Perspective: New Recommendations for the Treatment of Systemic Hypertension and their Potential Implications for Glaucoma Management.

PubMed

De Moraes, Carlos Gustavo; Cioffi, George A; Weinreb, Robert N; Liebmann, Jeffrey M

2018-05-10

There is compelling evidence that low systemic blood pressure is associated with glaucoma prevalence and progression. Recently, new guidelines for treatment of systemic hypertension have been implemented and recommend lower target blood pressure. These guidelines may have implications on the rates of glaucoma progression seen in clinical practice and how clinicians should be prepared to identify patients at risk. More importantly, a new paradigm to monitor glaucoma progression is patients treated for systemic hypertension may be warranted in light of these recent changes.

Different Argentine Rural Extensionists' Mindsets and Their Practical Implications

ERIC Educational Resources Information Center

Landini, Fernando

2015-01-01

Purpose: This paper reflects upon the practice of Argentine rural extensionists working in the extension public system through the process of identifying different rural extensionists' types of mindsets and comparing them with transfer of technology extension approach, dialogical processes of horizontal knowledge exchange, participatory…

Practical tolerancing and performance implications for XUV projection lithography reduction systems (Poster Paper)

NASA Astrophysics Data System (ADS)

Viswanathan, Vriddhachalam K.

1992-07-01

Practical considerations that will strongly affect the imaging capabilities of reflecting systems for extreme-ultraviolet (XUV) projection lithography include manufacturing tolerances and thermal distortion of the mirror surfaces due to absorption of a fraction of the incident radiation beam. We have analyzed the potential magnitudes of these effects for two types of reflective projection optical designs. We find that concentric, symmetric two-mirror systems are less sensitive to manufacturing errors and thermal distortion than off-axis, four-mirror systems.

Ethical Implications of Digital Imaging in Photojournalism.

ERIC Educational Resources Information Center

Terry, Danal; Lasorsa, Dominic L.

Arguing that the news media are about to adopt digital imaging systems that will have far-reaching implications for the practice of journalism, this paper discusses how the news media is expected to adopt the new technology and explains why the marriage of journalism and digital imaging will create ethical issues with respect to photo manipulation…

Federalism and social justice: implications for social work.

PubMed

Linhorst, Donald M

2002-07-01

Federalism is a system of government that divides power between two or more levels of government. During the current conservative political climate in the United States, power has shifted increasingly from the federal government to states, a move that has implications for the achievement of social justice. Consequently, it is now necessary for social workers to engage in political activity at the state and local levels, in addition to the federal level, to promote social justice. Implications for social work policy practice, research, and education for advancing social justice within the federal system of government are explored.

Performance management in healthcare: a critical analysis.

PubMed

Hewko, Sarah J; Cummings, Greta G

2016-01-01

Purpose - The purpose of this paper is to explore the underlying theoretical assumptions and implications of current micro-level performance management and evaluation (PME) practices, specifically within health-care organizations. PME encompasses all activities that are designed and conducted to align employee outputs with organizational goals. Design/methodology/approach - PME, in the context of healthcare, is analyzed through the lens of critical theory. Specifically, Habermas' theory of communicative action is used to highlight some of the questions that arise in looking critically at PME. To provide a richer definition of key theoretical concepts, the authors conducted a preliminary, exploratory hermeneutic semantic analysis of the key words "performance" and "management" and of the term "performance management". Findings - Analysis reveals that existing micro-level PME systems in health-care organizations have the potential to create a workforce that is compliant, dependent, technically oriented and passive, and to support health-care systems in which inequalities and power imbalances are perpetually reinforced. Practical implications - At a time when the health-care system is under increasing pressure to provide high-quality, affordable services with fewer resources, it may be wise to investigate new sector-specific ways of evaluating and managing performance. Originality/value - In this paper, written for health-care leaders and health human resource specialists, the theoretical assumptions and implications of current PME practices within health-care organizations are explored. It is hoped that readers will be inspired to support innovative PME practices within their organizations that encourage peak performance among health-care professionals.

Bridging the gap from values to actions: a family systems framework for family-centered AAC services.

PubMed

Mandak, Kelsey; O'Neill, Tara; Light, Janice; Fosco, Gregory M

2017-03-01

Despite the growing recognition of the importance of family involvement in augmentative and alternative communication (AAC) intervention, little guidance exists on how professionals can establish successful collaborative relationships with families. In this paper, we discuss family systems theory and ecological systems theory as a framework to guide family-centered AAC practice, review family-focused research in AAC, consider how AAC may impact the family system, and provide examples of the clinical implications of using the proposed family systems framework to improve family-centered AAC practice.

Coordination of care by primary care practices: strategies, lessons and implications.

PubMed

O'Malley, Ann S; Tynan, Ann; Cohen, Genna R; Kemper, Nicole; Davis, Matthew M

2009-04-01

Despite calls from numerous organizations and payers to improve coordination of care, there are few published accounts of how care is coordinated in real-world primary care practices. This study by the Center for Studying Health System Change (HSC) documents strategies that a range of physician practices use to coordinate care for their patients. While there was no single recipe for coordination given the variety of patient, physician, practice and market factors, some cross-cutting lessons were identified, such as the value of a commitment to interpersonal continuity of care as a foundation for coordination. Respondents also identified the importance of system support for the standardization of office processes to foster care coordination. While larger practices may have more resources to invest, many of the innovations described could be scaled to smaller practices. Some coordination strategies resulted in improved efficiency over time for practices, but by and large, physician practices currently pursue these efforts at their own expense. In addition to sharing information on effective strategies among practices, the findings also provide policy makers with a snapshot of the current care coordination landscape and implications for initiatives to improve coordination. Efforts to provide technical support to practices to improve coordination, for example, through medical-home initiatives, need to consider the baseline more typical practices may be starting from and tailor their support to practices ranging widely in size, resources and presence of standardized care processes. If aligned with payment incentives, some of these strategies have the potential to increase quality and satisfaction among patients and providers by helping to move the health care delivery system toward better coordinated care.

"Managed" Teacher Turnover: A Strategy for School Improvement

ERIC Educational Resources Information Center

Lewis, Jessica L.; London, Tim D.

2009-01-01

Given the negative implications of unmanaged teacher attrition for student learning and the potential of leadership actions to affect this dynamic, this article highlights the practices of one principal in the Chicago Public School (CPS) system who used teacher attrition to her school's advantage. Her actions reveal leadership practices that can…

The Adoption of Integrated Pest Management Practices among Texas Cotton Growers.

ERIC Educational Resources Information Center

Thomas, John K.; And Others

1990-01-01

Describes integrated pest management (IPM), a more advanced approach than chemical pesticide. Applies diffusion and farming-systems theories to create analytical model to explain IPM's adoption, use, and implications for agricultural change. Telephone surveys of Texas cotton growers on IPM practices found different sources of IPM information…

Postural perturbations: new insights for treatment of balance disorders

NASA Technical Reports Server (NTRS)

Horak, F. B.; Henry, S. M.; Shumway-Cook, A.; Peterson, B. W. (Principal Investigator)

1997-01-01

This article reviews the neural control of posture as understood through studies of automatic responses to mechanical perturbations. Recent studies of responses to postural perturbations have provided a new view of how postural stability is controlled, and this view has profound implications for physical therapy practice. We discuss the implications for rehabilitation of balance disorders and demonstrate how an understanding of the specific systems underlying postural control can help to focus and enrich our therapeutic approaches. By understanding the basic systems underlying control of balance, such as strategy selection, rapid latencies, coordinated temporal spatial patterns, force control, and context-specific adaptations, therapists can focus their treatment on each patient's specific impairments. Research on postural responses to surface translations has shown that balance is not based on a fixed set of equilibrium reflexes but on a flexible, functional motor skill that can adapt with training and experience. More research is needed to determine the extent to which quantification of automatic postural responses has practical implications for predicting falls in patients with constraints in their postural control system.

Implications for Intelligent Tutoring Systems for Research and Practice in Foreign Language Learning, NFLC Occasional Papers.

ERIC Educational Resources Information Center

Ginsberg, Ralph B.

Most of the now commonplace computer-assisted instruction (CAI) uses computers to increase the capacity to perform logical, numerical, and symbolic computations. However, computers are an interactive and potentially intelligent medium. The implications of artificial intelligence (AI) for learning are more radical than those for traditional CAI. AI…

My genes made me do it? The implications of behavioural genetics for responsibility and blame.

PubMed

Levitt, Mairi; Manson, Neil

2007-03-01

The idea of individual responsibility for action is central to our conception of what it is to be a person. Behavioural genetic research may seem to call into question the idea of individual responsibility with possible implications for the criminal justice system. These implications will depend on the understandings of the various agencies and professional groups involved in responding to violent and anti-social behaviour, and, the result of negotiations between them over resulting practice. The paper considers two kinds of approaches to the question of responsibility and 'criminal genes' arising from a sociological and philosophical perspective respectively. One is to consider the social context and possible practical implications of research into 'criminal genes' which will later be examined through interviews and discussions with a range of experts including lawyers and social workers. A second and different kind of approach is to ask whether the findings of behavioural genetics ought to have implications for attributions of responsibility. Issues of genetic influence are central to both approaches.

Do Farmers Using Conventional and Non-Conventional Systems of Agriculture Have Different Perceptions of the Diversity of Wild Birds? Implications for Conservation.

PubMed

Silva-Andrade, Horasa Lima; de Andrade, Luciano Pires; Muniz, Lauana Souza; Telino-Júnior, Wallace Rodrigues; Albuquerque, Ulysses Paulino; Lyra-Neves, Rachel Maria

2016-01-01

Farmers' perceptions of birds' interactions with agricultural production systems are fundamental to species conservation efforts. In the present study, we evaluated the perceptions of birds held by farmers who engage in conventional and non-conventional agricultural production processes and the implications of potential differences in these perceptions on species conservation. To accomplish this, data were collected using questionnaires, semi-structured interviews, and other complementary sources of information gathered from 191 farmers in northeastern Brazil. Although some similarities were identified among the farmers in their perceptions and local ecological knowledge (LEK) of birds, differences existed between the conventional and non-conventional farmers in their attitudes toward, conflicts with, and usage of bird species. Compared to the conventional farmers, the non-conventional farmers could identify more bird species, possessed more favorable attitudes toward birds, and engaged in practices more beneficial to the conservation of avifauna. The perceptions that were identified were related to the type of agriculture practiced, and such perceptions may affect the conservation of bird species. Therefore, the adoption of certain agricultural practices has important implications for conservation. Our results indicate the need for investment in public policies, programs and actions that account for farmers' knowledge and perceptions. Such investments will contribute to the development and adoption of practices supporting wild bird conservation in agricultural areas.

Do Farmers Using Conventional and Non-Conventional Systems of Agriculture Have Different Perceptions of the Diversity of Wild Birds? Implications for Conservation

PubMed Central

de Andrade, Luciano Pires; Muniz, Lauana Souza; Telino-Júnior, Wallace Rodrigues; Albuquerque, Ulysses Paulino; Lyra-Neves, Rachel Maria

2016-01-01

Farmers’ perceptions of birds’ interactions with agricultural production systems are fundamental to species conservation efforts. In the present study, we evaluated the perceptions of birds held by farmers who engage in conventional and non-conventional agricultural production processes and the implications of potential differences in these perceptions on species conservation. To accomplish this, data were collected using questionnaires, semi-structured interviews, and other complementary sources of information gathered from 191 farmers in northeastern Brazil. Although some similarities were identified among the farmers in their perceptions and local ecological knowledge (LEK) of birds, differences existed between the conventional and non-conventional farmers in their attitudes toward, conflicts with, and usage of bird species. Compared to the conventional farmers, the non-conventional farmers could identify more bird species, possessed more favorable attitudes toward birds, and engaged in practices more beneficial to the conservation of avifauna. The perceptions that were identified were related to the type of agriculture practiced, and such perceptions may affect the conservation of bird species. Therefore, the adoption of certain agricultural practices has important implications for conservation. Our results indicate the need for investment in public policies, programs and actions that account for farmers’ knowledge and perceptions. Such investments will contribute to the development and adoption of practices supporting wild bird conservation in agricultural areas. PMID:27243222

Three Views of Systems Theories and Their Implications for Sustainability Education

ERIC Educational Resources Information Center

Porter, Terry; Cordoba, Jose

2009-01-01

Worldwide, there is an emerging interest in sustainability and sustainability education. A popular and promising approach is the use of systems thinking. However, the systems approach to sustainability has neither been clearly defined nor has its practical application followed any systematic rigor, resulting in confounded and underspecified…

Feminism Lives On: Incorporating Contemporary Feminism into Counseling Practice with Families and Youth

ERIC Educational Resources Information Center

Bordeau, Wendy Charkow; Briggs, Michele Kielty; Staton, A. Renee; Wasik, Suzan Zuljani

2008-01-01

Feminist contributions to counseling practice with families and children are reviewed, with a focus on the Third Wave feminist movement and its implications for family development and intervention. Recommendations for empowering young clients and their support systems as well as current challenges and research needs are also considered.

Building a Socially Supportive Environment. ERIC-IRCD Urban Disadvantaged Series, Number 16.

