attitudes that critical thinkers should have. The other two themes, influential factors of critical thinking in nursing education, and strategies to promote critical thinking, describe the obstacles and strategies in teaching and learning critical thinking. The 17 studies illustrated that the definition and concept of critical thinking may change from time to time, and hence there is a need to clarify educators' perspective towards critical thinking. There is also a need to evaluate the efficacy of the new strategies mentioned in several selected studies, such as art-based, questioning, cross-cultural nursing experience, and preceptorship. With a better understanding of critical thinking in nursing education, educators and nursing faculty are able to develop better strategies in enhancing critical thinking development in nursing students, in turn preparing them for future clinical practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Healthcare disparities in critical illness.

PubMed

Soto, Graciela J; Martin, Greg S; Gong, Michelle Ng

2013-12-01

To summarize the current literature on racial and gender disparities in critical care and the mechanisms underlying these disparities in the course of acute critical illness. MEDLINE search on the published literature addressing racial, ethnic, or gender disparities in acute critical illness, such as sepsis, acute lung injury, pneumonia, venous thromboembolism, and cardiac arrest. Clinical studies that evaluated general critically ill patient populations in the United States as well as specific critical care conditions were reviewed with a focus on studies evaluating factors and contributors to health disparities. Study findings are presented according to their association with the prevalence, clinical presentation, management, and outcomes in acute critical illness. This review presents potential contributors for racial and gender disparities related to genetic susceptibility, comorbidities, preventive health services, socioeconomic factors, cultural differences, and access to care. The data are organized along the course of acute critical illness. The literature to date shows that disparities in critical care are most likely multifactorial involving individual, community, and hospital-level factors at several points in the continuum of acute critical illness. The data presented identify potential targets as interventions to reduce disparities in critical care and future avenues for research.

A cross-sectional study examining factors related to critical thinking in nursing.

PubMed

Lang, Gary Morris; Beach, Nick Lee; Patrician, Patricia A; Martin, Cheryl

2013-01-01

The purpose of this study was to examine critical thinking skills among registered nurses who work in a military hospital. Sixty-five nurses were administered the Health Sciences Reasoning Test to obtain scores in inductive reasoning, deductive reasoning, interpretation, analysis, and evaluation skills. Results showed no significant association between critical thinking skills and years of experience; however, differences were identified among racial/ethnic groups. It is hoped that findings from this study create a platform for dialogue among staff development nurses who are best situated to develop strategies that address these issues.

A Profile of Injuries Sustained by Law Enforcement Officers: A Critical Review.

PubMed

Lyons, Kate; Radburn, Cameron; Orr, Robin; Pope, Rodney

2017-02-03

Due to the unpredictable, varied and often physical nature of law enforcement duties, police officers are at a high risk of work-related physical injury. The aim of this critical narrative review was to identify and synthesize key findings of studies that have investigated musculoskeletal injuries sustained by law enforcement officers during occupational tasks. A systematic search of four databases using key search terms was conducted to identify potentially relevant studies, which were assessed against key inclusion and exclusion criteria to determine studies to be included in the review. Included studies were critically appraised and the level of evidence determined. Relevant data were extracted, tabulated and synthesized. The 16 identified studies ranged in percentage quality scores from 25.00% to 65.00%, with a mean score of 41.25% and high interrater agreement in scores reflected in a Cohen's Kappa coefficient, κ = 0.977. The most common body site of injury was the upper extremity, the most common injury types were soft-tissue sprains and strains and the most common cause of injury was a non-compliant offender, often involving assault. However, there was limited peer reviewed research in this area and the published research had a narrow focus and was of low to fair methodological quality.

A Profile of Injuries Sustained by Law Enforcement Officers: A Critical Review

PubMed Central

Lyons, Kate; Radburn, Cameron; Orr, Robin; Pope, Rodney

2017-01-01

Due to the unpredictable, varied and often physical nature of law enforcement duties, police officers are at a high risk of work-related physical injury. The aim of this critical narrative review was to identify and synthesize key findings of studies that have investigated musculoskeletal injuries sustained by law enforcement officers during occupational tasks. A systematic search of four databases using key search terms was conducted to identify potentially relevant studies, which were assessed against key inclusion and exclusion criteria to determine studies to be included in the review. Included studies were critically appraised and the level of evidence determined. Relevant data were extracted, tabulated and synthesized. The 16 identified studies ranged in percentage quality scores from 25.00% to 65.00%, with a mean score of 41.25% and high interrater agreement in scores reflected in a Cohen’s Kappa coefficient, κ = 0.977. The most common body site of injury was the upper extremity, the most common injury types were soft-tissue sprains and strains and the most common cause of injury was a non-compliant offender, often involving assault. However, there was limited peer reviewed research in this area and the published research had a narrow focus and was of low to fair methodological quality. PMID:28165373

Critical Thinking in Gifted Children's Offline and Online Peer Feedback

ERIC Educational Resources Information Center

Miller, Myriah T.; Olthouse, Jill

2013-01-01

This comparative study identified the differences between gifted children's offline and online peer feedback within a summer talented writer's workshop. Researchers analyzed ten students' writings for degrees of critical thinking evident in their feedback. Online feedback included students' writings in social writing sites Storybird.com and…

Evaluation of critical temperatures for heat damage in northern highbush blueberry

USDA-ARS?s Scientific Manuscript database

Overhead sprinklers are often used to cool blueberry fields in the Pacific Northwest, but more information is needed to determine exactly when cooling is needed. The objective of this study was to identify the critical temperatures for heat damage in northern highbush blueberry (Vaccinium corymbosum...

Ubiquitous Learning Ecologies for a Critical Cyber-Citizenship

ERIC Educational Resources Information Center

Díez-Gutiérrez, Enrique; Díaz-Nafría, José-María

2018-01-01

The aim of this research is to identify and analyse the ubiquitous learning acquired through blending education settings devoted to the "lifelong training of trainers" and how these contribute to the development of a conscious, critic and engaged citizenship. Through active exploration of the learning process, the study analyses the…

Practices of Compassionate, Critical, Justice-Oriented Teacher Education

ERIC Educational Resources Information Center

Conklin, Hilary G.; Hughes, Hilary E.

2016-01-01

In this cross-institutional, qualitative case study, two teacher educators in urban teacher education programs identify and analyze the components of our teacher education practice in relation to a vision of compassionate, critical, justice-oriented teacher education. Using Grossman et al.'s concepts of preparation for professional practice as an…

Determining the Critical Skills Beginning Agriculture Teachers Need to Successfully Teach Welding

ERIC Educational Resources Information Center

Pate, Michael L.; Warnick, Brian K.; Meyers, Tiffany

2012-01-01

Using the Delphi technique, agriculture teachers with significant experience teaching welding were asked to help determine the critical skills beginning agriculture teachers need to successfully teach welding. The study's objectives sought to (1) identify the knowledge and technical skill competencies that beginning agriculture teachers need to…

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

ERIC Educational Resources Information Center

Hubbard, Jerry D.

2017-01-01

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

Critical Factors for Improving Social Sustainability of Urban Renewal Projects

ERIC Educational Resources Information Center

Chan, Edwin; Lee, Grace K. L.

2008-01-01

This study reviews the sustainable urban design concept and identifies critical factors for enhancing social sustainability of urban renewal projects. Through a questionnaire survey carried out in Hong Kong, the opinions of architects, planners, property development managers, and local citizens were sought and evaluated. The results derived from…

Pornography in the Classroom: Another Challenge for Art Education.

ERIC Educational Resources Information Center

Blandy, Doug; Congdon, Kristin G.

1990-01-01

Maintains that visual images of people contribute to how people perceive themselves and others. Explores ramifications of this under social conditions where pornography is evident and accessible. Examines definitions of pornography. Applies critical theory to art education, stressing that art educators should identify and critically study artworks…

Validating the Watson Glaser Critical Thinking Appraisal

ERIC Educational Resources Information Center

Hassan, Karma El; Madhum, Ghida

2007-01-01

This study validated the Watson Glaser Critical Thinking Appraisal (WGCTA) on a sample of 273 private university students in Lebanon. For that purpose, evidence for construct validation was investigated through identifying the test's factor structure and subscale total correlations, in addition to differences in scores by gender, different levels,…

Older Women in the Academy: Games We Learn To Play Coping with Systems of Inequity.

ERIC Educational Resources Information Center

Erickson, Jacqueline M.

This critical qualitative study explored the obstacles older women encounter as they pursue doctorates. Introductory material identifies steps in a critical qualitative approach including monological data collection, preliminary reconstructive analysis, dialogical data generation, and description and explanation of system relationships. Four women…

How Cognitive Processes Aid Program Understanding.

DTIC Science & Technology

1985-06-01

information critical to program understanding are...are used in conjunction with a ;rcgrarrrer ’s nowledge base and categories cf information critical to prcgrar understanding are identified. The model... understanding . Further, the study contends that the effectiveness of these processes is aeleraent upon the extent of the programmer’s knowledge base.

How Critical Thinking, Multicultural Education and Teacher Qualification Affect Anti-Immigrant Attitudes

ERIC Educational Resources Information Center

Hjerm, Mikael; Johansson Sevä, Ingemar; Werner, Lena

2018-01-01

Previous studies identify a relationship between education and anti-immigrant attitudes. There is, however, uncertainty regarding the underlying explanations linking education to attitudes. In this article, we examine whether a relationship exists between exposure to teaching about critical thinking as well as multiculturalism (measured as…

Identifying critical transitions and their leading biomolecular networks in complex diseases.

PubMed

Liu, Rui; Li, Meiyi; Liu, Zhi-Ping; Wu, Jiarui; Chen, Luonan; Aihara, Kazuyuki

2012-01-01

Identifying a critical transition and its leading biomolecular network during the initiation and progression of a complex disease is a challenging task, but holds the key to early diagnosis and further elucidation of the essential mechanisms of disease deterioration at the network level. In this study, we developed a novel computational method for identifying early-warning signals of the critical transition and its leading network during a disease progression, based on high-throughput data using a small number of samples. The leading network makes the first move from the normal state toward the disease state during a transition, and thus is causally related with disease-driving genes or networks. Specifically, we first define a state-transition-based local network entropy (SNE), and prove that SNE can serve as a general early-warning indicator of any imminent transitions, regardless of specific differences among systems. The effectiveness of this method was validated by functional analysis and experimental data.

Factors influencing patient compliance with therapeutic regimens in chronic heart failure: A critical incident technique analysis.

PubMed

Strömberg, A; Broström, A; Dahlström, U; Fridlund, B

1999-01-01

The aim of this study was to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure. A qualitative design with a critical incident technique was used. Incidents were collected through interviews with 25 patients with heart failure strategically selected from a primary health care clinic, a medical ward, and a specialist clinic. Two hundred sixty critical incidents were identified in the interviews and 2 main areas emerged in the analysis: inward factors and outward factors. The inward factors described how compliance was influenced by the personality of the patient, the disease, and the treatment. The outward factors described how compliance was influenced by social activities, social relationships, and health care professionals. By identifying the inward and outward factors influencing patients with chronic heart failure, health care professionals can assess whether intervention is needed to increase compliance.

Current practices in the identification of critical habitat for threatened species.

PubMed

Camaclang, Abbey E; Maron, Martine; Martin, Tara G; Possingham, Hugh P

2015-04-01

The term critical habitat is used to describe the subset of habitat that is essential to the survival and recovery of species. Some countries legally require that critical habitat of listed threatened and endangered species be identified and protected. However, there is little evidence to suggest that the identification of critical habitat has had much impact on species recovery. We hypothesized that this may be due at least partly to a mismatch between the intent of critical habitat identification, which is to protect sufficient habitat for species persistence and recovery, and its practice. We used content analysis to systematically review critical habitat documents from the United States, Canada, and Australia. In particular, we identified the major trends in type of information used to identify critical habitat and in occupancy of habitat identified as critical. Information about population viability was used to identify critical habitat for only 1% of the species reviewed, and for most species, designated critical habitat did not include unoccupied habitat. Without reference to population viability, it is difficult to determine how much of a species' occupied and unoccupied habitat will be required for persistence. We therefore conclude that the identification of critical habitat remains inconsistent with the goal of protecting sufficient habitat to support persistence and recovery of the species. Ensuring that critical habitat identification aligns more closely with its intent will improve the accuracy of the designations and may therefore help improve the benefits to species recovery when combined with adequate implementation and enforcement of legal protections. © 2014 Society for Conservation Biology.

Use of failure mode, effect and criticality analysis to improve safety in the medication administration process.

PubMed

Rodriguez-Gonzalez, Carmen Guadalupe; Martin-Barbero, Maria Luisa; Herranz-Alonso, Ana; Durango-Limarquez, Maria Isabel; Hernandez-Sampelayo, Paloma; Sanjurjo-Saez, Maria

2015-08-01

To critically evaluate the causes of preventable adverse drug events during the nurse medication administration process in inpatient units with computerized prescription order entry and profiled automated dispensing cabinets in order to prioritize interventions that need to be implemented and to evaluate the impact of specific interventions on the criticality index. This is a failure mode, effects and criticality analysis (FMECA) study. A multidisciplinary consensus committee composed of pharmacists, nurses and doctors evaluated the process of administering medications in a hospital setting in Spain. By analysing the process, all failure modes were identified and criticality was determined by rating severity, frequency and likelihood of failure detection on a scale of 1 to 10, using adapted versions of already published scales. Safety strategies were identified and prioritized. Through consensus, the committee identified eight processes and 40 failure modes, of which 20 were classified as high risk. The sum of the criticality indices was 5254. For the potential high-risk failure modes, 21 different potential causes were found resulting in 24 recommendations. Thirteen recommendations were prioritized and developed over a 24-month period, reducing total criticality from 5254 to 3572 (a 32.0% reduction). The recommendations with a greater impact on criticality were the development of an electronic medication administration record (-582) and the standardization of intravenous drug compounding in the unit (-168). Other improvements, such as barcode medication administration technology (-1033), were scheduled for a longer period of time because of lower feasibility. FMECA is a useful approach that can improve the medication administration process. © 2015 John Wiley & Sons, Ltd.

The optimal blood glucose level for critically ill adult patients.

PubMed

Lv, Shaoning; Ross, Paul; Tori, Kathleen

2017-09-01

Glycaemic control is recognized as one of the important aspects in managing critically ill patients. Both hyperglycaemia and hypoglycaemia independently increase the risk of patient mortality. Hence, the identification of optimal glycaemic control is of paramount importance in the management of critically ill patients. The aim of this literature review is to examine the current status of glycaemic control in critically ill adult patients. This literature review will focus on randomized controlled trials comparing intensive insulin therapy to conventional insulin therapy, with an objective to identify optimal blood glucose level targets for critically ill adult patients. A literature review was conducted to identify large randomized controlled trials for the optimal targeted blood glucose level for critically ill adult patients published since 2000. A total of eight studies fulfilled the selection criteria of this review. With current human and technology resources, the results of the studies support commencing glycaemic control once the blood glucose level of critically ill patients reaches 10 mmol/L and maintaining this level between 8 mmol/L and 10 mmol/L. This literature review provides a recommendation for targeting the optimal blood glucose level for critically ill patients within moderate blood glucose level target range (8-10 mmol/L). The need for uniformed glucometrics for unbiased reporting and further research for optimal blood glucose target is required, especially in light of new technological advancements in closed-loop insulin delivery and monitoring devices. This literature review has revealed a need to call for consensus in the measurement and reporting of glycaemic control using standardized glucometrics. © 2017 British Association of Critical Care Nurses.

Perceptions of the use of critical thinking teaching methods.

PubMed

Kowalczyk, Nina; Hackworth, Ruth; Case-Smith, Jane

2012-01-01

To identify the perceived level of competence in teaching and assessing critical thinking skills and the difficulties facing radiologic science program directors in implementing student-centered teaching methods. A total of 692 program directors received an invitation to complete an electronic survey soliciting information regarding the importance of critical thinking skills, their confidence in applying teaching methods and assessing student performance, and perceived obstacles. Statistical analysis included descriptive data, correlation coefficients, and ANOVA. Responses were received from 317 participants indicating program directors perceive critical thinking to be an essential element in the education of the student; however, they identified several areas for improvement. A high correlation was identified between the program directors' perceived level of skill and their confidence in critical thinking, and between their perceived level of skill and ability to assess the students' critical thinking. Key barriers to implementing critical thinking teaching strategies were identified. Program directors value the importance of implementing critical thinking teaching methods and perceive a need for professional development in critical thinking educational methods. Regardless of the type of educational institution in which the academic program is located, the level of education held by the program director was a significant factor regarding perceived confidence in the ability to model critical thinking skills and the ability to assess student critical thinking skills.

Competency of new graduate nurses: a review of their weaknesses and strategies for success.

PubMed

Theisen, Janelle L; Sandau, Kristin E

2013-09-01

Because of the ongoing nursing shortage and the increasing acuity of patients, new graduate nurses must master both psychomotor and critical thinking skills rapidly. Inadequate orientation leads to high turnover rates for new graduates. Health care leaders must examine the competencies needed for new graduate nurses to succeed in this environment. A critical review of studies (n = 26) was conducted to identify crucial competencies that are needed for new graduate nurses to be successful. Six areas were identified in which new graduates lacked competence: communication, leadership, organization, critical thinking, specific situations, and stress management. Strategies were identified to improve the transition of new graduates. Hospitals should consider implementing nurse residency programs that include strategies for clear communication and conflict management, prioritization skills, and leadership development. Schools of nursing should add communication strategies to their current focus on critical thinking, clinical reasoning, and simulation scenarios and include situation-specific skills such as end-of-life scenarios. Further research should focus on stress management, leadership, clinical reasoning, and evaluation of measurement tools for new graduates. Copyright 2013, SLACK Incorporated.

Critical shear stress measurement of cohesive soils in streams: identifying device-dependent variability using an in-situ jet test device and conduit flume

NASA Astrophysics Data System (ADS)

Mahalder, B.; Schwartz, J. S.; Palomino, A.; Papanicolaou, T.

2016-12-01

Cohesive soil erodibility and threshold shear stress for stream bed and bank are dependent on both soil physical and geochemical properties in association with the channel vegetative conditions. These properties can be spatially variable therefore making critical shear stress measurement in cohesive soil challenging and leads to a need for a more comprehensive understanding of the erosional processes in streams. Several in-situ and flume-type test devices for estimating critical shear stress have been introduced by different researchers; however reported shear stress estimates per device vary widely in orders of magnitude. Advantages and disadvantages exist between these devices. Development of in-situ test devices leave the bed and/or bank material relatively undisturbed and can capture the variable nature of field soil conditions. However, laboratory flumes provide a means to control environmental conditions that can be quantify and tested. This study was conducted to observe differences in critical shear stress using jet tester and a well-controlled conduit flume. Soil samples were collected from the jet test locations and tested in a pressurized flume following standard operational procedure to calculate the critical shear stress. The results were compared using statistical data analysis (mean-separation ANOVA procedure) to identify possible differences. In addition to the device comparison, the mini jet device was used to measure critical shear stress across geologically diverse regions of Tennessee, USA. Statistical correlation between critical shear stress and the soil physical, and geochemical properties were completed identifying that geological origin plays a significant role in critical shear stress prediction for cohesive soils. Finally, the critical shear stress prediction equations using the jet test data were examined with possible suggestions to modify based on the flume test results.

Investigation of criticality safety control infraction data at a nuclear facility

DOE PAGES

Cournoyer, Michael E.; Merhege, James F.; Costa, David A.; ...

2014-10-27

Chemical and metallurgical operations involving plutonium and other nuclear materials account for most activities performed at the LANL's Plutonium Facility (PF-4). The presence of large quantities of fissile materials in numerous forms at PF-4 makes it necessary to maintain an active criticality safety program. The LANL Nuclear Criticality Safety (NCS) Program provides guidance to enable efficient operations while ensuring prevention of criticality accidents in the handling, storing, processing and transportation of fissionable material at PF-4. In order to achieve and sustain lower criticality safety control infraction (CSCI) rates, PF-4 operations are continuously improved, through the use of Lean Manufacturing andmore » Six Sigma (LSS) business practices. Employing LSS, statistically significant variations (trends) can be identified in PF-4 CSCI reports. In this study, trends have been identified in the NCS Program using the NCS Database. An output metric has been developed that measures ADPSM Management progress toward meeting its NCS objectives and goals. Using a Pareto Chart, the primary CSCI attributes have been determined in order of those requiring the most management support. Data generated from analysis of CSCI data help identify and reduce number of corresponding attributes. In-field monitoring of CSCI's contribute to an organization's scientific and technological excellence by providing information that can be used to improve criticality safety operation safety. This increases technical knowledge and augments operational safety.« less

Strategic Planning for Research in Pediatric Critical Care

PubMed Central

Tamburro, Robert F.; Jenkins, Tammara L.; Kochanek, Patrick M.

2016-01-01

Objective To summarize the scientific priorities and potential future research directions for pediatric critical care research discussed by a panel of experts at the inaugural Strategic Planning Conference of the Pediatric Trauma and Critical Illness Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Data Sources Expert opinion expressed during the Strategic Planning Conference. Study Selection Not applicable Data Extraction Chaired by an experienced expert from the field, issues relevant to the conduct of pediatric critical care research were discussed and debated by the invited participants. Data Synthesis Common themes and suggested priorities were identified and coalesced. Conclusions Of the many pathophysiological conditions discussed, the multiple organ dysfunction syndrome emerged as a topic in need of more study that is most relevant to the field. Additionally, the experts offered that the inter-relationship and impact of critical illness on child development and family functioning are important research priorities. Consequently, long-term outcomes research was encouraged. The expert group also suggested that multidisciplinary conferences are needed to help identify key knowledge gaps to advance and direct research in the field. The Pediatric Critical Care and Trauma Scientist Development National K12 Program and the Collaborative Pediatric Critical Care Research Network were recognized as successful and important programs supported by the branch. The development of core data resources including biorepositories with robust phenotypic data using common data elements was also suggested to foster data sharing among investigators and to enhance disease diagnosis and discovery. Multicenter clinical trials and innovative study designs to address understudied and poorly understood conditions were considered important for field advancement. Finally, the growth of the pediatric critical care research workforce was offered as a priority that could be spawned in many ways including by expanded transdisciplinary and multiprofessional collaboration and diversity representation. PMID:27679964

What Do Student Learning Inventories Really Measure? A Critical Analysis of Students' Responses to the Approaches to Learning and Studying Inventory

ERIC Educational Resources Information Center

Mogashana, Disaapele; Case, Jennifer M.; Marshall, Delia

2012-01-01

Student learning inventories are used by both researchers and educators as tools to identify "at risk" students. This article critically interrogates the results of one of these inventories, the 18-item Approaches to Learning and Studying Inventory. In-depth interviews were held with a purposive sample of 10 first-year engineering…

Teacher as the Instrument of Evaluation: A Descriptive Case Study of Connoisseurship and Educational Criticism's Role in Project-Based Learning, Technology Arts Classroom

ERIC Educational Resources Information Center

Castro, Edward Anthony

2010-01-01

Purpose: The study's purpose was to determine the degree to which connoisseurship and educational criticism exists in student work evaluation; to identify master teachers' methods utilizing verbal feedback; and to determine the degree that project-based learning (PBL) principles serve as a "model of practice" for selected PBL technology…

The effect of chronotherapy on delirium in critical care - a systematic review.

PubMed

Luther, Roseanne; McLeod, Anne

2017-05-15

Delirium is highly prevalent within critical care and is linked to adverse clinical outcomes, increased mortality and impaired quality of life. Development of delirium is thought to be caused by multiple risk factors, including disruption of the circadian rhythm. Chronotherapeutic interventions, such as light therapy, music and use of eye shades, have been suggested as an option to improve circadian rhythm within intensive care units. This review aims to answer the question: Can chronotherapy reduce the prevalence of delirium in adult patients in critical care? This study is a systematic review of quantitative studies. Six major electronic databases were searched, and a hand search was undertaken using selected key search terms. Research quality was assessed using the critical appraisal skills programme tools. The studies were critically appraised by both authors independently, and data were extracted. Four themes addressing the research question were identified and critically evaluated. Six primary research articles that investigated different methods of chronotherapy were identified, and the results suggest that multi-component non-pharmacological interventions are the most effective for reducing the prevalence of delirium in critical care. The melatonergic agonist Ramelteon demonstrated statistically significant reductions in delirium; however, the reliability of the results in answering the review question was limited by the research design. The use of bright light therapy (BLT) and dynamic light application had mixed results, with issues with the research design and outcomes measured limiting the validity of the findings. Multi-component non-pharmacological interventions, such as noise and light control, can reduce delirium in critical care, whereas other interventions, such as BLT, have mixed outcomes. Melatonin, as a drug, may be a useful alternative to sedative-hypnotics. Chronotherapy can reduce the incidence of delirium within critical care, although further research is warranted. Staff education is essential in the implementation of chronotherapy. © 2017 British Association of Critical Care Nurses.

Descriptive Analysis in Education: A Guide for Researchers. NCEE 2017-4023

ERIC Educational Resources Information Center

Loeb, Susanna; Dynarski, Susan; McFarland, Daniel; Morris, Pamela; Reardon, Sean; Reber, Sarah

2017-01-01

Whether the goal is to identify and describe trends and variation in populations, create new measures of key phenomena, or describe samples in studies aimed at identifying causal effects, description plays a critical role in the scientific process in general and education research in particular. Descriptive analysis identifies patterns in data to…

Surrogate decision makers' perspectives on preventable breakdowns in care among critically ill patients: A qualitative study.

PubMed

Fisher, Kimberly A; Ahmad, Sumera; Jackson, Madeline; Mazor, Kathleen M

2016-10-01

To describe surrogate decision makers' (SDMs) perspectives on preventable breakdowns in care among critically ill patients. We screened 70 SDMs of critically ill patients for those who identified a preventable breakdown in care, defined as an event where the SDM believes something "went wrong", that could have been prevented, and resulted in harm. In-depth interviews were conducted with SDMs who identified an eligible event. 32 of 70 participants (46%) identified at least one preventable breakdown in care, with a total of 75 discrete events. Types of breakdowns involved medical care (n=52), communication (n=59), and both (n=40). Four additional breakdowns were related to problems with SDM bedside access to the patient. Adverse consequences of breakdowns included physical harm, need for additional medical care, emotional distress, pain, suffering, loss of trust, life disruption, impaired decision making, and financial expense. 28 of 32 SDMs raised their concerns with clinicians, yet only 25% were satisfactorily addressed. SDMs of critically ill patients frequently identify preventable breakdowns in care which result in harm. An in-depth understanding of the types of events SDMs find problematic and the associated harms is an important step towards improving the safety and patient-centeredness of healthcare. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Effects of Website Information Utility on the Outcomes of User-Website Interactions

ERIC Educational Resources Information Center

Hasley, Joseph Paul

2010-01-01

This study investigates the relationships between website information content utility and various outcomes of user interactions with e-tail websites. Although previous research has consistently identified high quality information content as a critical factor of successful e-commerce websites, those studies have not reported how to identify the…

Learning from the Past: Dual Credit

ERIC Educational Resources Information Center

Mansell, Nicole; Justice, Madeline

2014-01-01

This study involved identifying, categorizing, and comparing critical incidents related to qualifying dual credit high school students' decisions to enroll or not to enroll in dual credit coursework in either a traditional or early college high school. The purpose of the study was (a) to identify the reasons qualifying students decide to enroll in…

Replacement Behaviors for Identified Functions of Challenging Behaviors

ERIC Educational Resources Information Center

Matson, Johnny L.; Shoemaker, Mary E.; Sipes, Megan; Horovitz, Max; Worley, Julie A.; Kozlowski, Alison M.

2011-01-01

Functional assessment has become a major feature of learning-based research. A critical element of the majority of these studies includes not only methods and procedures to identify the cause of the challenging behavior, but to establish replacement treatment methods. By far the most common intervention in the 176 studies we reviewed was…

Identifying hotspots and management of critical ecosystem services in rapidly urbanizing Yangtze River Delta Region, China.

PubMed

Cai, Wenbo; Gibbs, David; Zhang, Lang; Ferrier, Graham; Cai, Yongli

2017-04-15

Rapid urbanization has altered many ecosystems, causing a decline in many ecosystem services, generating serious ecological crisis. To cope with these challenges, we presented a comprehensive framework comprising five core steps for identifying and managing hotspots of critical ecosystem services in a rapid urbanizing region. This framework was applied in the case study of the Yangtze River Delta (YRD) Region. The study showed that there was large spatial heterogeneity in the hotspots of ecosystem services in the region, hotspots of supporting services and regulating services aggregately distributing in the southwest mountainous areas while hotspots of provisioning services mainly in the northeast plain, and hotspots of cultural services widespread in the waterbodies and southwest mountainous areas. The regionalization of the critical ecosystem services was made through the hotspot analysis. This study provided valuable information for environmental planning and management in a rapid urbanizing region and helped improve China's ecological redlines policy at regional scale. Copyright © 2017 Elsevier Ltd. All rights reserved.

Moral distress: levels, coping and preferred interventions in critical care and transitional care nurses.

PubMed

Wilson, Melissa A; Goettemoeller, Diana M; Bevan, Nancy A; McCord, Jennifer M

2013-05-01

To examine the level and frequency of moral distress in staff nurses working in two types of units in an acute care hospital and to gather information for future interventions addressing moral distress. In 2008, the American Association of Critical Care Nurses published a Position Statement on Moral Distress. Nurses working in units where critically ill patients are admitted may encounter distressing situations. Moral distress is the painful feelings and/or psychological disequilibrium that may occur when taking care of patients. An exploratory, descriptive design study was used to identify the type and frequency of moral distress experienced by nurses. The setting was an acute care hospital in which the subjects were sampled from two groups of nurses based on their unit assignment. A descriptive, questionnaire study was used. Nurses completed the 38-item moral distress scale, a coping questionnaire, and indicated their preferred methods for institutional support in managing distressing situations. A convenience sample of staff nurses was approached to complete the moral distress questionnaire. Overall, the nurses reported low levels of moral distress. Situations creating the highest levels of moral distress were those related to futile care. A significance between group differences was found in the physician practice dimension. Specific resources were identified to help guide future interventions to recognise and manage moral distress. Nurses reported lower levels and frequency of moral distress in these units but their open-ended responses appeared to indicate moral distress. Nurses identified specific resources that they would find helpful to alleviate moral distress. There are numerous studies that identify the situations and the impact of moral distress, but not many studies explore treatments and interventions for moral distress. This study attempted to identify nurse preferences for lessening the impact of moral distress. © 2013 Blackwell Publishing Ltd.

Evaluation of speech errors in Putonghua speakers with cleft palate: a critical review of methodology issues.

PubMed

Jiang, Chenghui; Whitehill, Tara L

2014-04-01

Speech errors associated with cleft palate are well established for English and several other Indo-European languages. Few articles describing the speech of Putonghua (standard Mandarin Chinese) speakers with cleft palate have been published in English language journals. Although methodological guidelines have been published for the perceptual speech evaluation of individuals with cleft palate, there has been no critical review of methodological issues in studies of Putonghua speakers with cleft palate. A literature search was conducted to identify relevant studies published over the past 30 years in Chinese language journals. Only studies incorporating perceptual analysis of speech were included. Thirty-seven articles which met inclusion criteria were analyzed and coded on a number of methodological variables. Reliability was established by having all variables recoded for all studies. This critical review identified many methodological issues. These design flaws make it difficult to draw reliable conclusions about characteristic speech errors in this group of speakers. Specific recommendations are made to improve the reliability and validity of future studies, as well to facilitate cross-center comparisons.

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Factors Affecting Student Retention in Online Courses: Overcoming This Critical Problem

ERIC Educational Resources Information Center

Gaytan, Jorge

2013-01-01

The purpose of this study was to determine what a panel of 15 experts would identify as critical factors affecting student retention in online courses that will serve as implications for educational leaders to guide their student retention strategies, online organizational structures, institutional policies, and online instructional activities. A…

Measuring Person-Centered Care: A Critical Comparative Review of Published Tools

ERIC Educational Resources Information Center

Edvardsson, David; Innes, Anthea

2010-01-01

Purpose of the study: To present a critical comparative review of published tools measuring the person-centeredness of care for older people and people with dementia. Design and Methods: Included tools were identified by searches of PubMed, Cinahl, the Bradford Dementia Group database, and authors' files. The terms "Person-centered,"…

Exploring Prospective Teachers' Critical Thinking: Case-Based Pedagogy and the Standards of Professional Practice

ERIC Educational Resources Information Center

Cherubini, Lorenzo

2009-01-01

This qualitative constructivist research study employed a unique professional case-based pedagogy to investigate how concurrent Education undergraduate students made sense of the complex dilemmas inherent in the cases and in particular, the factors that influenced their critical thinking processes. The paper identifies three core categories that…

Education for Ethically Sensitive Teaching in Critical Incidents at School

ERIC Educational Resources Information Center

Hanhimaki, Eija; Tirri, Kirsi

2009-01-01

The purpose of the present study was to identify and investigate critical incidents at school that require ethically sensitive teaching. This kind of knowledge is needed in teacher education to prepare future teachers for their profession. The data included narrative interviews with 12 teachers from four urban schools in Finland. Critical…

Rate of Information-Processing as a Variable of Critical Reading.

ERIC Educational Resources Information Center

Van Voorhees, Sylvia Nash

This study investigated the relationship between rate of information processing and critical reading and the anciallary effect of anxiety on the two variables. A tenth grade sample, consisting of 52 fast readers and 52 slow readers, was identified. All subjects in the sample had intelligence quotients of 120 or higher and vocabulary and…

"Rocking the Boat": Developing a Shared Discourse of Resistance

ERIC Educational Resources Information Center

Young, Sara Lewis-Bernstein

2010-01-01

The purpose of this critical ethnographic study is to provide an account from within a public school of some of the ways that heterosexist discourses and silences are reproduced and challenged. As a classroom teacher and critical ethnographer, I conducted this research with straight-identified high school students as they came to understand,…

The Rhetorical Compact: Toward a New Genre of Rhetorical Criticism.

ERIC Educational Resources Information Center

Scott, David K.

This paper proposes the examination of the "rhetorical compact" as a new genre of rhetorical criticism. The paper contends that the study of rhetorical compacts and the resulting influence on rhetorical patterns can serve as a tool to the scholar seeking to identify the implicit strategies in textual analysis. It suggests a linear…

Experimental Study of Thermal Field Evolution in the Short-Impending Stage Before Earthquakes

NASA Astrophysics Data System (ADS)

Ren, Yaqiong; Ma, Jin; Liu, Peixun; Chen, Shunyun

2017-08-01

Phenomena at critical points are vital for identifying the short-impending stage prior to earthquakes. The peak stress is a critical point when stress is converted from predominantly accumulation to predominantly release. We call the duration between the peak stress and instability "the meta-instability stage", which refers to the short-impending stage of earthquakes. The meta-instability stage consists of a steady releasing quasi-static stage and an accelerated releasing quasi-dynamic stage. The turning point of the above two stages is the remaining critical point. To identify the two critical points in the field, it is necessary to study the characteristic phenomena of various physical fields in the meta-instability stage in the laboratory, and the strain and displacement variations were studied. Considering that stress and relative displacement can be detected by thermal variations and peculiarities in the full-field observations, we employed a cooled thermal infrared imaging system to record thermal variations in the meta-instability stage of stick slip events generated along a simulated, precut planer strike slip fault in a granodiorite block on a horizontally bilateral servo-controlled press machine. The experimental results demonstrate the following: (1) a large area of decreasing temperatures in wall rocks and increasing temperatures in sporadic sections of the fault indicate entrance into the meta-instability stage. (2) The rapid expansion of regions of increasing temperatures on the fault and the enhancement of temperature increase amplitude correspond to the turning point from the quasi-static stage to the quasi-dynamic stage. Our results reveal thermal indicators for the critical points prior to earthquakes that provide clues for identifying the short-impending stage of earthquakes.

Recognising safety critical events: can automatic video processing improve naturalistic data analyses?

PubMed

Dozza, Marco; González, Nieves Pañeda

2013-11-01

New trends in research on traffic accidents include Naturalistic Driving Studies (NDS). NDS are based on large scale data collection of driver, vehicle, and environment information in real world. NDS data sets have proven to be extremely valuable for the analysis of safety critical events such as crashes and near crashes. However, finding safety critical events in NDS data is often difficult and time consuming. Safety critical events are currently identified using kinematic triggers, for instance searching for deceleration below a certain threshold signifying harsh braking. Due to the low sensitivity and specificity of this filtering procedure, manual review of video data is currently necessary to decide whether the events identified by the triggers are actually safety critical. Such reviewing procedure is based on subjective decisions, is expensive and time consuming, and often tedious for the analysts. Furthermore, since NDS data is exponentially growing over time, this reviewing procedure may not be viable anymore in the very near future. This study tested the hypothesis that automatic processing of driver video information could increase the correct classification of safety critical events from kinematic triggers in naturalistic driving data. Review of about 400 video sequences recorded from the events, collected by 100 Volvo cars in the euroFOT project, suggested that drivers' individual reaction may be the key to recognize safety critical events. In fact, whether an event is safety critical or not often depends on the individual driver. A few algorithms, able to automatically classify driver reaction from video data, have been compared. The results presented in this paper show that the state of the art subjective review procedures to identify safety critical events from NDS can benefit from automated objective video processing. In addition, this paper discusses the major challenges in making such video analysis viable for future NDS and new potential applications for NDS video processing. As new NDS such as SHRP2 are now providing the equivalent of five years of one vehicle data each day, the development of new methods, such as the one proposed in this paper, seems necessary to guarantee that these data can actually be analysed. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

PubMed

Andreou, Christos; Papastavrou, Evridiki; Merkouris, Anastasios

2014-03-01

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

Instrumental Activities of Daily Living after Critical Illness: A Systematic Review.

PubMed

Hopkins, Ramona O; Suchyta, Mary R; Kamdar, Biren B; Darowski, Emily; Jackson, James C; Needham, Dale M

2017-08-01

Poor functional status is common after critical illness, and can adversely impact the abilities of intensive care unit (ICU) survivors to live independently. Instrumental activities of daily living (IADL), which encompass complex tasks necessary for independent living, are a particularly important component of post-ICU functional outcome. To conduct a systematic review of studies evaluating IADLs in survivors of critical illness. We searched PubMed, CINAHL, Cochrane Library, SCOPUS, and Web of Science for all relevant English-language studies published through December 31, 2016. Additional articles were identified from personal files and reference lists of eligible studies. Two trained researchers independently reviewed titles and abstracts, and potentially eligible full text studies. Eligible studies included those enrolling adult ICU survivors with IADL assessments, using a validated instrument. We excluded studies involving specific ICU patient populations, specialty ICUs, those enrolling fewer than 10 patients, and those that were not peer-reviewed. Variables related to IADLs were reported using the Patient Reported Outcomes Measurement Information System (PROMIS). Thirty of 991 articles from our literature search met inclusion criteria, and 23 additional articles were identified from review of reference lists and personal files. Sixteen studies (30%) published between 1999 and 2016 met eligibility criteria and were included in the review. Study definitions of impairment in IADLs were highly variable, as were reported rates of pre-ICU IADL dependencies (7-85% of patients). Eleven studies (69%) found that survivors of critical illness had new or worsening IADL dependencies. In three of four longitudinal studies, survivors with IADL dependencies decreased over the follow-up period. Across multiple studies, no risk factors were consistently associated with IADL dependency. Survivors of critical illness commonly experience new or worsening IADL dependency that may improve over time. As part of ongoing efforts to understand and improve functional status in ICU survivors, future research must focus on risk factors for IADL dependencies and interventions to improve these cognitive and physical dependencies after critical illness.

Short- and long-term impact of critical illness on relatives: literature review.

PubMed

Paul, Fiona; Rattray, Janice

2008-05-01

This paper is a report of a literature review undertaken to identify the short- and long-term impact of critical illness on relatives. Patients in intensive care can experience physical and psychological consequences, and their relatives may also experience such effects. Although it is recognized that relatives have specific needs, it is not clear whether these needs are always met and whether further support is required, particularly after intensive care. The following databases were searched for the period 1950-2007: Medline, British Nursing Index and Archive, EMBASE, CINAHL, PsycINFO and EMB Reviews--Cochrane Central Register of Clinical Trials. Search terms focused on adult relatives of critically ill adult patients during and after intensive care. Recurrent topics were categorized to structure the review, i.e. 'relatives needs', 'meeting relatives' needs', 'interventions', 'satisfaction', 'psychological outcomes' and 'coping'. Studies have mainly identified relatives' immediate needs using the Critical Care Family Needs Inventory. There are few studies of interventions to meet relatives' needs and the short- and long-term effects of critical illness on relatives. Despite widespread use of the Critical Care Family Needs Inventory, factors such as local or cultural differences may influence relatives' needs. Relatives may also have unidentified needs, and these needs should be explored. Limited research has been carried out into interventions to meet relatives' needs and the effects of critical illness on their well-being, yet some relatives may experience negative psychological consequences far beyond the acute phase of the illness.

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

PubMed

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

2010-12-01

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

Technologies for Developing Predictive Atomistic and Coarse-Grained Force Fields for Ionic Liquid Property Prediction

DTIC Science & Technology

2008-07-29

studied are set to zero and a constrained MM minimization is performed. It is critical that all other force field parameters (for bonds, angles, charges...identifying the symmetry of the problem and tailoring the parameterization accordingly may be critical . For Phase I, the above described procedure was...tasks and the evaluation of their properties. The tremendous number of possible ionic liquids that are within reach makes it critical that a reliable

Needed Research on Creativity. A Special Report of the USOE-Sponsored Grant Study: Critical Appraisal of Research in the Personality-Emotions-Motivation Domain.

ERIC Educational Resources Information Center

Torrance, E. Paul; And Others

This task group report is one of a series prepared by eminent psychologists who have served as consultants in the U.S. Office of Education-sponsored grant study to conduct a Critical Appraisal of the Personality-Emotion-motivation Domain. In order to achieve the goal of identifying important problems and areas for new research and methodological…

Human Capital: DOD Should Fully Develop Its Civilian Strategic Workforce Plan to Aid Decision Makers

DTIC Science & Technology

2014-07-01

Series (0185) Medical Officer Series (0602) Nurse Series (0610) Pharmacist Series (0660) Social Science N/Ab Financial Management Financial...contractor support. The pilot study involved three high-risk mission-critical occupations— Nursing , Fire Protection and Prevention, and Contracting...initial pilot study was limited to the three mission-critical occupation series that DOD has identified as high risk ( Nurse , Fire Protection and

Investigating the Impact of Maternal Residential Mobility on Identifying Critical Windows of Susceptibility to Ambient Air Pollution During Pregnancy.

PubMed

Warren, Joshua L; Son, Ji-Young; Pereira, Gavin; Leaderer, Brian P; Bell, Michelle L

2018-05-01

Identifying periods of increased vulnerability to air pollution during pregnancy with respect to the development of adverse birth outcomes can improve understanding of possible mechanisms of disease development and provide guidelines for protection of the child. Exposure to air pollution during pregnancy is typically based on the mother's residence at delivery, potentially resulting in exposure misclassification and biasing the estimation of critical windows of pregnancy. In this study, we determined the impact of maternal residential mobility during pregnancy on defining weekly exposure to particulate matter less than or equal to 10 μm in aerodynamic diameter (PM10) and estimating windows of susceptibility to term low birth weight. We utilized data sets from 4 Connecticut birth cohorts (1988-2008) that included information on all residential addresses between conception and delivery for each woman. We designed a simulation study to investigate the impact of increasing levels of mobility on identification of critical windows. Increased PM10 exposure during pregnancy weeks 16-18 was associated with an increased probability of term low birth weight. Ignoring residential mobility when defining weekly exposure had only a minor impact on the identification of critical windows for PM10 and term low birth weight in the data application and simulation study. Identification of critical pregnancy windows was robust to exposure misclassification caused by ignoring residential mobility in these Connecticut birth cohorts.

ITS Institutional and Legal Issues Program : Review of the Houston Smart Commuter Operational Test

DOT National Transportation Integrated Search

1997-01-01

The purpose of this study is to identify and evaluate critical issues relating to user acceptance of CVO services by interstate truck and bus drivers and to identify the CVO information needs of other interested parties.

When is critical care medicine cost-effective? A systematic review of the cost-effectiveness literature.

PubMed

Talmor, Daniel; Shapiro, Nathan; Greenberg, Dan; Stone, Patricia W; Neumann, Peter J

2006-11-01

Receiving care in an intensive care unit can greatly influence patients' survival and quality of life. Such treatments can, however, be extremely resource intensive. Therefore, it is increasingly important to understand the costs and consequences associated with interventions aimed at reducing mortality and morbidity of critically ill patients. Cost-effectiveness analyses (CEAs) have become increasingly common to aid decisions about the allocation of scarce healthcare resources. To identify published original CEAs presenting cost/quality-adjusted life year or cost/life-year ratios for treatments used in intensive care units, to summarize the results in an accessible format, and to identify areas in critical care medicine that merit further economic evaluation. We conducted a systematic search of the English-language literature for original CEAs of critical care interventions published from 1993 through 2003. We collected data on the target population, therapy or program, study results, analytic methods employed, and the cost-effectiveness ratios presented. We identified 19 CEAs published through 2003 with 48 cost-effectiveness ratios pertaining to treatment of severe sepsis, acute respiratory failure, and general critical care interventions. These ratios ranged from cost saving to 958,423 US dollars/quality-adjusted life year and from 1,150 to 575,054 US dollars/life year gained. Many studies reported favorable cost-effectiveness profiles (i.e., below 50,000 US dollars/life year or quality-adjusted life year). Specific interventions such as activated protein C for patients with severe sepsis have been shown to provide good value for money. However, overall there is a paucity of CEA literature on the management of the critically ill, and further high-quality CEA is needed. In particular, research should focus on costly interventions such as 24-hr intensivist availability, early goal-directed therapy, and renal replacement therapy. Recent guidelines for the conduct of CEAs in critical care may increase the number and improve the quality of future CEAs.

An evaluation of the critical care assistant role within an acute NHS Trust Critical Care Unit.

PubMed

McGloin, Sarah; Knowles, Judie

2005-01-01

This study provides an evaluation of a training programme designed for developing six critical care assistants to work alongside registered nurses to care for patients within the critical care environment. The programme was run as a pilot funded from the Department of Health's 'critical care bid'. At 18 months long, the programme incorporated a foundation programme, and National Vocational Qualification (NVQ) level 3 in care and adapted Operating Department Practitioner (ODP) NVQ units. Six critical care assistants successfully completed the programme; however, they all then left the unit to undertake further study for pre-registration nursing qualifications. Upon evaluation, a number of key issues were identified. Clear definition of the critical care assistants's role is essential as are dedicated practice development staff, who focus purely on developing the critical care assistant role. More importantly, however, with such key changes in the staffing structure within critical care units, appropriate change management techniques should be employed, ensuring that all staff contributing to the training and development are fully involved from the start.