ERIC Educational Resources Information Center

Gordon, Edmund W.

This paper examines the conflicts between and the inequities inherent in practically all present day social systems and suggests strategies for building a socially supportive environment. The study focuses on the practical implications of the nature-nurture controversy and contends that greater attention must be given to extrinsic factors in…

Human factors systems approach to healthcare quality and patient safety

PubMed Central

Carayon, Pascale; Wetterneck, Tosha B.; Rivera-Rodriguez, A. Joy; Hundt, Ann Schoofs; Hoonakker, Peter; Holden, Richard; Gurses, Ayse P.

2013-01-01

Human factors systems approaches are critical for improving healthcare quality and patient safety. The SEIPS (Systems Engineering Initiative for Patient Safety) model of work system and patient safety is a human factors systems approach that has been successfully applied in healthcare research and practice. Several research and practical applications of the SEIPS model are described. Important implications of the SEIPS model for healthcare system and process redesign are highlighted. Principles for redesigning healthcare systems using the SEIPS model are described. Balancing the work system and encouraging the active and adaptive role of workers are key principles for improving healthcare quality and patient safety. PMID:23845724

Primary Care Practice: Uncertainty and Surprise

NASA Astrophysics Data System (ADS)

Crabtree, Benjamin F.

I will focus my comments on uncertainty and surprise in primary care practices. I am a medical anthropologist by training, and have been a full-time researcher in family medicine for close to twenty years. In this talk I want to look at primary care practices as complex systems, particularly taking the perspective of translating evidence into practice. I am going to discuss briefly the challenges we have in primary care, and in medicine in general, of translating new evidence into the everyday care of patients. To do this, I will look at two studies that we have conducted on family practices, then think about how practices can be best characterized as complex adaptive systems. Finally, I will focus on the implications of this portrayal for disseminating new knowledge into practice.

Innovative Advances in Connectivity and Community Pharmacist Patient Care Services: Implications for Patient Safety.

PubMed

Bacci, Jennifer L; Berenbrok, Lucas A

2018-06-07

The scope of community pharmacy practice has expanded beyond the provision of drug product to include the provision of patient care services. Likewise, the community pharmacist's approach to patient safety must also expand beyond prevention of errors during medication dispensing to include optimization of medications and prevention of adverse events throughout the entire medication use process. Connectivity to patient data and other healthcare providers has been a longstanding challenge in community pharmacy with implications for the delivery and safety of patient care. Here, we describe three innovative advances in connectivity in community pharmacy practice that enhance patient safety in the provision of community pharmacist patient care services across the entire medication use process. Specifically, we discuss the growing use of immunization information systems, quality improvement platforms, and health information exchanges in community pharmacy practice and their implications for patient safety. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Youth with Behavioral Health Disorders Aging Out of Foster Care: a Systematic Review and Implications for Policy, Research, and Practice.

PubMed

Kang-Yi, Christina D; Adams, Danielle R

2017-01-01

This systematic review aimed to (1) identify and summarize empirical studies on youth with behavioral health disorders aging out of foster care and (2) address implications for behavioral health policy, research, and practice. We identified previous studies by searching PubMed, PsycINFO, EBSCO, and ISI Citation Indexes and obtaining references from key experts in the child welfare field. A total of 28 full articles published between 1991 and 2014 were reviewed and summarized into the key areas including systems of care, disability type, transition practice area, study methods, study sample, transition outcome measures, study analysis, and study findings. Considering how fast youth who have behavioral health disorders fall through the crack as they exit foster care, one cannot understate the importance of incorporating timely and appropriate transition planning and care coordination for youth who have behavioral health disorders aging out of foster care into the usual case management performed by behavioral health systems and service providers.

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

PubMed

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

2018-05-01

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

The Hidden Human Rights Curriculum of Surveillance Cameras in Schools: Due Process, Privacy and Trust

ERIC Educational Resources Information Center

Perry-Hazan, Lotem; Birnhack, Michael

2018-01-01

This article explores how school principals integrate Closed Circuit TV systems (CCTVs) in educational practices and analyses the pedagogical implications of these practices through the lens of human rights. Drawing on interviews with school principals and municipality officials, we found that schools use CCTVs for three main purposes: (1)…

Caffeine: implications of recent research for clinical practice.

PubMed

Wells, Susan J

1984-07-01

Caffeine is a central nervous system stimulant that has come under increasing scrutiny due to its effects on the health and mental health of those who consume it. This article summarizes the physiological effects of caffeine, reviews recent research on behavioral and mood changes associated with consumption, and discusses clinical implications for the mental health professional. Data on caffeine consumption and principal sources of caffeine are outlined.

Agreement of three interpretation systems of intrapartum foetal heart rate monitoring by different levels of physicians.

PubMed

Pruksanusak, Ninlapa; Thongphanang, Putthaporn; Chainarong, Natthicha; Suntharasaj, Thitima; Kor-Anantakul, Ounjai; Suwanrath, Chitkasaem; Petpichetchian, Chusana

2017-11-01

A prospective study was conducted in centre in Southern Thailand, to evaluate agreement in EFM interpretation among various physicians in order to find out the most practical system for daily use. We found strong agreement of very normal FHR tracings among the FIGO, NICHD 3-tier and 5-tier systems. The NICHD 3-tier was more compatible with the FIGO system than 5-tier system. Overall inter-observer agreement was moderate for the NICHD 3-tier system while inter-observer agreement of 5-tier system was fair also the intra-observer agreement was higher in the NICHD 3-tier system. So the 3-tier systems are more suitable than the 5-tier system in general obstetric practice. Impact statement What is already known on this subject: The 3-tier and 5-tier systems were widely used in general obstetrics practice. What the results of this study add: The inter- and intra-observer agreement of NICHD 3-tier system was higher than the 5-tier system. What the implications are of these findings for clinical practice and/or further research: The 3-tier systems were more suitable than the 5-tier systems in general obstetrics practice.

Personalizing knowledge delivery services: a conceptual framework

NASA Technical Reports Server (NTRS)

Majchrzak, Ann; Chelleppa, Ramnath K.; Cooper, Lynne P.; Hars, Alexander

2003-01-01

Consistent with the call of the Minnesota Symposium for new theory in knowledge management, we offer a new conceptualization of Knowledge Management Systems (KMS) as a portfolio of personalized knowledge delivery services. Borrowing from research on online consumer behavior, we describe the challenges imposed by personalized knowledge delivery services, and suggest design parameters that can help to overcome these challenges. We develop our design constructs through a set of hypotheses and discuss the research implications of our new conceptualization. Finally, we describe practical implications suggested by our conceptualization - practical suggestions that we hope to gain some experience with as part of an ongoing action research project at our partner organization.

Healthcare waste management: an interpretive structural modeling approach.

PubMed

Thakur, Vikas; Anbanandam, Ramesh

2016-06-13

Purpose - The World Health Organization identified infectious healthcare waste as a threat to the environment and human health. India's current medical waste management system has limitations, which lead to ineffective and inefficient waste handling practices. Hence, the purpose of this paper is to: first, identify the important barriers that hinder India's healthcare waste management (HCWM) systems; second, classify operational, tactical and strategical issues to discuss the managerial implications at different management levels; and third, define all barriers into four quadrants depending upon their driving and dependence power. Design/methodology/approach - India's HCWM system barriers were identified through the literature, field surveys and brainstorming sessions. Interrelationships among all the barriers were analyzed using interpretive structural modeling (ISM). Fuzzy-Matrice d'Impacts Croisés Multiplication Appliquée á un Classement (MICMAC) analysis was used to classify HCWM barriers into four groups. Findings - In total, 25 HCWM system barriers were identified and placed in 12 different ISM model hierarchy levels. Fuzzy-MICMAC analysis placed eight barriers in the second quadrant, five in third and 12 in fourth quadrant to define their relative ISM model importance. Research limitations/implications - The study's main limitation is that all the barriers were identified through a field survey and barnstorming sessions conducted only in Uttarakhand, Northern State, India. The problems in implementing HCWM practices may differ with the region, hence, the current study needs to be replicated in different Indian states to define the waste disposal strategies for hospitals. Practical implications - The model will help hospital managers and Pollution Control Boards, to plan their resources accordingly and make policies, targeting key performance areas. Originality/value - The study is the first attempt to identify India's HCWM system barriers and prioritize them.

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

PubMed

McCloskey, Donna Jo

2008-01-01

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

The Importance of College Roommate Relationships: A Review and Systemic Conceptualization

ERIC Educational Resources Information Center

Erb, Sarah E.; Renshaw, Keith D.; Short, Jerome L.; Pollard, Jeffrey W.

2014-01-01

This article reviews empirical studies of the role of college roommate relationships in students' mental health and college adjustment. We propose a systemic conceptualization of roommate relationships that highlights roommates' interdependence and origins of roommate relationship dynamics. We discuss practice implications for student…

Assessing the Organizational Social Context (OSC) of Child Welfare Systems: Implications for Research and Practice

ERIC Educational Resources Information Center

Glisson, Charles; Green, Philip; Williams, Nathaniel J.

2012-01-01

Objective: The study: (1) provides the first assessment of the a "priori" measurement model and psychometric properties of the Organizational Social Context (OSC) measurement system in a US nationwide probability sample of child welfare systems; (2) illustrates the use of the OSC in constructing norm-based organizational culture and climate…

Linking a Medical User Survey to Management for Library Effectiveness: II, A Checkland Soft Systems Study.

ERIC Educational Resources Information Center

Brember, V. L.

1985-01-01

Presents Checkland's soft systems methodology, discusses it in terms of the systems approach, and illustrates how it was used to relate evidence of user survey to practical problems of library management. Difficulties in using methodology are described and implications for library management and information science research are presented. (8…

The Ethics of Writing Instruction: Issues in Theory and Practice. Perspectives on Writing: Theory, Research, Practice. Volume 4.

ERIC Educational Resources Information Center

Pemberton, Michael A., Ed.

This collection of essays reveals a keen awareness of the degree to which ethics and ethical systems are located in particular instructional contexts. The essays consider the implications of these contexts from a variety of perspectives, both theoretical and pedagogical. In the collection's first part, Ethics and the Composition Classroom, are the…

Making sense of HUSK: practice implications for social change initiatives.

PubMed

McBeath, Bowen

2015-01-01

As an exemplar of bottom-up progressive social experimentation, HUSK provides opportunities to examine how innovative practice is supported and challenged in bureaucratic settings. In this analysis the author uses a sensemaking lens to identify critical issues and questions for those seeking to promote progressive change initiative in social welfare systems. Findings identify essential organizational and managerial supports needed to support service user voice and participation and reinforce the importance of reflexivity in practice and research.

Interfacing theories of program with theories of evaluation for advancing evaluation practice: Reductionism, systems thinking, and pragmatic synthesis.

PubMed

Chen, Huey T

2016-12-01

Theories of program and theories of evaluation form the foundation of program evaluation theories. Theories of program reflect assumptions on how to conceptualize an intervention program for evaluation purposes, while theories of evaluation reflect assumptions on how to design useful evaluation. These two types of theories are related, but often discussed separately. This paper attempts to use three theoretical perspectives (reductionism, systems thinking, and pragmatic synthesis) to interface them and discuss the implications for evaluation practice. Reductionism proposes that an intervention program can be broken into crucial components for rigorous analyses; systems thinking view an intervention program as dynamic and complex, requiring a holistic examination. In spite of their contributions, reductionism and systems thinking represent the extreme ends of a theoretical spectrum; many real-world programs, however, may fall in the middle. Pragmatic synthesis is being developed to serve these moderate- complexity programs. These three theoretical perspectives have their own strengths and challenges. Knowledge on these three perspectives and their evaluation implications can provide a better guide for designing fruitful evaluations, improving the quality of evaluation practice, informing potential areas for developing cutting-edge evaluation approaches, and contributing to advancing program evaluation toward a mature applied science. Copyright © 2016 Elsevier Ltd. All rights reserved.

Matching Impedances and Modes in Acoustic Levitation

NASA Technical Reports Server (NTRS)

Barmatz, M. B.

1985-01-01

Temperature differences accommodated with tunable coupler. Report discusses schemes for coupling sound efficiently from cool outside atmosphere into hot acoustic-levitation chamber. Theoretical studies have practical implications for material-processing systems that employ acoustic levitation.

Implications of an emerging EHR monoculture for hospitals and healthcare systems.

PubMed

Koppel, Ross; Lehmann, Christoph U

2015-03-01

In many hospitals and health systems, a 'new' electronic health record means a shift to one vendor: Epic, a vendor that dominates in large and medium hospital markets and continues its success with smaller institutions and ambulatory practices. Our paper examines the implications of this emerging monoculture: its advantages and disadvantages for physicians and hospitals and its role in innovation, professional autonomy, implementation difficulties, workflow, flexibility, cost, data standards, interoperability, and interactions with other information technology (IT) systems. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Future trends in health and health care: implications for social work practice in an aging society.

PubMed

Spitzer, William J; Davidson, Kay W

2013-01-01

Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.

Forensic psychology and correctional psychology: Distinct but related subfields of psychological science and practice.

PubMed

Neal, Tess M S

2018-02-12

This article delineates 2 separate but related subfields of psychological science and practice applicable across all major areas of the field (e.g., clinical, counseling, developmental, social, cognitive, community). Forensic and correctional psychology are related by their historical roots, involvement in the justice system, and the shared population of people they study and serve. The practical and ethical contexts of these subfields is distinct from other areas of psychology-and from one another-with important implications for ecologically valid research and ethically sound practice. Forensic psychology is a subfield of psychology in which basic and applied psychological science or scientifically oriented professional practice is applied to the law to help resolve legal, contractual, or administrative matters. Correctional psychology is a subfield of psychology in which basic and applied psychological science or scientifically oriented professional practice is applied to the justice system to inform the classification, treatment, and management of offenders to reduce risk and improve public safety. There has been and continues to be great interest in both subfields-especially the potential for forensic and correctional psychological science to help resolve practical issues and questions in legal and justice settings. This article traces the shared and separate developmental histories of these subfields, outlines their important distinctions and implications, and provides a common understanding and shared language for psychologists interested in applying their knowledge in forensic or correctional contexts. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The changing health care delivery structure: opportunities for nursing practice and administration.

PubMed

Barter, M; Graves, J; Phoon, J; Corder, K

1995-01-01

The increase in national health care expenditures has placed great stress on the economy and has contributed to a widespread consensus that reform of the health care delivery system is necessary. Three interrelated strategies are frequently used to cope with the turbulent environment in the health care industry today: managed care, hospital merger and acquisition to form integrated health care delivery systems, and redefined roles for nurses and other health care workers. These strategies have profound implications and will offer great opportunities for nursing administrators to foster nursing practice in new and improved systems of care delivery.

Utilizing a 'systems' approach to improve the management of waste from healthcare facilities: best practice case studies from England and Wales.

PubMed

Tudor, Terry L; Woolridge, Anne C; Bates, Margaret P; Phillips, Paul S; Butler, Sharon; Jones, Keith

2008-06-01

Changes in environmental legislation and standards governing healthcare waste, such as the Hazardous Waste Regulations are expected to have a significant impact on healthcare waste quantities and costs in England and Wales. This paper presents findings from two award winning case study organizations, the Cardiff and Vale NHS Trust and the Cornwall NHS Trust on 'systems' they have employed for minimizing waste. The results suggest the need for the development and implementation of a holistic range of systems in order to develop best practice, including waste minimization strategies, key performance indicators, and staff training and awareness. The implications for the sharing of best practice from the two case studies are also discussed.

Understanding human resource management practices in Botswana's public health sector.

PubMed

Seitio-Kgokgwe, Onalenna Stannie; Gauld, Robin; Hill, Philip C; Barnett, Pauline

2016-11-21

Purpose The purpose of this paper is to assess the management of the public sector health workforce in Botswana. Using institutional frameworks it aims to document and analyse human resource management (HRM) practices, and make recommendations to improve employee and health system outcomes. Design/methodology/approach The paper draws from a large study that used a mixed methods approach to assess performance of Botswana's Ministry of Health (MOH). It uses data collected through document analysis and in-depth interviews of 54 key informants comprising policy makers, senior staff of the MOH and its stakeholder organizations. Findings Public health sector HRM in Botswana has experienced inadequate planning, poor deployment and underutilization of staff. Lack of comprehensive retention strategies and poor working conditions contributed to the failure to attract and retain skilled personnel. Relationships with both formal and informal environments affected HRM performance. Research limitations/implications While document review was a major source of data for this paper, the weaknesses in the human resource information system limited availability of data. Practical implications This paper presents an argument for the need for consideration of formal and informal environments in developing effective HRM strategies. Originality/value This research provides a rare system-wide approach to health HRM in a Sub-Saharan African country. It contributes to the literature and evidence needed to guide HRM policy decisions and practices.

A Factor Analytic Investigation of the BASC-2 Behavioral and Emotional Screening System Parent Form: Psychometric Properties, Practical Implications, and Future Directions

ERIC Educational Resources Information Center

Dowdy, Erin; Chin, Jenna K.; Twyford, Jennifer M.; Dever, Bridget V.

2011-01-01

The Behavior Assessment System for Children, Second Edition (BASC-2) Behavioral and Emotional Screening System Parent Form (BESS Parent; Kamphaus & Reynolds, 2007) is a recently developed instrument designed to identify behavioral and emotional risk in students. To describe the underlying factor structure for this instrument, exploratory (EFA)…

Using a Research Instrument for Developing Quality at the University

ERIC Educational Resources Information Center

Parpala, Anna; Lindblom-Ylanne, Sari

2012-01-01

The University of Helsinki, along with the other European universities, is facing challenges for enhancing the quality of teaching and developing quality assurance systems with comparable criteria. To tackle these aims the university started to develop a student feedback system with a solid theoretical feedback and valuable practical implications.…

Systems Perspectives on External Quality Assurance: Implications for Micro-States

ERIC Educational Resources Information Center

Houston, Don; Maniku, Ahmed Ali

2005-01-01

Quality assurance in higher education is a mess: the "problem" of quality is embedded in complex sets of interacting issues that are of concern to many and varied stakeholders. Developing higher education systems that have responded to issues of quality through a "best practice" model of external quality assurance has produced…

Learning to Click: An Evaluation of the Personal Response System Clicker Technology in Introductory Marketing Courses

ERIC Educational Resources Information Center

Williamson Sprague, Elaine; Dahl, Darren W.

2010-01-01

The incorporation of personal response system (PRS) clickers into teaching pedagogy has created implications for teaching practice and student satisfaction. Using a current undergraduate business student population, the authors measure student attitudes and preferences and identify student performance outcomes relating to the use of PRS clickers.…

Thinking Comprehensively about Education: Spaces of Educative Possibility and Their Implications for Public Policy

ERIC Educational Resources Information Center

Dixon-Roman, Ezekiel, Ed.; Gordon, Edmund W., Ed.

2012-01-01

While much is known about the critical importance of educative experiences outside of school, little is known about the social systems, community programs, and everyday practices that can facilitate learning outside of the classroom. "Thinking Comprehensively About Education" sheds much-needed light on those systems, programs, and…

Making Decisions in a Time of Fiscal Stringency: The Longer-Term Implications.

ERIC Educational Resources Information Center

Bowen, Frank M.

The concept of traditional planning, programming, and budgeting systems (PPBS) is defined and compared with imperative planning, a term used to refer to whatever procedures higher education officials use to integrate program planning and budgeting. The University of Wisconsin system is described as an example of emerging budgetary practice in…

Diagnosing and Managing Violence

PubMed Central

2011-01-01

Available categorization systems for violence encountered in medical practice do not constitute optimal tools to guide management. In this article, 4 common patterns of violence across psychiatric diagnoses are described (defensive, dominance-defining, impulsive, and calculated) and management implications are considered. The phenomenologic and neurobiological rationale for a clinical classification system of violence is also presented. PMID:22295257

The Neural Mechanisms of Meditative Practices: Novel Approaches for Healthy Aging.

PubMed

Acevedo, Bianca P; Pospos, Sarah; Lavretsky, Helen

2016-01-01

Meditation has been shown to have physical, cognitive, and psychological health benefits that can be used to promote healthy aging. However, the common and specific mechanisms of response remain elusive due to the diverse nature of mind-body practices. In this review, we aim to compare the neural circuits implicated in focused-attention meditative practices that focus on present-moment awareness to those involved in active-type meditative practices (e.g., yoga) that combine movement, including chanting, with breath practices and meditation. Recent meta-analyses and individual studies demonstrated common brain effects for attention-based meditative practices and active-based meditations in areas involved in reward processing and learning, attention and memory, awareness and sensory integration, and self-referential processing and emotional control, while deactivation was seen in the amygdala, an area implicated in emotion processing. Unique effects for mindfulness practices were found in brain regions involved in body awareness, attention, and the integration of emotion and sensory processing. Effects specific to active-based meditations appeared in brain areas involved in self-control, social cognition, language, speech, tactile stimulation, sensorimotor integration, and motor function. This review suggests that mind-body practices can target different brain systems that are involved in the regulation of attention, emotional control, mood, and executive cognition that can be used to treat or prevent mood and cognitive disorders of aging, such as depression and caregiver stress, or serve as "brain fitness" exercise. Benefits may include improving brain functional connectivity in brain systems that generally degenerate with Alzheimer's disease, Parkinson's disease, and other aging-related diseases.

Cultural influences on science museum practices: A case study

NASA Astrophysics Data System (ADS)

Duensing, Sally Jeanne

This dissertation looks at how informal science museums and centers both reflect and create the cultural contexts in which they are embedded. Specifically, it explores the multiple cultural perspectives held by the staff of the Yapollo Science Center in Trinidad, West Indies. This study focuses on how these perspectives impact the science center's sense of mission, design of educational programs, and development of exhibits. The findings in this case study have implications for other science museums and learning environments. Through the conduct and analysis of interviews, group meetings and on-site observations, this study found that there are several cultural domains in which staff perspectives of museum practice are situated. These include the local popular Trinidadian culture, the formal school system, and international science center community practices. For example, learning in the science center is seen by Yapollo staff as a social endeavor, more than an individual act. There is an emphasis on group engagement and social learning processes in exhibit design and teaching programs. The impact of local culture is further evidenced by Trinidadian practices of social learning and social competition in steel pan learning and calypso competition. These practices inform images of learning at Yapollo. The study highlights the role of formal educational systems by discussing how staff's informal educational approaches have resulted in a dialectic with the local formal British based school system practices. The study also explores the ways staff have adapted exhibit and program ideas from the international science museum. The synthesis of these cultures creates its own cultural ways of thinking and practice about exhibits and pedagogy that form the shared common wisdom at Yapollo. Museum practice, in this context, is viewed as a culture shaping enterprise that is itself shaped by culture. It demonstrates that teaching and learning practices occur in, and can be reflected upon, in multiple cultural contexts. The findings of this study have implications for many other areas of sociocultural and educational research.

Multi-Modal Traveler Information System - Cellular 911-State of the Practice

DOT National Transportation Integrated Search

1997-05-19

Working paper evaluates the implemented public 911 and private non-911 cellular : based emergency centers around the country, and within the : Gary-Chicago-Milwaukee (GCM) Corridor and documents the impact, implications and : experiences of switching...

Scaling up Evidence-based Practices for Children and Families in New York State: Towards Evidence-based Policies on Implementation for State Mental Health Systems

PubMed Central

Hoagwood, Kimberly Eaton; Olin, S. Serene; Horwitz, Sarah; McKay, Mary; Cleek, Andrew; Gleacher, Alissa; Lewandowski, Eric; Nadeem, Erum; Acri, Mary; Chor, Ka Ho Brian; Kuppinger, Anne; Burton, Geraldine; Weiss, Dara; Frank, Samantha; Finnerty, Molly; Bradbury, Donna M.; Woodlock, Kristin M.; Hogan, Michael

2014-01-01

Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling-out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policy-makers, providers and family support specialists have worked in partnership since 2002 to redesign and evaluate the children’s mental health system. Five system strategies driven by empirically-based practices and organized within a state-supported infrastructure have been used in the child and family service system with over 2,000 providers: (a) business practices; (b) use of health information technologies in quality improvement; (c) specific clinical interventions targeted at common childhood disorders; (d) parent activation; and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems. PMID:24460518

Soil health paradigms and implications for disease management.

PubMed

Larkin, Robert P

2015-01-01

Soil health has been defined as the capacity of soil to function as a vital living system to sustain biological productivity, maintain environmental quality, and promote plant, animal, and human health. Building and maintaining soil health are essential to agricultural sustainability and ecosystem function. Management practices that promote soil health, including the use of crop rotations, cover crops and green manures, organic amendments, and conservation tillage, also have generally positive effects on the management of soilborne diseases through a number of potential mechanisms, including increasing soil microbial biomass, activity, and diversity, resulting in greater biological suppression of pathogens and diseases. However, there also may be particular disease issues associated with some soil health management practices. In this review, research and progress made over the past twenty years regarding soil health, sustainability, and soil health management practices, with an emphasis on their implications for and effects on plant disease and disease management strategies, are summarized.

The implications of Istanbul Declaration on organ trafficking and transplant tourism.

PubMed

Delmonico, Francis L

2009-04-01

Organ trafficking, transplant tourism and transplant commercialism are now defined by the Declaration of Istanbul; the Declaration provides principles of practice based on those definitions. Organ trafficking and transplant tourism should be prohibited because they violate the principles of equity, justice and respect for human dignity. This report provides a country-by-country description of current events that may effect the practice of transplantation internationally for the foreseeable future. The implications of the Istanbul Declaration are profound. It calls for a legal and professional framework in each country to govern organ donation and transplantation activities. It calls for a transparent regulatory oversight system that ensures donor and recipient safety and enforces the prohibitions of unethical practices. Governments should ensure the provision of care and follow-up of living donors be no less than the care and attention provided for transplants recipients.

Implications of pharmacogenomics for drug development and clinical practice.