Perceived barriers to the regionalization of adult critical care in the United States: a qualitative preliminary study

PubMed Central

Kahn, Jeremy M; Asch, Rebecca J; Iwashyna, Theodore J; Rubenfeld, Gordon D; Angus, Derek C; Asch, David A

2008-01-01

Background Regionalization of adult critical care services may improve outcomes for critically ill patients. We sought to develop a framework for understanding clinician attitudes toward regionalization and potential barriers to developing a tiered, regionalized system of care in the United States. Methods We performed a qualitative study using semi-structured interviews of critical care stakeholders in the United States, including physicians, nurses and hospital administrators. Stakeholders were identified from a stratified-random sample of United States general medical and surgical hospitals. Key barriers and potential solutions were identified by performing content analysis of the interview transcriptions. Results We interviewed 30 stakeholders from 24 different hospitals, representing a broad range of hospital locations and sizes. Key barriers to regionalization included personal and economic strain on families, loss of autonomy on the part of referring physicians and hospitals, loss of revenue on the part of referring physicians and hospitals, the potential to worsen outcomes at small hospitals by limiting services, and the potential to overwhelm large hospitals. Improving communication between destination and source hospitals, provider education, instituting voluntary objective criteria to become a designated referral center, and mechanisms to feed back patients and revenue to source hospitals were identified as potential solutions to some of these barriers. Conclusion Regionalization efforts will be met with significant conceptual and structural barriers. These data provide a foundation for future research and can be used to inform policy decisions regarding the design and implementation of a regionalized system of critical care. PMID:19014704

Evaluation of a Teleform-based data collection system: a multi-center obesity research case study.

PubMed

Jenkins, Todd M; Wilson Boyce, Tawny; Akers, Rachel; Andringa, Jennifer; Liu, Yanhong; Miller, Rosemary; Powers, Carolyn; Ralph Buncher, C

2014-06-01

Utilizing electronic data capture (EDC) systems in data collection and management allows automated validation programs to preemptively identify and correct data errors. For our multi-center, prospective study we chose to use TeleForm, a paper-based data capture software that uses recognition technology to create case report forms (CRFs) with similar functionality to EDC, including custom scripts to identify entry errors. We quantified the accuracy of the optimized system through a data audit of CRFs and the study database, examining selected critical variables for all subjects in the study, as well as an audit of all variables for 25 randomly selected subjects. Overall we found 6.7 errors per 10,000 fields, with similar estimates for critical (6.9/10,000) and non-critical (6.5/10,000) variables-values that fall below the acceptable quality threshold of 50 errors per 10,000 established by the Society for Clinical Data Management. However, error rates were found to widely vary by type of data field, with the highest rate observed with open text fields. Copyright © 2014 Elsevier Ltd. All rights reserved.

Identifying Core Competencies to Advance Female Professors' Careers: An Exploratory Study in United States Academia

ERIC Educational Resources Information Center

Seo, Ga-eun; Hedayati Mehdiabadi, Amir; Huang, Wenhao

2017-01-01

This exploratory study aims to identify the core competencies necessary to successfully advance the careers of female associate professors in higher education. To ascertain these core career competencies, a critical incident interview technique was employed. One-to-one semi-structured interviews with six female full professors at a major research…

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

Identifying the critical success factors in the coverage of low vision services using the classification analysis and regression tree methodology.

PubMed

Chiang, Peggy Pei-Chia; Xie, Jing; Keeffe, Jill Elizabeth

2011-04-25

To identify the critical success factors (CSF) associated with coverage of low vision services. Data were collected from a survey distributed to Vision 2020 contacts, government, and non-government organizations (NGOs) in 195 countries. The Classification and Regression Tree Analysis (CART) was used to identify the critical success factors of low vision service coverage. Independent variables were sourced from the survey: policies, epidemiology, provision of services, equipment and infrastructure, barriers to services, human resources, and monitoring and evaluation. Socioeconomic and demographic independent variables: health expenditure, population statistics, development status, and human resources in general, were sourced from the World Health Organization (WHO), World Bank, and the United Nations (UN). The findings identified that having >50% of children obtaining devices when prescribed (χ(2) = 44; P < 0.000), multidisciplinary care (χ(2) = 14.54; P = 0.002), >3 rehabilitation workers per 10 million of population (χ(2) = 4.50; P = 0.034), higher percentage of population urbanized (χ(2) = 14.54; P = 0.002), a level of private investment (χ(2) = 14.55; P = 0.015), and being fully funded by government (χ(2) = 6.02; P = 0.014), are critical success factors associated with coverage of low vision services. This study identified the most important predictors for countries with better low vision coverage. The CART is a useful and suitable methodology in survey research and is a novel way to simplify a complex global public health issue in eye care.

Characterizing critical care physician staffing in rural America: a description of Iowa intensive care unit staffing.

PubMed

Mohr, Nicholas M; Collier, John; Hassebroek, Elizabeth; Groth, Heather

2014-04-01

This study aimed to characterize intensive care unit (ICU) physician staffing patterns in a predominantly rural state. A prospective telephone survey of ICU nurse managers in all Iowa hospitals with an ICU was conducted. Of 122 Iowa hospitals, 64 ICUs in 58 (48%) hospitals were identified, and 46 (72%) responded to the survey. Most ICUs (96%) used an open admission model and cared for undifferentiated medical and surgical patients (88%), and only 27% of open ICUs required critical care or pulmonary consultation for admitted patients. Most (59%) Iowa ICUs had a critical care physician or pulmonologist available, and high-intensity staffing was practiced in 30% of ICUs. Most physicians identified as practicing critical care (63%) were not board certified in critical care. Critical care physicians were available in a minority of hospitals routinely for inpatient intubation and cardiac arrest management (29% and 10%, respectively), and emergency physicians and other practitioners commonly responded to emergencies throughout the hospital. Many Iowa hospitals have ICUs, and staffing patterns in Iowa ICUs mirror closely national staffing practices. Most ICUs are multispecialty, open ICUs in community hospitals. These factors should inform training and resource allocation for intensivists in rural states. © 2014.

Social Anxiety Disorder and Social Skills: A Critical Review of the Literature

ERIC Educational Resources Information Center

Angelico, Antonio Paulo; Crippa, Jose Alexandre S.; Loureiro, Sonia Regina

2013-01-01

The objective of this article is to present a critical analysis of the research outlines used in empirical studies published between the years 2000 and March of 2007 about social anxiety disorder and its associations with social skills. Seventeen papers were identified and grouped into two classes for analysis, namely: Characterization of Social…

A Critical Organizational Communication Framework for Communication and Instruction Scholarship: Narrative Explorations of Resistance, Racism, and Pedagogy

ERIC Educational Resources Information Center

Rudick, C. Kyle

2017-01-01

This study utilized a critical organizational communication framework to understand how student resistance is performed in relation to hegemonic systems that are (re)constituted through communication within and beyond the classroom (i.e., an institutional culture). I conducted multiple semistructured interviews with 14 self-identified students of…

Identification and Development of Critical Workforce Skills in the Chattanooga Region

ERIC Educational Resources Information Center

Dorris, John Peter

2012-01-01

The purpose of this quantitative study was to identify the workforce skills perceived to be critical in the Chattanooga region, and to explore how colleges and businesses can partner to effectively develop those skills. Data from a June 2011 survey of workforce stakeholders in the Chattanooga region were analyzed. The 78 survey respondents…

From Classroom to Workplace: An Exploration of How Teachers and Employers of Accounting Graduates Define and Assess Critical Thinking in Action

ERIC Educational Resources Information Center

Jagannathan, Christine

2017-01-01

Purpose: The purpose of this study was to explore how 2 important stakeholder groups of Southern California business education, regional faculty and employers of accounting graduates, defined and assessed critical thinking skills. Methods: A literature review identified 2 key variables--conceptualization and operational assessment of critical…

Decision Support for Renewal of Wastewater Collection and Water Distribution Systems

EPA Science Inventory

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

Universal time-dependent dispersion properties for diffusion in a one-dimensional critically tilted potential

NASA Astrophysics Data System (ADS)

Guérin, T.; Dean, D. S.

2017-01-01

We consider the time-dependent dispersion properties of overdamped tracer particles diffusing in a one-dimensional periodic potential under the influence of an additional constant tilting force F . The system is studied in the region where the force is close to the critical value Fc at which the barriers separating neighboring potential wells disappear. We show that, when F crosses the critical value, the shape of the mean-square displacement (MSD) curves is strongly modified. We identify a diffusive regime at intermediate-time scales with an effective diffusion coefficient which is much larger than the late-time diffusion coefficient for F >Fc , whereas for F

Training Select-in Interviewers for Astronaut Selection: A Program Evaluation

NASA Technical Reports Server (NTRS)

Hysong, S.; Galarza, L.; Holland, A.; Billica, Roger (Technical Monitor)

2000-01-01

Psychological factors critical to the success of short and long-duration missions have been identified in previous research; however, evaluation for such critical factors in astronaut applicants leaves much room for human interpretation. Thus, an evaluator training session was designed to standardize the interpretation of critical factors, as well as the structure of the select-in interview across evaluators. The purpose of this evaluative study was to determine the effectiveness of the evaluator training sessions and their potential impact on evaluator ratings.

Needed Research on Interpersonal Behavior Processes. A Special Report of the USOE-Sponsored Grant Study: Critical Appraisal of Research in the Personality-Emotions-Motivation Domain.

ERIC Educational Resources Information Center

Byrne, Donn; And Others

The task group report presented in this publication is one of a series prepared by eminent psychologists who have served as consultants in the U.S.O.E.-sponsored grant study to conduct a Critical Appraisal of the Personality-Emotions-Motivation-Domain. In order to achieve the goal of identifying important problems and areas for new research and…

Needed Research on Child Socialization. A Special Report of the USOE-Sponsored Grant Study: Critical Appraisal of Research in the Personality-Emotions-Motivation Domain.

ERIC Educational Resources Information Center

Gorsuch, Richard L.; And Others

The task group report presented in this publication is one of a series prepared by eminent psychologists who have served as consultants in the U.S. Office of Education-sponsored grant study to conduct a Critical Appraisal of the Personality-Emotions-Motivation Domain. In order to achieve the goal of identifying important problems and areas for new…

Global screening for Critical Habitat in the terrestrial realm.

PubMed

Brauneder, Kerstin M; Montes, Chloe; Blyth, Simon; Bennun, Leon; Butchart, Stuart H M; Hoffmann, Michael; Burgess, Neil D; Cuttelod, Annabelle; Jones, Matt I; Kapos, Val; Pilgrim, John; Tolley, Melissa J; Underwood, Emma C; Weatherdon, Lauren V; Brooks, Sharon E

2018-01-01

Critical Habitat has become an increasingly important concept used by the finance sector and businesses to identify areas of high biodiversity value. The International Finance Corporation (IFC) defines Critical Habitat in their highly influential Performance Standard 6 (PS6), requiring projects in Critical Habitat to achieve a net gain of biodiversity. Here we present a global screening layer of Critical Habitat in the terrestrial realm, derived from global spatial datasets covering the distributions of 12 biodiversity features aligned with guidance provided by the IFC. Each biodiversity feature is categorised as 'likely' or 'potential' Critical Habitat based on: 1. Alignment between the biodiversity feature and the IFC Critical Habitat definition; and 2. Suitability of the spatial resolution for indicating a feature's presence on the ground. Following the initial screening process, Critical Habitat must then be assessed in-situ by a qualified assessor. This analysis indicates that a total of 10% and 5% of the global terrestrial environment can be considered as likely and potential Critical Habitat, respectively, while the remaining 85% did not overlap with any of the biodiversity features assessed and was classified as 'unknown'. Likely Critical Habitat was determined principally by the occurrence of Key Biodiversity Areas and Protected Areas. Potential Critical Habitat was predominantly characterised by data representing highly threatened and unique ecosystems such as ever-wet tropical forests and tropical dry forests. The areas we identified as likely or potential Critical Habitat are based on the best available global-scale data for the terrestrial realm that is aligned with IFC's Critical Habitat definition. Our results can help businesses screen potential development sites at the early project stage based on a range of biodiversity features. However, the study also demonstrates several important data gaps and highlights the need to incorporate new and improved global spatial datasets as they become available.

Wind-induced vibration of stay cables : brief

DOT National Transportation Integrated Search

2005-02-01

The objectives of this project were to: : Identify gaps in current knowledge base : Conduct analytical and experimental research in critical areas : Study performance of existing cable-stayed bridges : Study current mitigation methods...

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

NASA Astrophysics Data System (ADS)

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

2005-05-01

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

Risk Factors for Intracardiac Thrombosis in the Right Atrium and Superior Vena Cava in Critically Ill Neonates who Required the Installation of a Central Venous Catheter.

PubMed

Ulloa-Ricardez, Alfredo; Romero-Espinoza, Lizett; Estrada-Loza, María de Jesús; González-Cabello, Héctor Jaime; Núñez-Enríquez, Juan Carlos

2016-08-01

Central venous catheter (CVC) installation is essential for the treatment of critically ill neonates; however, it is associated with the development of neonatal intracardiac thrombosis, which is a complication that is associated with a poor prognosis. We aimed to identify specific risk factors for the development of intracardiac thrombosis in the right atrium (RA) and superior vena cava (SVC) related to the use of CVC in critically ill neonates. A case-control study was conducted at the tertiary referral neonatal intensive care unit of the Pediatric Hospital Siglo XXI in Mexico City, Mexico from 2008 to 2013. The included cases (n = 43) were de novo patients with intracardiac thrombosis in the RA and SVC diagnosed by echocardiography. The controls (n = 43) were neonates without intracardiac thrombosis or thrombosis at other sites. A logistic regression analysis was conducted, and odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. The independent risk factors for intracardiac thrombosis in the RA and SVC were the surgical cut-down insertion technique (OR = 2.98; 95% CI: 1.18-9.10), a maternal history of gestational diabetes/diabetes mellitus (OR = 10.64; 95% CI: 1.13-121.41), Staphylococcus epidermidis infection (OR = 7.09; 95% CI: 1.09-45.92), and CVC placement in the SVC (OR = 5.77; 95% CI: 1.10-30.18). This study allowed us to identify several contributing factors to the development of intracardiac thrombosis in the RA and SVC related to the installation of a CVC in a subgroup of critically ill neonates. Multicenter and well-designed studies with a larger number of patients could help validate our findings and/or identify other risk factors that were not identified in the present study. Copyright © 2015. Published by Elsevier B.V.

Part 1: Pressure ulcer assessment - the development of Critical Care Pressure Ulcer Assessment Tool made Easy (CALCULATE).

PubMed

Richardson, Annette; Barrow, Isabel

2015-11-01

Critically ill patients are at high risk of developing pressure ulcers resulting in serious untoward patient and health care system outcomes. Pressure ulcer prevention is therefore an important patient safety priority and establishing a structured approach to pressure ulcer risk assessment to identify patients at risk is a critical first step. The literature was searched using three electronic databases from 2000 to 2011 to identify papers reporting on pressure ulcer risk factors and assessment in adult critical care. The review and appraisal of papers were conducted by two critical care nurses. Papers underwent detailed review if they met inclusion criteria where they identified pressure ulcer assessment scores, scales or risk factors and related to adult critical care patients Seven papers were reviewed. No single assessment tool was sufficiently validated for critically ill patients and seven key critical care risk factors were identified. These risk factors were: mechanical ventilation, impaired circulation, dialysis, long surgery, low protein and too unstable to turn. The tool Critical Care Pressure Ulcer Assessment Tool made Easy (CALCULATE) was developed utilizing the risk factors from the literature and expert critical care nursing consensus decision-making. In the absence of current consensus, valid assessment scales and limited evidence for the most appropriate pressure ulcer assessment for critically ill patients, this assessment tool offers an easy, appropriate alternative for critically ill patients than existing tools primarily validated for acute care wards. 'CALCULATE' offers an important contribution towards the advancement and development of critical care pressure ulcer risk assessment. Future research is needed to further enhance and inform pressure ulcer risk assessment of the critically ill patients. The identification of critical care risk factors may be an indicative method of assessing pressure ulcer risk in the critically ill patients. © 2015 British Association of Critical Care Nurses.

A Survey of Correspondence Course Training.

ERIC Educational Resources Information Center

Rocklyn, Eugene H.

Correspondence course training (CCT) systems, primarily in the military and government sectors, were surveyed to identify their critical problems. Other study objectives were to formulate the basic design of a CCT system to solve these problems and identify course completion factors and trends in systems operations. Seventeen CCT organizations…

14 CFR 26.43 - Holders of and applicants for type certificates-Repairs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... payload capacity of 7,500 pounds or more. (b) List of fatigue critical baseline structure. For airplanes...) Identify fatigue critical baseline structure for all airplane model variations and derivatives approved... affects fatigue critical baseline structure identified under paragraph (b)(1) of this section; (2) Perform...

14 CFR 26.43 - Holders of and applicants for type certificates-Repairs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... payload capacity of 7,500 pounds or more. (b) List of fatigue critical baseline structure. For airplanes...) Identify fatigue critical baseline structure for all airplane model variations and derivatives approved... affects fatigue critical baseline structure identified under paragraph (b)(1) of this section; (2) Perform...

14 CFR 26.43 - Holders of and applicants for type certificates-Repairs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... payload capacity of 7,500 pounds or more. (b) List of fatigue critical baseline structure. For airplanes...) Identify fatigue critical baseline structure for all airplane model variations and derivatives approved... affects fatigue critical baseline structure identified under paragraph (b)(1) of this section; (2) Perform...

14 CFR 26.43 - Holders of and applicants for type certificates-Repairs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... payload capacity of 7,500 pounds or more. (b) List of fatigue critical baseline structure. For airplanes...) Identify fatigue critical baseline structure for all airplane model variations and derivatives approved... affects fatigue critical baseline structure identified under paragraph (b)(1) of this section; (2) Perform...

14 CFR 26.43 - Holders of and applicants for type certificates-Repairs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... payload capacity of 7,500 pounds or more. (b) List of fatigue critical baseline structure. For airplanes...) Identify fatigue critical baseline structure for all airplane model variations and derivatives approved... affects fatigue critical baseline structure identified under paragraph (b)(1) of this section; (2) Perform...

Contamination control in hybrid microelectronic modules. Identification of critical process and contaminants, part 1

NASA Technical Reports Server (NTRS)

Himmel, R. P.

1975-01-01

Hybrid processes, handling procedures, and materials were examined to identify the critical process steps in which contamination is most likely to occur, to identify the particular contaminants associated with these critical steps, and to propose method for the control of these contaminants.

Identifying Opportunities for Vertical Integration of Biochemistry and Clinical Medicine.

PubMed

Wendelberger, Karen J.; Burke, Rebecca; Haas, Arthur L.; Harenwattananon, Marisa; Simpson, Deborah

1998-01-01

Objectives: Retention of basic science knowledge, as judged by National Board of Medical Examiners' (NBME) data, suffers due to lack of apparent relevance and isolation of instruction from clinical application, especially in biochemistry. However, the literature reveals no systematic process for identifying key biochemical concepts and associated clinical conditions. This study systematically identified difficult biochemical concepts and their common clinical conditions as a critical step towards enhancing relevance and retention of biochemistry.Methods: A multi-step/ multiple stakeholder process was used to: (1) identify important biochemistry concepts; (2) determine students' perceptions of concept difficulty; (3) assess biochemistry faculty, student, and clinical teaching scholars' perceived relevance of identified concepts; and (4) identify associated common clinical conditions for relevant and difficult concepts. Surveys and a modified Delphi process were used to gather data, subsequently analyzed using SPSS for Windows.Results: Sixteen key biochemical concepts were identified. Second year medical students rated 14/16 concepts as extremely difficult while fourth year students rated nine concepts as moderately to extremely difficult. On average, each teaching scholar generated common clinical conditions for 6.2 of the 16 concepts, yielding a set of seven critical concepts and associated clinical conditions.Conclusions: Key stakeholders in the instructional process struggle to identify biochemistry concepts that are critical, difficult to learn and associated with common clinical conditions. However, through a systematic process beginning with identification of concepts and associated clinical conditions, relevance of basic science instruction can be enhanced.

Relationships between duration of practice, educational level, and perception of barriers to implement evidence-based practice among critical care nurses.

PubMed

Phillips, Carswella

2015-12-01

Globally, a greater emphasis has been placed on the delivery of safe, patient-centered, evidence-based nursing care. As point-of-care providers, critical care nurses play a key role in ensuring that patients receive the safest, most effective treatment available. In order to deliver scientific-based care, critical care nurses must stay abreast of the current trends, as well as engage in the evidence-based practice process. This study aimed to describe research activities, to identify barriers to implement evidence-based practice and to explore professional factors related to the use of evidence-based practice among critical care nurses at three teaching hospitals in south-eastern United States. A survey design and convenience sampling method was used. A sample of 30 critical care staff nurses participated in the study. A 61-item online questionnaire composed of a demographic survey - BARRIERS scale - and Evidence-Based Practice Questionnaire was used. Simple descriptive statistics, Pearson's product moment correlations, and independent-sample t test procedures were used to analyze the data. Critical care nurses' reported positive attitudes, but viewed knowledge and use of evidence-based practice less favorably. These results may indicate that having a positive attitude towards evidence-based practice does not necessarily translate to knowledge and use of the evidence-based practice process in clinical practice. An unwillingness to change and time constraints were identified as the top barriers to use evidence-based practice in this study. Perceptions of barriers to use evidence-based practice were higher in those critical care nurses who had less practical experience and educational preparation. The results suggest that critical care nurses possess the foundation to engage in the evidence-based practice process; however, their knowledge, practice, and attitudes just need to be cultivated and strengthened. Understanding the nurses' professional factors, current use and barriers to implement evidence-based practice is an essential step to ensuring competency and value for engaging in the evidence-based practice process. The results of this study support the need for future research to address barriers that impact critical care nurses' ability to deliver state-of-the-science care.

Strategic Planning for Research in Pediatric Critical Care.

PubMed

Tamburro, Robert F; Jenkins, Tammara L; Kochanek, Patrick M

2016-11-01

To summarize the scientific priorities and potential future research directions for pediatric critical care research discussed by a panel of experts at the inaugural Strategic Planning Conference of the Pediatric Trauma and Critical Illness Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Expert opinion expressed during the Strategic Planning Conference. Not applicable. Chaired by an experienced expert from the field, issues relevant to the conduct of pediatric critical care research were discussed and debated by the invited participants. Common themes and suggested priorities were identified and coalesced. Of the many pathophysiologic conditions discussed, the multiple organ dysfunction syndrome emerged as a topic in need of more study that is most relevant to the field. Additionally, the experts offered that the interrelationship and impact of critical illness on child development and family functioning are important research priorities. Consequently, long-term outcomes research was encouraged. The expert group also suggested that multidisciplinary conferences are needed to help identify key knowledge gaps to advance and direct research in the field. The Pediatric Critical Care and Trauma Scientist Development National K12 Program and the Collaborative Pediatric Critical Care Research Network were recognized as successful and important programs supported by the branch. The development of core data resources including biorepositories with robust phenotypic data using common data elements was also suggested to foster data sharing among investigators and to enhance disease diagnosis and discovery. Multicenter clinical trials and innovative study designs to address understudied and poorly understood conditions were considered important for field advancement. Finally, the growth of the pediatric critical care research workforce was offered as a priority that could be spawned in many ways including by expanded transdisciplinary and multiprofessional collaboration and diversity representation.

Quality-by-design III: application of near-infrared spectroscopy to monitor roller compaction in-process and product quality attributes of immediate release tablets.

PubMed

Kona, Ravikanth; Fahmy, Raafat M; Claycamp, Gregg; Polli, James E; Martinez, Marilyn; Hoag, Stephen W

2015-02-01

The objective of this study is to use near-infrared spectroscopy (NIRS) coupled with multivariate chemometric models to monitor granule and tablet quality attributes in the formulation development and manufacturing of ciprofloxacin hydrochloride (CIP) immediate release tablets. Critical roller compaction process parameters, compression force (CFt), and formulation variables identified from our earlier studies were evaluated in more detail. Multivariate principal component analysis (PCA) and partial least square (PLS) models were developed during the development stage and used as a control tool to predict the quality of granules and tablets. Validated models were used to monitor and control batches manufactured at different sites to assess their robustness to change. The results showed that roll pressure (RP) and CFt played a critical role in the quality of the granules and the finished product within the range tested. Replacing binder source did not statistically influence the quality attributes of the granules and tablets. However, lubricant type has significantly impacted the granule size. Blend uniformity, crushing force, disintegration time during the manufacturing was predicted using validated PLS regression models with acceptable standard error of prediction (SEP) values, whereas the models resulted in higher SEP for batches obtained from different manufacturing site. From this study, we were able to identify critical factors which could impact the quality attributes of the CIP IR tablets. In summary, we demonstrated the ability of near-infrared spectroscopy coupled with chemometrics as a powerful tool to monitor critical quality attributes (CQA) identified during formulation development.

Pediatric Critical Care Nursing Research Priorities-Initiating International Dialogue.

PubMed

Tume, Lyvonne N; Coetzee, Minette; Dryden-Palmer, Karen; Hickey, Patricia A; Kinney, Sharon; Latour, Jos M; Pedreira, Mavilde L G; Sefton, Gerri R; Sorce, Lauren; Curley, Martha A Q

2015-07-01

To identify and prioritize research questions of concern to the practice of pediatric critical care nursing practice. One-day consensus conference. By using a conceptual framework by Benner et al describing domains of practice in critical care nursing, nine international nurse researchers presented state-of-the-art lectures. Each identified knowledge gaps in their assigned practice domain and then poised three research questions to fill that gap. Then, meeting participants prioritized the proposed research questions using an interactive multivoting process. Seventh World Congress on Pediatric Intensive and Critical Care in Istanbul, Turkey. Pediatric critical care nurses and nurse scientists attending the open consensus meeting. Systematic review, gap analysis, and interactive multivoting. The participants prioritized 27 nursing research questions in nine content domains. The top four research questions were 1) identifying nursing interventions that directly impact the child and family's experience during the withdrawal of life support, 2) evaluating the long-term psychosocial impact of a child's critical illness on family outcomes, 3) articulating core nursing competencies that prevent unstable situations from deteriorating into crises, and 4) describing the level of nursing education and experience in pediatric critical care that has a protective effect on the mortality and morbidity of critically ill children. The consensus meeting was effective in organizing pediatric critical care nursing knowledge, identifying knowledge gaps and in prioritizing nursing research initiatives that could be used to advance nursing science across world regions.

Implementation of a pediatric critical care focused bedside ultrasound training program in a large academic PICU.

PubMed

Conlon, Thomas W; Himebauch, Adam S; Fitzgerald, Julie C; Chen, Aaron E; Dean, Anthony J; Panebianco, Nova; Darge, Kassa; Cohen, Meryl S; Greeley, William J; Berg, Robert A; Nishisaki, Akira

2015-03-01

To determine the feasibility and describe the process of implementing a pediatric critical care bedside ultrasound program in a large academic PICU and to evaluate the impact of bedside ultrasound on clinical management. Retrospective case series, description of program implementation. Single-center quaternary noncardiac PICU in a children's hospital. Consecutive patients from January 22, 2012, to July 22, 2012, with bedside ultrasounds performed and interpreted by pediatric critical care practitioners. A pediatric critical care bedside ultrasound program consisting of a 2-day immersive course followed by clinical performance with internal quality assurance review was implemented. Studies performed in the PICU following training were documented and reviewed against reference standards including subspecialist-performed ultrasound or clinical response. Seventeen critical care faculties and eight fellows recorded 201 bedside ultrasound studies over 6 months in defined core applications: 57 procedural (28%), 76 hemodynamic (38%), 35 thoracic (17%), and 33 abdominal (16%). A quality assurance review identified 23 studies (16% of all nonprocedural studies) as critical (affected clinical management or gave valuable information). Forty-eight percent of those studies (11/23) were within the hemodynamic core. The proportion of critical studies were not significantly different across the applications (hemodynamic, 11/76 [15%] vs thoracic and abdominal, 12/68 [18%]; p = 0.65). Examples of critical studies include evidence of tamponade secondary to pleural effusions, identification of pulmonary hypertension, hemodynamic assessment before tracheal intubation, recognition of hypovolemia and systemic vascular resistance abnormalities, determination of pneumothorax, location of chest tube and urinary catheter, and differentiation of pleural fluid from pulmonary consolidation. Implementation of a critical care bedside ultrasound program for critical care providers in a large academic PICU is feasible. Bedside ultrasound evaluation and interpretation by intensivists affected the management of critically ill children.

An Exploration of a Public Day School for Students with Emotional and Behavioral Disabilities

ERIC Educational Resources Information Center

Abdulalim, Latif

2014-01-01

This study examined programming practices that have identified in the research as critical for school success for students with emotional and behavioral disorders (EBD). Secondary purposes of the study were to identify the extent to which these practices were used and to examine student social/emotional and academic outcome data in a public day…

Knowing What I Can Do and Who I Can Be: Youth Identify Transformational Benefits of Participatory Action Research

ERIC Educational Resources Information Center

Zaal, Mayida; Terry, John

2013-01-01

To engage critically in their communities, young people must be equipped to identify and study problems that directly affect them. Our qualitative study reveals that youth participatory action research (YPAR) is one such approach, disclosing and affirming inherent gifts and talents in youth while collaboratively developing within them the critical…

Analyzing course objectives: assessing critical thinking in the pharmacy curriculum.

PubMed

Vuchetich, Phillip J; Hamilton, William R; Ahmad, S Omar; Makoid, Michael C

2006-01-01

Assessment of critical thinking objectives in a pharmacy program curriculum is an important part of program assessment. This study measures the proportion of cognitive learning objectives at various levels of Bloom's taxonomy throughout the required curriculum using the stated objectives in course syllabi (the explicit curriculum). In one entry level doctor of pharmacy program, 54.90% of cognitive objectives identified critical thinking outcomes using the rubric of Bloom's level 3 or higher as an indicator of critical thinking. In this program, there was a similar percent of critical thinking objectives in each of the first three years, but the final year of the curriculum had a higher percent of critical thinking objectives than each of the first three years (p = 0.0018, Kruskal-Wallis test). The increase in critical thinking in the final year suggests that the explicit expectations in the syllabi are weighted toward a higher percent of critical thinking objectives during clinical rotations. The methods described in the study may serve as tools for a curriculum committee or program assessment team to compare critical thinking in the curriculum at different points in time, and may assist in curricular mapping efforts. These methods may complement studies measuring the implicit curriculum (that which the faculty actually teach, which may not be stated in the explicit curriculum.).

Avionic architecture requirements for Space Exploration Initiative systems

NASA Technical Reports Server (NTRS)

Herbella, C. G.; Brown, D. C.

1991-01-01

The authors discuss NASA's Strategic Avionics Technology Working Group (SATWG) and the results of the first study commissioned by the SATWG, the Space Avionics Requirements Study (SARS). The goal of the SARS task was to show that an open avionics architecture, using modular, standardized components, could be applied across the wide range of systems that comprise the Space Exploration Initiative. The study addressed systems ranging from expendable launch vehicles and the space station to surface systems such as Mars or lunar rovers and habitats. Top-level avionics requirements were derived from characterizations of each of the systems considered. Then a set of avionics subsystems were identified, along with estimates of the numbers and types of modules needed to meet the requirements. Applicability of these results across the infrastructure was then illustrated. In addition to these tasks, critical technologies were identified, characterized, and assessed in terms of their criticality and impact on the program. Design, development, test, and evaluation methods were addressed to identify potential areas of improvement.

Nursing care plans versus concept maps in the enhancement of critical thinking skills in nursing students enrolled in a baccalaureate nursing program.

PubMed

Sinatra-Wilhelm, Tina

2012-01-01

Appropriate and effective critical thinking and problem solving is necessary for all nurses in order to make complex decisions that improve patient outcomes, safety, and quality of nursing care. With the current emphasis on quality improvement, critical thinking ability is a noteworthy concern within the nursing profession. An in-depth review of literature related to critical thinking was performed. The use of nursing care plans and concept mapping to improve critical thinking skills was among the recommendations identified. This study compares the use of nursing care plans and concept mapping as a teaching strategy for the enhancement of critical thinking skills in baccalaureate level nursing students. The California Critical Thinking Skills Test was used as a method of comparison and evaluation. Results indicate that concept mapping enhances critical thinking skills in baccalaureate nursing students.

Critical thinking dispositions and learning styles of baccalaureate nursing students from China.

PubMed

Zhang, Huan; Lambert, Vickie

2008-09-01

Although considerable information exists regarding the learning styles and critical thinking dispositions of nursing students from Western countries, limited comparable information exists within China. The purposes of this study were to assess the learning styles and critical thinking dispositions of Chinese baccalaureate nursing students and to identify the relationships among the learning styles, critical thinking dispositions, and demographics. The sample consisted of 100 Chinese baccalaureate nursing students enrolled at two universities. The data were obtained through a Demographic Data Questionnaire, the California Critical Thinking Disposition Inventory, and the Index of Learning Styles. The primary learning style dimensions were found to be reflective, sensing, visual, and global, while the critically thinking abilities was found to be weak. A number of positive and negative correlations were found among the demographics, learning styles, and critical thinking dispositions. These findings suggest further examination on how to increase nursing students' critical thinking skills based upon their preferred learning styles.

Early warning signals for critical transitions in a thermoacoustic system

PubMed Central

Gopalakrishnan, E. A.; Sharma, Yogita; John, Tony; Dutta, Partha Sharathi; Sujith, R. I.

2016-01-01

Dynamical systems can undergo critical transitions where the system suddenly shifts from one stable state to another at a critical threshold called the tipping point. The decrease in recovery rate to equilibrium (critical slowing down) as the system approaches the tipping point can be used to identify the proximity to a critical transition. Several measures have been adopted to provide early indications of critical transitions that happen in a variety of complex systems. In this study, we use early warning indicators to predict subcritical Hopf bifurcation occurring in a thermoacoustic system by analyzing the observables from experiments and from a theoretical model. We find that the early warning measures perform as robust indicators in the presence and absence of external noise. Thus, we illustrate the applicability of these indicators in an engineering system depicting critical transitions. PMID:27767065

Family needs and involvement in the intensive care unit: a literature review.

PubMed

Al-Mutair, Abbas Saleh; Plummer, Virginia; O'Brien, Anthony; Clerehan, Rosemary

2013-07-01

To understand the needs of critically ill patient families', seeking to meet those needs and explore the process and patterns of involving family members during routine care and resuscitation and other invasive procedures. A structured literature review using Cumulative Index to Nursing and Allied Health Literature, Pubmed, Proquest, Google scholar, Meditext database and a hand search of critical care journals via identified search terms for relevant articles published between 2000 and 2010. Thirty studies were included in the review either undertaken in the Intensive Care Unit or conducted with critical care staff using different methods of inquiry. The studies were related to family needs; family involvement in routine care; and family involvement during resuscitation and other invasive procedures. The studies revealed that family members ranked both the need for assurance and the need for information as the most important. They also perceived their important needs as being unmet, and identified the nurses as the best staff to meet these needs, followed by the doctors. The studies demonstrate that both family members and healthcare providers have positive attitudes towards family involvement in routine care. However, family members and healthcare providers had significantly different views of family involvement during resuscitation and other invasive procedures. Meeting Intensive Care Unit family needs can be achieved by supporting and involving families in the care of the critically ill family member. More emphasis should be placed on identifying the family needs in relation to the influence of cultural values and religion held by the family members and the organisational climate and culture of the working area in the Intensive Care Unit. © 2013 Blackwell Publishing Ltd.

Non-Technical Skills for Surgeons (NOTSS): Critical appraisal of its measurement properties.

PubMed

Jung, James J; Borkhoff, Cornelia M; Jüni, Peter; Grantcharov, Teodor P

2018-02-17

To critically appraise the development and measurement properties, including sensibility, reliability, and validity of the Non-Technical Skills of Surgeons (NOTSS) system. Articles that described development process of the NOTSS system were identified. Relevant primary studies that presented evidence of reliability and validity were identified through a comprehensive literature review. NOTSS was developed through robust item generation and reduction strategies. It was shown to have good content validity, acceptability, and feasibility. Inter-rater reliability increased with greater expertise and number of assessors. Studies demonstrated evidence of cross-sectional construct validity, in that the tool was able to differentiate known groups of varied non-technical skill levels. Evidence of longitudinal construct validity also existed to demonstrate that NOTSS detected changes in non-technical skills before and after targeted training. In populations and settings presented in our critical appraisal, NOTSS provided reliable and valid measurements of intraoperative non-technical skills of surgeons. Copyright © 2018 Elsevier Inc. All rights reserved.

Technical Feasibility Assessment of Lunar Base Mission Scenarios

NASA Astrophysics Data System (ADS)

Magelssen, Trygve ``Spike''; Sadeh, Eligar

2005-02-01

Investigation of the literature pertaining to lunar base (LB) missions and the technologies required for LB development has revealed an information gap that hinders technical feasibility assessment. This information gap is the absence of technical readiness levels (TRL) (Mankins, 1995) and information pertaining to the criticality of the critical enabling technologies (CETs) that enable mission success. TRL is a means of identifying technical readiness stages of a technology. Criticality is defined as the level of influence the CET has on the mission scenario. The hypothesis of this research study is that technical feasibility is a function of technical readiness and technical readiness is a function of criticality. A newly developed research analysis method is used to identify the technical feasibility of LB mission scenarios. A Delphi is used to ascertain technical readiness levels and CET criticality-to-mission. The research analysis method is applied to the Delphi results to determine the technical feasibility of the LB mission scenarios that include: observatory, science research, lunar settlement, space exploration gateway, space resource utilization, and space tourism. The CETs identified encompasses four major system level technologies of: transportation, life support, structures, and power systems. Results of the technical feasibility assessment show the observatory and science research LB mission scenarios to be more technical ready out of all the scenarios, but all mission scenarios are in very close proximity to each other in regard to criticality and TRL and no one mission scenario stands out as being absolutely more technically ready than any of the other scenarios. What is significant and of value are the Delphi results concerning CET criticality-to-mission and the TRL values evidenced in the Tables that can be used by anyone assessing the technical feasibility of LB missions.

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

PubMed

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

2016-11-01

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

Using Interactive Management to Facilitate a Student-Centred Conceptualisation of Critical Thinking: A Case Study

ERIC Educational Resources Information Center

Dwyer, Christopher P.; Hogan, Michael J.; Harney, Owen M.; O'Reilly, John

2014-01-01

Critical thinking (CT) is a metacognitive process, consisting of a number of sub-skills and dispositions, that, when used appropriately, increases the chances of producing a logical solution to a problem or a valid conclusion to an argument. CT has been identified as a fundamental learning objective of third-level education; however, students…

Predicting Parental Mediation Behaviors: The Direct and Indirect Influence of Parents' Critical Thinking about Media and Attitudes about Parent-Child Interactions

ERIC Educational Resources Information Center

Rasmussen, Eric C.; White, Shawna R.; King, Andy J.; Holiday, Steven; Densley, Rebecca L.

2016-01-01

Many parents fail to interact with their children regularly about media content and past research has identified few predictors of parents' engagement in parental mediation behaviors. This correlational study explored the relationship between parents' critical thinking about media and parents' provision of both active and restrictive mediation of…

University Choice: What Do We Know, What Don't We Know and What Do We Still Need to Find Out?

ERIC Educational Resources Information Center

Hemsley-Brown, Jane; Oplatka, Izhar

2015-01-01

Purpose: The purpose of this paper is to systematically document, scrutinise and critically analyse the current research literature on higher education choice to: establish the scope of the studies; map the factors associated with choice; identify the key strengths and weaknesses in the research literature; critically analyse the extant research…

Construct validity of the Health Science Reasoning Test.

PubMed

Huhn, Karen; Black, Lisa; Jensen, Gail M; Deutsch, Judith E

2011-01-01

The aim of this study was to evaluate the construct validity of the Health Science Reasoning Test (HSRT) by determining if the test could discriminate between expert and novice physical therapists' critical-thinking skills. Experts identified from a random list of certified clinical specialists and students in the first year of their physical therapy education from two physical therapy programs completed the HSRT. Experts (n = 73) had a higher total HSRT score (mean 24.06, SD 3.92) than the novices (n = 79) (mean 22.49, SD 3.2), with the difference being statistically significant t (148) = 2.67, p = 0.008. The HSRT total score discriminated between expert and novice critical-thinking skills, therefore establishing construct validity. To our knowledge, this is the first study to compare expert and novice performance on a standardized test. The opportunity to have a tool that provides evidence of students' critical thinking skills could be helpful for educators and students. The test results could aid in identifying areas of students' strengths and weaknesses, thereby enabling targeted remediation to improve critical thinking skills, which are key factors in clinical reasoning, a necessary skill for effective physical therapy practice.

Introduction and executive summary: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

Christian, Michael D; Devereaux, Asha V; Dichter, Jeffrey R; Rubinson, Lewis; Kissoon, Niranjan

2014-10-01

Natural disasters, industrial accidents, terrorism attacks, and pandemics all have the capacity to result in large numbers of critically ill or injured patients. This supplement provides suggestions for all of those involved in a disaster or pandemic with multiple critically ill patients, including front-line clinicians, hospital administrators, professional societies, and public health or government officials. The current Task Force included a total of 100 participants from nine countries, comprised of clinicians and experts from a wide variety of disciplines. Comprehensive literature searches were conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert-opinion-based suggestions that are presented in this supplement using a modified Delphi process. The ultimate aim of the supplement is to expand the focus beyond the walls of ICUs to provide recommendations for the management of all critically ill or injured adults and children resulting from a pandemic or disaster wherever that care may be provided. Considerations for the management of critically ill patients include clinical priorities and logistics (supplies, evacuation, and triage) as well as the key enablers (systems planning, business continuity, legal framework, and ethical considerations) that facilitate the provision of this care. The supplement also aims to illustrate how the concepts of mass critical care are integrated across the spectrum of surge events from conventional through contingency to crisis standards of care.

Do scores on three commonly used measures of critical thinking correlate with academic success of health professions trainees? A systematic review and meta-analysis.

PubMed

Ross, David; Loeffler, Kim; Schipper, Shirley; Vandermeer, Ben; Allan, G Michael

2013-05-01

To determine whether the three commonly used measures of critical thinking correlate with academic success of medical professionals in training. The search for English-language articles (from 1980 to 2011) used Medline, Embase, Scopus, Cochrane Library on Ovid, Proquest Dissertations, Health and Psychosocial Instruments, PsychINFO, and references of included articles. Studies comparing critical thinking with academic success among medical professionals were included. Two authors performed study selection independently, with disagreement resolved by consensus. Two authors independently abstracted data on study characteristics, quality, and outcomes, with disagreement resolved by a third author. Critical thinking tests studied were the California Critical Thinking Skills Test (CCTST), California Critical Thinking Disposition Inventory (CCTDI), and Watson-Glaser Critical Thinking Appraisal. Correlation coefficients were pooled in meta-analysis. The search identified 557 studies: 52 met inclusion for systematic review, 41 of which were meta-analyzed. Critical thinking was positively correlated with academic success, r=0.31 (95% confidence intervals [CI] 0.26, 0.35), with a moderate statistical heterogeneity (I=67%). In subgroup analysis, only student type had statistical significance for correlation, although bias was likely due to low numbers for some student types. In direct comparison, using studies that employed two critical thinking tests, the CCTDI (r=0.23, 95% CI 0.15, 0.30) was significantly inferior (P<.001) to the CCTST (r=0.39, 95% CI 0.33, 0.45). Critical thinking was moderately correlated with academic success of medical professionals in training. The CCTDI was inferior to the CCTST in correlating with academic success.

Critical Slowing Down Governs the Transition to Neuron Spiking

PubMed Central

Meisel, Christian; Klaus, Andreas; Kuehn, Christian; Plenz, Dietmar

2015-01-01

Many complex systems have been found to exhibit critical transitions, or so-called tipping points, which are sudden changes to a qualitatively different system state. These changes can profoundly impact the functioning of a system ranging from controlled state switching to a catastrophic break-down; signals that predict critical transitions are therefore highly desirable. To this end, research efforts have focused on utilizing qualitative changes in markers related to a system’s tendency to recover more slowly from a perturbation the closer it gets to the transition—a phenomenon called critical slowing down. The recently studied scaling of critical slowing down offers a refined path to understand critical transitions: to identify the transition mechanism and improve transition prediction using scaling laws. Here, we outline and apply this strategy for the first time in a real-world system by studying the transition to spiking in neurons of the mammalian cortex. The dynamical system approach has identified two robust mechanisms for the transition from subthreshold activity to spiking, saddle-node and Hopf bifurcation. Although theory provides precise predictions on signatures of critical slowing down near the bifurcation to spiking, quantitative experimental evidence has been lacking. Using whole-cell patch-clamp recordings from pyramidal neurons and fast-spiking interneurons, we show that 1) the transition to spiking dynamically corresponds to a critical transition exhibiting slowing down, 2) the scaling laws suggest a saddle-node bifurcation governing slowing down, and 3) these precise scaling laws can be used to predict the bifurcation point from a limited window of observation. To our knowledge this is the first report of scaling laws of critical slowing down in an experiment. They present a missing link for a broad class of neuroscience modeling and suggest improved estimation of tipping points by incorporating scaling laws of critical slowing down as a strategy applicable to other complex systems. PMID:25706912

The experiences of families of critically ill patients in Greece: a social constructionist grounded theory study.

PubMed

Plakas, Sotirios; Cant, Bob; Taket, Ann

2009-02-01

The experiences of patients' families in intensive care units (ICUs) are of international concern. In Greece however, adequate attention has not been paid to this issue. To explore the experiences of critical care patients' families in Greece. The intensive care units of 3 general district hospitals in the area of Athens, Greece. The social constructionist version of grounded theory was used. In-depth interviews with 25 relatives of critically ill patients were carried out, and participant and non-participant observation was used to cross-validate the data obtained. Seven major categories were identified, with 32 components across all categories. The experiences of families revolved around the two core categories of "Intense Emotions" and "Vigilant Attendance". The study conceptualised two new categories in this field, "Religiosity" and "Loss of Intimacy" and enhanced the category "Vigilant Attendance". Three further categories were identified, namely "Caring", "Dignity" and "Information". The various interrelationships between the categories were also examined. The study has examined the experience of Greek patients' families from a qualitative perspective and suggests that major changes need to be made in terms of management and support.

Critical components of reflective supervision: responses from expert supervisors in the field.

PubMed

Tomlin, Angela M; Weatherston, Deborah J; Pavkov, Thomas

2014-01-01

This article offers a brief review of the history of supervision, defines reflective supervision, and reports the results of a Delphi study designed to identify critical components of reflective supervision. Academicians and master clinicians skilled in providing reflective supervision participated in a three-phase survey to elicit beliefs about best practice when engaging in reflective supervision. The process yielded consensus descriptions of optimal characteristics and behaviors of supervisors and supervisees when entering into supervisory relationships that encourage reflective practice. These results, although preliminary, suggest that it is possible to identify elements that are integral to effective reflective supervision. These initial findings may be used for future study of the reflective supervisory process. © 2013 Michigan Association for Infant Mental Health.

Small Engine Component Technology (SECT) study

NASA Technical Reports Server (NTRS)

Singh, B.

1986-01-01

Small advanced (450 to 850 pounds thrust, 2002 to 3781 N) gas turbine engines were studied for a subsonic strategic cruise missile application, using projected year 2000 technology. An aircraft, mission characteristics, and baseline (state-of-the-art) engine were defined to evaluate technology benefits. Engine performance and configuration analyses were performed for two and three spool turbofan and propfan engine concepts. Mission and Life Cycle Cost (LCC) analyses were performed in which the candidate engines were compared to the baseline engines over a prescribed mission. The advanced technology engines reduced system LCC up to 41 percent relative to the baseline engine. Critical aerodynamic, materials, and mechanical systems turbine engine technologies were identified and program plans were defined for each identified critical technology.

Empowertise Me! Understanding Marketplace Feminism through Deconstructing Advertisements

ERIC Educational Resources Information Center

Silverman, Rachel E.

2018-01-01

Courses: Introduction to advanced classes in Media Studies, Women's Studies, Gender Studies, Race, Communication, and Advertising. Objectives: In this unit activity, students critically assess advertisements that co-opt female empowerment and then identify ways they can resist such strategies.

Industrial Water Analysis Program: A Critical Study.

DTIC Science & Technology

1983-09-01

Patterson Air Force Base, Ohio UMAMUION lTATEMNT A APtO.6UPbhtd3WJ 83 11 04 014’ X. .. . INDUSTRIAL WATER ANALYSIS PROGRAM: A CRITICAL STUDY Dennis C...Twhoo-17 (ATC) Wright-FPafewon AFB O 44 3 1S. KEY WORDS (Continue on reverse aide if necessary and identify by block number) Industrial Water Analysis ...Boiler Water Analysis Preservation Procedures Air Force Industrial Water Stabilization Procedures 20. ABSTRACT (Continue on reverse side it necessary and

SU-F-T-246: Evaluation of Healthcare Failure Mode And Effect Analysis For Risk Assessment

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

Harry, T; University of California, San Diego, La Jolla, CA; Manger, R

Purpose: To evaluate the differences between the Veteran Affairs Healthcare Failure Modes and Effect Analysis (HFMEA) and the AAPM Task Group 100 Failure and Effect Analysis (FMEA) risk assessment techniques in the setting of a stereotactic radiosurgery (SRS) procedure were compared respectively. Understanding the differences in the techniques methodologies and outcomes will provide further insight into the applicability and utility of risk assessments exercises in radiation therapy. Methods: HFMEA risk assessment analysis was performed on a stereotactic radiosurgery procedure. A previous study from our institution completed a FMEA of our SRS procedure and the process map generated from this workmore » was used for the HFMEA. The process of performing the HFMEA scoring was analyzed, and the results from both analyses were compared. Results: The key differences between the two risk assessments are the scoring criteria for failure modes and identifying critical failure modes for potential hazards. The general consensus among the team performing the analyses was that scoring for the HFMEA was simpler and more intuitive then the FMEA. The FMEA identified 25 critical failure modes while the HFMEA identified 39. Seven of the FMEA critical failure modes were not identified by the HFMEA and 21 of the HFMEA critical failure modes were not identified by the FMEA. HFMEA as described by the Veteran Affairs provides guidelines on which failure modes to address first. Conclusion: HFMEA is a more efficient model for identifying gross risks in a process than FMEA. Clinics with minimal staff, time and resources can benefit from this type of risk assessment to eliminate or mitigate high risk hazards with nominal effort. FMEA can provide more in depth details but at the cost of elevated effort.« less

Reliable Communication Models in Interdependent Critical Infrastructure Networks

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

Lee, Sangkeun; Chinthavali, Supriya; Shankar, Mallikarjun

Modern critical infrastructure networks are becoming increasingly interdependent where the failures in one network may cascade to other dependent networks, causing severe widespread national-scale failures. A number of previous efforts have been made to analyze the resiliency and robustness of interdependent networks based on different models. However, communication network, which plays an important role in today's infrastructures to detect and handle failures, has attracted little attention in the interdependency studies, and no previous models have captured enough practical features in the critical infrastructure networks. In this paper, we study the interdependencies between communication network and other kinds of critical infrastructuremore » networks with an aim to identify vulnerable components and design resilient communication networks. We propose several interdependency models that systematically capture various features and dynamics of failures spreading in critical infrastructure networks. We also discuss several research challenges in building reliable communication solutions to handle failures in these models.« less

Using the Critical Incident Technique for Triangulation and Elaboration of Communication Management Competencies

ERIC Educational Resources Information Center

Brunton, Margaret Ann; Jeffrey, Lynn Maud

2010-01-01

This paper presents the findings from research using the critical incident technique to identify the use of key competencies for communication management practitioners. Qualitative data was generated from 202 critical incidents reported by 710 respondents. We also present a brief summary of the quantitative data, which identified two superordinate…

Universal time-dependent dispersion properties for diffusion in a one-dimensional critically tilted potential.

PubMed

Guérin, T; Dean, D S

2017-01-01

We consider the time-dependent dispersion properties of overdamped tracer particles diffusing in a one-dimensional periodic potential under the influence of an additional constant tilting force F. The system is studied in the region where the force is close to the critical value F_{c} at which the barriers separating neighboring potential wells disappear. We show that, when F crosses the critical value, the shape of the mean-square displacement (MSD) curves is strongly modified. We identify a diffusive regime at intermediate-time scales with an effective diffusion coefficient which is much larger than the late-time diffusion coefficient for F>F_{c}, whereas for F

Quantum critical spin-2 chain with emergent SU(3) symmetry.

PubMed

Chen, Pochung; Xue, Zhi-Long; McCulloch, I P; Chung, Ming-Chiang; Huang, Chao-Chun; Yip, S-K

2015-04-10

We study the quantum critical phase of an SU(2) symmetric spin-2 chain obtained from spin-2 bosons in a one-dimensional lattice. We obtain the scaling of the finite-size energies and entanglement entropy by exact diagonalization and density-matrix renormalization group methods. From the numerical results of the energy spectra, central charge, and scaling dimension we identify the conformal field theory describing the whole critical phase to be the SU(3)_{1} Wess-Zumino-Witten model. We find that, while the Hamiltonian is only SU(2) invariant, in this critical phase there is an emergent SU(3) symmetry in the thermodynamic limit.

Reproducibility of clinical research in critical care: a scoping review.

PubMed

Niven, Daniel J; McCormick, T Jared; Straus, Sharon E; Hemmelgarn, Brenda R; Jeffs, Lianne; Barnes, Tavish R M; Stelfox, Henry T

2018-02-21

The ability to reproduce experiments is a defining principle of science. Reproducibility of clinical research has received relatively little scientific attention. However, it is important as it may inform clinical practice, research agendas, and the design of future studies. We used scoping review methods to examine reproducibility within a cohort of randomized trials examining clinical critical care research and published in the top general medical and critical care journals. To identify relevant clinical practices, we searched the New England Journal of Medicine, The Lancet, and JAMA for randomized trials published up to April 2016. To identify a comprehensive set of studies for these practices, included articles informed secondary searches within other high-impact medical and specialty journals. We included late-phase randomized controlled trials examining therapeutic clinical practices in adults admitted to general medical-surgical or specialty intensive care units (ICUs). Included articles were classified using a reproducibility framework. An original study was the first to evaluate a clinical practice. A reproduction attempt re-evaluated that practice in a new set of participants. Overall, 158 practices were examined in 275 included articles. A reproduction attempt was identified for 66 practices (42%, 95% CI 33-50%). Original studies reported larger effects than reproduction attempts (primary endpoint, risk difference 16.0%, 95% CI 11.6-20.5% vs. 8.4%, 95% CI 6.0-10.8%, P = 0.003). More than half of clinical practices with a reproduction attempt demonstrated effects that were inconsistent with the original study (56%, 95% CI 42-68%), among which a large number were reported to be efficacious in the original study and to lack efficacy in the reproduction attempt (34%, 95% CI 19-52%). Two practices reported to be efficacious in the original study were found to be harmful in the reproduction attempt. A minority of critical care practices with research published in high-profile journals were evaluated for reproducibility; less than half had reproducible effects.

Critical thinking in nursing: Scoping review of the literature.

PubMed

Zuriguel Pérez, Esperanza; Lluch Canut, Maria Teresa; Falcó Pegueroles, Anna; Puig Llobet, Montserrat; Moreno Arroyo, Carmen; Roldán Merino, Juan

2015-12-01

This article seeks to analyse the current state of scientific knowledge concerning critical thinking in nursing. The methodology used consisted of a scoping review of the main scientific databases using an applied search strategy. A total of 1518 studies published from January 1999 to June 2013 were identified, of which 90 met the inclusion criteria. The main conclusion drawn is that critical thinking in nursing is experiencing a growing interest in the study of both its concepts and its dimensions, as well as in the development of training strategies to further its development among both students and professionals. Furthermore, the analysis reveals that critical thinking has been investigated principally in the university setting, independent of conceptual models, with a variety of instruments used for its measurement. We recommend (i) the investigation of critical thinking among working professionals, (ii) the designing of evaluative instruments linked to conceptual models and (iii) the identification of strategies to promote critical thinking in the context of providing nursing care. © 2014 Wiley Publishing Asia Pty Ltd.

Powerless positions, silenced voices? - critical views on health and social care management.

PubMed

Hujala, Anneli; Laulainen, Sanna; Lindberg, Kajsa

2014-01-01

The purpose of this paper is to provide background to this special issue and consider how critically oriented research can be applied to health and social care management. Basic principles of critical management studies are introduced briefly to frame subsequent papers in this issue. In order to identify the wicked problems and darker sides of the care field, there is a need to study things in alternative ways through critical lenses. Giving a voice to those in less powerful positions may result in redefinition and redesign of conventional roles and agency of patients, volunteers and professionals and call into question the taken-for-granted understanding of health and social care management. The special issue as a whole was designed to enhance critical approaches to the discussion in the field of health and social care. This editorial hopefully raises awareness of CMS and serves as an opening for further discussion on critical views in the research on management and organization in this field.

Strategies used for the promotion of critical thinking in nursing undergraduate education: A systematic review.

PubMed

Carvalho, Diana P S R P; Azevedo, Isabelle C; Cruz, Giovanna K P; Mafra, Gabriela A C; Rego, Anna L C; Vitor, Allyne F; Santos, Viviane E P; Cogo, Ana L P; Ferreira Júnior, Marcos A

2017-10-01

Identifying the strategies used to promote critical thinking (CT) during undergraduate education in nursing courses. Systematic review. Five electronic databases were searched without language, publication time or geographic filters. A systematic review of the literature. Including experimental studies that considered at least one teaching strategy to promote critical thinking of undergraduate students in Nursing courses. The search for studies occurred in three phases: title and summary review, complete text and implementation of a clinical form of selection according to predetermined criteria. All included studies were assessed for quality through a classification tool for experimental studies. Six studies were selected. The results were grouped into three key themes: an evaluation of the quality of the selected studies, characterization of the studies and the strategies used to promote critical thinking. All selected studies were in English, with significant conceptual similarity of Critical Thinking and dominance in choosing the approached theme during strategies in clinical nursing education with an emphasis on the nursing process. The most widely used teaching intervention was Problem-Based Learning. Nursing education mediated by strategies that stimulate CT is considered a positive difference in undergraduate curriculums. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pathway cross-talk network analysis identifies critical pathways in neonatal sepsis.

PubMed

Meng, Yu-Xiu; Liu, Quan-Hong; Chen, Deng-Hong; Meng, Ying

2017-06-01

Despite advances in neonatal care, sepsis remains a major cause of morbidity and mortality in neonates worldwide. Pathway cross-talk analysis might contribute to the inference of the driving forces in bacterial sepsis and facilitate a better understanding of underlying pathogenesis of neonatal sepsis. This study aimed to explore the critical pathways associated with the progression of neonatal sepsis by the pathway cross-talk analysis. By integrating neonatal transcriptome data with known pathway data and protein-protein interaction data, we systematically uncovered the disease pathway cross-talks and constructed a disease pathway cross-talk network for neonatal sepsis. Then, attract method was employed to explore the dysregulated pathways associated with neonatal sepsis. To determine the critical pathways in neonatal sepsis, rank product (RP) algorithm, centrality analysis and impact factor (IF) were introduced sequentially, which synthetically considered the differential expression of genes and pathways, pathways cross-talks and pathway parameters in the network. The dysregulated pathways with the highest IF values as well as RP<0.01 were defined as critical pathways in neonatal sepsis. By integrating three kinds of data, only 6919 common genes were included to perform the pathway cross-talk analysis. By statistic analysis, a total of 1249 significant pathway cross-talks were selected to construct the pathway cross-talk network. Moreover, 47 dys-regulated pathways were identified via attract method, 20 pathways were identified under RP<0.01, and the top 10 pathways with the highest IF were also screened from the pathway cross-talk network. Among them, we selected 8 common pathways, i.e. critical pathways. In this study, we systematically tracked 8 critical pathways involved in neonatal sepsis by integrating attract method and pathway cross-talk network. These pathways might be responsible for the host response in infection, and of great value for advancing diagnosis and therapy of neonatal sepsis. Copyright © 2017 Elsevier Ltd. All rights reserved.

The role of technology in critical care nursing.

PubMed

Crocker, Cheryl; Timmons, Stephen

2009-01-01

This paper is a report of a study to identify the meaning for critical care nurses of technology related to weaning from mechanical ventilation and to explore how that technology was used in practice. The literature concerned with the development of critical care (intensive care and high dependency units) focuses mainly on innovative medical technology. Although this use of technology in critical care is portrayed as new, it actually represents a transfer of technology from operating theatres. An ethnographic study was conducted and data were collected on one critical care unit in a large teaching hospital over a 6-month period in 2004. The methods included participant observation, interviews and the collection of field notes. The overall theme 'The nursing-technology relation' was identified. This comprised three sub-themes: definition of technology, technology transferred and technology transformed. Novice nurses took a task-focussed approach to weaning, treating it as a 'medical' technology transferred to them from doctors. Expert nurses used technology differently and saw its potential to become a 'nursing technology'. Nurses need to examine how they can adapt and to 'reconfigure' technology so that it can be transformed into a nursing technology. Those technologies that do not fit with nursing may have no place there. Rather than simply extending and expanding their roles through technology transfer, nurses should transform those technologies that preserve the essence of nursing and can contribute to a positive outcome for patients.

Critical inquiry and knowledge translation: exploring compatibilities and tensions

PubMed Central

Reimer-Kirkham, Sheryl; Varcoe, Colleen; Browne, Annette J.; Lynam, M. Judith; Khan, Koushambhi Basu; McDonald, Heather

2016-01-01

Knowledge translation has been widely taken up as an innovative process to facilitate the uptake of research-derived knowledge into health care services. Drawing on a recent research project, we engage in a philosophic examination of how knowledge translation might serve as vehicle for the transfer of critically oriented knowledge regarding social justice, health inequities, and cultural safety into clinical practice. Through an explication of what might be considered disparate traditions (those of critical inquiry and knowledge translation), we identify compatibilities and discrepancies both within the critical tradition, and between critical inquiry and knowledge translation. The ontological and epistemological origins of the knowledge to be translated carry implications for the synthesis and translation phases of knowledge translation. In our case, the studies we synthesized were informed by various critical perspectives and hence we needed to reconcile differences that exist within the critical tradition. A review of the history of critical inquiry served to articulate the nature of these differences while identifying common purposes around which to strategically coalesce. Other challenges arise when knowledge translation and critical inquiry are brought together. Critique is one of the hallmark methods of critical inquiry and, yet, the engagement required for knowledge translation between researchers and health care administrators, practitioners, and other stakeholders makes an antagonistic stance of critique problematic. While knowledge translation offers expanded views of evidence and the complex processes of knowledge exchange, we have been alerted to the continual pull toward epistemologies and methods reminiscent of the positivist paradigm by their instrumental views of knowledge and assumptions of objectivity and political neutrality. These types of tensions have been productive for us as a research team in prompting a critical reconceptualization of knowledge translation. PMID:19527437

Critical inquiry and knowledge translation: exploring compatibilities and tensions.

PubMed

Reimer-Kirkham, Sheryl; Varcoe, Colleen; Browne, Annette J; Lynam, M Judith; Khan, Koushambhi Basu; McDonald, Heather

2009-07-01

Knowledge translation has been widely taken up as an innovative process to facilitate the uptake of research-derived knowledge into health care services. Drawing on a recent research project, we engage in a philosophic examination of how knowledge translation might serve as vehicle for the transfer of critically oriented knowledge regarding social justice, health inequities, and cultural safety into clinical practice. Through an explication of what might be considered disparate traditions (those of critical inquiry and knowledge translation), we identify compatibilities and discrepancies both within the critical tradition, and between critical inquiry and knowledge translation. The ontological and epistemological origins of the knowledge to be translated carry implications for the synthesis and translation phases of knowledge translation. In our case, the studies we synthesized were informed by various critical perspectives and hence we needed to reconcile differences that exist within the critical tradition. A review of the history of critical inquiry served to articulate the nature of these differences while identifying common purposes around which to strategically coalesce. Other challenges arise when knowledge translation and critical inquiry are brought together. Critique is one of the hallmark methods of critical inquiry and, yet, the engagement required for knowledge translation between researchers and health care administrators, practitioners, and other stakeholders makes an antagonistic stance of critique problematic. While knowledge translation offers expanded views of evidence and the complex processes of knowledge exchange, we have been alerted to the continual pull toward epistemologies and methods reminiscent of the positivist paradigm by their instrumental views of knowledge and assumptions of objectivity and political neutrality. These types of tensions have been productive for us as a research team in prompting a critical reconceptualization of knowledge translation.

Identifying Critical Issues and Problems in Technology Education Using a Modified-Delphi Technique.

ERIC Educational Resources Information Center

Wicklein, Robert C.

1993-01-01

Critical issues for technology education (TE) identified by a 25-member Delphi panel were identification of the knowledge base, curriculum development approaches, interdisciplinary approaches, and teacher education reform. Problems identified included inadequate marketing/public relations, teacher shortage, lack of content consensus, and…

Development and validation of a risk model for identification of non-neutropenic, critically ill adult patients at high risk of invasive Candida infection: the Fungal Infection Risk Evaluation (FIRE) Study.

PubMed

Harrison, D; Muskett, H; Harvey, S; Grieve, R; Shahin, J; Patel, K; Sadique, Z; Allen, E; Dybowski, R; Jit, M; Edgeworth, J; Kibbler, C; Barnes, R; Soni, N; Rowan, K

2013-02-01

There is increasing evidence that invasive fungal disease (IFD) is more likely to occur in non-neutropenic patients in critical care units. A number of randomised controlled trials (RCTs) have evaluated antifungal prophylaxis in non-neutropenic, critically ill patients, demonstrating a reduction in the risk of proven IFD and suggesting a reduction in mortality. It is necessary to establish a method to identify and target antifungal prophylaxis at those patients at highest risk of IFD, who stand to benefit most from any antifungal prophylaxis strategy. To develop and validate risk models to identify non-neutropenic, critically ill adult patients at high risk of invasive Candida infection, who would benefit from antifungal prophylaxis, and to assess the cost-effectiveness of targeting antifungal prophylaxis to high-risk patients based on these models. Systematic review, prospective data collection, statistical modelling, economic decision modelling and value of information analysis. Ninety-six UK adult general critical care units. Consecutive admissions to participating critical care units. None. Invasive fungal disease, defined as a blood culture or sample from a normally sterile site showing yeast/mould cells in a microbiological or histopathological report. For statistical and economic modelling, the primary outcome was invasive Candida infection, defined as IFD-positive for Candida species. Systematic review: Thirteen articles exploring risk factors, risk models or clinical decision rules for IFD in critically ill adult patients were identified. Risk factors reported to be significantly associated with IFD were included in the final data set for the prospective data collection. Data were collected on 60,778 admissions between July 2009 and March 2011. Overall, 383 patients (0.6%) were admitted with or developed IFD. The majority of IFD patients (94%) were positive for Candida species. The most common site of infection was blood (55%). The incidence of IFD identified in unit was 4.7 cases per 1000 admissions, and for unit-acquired IFD was 3.2 cases per 1000 admissions. Statistical modelling: Risk models were developed at admission to the critical care unit, 24 hours and the end of calendar day 3. The risk model at admission had fair discrimination (c-index 0.705). Discrimination improved at 24 hours (c-index 0.823) and this was maintained at the end of calendar day 3 (c-index 0.835). There was a drop in model performance in the validation sample. Economic decision model: Irrespective of risk threshold, incremental quality-adjusted life-years of prophylaxis strategies compared with current practice were positive but small compared with the incremental costs. Incremental net benefits of each prophylaxis strategy compared with current practice were all negative. Cost-effectiveness acceptability curves showed that current practice was the strategy most likely to be cost-effective. Across all parameters in the decision model, results indicated that the value of further research for the whole population of interest might be high relative to the research costs. The results of the Fungal Infection Risk Evaluation (FIRE) Study, derived from a highly representative sample of adult general critical care units across the UK, indicated a low incidence of IFD among non-neutropenic, critically ill adult patients. IFD was associated with substantially higher mortality, more intensive organ support and longer length of stay. Risk modelling produced simple risk models that provided acceptable discrimination for identifying patients at 'high risk' of invasive Candida infection. Results of the economic model suggested that the current most cost-effective treatment strategy for prophylactic use of systemic antifungal agents among non-neutropenic, critically ill adult patients admitted to NHS adult general critical care units is a strategy of no risk assessment and no antifungal prophylaxis. Funding for this study was provided by the Health Technology Assessment programme of the National Institute for Health Research.

Major QTLs for critical photoperiod and vernalization underlie extensive variation in flowering in the Mimulus guttatus species complex.

PubMed

Friedman, Jannice; Willis, John H

2013-07-01

Species with extensive ranges experience highly variable environments with respect to temperature, light and soil moisture. Synchronizing the transition from vegetative to floral growth is important to employ favorable conditions for reproduction. Optimal timing of this transition might be different for semelparous annual plants and iteroparous perennial plants. We studied variation in the critical photoperiod necessary for floral induction and the requirement for a period of cold-chilling (vernalization) in 46 populations of annuals and perennials in the Mimulus guttatus species complex. We then examined critical photoperiod and vernalization QTLs in growth chambers using F(2) progeny from annual and perennial parents that differed in their requirements for flowering. We identify extensive variation in critical photoperiod, with most annual populations requiring substantially shorter day lengths to initiate flowering than perennial populations. We discover a novel type of vernalization requirement in perennial populations that is contingent on plants experiencing short days first. QTL analyses identify two large-effect QTLs which influence critical photoperiod. In two separate vernalization experiments we discover each set of crosses contain different large-effect QTLs for vernalization. Mimulus guttatus harbors extensive variation in critical photoperiod and vernalization that may be a consequence of local adaptation. © 2013 The Authors. New Phytologist © 2013 New Phytologist Trust.

Rectal and Naris Swabs: Practical and Informative Samples for Analyzing the Microbiota of Critically Ill Patients.

PubMed

Bansal, Saumya; Nguyen, Jenny P; Leligdowicz, Aleksandra; Zhang, Yu; Kain, Kevin C; Ricciuto, Daniel R; Coburn, Bryan

2018-06-27

Commensal microbiota are immunomodulatory, and their pathological perturbation can affect the risk and outcomes of infectious and inflammatory diseases. Consequently, the human microbiota is an emerging diagnostic and therapeutic target in critical illness. In this study, we compared four sample types-rectal, naris, and antecubital swabs and stool samples-for 16S rRNA gene microbiota sequencing in intensive care unit (ICU) patients. Stool samples were obtained in only 31% of daily attempts, while swabs were reliably obtained (≥97% of attempts). Swabs were compositionally distinct by anatomical site, and rectal swabs identified within-patient temporal trends in microbiota composition. Rectal swabs from ICU patients demonstrated differences from healthy stool similar to those observed in comparing stool samples from ICU patients to those from the same healthy controls. Rectal swabs are a useful complement to other sample types for analysis of the intestinal microbiota in critical illness, particularly when obtaining stool may not be feasible or practical. IMPORTANCE Perturbation of the microbiome has been correlated with various infectious and inflammatory diseases and is common in critically ill patients. Stool is typically used to sample the microbiota in human observational studies; however, it is often unavailable for collection from critically ill patients, reducing its utility as a sample type to study this population. Our research identified alternatives to stool for sampling the microbiota during critical illness. Rectal and naris swabs were practical alternatives for use in these patients, as they were observed to be more reliably obtained than stool, were suitable for culture-independent analysis, and successfully captured within- and between-patient microbiota differences. Copyright © 2018 Bansal et al.

Special populations: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

Dries, David; Reed, Mary Jane; Kissoon, Niranjan; Christian, Michael D; Dichter, Jeffrey R; Devereaux, Asha V; Upperman, Jeffrey S

2014-10-01

Past disasters have highlighted the need to prepare for subsets of critically ill, medically fragile patients. These special patient populations require focused disaster planning that will address their medical needs throughout the event to prevent clinical deterioration. The suggestions in this article are important for all who are involved in large-scale disasters or pandemics with multiple critically ill or injured patients, including frontline clinicians, hospital administrators, and public health or government officials. Key questions regarding the care of critically ill or injured special populations during disasters or pandemics were identified, and a systematic literature review (1985-2013) was performed. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. The panel did not include pediatrics as a separate special population because pediatrics issues are embedded in each consensus document. Fourteen suggestions were formulated regarding the care of critically ill and injured patients from special populations during pandemics and disasters. The suggestions cover the following areas: defining special populations for mass critical care, special population planning, planning for access to regionalized service for special populations, triage and resource allocation of special populations, therapeutic considerations, and crisis standards of care for special populations. Chronically ill, technologically dependent, and complex critically ill patients present a unique challenge to preparing and implementing mass critical care. There are, however, unique opportunities to engage patients, primary physicians, advocacy groups, and professional organizations to lessen the impact of disaster on these special populations.

The burden of surgical diseases on critical care services at a tertiary hospital in sub-Saharan Africa.

PubMed

Tomlinson, Jared; Haac, Bryce; Kadyaudzu, Clement; Samuel, Jonathan C; Campbell, Emilia L P; Lee, Clara N; Charles, Anthony G

2013-01-01

In many developing countries, including those of sub-Saharan Africa, care of the critically ill is poorly developed. We sought to elucidate the characteristics and outcomes of critically ill patients in order to better define the burden of disease and identify strategies for improving care. We conducted a cross sectional observation study of patients admitted to the intensive care unit at Kamuzu Central Hospital in 2010. Demographics, patient characteristics, clinical specialty and outcome data was collected for the 234 patients admitted during the study period. Older age and admission from trauma, general surgery or medical services were associated with increased mortality. The lowest mortality was among obstetrical and gynaecology patients. Use of the ventilator and transfusions were not associated with increased mortality. Patients with head injuries had the highest mortality rate. Rationing of critical care resources, using admitting diagnosis or scoring tools, can maximize access to critical care services in resource-limited settings. Furthermore, improvements of critical care services will be central to future efforts to reduce surgical morbidity and mortality and improving outcomes in all critically ill patients.

Audits and critical incident reporting in paediatric anaesthesia: lessons from 75,331 anaesthetics.

PubMed

Wan, Sharon; Siow, Yew Nam; Lee, Su Min; Ng, Agnes

2013-02-01

This study reports our experience of audit and critical incidents observed by paediatric anaesthetics from 2000 to 2010 at a paediatric teaching hospital in Singapore. Data pertaining to patient demographics, practices and critical incidents during anaesthesia and in the perioperative period were prospectively collected via an audit form and retrospectively analysed thereafter. A total of 2,519 incidents were noted at the 75,331 anaesthetics performed during the study period. There were nine deaths reported. The majority of incidents reported were respiratory critical incidents (n = 1,757, 69.8%), followed by cardiovascular incidents (n = 238, 9.5%). Risk factors for critical incidents included age less than one year, and preterm and former preterm children. Critical incident reporting has value, as it provides insights into the system and helps to identify active and system errors, thus enabling the formulation of effective preventive strategies. By creating and maintaining an environment that encourages reporting, we have maintained a high and consistent reporting rate through the years. The teaching of analysis of critical incidents should be regarded by all clinicians as an important tool for improving patient safety.

An Integrative Review of the Concealed Connection: Nurse Educators' Critical Thinking.

PubMed

Raymond, Christy; Profetto-McGrath, Joanne; Myrick, Florence; Strean, William B

2017-11-01

The role of nurse educators in the development of students' critical thinking has been overlooked despite the emphasized need for effective teaching methods. An integrative review was performed to examine both quantitative and qualitative research published from 2000 to 2015 related to nurse educators' critical thinking. Many barriers and facilitators existing on individual, interpersonal, and contextual levels affected nurse educators' critical thinking. Various tools have been used to measure nurse educators' critical thinking. This review also highlighted the continued lack of a consensus definition of critical thinking and the limited presence of conceptual models to guide the use of critical thinking in nursing education. Continued examination of nurse educators' critical thinking is needed, given the limited number of studies that have been completed. Much needs to be explored further, including conceptualizations of critical thinking and confirmation of emerging themes identified in this review. [J Nurs Educ. 2017;56(11):648-654.]. © 2017 Raymond, Profetto-McGrath, Myrick, et al.

Developing a Capacity to Engage in Critical Reflection: Students' "Ways of Knowing" within an Undergraduate Business and Accounting Programme

ERIC Educational Resources Information Center

Lucas, Ursula; Tan, Phaik Leng

2013-01-01

The development of a capacity to engage in critical reflection is central to higher education. However, students vary in this capacity and its development requires students to move from an absolute towards a contextual way of knowing. Using 32 semi-structured interviews, this study identifies the ways of knowing of 17 business and accounting…

Windows of sensitivity to toxic chemicals in the motor effects development.

PubMed

Ingber, Susan Z; Pohl, Hana R

2016-02-01

Many chemicals currently used are known to elicit nervous system effects. In addition, approximately 2000 new chemicals introduced annually have not yet undergone neurotoxicity testing. This review concentrated on motor development effects associated with exposure to environmental neurotoxicants to help identify critical windows of exposure and begin to assess data needs based on a subset of chemicals thoroughly reviewed by the Agency for Toxic Substances and Disease Registry (ATSDR) in Toxicological Profiles and Addenda. Multiple windows of sensitivity were identified that differed based on the maturity level of the neurological system at the time of exposure, as well as dose and exposure duration. Similar but distinct windows were found for both motor activity (GD 8-17 [rats], GD 12-14 and PND 3-10 [mice]) and motor function performance (insufficient data for rats, GD 12-17 [mice]). Identifying specific windows of sensitivity in animal studies was hampered by study designs oriented towards detection of neurotoxicity that occurred at any time throughout the developmental process. In conclusion, while this investigation identified some critical exposure windows for motor development effects, it demonstrates a need for more acute duration exposure studies based on neurodevelopmental windows, particularly during the exposure periods identified in this review. Published by Elsevier Inc.

Windows of sensitivity to toxic chemicals in the motor effects development✩

PubMed Central

Ingber, Susan Z.; Pohl, Hana R.

2017-01-01

Many chemicals currently used are known to elicit nervous system effects. In addition, approximately 2000 new chemicals introduced annually have not yet undergone neurotoxicity testing. This review concentrated on motor development effects associated with exposure to environmental neurotoxicants to help identify critical windows of exposure and begin to assess data needs based on a subset of chemicals thoroughly reviewed by the Agency for Toxic Substances and Disease Registry (ATSDR) in Toxicological Profiles and Addenda. Multiple windows of sensitivity were identified that differed based on the maturity level of the neurological system at the time of exposure, as well as dose and exposure duration. Similar but distinct windows were found for both motor activity (GD 8–17 [rats], GD 12–14 and PND 3–10 [mice]) and motor function performance (insufficient data for rats, GD 12–17 [mice]). Identifying specific windows of sensitivity in animal studies was hampered by study designs oriented towards detection of neurotoxicity that occurred at any time throughout the developmental process. In conclusion, while this investigation identified some critical exposure windows for motor development effects, it demonstrates a need for more acute duration exposure studies based on neurodevelopmental windows, particularly during the exposure periods identified in this review. PMID:26686904

Demonstration Tokamak Hybrid Reactor (DTHR) blanket design study, December 1978

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

Not Available

1978-01-01

This work represents only the second iteration of the conceptual design of a DTHR blanket; consequently, a number of issues important to a detailed blanket design have not yet been evaluated. The most critical issues identified are those of two-phase flow maldistribution, flow instabilities, flow stratification for horizontal radial inflow of boiling water, fuel rod vibrations, corrosion of clad and structural materials by high quality steam, fretting and cyclic loads. Approaches to minimizing these problems are discussed and experimental testing with flow mock-ups is recommended. These implications on a commercial blanket design are discussed and critical data needs are identified.

Needed Research on Trait Structure, Multivariate Approach. A Special Report of the USOE-Sponsored Grant Study: Critical Appraisal of Research in the Personality-Emotions-Motivation Domain. IBR Report No. 73-21.

ERIC Educational Resources Information Center

Cartwright, Desmond S.; And Others

The task group report presented in this publication is one of a series prepared by eminent psychologists who have served as consultants in the U.S.O.E.-sponsored grant study to conduct a Critical Appraisal of the Personality-Emotions-Motivation Domain. In order to achieve the goal of identifying important problems and areas for new research and…

Needed Research on the Genes and Environment in Human Psychological Development: Perspectives from Behavior Genetics. A Special Report of the USOE-Sponsored Grant Study: Critical Appraisal of Research in the Personality-Emotions-Motivation Domain.

ERIC Educational Resources Information Center

Loehlin, John C.; And Others

The task group report presented in this publication is one of a series prepared by eminent psychologists who have served as consultants in the U.S.O.E.-sponsored grant study to conduct a Critical Appraisal of the Personality-Emotions-Motivation Domain. In order to attain the goal of identifying important problems and areas for new research and…

Thermophilic treatment of acidified and partially acidified wastewater using an anaerobic submerged MBR: Factors affecting long-term operational flux.

PubMed

Jeison, D; van Lier, J B

2007-09-01

The long-term operation of two thermophilic anaerobic submerged membrane bioreactors (AnSMBRs) was studied using acidified and partially acidified synthetic wastewaters. In both reactors, cake formation was identified as the key factor governing critical flux. Even though cake formation was observed to be mostly reversible, particle deposition proceeds fast once the critical flux is exceeded. Very little irreversible fouling was observed during long-term operation, irrespective of the substrate. Critical flux values at the end of the reactors operation were 7 and 3L/m(2)h for the AnSMBRs fed with acidified and partially acidified wastewaters, respectively, at a gas superficial velocity of 70m/h. Small particle size was identified as the responsible parameter for the low observed critical flux values. The degree of wastewater acidification significantly affected the physical properties of the sludge, determining the attainable flux. Based on the fluxes observed in this research, the membrane costs would be in the range of 0.5euro/m(3) of treated wastewater. Gas sparging was ineffective in increasing the critical flux values. However, preliminary tests showed that cross-flow operation may be a feasible alternative to reduce particle deposition.

Evacuation of the ICU: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

King, Mary A; Niven, Alexander S; Beninati, William; Fang, Ray; Einav, Sharon; Rubinson, Lewis; Kissoon, Niranjan; Devereaux, Asha V; Christian, Michael D; Grissom, Colin K

2014-10-01

Despite the high risk for patient harm during unanticipated ICU evacuations, critical care providers receive little to no training on how to perform safe and effective ICU evacuations. We reviewed the pertinent published literature and offer suggestions for the critical care provider regarding ICU evacuation. The suggestions in this article are important for all who are involved in pandemics or disasters with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. The Evacuation and Mobilization topic panel used the American College of Chest Physicians (CHEST) Guidelines Oversight Committee's methodology to develop seven key questions for which specific literature searches were conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. Based on current best evidence, we provide 13 suggestions outlining a systematic approach to prepare for and execute an effective ICU evacuation during a disaster. Interhospital and intrahospital collaboration and functional ICU communication are critical for success. Pre-event planning and preparation are required for a no-notice evacuation. A Critical Care Team Leader must be designated within the Hospital Incident Command System. A three-stage ICU Evacuation Timeline, including (1) no immediate threat, (2) evacuation threat, and (3) evacuation implementation, should be used. Detailed suggestions on ICU evacuation, including regional planning, evacuation drills, patient transport preparation and equipment, patient prioritization and distribution for evacuation, patient information and tracking, and federal and international evacuation assistance systems, are also provided. Successful ICU evacuation during a disaster requires active preparation, participation, communication, and leadership by critical care providers. Critical care providers have a professional obligation to become better educated, prepared, and engaged with the processes of ICU evacuation to provide a safe continuum of critical care during a disaster.

Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness

PubMed Central

Plummer, Mark P.; Finnis, Mark E.; Phillips, Liza K.; Kar, Palash; Bihari, Shailesh; Biradar, Vishwanath; Moodie, Stewart; Horowitz, Michael; Shaw, Jonathan E.; Deane, Adam M.

2016-01-01

Objective Stress induced hyperglycemia occurs in critically ill patients who have normal glucose tolerance following resolution of their acute illness. The objective was to evaluate the association between stress induced hyperglycemia and incident diabetes in survivors of critical illness. Design Retrospective cohort study. Setting All adult patients surviving admission to a public hospital intensive care unit (ICU) in South Australia between 2004 and 2011. Patients Stress induced hyperglycemia was defined as a blood glucose ≥ 11.1 mmol/L (200 mg/dL) within 24 hours of ICU admission. Prevalent diabetes was identified through ICD-10 coding or prior registration with the Australian National Diabetes Service Scheme (NDSS). Incident diabetes was identified as NDSS registration beyond 30 days after hospital discharge until July 2015. The predicted risk of developing diabetes was described as sub-hazard ratios using competing risk regression. Survival was assessed using Cox proportional hazards regression. Main Results Stress induced hyperglycemia was identified in 2,883 (17%) of 17,074 patients without diabetes. The incidence of type 2 diabetes following critical illness was 4.8% (821 of 17,074). The risk of diabetes in patients with stress induced hyperglycemia was approximately double that of those without (HR 1.91 (95% CI 1.62, 2.26), p<0.001) and was sustained regardless of age or severity of illness. Conclusions Stress induced hyperglycemia identifies patients at subsequent risk of incident diabetes. PMID:27824898

Comprehensive assessment of critical care needs in a community hospital*.

PubMed

Sarti, Aimee J; Sutherland, Stephanie; Landriault, Angèle; Fothergill-Bourbonnais, Frances; Bouali, Redouane; Willett, Timothy; Hamstra, Stanley J; Cardinal, Pierre

2014-04-01

To design and implement a needs assessment process that identifies gaps in caring for critically ill patients in a community hospital. This mixed-method study was conducted between June 2011 and February 2012. A conceptual framework, centered on the critically ill patient, guided the design and selection of the data collection instruments. Different perspectives sampled included regional leaders, healthcare professionals at the community hospital and its referral hospital, as well as family members of patients who had received care at the community ICU. Data sources included interviews (n = 22), walk-throughs (n = 5), focus groups (n = 31), database searches, context questionnaires (n = 8), family surveys (n = 16), and simulations (n = 13). None. Nine needs were identified. At the community hospital, needs identified included lack of access to human resources, gaps in expertise, poor patient flow and ICU bed use, communication, lack of educational opportunities, and gaps in end-of-life care and interprofessional teamwork. Needs were also identified in the interhospital interaction between the community and referral hospitals, which included an inadequate hospital network and gaps in transfer and repatriation of patients. The methodology uncovered the causes and widespread impact of each need and how they interacted with one another. Proposed solutions by the participants are presented including both organizational and educational/clinical solutions. This study captured needs in a complex, interprofessional, interhospital context, which can be targeted with tailored interventions to improve patient outcomes in a community hospital. Furthermore, this study provides a preliminary framework and rigorous methodology to performing a needs assessment in this setting.

A View from the Aisle Revisited: Delight and Outrage in the Classroom

ERIC Educational Resources Information Center

Swanson, Scott R.; Azab, Carol; Davis, J. Charlene

2015-01-01

This research explores marketing students' emotional reactions to classroom encounters. We identify what types of critical incidents lead to specific emotional outcomes. The study included a sample of 1,208 marketing undergraduates. Findings confirm the viability of the taxonomies identified by Swanson and Davis (2000). We expand their framework…

Social Capital Networking and Immigrant Populations in Rural Minnesota a Qualitative Research Project

ERIC Educational Resources Information Center

Laeger-Hagemeister, Mary A.

2011-01-01

Combining social capital theory and immigration history and theory a qualitative study was conducted using a variation of Critical Incident Technique to identify the motivations of individuals in rural communities who championed community responses to the influx of large immigrant populations. Twenty-eight individuals identified as key champions…

Identifying critical success factors (CSFs) of implementing building information modeling (BIM) in Malaysian construction industry

NASA Astrophysics Data System (ADS)

Yaakob, Mazri; Ali, Wan Nur Athirah Wan; Radzuan, Kamaruddin

2016-08-01

Building Information Modeling (BIM) is defined as existing from the earliest concept to demolition and it involves creating and using an intelligent 3D model to inform and communicate project decisions. This research aims to identify the critical success factors (CSFs) of BIM implementation in Malaysian construction industry. A literature review was done to explore previous BIM studies on definitions and history of BIM, construction issues, application of BIM in construction projects as well as benefits of BIM. A series of interviews with multidisciplinary Malaysian construction experts will be conducted purposely for data collection process guided by the research design and methodology approach of this study. The analysis of qualitative data from the process will be combined with criteria identified in the literature review in order to identify the CSFs. Finally, the CSFs of BIM implementation will be validated by further Malaysian industrialists during a workshop. The validated CSFs can be used as a term of reference for both Malaysian practitioners and academics towards measuring BIM effectiveness level in their organizations.

Assessing Clinical Laboratory Quality: A College of American Pathologists Q-Probes Study of Prothrombin Time INR Structures, Processes, and Outcomes in 98 Laboratories.

PubMed

Howanitz, Peter J; Darcy, Theresa P; Meier, Frederick A; Bashleben, Christine P

2015-09-01

The anticoagulant warfarin has been identified as the second most frequent drug responsible for serious, disabling, and fatal adverse drug events in the United States, and its effect on blood coagulation is monitored by the laboratory test called international normalized ratio (INR). To determine the presence of INR policies and procedures, INR practices, and completeness and timeliness of reporting critical INR results in participants' clinical laboratories. Participants reviewed their INR policies and procedure requirements, identified their practices by using a questionnaire, and studied completeness of documentation and timeliness of reporting critical value INR results for outpatients and emergency department patients. In 98 participating institutions, the 5 required policies and procedures were in place in 93% to 99% of clinical laboratories. Fifteen options for the allowable variations among duplicate results from different analyzers, 12 different timeliness goals for reporting critical values, and 18 unique critical value limits were used by participants. All required documentation elements were present in 94.8% of 192 reviewed INR validation reports. Critical value INR results were reported within the time frame established by the laboratory for 93.4% of 2604 results, but 1.0% of results were not reported. Although the median laboratories successfully communicated all critical results within their established time frames and had all the required validation elements based in their 2 most recent INR calculations, those participants at the lowest 10th percentile were successful in 80.0% and 85.7% of these requirements, respectively. Significant opportunities exist for adherence to INR procedural requirements and for practice patterns and timeliness goals for INR critical results' reporting.

Strategies to overcome obstacles in the facilitation of critical thinking in nursing education.

PubMed

Mangena, Agnes; Chabeli, Mary M

2005-05-01

This paper seeks to describe strategies that can be used to overcome obstacles in the facilitation of critical thinking in nursing education. A qualitative, explorative, descriptive and contextual design was used to conduct the research in which fourth year basic comprehensive students and nurse educators volunteered to take part in the study by signing an informed consent. The participants were purposively selected. Focus group interviews were used to collect data from both groups. Tesch's descriptive method of open coding described in (Creswell, J. 1994. Qualitative and quantitative approach. Sage, London.) was used to analyse data. (Democratic Nursing Organisation of South Africa, 1998. Ethical standards for nurse researchers. Denosa, Pretoria) ethical standards for research were observed to maintain the standard and quality of the research. (Lincoln, Y.S., Guba, E.G. 1985. Naturalistic inquiry. Sage, London.) framework was used to ensure trustworthiness of the study. The following obstacles were identified and recontextualised within the existing literature to be able to describe the strategies to overcome the identified obstacles to the facilitation of critical thinking of students: the educators' lack of knowledge; use of teaching and assessment methods that do not facilitate critical thinking of learners; the negative attitudes of educators and their resistance to change; inappropriate selection process and poor educational background that did not facilitate critical thinking of students; inadequate socialisation, cultural and instructional language incompetence. Findings indicated that there is a need for nurse educators to model critical thinking in all aspects of nursing education. It is recommended that there be a whole paradigm shift in nursing education from the traditional teacher-centred methods to a more learner-centred approach that will facilitate critical thinking of student nurses.

Exploring experienced nurses' attitudes, views and expectations of new graduate nurses: a critical review.

PubMed

Freeling, Michelle; Parker, Steve

2015-02-01

This critical review evaluates the existing primary research literature to identify experienced registered nurses' attitudes, views and expectations of graduate nurses which may create a barrier for optimal graduate nurse performance. Relevant primary studies were identified by searching online databases using a wide variety of appropriate keyword combinations. Online databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, PsycINFO and Google Scholar were comprehensively searched for relevant research. The selected studies were subjected to a rigorous critical appraisal to evaluate the studies and to determine if the findings were applicable to practice. A manual method of thematic analysis was conducted to highlight explicit and implicit themes from the reviewed studies. Themes were grouped and continually reduced until only essential themes remain. Themes and subthemes emerged which were then compared and contrasted to analyse results. The four major themes identified include nursing skills, inadequate preparation during academic program, attitudes and ward culture and concerns with confidence. Subthemes were identified within these categories. Findings indicate experienced registered nurses discussed themes including 'nursing skills', 'inadequate preparation during academic program', 'attitudes and ward culture' and 'concerns with confidence'. Concerns were raised including the value of traditional training versus tertiary education programs, coping with unprofessional behaviour and inadequate preparation for practice. Further research is required to fully address management of the theory-practice gap, as well as the attitudes of experienced registered nurses educated in traditional programs versus those in tertiary education programs. Nurse managers should be aware of the possible occurrence of unprofessional behaviour, and increased workplace training regarding lateral violence would assist in raising awareness regarding negative and unacceptable behaviour. Copyright © 2014 Elsevier Ltd. All rights reserved.

De novo transcriptome analysis in Dendrobium and identification of critical genes associated with flowering.

PubMed

Chen, Yue; Shen, Qi; Lin, Renan; Zhao, Zhuangliu; Shen, Chenjia; Sun, Chongbo

2017-10-01

Artificial control of flowering time is pivotal for the ornamental value of orchids including the genus Dendrobium. Although various flowering pathways have been revealed in model plants, little information is available on the genetic regualtion of flowering in Dendrobium. To identify the critical genes associated with flowering, transcriptomes from four organs (leaf, root, stem and flower) of D. officinale were analyzed in our study. In total, 2645 flower-specific transcripts were identified. Functional annotation and classification suggested that several metabolic pathways, including four sugar-related pathways and two fatty acid-related pathways, were enriched. A total of 24 flowering-related transcripts were identified in D. officinale according to the similarities to their homologous genes from Arabidopsis, suggesting that most classical flowering pathways existed in D. officinale. Furthermore, phylogenetic analysis suggested that the FLOWERING LOCUS T homologs in orchids are highly conserved during evolution process. In addition, expression changes in nine randomly-selected critical flowering-related transcripts between the vegetative stage and reproductive stage were quantified by qRT-PCR analysis. Our study provided a number of candidate genes and sequence resources for investigating the mechanisms underlying the flowering process of the Dendrobium genus. Copyright © 2017. Published by Elsevier Masson SAS.

Critical Technology Determination for Future Human Space Flight

NASA Technical Reports Server (NTRS)

Mercer, Carolyn R.; Vangen, Scott D.; Williams-Byrd, Julie A.; Steckleim, Jonette M.; Alexander, Leslie; Rahman, Shamin A.; Rosenthal, Matthew; Wiley, Dianne S.; Davison, Stephan C.; Korsmeyer, David J.;

Critical Technology Determination for Future Human Space Flight

NASA Technical Reports Server (NTRS)

Mercer, Carolyn R.; Vangen, Scott D.; Williams-Byrd, Julie A.; Stecklein, Jonette M.; Rahman, Shamim A.; Rosenthal, Matthew E.; Hornyak, David M.; Alexander, Leslie; Korsmeyer, David J.; Tu, Eugene L.;

Development of Geostatistical Models to Estimate CO2 Storage Resource in Sedimentary Geologic Formations

NASA Astrophysics Data System (ADS)

Popova, Olga H.