PubMed

Ginsburg, Geoffrey S; Konstance, Richard P; Allsbrook, Jennifer S; Schulman, Kevin A

2005-11-14

Pharmacogenomics is likely to be among the first clinical applications of the Human Genome Project and is certain to have an enormous impact on the clinical practice of medicine. Herein, we discuss the potential implications of pharmacogenomics on the drug development process, including drug safety, productivity, market segmentation, market expansion, differentiation, and personalized health care. We also review 3 challenges facing the translation of pharmacogenomics into clinical practice: dependence on information technology, limited health care financing, and the scientific uncertainty surrounding validation of specific applications of the technology. To our knowledge, there is currently no formal agenda to promote and cultivate innovation, to develop progressive information technology, or to obtain the financing that would be required to advance the use of pharmacogenomic technologies in patient care. Although the potential of these technologies is driving change in the development of clinical sciences, it remains to be seen which health care systems level needs will be addressed.

A focus on the asthma HEDIS measure and its implications for clinical practice.

PubMed

Davies, Thomas J; Bunn, William B; Fromer, Leonard; Gelfand, Erwin W; Colice, Gene L

2006-02-01

With more than $16.1 billion in annual costs, the asthma management system is inadequate and needs revision to improve health and financial outcomes. Solutions may be found in the National Committee for Quality Assurance's guidelines and in such programs as Pay for Performance that financially reward providers for adherence to standards of practice based on Health Plan Employer Data and Information Set measures.

Ground cover, erosion risk and production implications of targeted management practices in Australian mixed farming systems: lessons from the Grain and Graze program

USDA-ARS?s Scientific Manuscript database

Maintaining the productive capacity of the agricultural soils of Australia's broadacre cropping zone requires careful management, given a highly variable climate and soils that are susceptible to degradation. Mixed croplivestock farming systems are the predominant land use across these regions and m...

Water Security and Farming Systems: Implications for Advisory Practice and Policy-Making

ERIC Educational Resources Information Center

Nettle, Ruth; Paine, Mark

2009-01-01

Water issues are a feature of public debate in Australia. The increasing privatisation of water and changes to water allocation systems are resulting in change, often referred to as water "wars" (de Villiers, 1999). The Australian dairy industry uses 25% of the surface irrigation water in Australia. How does a rural industry like…

Teachers' Implicit Meaning Systems and Their Implications for Pedagogical Thinking and Practice: A Case Study from Finland

ERIC Educational Resources Information Center

Rissanen, Inkeri; Kuusisto, Elina; Hanhimäki, Eija; Tirri, Kirsi

2018-01-01

This qualitative case study examines teachers' implicit meaning systems built around their core beliefs on the malleability of human qualities. Previous research has demonstrated the influence of students' implicit theories on motivation and achievement and has presented successful interventions for students. However, research on teachers'…

Possibilities and Implications of Using a Motion-Tracking System in Physical Education

ERIC Educational Resources Information Center

Chow, Jia Yi; Tan, Clara Wee Keat; Lee, Miriam Chang Yi; Button, Chris

2014-01-01

Advances in technology have created new opportunities for enhanced delivery of teaching to improve the acquisition of game skills in physical education (PE). The availability of a motion-tracking system (i.e. the A-Eye), which determines positional information of students in a practice context, might offer a suitable technology to support…

Systematically Evaluating the Effectiveness of an Information Systems Capstone Course: Implications for Practice

ERIC Educational Resources Information Center

Gill, T. Grandon; Ritzhaupt, Albert D.

2013-01-01

The information systems capstone experience for undergraduate majors is a topic frequently discussed in academic circles within the field. Though very little consensus exists on this topic, there are core themes that emerge in the design, development, and delivery of the undergraduate capstone courses. Our analysis of prior literature reveals four…

PDS Leadership Team as Community of Practice: Implications for Local School System and Higher Education Partnerships

ERIC Educational Resources Information Center

Frazier, Laura Corbin; Brown-Hobbs, Stacey; Civetti, Linda; Gordon, Paula

2015-01-01

Professional development school (PDS) partnerships have existed in one local school system (LSS) with three different institutions of higher education (IHE) for over a decade. Commonalities and distinctive features were noted between the partnerships. In an attempt to establish standardized and equitable policies from the LSS level,…

Unlicensed staff members' experiences with patients' pain on an inpatient oncology unit: implications for redesigning the care delivery system.

PubMed

Schulman-Green, Dena; Harris, Debra; Xue, Ying; Loseth, Diane B; Czaplinski, Cindy; Donovan, Constance; McCorkle, Ruth

2005-01-01

Although unlicensed staff have routine contact with patients in pain, little research relates to their role with these patients. The purpose of this study was to describe the experiences of unlicensed inpatient hospital staff caring for cancer patients in pain. We sought to understand pain identification and communication practices, describe common practice situations, and identify training needs. We conducted 4 focus groups with unit secretaries, nurses' aides, and housekeepers (N = 24) on 2 inpatient oncology units at an urban, northeastern teaching hospital. Group processes were tape-recorded, transcribed, and analyzed using Atlas/ti software and content analysis. Analysis generated 5 issues related to pain in the daily practice of unlicensed staff: perceived function with pain, building relationships with patients, interpreting patients' pain, system issues, and job challenges and coping strategies. Unlicensed staff reported performing important functions related to pain, including alerting nursing staff to patients' pain, and providing psychosocial support. Participants shared difficulties of working with patients in pain and expressed interest in education on pain identification and course of illness. Findings provide insight into the role of unlicensed staff, and have implications for the educational preparation of this group as well as the nature of their participation in the care delivery system.

Educational Organization for the Future

ERIC Educational Resources Information Center

Cote, Ron Roy

1977-01-01

Five basic components of the emerging educational system--forecasts and assessment, program planning, alternative environments, electronics and socialization, and differentiated faculty--summarize both current trends in educational practice and the implications for schools provided by analysts of the radically different society America is…

A Prospective Examination of Clinician and Supervisor Turnover Within the Context of Implementation of Evidence-Based Practices in a Publicly-Funded Mental Health System.

PubMed

Beidas, Rinad S; Marcus, Steven; Wolk, Courtney Benjamin; Powell, Byron; Aarons, Gregory A; Evans, Arthur C; Hurford, Matthew O; Hadley, Trevor; Adams, Danielle R; Walsh, Lucia M; Babbar, Shaili; Barg, Frances; Mandell, David S

2016-09-01

Staff turnover rates in publicly-funded mental health settings are high. We investigated staff and organizational predictors of turnover in a sample of individuals working in an urban public mental health system that has engaged in a system-level effort to implement evidence-based practices. Additionally, we interviewed staff to understand reasons for turnover. Greater staff burnout predicted increased turnover, more openness toward new practices predicted retention, and more professional recognition predicted increased turnover. Staff reported leaving their organizations because of personal, organizational, and financial reasons; just over half of staff that left their organization stayed in the public mental health sector. Implications include an imperative to focus on turnover, with a particular emphasis on ameliorating staff burnout.

Biomimicry, Biofabrication, and Biohybrid Systems: The Emergence and Evolution of Biological Design.

PubMed

Raman, Ritu; Bashir, Rashid

2017-10-01

The discipline of biological design has a relatively short history, but has undergone very rapid expansion and development over that time. This Progress Report outlines the evolution of this field from biomimicry to biofabrication to biohybrid systems' design, showcasing how each subfield incorporates bioinspired dynamic adaptation into engineered systems. Ethical implications of biological design are discussed, with an emphasis on establishing responsible practices for engineering non-natural or hypernatural functional behaviors in biohybrid systems. This report concludes with recommendations for implementing biological design into educational curricula, ensuring effective and responsible practices for the next generation of engineers and scientists. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Service Providers’ Experiences and Perspectives on Recovery-Oriented Mental Health System Reform

PubMed Central

Piat, Myra; Lal, Shalini

2016-01-01

Objective With the use of a qualitative approach, this study focuses on service providers’ experiences and perspectives on recovery-oriented reform. Methods Nine focus groups were conducted with a sample of 68 service providers recruited from three Canadian sites. Results Three major themes were identified: 1) positive attitudes towards recovery-oriented reform; 2) skepticism towards recovery-oriented reform; and 3) challenges associated with implementing recovery-oriented practice. These challenges pertained to conceptual uncertainty and consistency around the meanings of recovery; application of recovery-oriented practice with certain populations and in certain contexts; bureaucratization of recovery-oriented tools; limited leadership support; and, societal stigma and social exclusion of persons with mental illnesses. Conclusions and Implications for Practice The findings point towards challenges that might arise as system planners move ahead in their efforts toward implementing recovery within the mental health system. In this regard, we offer several recommendations for the planning of organizational and educational practices that support the implementation of recovery-oriented practice. PMID:22491368

Integrated Medical-Dental Delivery Systems: Models in a Changing Environment and Their Implications for Dental Education.

PubMed

Jones, Judith A; Snyder, John J; Gesko, David S; Helgeson, Michael J

2017-09-01

Models and systems of the dental care delivery system are changing. Solo practice is no longer the only alternative for graduating dentists. Over half of recent graduates are employees, and more than ever before, dentists are practicing in groups. This trend is expected to increase over the next 25 years. This article examines various models of dental care delivery, explains why it is important to practice in integrated medical-dental teams, and defines person-centered care, contrasting it with patient-centered care. Systems of care in which teams are currently practicing integrated oral health care delivery are described, along with speculation on the future of person-centered care and the team approach. Critical steps in the education of dental and other health care professionals and the development of clinical models of care in moving forward are considered. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

Section 3: Quality and Value-Based Requirements

NASA Astrophysics Data System (ADS)

Mylopoulos, John

Traditionally, research and practice in software engineering has focused its attention on specific software qualities, such as functionality and performance. According to this perspective, a system is deemed to be of good quality if it delivers all required functionality (“fitness-for-purpose”) and its performance is above required thresholds. Increasingly, primarily in research but also in practice, other qualities are attracting attention. To facilitate evolution, maintainability and adaptability are gaining popularity. Usability, universal accessibility, innovativeness, and enjoyability are being studied as novel types of non-functional requirements that we do not know how to define, let alone accommodate, but which we realize are critical under some contingencies. The growing importance of the business context in the design of software-intensive systems has also thrust economic value, legal compliance, and potential social and ethical implications into the forefront of requirements topics. A focus on the broader user environment and experience, as well as the organizational and societal implications of system use, thus has become more central to the requirements discourse. This section includes three contributions to this broad and increasingly important topic.

Women's health nursing in the context of the National Health Information Infrastructure.

PubMed

Jenkins, Melinda L; Hewitt, Caroline; Bakken, Suzanne

2006-01-01

Nurses must be prepared to participate in the evolving National Health Information Infrastructure and the changes that will consequently occur in health care practice and documentation. Informatics technologies will be used to develop electronic health records with integrated decision support features that will likely lead to enhanced health care quality and safety. This paper provides a summary of the National Health Information Infrastructure and highlights electronic health records and decision support systems within the context of evidence-based practice. Activities at the Columbia University School of Nursing designed to prepare nurses with the necessary informatics competencies to practice in a National Health Information Infrastructure-enabled health care system are described. Data are presented from electronic (personal digital assistant) encounter logs used in our Women's Health Nurse Practitioner program to support evidence-based advanced practice nursing care. Implications for nursing practice, education, and research in the evolving National Health Information Infrastructure are discussed.

Pathways Between Marriage and Parenting for Wives and Husbands: The Role of Coparenting1

PubMed Central

Morrill, Melinda

2016-01-01

As family systems research has expanded, so have investigations into how marital partners coparent together. Although coparenting research has increasingly found support for the influential role of coparenting on both marital relationships and parenting practices, coparenting has traditionally been investigated as part of an indirect system which begins with marital health, is mediated by coparenting processes, and then culminates in each partner's parenting. The field has not tested how this traditional model compares to the equally plausible alternative model in which coparenting simultaneously predicts both marital relationships and parenting practices. Furthermore, statistical and practical limitations have typically resulted in only one parent being analyzed in these models. This study used model-fitting analyses to include both wives and husbands in a test of these two alternative models of the role of coparenting in the family system. Our data suggested that both the traditional indirect model (marital health to coparenting to parenting practices), and the alternative predictor model where coparenting alliance directly and simultaneously predicts marital health and parenting practices, fit for both spouses. This suggests that dynamic and multiple roles may be played by coparenting in the overall family system, and raises important practical implications for family clinicians. PMID:20377635

Education System of John Amos Comenius and Its Implications in Modern Didactics

ERIC Educational Resources Information Center

Lukaš, Mirko; Munjiza, Emerik

2014-01-01

The authors were particularly interested in scientific conceptions shaped and systematized in subject-teaching school system proposed by J.A. Comenius, which are still actively applied in day-to-day school practice. Within the analysed ideas of J.A. Comenius the goal and the task of this paper is to present to the pedagogic public the originality…

How secure is your information system? An investigation into actual healthcare worker password practices.

PubMed

Cazier, Joseph A; Medlin, B Dawn

2006-09-27

For most healthcare information systems, passwords are the first line of defense in keeping patient and administrative records private and secure. However, this defense is only as strong as the passwords employees chose to use. A weak or easily guessed password is like an open door to the medical records room, allowing unauthorized access to sensitive information. In this paper, we present the results of a study of actual healthcare workers' password practices. In general, the vast majority of these passwords have significant security problems on several dimensions. Implications for healthcare professionals are discussed.