Dental hygiene students must embody effective critical thinking skills in order to provide evidence-based comprehensive patient care. The problem addressed in this study it was not known if and to what extent concept mapping and reflective journaling activities embedded in a curriculum over a 4-week period, impacted the critical thinking skills of 22 first and second-year dental hygiene students attending a community college in the Midwest. The overarching research questions were: what is the effect of concept mapping, and what is the effect of reflective journaling on the level of critical thinking skills of first and second year dental hygiene students? This quantitative study employed a quasi-experimental, pretest-posttest design. Analysis of Covariance (ANCOVA) assessed students' mean scores of critical thinking on the California Critical Thinking Skills Test (CCTST) pretest and posttest for the concept mapping and reflective journaling treatment groups. The results of the study found an increase in CCTST posttest scores with the use of both concept mapping and reflective journaling. However, the increase in scores was not found to be statistically significant. Hence, this study identified concept mapping using Ausubel's assimilation theory and reflective journaling incorporating Johns's revision of Carper's patterns of knowing as potential instructional strategies and theoretical models to enhance undergraduate students' critical thinking skills. More research is required in this area to draw further conclusions. Keywords: Critical thinking, critical thinking development, critical thinking skills, instructional strategies, concept mapping, reflective journaling, dental hygiene, college students.

Critical thinking and creativity in nursing: learners' perspectives.

PubMed

Chan, Zenobia C Y

2013-05-01

Although the development of critical thinking and the development of creativity are major areas in nursing programme, little has been explored about learners' perspectives towards these two concepts, especially in Chinese contexts. This study aimed to reveal nursing learners' perspectives on creativity and critical thinking. Qualitative data collection methods were adopted, namely group interviews and concept map drawings. The process of data collection was conducted in private rooms at a University. 36 nursing students from two problem-based learning classes were recruited in two groups for the study. After data collection, content analysis with axial coding approach was conducted to explore the narrative themes, to summarise the main ideas, and to make valid inferences from the connections among critical thinking, creativity, and other exogenous variables. Based on the findings, six major themes were identified: "revisiting the meanings of critical thinking"; "critical thinking and knowledge: partners or rivals?"; "is critical thinking criticising?"; "revising the meanings of creativity"; "creativity and experience: partners or rivals?"; and "should creativity be practical?". This study showed that learners had diverse perspectives towards critical thinking and creativity, and their debate on these two domains provided implications on nursing education, since the voices of learners are crucial in teaching. By closing the gap between learners and educators, this study offered some insights on nursing education in the new curriculum, in particular to co-construct nursing knowledge which is student-driven, and to consider students' voices towards understanding and applying creativity and critical thinking in nursing. Copyright © 2012 Elsevier Ltd. All rights reserved.

Factors influencing cancer treatment decision-making by indigenous peoples: a systematic review.

PubMed

Tranberg, Rona; Alexander, Susan; Hatcher, Deborah; Mackey, Sandra; Shahid, Shaouli; Holden, Lynda; Kwok, Cannas

2016-02-01

We aim to systematically review studies that identify factors influencing cancer treatment decision-making among indigenous peoples. Following the outline suggested by the Preferred Reporting Items for Systematic Review and Meta-analysis, a rigorous systematic review and meta-synthesis were conducted of factors that influence cancer treatment decision-making by indigenous peoples. A total of 733 articles were retrieved from eight databases and a manual search. After screening the titles and abstracts, the full text of 26 articles were critically appraised, resulting in five articles that met inclusion criteria for the review. Because the five articles to be reviewed were qualitative studies, the Critical Appraisal Skills Program toolkit was used to evaluate the methodological quality. A thematic synthesis was employed to identify common themes across the studies. Multiple socio-economic and cultural factors were identified that all had the potential to influence cancer treatment decision-making by indigenous people. These factors were distilled into four themes: spiritual beliefs, cultural influences, communication and existing healthcare systems and structures. Although existing research identified multiple factors influencing decision-making, this review identified that quality studies in this domain are scarce. There is scope for further investigation, both into decision-making factors and into the subsequent design of culturally appropriate programmes and services that meet the needs of indigenous peoples. Copyright © 2015 John Wiley & Sons, Ltd.

Enhancement of critical heat flux in nucleate boiling of nanofluids: a state-of-art review

PubMed Central

2011-01-01

Nanofluids (suspensions of nanometer-sized particles in base fluids) have recently been shown to have nucleate boiling critical heat flux (CHF) far superior to that of the pure base fluid. Over the past decade, numerous experimental and analytical studies on the nucleate boiling CHF of nanofluids have been conducted. The purpose of this article is to provide an exhaustive review of these studies. The characteristics of CHF enhancement in nanofluids are systemically presented according to the effects of the primary boiling parameters. Research efforts to identify the effects of nanoparticles underlying irregular enhancement phenomena of CHF in nanofluids are then presented. Also, attempts to explain the physical mechanism based on available CHF theories are described. Finally, future research needs are identified. PMID:21711949

Nurses’ Experiences of Managing and Management in a Critical Care Unit

PubMed Central

Ogle, K. Robyn; Glass, Nel

2014-01-01

In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses’ experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of “junior novice.” Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem. PMID:28462287

Global screening for Critical Habitat in the terrestrial realm

PubMed Central

Blyth, Simon; Bennun, Leon; Butchart, Stuart H. M.; Hoffmann, Michael; Burgess, Neil D.; Cuttelod, Annabelle; Jones, Matt I.; Kapos, Val; Pilgrim, John; Tolley, Melissa J.; Underwood, Emma C.; Weatherdon, Lauren V.

2018-01-01

Critical Habitat has become an increasingly important concept used by the finance sector and businesses to identify areas of high biodiversity value. The International Finance Corporation (IFC) defines Critical Habitat in their highly influential Performance Standard 6 (PS6), requiring projects in Critical Habitat to achieve a net gain of biodiversity. Here we present a global screening layer of Critical Habitat in the terrestrial realm, derived from global spatial datasets covering the distributions of 12 biodiversity features aligned with guidance provided by the IFC. Each biodiversity feature is categorised as ‘likely’ or ‘potential’ Critical Habitat based on: 1. Alignment between the biodiversity feature and the IFC Critical Habitat definition; and 2. Suitability of the spatial resolution for indicating a feature’s presence on the ground. Following the initial screening process, Critical Habitat must then be assessed in-situ by a qualified assessor. This analysis indicates that a total of 10% and 5% of the global terrestrial environment can be considered as likely and potential Critical Habitat, respectively, while the remaining 85% did not overlap with any of the biodiversity features assessed and was classified as ‘unknown’. Likely Critical Habitat was determined principally by the occurrence of Key Biodiversity Areas and Protected Areas. Potential Critical Habitat was predominantly characterised by data representing highly threatened and unique ecosystems such as ever-wet tropical forests and tropical dry forests. The areas we identified as likely or potential Critical Habitat are based on the best available global-scale data for the terrestrial realm that is aligned with IFC’s Critical Habitat definition. Our results can help businesses screen potential development sites at the early project stage based on a range of biodiversity features. However, the study also demonstrates several important data gaps and highlights the need to incorporate new and improved global spatial datasets as they become available. PMID:29565977

Using simulation to test critical thinking skills of nursing students.

PubMed

Johannsson, S L; Wertenberger, D H

1996-10-01

The purpose of this pilot study was to evaluate the effectiveness of using simulations to test critical thinking ability of nursing students. Nine medical and surgical videotaped vignettes were selected from the critical thinking component of the Performance Based Development System (PBDS). Pathology, difficulty rating and the obviousness of cues varied between vignettes. Each student was rated as acceptable, partially acceptable or unacceptable in their ability to identify a problem and provide appropriate nursing interventions with rationale for each vignette. A paper and pencil exercise and interviews were used to validate findings obtained from the video simulations. The pros and cons of using video simulations to assess critical thinking abilities of nursing students are discussed.

A systematic and critical review of model-based economic evaluations of pharmacotherapeutics in patients with bipolar disorder.

PubMed

Mohiuddin, Syed

2014-08-01

Bipolar disorder (BD) is a chronic and relapsing mental illness with a considerable health-related and economic burden. The primary goal of pharmacotherapeutics for BD is to improve patients' well-being. The use of decision-analytic models is key in assessing the added value of the pharmacotherapeutics aimed at treating the illness, but concerns have been expressed about the appropriateness of different modelling techniques and about the transparency in the reporting of economic evaluations. This paper aimed to identify and critically appraise published model-based economic evaluations of pharmacotherapeutics in BD patients. A systematic review combining common terms for BD and economic evaluation was conducted in MEDLINE, EMBASE, PSYCINFO and ECONLIT. Studies identified were summarised and critically appraised in terms of the use of modelling technique, model structure and data sources. Considering the prognosis and management of BD, the possible benefits and limitations of each modelling technique are discussed. Fourteen studies were identified using model-based economic evaluations of pharmacotherapeutics in BD patients. Of these 14 studies, nine used Markov, three used discrete-event simulation (DES) and two used decision-tree models. Most of the studies (n = 11) did not include the rationale for the choice of modelling technique undertaken. Half of the studies did not include the risk of mortality. Surprisingly, no study considered the risk of having a mixed bipolar episode. This review identified various modelling issues that could potentially reduce the comparability of one pharmacotherapeutic intervention with another. Better use and reporting of the modelling techniques in the future studies are essential. DES modelling appears to be a flexible and comprehensive technique for evaluating the comparability of BD treatment options because of its greater flexibility of depicting the disease progression over time. However, depending on the research question, modelling techniques other than DES might also be appropriate in some cases.

Predicting ecosystem shifts requires new approaches that integrate the effects of climate change across entire systems

PubMed Central

Russell, Bayden D.; Harley, Christopher D. G.; Wernberg, Thomas; Mieszkowska, Nova; Widdicombe, Stephen; Hall-Spencer, Jason M.; Connell, Sean D.

2012-01-01

Most studies that forecast the ecological consequences of climate change target a single species and a single life stage. Depending on climatic impacts on other life stages and on interacting species, however, the results from simple experiments may not translate into accurate predictions of future ecological change. Research needs to move beyond simple experimental studies and environmental envelope projections for single species towards identifying where ecosystem change is likely to occur and the drivers for this change. For this to happen, we advocate research directions that (i) identify the critical species within the target ecosystem, and the life stage(s) most susceptible to changing conditions and (ii) the key interactions between these species and components of their broader ecosystem. A combined approach using macroecology, experimentally derived data and modelling that incorporates energy budgets in life cycle models may identify critical abiotic conditions that disproportionately alter important ecological processes under forecasted climates. PMID:21900317

Nurses' shift reports: a systematic literature search and critical review of qualitative field studies.

PubMed

Buus, Niels; Hoeck, Bente; Hamilton, Bridget Elizabeth

2017-10-01

To identify reporting practices that feature in studies of nurses' shift reports across diverse nursing specialities. The objectives were to perform an exhaustive systematic literature search and to critically review the quality and findings of qualitative field studies of nurses' shift reports. Nurses' shift reports are routine occurrences in healthcare organisations that are viewed as crucial for patient outcomes, patient safety and continuity of care. Studies of communication between nurses attend primarily to 1:1 communication and analyse the adequacy and accuracy of patient information and feature handovers at the bedside. Still, verbal reports between groups of nurses about patients are commonplace. Shift reports are obvious sites for studying the situated accomplishment of professional nursing at the group level. This review is focused exclusively on qualitative field research for nuanced and contextualised insights into nurses' everyday shift reporting practices. The study is a systematic literature search and critical review of qualitative field analyses of nurses' shift reports. We searched in the databases CIHAHL, PubMed and PsycINFO and identified and reviewed 19 articles published 1992-2014. Data were systematically extracted using criteria for the evaluation of qualitative research reports. The studies described shift report practices and identified several factors contributing to distribution of clinical knowledge. Shift report practices were described as highly conventionalised and locally situated, but with occasional opportunities for improvisation and negotiation between nurses. Finally, shift reports were described as multifunctional meetings, with individual and social effects for nurses and teams. Innovations in between-shift communications can benefit from this analysis, by providing for the many functions of handovers that are revealed in field studies. Leaders and practising nurses may consider what are the best opportunities for nurses to work up clinical knowledge and negotiate care. © 2016 John Wiley & Sons Ltd.

Microwave Power Transmission Workshop summary

NASA Technical Reports Server (NTRS)

Freeman, J. W.

1980-01-01

The assumptions, methodologies, and conclusions of the NASA SPS studies were assessed and criticized to identify critical issues and to make recommendations for follow-on works. An assessment of the following items was made: beam forming and control, microwave amplifiers, radiating elements, and the rectenna. It was concluded that top priority should be given to determining an upper limit for permissible microwave power density which can be sent through the ionosphere.

Identification of critical contaminants in wastewater effluent for managed aquifer recharge.

PubMed

Yuan, Jie; Van Dyke, Michele I; Huck, Peter M

2017-04-01

Managed aquifer recharge (MAR) using highly treated effluent from municipal wastewater treatment plants has been recognized as a promising strategy for indirect potable water reuse. Treated wastewater effluent can contain a number of residual contaminants that could have adverse effects on human health, and some jurisdictions have regulations in place to govern these. For those that do not, but where reuse may be under consideration, it is of crucial importance to develop a strategy for identifying priority contaminants, which can then be used to understand the water treatment technologies that might be required. In this study, a multi-criteria approach to identify critical contaminants in wastewater effluent for MAR was developed and applied using a case study site located in southern Ontario, Canada. An important aspect of this approach was the selection of representative compounds for each group of contaminants, based on potential for occurrence in wastewater and expected health or environmental impacts. Due to a lack of MAR regulations in Canada, the study first proposed potential recharge water quality targets. Predominant contaminants, potential additional contaminants, and potential emerging contaminants, which together comprise critical contaminants for MAR with reclaimed water, were then selected based on the case study wastewater effluent monitoring data and literature data. This paper proposes an approach for critical contaminant selection, which will be helpful to guide future implementation of MAR projects using wastewater treatment plant effluents. Copyright © 2016 Elsevier Ltd. All rights reserved.

Discerning Thermodynamic Basis of Self-Organization in Critical Zone Structure and Function

NASA Astrophysics Data System (ADS)

Richardson, M.; Kumar, P.

2017-12-01

Self-organization characterizes the spontaneous emergence of order. Self-organization in the Critical Zone, the region of Earth's skin from below the groundwater table to the top of the vegetation canopy, involves the interaction of biotic and abiotic processes occurring through a hierarchy of temporal and spatial scales. The self-organization is sustained through input of energy and material in an open system framework, and the resulting formations are called dissipative structures. Why do these local states of organization form and how are they thermodynamically favorable? We hypothesize that structure formation is linked to energy conversion and matter throughput rates across driving gradients. Furthermore, we predict that structures in the Critical Zone evolve based on local availability of nutrients, water, and energy. By considering ecosystems as open thermodynamic systems, we model and study the throughput signatures on short times scales to determine origins and characteristics of ecosystem structure. This diagnostic approach allows us to use fluxes of matter and energy to understand the thermodynamic drivers of the system. By classifying the fluxes and dynamics in a system, we can identify patterns to determine the thermodynamic drivers for organized states. Additionally, studying the partitioning of nutrients, water, and energy throughout ecosystems through dissipative structures will help identify reasons for structure shapes and how these shapes impact major Critical Zone functions.

Study of quiet turbofan STOL aircraft for short haul transportation

NASA Technical Reports Server (NTRS)

Higgins, T. P.; Stout, E. G.; Sweet, H. S.

1973-01-01

A study of quiet turbofan short takeoff aircraft for short haul air transportation was conducted. The objectives of the study were to: (1) define representative aircraft configurations, characteristics, and costs associated with their development, (2) identify critical technology and technology related problems to be resolved in successful introduction of representative short haul aircraft, (3) determine relationships between quiet short takeoff aircraft and the economic and social viability of short haul, and (4) identify high payoff technology areas.

SNOWMASS (DPF Community Summer Study)

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

Cronin-Hennessy, et al, Daniel

2013-08-06

The 2013 Community Summer Study, known as Snowmass," brought together nearly 700 physicists to identify the critical research directions for the United States particle physics program. Commissioned by the American Physical Society, this meeting was the culmination of intense work over the past year by more than 1000 physicists that defined the most important questions for this field and identified the most promising opportunities to address them. This Snowmass study report is a key resource for setting priorities in particle physics.

Network modularity reveals critical scales for connectivity in ecology and evolution

USGS Publications Warehouse

Fletcher, Robert J.; Revell, Andre; Reichert, Brian E.; Kitchens, Wiley M.; Dixon, J.; Austin, James D.

2013-01-01

For nearly a century, biologists have emphasized the profound importance of spatial scale for ecology, evolution and conservation. Nonetheless, objectively identifying critical scales has proven incredibly challenging. Here we extend new techniques from physics and social sciences that estimate modularity on networks to identify critical scales for movement and gene flow in animals. Using four species that vary widely in dispersal ability and include both mark-recapture and population genetic data, we identify significant modularity in three species, two of which cannot be explained by geographic distance alone. Importantly, the inclusion of modularity in connectivity and population viability assessments alters conclusions regarding patch importance to connectivity and suggests higher metapopulation viability than when ignoring this hidden spatial scale. We argue that network modularity reveals critical meso-scales that are probably common in populations, providing a powerful means of identifying fundamental scales for biology and for conservation strategies aimed at recovering imperilled species.

Moving from technical to critical reflection in journalling: an investigation of students' ability to incorporate three levels of reflective writing.

PubMed

Usher, K; Tollefson, J; Francis, D

2001-01-01

This paper outlines a research project aimed at changing the levels of reflection of preregistration nursing students in a tertiary institution. Whilst reflection is widely espoused now in nursing, few studies have been found that identify whether the level of reflective writing can be identified or developed by students. Anecdotal and research evidence (Powell 1989; van Manen 1977) however indicates that most student reflective writing occurs at the technical level. A descriptive exploratory study using both qualitative and quantitative techniques was undertaken to apply van Manen's (1977) levels in a structured way in an attempt to facilitate the student's understanding and use of the levels in their reflective writing. The findings of the study indicate that student self evaluation and identification of the levels in their own writing can lead to change in the levels of critical reflective writing achieved by undergraduate students.

Aviation occupant survival factors: an empirical study of the SQ006 accident.

PubMed

Chang, Yu-Hern; Yang, Hui-Hua

2010-03-01

We present an empirical study of Singapore Airline (SIA) flight SQ006 to illustrate the critical factors that influence airplane occupant survivability. The Fuzzy Delphi Method was used to identify and rank the survival factors that may reduce injury and fatality in potentially survivable accidents. This is the first attempt by a group from both the public and private sectors in Taiwan to focus on cabin-safety issues related to survival factors. We designed a comprehensive survey based on our discussions with aviation safety experts. We next designed an array of important cabin-safety dimensions and then investigated and selected the critical survival factors for each dimension. Our findings reveal important cabin safety and survivability information that should provide a valuable reference for developing and evaluating aviation safety programs. We also believe that the results will be practical for designing cabin-safety education material for air travelers. Finally, the major contribution of this research is that it has identified 47 critical factors that influence accident survivability; therefore, it may encourage improvements that will promote more successful cabin-safety management. Copyright 2009 Elsevier Ltd. All rights reserved.

The experience of critically ill children: A phenomenological study of discomfort and comfort.

PubMed

Carnevale, Franco A; Gaudreault, Josée

2013-01-01

Emerging evidence indicates that critically ill children are particularly at risk for incurring significant psychological harm. Little is known about these children's actual experiences. The aim of the study was to examine children's experience of critical illness. The research question was: What are a critically ill child's sources of discomfort and comfort? Interpretive phenomenology was selected as the study's method. Children's accounts were examined to identify what they considered meaningful, in terms of their experienced discomfort and comfort. Data sources included formal and informal interviews with child-participants, drawings provided by some participants, and field-notes documenting observed non-verbal data. Twelve children were enrolled in the study, ranging from 3 to 17years of age; including four girls and eight boys. Although all participants were able to discuss the discomfort and comfort they experienced, they reported difficulties in remembering part or most of their experience. Some participants characterized their Pediatric Intensive Care Unit stay quite favourably or as "not that bad", while some described their experience unfavourably. Diverse types of discomforts were reported, including fears and worries, hurt and pain, invasive interventions, missing significant people, noise, food or eating problems, boredom, physical symptoms, as well as four additional discomforts reported by individual participants. Several sources of comfort were described, including parents, visitors and friends, hospital staff (principally nurses), stuffed animal/favourite blanket, entertainment and play, food, selected medical interventions, thinking of going home, being able to walk or run, sleep, waking up, gifts, along with two other comforts reported by individual participants. Embodiment and a tension between aloneness and being with were identified as the principal phenomena underlying these children's experiences. The findings complement existing knowledge regarding the psychological impact of critical illness by highlighting how children regard specific phenomena as discomforting or comforting. This sheds light on future directions for practice and research development in pediatric critical care.

The effect of human patient simulation on critical thinking and its predictors in prelicensure nursing students.

PubMed

Shinnick, Mary Ann; Woo, Mary A

2013-09-01

Human patient simulation (HPS) is becoming a popular teaching method in nursing education globally and is believed to enhance both knowledge and critical thinking. While there is evidence that HPS improves knowledge, there is no objective nursing data to support HPS impact on critical thinking. Therefore, we studied knowledge and critical thinking before and after HPS in prelicensure nursing students and attempted to identify the predictors of higher critical thinking scores. Using a one-group, quasi-experimental, pre-test post-test design, 154 prelicensure nursing students (age 25.7± 6.7; gender=87.7% female) from 3 schools were studied at the same point in their curriculum using a high-fidelity simulation. Pre- and post-HPS assessments of knowledge, critical thinking, and self-efficacy were done as well as assessments for demographics and learning style. There was a mean improvement in knowledge scores of 6.5 points (P<0.001), showing evidence of learning. However, there was no statistically significant change in the critical thinking scores. A logistic regression with 10 covariates revealed three variables to be predictors of higher critical thinking scores: greater "age" (P=0.01), baseline "knowledge" (P=0.04) and a low self-efficacy score ("not at all confident") in "baseline self-efficacy in managing a patient's fluid levels" (P=.05). This study reveals that gains in knowledge with HPS do not equate to changes in critical thinking. It does expose the variables of older age, higher baseline knowledge and low self-efficacy in "managing a patient's fluid levels" as being predictive of higher critical thinking ability. Further study is warranted to determine the effect of repeated or sequential simulations (dosing) and timing after the HPS experience on critical thinking gains. Copyright © 2012 Elsevier Ltd. All rights reserved.

Using a Brief Preschool Early Numeracy Skills Screener to Identify Young Children with Mathematics Difficulties

ERIC Educational Resources Information Center

Purpura, David J.; Reid, Erin E.; Eiland, Michael D.; Baroody, Arthur J.

2015-01-01

A critical component in enhancing academic success is identifying children at risk of later academic difficulties. Although significant efforts have been devoted to design effective assessment processes in elementary school, fewer efforts (particularly for mathematics) have been made for preschool. The focus of this study was to design and…

User community development for the space transportation system/Skylab

NASA Technical Reports Server (NTRS)

Archer, J. L.; Beauchamp, N. A.

1974-01-01

The New User Function plan for identifying beneficial uses of space is described. Critical issues such as funding, manpower, and protection of user proprietary rights are discussed along with common barriers which impede the development of a user community. Studies for developing methodologies of identifying new users and uses of the space transportation system are included.

Advance to and Persistence in Graduate School: Identifying the Influential Factors and Major-Based Differences

ERIC Educational Resources Information Center

Xu, Yonghong Jade

2014-01-01

Structured within an expanded econometric theoretical framework, this study uses national data sources to identify the critical factors that influence college graduates' advance to and persistence in graduate education and to compare the systematic differences between students in the STEM and non-STEM majors. The findings indicate that there is a…

Identifying Taiwanese University Students' Physics Learning Profiles and Their Role in Physics Learning Self-Efficacy

ERIC Educational Resources Information Center

Lin, Tzung-Jin; Liang, Jyh-Chong; Tsai, Chin-Chung

2015-01-01

The main purposes of this study were to identify Taiwanese university students' physics learning profiles in terms of their critical conceptions of learning physics and to compare their physics learning self-efficacy with the different learning profiles. A total of 250 Taiwanese undergraduates who were majoring in physics participated in this…

Modelling emergency decisions: recognition-primed decision making. The literature in relation to an ophthalmic critical incident.

PubMed

Bond, Susan; Cooper, Simon

2006-08-01

To review and reflect on the literature on recognition-primed decision (RPD) making and influences on emergency decisions with particular reference to an ophthalmic critical incident involving the sub-arachnoid spread of local anaesthesia following the peribulbar injection. This paper critics the literature on recognition-primed decision making, with particular reference to emergency situations. It illustrates the findings by focussing on an ophthalmic critical incident. Systematic literature review with critical incident reflection. Medline, CINAHL and PsychINFO databases were searched for papers on recognition-primed decision making (1996-2004) followed by the 'snowball method'. Studies were selected in accordance with preset criteria. A total of 12 papers were included identifying the recognition-primed decision making as a good theoretical description of acute emergency decisions. In addition, cognitive resources, situational awareness, stress, team support and task complexity were identified as influences on the decision process. Recognition-primed decision-making theory describes the decision processes of experts in time-bound emergency situations and is the foundation for a model of emergency decision making (Fig. 2). Decision theory and models, in this case related to emergency situations, inform practice and enhance clinical effectiveness. The critical incident described highlights the need for nurses to have a comprehensive and in-depth understanding of anaesthetic techniques as well as an ability to manage and resuscitate patients autonomously. In addition, it illustrates how the critical incidents should influence the audit cycle with improvements in patient safety.

Payload/orbiter contamination control requirement study, volume 1, exhibit A

NASA Technical Reports Server (NTRS)

Bareiss, L. E.; Hooper, V. W.; Rantanen, R. O.; Ress, E. B.

1974-01-01

This study is to identify and quantify the expected molecular and particulate on orbit contaminant environment for selected shuttle payloads as a result of major spacelab and shuttle orbiter contaminant sources. This investigation reviews individual payload susceptibilities to contamination, identifies the combined induced environment, identifies the risk of spacelab/payload critical surface(s) degradation, and provides preliminary contamination recommendations. It also establishes limiting factors which may depend upon operational activities associated with the payloads, spacelab, and the shuttle orbiter interface or upon independent payload functional activities.

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

PubMed

Giacomini, Mita; Cook, Deborah; DeJean, Deirdre

2009-04-01

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

The Anatomy of Critical Discourse.

ERIC Educational Resources Information Center

Rosenfield, Lawrence W.

1968-01-01

Critical discourse is best understood when its logical features are identified. An examination of the basic elements and modes of rhetorical criticism (a form of critical discourse) produces a finite set of options for the critic, thus enabling him to develop a system of alternatives in his critical efforts. For example, by selecting from among…

Systems modeling and simulation applications for critical care medicine

PubMed Central

2012-01-01

Critical care delivery is a complex, expensive, error prone, medical specialty and remains the focal point of major improvement efforts in healthcare delivery. Various modeling and simulation techniques offer unique opportunities to better understand the interactions between clinical physiology and care delivery. The novel insights gained from the systems perspective can then be used to develop and test new treatment strategies and make critical care delivery more efficient and effective. However, modeling and simulation applications in critical care remain underutilized. This article provides an overview of major computer-based simulation techniques as applied to critical care medicine. We provide three application examples of different simulation techniques, including a) pathophysiological model of acute lung injury, b) process modeling of critical care delivery, and c) an agent-based model to study interaction between pathophysiology and healthcare delivery. Finally, we identify certain challenges to, and opportunities for, future research in the area. PMID:22703718

Reliability of serum creatinine-based formulae estimating renal function in non-critically ill surgery patients: Focus on augmented renal clearance.

PubMed

Declercq, Peter; Gijsen, Matthias; Meijers, Björn; Schetz, Marie; Nijs, Stefaan; D'Hoore, André; Wauters, Joost; Spriet, Isabel

2018-05-07

Formulae estimating glomerular filtration rate (GFR) are frequently used to guide drug dosing. The objectives of this prospective single-center study were to evaluate agreement between these equations and measured creatinine clearance (CrCl) in non-critically ill surgery patients with normal kidney function and augmented renal clearance (ARC, CrCl ≥ 130 mL/min/1.73 m²), to determine predictors for disagreement, define a GFR estimator cut-off value identifying ARC and determine the ARC prevalence and duration in non-critically ill surgical patients. Hospitalized adult non-critically ill abdominal and trauma surgery patients were eligible for inclusion. Measured CrCl based on an 8-hour urinary collection (CrCl 8h ) was used as the primary method for determining kidney function. Agreement between equations and measured CrCl 8h was assessed in terms of precision, defined as a bias within ±10 mL/min/1.73 m². Predictors for disagreement were identified for the most precise estimator using an ordinal logistic regression model with negative bias, agreement and positive bias as outcome variables. A receiver operating characteristic (ROC) analysis was performed to identify an estimator cut-off predicting ARC, which was subsequently applied for the daily proportion of patients displaying ARC and ARC duration. During the study period (14/11/2013 - 13/05/2014), in 232 adult non-critically ill abdominal and trauma surgery patients, all estimators tend to underestimate CrCl 8h (mean bias ranging from 17 to 22 mL/min/1.73 m²), especially in patients displaying ARC (mean bias ranging from 44 to 56 mL/min/1.73 m²). eGFR CKD-EPI performed the best. Younger age and low ASA score independently predicted underestimation of CrCl 8h . Three different eGFR CKD-EPI cut-offs with decreasing sensitivity and increasing specificity (84, 95 and 112 mL/min/1.73 m²) identified, respectively, 65%, 44% and 14% patients displaying ARC. The median ARC duration was 4, 4 and 3 days, respectively. In surgical patients, eGFR frequently underestimates measured CrCl, especially in young patients with low ASA score. eGFR cut-offs predicting ARC were identified. © 2018 John Wiley & Sons Ltd.

Clinical reasoning and critical thinking.

PubMed

da Silva Bastos Cerullo, Josinete Aparecida; de Almeida Lopes Monteiro da Cruz, Diná

2010-01-01

This study identifies and analyzes nursing literature on clinical reasoning and critical thinking. A bibliographical search was performed in LILACS, SCIELO, PUBMED and CINAHL databases, followed by selection of abstracts and the reading of full texts. Through the review we verified that clinical reasoning develops from scientific and professional knowledge, is permeated by ethical decisions and nurses values and also that there are different personal and institutional strategies that might improve the critical thinking and clinical reasoning of nurses. Further research and evaluation of educational programs on clinical reasoning that integrate psychosocial responses to physiological responses of people cared by nurses is needed.

Key Future Engineering Capabilities for Human Capital Retention

NASA Astrophysics Data System (ADS)

Sivich, Lorrie

Projected record retirements of Baby Boomer generation engineers have been predicted to result in significant losses of mission-critical knowledge in space, national security, and future scientific ventures vital to high-technology corporations. No comprehensive review or analysis of engineering capabilities has been performed to identify threats related to the specific loss of mission-critical knowledge posed by the increasing retirement of tenured engineers. Archival data from a single diversified Fortune 500 aerospace manufacturing engineering company's engineering career database were analyzed to ascertain whether relationships linking future engineering capabilities, engineering disciplines, and years of engineering experience could be identified to define critical knowledge transfer models. Chi square, logistic, and linear regression analyses were used to map patterns of discipline-specific, mission-critical knowledge using archival data of engineers' perceptions of engineering capabilities, key developmental experiences, and knowledge learned from their engineering careers. The results from the study were used to document key engineering future capabilities. The results were then used to develop a proposed human capital retention plan to address specific key knowledge gaps of younger engineers as veteran engineers retire. The potential for social change from this study involves informing leaders of aerospace engineering corporations on how to build better quality mentoring or succession plans to fill the void of lost knowledge from retiring engineers. This plan can secure mission-critical knowledge for younger engineers for current and future product development and increased global competitiveness in the technology market.

Transcranial direct current stimulation (tDCS) to improve naming ability in post-stroke aphasia: A critical review.

PubMed

ALHarbi, Mohammed F; Armijo-Olivo, Susan; Kim, Esther S

2017-08-14

Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulation tool that can be used to influence cortical brain activity to induce measurable behavioral changes. Although there is growing evidence that tDCS combined with behavioural language therapy could boost language recovery in patients with post-stroke aphasia, there is great variability in patient characteristics, treatment protocols, and outcome measures in these studies that poses challenges for analyzing the evidence. The purpose of this study is to critically analyze the methodological rigor of the evidence regarding the use of tDCS for post-stroke anomia. This critical review was conducted by searching four databases (MEDLINE, EMBase, PsycINFO, and CINAHL). Nineteen studies fully met the inclusion criteria. Three critical appraisal tools and Robey and Schultz's (1998) five- phase model for conducting clinical outcome research were adopted to evaluate and analyze the current level of evidence. Methodological issues of the studies were also identified. The current level of evidence for using tDCS for anomia is at the pre-efficacy level with emerging evidence at the efficacy level. Lack of proper evaluation of carry-over effects in cross-over studies, lack of or unclear randomization, allocation concealment, and incomplete data handling were the main methodological issues that could threaten the validity of the tDCS for anomia studies. Several methodological issues have been identified in pre-efficacy studies that pose challenges in determining whether tDCS is a beneficial adjunct to behavioral aphasia therapy. Future studies need to improve the quality of the methods used to investigate the effect of tDCS for anomia. Copyright © 2017 Elsevier B.V. All rights reserved.

The Relationship Between the California Critical Thinking Disposition Inventory and Student Learning Outcomes in Baccalaureate Nursing Students.

PubMed

Searing, Lisabeth Meade; Kooken, Wendy Carter

2016-04-01

Critical thinking is the foundation for nurses' decision making. One school of nursing used the California Critical Thinking Disposition Inventory (CCTDI) to document improvement in critical thinking dispositions. A retrospective study of 96 nursing students' records examined the relationships between the CCTDI and learning outcomes. Correlational statistics assessed relationships between CCTDI scores and cumulative grade point averages (GPA) and scores on two Health Education Systems Incorporated (HESI) examinations. Ordinal regression assessed predictive relationships between CCTDI scores and science course grades and NCLEX-RN success. First-year CCTDI scores did not predict first-year science grades. Senior-year CCTDI scores did not correlate with cumulative GPA or HESI RN Exit Exam scores, but were weakly correlated with HESI Pharmacology Exam scores. CCTDI scores did not predict NCLEX-RN success. This study did not identify meaningful relationships between critical thinking dispositions, as measured by the CCTDI, and important learning outcomes. The results do not support the efficacy of using the CCTDI in nursing education. Copyright 2016, SLACK Incorporated.

Scaling functions for the Inverse Compressibility near the QCD critical point

NASA Astrophysics Data System (ADS)

Lacey, Roy

2017-09-01

The QCD phase diagram can be mapped out by studying fluctuations and their response to changes in the temperature and baryon chemical potential. Theoretical studies indicate that the cumulant ratios Cn /Cm used to characterize the fluctuation of conserved charges, provide a valuable probe of deconfinement and chiral dynamics, as well as for identifying the position of the critical endpoint (CEP) in the QCD phase diagram. The ratio C1 /C2 , which is linked to the inverse compressibility, vanishes at the CEP due to the divergence of the net quark number fluctuations at the critical point belonging to the Z(2) universality class. Therefore, it's associated scaling function can give insight on the location of the critical end point, as well as the critical exponents required to assign its static universality class. Scaling functions for the ratio C1 /C2 , obtained from net-proton multiplicity distributions for a broad range of collision centralities in Au+Au (√{sNN} = 7.7 - 200 GeV) collisions will be presented and discussed.

Impact of a concept map teaching approach on nursing students' critical thinking skills.

PubMed

Kaddoura, Mahmoud; Van-Dyke, Olga; Yang, Qing

2016-09-01

Nurses confront complex problems and decisions that require critical thinking in order to identify patient needs and implement best practices. An active strategy for teaching students the skills to think critically is the concept map. This study explores the development of critical thinking among nursing students in a required pathophysiology and pharmacology course during the first year of a Bachelor of Science in Nursing in response to concept mapping as an interventional strategy, using the Health Education Systems, Incorporated critical thinking test. A two-group experimental study with a pretest and posttest design was used. Participants were randomly divided into a control group (n = 42) taught by traditional didactic lecturing alone, and an intervention group (n = 41), taught by traditional didactic lecturing with concept mapping. Students in the concept mapping group performed much better on the Health Education Systems, Incorporated than students in the control group. It is recommended that deans, program directors, and nursing faculties evaluate their curricula to integrate concept map teaching strategies in courses in order to develop critical thinking abilities in their students. © 2016 John Wiley & Sons Australia, Ltd.

Evacuation of the ICU

PubMed Central

Niven, Alexander S.; Beninati, William; Fang, Ray; Einav, Sharon; Rubinson, Lewis; Kissoon, Niranjan; Devereaux, Asha V.; Christian, Michael D.; Grissom, Colin K.; Christian, Michael D.; Devereaux, Asha V.; Dichter, Jeffrey R.; Kissoon, Niranjan; Rubinson, Lewis; Amundson, Dennis; Anderson, Michael R.; Balk, Robert; Barfield, Wanda D.; Bartz, Martha; Benditt, Josh; Beninati, William; Berkowitz, Kenneth A.; Daugherty Biddison, Lee; Braner, Dana; Branson, Richard D; Burkle, Frederick M.; Cairns, Bruce A.; Carr, Brendan G.; Courtney, Brooke; DeDecker, Lisa D.; De Jong, Marla J.; Dominguez-Cherit, Guillermo; Dries, David; Einav, Sharon; Erstad, Brian L.; Etienne, Mill; Fagbuyi, Daniel B.; Fang, Ray; Feldman, Henry; Garzon, Hernando; Geiling, James; Gomersall, Charles D.; Grissom, Colin K.; Hanfling, Dan; Hick, John L.; Hodge, James G.; Hupert, Nathaniel; Ingbar, David; Kanter, Robert K.; King, Mary A.; Kuhnley, Robert N.; Lawler, James; Leung, Sharon; Levy, Deborah A.; Lim, Matthew L.; Livinski, Alicia; Luyckx, Valerie; Marcozzi, David; Medina, Justine; Miramontes, David A.; Mutter, Ryan; Niven, Alexander S.; Penn, Matthew S.; Pepe, Paul E.; Powell, Tia; Prezant, David; Reed, Mary Jane; Rich, Preston; Rodriquez, Dario; Roxland, Beth E.; Sarani, Babak; Shah, Umair A.; Skippen, Peter; Sprung, Charles L.; Subbarao, Italo; Talmor, Daniel; Toner, Eric S.; Tosh, Pritish K.; Upperman, Jeffrey S.; Uyeki, Timothy M.; Weireter, Leonard J.; West, T. Eoin; Wilgis, John; Ornelas, Joe; McBride, Deborah; Reid, David; Baez, Amado; Baldisseri, Marie; Blumenstock, James S.; Cooper, Art; Ellender, Tim; Helminiak, Clare; Jimenez, Edgar; Krug, Steve; Lamana, Joe; Masur, Henry; Mathivha, L. Rudo; Osterholm, Michael T.; Reynolds, H. Neal; Sandrock, Christian; Sprecher, Armand; Tillyard, Andrew; White, Douglas; Wise, Robert; Yeskey, Kevin

2014-01-01

BACKGROUND: Despite the high risk for patient harm during unanticipated ICU evacuations, critical care providers receive little to no training on how to perform safe and effective ICU evacuations. We reviewed the pertinent published literature and offer suggestions for the critical care provider regarding ICU evacuation. The suggestions in this article are important for all who are involved in pandemics or disasters with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. METHODS: The Evacuation and Mobilization topic panel used the American College of Chest Physicians (CHEST) Guidelines Oversight Committee’s methodology to develop seven key questions for which specific literature searches were conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. RESULTS: Based on current best evidence, we provide 13 suggestions outlining a systematic approach to prepare for and execute an effective ICU evacuation during a disaster. Interhospital and intrahospital collaboration and functional ICU communication are critical for success. Pre-event planning and preparation are required for a no-notice evacuation. A Critical Care Team Leader must be designated within the Hospital Incident Command System. A three-stage ICU Evacuation Timeline, including (1) no immediate threat, (2) evacuation threat, and (3) evacuation implementation, should be used. Detailed suggestions on ICU evacuation, including regional planning, evacuation drills, patient transport preparation and equipment, patient prioritization and distribution for evacuation, patient information and tracking, and federal and international evacuation assistance systems, are also provided. CONCLUSIONS: Successful ICU evacuation during a disaster requires active preparation, participation, communication, and leadership by critical care providers. Critical care providers have a professional obligation to become better educated, prepared, and engaged with the processes of ICU evacuation to provide a safe continuum of critical care during a disaster. PMID:25144509

Long-term psychosocial impact reported by childhood critical illness survivors: a systematic review

PubMed Central

Manning, Joseph C; Hemingway, Pippa; Redsell, Sarah A

2014-01-01

Aim To undertake a qualitative systematic review that explores psychological and social impact, reported directly from children and adolescents at least 6 months after their critical illness. Background Significant advances in critical care have reduced mortality from childhood critical illness, with the majority of patients being discharged alive. However, it is widely reported that surviving critical illness can be traumatic for both children and their family. Despite a growing body of literature in this field, the psychological and social impact of life threatening critical illness on child and adolescent survivors, more than 6 months post event, remains under-reported. Data sources Searches of six online databases were conducted up to February 2012. Review methods Predetermined criteria were used to select studies. Methodological quality was assessed using a standardized checklist. An adapted version of the thematic synthesis approach was applied to extract, code and synthesize data. Findings Three studies met the inclusion criteria, which were all of moderate methodological quality. Initial coding and synthesis of data resulted in five descriptive themes: confusion and uncertainty, other people's narratives, focus on former self and normality, social isolation and loss of identity, and transition and transformation. Further synthesis culminated in three analytical themes that conceptualize the childhood survivors' psychological and social journey following critical illness. Conclusions Critical illness in childhood can expose survivors to a complex trajectory of recovery, with enduring psychosocial adversity manifesting in the long term. Nurses and other health professionals must be aware and support the potential multifaceted psychosocial needs that may arise. Parents and families are identified as fundamental in shaping psychological and social well-being of survivors. Therefore intensive care nurses must take opportunities to raise parents' awareness of the journey of survival and provide appropriate support. Further empirical research is warranted to explore the deficits identified with the existing literature. PMID:24147805

A self-report critical incident assessment tool for army night vision goggle helicopter operations.

PubMed

Renshaw, Peter F; Wiggins, Mark W

2007-04-01

The present study sought to examine the utility of a self-report tool that was designed as a partial substitute for a face-to-face cognitive interview for critical incidents involving night vision goggles (NVGs). The use of NVGs remains problematic within the military environment, as these devices have been identified as a factor in a significant proportion of aircraft accidents and incidents. The self-report tool was structured to identify some of the cognitive features of human performance that were associated with critical incidents involving NVGs. The tool incorporated a number of different levels of analysis, ranging from specific behavioral responses to broader cognitive constructs. Reports were received from 30 active pilots within the Australian Army using the NVG Critical Incident Assessment Tool (NVGCIAT). The results revealed a correspondence between specific types of NVG-related errors and elements of the Human Factors Analysis and Classification System (HFACS). In addition, uncertainty emerged as a significant factor associated with the critical incidents that were recalled by operators. These results were broadly consistent with previous research and provide some support for the utility of subjective assessment tools as a means of extracting critical incident-related data when face-to-face cognitive interviews are not possible. In some circumstances, the NVGCIAT might be regarded as a substitute cognitive interview protocol with some level of diagnosticity.

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

PubMed

Swart, Ruth

2017-03-01

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

An analysis of narratives to identify critical thinking contexts in psychiatric clinical practice.

PubMed

Mun, Mi Suk

2010-02-01

The development of students' critical thinking abilities is one of the greatest challenges facing contemporary nursing educators. Nursing educators should know about what kind of contents or situations need critical thinking. The research was undertaken to identify the critical thinking contexts that nursing students confront in psychiatric clinical practices. Students were asked to document their everyday experience. The narratives were analysed and interpreted from the philosophical notion of hermeneutics. Four themes emerged as critical thinking contexts: anxiety, conflict, hyper-awareness, dilemmas. Writing narratives appear to provide opportunities for reflection in addition to facilitating critical thinking and communicative skills in students. Also, for the instructor, students' clinical narratives could provide insight to understand how students are thinking and to share student's personal difficulties.

Impact of critical thinking disposition, general self-efficacy, and leadership on clinical competence in nursing students.

PubMed

Park, Jee Won; Kim, Chun Ja; Kim, Yong Soon; Yoo, Moon Sook; Yoo, Hyera; Chae, Sun Mi; Ahn, Jeong Ah

2012-09-01

The purpose of this study was to evaluate the relationships among critical thinking disposition, general self-efficacy, leadership and clinical competence, and identify the factors influencing clinical competence in nursing students. In this descriptive study, 153 nursing students (from 2nd to 4th school year) of a university in South Korea were enrolled in December 2010. The instruments for this study were the Korean versions of the Critical Thinking Disposition Scale, General Self-Efficacy Scale, Leadership Inventory, and Clinical Competence Scale. Data were analyzed by descriptive statistics, t-test, MANOVA, Pearson correlation, and multiple linear regression with PASW 18.0 software. The mean scores (ranging from 1 to 5) in nursing students for critical thinking disposition, general self-efficacy, leadership, and clinical competence were 3.44, 3.51, 3.55, and 3.42, respectively. Positive correlations were found for clinical competence with critical thinking disposition, general self-efficacy, and leadership. The strongest predictor of clinical competence was leadership. In addition, leadership, nursing school year, and subjective academic achievement accounted for 34.5% of variance in clinical competence. This study revealed that developing leadership, critical thinking disposition, and self-efficacy in undergraduate nursing education is important to improve clinical competence of nursing students.

Probing concept of critical thinking in nursing education in Iran: a concept analysis.

PubMed

Tajvidi, Mansooreh; Ghiyasvandian, Shahrzad; Salsali, Mahvash

2014-06-01

Given the wide disagreement over the definition of critical thinking in different disciplines, defining and standardizing the concept according to the discipline of nursing is essential. Moreover, there is limited scientific evidence regarding critical thinking in the context of nursing in Iran. The aim of this study was to analyze and clarify the concept of critical thinking in nursing education in Iran. We employed the hybrid model to define the concept of critical thinking. The hybrid model has three interconnected phases--the theoretical phase, the fieldwork phase, and the final analytic phase. In the theoretical phase, we searched the online scientific databases (such as Elsevier, Wiley, CINAHL, Proquest, Ovid, and Springer as well as Iranian databases such as SID, Magiran, and Iranmedex). In the fieldwork phase, a purposive sample of 17 nursing faculties, PhD students, clinical instructors, and clinical nurses was recruited. Participants were interviewed by using an interview guide. In the analytical phase we compared the data from the theoretical and the fieldwork phases. The concept of critical thinking had many different antecedents, attributes, and consequences. Antecedents, attributes, and consequences of critical thinking concept identified in the theoretical phase were in some ways different and in some way similar to antecedents, attributes, and consequences identified in the fieldwork phase. Finally critical thinking in nursing education in Iran was clarified. Critical thinking is a logical, situational, purposive, and outcome-oriented thinking process. It is an acquired and evolving ability which develops individually. Such thinking process could lead to the professional accountability, personal development, God's consent, conscience appeasement, and personality development. Copyright © 2014. Published by Elsevier B.V.

Stress hyperglycaemia in critically ill patients and the subsequent risk of diabetes: a systematic review and meta-analysis.

PubMed

Ali Abdelhamid, Yasmine; Kar, Palash; Finnis, Mark E; Phillips, Liza K; Plummer, Mark P; Shaw, Jonathan E; Horowitz, Michael; Deane, Adam M

2016-09-27

Hyperglycaemia occurs frequently in critically ill patients without diabetes. We conducted a systematic review and meta-analysis to evaluate whether this 'stress hyperglycaemia' identifies survivors of critical illness at increased risk of subsequently developing diabetes. We searched the MEDLINE and Embase databases from their inception to February 2016. We included observational studies evaluating adults admitted to the intensive care unit (ICU) who developed stress hyperglycaemia if the researchers reported incident diabetes or prediabetes diagnosed ≥3 months after hospital discharge. Two reviewers independently screened the titles and abstracts of identified studies and evaluated the full text of relevant studies. Data were extracted using pre-defined data fields, and risk of bias was assessed using the Newcastle-Ottawa Scale. Pooled ORs with 95 % CIs for the occurrence of diabetes were calculated using a random-effects model. Four cohort studies provided 2923 participants, including 698 with stress hyperglycaemia and 131 cases of newly diagnosed diabetes. Stress hyperglycaemia was associated with increased risk of incident diabetes (OR 3.48; 95 % CI 2.02-5.98; I 2  = 36.5 %). Studies differed with regard to definitions of stress hyperglycaemia, follow-up and cohorts studied. Stress hyperglycaemia during ICU admission is associated with increased risk of incident diabetes. The strength of this association remains uncertain because of statistical and clinical heterogeneity among the included studies.

Understanding critical health literacy: a concept analysis.

PubMed

Sykes, Susie; Wills, Jane; Rowlands, Gillian; Popple, Keith

2013-02-18

Interest in and debates around health literacy have grown over the last two decades and key to the discussions has been the distinction made between basic functional health literacy, communicative/interactive health literacy and critical health literacy. Of these, critical health literacy is the least well developed and differing interpretations of its constituents and relevance exist. The aim of this study is to rigorously analyse the concept of critical health literacy in order to offer some clarity of definition upon which appropriate theory, well grounded practice and potential measurement tools can be based. The study uses a theoretical and colloquial evolutionary concept analysis method to systematically identify the features associated with this concept. A unique characteristic of this method is that it practically combines an analysis of the literature with in depth interviews undertaken with practitioners and policy makers who have an interest in the field. The study also analyses how the concept is understood across the contexts of time, place, discipline and use by health professionals, policy makers and academics. Findings revealed a distinct set of characteristics of advanced personal skills, health knowledge, information skills, effective interaction between service providers and users, informed decision making and empowerment including political action as key features of critical health literacy. The potential consequences of critical health literacy identified are in improving health outcomes, creating more effective use of health services and reducing inequalities in health thus demonstrating the relevance of this concept to public health and health promotion. While critical health literacy is shown to be a unique concept, there remain significant contextual variations in understanding particularly between academics, practitioners and policy makers. Key attributes presented as part of this concept when it was first introduced in the literature, particularly those around empowerment, social and political action and the existence of the concept at both an individual and population level, have been lost in more recent representations. This has resulted in critical health literacy becoming restricted to a higher order cognitive individual skill rather than a driver for political and social change. The paper argues that in order to retain the uniqueness and usefulness of the concept in practice efforts should be made to avoid this dilution of meaning.

Analytical Approaches for Identification and Representation of Critical Protection Systems in Transient Stability Studies

NASA Astrophysics Data System (ADS)

Hedman, Mojdeh Khorsand

After a major disturbance, the power system response is highly dependent on protection schemes and system dynamics. Improving power systems situational awareness requires proper and simultaneous modeling of both protection schemes and dynamic characteristics in power systems analysis tools. Historical information and ex-post analysis of blackouts reaffirm the critical role of protective devices in cascading events, thereby confirming the necessity to represent protective functions in transient stability studies. This dissertation is aimed at studying the importance of representing protective relays in power system dynamic studies. Although modeling all of the protective relays within transient stability studies may result in a better estimation of system behavior, representing, updating, and maintaining the protection system data becomes an insurmountable task. Inappropriate or outdated representation of the relays may result in incorrect assessment of the system behavior. This dissertation presents a systematic method to determine essential relays to be modeled in transient stability studies. The desired approach should identify protective relays that are critical for various operating conditions and contingencies. The results of the transient stability studies confirm that modeling only the identified critical protective relays is sufficient to capture system behavior for various operating conditions and precludes the need to model all of the protective relays. Moreover, this dissertation proposes a method that can be implemented to determine the appropriate location of out-of-step blocking relays. During unstable power swings, a generator or group of generators may accelerate or decelerate leading to voltage depression at the electrical center along with generator tripping. This voltage depression may cause protective relay mis-operation and unintentional separation of the system. In order to avoid unintentional islanding, the potentially mis-operating relays should be blocked from tripping with the use of out-of-step blocking schemes. Blocking these mis-operating relays, combined with an appropriate islanding scheme, help avoid a system wide collapse. The proposed method is tested on data from the Western Electricity Coordinating Council. A triple line outage of the California-Oregon Intertie is studied. The results show that the proposed method is able to successfully identify proper locations of out-of-step blocking scheme.

Standardization of haematology critical results management in adults: an International Council for Standardization in Haematology, ICSH, survey and recommendations.

PubMed

Keng, T B; De La Salle, B; Bourner, G; Merino, A; Han, J-Y; Kawai, Y; Peng, M T; McCafferty, R

2016-10-01

These recommendations are intended to develop a consensus in the previously published papers as to which parameters and what values should be considered critical. A practical guide on the standardization of critical results management in haematology laboratories would be beneficial as part of good laboratory and clinical practice and for use by laboratory-accrediting agencies. A working group with members from Europe, America, Australasia and Asia was formed by International Council for Standardization in Haematology. A pattern of practice survey of 21 questions was distributed in 2014, and the data were collected electronically by Survey Monkey. The mode, or most commonly occurring value, was selected as the threshold for the upper and lower alert limits for critical results reporting. A total of 666 laboratories submitted data to this study and, of these, 499 submitted complete responses. Full blood count critical results alert thresholds, morphology findings that trigger critical result notification, critical results alert list, notification process and maintenance of critical results management protocol are described. This international survey provided a snapshot of the current practice worldwide and has identified the existence of considerable heterogeneity of critical results management. The recommendations in this study represent a consensus of good laboratory practice. They are intended to encourage the implementation of a standardized critical results management protocol in the laboratory. © 2016 John Wiley & Sons Ltd.

The Burden of Surgical Diseases on Critical Care Services at a Tertiary Referral Hospital in Sub-Saharan Africa

PubMed Central

Tomlinson, Jared; Haac, Bryce; Kadyaudzu, Clement; Samuel, Jonathan C; Campbell, Emilia LP; Lee, Clara; Charles, Anthony G

2013-01-01

In many developing countries including those of sub-Saharan Africa care of the critically ill is poorly developed. We therefore sought to elucidate the characteristics and outcomes of critically ill patients to better define the burden of disease and identify strategies for improving care. We conducted a cross sectional observation study of patients admitted to the intensive care unit at Kamuzu Central Hospital in 2010. Demographic, patient characteristics, clinical specialty and outcome data was collected. There were 234 patients admitted during the study period. Older age and admission from trauma, general surgery or medical services were associated with increased mortality. The lowest mortality was among obstetrical and gynecologic patients. Use of the ventilator and transfusions were not associated with increased mortality. Head injured patients had the highest mortality rate among all diagnoses. Rationing of critical care resources using admitting diagnosis or scoring tools can maximize access to critical care services in resource-limited settings. Furthermore, improvements on critical care services will be central to future efforts at reducing surgical morbidity and mortality and improving outcomes in all critically ill patients. PMID:23492923

Quantitative research on critical thinking and predicting nursing students' NCLEX-RN performance.

PubMed

Romeo, Elizabeth M

2010-07-01

The concept of critical thinking has been influential in several disciplines. Both education and nursing in general have been attempting to define, teach, and measure this concept for decades. Nurse educators realize that critical thinking is the cornerstone of the objectives and goals for nursing students. The purpose of this article is to review and analyze quantitative research findings relevant to the measurement of critical thinking abilities and skills in undergraduate nursing students and the usefulness of critical thinking as a predictor of National Council Licensure Examination-Registered Nurse (NCLEX-RN) performance. The specific issues that this integrative review examined include assessment and analysis of the theoretical and operational definitions of critical thinking, theoretical frameworks used to guide the studies, instruments used to evaluate critical thinking skills and abilities, and the role of critical thinking as a predictor of NCLEX-RN outcomes. A list of key assumptions related to critical thinking was formulated. The limitations and gaps in the literature were identified, as well as the types of future research needed in this arena. Copyright 2010, SLACK Incorporated.

Water vapour and wind measurements by a two micron space lidar

NASA Astrophysics Data System (ADS)

Ghibaudo, J.-B.; Labandibar, J.-Y.

2018-04-01

AEROSPATIALE presents the main results of the feasibility study under ESA contract on a coherent 2μm lidar instrument capable of measuring water vapour and wind velocity in the planetary boundary layer. The selected instrument configuration and the associated performance are provided, and the main critical subsystems identified (laser configuration, coherent receiver chain architecture, frequency locking and offsetting architecture. The second phase of this study is dedicated to breadboard the most critical elements of such an instrument in order to technologically consolidate its feasibility.

Report: Science to Support Rulemaking

EPA Pesticide Factsheets

Report #2003-P-00003, November 15, 2002. The rules included in the pilot study were not a representative statistical sample of EPA rules, and we did not identify all ofthe critical science inputs for every rule.

An analysis of the stressors and coping strategies of Chinese adults with a partner admitted to an intensive care unit in Hong Kong: an exploratory study.

PubMed

Chan, Keung-Sum; Twinn, Sheila

2007-01-01

The aim of this study was to identify the major stressors affecting Chinese adults whose partner had been admitted to an intensive care unit and to understand the major coping strategies employed to manage such stressors. Recently a greater number of patients of higher acuity have been admitted to intensive care units and survive lengthy illnesses of an unpredictable course. Such critical illnesses have been identified as a major life event to family members of these patients. Little is known, however, about the stressors and coping mechanisms of Chinese adults whose critically ill partner is admitted to an intensive care unit. An exploratory qualitative design was selected to achieve the aims of the study. A purposive sample of 10 Chinese adults with a partner in an intensive care unit of a regional general hospital in Hong Kong participated in tape-recorded semi-structured interviews. Content analysis was employed to analyse the translated interviews. Categories of stressors included uncertainty, difficulties in communication, changes in roles and responsibilities, difficulties in decision making, financial strain as well as changes in relationships. Analysis identified a range of coping strategies which included seeking information, seeking support, reliance on cultural beliefs and practices, turning to religious beliefs, maintaining hope and acceptance of illness. The findings demonstrate the importance of cultural beliefs and practices in determining the coping mechanisms employed to manage the stressors identified by this sample of Chinese adults. Such findings indicate the use of both internal and external coping strategies in order to maintain equilibrium in the family. Implications for nursing practice highlight the significance of seeking information throughout the critical period and also culturally appropriate support from healthcare professionals.

Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies.

PubMed

Parry, Selina M; Knight, Laura D; Connolly, Bronwen; Baldwin, Claire; Puthucheary, Zudin; Morris, Peter; Mortimore, Jessica; Hart, Nicholas; Denehy, Linda; Granger, Catherine L

2017-04-01

To identify, evaluate and synthesise studies examining the barriers and enablers for survivors of critical illness to participate in physical activity in the ICU and post-ICU settings from the perspective of patients, caregivers and healthcare providers. Systematic review of articles using five electronic databases: MEDLINE, CINAHL, EMBASE, Cochrane Library, Scopus. Quantitative and qualitative studies that were published in English in a peer-reviewed journal and assessed barriers or enablers for survivors of critical illness to perform physical activity were included. Prospero ID: CRD42016035454. Eighty-nine papers were included. Five major themes and 28 sub-themes were identified, encompassing: (1) patient physical and psychological capability to perform physical activity, including delirium, sedation, illness severity, comorbidities, weakness, anxiety, confidence and motivation; (2) safety influences, including physiological stability and concern for lines, e.g. risk of dislodgement; (3) culture and team influences, including leadership, interprofessional communication, administrative buy-in, clinician expertise and knowledge; (4) motivation and beliefs regarding the benefits/risks; and (5) environmental influences, including funding, access to rehabilitation programs, staffing and equipment. The main barriers identified were patient physical and psychological capability to perform physical activity, safety concerns, lack of leadership and ICU culture of mobility, lack of interprofessional communication, expertise and knowledge, and lack of staffing/equipment and funding to provide rehabilitation programs. Barriers and enablers are multidimensional and span diverse factors. The majority of these barriers are modifiable and can be targeted in future clinical practice.

Mechanisms and function of autophagy in intestinal disease.

PubMed

Lassen, Kara G; Xavier, Ramnik J

2018-01-01

The discovery of numerous genetic variants in the human genome that are associated with inflammatory bowel disease (IBD) has revealed critical pathways that play important roles in intestinal homeostasis. These genetic studies have identified a critical role for macroautophagy/autophagy and more recently, lysosomal function, in maintaining the intestinal barrier and mucosal homeostasis. This review highlights recent work on the functional characterization of IBD-associated human genetic variants in cell type-specific functions for autophagy.

Advanced development and calibration of the network robustness index to identify critical road network links.

DOT National Transportation Integrated Search

2010-05-31

In this research project, transportation flexibility and reliability concepts are extended and applied : to a new method for identifying the most critical links in a road network. Current transportation : management practices typically utilize locali...

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

Ackerman, G; Bale, J; Moran, K

Certain types of infrastructure--critical infrastructure (CI)--play vital roles in underpinning our economy, security, and way of life. One particular type of CI--that relating to chemicals--constitutes both an important element of our nation's infrastructure and a particularly attractive set of potential targets. This is primarily because of the large quantities of toxic industrial chemicals (TICs) it employs in various operations and because of the essential economic functions it serves. This study attempts to minimize some of the ambiguities that presently impede chemical infrastructure threat assessments by providing new insight into the key motivational factors that affect terrorist organizations propensity to attackmore » chemical facilities. Prepared as a companion piece to the Center for Nonproliferation Studies August 2004 study--''Assessing Terrorist Motivations for Attacking Critical Infrastructure''--it investigates three overarching research questions: (1) why do terrorists choose to attack chemical-related infrastructure over other targets; (2) what specific factors influence their target selection decisions concerning chemical facilities; and (3) which, if any, types of groups are most inclined to attack chemical infrastructure targets? The study involved a multi-pronged research design, which made use of four discrete investigative techniques to answer the above questions as comprehensively as possible. These include: (1) a review of terrorism and threat assessment literature to glean expert consensus regarding terrorist interest in targeting chemical facilities; (2) the preparation of case studies to help identify internal group factors and contextual influences that have played a significant role in leading some terrorist groups to attack chemical facilities; (3) an examination of data from the Critical Infrastructure Terrorist Incident Catalog (CrITIC) to further illuminate the nature of terrorist attacks against chemical facilities to date; and (4) the refinement of the DECIDe--the Determinants Effecting Critical Infrastructure Decisions--analytical framework to make the factors and dynamics identified by the study more ''usable'' in future efforts to assess terrorist intentions to target chemical-related infrastructure.« less

Critical Appraisal Toolkit (CAT) for assessing multiple types of evidence

PubMed Central

Moralejo, D; Ogunremi, T; Dunn, K

2017-01-01

Healthcare professionals are often expected to critically appraise research evidence in order to make recommendations for practice and policy development. Here we describe the Critical Appraisal Toolkit (CAT) currently used by the Public Health Agency of Canada. The CAT consists of: algorithms to identify the type of study design, three separate tools (for appraisal of analytic studies, descriptive studies and literature reviews), additional tools to support the appraisal process, and guidance for summarizing evidence and drawing conclusions about a body of evidence. Although the toolkit was created to assist in the development of national guidelines related to infection prevention and control, clinicians, policy makers and students can use it to guide appraisal of any health-related quantitative research. Participants in a pilot test completed a total of 101 critical appraisals and found that the CAT was user-friendly and helpful in the process of critical appraisal. Feedback from participants of the pilot test of the CAT informed further revisions prior to its release. The CAT adds to the arsenal of available tools and can be especially useful when the best available evidence comes from non-clinical trials and/or studies with weak designs, where other tools may not be easily applied. PMID:29770086

Conflict management styles among Iranian critical care nursing staff: a cross-sectional study.

PubMed

Ahanchian, Mohammad Reza; Emami Zeydi, Amir; Armat, Mohammad Reza

2015-01-01

Conflict among nurses has been recognized as an extremely important issue within health care settings throughout the world. Identifying the conflict management style would be a key strategy for conflict management. The aim of this study was to evaluate the prevalence of conflict management styles and its related factors among Iranian critical care nursing staff. In a descriptive cross-sectional study, a total of 149 critical care nurses who worked in the critical care units of 4 teaching hospitals in Sari (Iran) were evaluated. A 2-part self-reported questionnaire including personal information and Rahim Organizational Conflict Inventory II was used for data collection. Although Iranian critical care nurses used all 5 conflict management styles to manage conflict with their peers, the collaborating style was the most prevalent conflict management style used by them, followed by compromising, accommodating, avoiding, and competing. Male gender was a predictor for both compromising and competing styles, whereas position and shift time were significant predictors for compromising and competing styles, respectively. Based on the results of this study, nurse managers need to take these factors into account in designing programs to help nurses constructively manage unavoidable conflicts in health care setting.

Critical thinking of student nurses during clinical accompaniment.

PubMed

Uys, B Y; Meyer, S M

2005-08-01

The purpose of this study was to investigate the methods of clinical accompaniment used by clinical facilitators in practice. The findings of the study also reflected facilitators' perceptions regarding critical thinking and the facilitation thereof. A quantitative research design was used. A literature study was conducted to identify the methods of accompaniment that facilitate critical thinking. Data was collected by means of a questionnaire developed for that purpose. Making a content-related validity judgment, and involving seven clinical facilitators in an academic institution, ensured the validity of the questionnaire. The results of the study indicated that various clinical methods of accompaniment were used. To a large extent, these methods correlated with those discussed in the literature review. The researcher further concluded that the concepts 'critical thinking' and 'facilitation' were not interpreted correctly by the respondents, and would therefore not be implemented in a proper manner in nursing practice. Furthermore, it seemed evident that tutor-driven learning realised more often than student-driven learning. In this regard, the requirement of outcomes-based education was not satisfied. The researcher is therefore of the opinion that a practical programme for the development of critical thinking skills during clinical accompaniment must be developed within the framework of outcomes-based education.

A pilot study of research utilization practices and critical thinking dispositions of Alberta dental hygienists.

PubMed

Cobban, S J; Profetto-McGrath, J

2008-08-01

In order to test interventions for increasing uptake of research findings into dental hygiene practice, we must first identify factors that influence research use. There has been little work on this topic in dental hygiene, but much in other disciplines that can provide exemplars of how others have approached the study of this phenomenon. A pilot study was conducted to determine if protocols used to study research utilization (RU) behaviours and critical thinking dispositions (CTD) in nursing could also be applied to dental hygiene. A cross-sectional survey design was used with a random sample of 640 practicing dental hygienists in Alberta, Canada. Three questionnaires were included: one to capture measures of RU including direct, indirect and symbolic RU; the California Critical Thinking Dispositions Inventory (CCTDI) and a demographics questionnaire. Mean responses for the three types of RU were highest for indirect at 3.52 (SD 0.720), followed by direct at 3.13 (SD 0.903) and symbolic 2.86 (SD 0.959). The majority (74.8%) scored between 280 and 350 on the CCTDI (maximum 420). Cronbach's alpha reliability for the RU measures and four of the seven sub-scales were over .7, indicating internal consistency reliability. The instruments proved reliable for this population, but other challenges, including a low response rate, were identified during the process of using the RU questionnaire in the context of dental hygiene practice. Pilot testing identified the need for improvements to the presentation of scales to reduce cognitive load and improve the response rate.

Critical success factors for competitiveness of construction companies: A critical review

NASA Astrophysics Data System (ADS)

Hanafi, Abdul Ghafur; Nawi, Mohd Nasrun Mohd

2016-08-01

Making progress basically, a fundamental issue for the construction companies to get by in a highly competitive industry. From time to time, industry players are facing stiff and tough competition due to large number of players, whether existing or new players involved from various background and track record. Furthermore, the large numbers of component deciding the competitiveness of contractors, whose organization structures and governance have turned out to be more muddled. Different construction companies have their own unique criteria which may differ from one to another. The enormous amount of issues needs to bring down to manageable numbers so that measures can be identified and scrutinized to enhance competitiveness. This paper discusses the result from the critical investigation from past studies in the Asian countries, namely China, India, Thailand, Singapore and Malaysia. Several fundamental factors have been identified as CSFs in construction companies in respective country. Also highlighted a critical survey based upon various literatures written on this subject where critical success factors (CSFs) as a yardstick to gauge the relationship among CSFs in various construction companies in the Asian region. Far reaching estimation of an organization's performance and resulting input to its supervision is crucial for business change. Estimation additionally empowers organizations to be contrasted from one another on the premise of institutionalized data, permitting best practices to be distinguished and connected more widely. Different countries have their own set of critical success factors (CSFs) which may differ in term of priority and at the same time share common elements of success factor in accomplishment as a construction companies. The study, which is exploratory in nature, embraced the content investigation and inductive technique to accomplish its objectives.

Swallowing and deep brain stimulation in Parkinson's disease: a systematic review.

PubMed

Troche, Michelle S; Brandimore, Alexandra E; Foote, Kelly D; Okun, Michael S

2013-09-01

The purpose of this review is to assess the current state of the literature on the topic of deep brain stimulation (DBS) and its effects on swallowing function in Parkinson's disease (PD). Pubmed, Cochrane review, and web of science searches were completed on all articles addressing DBS that contained a swallowing outcome measure. Outcome measures included the penetration/aspiration scale, pharyngeal transit time, oropharyngeal residue, drooling, aspiration pneumonia, death, hyolaryngeal excursion, epiglottic inversion, UPDRS scores, and presence of coughing/throat clearing during meals. The search identified 13 studies specifically addressing the effects of DBS on swallowing. Critical assessment of the 13 identified peer-reviewed publications revealed nine studies employing an experimental design, (e.g. "on" vs. "off", pre- vs. post-DBS) and four case reports. None of the nine experimental studies were found to identify clinically significant improvement or decline in swallowing function with DBS. Despite these findings, several common threads were identified across experimental studies and will be examined in this review. Additionally, available data demonstrate that, although subthalamic nucleus (STN) stimulation has been considered to cause more impairment to swallowing function than globus pallidus internus (GPi) stimulation, there are no experimental studies directly comparing swallowing function in STN vs. GPi. Moreover, there has been no comparison of unilateral vs. bilateral DBS surgery and the coincident effects on swallowing function. This review includes a critical analysis of all experimental studies and discusses methodological issues that should be addressed in future studies. Copyright © 2013 Elsevier Ltd. All rights reserved.

Swallowing and deep brain stimulation in Parkinson’s disease: A systematic review

PubMed Central

Troche, Michelle S.; Brandimore, Alexandra E.; Foote, Kelly D.; Okun, Michael S.

2013-01-01

The purpose of this review is to assess the current state of the literature on the topic of deep brain stimulation (DBS) and its effects on swallowing function in Parkinson’s disease (PD). Pubmed, Cochrane review, and web of science searches were completed on all articles addressing DBS that contained a swallowing outcome measure. Outcome measures included the penetration/aspiration scale, pharyngeal transit time, oropharyngeal residue, drooling, aspiration pneumonia, death, hyolaryngeal excursion, epiglottic inversion, UPDRS scores, and presence of coughing/throat clearing during meals. The search identified 13 studies specifically addressing the effects of DBS on swallowing. Critical assessment of the 13 identified peer-reviewed publications revealed nine studies employing an experimental design, (e.g. “on” vs. “off”, pre- vs. post-DBS) and four case reports. None of the nine experimental studies were found to identify clinically significant improvement or decline in swallowing function with DBS. Despite these findings, several common threads were identified across experimental studies and will be examined in this review. Additionally, available data demonstrate that, although subthalamic nucleus (STN) stimulation has been considered to cause more impairment to swallowing function than globus pallidus internus (GPi) stimulation, there are no experimental studies directly comparing swallowing function in STN vs. GPi. Moreover, there has been no comparison of unilateral vs. bilateral DBS surgery and the coincident effects on swallowing function. This review includes a critical analysis of all experimental studies and discusses methodological issues that should be addressed in future studies. PMID:23726461

Consistency Study About Critical Thinking Skill of PGSD Students (Teacher Candidate of Elementary School) on Energy Material

NASA Astrophysics Data System (ADS)

Wijayanti, M. D.; Raharjo, S. B.; Saputro, S.; Mulyani, S.

2017-09-01

This study aims to examine the consistency of critical thinking ability of PGSD students in Energy material. The study population is PGSD students in UNS Surakarta. Samples are using cluster random sampling technique obtained by 101 students. Consistency of student’s response in knowing the critical thinking ability of PGSD students can be used as a benchmark of PGSD students’ understanding to see the equivalence of IPA problem, especially in energy material presented with various phenomena. This research uses descriptive method. Data are obtained through questionnaires and interviews. The research results that the average level of critical thinking in this study is divided into 3 levels, i.e.: level 1 (54.85%), level 2 (19.93%), and level 3 (25.23%). The data of the research result affect to the weak of students’ Energy materials’ understanding. In addition, indicators identify that assumptions and arguments analysis are also still low. Ideally, the consistency of critical thinking ability as a whole has an impact on the expansion of students’ conceptual understanding. The results of the study may become a reference to improve the subsequent research in order to obtain positive changes in the ability of critical thinking of students who directly improve the concept of students’ better understanding, especially in energy materials at various real problems occured.

Mortuary operations following mass fatality natural disasters: a review.

PubMed

Anderson, Madelyn; Leditschke, Jodie; Bassed, Richard; Cordner, Stephen M; Drummer, Olaf H

2017-03-01

This is a critical review to discuss the best practice approaches to mortuary operations in preparation for and the response to natural, mass fatality, disaster events, as identified by a review of published articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) Statement guided the identification of potential articles to use in this critical review. Subsequent searches were also conducted to identify articles relating to heat wave, and flood mortality. All identified peer-reviewed studies published in English which discussed the preparation and response of mortuaries to mass fatality natural disasters occurring in developed countries were included. Using the PRISMA-P method of identifying articles, 18 articles were selected for inclusion in this review. Although there are numerous articles which describe the mortuary response to mass fatality incidents, few articles analyzed the response, or discussed the roles which supported and enabled the organization to undertake the task of identifying disaster victims. It is thus difficult to determine objectively if the actions and activities outlined in the articles represent best-practice.

Microbe-ID: An open source toolbox for microbial genotyping and species identification

USDA-ARS?s Scientific Manuscript database

Development of tools to identify species, genotypes, or novel strains of invasive organisms is critical for monitoring emergence and implementing rapid response measures. Molecular markers, although critical to identifying species or genotypes, require bioinformatic tools for analysis. However, user...

The Parent Perspective: “Being a Good Parent” When Making Critical Decisions in the PICU

PubMed Central

October, Tessie W.; Fisher, Kiondra R.; Feudtner, Chris; Hinds, Pamela S.

2015-01-01

Objective To identify factors important to parents making decisions for their critically ill child. Design Prospective cross-sectional study. Setting Single center, tertiary care PICU. Subjects Parents making critical treatment decisions for their child. Intervention One-on-one interviews that used the Good Parent Tool-2 open-ended question that asks parents to describe factors important for parenting their ill child and how clinicians could help them achieve their definition of “being a good parent” to their child. Parent responses were analyzed thematically. Parents also ranked themes in order of importance to them using the Good Parent Ranking Exercise. Measurement and Main Results Of 53 eligible parents, 43 (81%) participated. We identified nine themes through content analysis of the parent’s narrative statements from the Good Parent Tool. Most commonly (60% of quotes) components of being a good parent described by parents included focusing on their child’s quality of life, advocating for their child with the medical team, and putting their child’s needs above their own. Themes key to parental decision making were similar regardless of parent race and socioeconomic status or child’s clinical status. We identified nine clinician strategies identified by parents as helping them fulfill their parenting role, most commonly, parents wanted to be kept informed (32% of quotes). Using the Good Parent Ranking Exercise, fathers ranked making informed medical decisions as most important, whereas mothers ranked focusing on the child’s health and putting their child’s needs above their own as most important. However, mothers who were not part of a couple ranked making informed medical decisions as most important. Conclusion These findings suggest a range of themes important for parents to “be a good parent” to their child while making critical decisions. Further studies need to explore whether clinician’s knowledge of the parent’s most valued factor can improve family-centered care. PMID:24583502

Development of a Premium Quality Plasma-derived IVIg (IQYMUNE®) Utilizing the Principles of Quality by Design-A Worked-through Case Study.

PubMed

Paolantonacci, Philippe; Appourchaux, Philippe; Claudel, Béatrice; Ollivier, Monique; Dennett, Richard; Siret, Laurent

2018-01-01

Polyvalent human normal immunoglobulins for intravenous use (IVIg), indicated for rare and often severe diseases, are complex plasma-derived protein preparations. A quality by design approach has been used to develop the Laboratoire Français du Fractionnement et des Biotechnologies new-generation IVIg, targeting a high level of purity to generate an enhanced safety profile while maintaining a high level of efficacy. A modular approach of quality by design was implemented consisting of five consecutive steps to cover all the stages from the product design to the final product control strategy.A well-defined target product profile was translated into 27 product quality attributes that formed the basis of the process design. In parallel, a product risk analysis was conducted and identified 19 critical quality attributes among the product quality attributes. Process risk analysis was carried out to establish the links between process parameters and critical quality attributes. Twelve critical steps were identified, and for each of these steps a risk mitigation plan was established.Among the different process risk mitigation exercises, five process robustness studies were conducted at qualified small scale with a design of experiment approach. For each process step, critical process parameters were identified and, for each critical process parameter, proven acceptable ranges were established. The quality risk management and risk mitigation outputs, including verification of proven acceptable ranges, were used to design the process verification exercise at industrial scale.Finally, the control strategy was established using a mix, or hybrid, of the traditional approach plus elements of the quality by design enhanced approach, as illustrated, to more robustly assign material and process controls and in order to securely meet product specifications.The advantages of this quality by design approach were improved process knowledge for industrial design and process validation and a clear justification of the process and product specifications as a basis for control strategy and future comparability exercises. © PDA, Inc. 2018.

Interprofessional Care and Teamwork in the ICU.

PubMed

Donovan, Anne L; Aldrich, J Matthew; Gross, A Kendall; Barchas, Denise M; Thornton, Kevin C; Schell-Chaple, Hildy M; Gropper, Michael A; Lipshutz, Angela K M

2018-06-01

We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives. Additional articles were identified through a review of the reference lists of identified articles. Original articles, review articles, and systematic reviews were considered. Manuscripts were selected for inclusion based on expert opinion of well-designed or key studies and review articles. "Interprofessional care" refers to care provided by a team of healthcare professionals with overlapping expertise and an appreciation for the unique contribution of other team members as partners in achieving a common goal. A robust body of data supports improvement in patient-level outcomes when care is provided by an interprofessional team. Critical care nurses, advanced practice providers, pharmacists, respiratory care practitioners, rehabilitation specialists, dieticians, social workers, case managers, spiritual care providers, intensivists, and nonintensivist physicians each provide unique expertise and perspectives to patient care, and therefore play an important role in a team that must address the diverse needs of patients and families in the ICU. Engaging patients and families as partners in their healthcare is also critical. Many important ICU quality improvement initiatives require an interprofessional approach, including Awakening and Breathing Coordination, Delirium, Early Exercise/Mobility, and Family Empowerment bundle implementation, interprofessional rounding practices, unit-based quality improvement initiatives, Patient and Family Advisory Councils, end-of-life care, coordinated sedation awakening and spontaneous breathing trials, intrahospital transport, and transitions of care. A robust body of evidence supports an interprofessional approach as a key component in the provision of high-quality critical care to patients of increasing complexity and with increasingly diverse needs.

Identifying Gifted Students in Puerto Rico: Validation of a Spanish Translation of the Gifted Rating Scales

ERIC Educational Resources Information Center

Rosado, Javier I.; Pfeiffer, Steven; Petscher, Yaacov

2015-01-01

The challenge of correctly identifying gifted students is a critical issue. Gifted education in Puerto Rico is marked by insufficient support and a lack of appropriate identification methods. This study examined the reliability and validity of a Spanish translation of the "Gifted Rating Scales-School Form" (GRS) with a sample of 618…

In Search of Signature Pedagogies for Teacher Education: The Critical Case of Kodaly-Inspired Music Teacher Education

ERIC Educational Resources Information Center

Baumann, Paul Joseph

2010-01-01

The purposes of this study are to identify the features of Kodaly-inspired music teacher education programs that either confirm or refute the notion that signature pedagogies (Shulman, 2005 a, b, c) are present in this form of teacher education and to identify whether and how philosophical, pedagogical, and institutional influences support such…

Barriers and Facilitators to Smoking Cessation Among People With Severe Mental Illness: A Critical Appraisal of Qualitative Studies.

PubMed

Trainor, Katie; Leavey, Gerard

2017-01-01

People with severe mental illness (PWSMI) die 15-20 years earlier than people in the general population and this is often due to preventable smoking-related health conditions. Studies that identify barriers and facilitators to smoking cessation are crucial for policy makers and health care professionals. This appraisal aims to identify and critically appraise qualitative studies which explore smoking experiences and barriers to smoking cessation among PWSMI. Articles were retrieved from electronic health related databases including Web of Science, Scopus, PubMed, Sage, Biomed, Medline, Embase, and electronic hand searches of bibliographies from key articles. Eleven papers were identified. Although the overall quality of studies were sufficient, most had limited information relating to trustworthiness and sociodemographic details. Cost savings and health benefits were frequently cited as facilitators to quitting, however may be of limited impact as smoking for existential purposes, social inclusion, and mental health management appear to be considered highly important among PWSMI. Findings were restricted to predominantly individual barriers to smoking cessation which may be more resistant to change as service users rely on smoking to manage their mental health and smoking is embedded in the culture of mental health settings. This critical appraisal identifies qualitative evidence regarding which factors facilitate or prevent individuals with severe mental illness from engaging with smoking cessation. Healthcare professionals and policy makers should address external barriers to quitting smoking as this may increase participation in intervention studies, inform policy and assist in the development of a feasible and acceptable smoking cessation intervention among PWSMI. Methodological considerations highlight that future research should include sociodemographic and contextual factors to improve utility and applicability of findings. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Seeking out SARI: an automated search of electronic health records.

PubMed

O'Horo, John C; Dziadzko, Mikhail; Sakusic, Amra; Ali, Rashid; Sohail, M Rizwan; Kor, Daryl J; Gajic, Ognjen

2018-06-01

The definition of severe acute respiratory infection (SARI) - a respiratory illness with fever and cough, occurring within the past 10 days and requiring hospital admission - has not been evaluated for critically ill patients. Using integrated electronic health records data, we developed an automated search algorithm to identify SARI cases in a large cohort of critical care patients and evaluate patient outcomes. We conducted a retrospective cohort study of all admissions to a medical intensive care unit from August 2009 through March 2016. Subsets were randomly selected for deriving and validating a search algorithm, which was compared with temporal trends in laboratory-confirmed influenza to ensure that SARI was correlated with influenza. The algorithm was applied to the cohort to identify clinical differences for patients with and without SARI. For identifying SARI, the algorithm (sensitivity, 86.9%; specificity, 95.6%) outperformed billing-based searching (sensitivity, 73.8%; specificity, 78.8%). Automated searching correlated with peaks in laboratory-confirmed influenza. Adjusted for severity of illness, SARI was associated with more hospital, intensive care unit and ventilator days but not with death or dismissal to home. The search algorithm accurately identified SARI for epidemiologic study and surveillance.

Strategic Management of Educational Technology--The Importance of Leadership and Management

ERIC Educational Resources Information Center

Moser, Franziska Zellweger

2007-01-01

Through case study research critical leadership and management tasks are identified regarding the integration of educational technology in teaching at research universities. The institutions studied, regardless their different characteristics and approaches, face common difficulties in engaging "second-wave" faculty. Furthermore, the coordination…

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

PubMed

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

2015-12-01

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

Patient perceptions of helpful communication in the context of advanced cancer.

PubMed

Stajduhar, Kelli I; Thorne, Sally E; McGuinness, Liza; Kim-Sing, Charmaine

2010-07-01

Based on a secondary analysis of data from a large qualitative study on cancer care communication, we address the question: what do patients with advanced cancer identify as helpful in their communication encounters with health care providers? Communication is of critical importance to the care of patients with advanced cancer. A better understanding of what such patients identify as helpful in their communication encounters with nurses and other health care providers seems critical to creating evidence-informed recommendations for best practices. Secondary analysis of qualitative interview data. Data from 18 participants interviewed individually and 16 focus group participants, with advanced cancer in the palliative phase of care. Interpretive description methodology informed data collection and analysis. Findings suggest four key elements are critically important to consider in communications with patients in an advanced or palliative phase - respecting the importance of time, demonstrating caring, acknowledging fear and balancing hope and honesty in the provision of information. Communication is an important element in the provision of advanced cancer care. Findings emphasise the complex meanings inherent in cancer care communication and identify central themes that are fundamental to effective cancer care communication. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Systematic review: factors contributing to burnout in dentistry.

PubMed

Singh, P; Aulak, D S; Mangat, S S; Aulak, M S

2016-01-01

Dentists and dental students have been reported to be at high risk of burnout and risk factors have been identified. Despite research into burnout in dentists, only a few papers have identified significantly associated factors. To identify the most significant factors associated with burnout in dentists and dental students in published literature. We systematically searched MEDLINE, EMBASE and HMIC electronic databases to source literature on the factors associated with burnout in dentists. We critically appraised and themed papers using the Critical Appraisal Skills Programme to find the most significant factors. From 115 studies identified by the search string, we deemed 33 papers to be relevant for review. The most prevalent and significant factors associated with burnout were: younger age, male gender, student status, high job-strain/working hours, those enrolled in clinical degree programmes and certain personality types. However, only a limited amount of literature explored the directional relationship between these factors and burnout. This review identified several significant factors contributing to burnout in dentists and dental students. Further longitudinal and prospective studies are required to assess causation. Burnout should be considered a multifactorial phenomenon that can develop early in a dental career. Screening programmes and coping strategies might help to identify and prevent it. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Characterization and source identification of pollutants in runoff from a mixed land use watershed using ordination analyses.

PubMed

Lee, Dong Hoon; Kim, Jin Hwi; Mendoza, Joseph A; Lee, Chang Hee; Kang, Joo-Hyon

2016-05-01

While identification of critical pollutant sources is the key initial step for cost-effective runoff management, it is challenging due to the highly uncertain nature of runoff pollution, especially during a storm event. To identify critical sources and their quantitative contributions to runoff pollution (especially focusing on phosphorous), two ordination methods were used in this study: principal component analysis (PCA) and positive matrix factorization (PMF). For the ordination analyses, we used runoff quality data for 14 storm events, including data for phosphorus, 11 heavy metal species, and eight ionic species measured at the outlets of subcatchments with different land use compositions in a mixed land use watershed. Five factors as sources of runoff pollutants were identified by PCA: agrochemicals, groundwater, native soils, domestic sewage, and urban sources (building materials and automotive activities). PMF identified similar factors to those identified by PCA, with more detailed source mechanisms for groundwater (i.e., nitrate leaching and cation exchange) and urban sources (vehicle components/motor oils/building materials and vehicle exhausts), confirming the sources identified by PCA. PMF was further used to quantify contributions of the identified sources to the water quality. Based on the results, agrochemicals and automotive activities were the two dominant and ubiquitous phosphorus sources (39-61 and 16-47 %, respectively) in the study area, regardless of land use types.

A risk assessment methodology for critical transportation infrastructure.

DOT National Transportation Integrated Search

2002-01-01

Infrastructure protection typifies a problem of risk assessment and management in a large-scale system. This study offers a methodological framework to identify, prioritize, assess, and manage risks. It includes the following major considerations: (1...

Novel Yeast-based Strategy Unveils Antagonist Binding Regions on the Nuclear Xenobiotic Receptor PXR*

PubMed Central

Li, Hao; Redinbo, Matthew R.; Venkatesh, Madhukumar; Ekins, Sean; Chaudhry, Anik; Bloch, Nicolin; Negassa, Abdissa; Mukherjee, Paromita; Kalpana, Ganjam; Mani, Sridhar

2013-01-01

The pregnane X receptor (PXR) is a master regulator of xenobiotic metabolism, and its activity is critical toward understanding the pathophysiology of several diseases, including inflammation, cancer, and steatosis. Previous studies have demonstrated that ketoconazole binds to ligand-activated PXR and antagonizes receptor control of gene expression. Structure-function as well as computational docking analysis suggested a putative binding region containing critical charge clamp residues Gln-272, and Phe-264 on the AF-2 surface of PXR. To define the antagonist binding surface(s) of PXR, we developed a novel assay to identify key amino acid residues on PXR based on a yeast two-hybrid screen that examined mutant forms of PXR. This screen identified multiple “gain-of-function” mutants that were “resistant” to the PXR antagonist effects of ketoconazole. We then compared our screen results identifying key PXR residues to those predicted by computational methods. Of 15 potential or putative binding residues based on docking, we identified three residues in the yeast screen that were then systematically verified to functionally interact with ketoconazole using mammalian assays. Among the residues confirmed by our study was Ser-208, which is on the opposite side of the protein from the AF-2 region critical for receptor regulation. The identification of new locations for antagonist binding on the surface or buried in PXR indicates novel aspects to the mechanism of receptor antagonism. These results significantly expand our understanding of antagonist binding sites on the surface of PXR and suggest new avenues to regulate this receptor for clinical applications. PMID:23525103

Encoding context and false recognition memories.

PubMed

Bruce, Darryl; Phillips-Grant, Kimberly; Conrad, Nicole; Bona, Susan

2004-09-01

False recognition of an extralist word that is thematically related to all words of a study list may reflect internal activation of the theme word during encoding followed by impaired source monitoring at retrieval, that is, difficulty in determining whether the word had actually been experienced or merely thought of. To assist source monitoring, distinctive visual or verbal contexts were added to study words at input. Both types of context produced similar effects: False alarms to theme-word (critical) lures were reduced; remember judgements of critical lures called old were lower; and if contextual information had been added to lists, subjects indicated as much for list items and associated critical foils identified as old. The visual and verbal contexts used in the present studies were held to disrupt semantic categorisation of list words at input and to facilitate source monitoring at output.

Ferromagnetic quantum criticality: New aspects from the phase diagram of LaCrGe3

NASA Astrophysics Data System (ADS)

Taufour, Valentin; Kaluarachchi, Udhara S.; Bud'ko, Sergey L.; Canfield, Paul C.

2018-05-01

Recent theoretical and experimental studies have shown that ferromagnetic quantum criticality is always avoided in clean systems. Two possibilities have been identified. In the first scenario, the ferromagnetic transition becomes of the first order at a tricritical point before being suppressed. A wing structure phase diagram is observed indicating the possibility of a new type of quantum critical point under magnetic field. In a second scenario, a transition to a modulated magnetic phase occurs. Our recent studies on the compound LaCrGe3 illustrate a third scenario where not only a new magnetic phase occurs, but also a change of order of the transition at a tricritical point leading to a wing-structure phase diagram. Careful experimental study of the phase diagram near the tricritical point also illustrates new rules near this type of point.

Critical Thresholds in Earth-System Dynamics

NASA Astrophysics Data System (ADS)

Rothman, D.

2017-12-01

The history of the Earth system is a story of change. Some changesare gradual and benign, but others, especially those associated withcatastrophic mass extinction, are relatively abrupt and destructive.What sets one group apart from the other? Here I hypothesize thatperturbations of Earth's carbon cycle lead to mass extinction if theyexceed either a critical rate at long time scales or a critical sizeat short time scales. By analyzing 31 carbon-isotopic events duringthe last 542 million years, I identify the critical rate with a limitimposed by mass conservation. Further analysis identifies thecrossover timescale separating fast from slow events with thetimescale of the ocean's homeostatic response to a change in pH. Theproduct of the critical rate and the crossover timescale then yieldsthe critical size. The modern critical size for the marine carboncycle is roughly similar to the mass of carbon that human activitieswill likely have added to the oceans by the year 2100.

Nursing students' critical thinking disposition according to academic level and satisfaction with nursing.

PubMed

Kim, Dong Hee; Moon, Seongmi; Kim, Eun Jung; Kim, Young-Ju; Lee, Sunhee

2014-01-01

The development of critical thinking dispositions has become an important issue in nursing education in Korea. Nursing colleges in Korea have developed teaching strategies and curricula that focus on developing critical thinking dispositions. It is an imperative step that evaluates the changing pattern and development of students' critical thinking dispositions. This study identified critical thinking dispositions of Korean nursing students according to academic level and satisfaction with nursing. A cross-sectional questionnaire survey was conducted among 1074 students in four colleges who completed the self-reported Critical Thinking Disposition Scale. Descriptive and univariate general linear model analyses were performed. The critical thinking disposition score increased according to academic level until junior year, after which it decreased in the senior year. Nursing students who were satisfied with nursing reported higher levels of critical thinking than those who were not satisfied or who responded neutrally. The critical thinking scores of nursing students not satisfied with nursing dropped greatly in the senior year. These results suggest the importance of targeting the development of curriculum and teaching methods for seniors and students who have a lower level of satisfaction with nursing to increase their critical thinking dispositions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Teaching Critical Thinking by Examining Assumptions

ERIC Educational Resources Information Center

Yanchar, Stephen C.; Slife, Brent D.

2004-01-01

We describe how instructors can integrate the critical thinking skill of examining theoretical assumptions (e.g., determinism and materialism) and implications into psychology courses. In this instructional approach, students formulate questions that help them identify assumptions and implications, use those questions to identify and examine the…

SCREEN: A simple layperson administered screening algorithm in low resource international settings significantly reduces waiting time for critically ill children in primary healthcare clinics.

PubMed

Hansoti, Bhakti; Jenson, Alexander; Kironji, Antony G; Katz, Joanne; Levin, Scott; Rothman, Richard; Kelen, Gabor D; Wallis, Lee A

2017-01-01

In low resource settings, an inadequate number of trained healthcare workers and high volumes of children presenting to Primary Healthcare Centers (PHC) result in prolonged waiting times and significant delays in identifying and evaluating critically ill children. The Sick Children Require Emergency Evaluation Now (SCREEN) program, a simple six-question screening algorithm administered by lay healthcare workers, was developed in 2014 to rapidly identify critically ill children and to expedite their care at the point of entry into a clinic. We sought to determine the impact of SCREEN on waiting times for critically ill children post real world implementation in Cape Town, South Africa. This is a prospective, observational implementation-effectiveness hybrid study that sought to determine: (1) the impact of SCREEN implementation on waiting times as a primary outcome measure, and (2) the effectiveness of the SCREEN tool in accurately identifying critically ill children when utilised by the QM and adherence by the QM to the SCREEN algorithm as secondary outcome measures. The study was conducted in two phases, Phase I control (pre-SCREEN implementation- three months in 2014) and Phase II (post-SCREEN implementation-two distinct three month periods in 2016). In Phase I, 1600 (92.38%) of 1732 children presenting to 4 clinics, had sufficient data for analysis and comprised the control sample. In Phase II, all 3383 of the children presenting to the 26 clinics during the sampling time frame had sufficient data for analysis. The proportion of critically ill children who saw a professional nurse within 10 minutes increased tenfold from 6.4% to 64% (Phase I to Phase II) with the median time to seeing a professional nurse reduced from 100.3 minutes to 4.9 minutes, (p < .001, respectively). Overall layperson screening compared to Integrated Management of Childhood Illnesses (IMCI) designation by a nurse had a sensitivity of 94.2% and a specificity of 88.1%, despite large variance in adherence to the SCREEN algorithm across clinics. The SCREEN program when implemented in a real-world setting can significantly reduce waiting times for critically ill children in PHCs, however further work is required to improve the implementation of this innovative program.