How Secure Is Your Information System? An Investigation into Actual Healthcare Worker Password Practices

PubMed Central

Cazier, Joseph A; Medlin, B. Dawn

2006-01-01

For most healthcare information systems, passwords are the first line of defense in keeping patient and administrative records private and secure. However, this defense is only as strong as the passwords employees chose to use. A weak or easily guessed password is like an open door to the medical records room, allowing unauthorized access to sensitive information. In this paper, we present the results of a study of actual healthcare workers' password practices. In general, the vast majority of these passwords have significant security problems on several dimensions. Implications for healthcare professionals are discussed. PMID:18066366

The melatonergic system in mood and anxiety disorders and the role of agomelatine: implications for clinical practice.

PubMed

De Berardis, Domenico; Marini, Stefano; Fornaro, Michele; Srinivasan, Venkataramanujam; Iasevoli, Felice; Tomasetti, Carmine; Valchera, Alessandro; Perna, Giampaolo; Quera-Salva, Maria-Antonia; Martinotti, Giovanni; di Giannantonio, Massimo

2013-06-13

Melatonin exerts its actions through membrane MT1/MT2 melatonin receptors, which belong to the super family of G-protein-coupled receptors consisting of the typical seven transmembrane domains. MT1 and MT2 receptors are expressed in various tissues of the body either as single ones or together. A growing literature suggests that the melatonergic system may be involved in the pathophysiology of mood and anxiety disorders. In fact, some core symptoms of depression show disturbance of the circadian rhythm in their clinical expression, such as diurnal mood and other symptomatic variation, or are closely linked to circadian system functioning, such as sleep-wake cycle alterations. In addition, alterations have been described in the circadian rhythms of several biological markers in depressed patients. Therefore, there is interest in developing antidepressants that have a chronobiotic effect (i.e., treatment of circadian rhythm disorders). As melatonin produces chronobiotic effects, efforts have been aimed at developing agomelatine, an antidepressant with melatonin agonist activity. The present paper reviews the role of the melatonergic system in the pathophysiology of mood and anxiety disorders and the clinical characteristics of agomelatine. Implications of agomelatine in "real world" clinical practice will be also discussed.

Counseling Conservative and Fundamentalist Christians: Issues and Implications for the Counselor.

ERIC Educational Resources Information Center

Hannon, J. Wade; And Others

1994-01-01

Explores special considerations for counseling adherents of fundamentalist Christian belief systems. Discusses identification of fundamentalists and assessment of the impact of religiosity on presenting counseling problems. Reviews oppressive effects of fundamentalist patriarchal beliefs and practices on women in counseling, and gives suggestions…

Empowerment and Social Support: Implications for Practice and Programming Among Minority Women with Substance Abuse and Criminal Justice Histories.

PubMed

Barringer, Alexandra; Hunter, Bronwyn A; Salina, Doreen D; Jason, Leonard A

2017-01-01

Programs for women with substance abuse and criminal justice histories often incorporate empowerment and social support into service delivery systems. Women's empowerment research has focused on the relationship between women's personal identities and the larger sociopolitical context, with an emphasis on how community-based resources are critical for promoting well-being. Social support often protects against negative outcomes for individuals who live with chronic stress. However, few studies have evaluated community resource knowledge and empowerment among marginalized women or how social support might strengthen or weaken this relationship. This study investigated resource knowledge, social support, and empowerment among 200 minority women in substance abuse recovery who had recent criminal justice involvement. Results indicated that resource knowledge was related to empowerment and belonging social support marginally moderated this relationship. In addition, education level increased and current involvement in the criminal justice system decreased empowerment. Implications for research, practice, and policy are discussed.

Empowerment and Social Support: Implications for Practice and Programming among Minority Women with Substance Abuse and Criminal Justice Histories

PubMed Central

Barringer, Alexandra; Hunter, Bronwyn A.; Salina, Doreen; Jason, Leonard A.

2016-01-01

Programs for women with substance abuse and criminal justice histories often incorporate empowerment and social support into service delivery systems. Women’s empowerment research has focused on the relationship between women’s personal identities and the larger sociopolitical context, with an emphasis on how community based resources are critical for promoting well-being. Social support often protects against negative outcomes for individuals who live with chronic stress. However, few studies have evaluated community resource knowledge and empowerment among marginalized women or how social support might strengthen or weaken this relationship. This study investigated resource knowledge, social support and empowerment among 200 minority women in substance abuse recovery who had recent criminal justice involvement. Results indicated that resource knowledge was related to empowerment and belonging social support marginally moderated this relationship. In addition, education level increased and current involvement in the criminal justice system decreased empowerment. Implications for research, practice and policy are discussed. PMID:27084362

A prospective examination of clinician and supervisor turnover within the context of implementation of evidence-based practices in a publicly-funded mental health system

PubMed Central

Marcus, Steven; Wolk, Courtney Benjamin; Powell, Byron; Aarons, Gregory A.; Evans, Arthur C.; Hurford, Matthew O.; Hadley, Trevor; Adams, Danielle R.; Walsh, Lucia M.; Babbar, Shaili; Barg, Frances; Mandell, David S.

2015-01-01

Staff turnover rates in publicly-funded mental health settings are high. We investigated staff and organizational predictors of turnover in a sample of individuals working in an urban public mental health system that has engaged in a system-level effort to implement evidence-based practices. Additionally, we interviewed staff to understand reasons for turnover. Greater staff burnout predicted increased turnover, more openness toward new practices predicted retention, and more professional recognition predicted increased turnover. Staff reported leaving their organizations because of personal, organizational, and financial reasons; just over half of staff that left their organization stayed in the public mental health sector. Implications include an imperative to focus on turnover, with a particular emphasis on ameliorating staff burnout. PMID:26179469

Applying the Policy Ecology Framework to Philadelphia’s Behavioral Health Transformation Efforts

PubMed Central

Powell, Byron J.; Beidas, Rinad S.; Rubin, Ronnie M.; Stewart, Rebecca E.; Wolk, Courtney Benjamin; Matlin, Samantha L.; Weaver, Shawna; Hurford, Matthew O.; Evans, Arthur C.; Hadley, Trevor R.; Mandell, David S.

2016-01-01

Raghavan et al. (2008) proposed that effective implementation of evidence-based practices requires implementation strategies deployed at multiple levels of the “policy ecology,” including the organizational, regulatory or purchaser agency, political, and social levels. However, much of implementation research and practice targets providers without accounting for contextual factors that may influence provider behavior. This paper examines Philadelphia’s efforts to work toward an evidence-based and recovery-oriented behavioral health system, and uses the policy ecology framework to illustrate how multifaceted, multilevel implementation strategies can facilitate the widespread implementation of evidence-based practices. Ongoing challenges and implications for research and practice are discussed. PMID:27032411

Economic empowerment of impoverished IPV survivors: a review of best practice literature and implications for policy.

PubMed

Hahn, Sur Ah; Postmus, Judy L

2014-04-01

Best practices in advocating for economic empowerment of impoverished intimate partner violence (IPV) survivors require the comprehensive and holistic organization of program and service delivery systems. This article outlines the best practices literature that addresses IPV in the lives of impoverished women, as well as the literature that specifically examines the interventions to economically empower IPV survivors--whether impoverished or not. This article concludes with suggestions for policy makers on how to incorporate these best practices into the Violence Against Women Act and for practitioners to ensure a comprehensive approach to interventions for impoverished IPV survivors.

Improving nutritional care: innovation and good practice.

PubMed

Chapman, Carol; Barker, Mary; Lawrence, Wendy

2015-04-01

This paper presents examples of good practice in nutritional screening and care and identifies methods used to overcome contextual constraints and discusses the implications for nursing practice in hospitals. Nutritional screening is an important step in identifying those at risk of malnutrition, but does not produce improved nutritional care unless it results in a care plan that is acted on. The importance of nutrition and implications for clinical care make it imperative to improve practice. Qualitative investigation. Between January 2011-February 2012, focus groups were held using a semi-structured discussion guide with nine groups of health professionals (n = 80) from one hospital: four with nurses, three with doctors and two with dietitians. Discussions were audio-recorded, transcribed and coded into themes and sub-themes, which were then depicted in a thematic map and illustrated with verbatim quotes. Three strategies for sustaining effective nutritional practice emerged: establishing routines to ensure screening was undertaken; re-organizing aspects of care to promote good practice; developing innovative approaches. Issues to be addressed were the perceived disconnection between mandatory screening and the delivery of effective care, a requirement for nutrition education, organizational constraints of a large university hospital and the complexities of multidisciplinary working. Professionals seeking to improve nutritional care in hospitals need to understand the interaction of system and person to facilitate change. Nursing staff need to be able to exercise autonomy and the hospital system must offer enough flexibility to allow wards to organize nutritional screening and care in a way that meets the needs of individual patients. © 2014 John Wiley & Sons Ltd.

Introduction: health of the health care system in Korea.

PubMed

Kim, Dong Soo

2010-03-01

This study is a mega evaluation of Korea's health care system as developed thus far. It aims to review the historical context in which this system was developed and the political stage and motivation for such development. It will highlight unique features of the system and some comparative analysis with other developed nations. Then it will introduce selective, specific areas and aspects of the health care system, service delivery, and practices. It will suggest its implications for future direction.

Micro sensor node for air pollutant monitoring: hardware and software issues.

PubMed

Choi, Sukwon; Kim, Nakyoung; Cha, Hojung; Ha, Rhan

2009-01-01

Wireless sensor networks equipped with various gas sensors have been actively used for air quality monitoring. Previous studies have typically explored system issues that include middleware or networking performance, but most research has barely considered the details of the hardware and software of the sensor node itself. In this paper, we focus on the design and implementation of a sensor board for air pollutant monitoring applications. Several hardware and software issues are discussed to explore the possibilities of a practical WSN-based air pollution monitoring system. Through extensive experiments and evaluation, we have determined the various characteristics of the gas sensors and their practical implications for air pollutant monitoring systems.

From jhum to broom: Agricultural land-use change and food security implications on the Meghalaya Plateau, India.

PubMed

Behera, Rabi Narayan; Nayak, Debendra Kumar; Andersen, Peter; Måren, Inger Elisabeth

2016-02-01

Human population growth in the developing world drives land-use changes, impacting food security. In India, the dramatic change in demographic dynamics over the past century has reduced traditional agricultural land-use through increasing commercialization. Here, we analyze the magnitude and implications for the farming system by the introduction of cash-cropping, replacing the traditional slash and burn rotations (jhum), of the tribal people on the Meghalaya Plateau, northeast India, by means of agricultural census data and field surveys conducted in seven villages. Land-use change has brought major alterations in hill agricultural practices, enhanced cash-cropping, promoted mono-cropping, changed food consumption patterns, underpinned the emergence of a new food system, and exposed farmers and consumers to the precariousness of the market, all of which have both long- and short-term food security implications. We found dietary diversity to be higher under jhum compared to any of the cash-crop systems, and higher under traditional cash-cropping than under modern cash-cropping.

Concepts of sustainability, motivations for pest management approaches, and implications for communicating change

USDA-ARS?s Scientific Manuscript database

Effective communication with farmers is an essential component of impacting their decision processes and encouraging changes in pest management practices, but requires a system of research and extension management that differs from that to which most biological scientists are accustomed. We present...

Impact of a Generalizable Reminder System on Colorectal Cancer Screening in Diverse Primary Care Practices

PubMed Central

Nease, Donald E.; Ruffin, Mack T.; Klinkman, Michael S.; Jimbo, Masahito; Braun, Thomas M.; Underwood, Jennifer M.

2015-01-01

Background Computerized reminder systems (CRS) show promise for increasing preventive services such as colorectal cancer (CRC) screening. However, prior research has not evaluated a generalizable CRS across diverse, community primary care practices. We evaluated whether a generalizable CRS, ClinfoTracker, could improve screening rates for CRC in diverse primary care practices. Methods The study was a prospective trial to evaluate ClinfoTracker using historical control data in 12 Great Lakes Research In Practice Network community-based, primary care practices distributed from Southeast to Upper Peninsula Michigan. Our outcome measures were pre- and post-study practice-level CRC screening rates among patients seen during the 9-month study period. Ability to maintain the CRS was measured by days of reminder printing. Field notes were used to examine each practice’s cohesion and technology capabilities. Results All but one practice increased their CRC screening rates, ranging from 3.3% to 16.8% improvement. t tests adjusted for within practice correlation showed improvement in screening rates across all 12 practices, from 41.7% to 50.9%, P = 0.002. Technology capabilities impacted printing days (74% for high technology vs. 45% for low technology practices, P = 0.01), and cohesion demonstrated an impact trend for screening (15.3% rate change for high cohesion vs. 7.9% for low cohesion practices). Conclusions Implementing a generalizable CRS in diverse primary care practices yielded significant improvements in CRC screening rates. Technology capabilities are important in maintaining the system, but practice cohesion may have a greater influence on screening rates. This work has important implications for practices implementing reminder systems. PMID:18725836

How Do Scientists Define Openness? Exploring the Relationship Between Open Science Policies and Research Practice.