Critical care ultrasound training: a survey of US fellowship directors.

PubMed

Mosier, Jarrod M; Malo, Josh; Stolz, Lori A; Bloom, John W; Reyes, Nathaniel A; Snyder, Linda S; Adhikari, Srikar

2014-08-01

The purpose of this study is to describe the current state of bedside ultrasound use and training among critical care (CC) training programs in the United States. This was a cross-sectional survey of all program directors for Accreditation Council for Graduate Medical Education accredited programs during the 2012 to 2013 academic year in CC medicine, surgical CC, pulmonary and critical care, and anesthesia CC. Availability, current use, and barriers to training in CC ultrasound were assessed. Sixty of 195 (31%; 95% confidence interval [CI], 24%-38%) program directors responded. Most of the responding programs had an ultrasound system available for use (54/60, 90%; 95% CI, 79%-96%) and identified ultrasound training as useful (59/60, 98%; 95% CI, 91%-100%) but lacked a formal curriculum (25/60, 42%; 95% CI, 29%-55%) or trained faculty (mean percentage of faculty trained in ultrasound: pulmonary and critical care, 25%; surgical CC, 33%; anesthesia CC, 20%; CC medicine, 7%), and relied on informal teaching (45/60, 77%; 95% CI, 62%-85%). Faculty with expertise (53/60, 88%; 95% CI, 77%-95%), simulation training (60/60, 100%; 95% CI, 94%-100%), establishing and meeting required number of examinations (47/60, 78%; 95% CI, 66%-88%), and regular review sessions (49/60, 82%; 95% CI, 70%-90%) were identified as necessary to improve ultrasound training. Most responding programs (32/35 91%; 95% CI, 77%-98%) without a formal curriculum plan to create one in the next 5 years. This study identified deficiencies in current training, suggesting a need for a formal curriculum for bedside ultrasound training in CC fellowship programs. Copyright © 2014 Elsevier Inc. All rights reserved.

A study of the development of critical thinking skills using an innovative web 2.0 tool.

PubMed

Eales-Reynolds, Lesley-Jane; Gillham, David; Grech, Carol; Clarke, Colin; Cornell, Jacqueline

2012-10-01

Healthcare educators face numerous challenges including technological change, information overload, and the need to maintain clinical expertise and research knowledge across multiple specialities. Students also need to develop their capacity for critical thinking, using and discriminating between diverse sources of knowledge in order to advance their own practice. To investigate student perceptions of the affordances of a novel web 2.0-based tool--the Web Resource Appraisal Process (WRAP), designed to support the development of critical thinking skills, and to identify how student's understanding of critical thinking and their use of web 2.0 resources might inform the cross-disciplinary development of the WRAP. A two phase, action research study of student perceptions of the WRAP and their ability to source and identify valid information sources. Implemented at the University of South Australia, development of the WRAP is an international project with the University of Westminster, UK. Students from international locations participated in the project. A mixed methods approach was adopted involving a two phase action research study. In phase one, student perceptions of the WRAP were obtained using a modified course feedback questionnaire. This informed the development of a subsequent questionnaire used to survey student perceptions of their usage of online resources, the ease of access of such resources and their approaches to determining their validity. Results suggest that students mainly use traditional resources when preparing work for assessment and they either do not understand the concept of, or do not exercise, critical thinking skills in such activities. However, the feedback from students using the WRAP, demonstrated that they found it instructive and useful. To ensure that practice developments are based on authoritative evidence, students need to develop critical thinking skills which may be facilitated by tools such as the WRAP. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

A quantitative metric to identify critical elements within seafood supply networks.

PubMed

Plagányi, Éva E; van Putten, Ingrid; Thébaud, Olivier; Hobday, Alistair J; Innes, James; Lim-Camacho, Lilly; Norman-López, Ana; Bustamante, Rodrigo H; Farmery, Anna; Fleming, Aysha; Frusher, Stewart; Green, Bridget; Hoshino, Eriko; Jennings, Sarah; Pecl, Gretta; Pascoe, Sean; Schrobback, Peggy; Thomas, Linda

2014-01-01

A theoretical basis is required for comparing key features and critical elements in wild fisheries and aquaculture supply chains under a changing climate. Here we develop a new quantitative metric that is analogous to indices used to analyse food-webs and identify key species. The Supply Chain Index (SCI) identifies critical elements as those elements with large throughput rates, as well as greater connectivity. The sum of the scores for a supply chain provides a single metric that roughly captures both the resilience and connectedness of a supply chain. Standardised scores can facilitate cross-comparisons both under current conditions as well as under a changing climate. Identification of key elements along the supply chain may assist in informing adaptation strategies to reduce anticipated future risks posed by climate change. The SCI also provides information on the relative stability of different supply chains based on whether there is a fairly even spread in the individual scores of the top few key elements, compared with a more critical dependence on a few key individual supply chain elements. We use as a case study the Australian southern rock lobster Jasus edwardsii fishery, which is challenged by a number of climate change drivers such as impacts on recruitment and growth due to changes in large-scale and local oceanographic features. The SCI identifies airports, processors and Chinese consumers as the key elements in the lobster supply chain that merit attention to enhance stability and potentially enable growth. We also apply the index to an additional four real-world Australian commercial fishery and two aquaculture industry supply chains to highlight the utility of a systematic method for describing supply chains. Overall, our simple methodological approach to empirically-based supply chain research provides an objective method for comparing the resilience of supply chains and highlighting components that may be critical.

A Quantitative Metric to Identify Critical Elements within Seafood Supply Networks

PubMed Central

Plagányi, Éva E.; van Putten, Ingrid; Thébaud, Olivier; Hobday, Alistair J.; Innes, James; Lim-Camacho, Lilly; Norman-López, Ana; Bustamante, Rodrigo H.; Farmery, Anna; Fleming, Aysha; Frusher, Stewart; Green, Bridget; Hoshino, Eriko; Jennings, Sarah; Pecl, Gretta; Pascoe, Sean; Schrobback, Peggy; Thomas, Linda

2014-01-01

A theoretical basis is required for comparing key features and critical elements in wild fisheries and aquaculture supply chains under a changing climate. Here we develop a new quantitative metric that is analogous to indices used to analyse food-webs and identify key species. The Supply Chain Index (SCI) identifies critical elements as those elements with large throughput rates, as well as greater connectivity. The sum of the scores for a supply chain provides a single metric that roughly captures both the resilience and connectedness of a supply chain. Standardised scores can facilitate cross-comparisons both under current conditions as well as under a changing climate. Identification of key elements along the supply chain may assist in informing adaptation strategies to reduce anticipated future risks posed by climate change. The SCI also provides information on the relative stability of different supply chains based on whether there is a fairly even spread in the individual scores of the top few key elements, compared with a more critical dependence on a few key individual supply chain elements. We use as a case study the Australian southern rock lobster Jasus edwardsii fishery, which is challenged by a number of climate change drivers such as impacts on recruitment and growth due to changes in large-scale and local oceanographic features. The SCI identifies airports, processors and Chinese consumers as the key elements in the lobster supply chain that merit attention to enhance stability and potentially enable growth. We also apply the index to an additional four real-world Australian commercial fishery and two aquaculture industry supply chains to highlight the utility of a systematic method for describing supply chains. Overall, our simple methodological approach to empirically-based supply chain research provides an objective method for comparing the resilience of supply chains and highlighting components that may be critical. PMID:24633147

Revolution or evolution? An analysis of E-health innovation and impact using a hypercube model.

PubMed

Wu, Jen-Her; Huang, An-Sheng; Hisa, Tzyh-Lih; Tsai, Hsien-Tang

2006-01-01

This study utilises a hypercube innovation model to analyse the changes in both healthcare informatics and medical related delivery models based on the innovations from Tele-healthcare, electronic healthcare (E-healthcare), to mobile healthcare (M-healthcare). Further, the critical impacts of these E-health innovations on the stakeholders: healthcare customers, hospitals, healthcare complementary providers and healthcare regulators are identified. Thereafter, the critical capabilities for adopting each innovation are discussed.

Understanding successful and unsuccessful landings of aerial maneuver variations in professional surfing.

PubMed

Forsyth, J R; Riddiford-Harland, D L; Whitting, J W; Sheppard, J M; Steele, J R

2018-05-01

Although performing aerial maneuvers can increase wave score and winning potential in competitive surfing, the critical features underlying successful aerial performance have not been systematically investigated. This study aimed to analyze highly skilled aerial maneuver performance and to identify the critical features associated with successful or unsuccessful landing. Using video recordings of the World Surf League's Championship Tour, every aerial performed during the quarterfinal, semifinal, and final heats from the 11 events in the 2015 season was viewed. From this, 121 aerials were identified with the Frontside Air (n = 15) and Frontside Air Reverse (n = 67) being selected to be qualitatively assessed. Using chi-squared analyses, a series of key critical features, including landing over the center of the surfboard (FS Air χ 2  = 14.00, FS Air Reverse χ 2  = 26.61; P < .001) and landing with the lead ankle in dorsiflexion (FS Air χ 2  = 3.90, FS Air Reverse χ 2  = 13.64; P < .05), were found to be associated with successful landings. These critical features help surfers land in a stable position, while maintaining contact with the surfboard. The results of this study provide coaches with evidence to adjust the technique of their athletes to improve their winning potential. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Assessing Terrorist Motivations for Attacking Critical Infrastructure

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

Ackerman, G; Abhayaratne, P; Bale, J

Certain types of infrastructure--critical infrastructure (CI)--play vital roles in underpinning our economy, security and way of life. These complex and often interconnected systems have become so ubiquitous and essential to day-to-day life that they are easily taken for granted. Often it is only when the important services provided by such infrastructure are interrupted--when we lose easy access to electricity, health care, telecommunications, transportation or water, for example--that we are conscious of our great dependence on these networks and of the vulnerabilities that stem from such dependence. Unfortunately, it must be assumed that many terrorists are all too aware that CImore » facilities pose high-value targets that, if successfully attacked, have the potential to dramatically disrupt the normal rhythm of society, cause public fear and intimidation, and generate significant publicity. Indeed, revelations emerging at the time of this writing about Al Qaida's efforts to prepare for possible attacks on major financial facilities in New York, New Jersey, and the District of Columbia remind us just how real and immediate such threats to CI may be. Simply being aware that our nation's critical infrastructure presents terrorists with a plethora of targets, however, does little to mitigate the dangers of CI attacks. In order to prevent and preempt such terrorist acts, better understanding of the threats and vulnerabilities relating to critical infrastructure is required. The Center for Nonproliferation Studies (CNS) presents this document as both a contribution to the understanding of such threats and an initial effort at ''operationalizing'' its findings for use by analysts who work on issues of critical infrastructure protection. Specifically, this study focuses on a subsidiary aspect of CI threat assessment that has thus far remained largely unaddressed by contemporary terrorism research: the motivations and related factors that determine whether a terrorist organization will attack critical infrastructure. In other words, this research investigates: (1) why terrorists choose to attack critical infrastructure rather than other targets; (2) how groups make such decisions; (3) what, if any, types of groups are most inclined to attack critical infrastructure targets; and (4) which types of critical infrastructure terrorists prefer to attack and why. In an effort to address the above questions as comprehensively as possible, the project team employed four discrete investigative approaches in its research design. These include: (1) a review of existing terrorism and threat assessment literature to glean expert consensus regarding terrorist target selection, as well as to identify theoretical approaches that might be valuable to analysts and decision-makers who are seeking to understand such terrorist group decision-making processes; (2) the preparation of several concise case studies to help identify internal group factors and contextual influences that have played significant roles in leading some terrorist groups to attack critical infrastructure; (3) the creation of a new database--the Critical Infrastructure Terrorist Incident Catalog (CrITC)--to capture a large sample of empirical CI attack data that might be used to illuminate the nature of such attacks to date; and (4) the development of a new analytical framework--the Determinants Effecting Critical Infrastructure Decisions (DECIDe) Framework--designed to make the factors and dynamics identified by the study more ''usable'' in any future efforts to assess terrorist intentions to target critical infrastructure. Although each is addressed separately in the following chapters, none of the four aspects of this study were developed in isolation. Rather, all the constituent elements of the project informed--and were informed by--the others. For example, the review of the available literature on terrorist target selection made possible the identification of several target selection factors that were both important in the development of the analytical framework and subsequently validated by the case studies. Similarly, statistical analysis of the CrITIC data yielded measurable evidence that supported hypotheses derived from the framework, the case studies, and the writings of various experts. Besides providing an important mechanism of self-reinforcement and validation, the project's multifaceted nature made it possible to discern aspects of CI attack motivations that would likely have been missed if any single approach had been adopted.« less

Medical Simulation as a Vital Adjunct to Identifying Clinical Life-Threatening Gaps in Austere Environments.

PubMed

Chima, Adaora M; Koka, Rahul; Lee, Benjamin; Tran, Tina; Ogbuagu, Onyebuchi U; Nelson-Williams, Howard; Rosen, Michael; Koroma, Michael; Sampson, John B

2018-04-01

Maternal mortality and morbidity are major causes of death in low-resource countries, especially those in Sub-Saharan Africa. Healthcare workforce scarcities present in these locations result in poor perioperative care access and quality. These scarcities also limit the capacity for progressive development and enhancement of workforce training, and skills through continuing medical education. Newly available low-cost, in-situ simulation systems make it possible for a small cadre of trainers to use simulation to identify areas needing improvement and to rehearse best practice approaches, relevant to the context of target environments. Nurse anesthetists were recruited throughout Sierra Leone to participate in simulation-based obstetric anesthesia scenarios at the country's national referral maternity hospital. All subjects participated in a detailed computer assisted training program to familiarize themselves with the Universal Anesthesia Machine (UAM). An expert panel rated the morbidity/mortality risk of pre-identified critical incidents within the scenario via the Delphi process. Participant responses to critical incidents were observed during these scenarios. Participants had an obstetric anesthesia pretest and post-test as well as debrief sessions focused on reviewing the significance of critical incident responses observed during the scenario. 21 nurse anesthetists, (20% of anesthesia providers nationally) participated. Median age was 41 years and median experience practicing anesthesia was 3.5 years. Most participants (57.1%) were female, two-thirds (66.7%) performed obstetrics anesthesia daily but 57.1% had no experience using the UAM. During the simulation, participants were observed and assessed on critical incident responses for case preparation with a median score of 7 out of 13 points, anesthesia management with a median score of 10 out of 20 points and rapid sequence intubation with a median score of 3 out of 10 points. This study identified substantial risks to patient care and provides evidence to support the feasibility and value of in-situ simulation-based performance assessment for identifying critical gaps in safe anesthesia care in the low-resource settings. Further investigations may validate the impact and sustainability of simulation based training on skills transfer and retention among anesthesia providers low resource environments. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Profile of Students’ Critical Thinking Skill Measured by Science Virtual Test on Living Things and Environmental Sustainability Theme

NASA Astrophysics Data System (ADS)

Maulida, N. I.; Firman, H.; Rusyati, L.

2017-02-01

The aims of this study are: (1) to investigate the level of students’ critical thinking skill on living things and environmental sustainability theme for each Inch’ critical thinking elements and overall, (2) to investigate the level of students’ critical thinking skill on living things characteristic, biodiversity, energy resources, ecosystem, environmental pollution, and global warming topics. The research was conducted due to the important of critical thinking measurement to get the current skill description as the basic consideration for further critical thinking skill improvement in lower secondary science. The research method used was descriptive. 331 seventh grade students taken from five lower secondary schools in Cirebon were tested to get the critical thinking skill data by using Science Virtual Test as the instrument. Generally, the mean scores on eight Inch’ critical thinking elements and overall score from descriptive statistic reveals a moderate attainments level. Students’ critical thinking skill on biodiversity, energy resources, ecosystem, environmental pollution, and global warming topics are in moderate level. While students’ critical thinking skill on living things characteristic is identified as high level. Students’ experience in thinking critically during science learning process and the characteristic of the topic are emerged as the reason behind the students’ critical thinking skill level on certain science topic.

Proposed strategies for designing sustainable high-rise apartment buildings in Ho Chi Minh City responding to critical urban issues

NASA Astrophysics Data System (ADS)

Truong, Nguyen Hoang Long; Huan Giang, Ngoc; Binh Duong, Trong

2018-03-01

This paper aims at finding practical strategies for designing sustainable high-rise apartment buildings in Ho Chi Minh City responding to varied municipal issues. Two steps are made. Step-1 identifies the critical issues of Ho Chi Minh City which are associated with high-rise apartment building projects. Step-2 finds potential and applicable strategies which are solutions for the critical issues in Step-1 with reference of seven selected assessment methods. The study finds the set of 58 strategies applicable to designing sustainable high-rise apartment buildings in Ho Chi Minh City.

Design of a Blended Learning Environment: Considerations and Implementation Issues

ERIC Educational Resources Information Center

Gedik, Nuray; Kiraz, Ercan; Ozden, M. Yasar

2013-01-01

This study identified critical issues in the design of a blended learning environment by examining basic design considerations and implementation issues. Following a design-based research approach with the phenomenological tradition of qualitative research, the study investigated instructor experiences relating to the design, development, and…

Intermediality: Bridge to Critical Media Literacy.

ERIC Educational Resources Information Center

Pailliotet, Ann Watts; Semali, Ladislaus; Rodenberg, Rita K.; Giles, Jackie K.; Macaul, Sherry L.

2000-01-01

Defines "intermediality" as the ability to critically read and write with and across varied symbol systems. Relates it to critical media literacy. Offers rationales for teaching critical media literacy in general, and intermedial instruction in particular. Identifies seven guiding intermedial elements: theory, texts, processes, contexts,…

Incidence and predictors of critical events during urgent air–medical transport

PubMed Central

Singh, Jeffrey M.; MacDonald, Russell D.; Bronskill, Susan E.; Schull, Michael J.

2009-01-01

Background Little is known about the risks of urgent air–medical transport used in regionalized health care systems. We sought to determine the incidence of intransit critical events and identify factors associated with these events. Methods We conducted a population-based, retrospective cohort study using clinical and administrative data. We included all adults undergoing urgent air–medical transport in the Canadian province of Ontario between Jan. 1, 2004, and May 31, 2006. The primary outcome was in-transit critical events, which we defined as death, major resuscitative procedure, hemodynamic deterioration, or inadvertent extubation or respiratory arrest. Results We identified 19 228 patients who underwent air–medical transport during the study period. In-transit critical events were observed in 5.1% of all transports, for a rate of 1 event per 12.6 hours of transit time. Events consisted primarily of new hypotension or airway management procedures. Independent predictors of critical events included female sex (adjusted odds ratio [OR] 1.3, 95% confidence interval [CI] 1.1–1.5), assisted ventilation before transport (adjusted OR 3.0, 95% CI 2.3–3.7), hemodynamic instability before transport (adjusted OR 3.2, 95% CI 2.5–4.1), transport in a fixed-wing aircraft (adjusted OR 1.5, 95% CI 1.2–1.8), increased duration of transport (adjusted OR 1.02 per 10-minute increment, 95% CI 1.01–1.03), on-scene calls (adjusted OR 1.7, 95% CI 1.4–2.1) and type of crew (adjusted OR 0.6 for advanced care paramedics v. critical care paramedics, 95% CI 0.5–0.7). Interpretation Critical events occurred in about 1 in every 20 air–medical transports and were associated with multiple risk factors at the patient, transport and system levels. These findings have implications for the refinement of training of paramedic transport crews and processes for triage and transport. PMID:19752105

External Criticism by Parents and Obsessive Beliefs in Adolescents: Mediating Role of Beliefs associated with Inflated Responsibility.

PubMed

Halvaiepour, Zohreh; Nosratabadi, Mehdi

2015-09-18

Obsessive-compulsive disorder (OCD) is considered as a rare disorder in children. According to cognitive theories, criticism triggers responsibility behavior and thus causes obsessive behaviors. The purpose of the present study was to investigate the mediating role of beliefs associated with responsibility in the relationship between external criticism of parents and obsessive beliefs in adolescents. In this study, 547 high school students aged from 15 to18 years were selected using multi-stage cluster random sampling from four regions of the education office in Shiraz. Obsessive Beliefs Questionnaire-child version (OBQ-CV), Pathway to Inflated Responsibility beliefs Scale (PIRBS), and perceived criticism questionnaire were used to collect data. Pearson's correlation was used to investigate the relationship between the study variables. For analysis of mediation model, multiple mediators analysis using Macro Software was used. External criticism only indirectly and through beliefs associated with inflated responsibility accounts for 6% of the variance of responsibility, 14% of the variance of threat estimation and 10% of the variance of perfectionism of obsessive beliefs (P<0.05). However, external criticism, both directly and indirectly and through beliefs associated with inflated responsibility accounts for 7% of the variance of the importance of obsessive beliefs. This study showed that the beliefs associated with inflated responsibility can mediate the relationship between external criticism and obsessive beliefs. According to the cognitive model of Salkovskis, criticism by parents, as a violation to and an influence on children, by affecting the subscales of inflated responsibility, can increase the symptoms of obsessive-compulsive disorder. In order to identify potential affecting mechanisms of criticism on obsessive-compulsive disorder, further experimental research is required.

Observational studies using propensity score analysis underestimated the effect sizes in critical care medicine.

PubMed

Zhang, Zhongheng; Ni, Hongying; Xu, Xiao

2014-08-01

Propensity score (PS) analysis has been increasingly used in critical care medicine; however, its validation has not been systematically investigated. The present study aimed to compare effect sizes in PS-based observational studies vs. randomized controlled trials (RCTs) (or meta-analysis of RCTs). Critical care observational studies using PS were systematically searched in PubMed from inception to April 2013. Identified PS-based studies were matched to one or more RCTs in terms of population, intervention, comparison, and outcome. The effect sizes of experimental treatments were compared for PS-based studies vs. RCTs (or meta-analysis of RCTs) with sign test. Furthermore, ratio of odds ratio (ROR) was calculated from the interaction term of treatment × study type in a logistic regression model. A ROR < 1 indicates greater benefit for experimental treatment in RCTs compared with PS-based studies. RORs of each comparison were pooled by using meta-analytic approach with random-effects model. A total of 20 PS-based studies were identified and matched to RCTs. Twelve of the 20 comparisons showed greater beneficial effect for experimental treatment in RCTs than that in PS-based studies (sign test P = 0.503). The difference was statistically significant in four comparisons. ROR can be calculated from 13 comparisons, of which four showed significantly greater beneficial effect for experimental treatment in RCTs. The pooled ROR was 0.71 (95% CI: 0.63, 0.79; P = 0.002), suggesting that RCTs (or meta-analysis of RCTs) were more likely to report beneficial effect for the experimental treatment than PS-based studies. The result remained unchanged in sensitivity analysis and meta-regression. In critical care literature, PS-based observational study is likely to report less beneficial effect of experimental treatment compared with RCTs (or meta-analysis of RCTs). Copyright © 2014 Elsevier Inc. All rights reserved.

Harnessing and Modulating Inflammation in Strategies for Bone Regeneration

PubMed Central

Mountziaris, Paschalia M.; Spicer, Patrick P.; Kasper, F. Kurtis

2011-01-01

Inflammation is an immediate response that plays a critical role in healing after fracture or injury to bone. However, in certain clinical contexts, such as in inflammatory diseases or in response to the implantation of a biomedical device, the inflammatory response may become chronic and result in destructive catabolic effects on the bone tissue. Since our previous review 3 years ago, which identified inflammatory signals critical for bone regeneration and described the inhibitory effects of anti-inflammatory agents on bone healing, a multitude of studies have been published exploring various aspects of this emerging field. In this review, we distinguish between regenerative and damaging inflammatory processes in bone, update our discussion of the effects of anti-inflammatory agents on bone healing, summarize recent in vitro and in vivo studies demonstrating how inflammation can be modulated to stimulate bone regeneration, and identify key future directions in the field. PMID:21615330

Vocational Support Approaches in Autism Spectrum Disorder: A Synthesis Review of the Literature

ERIC Educational Resources Information Center

Nicholas, David B.; Attridge, Mark; Zwaigenbaum, Lonnie; Clarke, Margaret

2015-01-01

This synthesis-based analysis identifies and reviews studies evaluating vocational resources for adults with autism spectrum disorder. It is based on a larger systematic review of intervention studies in autism spectrum disorder, from which a critical interpretive synthesis was conducted on studies related to vocation and autism spectrum disorder.…

Latinas in Higher Education: An Interpretive Study of Experiential Influences That Impact Their Life Choices

ERIC Educational Resources Information Center

Torres-Capeles, Belkis

2012-01-01

This basic interpretive qualitative study used individual semi-structured interviews to explore and understand the experiences of seven self-identified Latina participants, who reside in Northeast Ohio and belong to a volunteer organization promoting professional Latinas. The study used Latina Critical Race theory and feminist perspectives to…

Robustness of critical points in a complex adaptive system: Effects of hedge behavior

NASA Astrophysics Data System (ADS)

Liang, Yuan; Huang, Ji-Ping

2013-08-01

In our recent papers, we have identified a class of phase transitions in the market-directed resource-allocation game, and found that there exists a critical point at which the phase transitions occur. The critical point is given by a certain resource ratio. Here, by performing computer simulations and theoretical analysis, we report that the critical point is robust against various kinds of human hedge behavior where the numbers of herds and contrarians can be varied widely. This means that the critical point can be independent of the total number of participants composed of normal agents, herds and contrarians, under some conditions. This finding means that the critical points we identified in this complex adaptive system (with adaptive agents) may also be an intensive quantity, similar to those revealed in traditional physical systems (with non-adaptive units).

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

PubMed Central

2010-01-01

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

Community-level climate change vulnerability research: trends, progress, and future directions

NASA Astrophysics Data System (ADS)

McDowell, Graham; Ford, James; Jones, Julie

2016-03-01

This study systematically identifies, characterizes, and critically evaluates community-level climate change vulnerability assessments published over the last 25 years (n = 274). We find that while the field has advanced considerably in terms of conceptual framing and methodological approaches, key shortcomings remain in how vulnerability is being studied at the community-level. We argue that vulnerability research needs to more critically engage with the following: methods for evaluating future vulnerability, the relevance of vulnerability research for decision-making, interdependencies between social and ecological systems, attention to researcher / subject power dynamics, critical interpretation of key terms, and consideration of the potentially positive opportunities presented by a changing climate. Addressing these research needs is necessary for generating knowledge that supports climate-affected communities in navigating the challenges and opportunities ahead.

Grand Theft Auto is a "Sandbox" Game, but There are Weapons, Criminals, and Prostitutes in the Sandbox: Response to Ferguson and Donnellan (2017).

PubMed

Gabbiadini, Alessandro; Bushman, Brad J; Riva, Paolo; Andrighetto, Luca; Volpato, Chiara

2017-12-01

In this issue, (Ferguson, C. J., & Donnellan, B. D., Journal of Youth and and Adolescence, published online 21 June 2017) criticize one of our studies (Gabbiadini, A., Riva, P., Andrighetto, L., Volpato, C., & Bushman, B. J., PLoS ONE, 11: 1-14, 2016) that found violent sexist video games can reduce empathy for female violence victims in male players who identify with violent male game characters, and do so by increasing masculine beliefs. Their main criticism is a "straw person" argument built on a claim that we never made (i.e., a direct effect of sexist-violent video games on empathy). They also made several other criticisms of our article. We appreciate the opportunity to respond to their criticisms in this article. We also point out some flaws in their reanalysis. Despite their criticisms, the core contributions of our original article remain intact.

The Top Ten Websites in Critical Care Medicine Education Today.

PubMed

Wolbrink, Traci A; Rubin, Lucy; Burns, Jeffrey P; Markovitz, Barry

2018-01-01

The number of websites for the critical care provider is rapidly growing, including websites that are part of the Free Open Access Med(ical ed)ucation (FOAM) movement. With this rapidly expanding number of websites, critical appraisal is needed to identify quality websites. The last major review of critical care websites was published in 2011, and thus a new review of the websites relevant to the critical care clinician is necessary. A new assessment tool for evaluating critical care medicine education websites, the Critical Care Medical Education Website Quality Evaluation Tool (CCMEWQET), was modified from existing tools. A PubMed and Startpage search from 2007 to 2017 was conducted to identify websites relevant to critical care medicine education. These websites were scored based on the CCMEWQET. Ninety-seven websites relevant for critical care medicine education were identified and scored, and the top ten websites were described in detail. Common types of resources available on these websites included blog posts, podcasts, videos, online journal clubs, and interactive components such as quizzes. Almost one quarter of websites (n = 22) classified themselves as FOAM websites. The top ten websites most often included an editorial process, high-quality and appropriately attributed graphics and multimedia, scored much higher for comprehensiveness and ease of access, and included opportunities for interactive learning. Many excellent online resources for critical care medicine education currently exist, and the number is likely to continue to increase. Opportunities for improvement in many websites include more active engagement of learners, upgrading navigation abilities, incorporating an editorial process, and providing appropriate attribution for graphics and media.

Nutritional requirements of the critically ill patient.

PubMed

Chan, Daniel L

2004-02-01

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

Integrated Immunotherapy for Breast Cancer

DTIC Science & Technology

2013-09-01

that promotes appropriate cellular signals. For example, recent studies by Mohtashami et al have shown that expression of two critical Notch ligands...aggregate analysis for DC populations is identified in other tumors/cancers (10). We also have begun banking tumor associated stromal RNA , healthy stromal... RNA , as well as tumor RNA for future analysis on microarray or RNAseq to identify unique markers which may be influencing DC clustering or maturation

P-values: misunderstood and misused

NASA Astrophysics Data System (ADS)

Vidgen, Bertie; Yasseri, Taha

2016-03-01

P-values are widely used in both the social and natural sciences to quantify the statistical significance of observed results. The recent surge of big data research has made the p-value an even more popular tool to test the significance of a study. However, substantial literature has been produced critiquing how p-values are used and understood. In this paper we review this recent critical literature, much of which is routed in the life sciences, and consider its implications for social scientific research. We provide a coherent picture of what the main criticisms are, and draw together and disambiguate common themes. In particular, we explain how the False Discovery Rate is calculated, and how this differs from a p-value. We also make explicit the Bayesian nature of many recent criticisms, a dimension that is often underplayed or ignored. We conclude by identifying practical steps to help remediate some of the concerns identified. We recommend that (i) far lower significance levels are used, such as 0.01 or 0.001, and (ii) p-values are interpreted contextually, and situated within both the findings of the individual study and the broader field of inquiry (through, for example, meta-analyses).

Emergency material allocation with time-varying supply-demand based on dynamic optimization method for river chemical spills.

PubMed

Liu, Jie; Guo, Liang; Jiang, Jiping; Jiang, Dexun; Wang, Peng

2018-04-13

Aiming to minimize the damage caused by river chemical spills, efficient emergency material allocation is critical for an actual emergency rescue decision-making in a quick response. In this study, an emergency material allocation framework based on time-varying supply-demand constraint is developed to allocate emergency material, minimize the emergency response time, and satisfy the dynamic emergency material requirements in post-accident phases dealing with river chemical spills. In this study, the theoretically critical emergency response time is firstly obtained for the emergency material allocation system to select a series of appropriate emergency material warehouses as potential supportive centers. Then, an enumeration method is applied to identify the practically critical emergency response time, the optimum emergency material allocation and replenishment scheme. Finally, the developed framework is applied to a computational experiment based on south-to-north water transfer project in China. The results illustrate that the proposed methodology is a simple and flexible tool for appropriately allocating emergency material to satisfy time-dynamic demands during emergency decision-making. Therefore, the decision-makers can identify an appropriate emergency material allocation scheme in a balance between time-effective and cost-effective objectives under the different emergency pollution conditions.

Criticality Calculations with MCNP6 - Practical Lectures

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

Brown, Forrest B.; Rising, Michael Evan; Alwin, Jennifer Louise

2016-11-29

These slides are used to teach MCNP (Monte Carlo N-Particle) usage to nuclear criticality safety analysts. The following are the lecture topics: course information, introduction, MCNP basics, criticality calculations, advanced geometry, tallies, adjoint-weighted tallies and sensitivities, physics and nuclear data, parameter studies, NCS validation I, NCS validation II, NCS validation III, case study 1 - solution tanks, case study 2 - fuel vault, case study 3 - B&W core, case study 4 - simple TRIGA, case study 5 - fissile mat. vault, criticality accident alarm systems. After completion of this course, you should be able to: Develop an input modelmore » for MCNP; Describe how cross section data impact Monte Carlo and deterministic codes; Describe the importance of validation of computer codes and how it is accomplished; Describe the methodology supporting Monte Carlo codes and deterministic codes; Describe pitfalls of Monte Carlo calculations; Discuss the strengths and weaknesses of Monte Carlo and Discrete Ordinants codes; The diffusion theory model is not strictly valid for treating fissile systems in which neutron absorption, voids, and/or material boundaries are present. In the context of these limitations, identify a fissile system for which a diffusion theory solution would be adequate.« less

The Three Stages of Critical Policy Methodology: An Example from Curriculum Analysis

ERIC Educational Resources Information Center

Rata, Elizabeth

2014-01-01

The article identifies and discusses three stages in the critical policy methodology used in the sociology of education. These are: firstly, employing a political economy theoretical framework that identifies causal links between global forces and local developments; secondly, analysing educational policy within that theoretically conceptualised…

Critical Factors in Data Governance for Learning Analytics

ERIC Educational Resources Information Center

Elouazizi, Noureddine

2014-01-01

This paper identifies some of the main challenges of data governance modelling in the context of learning analytics for higher education institutions, and discusses the critical factors for designing data governance models for learning analytics. It identifies three fundamental common challenges that cut across any learning analytics data…

Discourses with potential to disrupt traditional nursing education: Nursing teachers' talk about norm-critical competence.

PubMed

Tengelin, Ellinor; Dahlborg-Lyckhage, Elisabeth

2017-01-01

This paper describes the discourses underlying nursing teachers' talk about their own norm-critical competence. Norm criticism is an approach that promotes awareness and criticism of the norms and power structures that exert an excluding effect in society in general and in the healthcare encounter in particular. Given the unequal relationships that can exist in healthcare, for example relationships shaped by racism, sexism and classism, a norm-critical approach to nursing education would help illuminate these matters. The studied empirical material consisted of focus group interviews. Nursing teachers discussed their norm-critical competence based on the university course "Norm-Aware Caring" in which they had recently participated. Through a critical discourse analysis, three discourses were identified in their talk, all of which had the potential to disrupt traditional, normative nursing education. However, in all three discourses there was an underlying discourse of normality, clearly positioning the teachers as exemplifying the "normal." The binary constructed between normality and otherness contradicts a basic tenet of the norm-critical approach and may hamper the development of genuine norm-critical competence in nursing education. © 2016 John Wiley & Sons Ltd.

Methodological and clinical implications of a three-in-one Russian doll design for tracking health trajectories and improving health and function through innovative exercise treatments in adults with disability.

PubMed

Rimmer, James H; Herman, Cassandra; Wingo, Brooks; Fontaine, Kevin; Mehta, Tapan

2018-03-14

Hybrid research designs targeting adults with neurologic disability are critical for improving the efficiency of models that can identify, track and intervene on identified health issues. Our Russian doll framework encompasses three study phases. Phase 1 involves prospectively following a cohort of participants with disability to examine the relationships between rates of health and functional deficits (e.g., pain, fatigue, deconditioning), functional measures (e.g., cardiorespiratory endurance, strength, balance), and environmental and sociocultural factors. In Phase 2, eligible participants with neurologic disability from Phase 1 (in our example, individuals with multiple sclerosis) are screened and randomized to a clinical exercise efficacy trial. In Phase 3, study participants are enrolled in a home-based teleexercise trial to test the feasibility and replicability of delivering the clinical exercise study in the home. This unique three-in-one Russian doll framework serves as a foundation for informing and guiding researchers and clinicians in treating certain health and functional deficits in people with neurologic disability using exercise as a primary treatment modality in both the clinical and home settings. It offers a unique perspective for understanding the critical issues of functioning, health maintenance and quality of life for people with neurologic disability across a longitudinal framework. Study 2 ClinicalTrials.gov identifier NCT02533882 (retroactively registered 03/06/2015). Study 3 ClinicalTrials.gov identifier NCT03108950 (retroactively registered 04/05/2017).

Clinical prediction models for mortality and functional outcome following ischemic stroke: A systematic review and meta-analysis

PubMed Central

Crayton, Elise; Wolfe, Charles; Douiri, Abdel

2018-01-01

Objective We aim to identify and critically appraise clinical prediction models of mortality and function following ischaemic stroke. Methods Electronic databases, reference lists, citations were searched from inception to September 2015. Studies were selected for inclusion, according to pre-specified criteria and critically appraised by independent, blinded reviewers. The discrimination of the prediction models was measured by the area under the curve receiver operating characteristic curve or c-statistic in random effects meta-analysis. Heterogeneity was measured using I2. Appropriate appraisal tools and reporting guidelines were used in this review. Results 31395 references were screened, of which 109 articles were included in the review. These articles described 66 different predictive risk models. Appraisal identified poor methodological quality and a high risk of bias for most models. However, all models precede the development of reporting guidelines for prediction modelling studies. Generalisability of models could be improved, less than half of the included models have been externally validated(n = 27/66). 152 predictors of mortality and 192 predictors and functional outcome were identified. No studies assessing ability to improve patient outcome (model impact studies) were identified. Conclusions Further external validation and model impact studies to confirm the utility of existing models in supporting decision-making is required. Existing models have much potential. Those wishing to predict stroke outcome are advised to build on previous work, to update and adapt validated models to their specific contexts opposed to designing new ones. PMID:29377923

A Critical Ear: Analysis of Value Judgments in Reviews of Beethoven's Piano Sonata Recordings

PubMed Central

Alessandri, Elena; Williamson, Victoria J.; Eiholzer, Hubert; Williamon, Aaron

2016-01-01

What sets a great music performance apart? In this study, we addressed this question through an examination of value judgments in written criticism of recorded performance. One hundred reviews of recordings of Beethoven's piano sonatas, published in the Gramophone between 1934 and 2010, were analyzed through a three-step qualitative analysis that identified the valence (positive/negative) expressed by critics' statements and the evaluation criteria that underpinned their judgments. The outcome is a model of the main evaluation criteria used by professional critics: aesthetic properties, including intensity, coherence, and complexity, and achievement-related properties, including sureness, comprehension, and endeavor. The model also emphasizes how critics consider the suitability and balance of these properties across the musical and cultural context of the performance. The findings relate directly to current discourses on the role of evaluation in music criticism and the generalizability of aesthetic principles. In particular, the perceived achievement of the performer stands out as a factor that drives appreciation of a recording. PMID:27065900

Leveraging Terminologies for Retrieval of Radiology Reports with Critical Imaging Findings

PubMed Central

Warden, Graham I.; Lacson, Ronilda; Khorasani, Ramin

2011-01-01

Introduction: Communication of critical imaging findings is an important component of medical quality and safety. A fundamental challenge includes retrieval of radiology reports that contain these findings. This study describes the expressiveness and coverage of existing medical terminologies for critical imaging findings and evaluates radiology report retrieval using each terminology. Methods: Four terminologies were evaluated: National Cancer Institute Thesaurus (NCIT), Radiology Lexicon (RadLex), Systemized Nomenclature of Medicine (SNOMED-CT), and International Classification of Diseases (ICD-9-CM). Concepts in each terminology were identified for 10 critical imaging findings. Three findings were subsequently selected to evaluate document retrieval. Results: SNOMED-CT consistently demonstrated the highest number of overall terms (mean=22) for each of ten critical findings. However, retrieval rate and precision varied between terminologies for the three findings evaluated. Conclusion: No single terminology is optimal for retrieving radiology reports with critical findings. The expressiveness of a terminology does not consistently correlate with radiology report retrieval. PMID:22195212

Type III interferon is a critical regulator of innate antifungal immunity.

PubMed

Espinosa, Vanessa; Dutta, Orchi; McElrath, Constance; Du, Peicheng; Chang, Yun-Juan; Cicciarelli, Bryan; Pitler, Amy; Whitehead, Ian; Obar, Joshua J; Durbin, Joan E; Kotenko, Sergei V; Rivera, Amariliz

2017-10-06

Type III interferons (IFN-λs) are the most recently found members of the IFN cytokine family and engage IFNLR1 and IL10R2 receptor subunits to activate innate responses against viruses. We have identified IFN-λs as critical instructors of antifungal neutrophil responses. Using Aspergillus fumigatus ( Af ) as a model to study antifungal immune responses, we found that depletion of CCR2 + monocytes compromised the ability of neutrophils to control invasive fungal growth. Using an unbiased approach, we identified type I and III IFNs as critical regulators of the interplay between monocytes and neutrophils responding to Af We found that CCR2 + monocytes are an important early source of type I IFNs that prime optimal expression of IFN-λ. Type III IFNs act directly on neutrophils to activate their antifungal response, and mice with neutrophil-specific deletion of IFNLR1 succumb to invasive aspergillosis. Dysfunctional neutrophil responses in CCR2-depleted mice were rescued by adoptive transfer of pulmonary CCR2 + monocytes or by exogenous administration of IFN-α and IFN-λ. Thus, CCR2 + monocytes promote optimal activation of antifungal neutrophils by initiating a coordinated IFN response. We have identified type III IFNs as critical regulators of neutrophil activation and type I IFNs as early stimulators of IFN-λ expression. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Potential for Bias When Estimating Critical Windows for Air Pollution in Children's Health.

PubMed

Wilson, Ander; Chiu, Yueh-Hsiu Mathilda; Hsu, Hsiao-Hsien Leon; Wright, Robert O; Wright, Rosalind J; Coull, Brent A

2017-12-01

Evidence supports an association between maternal exposure to air pollution during pregnancy and children's health outcomes. Recent interest has focused on identifying critical windows of vulnerability. An analysis based on a distributed lag model (DLM) can yield estimates of a critical window that are different from those from an analysis that regresses the outcome on each of the 3 trimester-average exposures (TAEs). Using a simulation study, we assessed bias in estimates of critical windows obtained using 3 regression approaches: 1) 3 separate models to estimate the association with each of the 3 TAEs; 2) a single model to jointly estimate the association between the outcome and all 3 TAEs; and 3) a DLM. We used weekly fine-particulate-matter exposure data for 238 births in a birth cohort in and around Boston, Massachusetts, and a simulated outcome and time-varying exposure effect. Estimates using separate models for each TAE were biased and identified incorrect windows. This bias arose from seasonal trends in particulate matter that induced correlation between TAEs. Including all TAEs in a single model reduced bias. DLM produced unbiased estimates and added flexibility to identify windows. Analysis of body mass index z score and fat mass in the same cohort highlighted inconsistent estimates from the 3 methods. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

An Assessment of Extension Education Curriculum at Land Grant Universities

ERIC Educational Resources Information Center

Harder, Amy; Mashburn, Diane; Benge, Matt

2009-01-01

A critical assessment of extension education is needed to ensure there are adequate opportunities for students to study extension education and that the curriculum is relevant to today's Cooperative Extension Service. This descriptive study was conducted to assess extension education curriculum by identifying and comparing the courses being taught…

Investigating critical incidents, driver restart period, sleep quantity, and crash countermeasures in commercial vehicle operations using naturalistic data collection.

DOT National Transportation Integrated Search

2016-11-01

The aim of this study was to compare the Large Truck Crash Causation Study (LTCCS) and Naturalistic Driving (ND) datasets to identify discrepancies and to determine the source(s) of these discrepancies. The project included a generalized comparative ...

The Complete Guide to Training Delivery: A Competency-Based Approach.

ERIC Educational Resources Information Center

King, Stephen B.; King, Marsha; Rothwell, William J.

This guide focuses on 14 instructor competencies identified by the International Board of Standards for Training, Performance, and Instruction. It provides examples, job aids, worksheets, case studies, and sample dialogs and contains actual experiences and critical incidents faced by trainers who participated in the survey study. Strategies to…

Staff Development for the Social Studies Teacher.

ERIC Educational Resources Information Center

Dillon-Peterson, Elizabeth; Greenawald, G. Dale

The book identifies critical variables that influence the success or failure of staff development programs for social studies teachers and provides suggestions for planning and implementing effective inservice activities. It is based on interviews with 24 educators of diverse backgrounds and the authors' own practical field experiences as well as…

Differential Contributions of Language Skills to Children's Episodic Recall

ERIC Educational Resources Information Center

Klemfuss, J. Zoe

2015-01-01

Theorists have identified language as a critical contributor to children's episodic memory development, yet studies linking language and memory have had mixed results. The present study aimed to clarify the mechanisms linking language and memory and to explain the previous mixed results. Sixty-four preschool children's receptive and productive…

Current Domestic Problems, Social Studies: 6416.18.

ERIC Educational Resources Information Center

Moore, John A.

Secondary students learn to deal objectively with domestic issues and problems in this quinmester elective course. Emphasis is upon providing students with an opportunity for indepth study in critical thinking on current controversial issues, using activity units as a principal teaching technique. The objectives are for students to identify and…

Mature Students Speak Up: Career Exploration and the Working Alliance

ERIC Educational Resources Information Center

Pott, Terilyn

2015-01-01

This exploratory study was undertaken to learn more about how mature students perceive the career counselling process in a post-secondary institution. Through the use of critical incident technique this study examined how three mature students interpret their relationship between themselves and their counsellors. Significant factors identified as…

"Comfort" as a Critical Success Factor in Blended Learning Courses

ERIC Educational Resources Information Center

Futch, Linda S.; deNoyelles, Aimee; Thompson, Kelvin; Howard, Wendy

2016-01-01

There are substantial quantitative research and anecdotal reports on blended learning and blended learning courses. However, few research studies focus on what happens at the classroom level. This research study aims to consider the highly contextual environment of effective blended learning courses by identifying the strategies instructors use to…

Reverse Engineering from Eminent Exemplars: How about a Retrospective Study Too?

ERIC Educational Resources Information Center

Simonton, Dean Keith

2017-01-01

In his target article, Sternberg (2017) quite rightly criticizes the approach to identifying giftedness that was initiated by Terman's (1925-1959) classic prospective study of high-IQ children. Sternberg then recommends a number of novel approaches to both identification and education. Nonetheless, this commentator recommends that future…

Cooperative Learning and Gifted Students: Report on Five Case Studies.

ERIC Educational Resources Information Center

Coleman, Mary Ruth; And Others

This study examined cooperative learning (CL) programs that were successfully meeting the needs of gifted students and identified factors critical to this success. Of 19 programs nominated as models of cooperative learning, 5 sites were selected and visited: Wilton Public Schools, Connecticut; Glenville Elementary School, Connecticut; Mary Taylor…

Neuroprotective Effects of Intravenous Anesthetics: A New Critical Perspective

PubMed Central

Bilotta, Federico; Stazi, Elisabetta; Zlotnik, Alexander; Gruenbaum, Shaun E.; Rosa, Giovanni

2015-01-01

Perioperative cerebral damage can result in various clinical sequela ranging from minor neurocognitive deficits to catastrophic neurological morbidity with permanent impairment and death. The goal of neuroprotective treatments is to reduce the clinical effects of cerebral damage through two major mechanisms: increased tolerance of neurological tissue to ischemia and changes in intra-cellular responses to energy supply deprivation. In this review, we present the clinical evidence of intravenous anesthetics on perioperative neuroprotection, and we also provide a critical perspective for future studies. The neuroprotective efficacy of the intravenous anesthetics thiopental, propofol and etomidate is unproven. Lidocaine may be neuroprotective in non-diabetic patients who have undergoing cardiac surgery with cardiopulmonary bypass (CBP) or with a 48-hour infusion, but conclusive data are lacking. There are several limitations of clinical studies that evaluate postoperative cognitive dysfunction (POCD), including difficulties in identifying patients at high-risk and a lack of consensus for defining the “gold-standard” neuropsychological testing. Although a battery of neurocognitive tests remains the primary method for diagnosing POCD, recent evidence suggests a role for novel biomarkers and neuroimaging to preemptively identify patients more susceptible to cognitive decline in the perioperative period. Current evidence, while inconclusive, suggest that intravenous anesthetics may be both neuroprotective and neurotoxic in the perioperative period. A critical analysis on data recorded from randomized control trials (RCTs) is essential in identifying patients who may benefit or be harmed by a particular anesthetic. RCTs will also contribute to defining methodologies for future studies on the neuroprotective effects of intravenous anesthetics. PMID:24669972

Evidence for the use of parenteral nutrition in the pediatric intensive care unit.