PubMed

Levin, Nadine; Leonelli, Sabina; Weckowska, Dagmara; Castle, David; Dupré, John

2016-06-01

This article documents how biomedical researchers in the United Kingdom understand and enact the idea of "openness." This is of particular interest to researchers and science policy worldwide in view of the recent adoption of pioneering policies on Open Science and Open Access by the U.K. government-policies whose impact on and implications for research practice are in need of urgent evaluation, so as to decide on their eventual implementation elsewhere. This study is based on 22 in-depth interviews with U.K. researchers in systems biology, synthetic biology, and bioinformatics, which were conducted between September 2013 and February 2014. Through an analysis of the interview transcripts, we identify seven core themes that characterize researchers' understanding of openness in science and nine factors that shape the practice of openness in research. Our findings highlight the implications that Open Science policies can have for research processes and outcomes and provide recommendations for enhancing their content, effectiveness, and implementation.

Cost and workforce implications of subjecting all physicians to aviation industry work-hour restrictions.

PubMed

Payette, Michael; Chatterjee, Abhishek; Weeks, William B

2009-06-01

Efforts to improve patient safety have attempted to incorporate aviation industry safety standards. We sought to evaluate the cost and workforce implications of applying aviation duty-hour restrictions to the entire practicing physician workforce. The work hours and personnel deficit for United States residents and practicing physicians that would be created by the adoption of aviation standards were calculated. Application of aviation standards to the resident workforce creates an estimated annual cost of $6.5 billion, requiring a 174% increase in the number of residents to meet the deficit. Its application to practicing physicians creates an additional annual cost of $80.4 billion, requiring a 71% increase in the physician workforce. Adding in the aviation industry's mandatory retirement age (65 years) increases annual costs by $10.5 billion. The cost per life-year saved would be $1,035,227. Application of aviation duty-hour restrictions to the United States health care system would be prohibitively costly. Alternate approaches for improving patient safety are warranted.

How Do Scientists Define Openness? Exploring the Relationship Between Open Science Policies and Research Practice

PubMed Central

Levin, Nadine; Leonelli, Sabina; Weckowska, Dagmara; Castle, David; Dupré, John

2016-01-01

This article documents how biomedical researchers in the United Kingdom understand and enact the idea of “openness.” This is of particular interest to researchers and science policy worldwide in view of the recent adoption of pioneering policies on Open Science and Open Access by the U.K. government—policies whose impact on and implications for research practice are in need of urgent evaluation, so as to decide on their eventual implementation elsewhere. This study is based on 22 in-depth interviews with U.K. researchers in systems biology, synthetic biology, and bioinformatics, which were conducted between September 2013 and February 2014. Through an analysis of the interview transcripts, we identify seven core themes that characterize researchers’ understanding of openness in science and nine factors that shape the practice of openness in research. Our findings highlight the implications that Open Science policies can have for research processes and outcomes and provide recommendations for enhancing their content, effectiveness, and implementation. PMID:27807390

Classification systems in nursing: formalizing nursing knowledge and implications for nursing information systems.

PubMed

Goossen, W T; Epping, P J; Abraham, I L

1996-03-01

The development of nursing information systems (NIS) is often hampered by the fact that nursing lacks a unified nursing terminology and classification system. Currently there exist various initiatives in this area. We address the question as to how current initiatives in the development of nursing terminology and classification systems can contribute towards the development of NIS. First, the rationale behind the formalization of nursing knowledge is discussed. Next, using a framework for nursing information processing, the most important developments in the field of nursing on formalization, terminology and classification are critically reviewed. The initiatives discussed include nursing terminology projects in several countries, and the International Classification of Nursing Practice. Suggestions for further developments in the area are discussed. Finally, implications for NIS are presented, as well as the relationships of these components to other sections of an integrated computerized patient record.

Workplace Democracy: A Review of Literature and Implications for Human Resource Development

ERIC Educational Resources Information Center

Hatcher, Tim

2007-01-01

A review of workplace democracy revealed that both practice and research need updating. The results are discussed in terms of history, theory, research and practice. Implications for human resource development research and practice are also included. (Contains 2 tables.)

Serving two (or more) masters: accomplishing autonomous nursing practice in chronic disease management.

PubMed

Kimpson, Sally; Purkis, Mary E

2011-07-01

The concept of professional autonomy has figured prominently in literature that addresses nursing's project of professionalization. Nursing's capacity to determine the nature and scope of its practice is related in important ways to the location of practice. Within highly structured environments such as acute-care hospitals, nurses' professional autonomy has frequently been contested yet is often implicated by nursing's elite as a necessary condition in the construction of quality work environments. Professional concerns and management practices related to retaining experienced nurses to support sustainability in healthcare delivery systems' impact on the ability of nurses to practice autonomously. Our paper focuses on the emerging field of practice of chronic disease management. We describe the complex relationships negotiated by a nurse in a theoretically autonomous practice setting as she seeks to fulfil both the requirements of a research protocol designed by physician experts representing the specialty of renal medicine, and her professional obligations to respond to the expressed needs of patients with early-stage renal disease. We utilize a case study approach to explore particular contemporary concerns that nurses in practice confront as they attempt to accomplish professional relationships with patients central to achieving prescribed medical outcomes where nursing practice, as an element of the achievement of those outcomes, is constituted as absent or unacknowledged by the medical researchers leading the project. Implications for nursing's discourses on the professional project of autonomy will be discussed. © 2011 Blackwell Publishing Ltd.

Net Metering Policy Development and Distributed Solar Generation in Minnesota: Overview of Trends in Nationwide Policy Development and Implications of Increasing the Eligible System Size Cap

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

Doris, E.; Busche, S.; Hockett, S.

2009-12-01

The goal of the Minnesota net metering policy is to give the maximum possible encouragement to distributed generation assets, especially solar electric systems (MN 2008). However, according to a published set of best practices (NNEC 2008) that prioritize the maximum development of solar markets within states, the Minnesota policy does not incorporate many of the important best practices that may help other states transform their solar energy markets and increase the amount of grid-connected distributed solar generation assets. Reasons cited include the low system size limit of 40kW (the best practices document recommends a 2 MW limit) and a lackmore » of language protecting generators from additional utility fees. This study was conducted to compare Minnesota's policies to national best practices. It provides an overview of the current Minnesota policy in the context of these best practices and other jurisdictions' net metering policies, as well as a qualitative assessment of the impacts of raising the system size cap within the policy based on the experiences of other states.« less

Postural Control in Children: Implications for Pediatric Practice

ERIC Educational Resources Information Center

Westcott, Sarah L.; Burtner, Patricia

2004-01-01

Based on a systems theory of motor control, reactive postural control (RPA) and anticipatory postural control (APA) in children are reviewed from several perspectives in order to develop an evidence-based intervention strategy for improving postural control in children with limitations in motor function. Research on development of postural…

The Implications of System 4 Approach on School Leadership Practices

ERIC Educational Resources Information Center

Khumalo, Steph Shuti

2015-01-01

School management is a highly contested research area. Credible research studies consistently argue that there is a positive relationship between school performance and school leadership. Like in any organisation, school principals deploy a number of leadership techniques to ensure that organisational objectives are achieved. School leadership is…

Inclusive Education Reform in Queensland: Implications for Policy and Practice

ERIC Educational Resources Information Center

Bourke, Patricia E.

2010-01-01

In Queensland, Australia, the school system is being reformed to be more "inclusive". However, the enthusiasm for "inclusive education" in Queensland seems to be waning amongst practitioners, and the "confusion, frustration, guilt and exhaustion" that has emerged with teachers and support practitioners in the UK is…

Family Change and Gender Differences: Implications for Theory and Practice.

ERIC Educational Resources Information Center

Hare-Mustin, Rachel T.

1988-01-01

Examines theories of gender differences. Discusses alpha bias, exaggeration of gender opposition, as characteristic of psychodynamic and sex role theories; and beta bias, denial of gender differences, as evident in systems theories. Calls for new model of gender differences which recognizes asymmetry in women's and men's roles and…

AEIS Policy vs. Site-Based Management: Research Agenda Implications.

ERIC Educational Resources Information Center

Nash, John B.

This paper examines the problems of centralized academic-indicator systems in light of the move toward site-based management. Problems with current practice are examined in the framework of critical inquiry. Alternatives to current accountability guidelines are presented that harmonize positivism with critical inquiry, while respecting both local…

A Short-Term Forecasting Procedure for Institution Enrollments.

ERIC Educational Resources Information Center

Pfitzner, Charles Barry

1987-01-01

Applies the Box-Jenkins time series methodology to enrollment data for the Virginia community college system. Describes the enrollment data set, the Box-Jenkins approach, and the forecasting results. Discusses the value of one-quarter ahead enrollment forecasts and implications for practice. Provides a technical discussion of the model. (DMM)

Building a First-Class Faculty Based on the Management Experience of the University of Pennsylvania

ERIC Educational Resources Information Center

Luo, Zhongshu

2014-01-01

The article analyzes the practice and experience of faculty management at the University of Pennsylvania and its implications for Chinese universities from the perspective of management systems and operation mechanisms. Recent reforms and innovation of faculty management at Sichuan University are described.

Microbiological Difference of Eggs From Traditional Cage and Free Range Production

USDA-ARS?s Scientific Manuscript database

Eggs from alternative production systems are a growing market share in the US. Meeting consumer requests for greater diversity in retail egg options has resulted in some unique challenges such as understanding the food safety implications of eggs from alternative housing practices. A study was con...

Ecological Education in Rural China: Rediscovering Traditional Knowledge

ERIC Educational Resources Information Center

Liu, Yan

2008-01-01

This article has implications for the ecological sustainability crisis now looming in China and what this portends for the practice of education. Chemical agriculture, although improving agricultural production, harms ecological systems in rural communities. The author presents research on a group of intellectuals and social activists in 1…

The "Good Enough" Parent: Implications for Child Protection

ERIC Educational Resources Information Center

Choate, Peter W.; Engstrom, Sandra

2014-01-01

Child protection workers must determine under what conditions a child should be sustained within the family system. A standard that is often referred to is "good enough" parenting or minimal parenting competence. Research and clinical literature fails to offer workers guidance on the practical application of this terminology. Such…

Practical Implications from Observed Lead Pipe Scale Mineralogy in a Blended Phosphate Treated System - slides

EPA Science Inventory

Many water utilities in the United States rely on the addition of phosphate-based corrosion inhibitors to optimize their corrosion control and comply with requirements of the Lead and Copper Rule. Orthophosphate is used on the theory of forming low solubility Pb(II)-orthophosphat...

On the Assessment of Paramedic Competence: A Narrative Review with Practice Implications.

PubMed

Tavares, W; Boet, S

2016-02-01

Paramedicine is experiencing significant growth in scope of practice, autonomy, and role in the health care system. Despite clinical governance models, the degree to which paramedicine ultimately can be safe and effective will be dependent on the individuals the profession deems suited to practice. This creates an imperative for those responsible for these decisions to ensure that assessments of paramedic competence are indeed accurate, trustworthy, and defensible. The purpose of this study was to explore and synthesize relevant theoretical foundations and literature informing best practices in performance-based assessment (PBA) of competence, as it might be applied to paramedicine, for design or evaluation of assessment programs. A narrative review methodology was applied to focus intentionally, but broadly, on purpose relevant, theoretically derived research that could inform assessment protocols in paramedicine. Primary and secondary studies from a number of health professions that contributed to and informed best practices related to the assessment of paramedic clinical competence were included and synthesized. Multiple conceptual frameworks, psychometric requirements, and emerging lines of research are forwarded. Seventeen practice implications are derived to promote understanding as well as best practices and evaluation criteria for educators, employers, and/or licensing/certifying bodies when considering the assessment of paramedic competence. The assessment of paramedic competence is a complex process requiring an understanding, appreciation for, and integration of conceptual and psychometric principles. The field of PBA is advancing rapidly with numerous opportunities for research.

Global Perspectives on Cancer Health Disparities: Impact, Utility, and Implications for Cancer Nursing

PubMed Central

So, Winnie K. W.; Chan, Raymond Javan; Truant, Tracy; Trevatt, Paul; Bialous, Stella Aguinaga; Barton-Burke, Margaret

2016-01-01

This paper examines cancer health disparities and contributing factors at national, regional, and international levels. The authors all live in different countries and regions with different health-care systems and practices. Despite the shared cancer nursing perspective, each country or global region approaches cancer disparities differently. With globalization the world is becoming smaller, and in turn becoming interconnected and interdependent. This article focuses on cancer health disparities and global cancer nursing, exemplifying these concepts about the impact and implications of person-centered care. PMID:28083548

Nonlinear Time Delayed Feedback Control of Aeroelastic Systems: A Functional Approach

NASA Technical Reports Server (NTRS)

Marzocca, Piergiovanni; Librescu, Liviu; Silva, Walter A.

2003-01-01

In addition to its intrinsic practical importance, nonlinear time delayed feedback control applied to lifting surfaces can result in interesting aeroelastic behaviors. In this paper, nonlinear aeroelastic response to external time-dependent loads and stability boundary for actively controlled lifting surfaces, in an incompressible flow field, are considered. The structural model and the unsteady aerodynamics are considered linear. The implications of the presence of time delays in the linear/nonlinear feedback control and of geometrical parameters on the aeroelasticity of lifting surfaces are analyzed and conclusions on their implications are highlighted.

Topical antibiotics: therapeutic value or ecologic mischief?

PubMed

Del Rosso, James Q; Kim, Grace K

2009-01-01

Based on antibiotic prescribing data from 2003, dermatologists account annually for 8-9 million prescriptions for oral antibiotics, and 3-4 million prescriptions for topical antibiotics. Overall, much of the emphasis on concerns related to emergence of clinically significant antibiotic-resistant bacterial strains focuses on use of systemic antibiotics, however, topical antibiotic use may also have potential implications. The following article discusses the perspectives of the authors related to the potential therapeutic benefits and ecologic implications ("ecologic mischief") of topical antibiotic therapy for specific indications encountered in ambulatory dermatology practice.

Increasing consolidation in healthcare markets: what are the antitrust policy implications?

PubMed Central

Haas-Wilson, D; Gaynor, M

1998-01-01

OBJECTIVE: To discuss the implications of the rapid transformation of the healthcare financing and delivery system for competition, social welfare, and antitrust policy. PRINCIPAL FINDING: Horizontal and vertical consolidations can enhance efficiency but can also be anticompetitive in markets characterized by entry barriers. RECOMMENDATION: Active enforcement of the antitrust laws is essential to ensure that competition in healthcare markets will lead to procompetitive, rather than anticompetitive effects. However, healthcare antitrust enforcement policy must be flexible enough to allow efficient new forms of organization and practice to emerge. PMID:9865226

Medical social work practice in child protection in China: A multiple case study in Shanghai hospitals.

PubMed

Zhao, Fang; Hämäläinen, Juha; Chen, Yu-Ting

2017-01-01

With the rapid development of the child welfare system in China over recent years, medical social work has been increasingly involved in providing child protection services in several hospitals in Shanghai. Focusing on five cases in this paper, the exploratory study aims to present a critical overview of current practices and effects of medical social work for child protection, based on a critical analysis of the multidimensional role of social work practitioners engaged in the provision of child protection services as well as potential challenges. Implications and suggestions for future improvements of China's child protection system are also discussed.

Customer Service: Implications for Reference Practice.

ERIC Educational Resources Information Center

Whitlatch, Jo Bell

1995-01-01

The past decade has seen an increasing emphasis on customer service in business research and management. Two concepts in understanding business customer service practices are discussed: the service encounter and total quality management. Highlights include customer service research and practices in business; implications for library reference…

Physician-Rating Web Sites: Ethical Implications.

PubMed

Samora, Julie Balch; Lifchez, Scott D; Blazar, Philip E

2016-01-01

To understand the ethical and professional implications of physician behavior changes secondary to online physician-rating Web sites (PRWs). The American Society for Surgery of the Hand (ASSH) Ethics and Professionalism Committee surveyed the ASSH membership regarding PRWs. We sent a 14-item questionnaire to 2,664 active ASSH members who practice in both private and academic settings in the United States. We received 312 responses, a 12% response incidence. More than 65% of the respondents had a slightly or highly unfavorable impression of these Web sites. Only 34% of respondents had ever updated or created a profile for PRWs, although 62% had observed inaccuracies in their profile. Almost 90% of respondents had not made any changes in their practice owing to comments or reviews. One-third of respondents had solicited favorable reviews from patients, and 3% of respondents have paid to improve their ratings. PRWs are going to become more prevalent, and more research is needed to fully understand the implications. There are several ethical implications that PRWs pose to practicing physicians. We contend that it is morally unsound to pay for good reviews. The recourse for physicians when an inaccurate and potentially libelous review has been written is unclear. Some physicians have required patients to sign a waiver preventing them from posting negative comments online. We propose the development of a task force to assess the professional, ethical, and legal implications of PRWs, including working with companies to improve accuracy of information, oversight, and feedback opportunities. It is expected that PRWs will play an increasing role in the future; it is unclear whether there will be a uniform reporting system, or whether these online ratings will influence referral patterns and/or quality improvement. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

A critical view of the 'social reinsertion' concept and its implications for the practice of psychologists in the area of mental health in the Brazilian Unified Health System (Sistema Único de Saúde).

PubMed

Frazatto, Carina F; Sawaia, Bader B

2016-03-01

Improving psychological practice in mental health services in the Brazilian Unified Health System (Sistema Único de Saúde) requires a critical analysis of core concepts of the psychiatric reform, such as 'social reinsertion'. This analysis, oriented by the dialectics of exclusion/inclusion, showed that this concept is impregnated with the adaptation paradigm and asylum view which prevents its effective implantation. The results suggest it is necessary to include social aspects in the discussion of mental health, articulating it with networks of social work and recuperating the revolutionary aspects of the psychiatric reform, thus demarcating the political nature of professional practices. © The Author(s) 2016.

Forensic case formulation: theoretical, ethical and practical issues.

PubMed

Davies, Jason; Black, Susie; Bentley, Natalie; Nagi, Claire

2013-10-01

Forensic case formulation, of increasing interest to practitioners and researchers raises many ethical, theoretical and practical issues for them. Systemic, contextual and individual factors which need to be considered include the multitude of staff often involved with any one individual, the pressure to 'get it right' because of the range of risk implications that are associated with individuals within forensic mental health settings, and individual parameters, for example reluctance to be engaged with services. Copyright © 2013 John Wiley & Sons, Ltd.

Toward an integrative understanding of narrative and emotion processes in Emotion-focused therapy of depression: implications for theory, research and practice.

PubMed

Angus, Lynne

2012-01-01

This paper addresses the fundamental contributions of client narrative disclosure in psychotherapy and its importance for the elaboration of new emotional meanings and self understanding in the context of Emotion-focused therapy (EFT) of depression. An overview of the multi-methodological steps undertaken to empirically investigate the contributions of client story telling, emotional differentiation and meaning-making processes (Narrative Processes Coding System; Angus et al., 1999) in EFT treatments of depression is provided, followed by a summary of key research findings that informed the development of a narrative-informed approach to Emotion-focused therapy of depression (Angus & Greenberg, 2011). Finally, the clinical practice and training implications of adopting a research-informed approach to working with narrative and emotion processes in EFT are described, and future research directions discussed.

How Medical Tourism Enables Preferential Access to Care: Four Patterns from the Canadian Context.

PubMed

Snyder, Jeremy; Johnston, Rory; Crooks, Valorie A; Morgan, Jeff; Adams, Krystyna

2017-06-01

Medical tourism is the practice of traveling across international borders with the intention of accessing medical care, paid for out-of-pocket. This practice has implications for preferential access to medical care for Canadians both through inbound and outbound medical tourism. In this paper, we identify four patterns of medical tourism with implications for preferential access to care by Canadians: (1) Inbound medical tourism to Canada's public hospitals; (2) Inbound medical tourism to a First Nations reserve; (3) Canadian patients opting to go abroad for medical tourism; and (4) Canadian patients traveling abroad with a Canadian surgeon. These patterns of medical tourism affect preferential access to health care by Canadians by circumventing domestic regulation of care, creating jurisdictional tensions over the provision of health care, and undermining solidarity with the Canadian health system.

Piercing and Tattoos in Adolescents: Legal and Medico-legal Implications.

PubMed

Conti, Adelaide; Bin, Paola; Casella, Claudia; Capasso, Emanuele; Fedeli, Piergiorgio; Salzano, Francesco Antonio; Terracciano, Lucia; Piras, Mauro

2018-01-01

Non-therapeutic body modification interventions are permitted within the limits of the use of one's own body that can be specified in the legal system. The authors take into consideration Italian regulation on tattooing and piercing, in particular in relation to adolescents. In Italy, several regions have therefore issued acts aimed at regulating the activities of tattoo and piercing also in reference to minors. Discussion. With regard to minors, the rules taken into account set precise limits in relation to the age criterion and subordinate the implementation of such practices to the provision of consent by legal representatives. If such practices are of an aesthetic nature, we cannot avoid considering the implications they have on health protection, and then adopt appropriate measures to protect the person who intends to undergo them, particularly in the case of minors.

Implications of complex adaptive systems theory for the design of research on health care organizations

PubMed Central

McDaniel, Reuben R.; Lanham, Holly Jordan; Anderson, Ruth A.

2013-01-01

Background Because health care organizations (HCOs) are complex adaptive systems (CASs), phenomena of interest often are dynamic and unfold in unpredictable ways, and unfolding events are often unique. Researchers of HCOs may recognize that the subject of their research is dynamic; however, their research designs may not take this into account. Researchers may also know that unfolding events are often unique, but their design may not have the capacity to obtain information from meager evidence. Purpose These two concerns led us to examine two ideas from organizational theory: (a) the ideas of K. E. Weick (1993) on organizational design as a verb and (b) the ideas of J. G. March, L. S. Sproull, and M. Tamuz (1991) on learning from samples of one or fewer. In this article, we applied these ideas to develop an enriched perspective of research design for studying CASs. Methodology/Approach We conducted a theoretical analysis of organizations as CASs, identifying relevant characteristics for research designs. We then explored two ideas from organizational theory and discussed the implications for research designs. Findings Weick's idea of “design as a verb” helps in understanding dynamic and process-oriented research design. The idea of “learning from samples of one or fewer” of March, Sproull, and Tamuz provides strategies for research design that enables learning from meager evidence. When studying HCOs, research designs are likely to be more effective when they (a) anticipate change, (b) include tension, (c) capitalize on serendipity, and (d) use an “act-then-look” mind set. Implications for practice are discussed. Practice Implications Practitioners who understand HCOs as CASs will be cautious in accepting findings from studies that treat HCOs mechanistically. They will consider the characteristics of CAS when evaluating the evidence base for practice. Practitioners can use the strategies proposed in this article to stimulate discussion with researchers seeking to conduct research in their HCO. PMID:19322050

Teacher Strategies for Effective Intervention with Students Presenting Social, Emotional and Behavioural Difficulties: Implications for Policy and Practice

ERIC Educational Resources Information Center

Cooper, Paul

2011-01-01

In this paper some key practice and policy implications emerging from a review of literature on effective teacher strategies for social, emotional and behavioural difficulties are set out. Particular attention is given to implications in relation to the development of teachers' skills.

Implementing Quality Improvement in Small, Autonomous Primary Care Practices: Implications for the Patient Centered Medical Home

PubMed Central

Arar, Nedal H.; Noel, Polly H.; Leykum, Luci; Zeber, John E.; Romero, Raquel; Parchman, Michael L.

2012-01-01

Background Implementing improvement programs to enhance quality of care within primary care clinics is complex, with limited practical guidance available to help practices during the process. Understanding how improvement strategies can be implemented in primary care is timely given the recent national movement towards transforming primary care into patient-centered medical homes (PCMH). This study examined practice members’ perceptions of the opportunities and challenges associated with implementing changes in their practice. Methods Semi-structured interviews were conducted with a purposive sample of 56 individuals working in 16 small, community-based primary care practices. The interview consisted of open-ended questions focused on participants’ perceptions of: (1) practice vision, (2) perceived need for practice improvement, and (3) barriers that hinder practice improvement. The interviews were conducted at the participating clinics and were tape-recorded, transcribed, and content analyzed. Results Content analysis identified two main domains for practice improvement related to: (1) the process of care, and (2) patients’ involvement in their disease management. Examples of desired process of care changes included improvement in patient tracking/follow-up system, standardization of processes of care, and overall clinic documentations. Changes related to the patients’ involvement in their care included improving (a) health education, and (b) self care management. Among the internal barriers were: staff readiness for change, poor communication, and relationship difficulties among team members. External barriers were: insurance regulations, finances and patient health literacy. Practice Implications Transforming their practices to more patient-centered models of care will be a priority for primary care providers. Identifying opportunities and challenges associated with implementing change is critical for successful improvement programs. Successful strategy for enhancing the adoption and uptake of PCMH elements should leverage areas of concordance between practice members’ perceived needs and planned improvement efforts. PMID:22186171

Analytical Implications of Using Practice Theory in Workplace Information Literacy Research

ERIC Educational Resources Information Center

Moring, Camilla; Lloyd, Annemaree

2013-01-01

Introduction: This paper considers practice theory and the analytical implications of using this theoretical approach in information literacy research. More precisely the aim of the paper is to discuss the translation of practice theoretical assumptions into strategies that frame the analytical focus and interest when researching workplace…

High-performance workplace practices in nursing homes: an economic perspective.

PubMed

Bishop, Christine E

2014-02-01

To develop implications for research, practice and policy, selected economics and human resources management research literature was reviewed to compare and contrast nursing home culture change work practices with high-performance human resource management systems in other industries. The organization of nursing home work under culture change has much in common with high-performance work systems, which are characterized by increased autonomy for front-line workers, self-managed teams, flattened supervisory hierarchy, and the aspiration that workers use specific knowledge gained on the job to enhance quality and customization. However, successful high-performance work systems also entail intensive recruitment, screening, and on-going training of workers, and compensation that supports selective hiring and worker commitment; these features are not usual in the nursing home sector. Thus despite many parallels with high-performance work systems, culture change work systems are missing essential elements: those that require higher compensation. If purchasers, including public payers, were willing to pay for customized, resident-centered care, productivity gains could be shared with workers, and the nursing home sector could move from a low-road to a high-road employment system.