PubMed

Fivez, Tom; Kerklaan, Dorian; Mesotten, Dieter; Verbruggen, Sascha; Joosten, Koen; Van den Berghe, Greet

2017-02-01

During hospitalization in a pediatric intensive care unit (PICU), critically ill children are fed artificially. Administered via the preferred enteral route, caloric targets are often not reached. Hence, parenteral nutrition is given to this patient population. In this review we analyzed the available evidence from randomized controlled trials (RCTs) that supports the use of parenteral nutrition in children during critical illness. A search strategy in Ovid MEDLINE and Ovid EMBASE was created and trial registries were screened to identify the relevant RCTs. Studies were included if they were randomized controlled trials, involved pediatric patients admitted to PICU, and compared different dosing/compositions of parenteral nutrition. Descriptive studies and reviews were excluded. Of the 584 articles identified by the search strategy, only 114 articles were retained after title screening. Further abstract and full text screening identified 6 small RCTs that compared two dosing/composition strategies of parenteral nutrition. These trials reported differences in surrogate endpoints without an effect on hard clinical endpoints. The RCTs observed improvements in these surrogate endpoints with the use of more calories or when parenteral glutamine or fish oil was added. The few RCTs suggest that surrogate endpoints can be affected by providing parenteral nutrition to critically ill children, but the studies were not statistically powered to draw meaningful clinical conclusions. Large RCTs with clinically relevant outcome measures are urgently needed to support the current nutritional guidelines that advise the use of parenteral nutrition in the PICU. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Adaptive optimal control of unknown constrained-input systems using policy iteration and neural networks.

PubMed

Modares, Hamidreza; Lewis, Frank L; Naghibi-Sistani, Mohammad-Bagher

2013-10-01

This paper presents an online policy iteration (PI) algorithm to learn the continuous-time optimal control solution for unknown constrained-input systems. The proposed PI algorithm is implemented on an actor-critic structure where two neural networks (NNs) are tuned online and simultaneously to generate the optimal bounded control policy. The requirement of complete knowledge of the system dynamics is obviated by employing a novel NN identifier in conjunction with the actor and critic NNs. It is shown how the identifier weights estimation error affects the convergence of the critic NN. A novel learning rule is developed to guarantee that the identifier weights converge to small neighborhoods of their ideal values exponentially fast. To provide an easy-to-check persistence of excitation condition, the experience replay technique is used. That is, recorded past experiences are used simultaneously with current data for the adaptation of the identifier weights. Stability of the whole system consisting of the actor, critic, system state, and system identifier is guaranteed while all three networks undergo adaptation. Convergence to a near-optimal control law is also shown. The effectiveness of the proposed method is illustrated with a simulation example.

Critical Point in Self-Organized Tissue Growth

NASA Astrophysics Data System (ADS)

Aguilar-Hidalgo, Daniel; Werner, Steffen; Wartlick, Ortrud; González-Gaitán, Marcos; Friedrich, Benjamin M.; Jülicher, Frank

2018-05-01

We present a theory of pattern formation in growing domains inspired by biological examples of tissue development. Gradients of signaling molecules regulate growth, while growth changes these graded chemical patterns by dilution and advection. We identify a critical point of this feedback dynamics, which is characterized by spatially homogeneous growth and proportional scaling of patterns with tissue length. We apply this theory to the biological model system of the developing wing of the fruit fly Drosophila melanogaster and quantitatively identify signatures of the critical point.

Fully integrated automated security surveillance system: managing a changing world through managed technology and product applications

NASA Astrophysics Data System (ADS)

Francisco, Glen; Brown, Todd

2012-06-01

Integrated security systems are essential to pre-empting criminal assaults. Nearly 500,000 sites have been identified (source: US DHS) as critical infrastructure sites that would suffer severe damage if a security breach should occur. One major breach in any of 123 U.S. facilities, identified as "most critical", threatens more than 1,000,000 people. The vulnerabilities of critical infrastructure are expected to continue and even heighten over the coming years.

Computer Software Training and HRD: What Are the Critical Issues?

ERIC Educational Resources Information Center

Altemeyer, Brad

2005-01-01

The paper explores critical issues for HRD practice from a parsonian framework across the HRD legs of organizational development, adult learning, and training and development. Insights into the critical issues emerge from this approach. Identifying successful transfer of training to be critical for organizational, group, and individual success.…

14 CFR 35.16 - Propeller critical parts.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Propeller critical parts. 35.16 Section 35... AIRWORTHINESS STANDARDS: PROPELLERS Design and Construction § 35.16 Propeller critical parts. The integrity of each propeller critical part identified by the safety analysis required by § 35.15 must be established...

Critical Learning Skills for Business Students

ERIC Educational Resources Information Center

Jance, Marsha; Morgan, Anita

2013-01-01

A survey addressing critical skills for business students was developed and disseminated. Sixteen critical skills (such as critical thinking and time management) were identified as skills that need to be acquired in order for business students to be successful in their advanced courses and careers. The survey was disseminated and taken by several…

Antiferromagnetic Potts Model on the Erdős-Rényi Random Graph

NASA Astrophysics Data System (ADS)

Contucci, Pierluigi; Dommers, Sander; Giardinà, Cristian; Starr, Shannon

2013-10-01

We study the antiferromagnetic Potts model on the Poissonian Erdős-Rényi random graph. By identifying a suitable interpolation structure and an extended variational principle, together with a positive temperature second-moment analysis we prove the existence of a phase transition at a positive critical temperature. Upper and lower bounds on the temperature critical value are obtained from the stability analysis of the replica symmetric solution (recovered in the framework of Derrida-Ruelle probability cascades) and from an entropy positivity argument.

Conducting transcultural research: critical thinking in Thailand.

PubMed

Jenkins, Sheryl D

2011-01-01

Little has been written to help researchers prepare for the unique challenges of conducting transcultural research. The purpose of this article is to discuss issues that arose during the planning and execution of a transcultural study designed to compare critical thinking in Thailand and the United States. The challenges of identifying a research site, selecting participants, incorporating Thai research into the literature review, traveling and living in a foreign culture, overcoming cultural barriers to research, and strengthening internal validity and reliability are addressed.

The Beginning of String Theory: A Historical Sketch

NASA Astrophysics Data System (ADS)

Vecchia, P. Di; Schwimmer, A.

In this note we follow the historical development of the ideas that led to the formulation of String Theory. We start from the inspired guess of Veneziano and its extension to the scattering of N scalar particles, then we describe how the study of its factorization properties allowed to identify the physical spectrum, and finally we discuss how the critical values of the intercept of the Regge trajectory and of the critical dimension were fixed to be α_0 =1 and d=26.

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

PubMed

Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

2013-07-01

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

Glutamine Randomized Studies in Early Life: The Unsolved Riddle of Experimental and Clinical Studies

PubMed Central

Briassouli, Efrossini; Briassoulis, George

2012-01-01

Glutamine may have benefits during immaturity or critical illness in early life but its effects on outcome end hardpoints are controversial. Our aim was to review randomized studies on glutamine supplementation in pups, infants, and children examining whether glutamine affects outcome. Experimental work has proposed various mechanisms of glutamine action but none of the randomized studies in early life showed any effect on mortality and only a few showed some effect on inflammatory response, organ function, and a trend for infection control. Although apparently safe in animal models (pups), premature infants, and critically ill children, glutamine supplementation does not reduce mortality or late onset sepsis, and its routine use cannot be recommended in these sensitive populations. Large prospectively stratified trials are needed to better define the crucial interrelations of “glutamine-heat shock proteins-stress response” in critical illness and to identify the specific subgroups of premature neonates and critically ill infants or children who may have a greater need for glutamine and who may eventually benefit from its supplementation. The methodological problems noted in the reviewed randomized experimental and clinical trials should be seriously considered in any future well-designed large blinded randomized controlled trial involving glutamine supplementation in critical illness. PMID:23019424

Treatment of hypophosphatemia in the intensive care unit: a review

PubMed Central

2010-01-01

Introduction Currently no evidence-based guideline exists for the approach to hypophosphatemia in critically ill patients. Methods We performed a narrative review of the medical literature to identify the incidence, symptoms, and treatment of hypophosphatemia in critically ill patients. Specifically, we searched for answers to the questions whether correction of hypophosphatemia is associated with improved outcome, and whether a certain treatment strategy is superior. Results Incidence: hypophosphatemia is frequently encountered in the intensive care unit; and critically ill patients are at increased risk for developing hypophosphatemia due to the presence of multiple causal factors. Symptoms: hypophosphatemia may lead to a multitude of symptoms, including cardiac and respiratory failure. Treatment: hypophosphatemia is generally corrected when it is symptomatic or severe. However, although multiple studies confirm the efficacy and safety of intravenous phosphate administration, it remains uncertain when and how to correct hypophosphatemia. Outcome: in some studies, hypophosphatemia was associated with higher mortality; a paucity of randomized controlled evidence exists for whether correction of hypophosphatemia improves the outcome in critically ill patients. Conclusions Additional studies addressing the current approach to hypophosphatemia in critically ill patients are required. Studies should focus on the association between hypophosphatemia and morbidity and/or mortality, as well as the effect of correction of this electrolyte disorder. PMID:20682049

Assessing Critical Thinking Outcomes of Dental Hygiene Students Utilizing Virtual Patient Simulation: A Mixed Methods Study.

PubMed

Allaire, Joanna L

2015-09-01

Dental hygiene educators must determine which educational practices best promote critical thinking, a quality necessary to translate knowledge into sound clinical decision making. The aim of this small pilot study was to determine whether virtual patient simulation had an effect on the critical thinking of dental hygiene students. A pretest-posttest design using the Health Science Reasoning Test was used to evaluate the critical thinking skills of senior dental hygiene students at The University of Texas School of Dentistry at Houston Dental Hygiene Program before and after their experience with computer-based patient simulation cases. Additional survey questions sought to identify the students' perceptions of whether the experience had helped develop their critical thinking skills and improved their ability to provide competent patient care. A convenience sample of 31 senior dental hygiene students completed both the pretest and posttest (81.5% of total students in that class); 30 senior dental hygiene students completed the survey on perceptions of the simulation (78.9% response rate). Although the results did not show a significant increase in mean scores, the students reported feeling that the use of virtual patients was an effective teaching method to promote critical thinking, problem-solving, and confidence in the clinical realm. The results of this pilot study may have implications to support the use of virtual patient simulations in dental hygiene education. Future research could include a larger controlled study to validate findings from this study.

Ferromagnetic quantum criticality: New aspects from the phase diagram of LaCrGe 3

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

Taufour, Valentin; Kaluarachchi, Udhara S.; Bud'ko, Sergey L.

Some Recent theoretical and experimental studies have shown that ferromagnetic quantum criticality is always avoided in clean systems. Two possibilities have been identified. In the first scenario, the ferromagnetic transition becomes of the first order at a tricritical point before being suppressed. A wing structure phase diagram is observed indicating the possibility of a new type of quantum critical point under magnetic field. In a second scenario, a transition to a modulated magnetic phase occurs. Our earlier studies on the compound LaCrGe 3 illustrate a third scenario where not only a new magnetic phase occurs, but also a change ofmore » order of the transition at a tricritical point leading to a wing-structure phase diagram. Careful experimental study of the phase diagram near the tricritical point also illustrates new rules near this type of point.« less

Ferromagnetic quantum criticality: New aspects from the phase diagram of LaCrGe 3

DOE PAGES

Taufour, Valentin; Kaluarachchi, Udhara S.; Bud'ko, Sergey L.; ...

2017-08-25

Some Recent theoretical and experimental studies have shown that ferromagnetic quantum criticality is always avoided in clean systems. Two possibilities have been identified. In the first scenario, the ferromagnetic transition becomes of the first order at a tricritical point before being suppressed. A wing structure phase diagram is observed indicating the possibility of a new type of quantum critical point under magnetic field. In a second scenario, a transition to a modulated magnetic phase occurs. Our earlier studies on the compound LaCrGe 3 illustrate a third scenario where not only a new magnetic phase occurs, but also a change ofmore » order of the transition at a tricritical point leading to a wing-structure phase diagram. Careful experimental study of the phase diagram near the tricritical point also illustrates new rules near this type of point.« less

Critical Consciousness and the Christian Conscience: Making the Necessary Connections between Faith-Based Learning and Critical Pedagogy

ERIC Educational Resources Information Center

Lee, Heekap; Givens, Ruth

2012-01-01

Critical pedagogy is a by product of postmodernism, which argues that reality is always subjective, and truth is identified through each person's experiences and environment. Can critical pedagogy be applied to faith-based education? The authors claim that it can. First, the theories and practices of critical pedagogy have strengthened faith-based…

The NIH Cognitive and Emotional Health Project. Report of the Critical Evaluation Study Committee.

PubMed

Hendrie, Hugh C; Albert, Marilyn S; Butters, Meryl A; Gao, Sujuan; Knopman, David S; Launer, Lenore J; Yaffe, Kristine; Cuthbert, Bruce N; Edwards, Emmeline; Wagster, Molly V

2006-01-01

The Cognitive and Emotional Health Project (CEHP) seeks to identify the demographic, social, and biological determinants of cognitive and emotional health in the older adult. As part of the CEHP, a critical evaluation study committee was formed to assess the state of epidemiological research on demographic, social, and biological determinants of cognitive and emotional health. Criteria for inclusion in the survey were large cohort studies, longitudinal in design, participants predominantly 65 years or older, with measurements of both cognition and emotion, and information on a wide variety of demographic, psychosocial, and biological factors. North American and European studies, which met these criteria, were selected for the review. Outcome measures included cognition, cognitive decline, and cognitive function. For emotion, symptoms included depression and anxiety, positive and negative affect, subjective well being, mastery, and resilience. Ninety-six papers were identified that addressed cognitive and emotional outcomes. A large variety of risk factors were consistently identified with cognitive outcomes, particularly those previously associated with increased risk of cardiovascular disease. There was considerable overlap between risk factors for cognitive and emotional outcomes. This review identifies a large number of lifestyle and health behaviors that alter the risk for maintenance of cognitive and emotional health. Large longitudinal cohort studies are a unique source to explore factors associated with cognitive and emotional health. Secondary analyses of these studies should be encouraged as should the development of standardized questionnaires to measure cognitive and emotional health. Future research in this field should study cognitive and emotional health simultaneously.

A qualitative analysis of how advanced practice nurses use clinical decision support systems.

PubMed

Weber, Scott

2007-12-01

The purpose of this study was to generate a grounded theory that will reflect the experiences of advanced practice nurses (APNs) working as critical care nurse practitioners (NPs) and clinical nurse specialists (CNS) with computer-based decision-making systems. A study design using grounded theory qualitative research methods and convenience sampling was employed in this study. Twenty-three APNs (13 CNS and 10 NPs) were recruited from 16 critical care units located in six large urban medical centers in the U.S. Midwest. Single-structured in-depth interviews with open-ended audio-taped questions were conducted with each APN. Through this process, APNs defined what they consider to be relevant themes and patterns of clinical decision system use in their critical care practices, and they identified the interrelatedness of the conceptual categories that emerged from the results. Data were analyzed using the constant comparative analysis method of qualitative research. APN participants were predominantly female, white/non-Hispanic, had a history of access to the clinical decision system used in their critical care settings for an average of 14 months, and had attended a formal training program to learn how to use clinical decision systems. "Forecasting decision outcomes," which was defined as the voluntary process employed to forecast the outcomes of patient care decisions in critical care prior to actual decision making, was the core variable describing system use that emerged from the responses. This variable consisted of four user constructs or components: (a) users' perceptions of their initial system learning experience, (b) users' sense of how well they understand how system technology works, (c) users' understanding of how system inferences are created or derived, and (d) users' relative trust of system-derived data. Each of these categories was further described through the grounded theory research process, and the relationships between the categories were identified. The findings of this study suggest that the main reason critical care APNs choose to integrate clinical decision systems into their practices is to provide an objective, scientifically derived, technology-based backup for human forecasting of the outcomes of patient care decisions prior to their actual decision making. Implications for nursing, health care, and technology research are presented.

Multisociety Task Force for Critical Care Research: key issues and recommendations.

PubMed

Deutschman, Clifford S; Ahrens, Tom; Cairns, Charles B; Sessler, Curtis N; Parsons, Polly E

2012-01-01

Research in critical care extends from the bench to the bedside, involving multiple departments, specialties, and funding organizations. Because of this diversity, it has been difficult for all stakeholders to collectively identify challenges and establish priorities. To define a comprehensive agenda for critical care research using input from a broad range of stakeholders to serve as a blueprint for future initiatives. The Critical Care Societies Collaborative (CCSC), consisting of the leadership of the American Association of Critical-Care Nurses (AACN), the American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), and the Society of Critical Care Medicine (SCCM), joined the US Critical Illness and Injury Trials Group (USCIITG) in forming a task force to define a comprehensive critical care research agenda. This group of 25 identified experts was divided into subgroups to address basic, translational, clinical, implementation, and educational research. The subgroups met via conference calls, and the entire task force met in person for a 2-day session. The result was a detailed discussion of the research priorities that served as the basis for this report. The task force identified challenges, specific priority areas, and recommendations for process improvements to support critical care research. Additionally, four overarching themes emerged: 1) the traditional "silo-ed" approach to critical care research is counterproductive and should be modified; 2) an approach that more effectively links areas of research (i.e., basic and translational research, or clinical research and implementation) should be embraced; 3) future approaches to human research should account for disease complexity and patient heterogeneity; and 4) an enhanced infrastructure for critical care research is essential for future success. This document contains the themes/recommendations developed by a large, multiprofessional cross section of critical care scientists, clinicians, and educators. It provides a unique framework for future research in critical care medicine.

Multisociety task force for critical care research: key issues and recommendations.

PubMed

Deutschman, Clifford S; Ahrens, Tom; Cairns, Charles B; Sessler, Curtis N; Parsons, Polly E

2012-01-01

Research in critical care extends from the bench to the bedside, involving multiple departments, specialties, and funding organizations. Because of this diversity, it has been difficult for all stakeholders to collectively identify challenges and establish priorities. To define a comprehensive agenda for critical care research using input from a broad range of stakeholders to serve as a blueprint for future initiatives. The Critical Care Societies Collaborative (CCSC), consisting of the leadership of the American Association of Critical-Care Nurses (AACN), the American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), and the Society of Critical Care Medicine (SCCM), joined the U.S. Critical Illness and Injury Trials Group (USCIITG) in forming a task force to define a comprehensive critical care research agenda. This group of 25 identified experts was divided into subgroups to address basic, translational, clinical, implementation, and educational research. The subgroups met via conference calls, and the entire task force met in person for a 2-day session. The result was a detailed discussion of the research priorities that served as the basis for this report. The task force identified challenges, specific priority areas, and recommendations for process improvements to support critical care research. Additionally, four overarching themes emerged: (1) the traditional "silo-ed" approach to critical care research is counterproductive and should be modified; (2) an approach that more effectively links areas of research (i.e., basic and translational research, or clinical research and implementation) should be embraced; (3) future approaches to human research should account for disease complexity and patient heterogeneity; and (4) an enhanced infrastructure for critical care research is essential for future success. This document contains the themes/recommendations developed by a large, multiprofessional cross-section of critical care scientists, clinicians, and educators. It provides a unique framework for future research in critical care medicine.

Multisociety task force for critical care research: key issues and recommendations.

PubMed

Deutschman, Clifford S; Ahrens, Tom; Cairns, Charles B; Sessler, Curtis N; Parsons, Polly E

2012-01-01

Research in critical care extends from the bench to the bedside, involving multiple departments, specialties, and funding organizations. Because of this diversity, it has been difficult for all stakeholders to collectively identify challenges and establish priorities. To define a comprehensive agenda for critical care research using input from a broad range of stakeholders to serve as a blueprint for future initiatives. The Critical Care Societies Collaborative (CCSC), consisting of the leadership of the American Association of Critical-Care Nurses (AACN), the American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), and the Society of Critical Care Medicine (SCCM), joined the US Critical Illness and Injury Trials Group (USCIITG) in forming a task force to define a comprehensive critical care research agenda. This group of 25 identified experts was divided into subgroups to address basic, translational, clinical, implementation, and educational research. The subgroups met via conference calls, and the entire task force met in person for a 2-day session. The result was a detailed discussion of the research priorities that served as the basis for this report. The task force identified challenges, specific priority areas, and recommendations for process improvements to support critical care research. Additionally, four overarching themes emerged: 1) the traditional "silo-ed" approach to critical care research is counterproductive and should be modified; 2) an approach that more effectively links areas of research (ie, basic and translational research, or clinical research and implementation) should be embraced; 3) future approaches to human research should account for disease complexity and patient heterogeneity; and 4) an enhanced infrastructure for critical care research is essential for future success. This document contains the themes/recommendations developed by a large, multiprofessional cross section of critical care scientists, clinicians, and educators. It provides a unique framework for future research in critical care medicine.

Multisociety Task Force for Critical Care Research: Key Issues and Recommendations

PubMed Central

Deutschman, Clifford S.; Ahrens, Tom; Cairns, Charles B.; Sessler, Curtis N.; Parsons, Polly E.

2012-01-01

Background: Research in critical care extends from the bench to the bedside, involving multiple departments, specialties, and funding organizations. Because of this diversity, it has been difficult for all stakeholders to collectively identify challenges and establish priorities. Objective: To define a comprehensive agenda for critical care research using input from a broad range of stakeholders to serve as a blueprint for future initiatives. Methods: The Critical Care Societies Collaborative (CCSC), consisting of the leadership of the American Association of Critical-Care Nurses (AACN), the American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), and the Society of Critical Care Medicine (SCCM), joined the U.S. Critical Illness and Injury Trials Group (USCIITG) in forming a task force to define a comprehensive critical care research agenda. This group of 25 identified experts was divided into subgroups to address basic, translational, clinical, implementation, and educational research. The subgroups met via conference calls, and the entire task force met in person for a 2-day session. The result was a detailed discussion of the research priorities that served as the basis for this report. Results: The task force identified challenges, specific priority areas, and recommendations for process improvements to support critical care research. Additionally, four overarching themes emerged: (1) the traditional “silo-ed” approach to critical care research is counterproductive and should be modified; (2) an approach that more effectively links areas of research (i.e., basic and translational research, or clinical research and implementation) should be embraced; (3) future approaches to human research should account for disease complexity and patient heterogeneity; and (4) an enhanced infrastructure for critical care research is essential for future success. Conclusions: This document contains the themes/recommendations developed by a large, multiprofessional cross-section of critical care scientists, clinicians, and educators. It provides a unique framework for future research in critical care medicine. PMID:22210788

Multisociety Task Force for Critical Care Research

PubMed Central

Deutschman, Clifford S.; Ahrens, Tom; Cairns, Charles B.; Sessler, Curtis N.

2012-01-01

Background: Research in critical care extends from the bench to the bedside, involving multiple departments, specialties, and funding organizations. Because of this diversity, it has been difficult for all stakeholders to collectively identify challenges and establish priorities. Objective: To define a comprehensive agenda for critical care research using input from a broad range of stakeholders to serve as a blueprint for future initiatives. Methods: The Critical Care Societies Collaborative (CCSC), consisting of the leadership of the American Association of Critical-Care Nurses (AACN), the American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), and the Society of Critical Care Medicine (SCCM), joined the US Critical Illness and Injury Trials Group (USCIITG) in forming a task force to define a comprehensive critical care research agenda. This group of 25 identified experts was divided into subgroups to address basic, translational, clinical, implementation, and educational research. The subgroups met via conference calls, and the entire task force met in person for a 2-day session. The result was a detailed discussion of the research priorities that served as the basis for this report. Results: The task force identified challenges, specific priority areas, and recommendations for process improvements to support critical care research. Additionally, four overarching themes emerged: 1) the traditional “silo-ed” approach to critical care research is counterproductive and should be modified; 2) an approach that more effectively links areas of research (ie, basic and translational research, or clinical research and implementation) should be embraced; 3) future approaches to human research should account for disease complexity and patient heterogeneity; and 4) an enhanced infrastructure for critical care research is essential for future success. Conclusions: This document contains the themes/recommendations developed by a large, multiprofessional cross section of critical care scientists, clinicians, and educators. It provides a unique framework for future research in critical care medicine. PMID:22215828

Disaster management and the critical thinking skills of local emergency managers: correlations with age, gender, education, and years in occupation.

PubMed

Peerbolte, Stacy L; Collins, Matthew Lloyd

2013-01-01

Emergency managers must be able to think critically in order to identify and anticipate situations, solve problems, make judgements and decisions effectively and efficiently, and assume and manage risk. Heretofore, a critical thinking skills assessment of local emergency managers had yet to be conducted that tested for correlations among age, gender, education, and years in occupation. An exploratory descriptive research design, using the Watson-Glaser Critical Thinking Appraisal-Short Form (WGCTA-S), was employed to determine the extent to which a sample of 54 local emergency managers demonstrated the critical thinking skills associated with the ability to assume and manage risk as compared to the critical thinking scores of a group of 4,790 peer-level managers drawn from an archival WGCTA-S database. This exploratory design suggests that the local emergency managers, surveyed in this study, had lower WGCTA-S critical thinking scores than their equivalents in the archival database with the exception of those in the high education and high experience group. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Vulnerability analysis and critical areas identification of the power systems under terrorist attacks

NASA Astrophysics Data System (ADS)

Wang, Shuliang; Zhang, Jianhua; Zhao, Mingwei; Min, Xu

2017-05-01

This paper takes central China power grid (CCPG) as an example, and analyzes the vulnerability of the power systems under terrorist attacks. To simulate the intelligence of terrorist attacks, a method of critical attack area identification according to community structures is introduced. Meanwhile, three types of vulnerability models and the corresponding vulnerability metrics are given for comparative analysis. On this basis, influence of terrorist attacks on different critical areas is studied. Identifying the vulnerability of different critical areas will be conducted. At the same time, vulnerabilities of critical areas under different tolerance parameters and different vulnerability models are acquired and compared. Results show that only a few number of vertex disruptions may cause some critical areas collapse completely, they can generate great performance losses the whole systems. Further more, the variation of vulnerability values under different scenarios is very large. Critical areas which can cause greater damage under terrorist attacks should be given priority of protection to reduce vulnerability. The proposed method can be applied to analyze the vulnerability of other infrastructure systems, they can help decision makers search mitigation action and optimum protection strategy.

Healthcare librarians and the delivery of critical appraisal training: attitudes, level of involvement and support.

PubMed

Maden-Jenkins, Michelle

2010-12-01

Although healthcare librarians are undertaking training in critical appraisal skills, what is not so clear is the impact of the training on the understanding and dissemination of these skills. This study aims to examine the attitudes of healthcare librarians towards delivering critical appraisal training and their level of involvement. A questionnaire survey of 57 library services across 48 NHS Trust Library Services in north-west England followed up with 21 semi-structured interviews. Seventy-three per cent of respondents felt that they ought to be involved in delivering critical appraisal training, however less than a third (29%) are actually involved. Librarians are involved in critical appraisal facilitation at various levels. Debate continues over the extent of librarian involvement in delivering critical appraisal training. As long as healthcare librarians recognise their own capabilities and identify the boundaries within which they feel comfortable then there is no reason why they should not be involved in delivering critical appraisal training. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

Understanding critical health literacy: a concept analysis

PubMed Central

2013-01-01

Background Interest in and debates around health literacy have grown over the last two decades and key to the discussions has been the distinction made between basic functional health literacy, communicative/interactive health literacy and critical health literacy. Of these, critical health literacy is the least well developed and differing interpretations of its constituents and relevance exist. The aim of this study is to rigorously analyse the concept of critical health literacy in order to offer some clarity of definition upon which appropriate theory, well grounded practice and potential measurement tools can be based. Method The study uses a theoretical and colloquial evolutionary concept analysis method to systematically identify the features associated with this concept. A unique characteristic of this method is that it practically combines an analysis of the literature with in depth interviews undertaken with practitioners and policy makers who have an interest in the field. The study also analyses how the concept is understood across the contexts of time, place, discipline and use by health professionals, policy makers and academics. Results Findings revealed a distinct set of characteristics of advanced personal skills, health knowledge, information skills, effective interaction between service providers and users, informed decision making and empowerment including political action as key features of critical health literacy. The potential consequences of critical health literacy identified are in improving health outcomes, creating more effective use of health services and reducing inequalities in health thus demonstrating the relevance of this concept to public health and health promotion. Conclusions While critical health literacy is shown to be a unique concept, there remain significant contextual variations in understanding particularly between academics, practitioners and policy makers. Key attributes presented as part of this concept when it was first introduced in the literature, particularly those around empowerment, social and political action and the existence of the concept at both an individual and population level, have been lost in more recent representations. This has resulted in critical health literacy becoming restricted to a higher order cognitive individual skill rather than a driver for political and social change. The paper argues that in order to retain the uniqueness and usefulness of the concept in practice efforts should be made to avoid this dilution of meaning. PMID:23419015

A longitudinal interprofessional simulation curriculum for critical care teams: Exploring successes and challenges.

PubMed

Leclair, Laurie W; Dawson, Mary; Howe, Alison; Hale, Sue; Zelman, Eric; Clouser, Ryan; Garrison, Garth; Allen, Gilman

2018-05-01

Interprofessional care teams are the backbone of intensive care units (ICUs) where severity of illness is high and care requires varied skills and experience. Despite this care model, longitudinal educational programmes for such workplace teams rarely include all professions. In this article, we report findings on the initial assessment and evaluation of an ongoing, longitudinal simulation-based curriculum for interprofessional workplace critical care teams. The study had two independent components, quantitative learner assessment and qualitative curricular evaluation. To assess curriculum effectiveness at meeting learning objectives, participant-reported key learning points identified using a self-assessment tool administered immediately following curricular participation were mapped to session learning objectives. To evaluate the curriculum, we conducted a qualitative study using a phenomenology approach involving purposeful sampling of nine curricular participants undergoing recorded semi-structured interviews. Verbatim transcripts were reviewed by two independent readers to derive themes further subdivided into successes and barriers. Learner self-assessment demonstrated that the majority of learners, across all professions, achieved at least one intended learning objective with senior learners more likely to report team-based objectives and junior learners more likely to report knowledge/practice objectives. Successes identified by curricular evaluation included authentic critical care curricular content, safe learning environment, and team comradery from shared experience. Barriers included unfamiliarity with the simulation environment and clinical coverage for curricular participation. This study suggests that a sustainable interprofessional curriculum for workplace ICU critical care teams can achieve the desired educational impact and effectively deliver authentic simulated work experiences if barriers to educational engagement and participation can be overcome.

Early mobilization in critically ill patients: patients' mobilization level depends on health care provider's profession.

PubMed

Garzon-Serrano, Jaime; Ryan, Cheryl; Waak, Karen; Hirschberg, Ronald; Tully, Susan; Bittner, Edward A; Chipman, Daniel W; Schmidt, Ulrich; Kasotakis, Georgios; Benjamin, John; Zafonte, Ross; Eikermann, Matthias

2011-04-01

To evaluate whether the level of mobilization achieved and the barriers for progressing to the next mobilization level differ between nurses and physical therapists. Prospective, observational study. Twenty-bed surgical intensive care unit (SICU) of the Massachusetts General Hospital. Sixty-three critically ill patients. Physical therapists and nurses performed 179 mobilization therapies with 63 patients. Mobilization was defined as the process of enhancing mobility in the SICU, including bed mobility, edge of bed activities, transfers out of bed to a chair, and gait training; the mobilization level was measured on the SICU optimal mobilization scale, a 5-point (0-4) numerical rating scale. Patients' level of mobilization achieved by physical therapists was significantly higher compared with that achieved by nurses (2.3 ± 1.2 mean ± SD versus 1.2 ± 1.2, respectively P < .0001). Different barriers for mobilization were identified by physical therapists and nurses: hemodynamic instability (26% versus 12%, P = .03) and renal replacement therapy (12% versus 1%, P = .03) were barriers rated higher by nurses, whereas neurologic impairment was rated higher by physical therapists providers (18% versus 38%, P = .002). No mobilization-associated adverse events were observed in this study. This study showed that physical therapists mobilize their critically ill patients to higher levels compared with nurses. Nurse and physical therapists identify different barriers for mobilization. Routine involvement of physical therapists in directing mobilization treatment may promote early mobilization of critically ill patients. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Pharmacoeconomics of parenteral nutrition in surgical and critically ill patients receiving structured triglycerides in China.

PubMed

Wu, Guo Hao; Ehm, Alexandra; Bellone, Marco; Pradelli, Lorenzo

2017-01-01

A prior meta-analysis showed favorable metabolic effects of structured triglyceride (STG) lipid emulsions in surgical and critically ill patients compared with mixed medium-chain/long-chain triglycerides (MCT/LCT) emulsions. Limited data on clinical outcomes precluded pharmacoeconomic analysis. We performed an updated meta-analysis and developed a cost model to compare overall costs for STGs vs MCT/LCTs in Chinese hospitals. We searched Medline, Embase, Wanfang Data, the China Hospital Knowledge Database, and Google Scholar for clinical trials comparing STGs to mixed MCT/LCTs in surgical or critically ill adults published between October 10, 2013 and September 19, 2015. Newly identified studies were pooled with the prior studies and an updated meta-analysis was performed. A deterministic simulation model was used to compare the effects of STGs and mixed MCT/LCT's on Chinese hospital costs. The literature search identified six new trials, resulting in a total of 27 studies in the updated meta-analysis. Statistically significant differences favoring STGs were observed for cumulative nitrogen balance, pre- albumin and albumin concentrations, plasma triglycerides, and liver enzymes. STGs were also associated with a significant reduction in the length of hospital stay (mean difference, -1.45 days; 95% confidence interval, -2.48 to -0.43; p=0.005) versus mixed MCT/LCTs. Cost analysis demonstrated a net cost benefit of ¥675 compared with mixed MCT/LCTs. STGs are associated with improvements in metabolic function and reduced length of hospitalization in surgical and critically ill patients compared with mixed MCT/LCT emulsions. Cost analysis using data from Chinese hospitals showed a corresponding cost benefit.

Incorporation of spatial interactions in location networks to identify critical geo-referenced routes for assessing disease control measures on a large-scale campus.

PubMed

Wen, Tzai-Hung; Chin, Wei Chien Benny

2015-04-14

Respiratory diseases mainly spread through interpersonal contact. Class suspension is the most direct strategy to prevent the spread of disease through elementary or secondary schools by blocking the contact network. However, as university students usually attend courses in different buildings, the daily contact patterns on a university campus are complicated, and once disease clusters have occurred, suspending classes is far from an efficient strategy to control disease spread. The purpose of this study is to propose a methodological framework for generating campus location networks from a routine administration database, analyzing the community structure of the network, and identifying the critical links and nodes for blocking respiratory disease transmission. The data comes from the student enrollment records of a major comprehensive university in Taiwan. We combined the social network analysis and spatial interaction model to establish a geo-referenced community structure among the classroom buildings. We also identified the critical links among the communities that were acting as contact bridges and explored the changes in the location network after the sequential removal of the high-risk buildings. Instead of conducting a questionnaire survey, the study established a standard procedure for constructing a location network on a large-scale campus from a routine curriculum database. We also present how a location network structure at a campus could function to target the high-risk buildings as the bridges connecting communities for blocking disease transmission.

Anticipating students' reasoning and planning prompts in structured problem-solving lessons

NASA Astrophysics Data System (ADS)

Vale, Colleen; Widjaja, Wanty; Doig, Brian; Groves, Susie

2018-02-01

Structured problem-solving lessons are used to explore mathematical concepts such as pattern and relationships in early algebra, and regularly used in Japanese Lesson Study research lessons. However, enactment of structured problem-solving lessons which involves detailed planning, anticipation of student solutions and orchestration of whole-class discussion of solutions is an ongoing challenge for many teachers. Moreover, primary teachers have limited experience in teaching early algebra or mathematical reasoning actions such as generalising. In this study, the critical factors of enacting the structured problem-solving lessons used in Japanese Lesson Study to elicit and develop primary students' capacity to generalise are explored. Teachers from three primary schools participated in two Japanese Lesson Study teams for this study. The lesson plans and video recordings of teaching and post-lesson discussion of the two research lessons along with students' responses and learning are compared to identify critical factors. The anticipation of students' reasoning together with preparation of supporting and challenging prompts was critical for scaffolding students' capacity to grasp and communicate generality.

A Qualitative Study of the Development of Health Literacy Capacities of Participants Attending a Community-Based Cardiovascular Health Programme.

PubMed

McKenna, Verna B; Sixsmith, Jane; Barry, Margaret M

2018-06-02

Health literacy is a critical determinant of health, which can empower individuals and lead to engagement in collective health promotion action and is also a crucial component in the self-management of illness. The current study moves beyond a focus on functional health literacy and presents findings from a longitudinal qualitative (LQ) study consisting of three phases. This paper presents findings from the second phase of the study, which assessed the development of health literacy capacities of individuals attending a structured cardiovascular risk reduction programme in Ireland. The study objectives were to: explore perceptions of changes in interactions and information exchange within health consultations; identify the facilitators associated with changes in health literacy capacities; assess developments in engagement with broader contexts for health literacy capacities. A LQ study design was undertaken, which employed repeat interview methodology with 19 participants (aged 36⁻76 years) 12 weeks after beginning a structured cardiovascular risk reduction programme. Health literacy levels were assessed using the HLS-EU 47 item instrument in phase 1 (68% limited health literacy (HL), 32% adequate health literacy). A semi-structured interview guide, (informed by Sørensen's conceptual model of health literacy), was used to explore the development of health literacy and to identify changes in knowledge, attitudes and experiences over time. Thematic analysis was used, informed by aspects of Saldaña's framework for longitudinal qualitative data analysis. All participants reported having acquired increased understanding of issues relevant to their health and self-care. Participants described health literacy capacities that incorporate aspects of all levels of health literacy (functional, interactive and critical). Core themes were identified corresponding to changes in these levels: re-engagement with health information and increased understanding of risk and protective factors (changes in functional health literacy); changes in interactions with healthcare providers (HCP) (changes in interactive health literacy); enhanced psychological insights and understanding the broader determinants of health (changes in critical health literacy). Findings support the development of health literacy capacities across the functional, interactive and critical health literacy domains. Participants are capable of locating responsibility for health beyond the individual level and are making sense of knowledge within their own social contexts. Individuals, regardless of their initial health literacy levels, are capable of engaging with broader issues that can impact on their health and can be supported to develop these critical health literacy capacities.

Replacement Planning: A Starting Point for Succession Planning and Talent Management

ERIC Educational Resources Information Center

Rothwell, William J.

2011-01-01

Replacement planning is a process of identifying short-term or long-term backups so that organizations have people who can assume responsibility for critical positions during emergencies. Individuals identified as "replacements" are not promised promotions; rather, they are prepared to the point where they can assume a critical position long…

Identifying and Prioritizing Critical Hardwood Resources

Treesearch

Sam C. Doak; Sharon Johnson; Marlyce Myers

1991-01-01

A logical framework is required to provide a focus for the implementation of a variety of landowner incentive techniques in accordance with existing goals to protect and enhance hardwood resources. A system is presented for identifying and prioritizing critical hardwood resources for site specific conservation purposes. Flexibility is built into this system so that...

Identifying critical issues in recreation planning and management: improving the management-research partnership

Treesearch

John H. Schomaker; David W. Lime

1988-01-01

The "nominal group" process is a proven technique to systematically arrive at a consensus about critical information needs in recreation planning and management. Using this process, 41 managers who attended a 1983 conference on river management identified 114 specific information needs grouped under 11 general questions. Clearly, some concerns of...

Identifying the Critical Time Period for Information Extraction when Recognizing Sequences of Play

ERIC Educational Resources Information Center

North, Jamie S.; Williams, A. Mark

2008-01-01

The authors attempted to determine the critical time period for information extraction when recognizing play sequences in soccer. Although efforts have been made to identify the perceptual information underpinning such decisions, no researchers have attempted to determine "when" this information may be extracted from the display. The authors…

Online adaptive optimal control for continuous-time nonlinear systems with completely unknown dynamics

NASA Astrophysics Data System (ADS)

Lv, Yongfeng; Na, Jing; Yang, Qinmin; Wu, Xing; Guo, Yu

2016-01-01

An online adaptive optimal control is proposed for continuous-time nonlinear systems with completely unknown dynamics, which is achieved by developing a novel identifier-critic-based approximate dynamic programming algorithm with a dual neural network (NN) approximation structure. First, an adaptive NN identifier is designed to obviate the requirement of complete knowledge of system dynamics, and a critic NN is employed to approximate the optimal value function. Then, the optimal control law is computed based on the information from the identifier NN and the critic NN, so that the actor NN is not needed. In particular, a novel adaptive law design method with the parameter estimation error is proposed to online update the weights of both identifier NN and critic NN simultaneously, which converge to small neighbourhoods around their ideal values. The closed-loop system stability and the convergence to small vicinity around the optimal solution are all proved by means of the Lyapunov theory. The proposed adaptation algorithm is also improved to achieve finite-time convergence of the NN weights. Finally, simulation results are provided to exemplify the efficacy of the proposed methods.

Simulation-based assessment to identify critical gaps in safe anesthesia resident performance.

PubMed

Blum, Richard H; Boulet, John R; Cooper, Jeffrey B; Muret-Wagstaff, Sharon L

2014-01-01

Valid methods are needed to identify anesthesia resident performance gaps early in training. However, many assessment tools in medicine have not been properly validated. The authors designed and tested use of a behaviorally anchored scale, as part of a multiscenario simulation-based assessment system, to identify high- and low-performing residents with regard to domains of greatest concern to expert anesthesiology faculty. An expert faculty panel derived five key behavioral domains of interest by using a Delphi process (1) Synthesizes information to formulate a clear anesthetic plan; (2) Implements a plan based on changing conditions; (3) Demonstrates effective interpersonal and communication skills with patients and staff; (4) Identifies ways to improve performance; and (5) Recognizes own limits. Seven simulation scenarios spanning pre-to-postoperative encounters were used to assess performances of 22 first-year residents and 8 fellows from two institutions. Two of 10 trained faculty raters blinded to trainee program and training level scored each performance independently by using a behaviorally anchored rating scale. Residents, fellows, facilitators, and raters completed surveys. Evidence supporting the reliability and validity of the assessment scores was procured, including a high generalizability coefficient (ρ = 0.81) and expected performance differences between first-year resident and fellow participants. A majority of trainees, facilitators, and raters judged the assessment to be useful, realistic, and representative of critical skills required for safe practice. The study provides initial evidence to support the validity of a simulation-based performance assessment system for identifying critical gaps in safe anesthesia resident performance early in training.

Construction of diagnosis system and gene regulatory networks based on microarray analysis.

PubMed

Hong, Chun-Fu; Chen, Ying-Chen; Chen, Wei-Chun; Tu, Keng-Chang; Tsai, Meng-Hsiun; Chan, Yung-Kuan; Yu, Shyr Shen

2018-05-01

A microarray analysis generally contains expression data of thousands of genes, but most of them are irrelevant to the disease of interest, making analyzing the genes concerning specific diseases complicated. Therefore, filtering out a few essential genes as well as their regulatory networks is critical, and a disease can be easily diagnosed just depending on the expression profiles of a few critical genes. In this study, a target gene screening (TGS) system, which is a microarray-based information system that integrates F-statistics, pattern recognition matching, a two-layer K-means classifier, a Parameter Detection Genetic Algorithm (PDGA), a genetic-based gene selector (GBG selector) and the association rule, was developed to screen out a small subset of genes that can discriminate malignant stages of cancers. During the first stage, F-statistic, pattern recognition matching, and a two-layer K-means classifier were applied in the system to filter out the 20 critical genes most relevant to ovarian cancer from 9600 genes, and the PDGA was used to decide the fittest values of the parameters for these critical genes. Among the 20 critical genes, 15 are associated with cancer progression. In the second stage, we further employed a GBG selector and the association rule to screen out seven target gene sets, each with only four to six genes, and each of which can precisely identify the malignancy stage of ovarian cancer based on their expression profiles. We further deduced the gene regulatory networks of the 20 critical genes by applying the Pearson correlation coefficient to evaluate the correlationship between the expression of each gene at the same stages and at different stages. Correlationships between gene pairs were calculated, and then, three regulatory networks were deduced. Their correlationships were further confirmed by the Ingenuity pathway analysis. The prognostic significances of the genes identified via regulatory networks were examined using online tools, and most represented biomarker candidates. In summary, our proposed system provides a new strategy to identify critical genes or biomarkers, as well as their regulatory networks, from microarray data. Copyright © 2018. Published by Elsevier Inc.

Identification of α-Chimaerin as a Candidate Gene for Critical Period Neuronal Plasticity in Cat and Mouse Visual Cortex

PubMed Central

2011-01-01

Background In cat visual cortex, critical period neuronal plasticity is minimal until approximately 3 postnatal weeks, peaks at 5 weeks, gradually declines to low levels at 20 weeks, and disappears by 1 year of age. Dark rearing slows the entire time course of this critical period, such that at 5 weeks of age, normal cats are more plastic than dark reared cats, whereas at 20 weeks, dark reared cats are more plastic. Thus, a stringent criterion for identifying genes that are important for plasticity in visual cortex is that they show differences in expression between normal and dark reared that are of opposite direction in young versus older animals. Results The present study reports the identification by differential display PCR of a novel gene, α-chimaerin, as a candidate visual cortex critical period plasticity gene that showed bidirectional regulation of expression due to age and dark rearing. Northern blotting confirmed the bidirectional expression and 5'RACE sequencing identified the gene. There are two alternatively-spliced α-chimaerin isoforms: α1 and α2. Western blotting extended the evidence for bidirectional regulation of visual cortex α-chimaerin isoform expression to protein in cats and mice. α1- and α2-Chimaerin were elevated in dark reared compared to normal visual cortex at the peak of the normal critical period and in normal compared to dark reared visual cortex at the nadir of the normal critical period. Analysis of variance showed a significant interaction in both cats and mice for both α-chimaerin isoforms, indicating that the effect of dark rearing depended on age. This differential expression was not found in frontal cortex. Conclusions Chimaerins are RhoGTPase-activating proteins that are EphA4 effectors and have been implicated in a number of processes including growth cone collapse, axon guidance, dendritic spine development and the formation of corticospinal motor circuits. The present results identify α-chimaerin as a candidate molecule for a role in the postnatal critical period of visual cortical plasticity. PMID:21767388

An Exploration of How Foster Parents Educationally Assist Foster Children: A Qualitative Phenomenological Study

ERIC Educational Resources Information Center

Zarate, Grace

2013-01-01

Foster children are academically at risk as a result of abuse, neglect and family disruptions. Findings from previous studies have underscored the critical role played by foster parents in monitoring the academic progress of the children placed in the home. The purpose of this qualitative phenomenological research study was to identify the skill…

Becoming a Race-Conscious Social Studies Teacher: The Influence of Personal and Professional Experiences

ERIC Educational Resources Information Center

Martell, Christopher C.; Stevens, Kaylene M.

2017-01-01

In this interpretive case study the researchers examined the beliefs of 13 self-identifying race-conscious secondary social studies teachers from diverse racial or ethnic, gender, and school-context backgrounds. The researchers found that the teachers' beliefs and views of practice were generally aligned with the main assertions of critical race…

Development of a Computer System To Educate Students To Evaluate and Interpret Published Drug Studies.

ERIC Educational Resources Information Center

Abate, Marie A.

The education of students in the techniques of critical appraisal of drug studies has been identified as a deficiency in many health sciences curricula. Errors in research design and inconsistencies in the reporting of study results persist in professional pharmacy and medical journals. Thus, thorough and accurate review and interpretation of…

Autonomous Pluralistic Learning Strategies among Mexican Indigenous and Minority University Students Learning English

ERIC Educational Resources Information Center

Despagne, Colette

2015-01-01

This critical ethnographic case study draws on Indigenous and minority students' process of learning English as a Foreign Language (EFL) in Mexico. The study specifically focuses on students who enrolled in a program called "A Wager with the Future." The aim of the study is to identify and understand contributing factors in these…

Equity- and Tolerance-Oriented Teachers: Approaches to Teaching Race in the Social Studies Classroom

ERIC Educational Resources Information Center

Martell, Christopher C.; Stevens, Kaylene M.

2017-01-01

In this interpretative case study, the researchers examined the beliefs and practices of 10 self-identifying race-conscious social studies teachers. Using critical race theory as the lens, the researchers found that most of the teachers made race explicit in their classrooms by including race in units not typically considered race-related and…

The application of hazard analysis and critical control points and risk management in the preparation of anti-cancer drugs.

PubMed

Bonan, Brigitte; Martelli, Nicolas; Berhoune, Malik; Maestroni, Marie-Laure; Havard, Laurent; Prognon, Patrice

2009-02-01

To apply the Hazard analysis and Critical Control Points method to the preparation of anti-cancer drugs. To identify critical control points in our cancer chemotherapy process and to propose control measures and corrective actions to manage these processes. The Hazard Analysis and Critical Control Points application began in January 2004 in our centralized chemotherapy compounding unit. From October 2004 to August 2005, monitoring of the process nonconformities was performed to assess the method. According to the Hazard Analysis and Critical Control Points method, a multidisciplinary team was formed to describe and assess the cancer chemotherapy process. This team listed all of the critical points and calculated their risk indexes according to their frequency of occurrence, their severity and their detectability. The team defined monitoring, control measures and corrective actions for each identified risk. Finally, over a 10-month period, pharmacists reported each non-conformity of the process in a follow-up document. Our team described 11 steps in the cancer chemotherapy process. The team identified 39 critical control points, including 11 of higher importance with a high-risk index. Over 10 months, 16,647 preparations were performed; 1225 nonconformities were reported during this same period. The Hazard Analysis and Critical Control Points method is relevant when it is used to target a specific process such as the preparation of anti-cancer drugs. This method helped us to focus on the production steps, which can have a critical influence on product quality, and led us to improve our process.

Critical Windows of Cardiovascular Susceptibility to Developmental Hypoxia in Common Snapping Turtle (Chelydra serpentina) Embryos.

PubMed

Tate, Kevin B; Kohl, Zachary F; Eme, John; Rhen, Turk; Crossley, Dane A

2015-01-01

Environmental conditions fluctuate dramatically in some reptilian nests. However, critical windows of environmental sensitivity for cardiovascular development have not been identified. Continuous developmental hypoxia has been shown to alter cardiovascular form and function in embryonic snapping turtles (Chelydra serpentina), and we used this species to identify critical periods during which hypoxia modifies the cardiovascular phenotype. We hypothesized that incubation in 10% O2 during specific developmental periods would have differential effects on the cardiovascular system versus overall somatic growth. Two critical windows were identified with 10% O2 from 50% to 70% of incubation, resulting in relative heart enlargement, either via preservation of or preferential growth of this tissue, while exposure to 10% O2 from 20% to 70% of incubation resulted in a reduction in arterial pressure. The deleterious or advantageous aspects of these embryonic phenotypes in posthatching snapping turtles have yet to be explored. However, identification of these critical windows has provided insight into how the developmental environment alters the phenotype of reptiles and will also be pivotal in understanding its impact on the fitness of egg-laying reptiles.

Comparing the Effects of Simulation-Based and Traditional Teaching Methods on the Critical Thinking Abilities and Self-Confidence of Nursing Students.

PubMed

Alamrani, Mashael Hasan; Alammar, Kamila Ahmad; Alqahtani, Sarah Saad; Salem, Olfat A

2018-06-01

Critical thinking and self-confidence are imperative to success in clinical practice. Educators should use teaching strategies that will help students enhance their critical thinking and self-confidence in complex content such as electrocardiogram interpretation. Therefore, teaching electrocardiogram interpretation to students is important for nurse educators. This study compares the effect of simulation-based and traditional teaching methods on the critical thinking and self-confidence of students during electrocardiogram interpretation sessions. Thirty undergraduate nursing students volunteered to participate in this study. The participants were divided into intervention and control groups, which were taught respectively using the simulation-based and traditional teaching programs. All of the participants were asked to complete the study instrumentpretest and posttest to measure their critical thinking and self-confidence. Improvement was observed in the control and experimental groups with respect to critical thinking and self-confidence, as evidenced by the results of the paired samples t test and the Wilcoxon signed-rank test (p < .05). However, the independent t test and Mann-Whitney U test indicate that the difference between the two groups was not significant (p > .05). This study evaluated an innovative simulation-based teaching method for nurses. No significant differences in outcomes were identified between the simulator-based and traditional teaching methods, indicating that well-implemented educational programs that use either teaching method effectively promote critical thinking and self-confidence in nursing students. Nurse educators are encouraged to design educational plans with clear objectives to improve the critical thinking and self-confidence of their students. Future research should compare the effects of several teaching sessions using each method in a larger sample.

A Contextual Analysis of the Quality Core Curriculum and the Georgia Performance Standards in Seventh Grade Social Studies: A Critical Race Perspective

ERIC Educational Resources Information Center

Candis, Matthew Reese

2013-01-01

In 1985 the state of Georgia introduced the Quality Core Curriculum (QCC) in accordance with the Quality Basic Education (QBE) Act. These learning standards identified the content knowledge that students were required to learn in each subject area at all grade levels. The QCC was replaced by the Georgia Performance Standards (GPS) to identify the…

Quality indicators of continuous renal replacement therapy (CRRT) care in critically ill patients: a systematic review.

PubMed

Rewa, Oleksa G; Villeneuve, Pierre-Marc; Lachance, Philippe; Eurich, Dean T; Stelfox, Henry T; Gibney, R T Noel; Hartling, Lisa; Featherstone, Robin; Bagshaw, Sean M

2017-06-01

Renal replacement therapy is increasingly utilized in the intensive care unit (ICU), of which continuous renal replacement therapy (CRRT) is most common. Despite CRRT being a relatively invasive and resource intensive technology, there remains wide practice variation in its application. This systematic review appraised the evidence for quality indicators (QIs) of CRRT care in critically ill patients. A comprehensive search strategy was developed and performed in five citation databases (Medline, Embase, CINAHL, Cochrane Library, and PubMed) and select grey literature sources. Two reviewers independently screened, selected, and extracted data using standardized forms. Each retrieved citation was appraised for quality using the Newcastle-Ottawa Scale (NOS) and Cochrane risk of bias tool. Data were summarized narratively. Our search yielded 8374 citations, of which 133 fulfilled eligibility. This included 97 cohort studies, 24 randomized controlled trials, 10 case-control studies, and 2 retrospective medical audits. The quality of retrieved studies was generally good. In total, 18 QIs were identified that were mentioned in 238 instances. Identified QIs were classified as related to structure (n = 4, 22.2 %), care processes (n = 9, 50.0 %), and outcomes (n = 5, 27.8 %). The most commonly mentioned QIs focused on filter lifespan (n = 98), small solute clearance (n = 46), bleeding (n = 30), delivered dose (n = 19), and treatment interruption (n = 5). Across studies, the definitions used for QIs evaluating similar constructs varied considerably. When identified, QIs were most commonly described as important (n = 144, 48.3 %), scientifically acceptable (n = 32, 10.7 %), and useable and/or feasible (n = 17, 5.7 %) by their primary study authors. We identified numerous potential QIs of CRRT care, characterized by heterogeneous definitions, varying quality of derivation, and limited evaluation. Further study is needed to prioritize a concise inventory of QIs to measure, improve, and benchmark CRRT care for critically ill patients. PROSPERO CRD42015015530.

Congruency in Defining Critical Thinking by Nurse Educators and Non-nurse Scholars.

ERIC Educational Resources Information Center

Gordon, Joanne M.

2000-01-01

Nurse educators (n=201) identified their concept of critical thinking and agreement with nonnurse experts (a Delphi panel of academic scholars) on critical thinking items. They agreed on skills and dispositions, but nurse educators were more likely to consider research, problem solving, decision making, and planning as critical thinking…

Survey of Professional Opinion on Critical Transition Skills for Adolescents and Young Adults Who Are Deaf.

ERIC Educational Resources Information Center

Bullis, Michael; Reiman, John W.

1989-01-01

Surveyed national sample of 307 professionals in relevant fields to obtain professional opinion on critical competencies necessary for deaf individuals to live and work successfully in the community. Findings identified 12 critical skills in employment and 10 critical skills in independent living. (Author/NB)

Physical indicators of hydrologic permanence in forested headwater streams

EPA Science Inventory

Recent court cases have brought headwater streams and their hydrologic permanence into the forefront for regulatory agencies, so rapid field-based indicators of hydrologic permanence in streams are critically needed. Our study objectives were to 1) identify environmental charact...

Three novel polymorphic microsatellite markers for the glaucoma locus GLC1B by datamining tetranucleotide repeats on chromosome 2p12-q12

PubMed Central

2009-01-01

In order to identify new markers around the glaucoma locus GLC1B as a tool to refine its critical region at 2p11.2-2q11.2, we searched the critical region sequence obtained from the UCSC database for tetranucleotide (GATA)n and (GTCT)n repeats of at least 10 units in length. Three out of four potential microsatellite loci were found to be polymorphic, heterozygosity ranging from 64.56% to 79.59%. The identified markers are useful not only for GLC1B locus but also for the study of other disease loci at 2p11.2-2q11.2, a region with scarcity of microsatellite markers. PMID:21637444

Journalists' Occupational Stress: A Comparative Study between Reporting Critical Events and Domestic News.

PubMed

Monteiro, Susana; Marques-Pinto, Alexandra

2017-07-27

Nowadays, journalism is considered a stressful occupation, not only due to the stress perceived in journalists' daily work but also due to the critical, potentially traumatic events they report. However, research on journalists' occupational stress in both these professional settings is still scarce. This study aims to characterize and compare occupational stress variables perceived by journalists in their daily work and in critical scenarios. Taking the Holistic Model of Occupational Stress by Nelson and Simmons (2003) as a framework, 25 Portuguese journalists, all with experience in reporting critical events, were interviewed on their perceptions of some core variables of the model: occupational stressors, distress and eustress emotional reactions, and the consequences of these experiences on their well-being. Differences among these core variables, according to the number of deployments to a critical event, were statistically analysed in order to ascertain whether repeated exposure to trauma influenced journalists' occupational stress perceptions. The data content analysis showed that occupational stressors and emotional reactions differed across settings, while the consequences associated with journalists' experiences were perceived as being mainly negative in both occupational contexts. Significant differences were identified in some of these variables according to the number of deployments to a critical event (p < .05). These findings may contribute to a reflection on the role of media organizations in preparing and supporting journalists in their work performance, and on the promotion of occupational health within the scope of journalists' daily work and critical events. The article closes with considerations for future studies.

Recruitment and Retention Strategies for Minority or Poor Clinical Research Participants: Lessons from the Healthy Aging in Neighborhoods of Diversity across the Life Span Study

ERIC Educational Resources Information Center

Ejiogu, Ngozi; Norbeck, Jennifer H.; Mason, Marc A.; Cromwell, Bridget C.; Zonderman, Alan B.; Evans, Michele K.

2011-01-01

Purpose of the study: Investigating health disparities requires studies designed to recruit and retain racially and socioeconomically diverse cohorts. It is critical to address the barriers that disproportionately affect participation in clinical research by minorities and the socioeconomically disadvantaged. This study sought to identify and…

Employee reactions and adjustment to euthanasia-related work: identifying turning-point events through retrospective narratives.

PubMed

Reeve, Charlie L; Spitzmuller, Christiane; Rogelberg, Steven G; Walker, Alan; Schultz, Lisa; Clark, Olga

2004-01-01

This study used a retrospective narrative procedure to examine the critical events that influence reactions and adjustment to euthanasia-related work of 35 employees who have stayed in the animal care and welfare field for at least 2 years. The study analyzed adjustment trajectory graphs and interview notes to identify turning-point events that spurred either a positive or negative change in shelter workers' psychological well-being. Analysis of the identified turning-point events revealed 10 common event themes that have implications for a range of work, personnel, and organizational practices. The article discusses implications for shelter, employee, and animal welfare.

Experimental investigation on flow patterns of RP-3 kerosene under sub-critical and supercritical pressures

NASA Astrophysics Data System (ADS)

Wang, Ning; Zhou, Jin; Pan, Yu; Wang, Hui

2014-02-01

Active cooling with endothermic hydrocarbon fuel is proved to be one of the most promising approaches to solve the thermal problem for hypersonic aircraft such as scramjet. The flow patterns of two-phase flow inside the cooling channels have a great influence on the heat transfer characteristics. In this study, phase transition processes of RP-3 kerosene flowing inside a square quartz-glass tube were experimentally investigated. Three distinct phase transition phenomena (liquid-gas two phase flow under sub-critical pressures, critical opalescence under critical pressure, and corrugation under supercritical pressures) were identified. The conventional flow patterns of liquid-gas two phase flow, namely bubble flow, slug flow, churn flow and annular flow are observed under sub-critical pressures. Dense bubble flow and dispersed flow are recognized when pressure is increased towards the critical pressure whilst slug flow, churn flow and annular flow disappear. Under critical pressure, the opalescence phenomenon is observed. Under supercritical pressures, no conventional phase transition characteristics, such as bubbles are observed. But some kind of corrugation appears when RP-3 transfers from liquid to supercritical. The refraction index variation caused by sharp density gradient near the critical temperature is thought to be responsible for this corrugation.

Assessment of cognitive bias in decision-making and leadership styles among critical care nurses: a mixed methods study.

PubMed

Lean Keng, Soon; AlQudah, Hani Nawaf Ibrahim

2017-02-01

To raise awareness of critical care nurses' cognitive bias in decision-making, its relationship with leadership styles and its impact on care delivery. The relationship between critical care nurses' decision-making and leadership styles in hospitals has been widely studied, but the influence of cognitive bias on decision-making and leadership styles in critical care environments remains poorly understood, particularly in Jordan. Two-phase mixed methods sequential explanatory design and grounded theory. critical care unit, Prince Hamza Hospital, Jordan. Participant sampling: convenience sampling Phase 1 (quantitative, n = 96), purposive sampling Phase 2 (qualitative, n = 20). Pilot tested quantitative survey of 96 critical care nurses in 2012. Qualitative in-depth interviews, informed by quantitative results, with 20 critical care nurses in 2013. Descriptive and simple linear regression quantitative data analyses. Thematic (constant comparative) qualitative data analysis. Quantitative - correlations found between rationality and cognitive bias, rationality and task-oriented leadership styles, cognitive bias and democratic communication styles and cognitive bias and task-oriented leadership styles. Qualitative - 'being competent', 'organizational structures', 'feeling self-confident' and 'being supported' in the work environment identified as key factors influencing critical care nurses' cognitive bias in decision-making and leadership styles. Two-way impact (strengthening and weakening) of cognitive bias in decision-making and leadership styles on critical care nurses' practice performance. There is a need to heighten critical care nurses' consciousness of cognitive bias in decision-making and leadership styles and its impact and to develop organization-level strategies to increase non-biased decision-making. © 2016 John Wiley & Sons Ltd.

The non-technical skills used by anaesthetic technicians in critical incidents reported to the Australian Incident Monitoring System between 2002 and 2008.

PubMed

Rutherford, J S; Flin, R; Irwin, A

2015-07-01

The outcome of critical incidents in the operating theatre has been shown to be influenced by the behaviour of anaesthetic technicians (ATs) assisting anaesthetists, but the specific non-technical skills involved have not been described. We performed a review of critical incidents (n=1433) reported to the Australian Incident Monitoring System between 2002 and 2008 to identify which non-technical skills were used by ATs. The reports were assessed if they mentioned anaesthetic assistance or had the boxes ticked to identify "inadequate assistance" or "absent supervision or assistance". A total of 90 critical incidents involving ATs were retrieved, 69 of which described their use of non-technical skills. In 20 reports, the ATs ameliorated the critical incident, whilst in 46 they exacerbated the critical incident, and three cases had both positive and negative non-technical skills described. Situation awareness was identified in 39 reports, task management in 23, teamwork in 21 and decision-making in two, but there were no descriptions of issues related to leadership, stress or fatigue management. Situation awareness, task management and teamwork appear to be important non-technical skills for ATs in the development or management of critical incidents in the operating theatre. This analysis has been used to support the development of a non-technical skills taxonomy for anaesthetic assistants.

Using an Integrated Hydrologic Model to Assess the Ecohydrological Impacts of Change on a Mountain Headwaters Critical Zone

NASA Astrophysics Data System (ADS)

Collins, C.; Maxwell, R. M.; Visser, A.

2016-12-01

The critical zone is the region of the Earth's crust where hydrogeology, ecology, and climate interact. As many critical zone processes are fundamental, the significance of studying critical zone processes goes beyond understanding the local ecohydrological setting. Therefore studying critical zone governing processes requires an interdisciplinary approach that integrates simulation and observation. In this study, a high-resolution integrated hydrologic model, ParFlow-CLM, was developed for the Providence Creek watershed. Providence Creek is a highly instrumented critical zone observatory (CZO) located in the southern Sierra Nevada Mountains, a region currently experiencing a range of short-term responses (i.e. tree mortality) to a severe four-year drought. Sources of plant water use, pathways and residence times of water through the subsurface are identified using a suite of isotopic signatures and numerical particle tracking. Implications of using a fully coupled integrated hydrologic model accompanied by tracer analysis include better understanding of water partitioning and water storage in the regolith and vegetation water use during drought time conditions. The importance of subsurface storage, plant available water and lateral flow during the 2012-2015 drought to mitigate vegetation stress are addressed and verified against observed tree mortality. The stream flow response to tree mortality in the aftermath of the drought, analogous to the Colorado Mountain Pine Beetle case, provides insight into the potential effects of proposed forest management practices.

The association between child exposure to intimate partner violence (IPV) and perpetration of IPV in adulthood-A systematic review.

PubMed

Kimber, Melissa; Adham, Sami; Gill, Sana; McTavish, Jill; MacMillan, Harriet L

2018-02-01

Increasingly recognized as a distinct form of childhood maltreatment, children's exposure to intimate partner violence (IPV) has been shown to be associated with an array of negative psychosocial outcomes, including elevated risk for additional violence over the life course. Although studies have identified child exposure to IPV as a predictor of IPV perpetration in adulthood, no review has critically evaluated the methodology of this quantitative work. The present study examines the association between childhood exposure to IPV and the perpetration of IPV in adulthood based on a systematic review of the literature from inception to January 4, 2016. Databases searched included Medline, Embase, PsycINFO, CINAHL, Cochrane Database of Systematic Reviews, Sociological Abstracts and ERIC. Database searches were complemented with backward and forward citation chaining. Studies were critically appraised using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Of 5601 articles identified by the search, 19 studies were included for data extraction. Sixteen of these studies found that child exposure to IPV was significantly and positively associated with adult IPV perpetration; three studies reported null findings. The methodological quality of the studies was low. Work thus far has tended to focus on child exposure to physical IPV and the perpetration of physical IPV within heterosexual contexts. In addition, measures of child exposure to IPV vary in their classification of what exposure entails. We critically discuss the strengths and limitations of the existing evidence and the theoretical frameworks informing this work. Copyright © 2017 Elsevier Ltd. All rights reserved.

Why did you decide to become a Geoscience Major: A Critical Incident Study for the Development of Recruiting Programs for Inspiring Interests in the Geosciences Amongst Pre-College Students

NASA Astrophysics Data System (ADS)

Carrick, T. L.; Miller, K. C.; Levine, R.; Martinez-Sussmann, C.; Velasco, A. A.

2011-12-01

Anecdotally, it is often stated that the majority of students that enter the geosciences usually do so sometime after their initial entrance into college. With the objective of providing concrete and useful information for individuals developing programs for inspiring interest in the Geosciences amongst pre-college students and trying to increase the number of freshman Geoscience majors, we conducted a critical incident study. Twenty-two students, who were undergraduate or graduate Geoscience majors, were asked, "Why did you decide to major in the Geosciences?" in a series of interviews. Their responses were then used to identify over 100 critical incidents, each of which described a specific behavior that was causally responsible for a student's choice to major in Geoscience. Using these critical incidents, we developed a preliminary taxonomy that is comprised of three major categories: Informal Exposure to the Geosciences (e.g., outdoor experiences, family involvement), Formal Exposure to the Geosciences (e.g., academic experiences, program participation) and a Combined Informal and Formal Exposure (e.g., media exposure). Within these three main categories we identified thirteen subcategories. These categories and subcategories, describe, classify, and provide concrete examples of strategies that were responsible for geosciences career choices. As a whole, the taxonomy is valuable as a new, data-based guide for designing geosciences recruitment programs for the pre-college student population.

Key factors for the implementation of successful, stand-alone village electrification schemes in Peru

NASA Astrophysics Data System (ADS)

Sanchez-Campos, Teodoro

The hypothesis of this work is that there are social, financial, technical, managerial institutional and political key factors that may either support or prevent the success of small stand alone energy systems in rural areas. This research work aims at contributing to the identification of such factors and study their relevance to the performance and sustainability of stand alone energy systems in rural areas; to meet its purpose, a wide range of literature was reviewed including rural electrification programmes and projects, research and development projects on access to electricity in rural areas, impact studies and others, and a field research survey was done the Andes and Upper Jungle regions in Peru. Nineteen possible critical factors were identified, thirteen with relevance at the local context (the community or village), and six with relevance at the national (or wider) context. From literature review it was found that the possible local critical factors were relevant only to four categories of factors instead of the six considered initially (i.e. social, financial, technological and managerial): the other two categories, political and institutional were found to be more relevant to the national context, therefore those were included in the group of possible critical factors of wider context. A series of questionnaires were designed to collect field data information, which was later used to analyse and establish the relation of each identified factor with the success of the systems studied. The survey research was implemented in 14 villages, 7 with small diesel sets and 7 with small hydropower schemes, all spread in the Andes and Upper Jungle of Peru, which were carefully selected to be representative of regions with isolated stand alone systems and with different socioeconomic background. Out of the 13 possible critical factors of local context, it was found that only 3 are really critical, the others are important but not critical; one of them (technical assistance) was found to be closely linked to national capacity, therefore for practical reasons both are considered as one critical factor or wider context. Although more research study is needed to establish a more clearer result on the factors of wider context (national context), it was found that out of the 6 factors of wider context only one appears to be critical, the other 5 are important but not critical. Therefore the summary of critical factors is as follows: a) Critical Factors of Local Context o Management o Local capacity b) Critical Factors of National Context o Technical Support/national capacity On the local factors, management appears to be the most critical of all factors, because with good management, most of the other factors can be overcome. It was also found that "The small enterprise model" tested by Practical Action on small scale hydropower schemes is proving to be successful and other organisations are starting to use it in different contexts. Therefore future research is recommended on this particular management model in order to be useful for rural electrification programmes based on decentralised energy generation systems.

The development and validation of a test of science critical thinking for fifth graders.

PubMed

Mapeala, Ruslan; Siew, Nyet Moi

2015-01-01

The paper described the development and validation of the Test of Science Critical Thinking (TSCT) to measure the three critical thinking skill constructs: comparing and contrasting, sequencing, and identifying cause and effect. The initial TSCT consisted of 55 multiple choice test items, each of which required participants to select a correct response and a correct choice of critical thinking used for their response. Data were obtained from a purposive sampling of 30 fifth graders in a pilot study carried out in a primary school in Sabah, Malaysia. Students underwent the sessions of teaching and learning activities for 9 weeks using the Thinking Maps-aided Problem-Based Learning Module before they answered the TSCT test. Analyses were conducted to check on difficulty index (p) and discrimination index (d), internal consistency reliability, content validity, and face validity. Analysis of the test-retest reliability data was conducted separately for a group of fifth graders with similar ability. Findings of the pilot study showed that out of initial 55 administered items, only 30 items with relatively good difficulty index (p) ranged from 0.40 to 0.60 and with good discrimination index (d) ranged within 0.20-1.00 were selected. The Kuder-Richardson reliability value was found to be appropriate and relatively high with 0.70, 0.73 and 0.92 for identifying cause and effect, sequencing, and comparing and contrasting respectively. The content validity index obtained from three expert judgments equalled or exceeded 0.95. In addition, test-retest reliability showed good, statistically significant correlations ([Formula: see text]). From the above results, the selected 30-item TSCT was found to have sufficient reliability and validity and would therefore represent a useful tool for measuring critical thinking ability among fifth graders in primary science.

Risk analysis of hematopoietic stem cell transplant process: failure mode, effect, and criticality analysis and hazard analysis critical control point methods integration based on guidelines to good manufacturing practice for medicinal product ANNEX 20 (February 2008).

PubMed

Gianassi, S; Bisin, S; Bindi, B; Spitaleri, I; Bambi, F

2010-01-01

The collection and handling of hematopoietic stem cells (HSCs) must meet high quality requirements. An integrated Quality Risk Management can help to identify and contain potential risks related to HSC production. Risk analysis techniques allow one to "weigh" identified hazards, considering the seriousness of their effects, frequency, and detectability, seeking to prevent the most harmful hazards. The Hazard Analysis Critical Point, recognized as the most appropriate technique to identify risks associated with physical, chemical, and biological hazards for cellular products, consists of classifying finished product specifications and limits of acceptability, identifying all off-specifications, defining activities that can cause them, and finally establishing both a monitoring system for each Critical Control Point and corrective actions for deviations. The severity of possible effects on patients, as well as the occurrence and detectability of critical parameters, are measured on quantitative scales (Risk Priority Number [RPN]). Risk analysis was performed with this technique on manipulation process of HPC performed at our blood center. The data analysis showed that hazards with higher values of RPN with greater impact on the process are loss of dose and tracking; technical skills of operators and manual transcription of data were the most critical parameters. Problems related to operator skills are handled by defining targeted training programs, while other critical parameters can be mitigated with the use of continuous control systems. The blood center management software was completed by a labeling system with forms designed to be in compliance with standards in force and by starting implementation of a cryopreservation management module. Copyright 2010 Elsevier Inc. All rights reserved.

Public Involvement Processes and Methodologies: An Analysis

Treesearch

Ernst Valfer; Stephen Laner; Daina Dravnieks

1977-01-01

This report explor'es some sensitive or critical areas in public involvement.. A 1972 RF&D workshop on public involvement identified a series of issues requiring research and analysis. A subsequent PNW study "Public Involvement and the Forest Service", (Hendee 1973) addressed many of these issues. This study assignment by the Chief's Office was...

ePortfolios in the Workplace for Human Capital Management: A Multiple Case Study

ERIC Educational Resources Information Center

Lievens, Ronald

2015-01-01

This study researches whether the ePortfolio is a suitable instrument for human capital management in the business environment. The implementation of ePortfolio systems in five different organizations is analyzed. It considers whether ePortfolio implementations were successful, and relevant critical success factors were identified. For the latter…

Significant Life Experiences on the Formation of Environmental Action among Chinese College Students

ERIC Educational Resources Information Center

Li, Danqing; Chen, Jin

2015-01-01

Determining the factors that influence young adults' engagement in environmental action is critical to further developing their active and important participation in environmental issues. In this paper, we designed two studies to identify life experiences of Chinese college students that foster environmental action. In Study 1, we used an…

A Culture-Based Model for Strategic Implementation of Virtual Education Delivery

ERIC Educational Resources Information Center

Burn, Janice; Thongprasert, Nalinee

2005-01-01

This study was designed to examine the critical success factors for implementing Virtual Education Delivery (VED) in Thailand, and to identify ways to facilitate such adoption and lead to effective outcomes. The study incorporated an analysis of three specific factors related to Thai culture: high power distance "Bhun Khun", uncertainty…

Achieving Next Generation Science Standards through Agricultural Contexts: A Delphi Study of Outdoor Education Experts

ERIC Educational Resources Information Center

Meals, Anthony; Washburn, Shannon

2015-01-01

A Delphi survey was conducted with 30 outdoor education experts in Kansas. Participant responses helped frame a Kansas definition of outdoor education and identified essential educational goals and outcomes, critical components for effective outdoor education programming, and barriers facing outdoor education in Kansas. The study highlights…

Characteristics of Family Literacy Programmes That Improve Child Literacy, Behaviour and Parenting Skills

ERIC Educational Resources Information Center

Terlitsky, Amy Bowlin; Wilkins, Julia

2015-01-01

Children who struggle with reading, a critical component of literacy, may exhibit behavioural problems. Having difficulties in both literacy and behaviour increases children's risk of poor educational outcomes. We reviewed 82 studies of family literacy programmes and identified 15 empirical studies that reported positive child outcomes related to…

Race, Difference, Meritocracy, and English: Majoritarian Stories in the Education of Secondary Multilingual Learners

ERIC Educational Resources Information Center

Mitchell, Kara

2013-01-01

In this study, empirical and conceptual scholarship (approximately 100 studies) regarding the education of secondary multilingual learners and their teachers are analyzed through the lens of critical race theory (CRT). Specifically, four common majoritarian stories are identified that are both challenged and endorsed in the research literature:…

Student Perceptions and Motivation in the Classroom: Exploring Relatedness and Value

ERIC Educational Resources Information Center

Kaufman, Annette; Dodge, Tonya

2009-01-01

According to Self-Determination Theory, feelings of relatedness and value of a behavior are critical factors that affect internalization and integration. The purpose of the current study was to identify factors that influence relatedness and value in an academic setting. Specifically, the study investigated the effects of autonomy, mastery goals,…

Studying Adolescent Male Sexuality: Where Are We?

ERIC Educational Resources Information Center

Smith, Laureen H.; Guthrie, Barbara J.; Oakley, Deborah J.

2005-01-01

This article critically reviews the literature about adolescent males' sexuality in order to describe the state of the science and to identify promising concepts and research designs that have the potential to guide the next generation of research. A critique was conducted on 94 peer-reviewed studies of sexual behaviors that included a sample of…

Employer Engagement: The Critical Role of Employee Commitment

ERIC Educational Resources Information Center

Drake, Julie; Blake, Joanne; Swallow, Wayne

2009-01-01

Purpose: The purpose of this paper is to introduce a case study that identifies the practical issues and implications of employer engagement through course design, delivery and employee commitment in a higher education course delivered in the financial services sector. Design/methodology/approach: Using a case study the paper draws on the course…

Values-Based Business Education for Empowerment, Self-Reliance and Poverty Reduction in Nigeria

ERIC Educational Resources Information Center

Umoru, Titus Amodu

2013-01-01

This study centered on values-based business education for empowerment, self-reliance and poverty reduction in Nigeria. The study identified 30 critical values business education students need to possess. 192 questionnaire items were constructed after careful review of literature (Njoku, 2007 and Living Values Education, 2013) and administered…

From equity to power: Critical Success Factors for Twinning between midwives, a Delphi study.

PubMed

Cadée, Franka; Nieuwenhuijze, Marianne J; Lagro-Janssen, Antoine L M; de Vries, Raymond

2018-02-28

To gain consensus for Critical Success Factors associated with Twinning in Midwifery. International publications identify midwifery as important for improving maternity care worldwide. Midwifery is a team effort where midwives play a key role. Yet their power to take on this role is often lacking. Twinning has garnered potential to develop power in professionals, however, its success varies because implementation is not always optimal. Critical Success Factors have demonstrated positive results in the managerial context and can be helpful to build effective Twinning relationships. We approached 56 midwife Twinning experts from 19 countries to participate in three Delphi rounds between 2016 - 2017. In round 1, experts gave input through an open ended questionnaire and this was analysed to formulate Critical Success Factors statements that were scored on a 1-7 Likert scale aiming to gain consensus in rounds 2 and 3. These statements were operationalized for practical use such as a check list in planning, monitoring and evaluation in the field. Thirty-three experts from 14 countries took part in all three Delphi rounds, producing 58 initial statements. This resulted in 25 Critical Success Factors covering issues of management, communication, commitment and values, most focus on equity. The Critical Success Factors formulated represent the necessary ingredients for successful Twinning by providing a practical implementation framework and promote further research into the effect of Twinning. Findings show that making equity explicit in Twinning may contribute towards the power of midwives to take on their identified key role. © 2018 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

Health-promoting conversations-A novel approach to families experiencing critical illness in the ICU environment.

PubMed

Hollman Frisman, Gunilla; Wåhlin, Ingrid; Orvelius, Lotti; Ågren, Susanna

2018-02-01

To identify and describe the outcomes of a nurse-led intervention, "Health-promoting conversations with families," regarding family functioning and well-being in families with a member who was critically ill. Families who have a critically ill family member in an intensive care unit face a demanding situation, threatening the normal functioning of the family. Yet, there is a knowledge gap regarding family members' well-being during and after critical illness. The study used a qualitative inductive-descriptive design. Eight families participated in health-promoting conversations aimed to create a context for change related to the families' identified problems and resources. Fifteen qualitative interviews were conducted with 18 adults who participated in health-promoting conversations about a critical illness in the family. Eight participants were patients (six men, two women) and 10 were family members (two male partners, five female partners, one mother, one daughter, one female grandchild). The interviews were analysed by conventional content analysis. Family members experienced strengthened togetherness, a caring attitude and confirmation through health-promoting conversations. The caring and calming conversations were appreciated despite the reappearance of exhausting feelings. Working through the experience and being confirmed promoted family well-being. Health-promoting conversations were considered to be healing, as the family members take part in sharing each other's feelings, thoughts and experiences with the critical illness. Health-promoting conversations could be a simple and effective nursing intervention for former intensive care patients and their families in any cultural context. © 2017 John Wiley & Sons Ltd.

Identifying risk event in Indonesian fresh meat supply chain

NASA Astrophysics Data System (ADS)

Wahyuni, H. C.; Vanany, I.; Ciptomulyono, U.

2018-04-01

The aim of this paper is to identify risk issues in Indonesian fresh meat supply chain from the farm until to the “plate”. The critical points for food safety in physical fresh meat product flow are also identified. The paper employed one case study in the Indonesian fresh meat company by conducting observations and in-depth three stages of interviews. At the first interview, the players, process, and activities in the fresh meat industry were identified. In the second interview, critical points for food safety were recognized. The risk events in each player and process were identified in the last interview. The research will be conducted in three stages, but this article focuses on risk identification process (first stage) only. The second stage is measuring risk and the third stage focuses on determining the value of risk priority. The results showed that there were four players in the fresh meat supply chain: livestock (source), slaughter (make), distributor and retail (deliver). Each player has different activities and identified 16 risk events in the fresh meat supply chain. Some of the strategies that can be used to reduce the occurrence of such risks include improving the ability of laborers on food safety systems, improving cutting equipment and distribution processes

Quantifying the Evolutionary Conservation of Genes Encoding Multidrug Efflux Pumps in the ESKAPE Pathogens To Identify Antimicrobial Drug Targets.

PubMed

Brooks, Lauren E; Ul-Hasan, Sabah; Chan, Benjamin K; Sistrom, Mark J

2018-01-01

Increasing rates of antibiotic-resistant bacterial infection are one of the most pressing contemporary global health concerns. The ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) have been identified as the leading global cause of multidrug-resistant bacterial infections, and overexpression of multidrug efflux (MEX) transport systems has been identified as one of the most critical mechanisms facilitating the evolution of multidrug resistance in ESKAPE pathogens. Despite efforts to develop efflux pump inhibitors to combat antibiotic resistance, the need persists to identify additional targets for future investigations. We evaluated evolutionary pressures on 110 MEX-encoding genes from all annotated ESKAPE organism genomes. We identify several MEX genes under stabilizing selection-representing targets which can facilitate broad-spectrum treatments with evolutionary constraints limiting the potential emergence of escape mutants. We also examine MEX systems being evaluated as drug targets, demonstrating that divergent selection may underlie some of the problems encountered in the development of effective treatments-specifically in relation to the NorA system in S. aureus. This study provides a comprehensive evolutionary context to efflux in the ESKAPE pathogens, which will provide critical context to the evaluation of efflux systems as antibiotic targets. IMPORTANCE Increasing rates of antibiotic-resistant bacterial infection are one of the most pressing contemporary global health concerns. The ESKAPE pathogen group represents the leading cause of these infections, and upregulation of efflux pump expression is a significant mechanism of resistance in these pathogens. This has resulted in substantial interest in the development of efflux pump inhibitors to combat antibiotic-resistant infections; however, no widespread treatments have been developed to date. Our study evaluates an often-underappreciated aspect of resistance-the impact of evolutionary selection. We evaluate selection on all annotated efflux genes in all sequenced ESKAPE pathogens, providing critical context for and insight into current and future development of efflux-targeting treatments for resistant bacterial infections.

Quantifying the Evolutionary Conservation of Genes Encoding Multidrug Efflux Pumps in the ESKAPE Pathogens To Identify Antimicrobial Drug Targets

PubMed Central

Ul-Hasan, Sabah; Chan, Benjamin K.; Sistrom, Mark J.

2018-01-01

ABSTRACT Increasing rates of antibiotic-resistant bacterial infection are one of the most pressing contemporary global health concerns. The ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) have been identified as the leading global cause of multidrug-resistant bacterial infections, and overexpression of multidrug efflux (MEX) transport systems has been identified as one of the most critical mechanisms facilitating the evolution of multidrug resistance in ESKAPE pathogens. Despite efforts to develop efflux pump inhibitors to combat antibiotic resistance, the need persists to identify additional targets for future investigations. We evaluated evolutionary pressures on 110 MEX-encoding genes from all annotated ESKAPE organism genomes. We identify several MEX genes under stabilizing selection—representing targets which can facilitate broad-spectrum treatments with evolutionary constraints limiting the potential emergence of escape mutants. We also examine MEX systems being evaluated as drug targets, demonstrating that divergent selection may underlie some of the problems encountered in the development of effective treatments—specifically in relation to the NorA system in S. aureus. This study provides a comprehensive evolutionary context to efflux in the ESKAPE pathogens, which will provide critical context to the evaluation of efflux systems as antibiotic targets. IMPORTANCE Increasing rates of antibiotic-resistant bacterial infection are one of the most pressing contemporary global health concerns. The ESKAPE pathogen group represents the leading cause of these infections, and upregulation of efflux pump expression is a significant mechanism of resistance in these pathogens. This has resulted in substantial interest in the development of efflux pump inhibitors to combat antibiotic-resistant infections; however, no widespread treatments have been developed to date. Our study evaluates an often-underappreciated aspect of resistance—the impact of evolutionary selection. We evaluate selection on all annotated efflux genes in all sequenced ESKAPE pathogens, providing critical context for and insight into current and future development of efflux-targeting treatments for resistant bacterial infections. PMID:29719870

Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients.

PubMed

Hou, Wen-Hsuan; Kang, Chun-Mei; Ho, Mu-Hsing; Kuo, Jessie Ming-Chuan; Chen, Hsiao-Lien; Chang, Wen-Yin

2017-03-01

To evaluate the accuracy of the inpatient fall risk screening tool and to identify the most critical fall risk factors in inpatients. Variations exist in several screening tools applied in acute care hospitals for examining risk factors for falls and identifying high-risk inpatients. Secondary data analysis. A subset of inpatient data for the period from June 2011-June 2014 was extracted from the nursing information system and adverse event reporting system of an 818-bed teaching medical centre in Taipei. Data were analysed using descriptive statistics, receiver operating characteristic curve analysis and logistic regression analysis. During the study period, 205 fallers and 37,232 nonfallers were identified. The results revealed that the inpatient fall risk screening tool (cut-off point of ≥3) had a low sensitivity level (60%), satisfactory specificity (87%), a positive predictive value of 2·0% and a negative predictive value of 99%. The receiver operating characteristic curve analysis revealed an area under the curve of 0·805 (sensitivity, 71·8%; specificity, 78%). To increase the sensitivity values, the Youden index suggests at least 1·5 points to be the most suitable cut-off point for the inpatient fall risk screening tool. Multivariate logistic regression analysis revealed a considerably increased fall risk in patients with impaired balance and impaired elimination. The fall risk factor was also significantly associated with days of hospital stay and with admission to surgical wards. The findings can raise awareness about the two most critical risk factors for falls among future clinical nurses and other healthcare professionals and thus facilitate the development of fall prevention interventions. This study highlights the needs for redefining the cut-off points of the inpatient fall risk screening tool to effectively identify inpatients at a high risk of falls. Furthermore, inpatients with impaired balance and impaired elimination should be closely monitored by nurses to prevent falling during hospitalisations. © 2016 John Wiley & Sons Ltd.

Best Practice in Developing Critical Analyses: An Empirical Study of Self-Efficacy from an Interdisciplinary Perspective

ERIC Educational Resources Information Center

Sams, Coleen; Sams, Doreen

2011-01-01

Despite substantial usage of case study analyses as learning tools in diverse fields of study, business graduate students often arrive with little to no prior knowledge in how to effectively use this tool. Using the Sams efficacy model (2009) strategic to business education this study identified a dearth in the usage of case study analyses in…

Organisational Issues for E-Learning: Critical Success Factors as Identified by HE Practitioners

ERIC Educational Resources Information Center

McPherson, Maggie; Nunes, Miguel Baptista

2006-01-01

Purpose: The purpose of this paper is to report on a research project that identified organisational critical success factors (CSFs) for e-learning implementation in higher education (HE). These CSFs can be used as a theoretical foundation upon which to base decision-making and strategic thinking about e-learning. Design/methodology/approach: The…

International Management Skills for Success in Asia: A Needs-Based Determination of Skills for Foreign Managers and Local Managers

ERIC Educational Resources Information Center

Neupert, Kent E.; Baughn, C. Cristopher; Dao, Thi Thanh Lam

2005-01-01

Purpose: This paper identifies skills necessary in order to succeed in Vietnam and proposes a training program to develop such skills. Design/methodology/approach: To determine necessary skills, 74 managers were interviewed using critical incident methodology to identify training needs. Critical incident approach asks respondents to describe the…

Critical Reflection to Identify Gaps between Espoused Theory and Theory-in-Use

ERIC Educational Resources Information Center

Savaya, Riki; Gardner, Fiona

2012-01-01

Critical reflection (CR) is a process by which one may identify the assumptions governing one's actions, question them, and develop alternative behaviors. This article presents two cases that demonstrate the use of CR to raise social workers' awareness of gaps between what Schon and Argryis term social workers' "espoused theories" and the…

Critical operations capabilities in a high cost environment: a multiple case study

NASA Astrophysics Data System (ADS)

Sansone, C.; Hilletofth, P.; Eriksson, D.

2018-04-01

Operations capabilities have been a popular research area for many years and several frameworks have been proposed in the literature. The current frameworks do not take specific contexts into consideration, for instance a high cost environment. This research gap is of particular interest since a manufacturing relocation process has been ongoing the last decades, leading to a huge amount of manufacturing being moved from high to low cost environments. The purpose of this study is to identify critical operations capabilities in a high cost environment. The two research questions were: What are the critical operations capabilities dimensions in a high cost environment? What are the critical operations capabilities in a high cost environment? A multiple case study was conducted and three Swedish manufacturing firms were selected. The study was based on the investigation of an existing framework of operations capabilities. The main dimensions of operations capabilities included in the framework were: cost, quality, delivery, flexibility, service, innovation and environment. Each of the dimensions included two or more operations capabilities. The findings confirmed the validity of the framework and its usefulness in a high cost environment and a new operations capability was revealed (employee flexibility).

Aripiprazole in the Maintenance Treatment of Bipolar Disorder: A Critical Review of the Evidence and Its Dissemination into the Scientific Literature

PubMed Central

Jureidini, Jon N.; Parry, Peter I.; Spielmans, Glen I.; Healy, David

2011-01-01

Background Aripiprazole, a second-generation antipsychotic medication, has been increasingly used in the maintenance treatment of bipolar disorder and received approval from the U.S. Food and Drug Administration for this indication in 2005. Given its widespread use, we sought to critically review the evidence supporting the use of aripiprazole in the maintenance treatment of bipolar disorder and examine how that evidence has been disseminated in the scientific literature. Methods and Findings We systematically searched multiple databases to identify double-blind, randomized controlled trials of aripiprazole for the maintenance treatment of bipolar disorder while excluding other types of studies, such as open-label, acute, and adjunctive studies. We then used a citation search to identify articles that cited these trials and rated the quality of their citations. Our evidence search protocol identified only two publications, both describing the results of a single trial conducted by Keck et al., which met criteria for inclusion in this review. We describe four issues that limit the interpretation of that trial as supporting the use of aripiprazole for bipolar maintenance: (1) insufficient duration to demonstrate maintenance efficacy; (2) limited generalizability due to its enriched sample; (3) possible conflation of iatrogenic adverse effects of abrupt medication discontinuation with beneficial effects of treatment; and (4) a low overall completion rate. Our citation search protocol yielded 80 publications that cited the Keck et al. trial in discussing the use of aripiprazole for bipolar maintenance. Of these, only 24 (30%) mentioned adverse events reported and four (5%) mentioned study limitations. Conclusions A single trial by Keck et al. represents the entirety of the literature on the use of aripiprazole for the maintenance treatment of bipolar disorder. Although careful review identifies four critical limitations to the trial's interpretation and overall utility, the trial has been uncritically cited in the subsequent scientific literature. Please see later in the article for the Editors' Summary PMID:21559324

The use of computational inspection to identify process window limiting hotspots and predict sub-15nm defects with high capture rate

NASA Astrophysics Data System (ADS)

Ham, Boo-Hyun; Kim, Il-Hwan; Park, Sung-Sik; Yeo, Sun-Young; Kim, Sang-Jin; Park, Dong-Woon; Park, Joon-Soo; Ryu, Chang-Hoon; Son, Bo-Kyeong; Hwang, Kyung-Bae; Shin, Jae-Min; Shin, Jangho; Park, Ki-Yeop; Park, Sean; Liu, Lei; Tien, Ming-Chun; Nachtwein, Angelique; Jochemsen, Marinus; Yan, Philip; Hu, Vincent; Jones, Christopher

2017-03-01

As critical dimensions for advanced two dimensional (2D) DUV patterning continue to shrink, the exact process window becomes increasingly difficult to determine. The defect size criteria shrink with the patterning critical dimensions and are well below the resolution of current optical inspection tools. As a result, it is more challenging for traditional bright field inspection tools to accurately discover the hotspots that define the process window. In this study, we use a novel computational inspection method to identify the depth-of-focus limiting features of a 10 nm node mask with 2D metal structures (single exposure) and compare the results to those obtained with a traditional process windows qualification (PWQ) method based on utilizing a focus modulated wafer and bright field inspection (BFI) to detect hotspot defects. The method is extended to litho-etch litho-etch (LELE) on a different test vehicle to show that overlay related bridging hotspots also can be identified.