Shifting from presumptive to test-based management of malaria - technical basis and implications for malaria control in Ghana.

PubMed

Baiden, F; Malm, K; Bart-Plange, C; Hodgson, A; Chandramohan, D; Webster, J; Owusu-Agyei, S

2014-06-01

The presumptive approach was the World Health Organisation (WHO) recommended to the management of malaria for many years and this was incorporated into syndromic guidelines such as the Integrated Management of Childhood Illnesses (IMCI). In early 2010 however, WHO issued revised treatment guidelines that call for a shift from the presumptive to the test-based approach. Practically, this implies that in all suspected cases, the diagnosis of uncomplicated malaria should be confirmed using rapid test before treatment is initiated. This revision effectively brings to an end an era of clinical practice that span several years. Its implementation has important implications for the health systems in malaria-endemic countries. On the basis of research in Ghana and other countries, and evidence from program work, the Ghana National Malaria Control Program has issued revised national treatment guidelines that call for implementation of test-based management of malaria in all cases, and across all age groups. This article reviews the evidence and the technical basis for the shift to test-based management and examines the implications for malaria control in Ghana.

Qualitative evaluation of a local coronary heart disease treatment pathway: practical implications and theoretical framework

PubMed Central

2012-01-01

Background Coronary heart disease (CHD) is a common medical problem in general practice. Due to its chronic character, shared care of the patient between general practitioner (GP) and cardiologist (C) is required. In order to improve the cooperation between both medical specialists for patients with CHD, a local treatment pathway was developed. The objective of this study was first to evaluate GPs’ opinions regarding the pathway and its practical implications, and secondly to suggest a theoretical framework of the findings by feeding the identified key factors influencing the pathway implementation into a multi-dimensional model. Methods The evaluation of the pathway was conducted in a qualitative design on a sample of 12 pathway developers (8 GPs and 4 cardiologists) and 4 pathway users (GPs). Face-to face interviews, which were aligned with previously conducted studies of the department and assumptions of the theory of planned behaviour (TPB), were performed following a semi-structured interview guideline. These were audio-taped, transcribed verbatim, coded, and analyzed according to the standards of qualitative content analysis. Results We identified 10 frequently mentioned key factors having an impact on the implementation success of the CHD treatment pathway. We thereby differentiated between pathway related (pathway content, effort, individual flexibility, ownership), behaviour related (previous behaviour, support), interaction related (patient, shared care/colleagues), and system related factors (context, health care system). The overall evaluation of the CHD pathway was positive, but did not automatically lead to a change of clinical behaviour as some GPs felt to have already acted as the pathway recommends. Conclusions By providing an account of our experience creating and implementing an intersectoral care pathway for CHD, this study contributes to our knowledge of factors that may influence physicians’ decisions regarding the use of a local treatment pathway. An improved adaptation of the pathway in daily practice might be best achieved by a combined implementation strategy addressing internal and external factors. A simple, direct adaptation regards the design of the pathway material (e.g. layout, PC version), or the embedding of the pathway in another programme, like a Disease Management Programme (DMP). In addition to these practical implications, we propose a theoretical framework to understand the key factors’ influence on the pathway implementation, with the identified factors along the microlevel (pathway related factors), the mesolevel (interaction related factors), and system- related factors along the macrolevel. PMID:22584032

Qualitative evaluation of a local coronary heart disease treatment pathway: practical implications and theoretical framework.

PubMed

Kramer, Lena; Schlößler, Kathrin; Träger, Susanne; Donner-Banzhoff, Norbert

2012-05-14

Coronary heart disease (CHD) is a common medical problem in general practice. Due to its chronic character, shared care of the patient between general practitioner (GP) and cardiologist (C) is required. In order to improve the cooperation between both medical specialists for patients with CHD, a local treatment pathway was developed. The objective of this study was first to evaluate GPs' opinions regarding the pathway and its practical implications, and secondly to suggest a theoretical framework of the findings by feeding the identified key factors influencing the pathway implementation into a multi-dimensional model. The evaluation of the pathway was conducted in a qualitative design on a sample of 12 pathway developers (8 GPs and 4 cardiologists) and 4 pathway users (GPs). Face-to face interviews, which were aligned with previously conducted studies of the department and assumptions of the theory of planned behaviour (TPB), were performed following a semi-structured interview guideline. These were audio-taped, transcribed verbatim, coded, and analyzed according to the standards of qualitative content analysis. We identified 10 frequently mentioned key factors having an impact on the implementation success of the CHD treatment pathway. We thereby differentiated between pathway related (pathway content, effort, individual flexibility, ownership), behaviour related (previous behaviour, support), interaction related (patient, shared care/colleagues), and system related factors (context, health care system). The overall evaluation of the CHD pathway was positive, but did not automatically lead to a change of clinical behaviour as some GPs felt to have already acted as the pathway recommends. By providing an account of our experience creating and implementing an intersectoral care pathway for CHD, this study contributes to our knowledge of factors that may influence physicians' decisions regarding the use of a local treatment pathway. An improved adaptation of the pathway in daily practice might be best achieved by a combined implementation strategy addressing internal and external factors. A simple, direct adaptation regards the design of the pathway material (e.g. layout, PC version), or the embedding of the pathway in another programme, like a Disease Management Programme (DMP). In addition to these practical implications, we propose a theoretical framework to understand the key factors' influence on the pathway implementation, with the identified factors along the microlevel (pathway related factors), the mesolevel (interaction related factors), and system- related factors along the macrolevel.

Information technology law and health systems in the European Union.

PubMed

Mossialos, Elias; Thomson, Sarah; Ter Linden, Annemarie

2004-01-01

This study aims to examine the impact of European Union (EU) law relating to information technology (IT) on health systems. The study identifies EU directives relating to IT, analyzes them in terms of their impact on the use of IT in health systems, and outlines their implications for health technology assessment (HTA). Analysis is based on a review of literature identified through relevant databases and Internet searches. Developments in IT have serious implications for EU health systems, presenting policy makers with new challenges. The European Commission has adopted a range of legal measures to protect consumers in the "information society" However, as few of them are health-specific, it is not evident that they have implications for health, health systems, or HTA, and they may not be effective in protecting consumers in the health sector. In light of the growing importance of IT in the health sector, legal and nonlegal measures need to be further developed at EU and international level. Where possible, future initiatives should pay attention to the particular characteristics of health goods and services and health systems. Although definitions of HTA usually recognize the importance of evaluating both the indirect, unintended consequences of health technologies and the legal aspects of their application, it seems that, in practice, HTA often overlooks or underestimates legislative matters. Those involved in HTA should be aware of the legal implications of using IT to provide health goods and services and compile, store, transfer, and disseminate health information electronically.

The Winter Park Amputee Ski Teaching System.

ERIC Educational Resources Information Center

O'Leary, Hal

The three track method of teaching amputees to ski is presented in the illustrated manual. Problems unique to amputee skiers--care of hands, conditioning, care of stump, fatigue, excessive standing, wind, and balance--are discussed in terms of their implications to the amputee skier and practical solutions in attempting to solve them. Specific…

Small Rural Schools in Ireland: Problems and Possibilities.

ERIC Educational Resources Information Center

Sugrue, Ciaran

This paper provides an overview of practices in small rural elementary schools in Ireland and recent trends related to school size. There are 3,200 "ordinary" elementary schools in the Republic of Ireland serving children aged 4-12 in eight levels: two preschool levels and grades 1-6. System-wide policies with implications for small…

Comparable Worth: Toward Theory and Practice in the United States.

ERIC Educational Resources Information Center

Feldberg, Roslyn L.

1984-01-01

Argues that the concept of comparable worth provides a viable way out of the growing poverty of women. Reviews the history of low wages for women in the United States, discusses anomalies in the dominant economic-gender system exposed by comparable worth, and addresses the social and political implications of comparable worth. (KH)

Breath Alcohol Ignition Interlock Devices : Policy and Implementing Implications [Mobile .MP4 (480x320/29.97fps/13.9MB)

DOT National Transportation Integrated Search

2011-01-01

The goal of this project is to perform a systematic review of breath alcohol ignition interlock devices (BAIID or IID) to understand how other states have integrated such systems into administrative and judicial practice and to make recommendations f...

Setting up a Free School: Successful Proposers' Experiences

ERIC Educational Resources Information Center

Miller, Paul; Craven, Barrie; Tooley, James

2014-01-01

The 2010 Academies Act was significant in introducing Free Schools to the English education system. Opening up funding to new, non-profit entrants on the basis of demand, the policy has aroused support and controversy on political, philosophical and practical educational grounds with implications for social justice in terms of equity and freedom.…

Term Relevance Feedback and Mediated Database Searching: Implications for Information Retrieval Practice and Systems Design.

ERIC Educational Resources Information Center

Spink, Amanda

1995-01-01

This study uses the human approach to examine the sources and effectiveness of search terms selected during 40 mediated interactive database searches and focuses on determining the retrieval effectiveness of search terms identified by users and intermediaries from retrieved items during term relevance feedback. (Author/JKP)

Twenty-One Leadership Responsibilities and Quality Management in the Context of Educational Baldrige Systems

ERIC Educational Resources Information Center

Ibach, Kimberly L.

2014-01-01

This body of work presents the summary of findings; explanation of implications; discussion of conclusions; and recommendations about practice, policy and future research regarding principal leadership in school districts recognized as national Baldrige Award winners. This study widened the scope and definition of quality management in education…

Breath Alcohol Ignition Interlock Devices : Policy and Implementing Implications [SD .MP4 (640x424/29.97fps/22.6MB)

DOT National Transportation Integrated Search

2011-01-01

The goal of this project is to perform a systematic review of breath alcohol ignition interlock devices (BAIID or IID) to understand how other states have integrated such systems into administrative and judicial practice and to make recommendations f...

The Alumni Survey: Program Implications for School Leaders

ERIC Educational Resources Information Center

Dickmann, Ellyn; Cooner, Donna; Dugan, James J.

2007-01-01

Universities have long practiced data collection techniques to gain insights and direction from their graduates, but public high schools are just now beginning to use this process to gather input from those who know the system the best--their alumni. Because past students' reflections on their high school education can indicate the level of…

Automated Essay Scoring: Psychometric Guidelines and Practices

ERIC Educational Resources Information Center

Ramineni, Chaitanya; Williamson, David M.

2013-01-01

In this paper, we provide an overview of psychometric procedures and guidelines Educational Testing Service (ETS) uses to evaluate automated essay scoring for operational use. We briefly describe the e-rater system, the procedures and criteria used to evaluate e-rater, implications for a range of potential uses of e-rater, and directions for…

PLA Philosophy, Policy, and Practice Implications: Revisiting the 2009 Hoffman, Travers, Evans, and Treadwell Study

ERIC Educational Resources Information Center

Travers, Nan L.

2013-01-01

The heart of prior learning assessment (PLA) is the quality and validity of the academic evaluation process itself. Institutions providing PLA opportunities are faced with issues of accountability from all constituents: students, faculty, state systems, and accrediting agencies. Increasingly, institutions are more and more accepting of different…

School Psychologists' Perceptions of Primary Care Partnerships: Implications for Building the Collaborative Bridge

ERIC Educational Resources Information Center

Bradley-Klug, Kathy L.; Jeffries-DeLoatche, Kendall L.; Walsh, Audra St. John; Bateman, Lisa P.; Nadeau, Josh; Powers, Derek J.; Cunningham, Jennifer

2013-01-01

There is a critical need to increase communication and collaboration across the educational and medical systems on behalf of students with paediatric health issues. The purpose of the current study was to investigate school psychologists' perceptions of their communication and collaboration practices with paediatric professionals (e.g.…

User Practices in Keyword and Boolean Searching on an Online Public Access Catalog.

ERIC Educational Resources Information Center

Ensor, Pat

1992-01-01

Discussion of keyword and Boolean searching techniques in online public access catalogs (OPACs) focuses on a study conducted at Indiana State University that examined users' attitudes toward searching on NOTIS (Northwestern Online Total Integrated System). Relevant literature is reviewed, and implications for library instruction are suggested. (17…

Potential Psychosocial and Instructional Consequences of the Common Core State Standards: Implications for Research and Practice

ERIC Educational Resources Information Center

Saeki, Elina; Pendergast, Laura; Segool, Natasha K.; von der Embse, Nathaniel P.

2015-01-01

Despite the recent rollout of the Common Core State Standards (CCSS), CCSS-aligned assessments, and test-based teacher evaluation systems, questions remain regarding the impact that these accountability policies will have on teachers and students. This article discusses the psychosocial and instructional consequences of test-based accountability…

Family-Centered Early Intervention for Communication Disorders: Prevention and Treatment. Excellence in Practice Series.

ERIC Educational Resources Information Center

Donahue-Kilburg, Gail

This book is designed to provide a broad range of information on family structure and function in an increasingly multicultural society, family system characteristics and the implications for intervention, communication development in the family context, the nature and delivery of family centered-services, specific requirements of Public Law…

Activity Theory and the New Literacy Studies: Modelling the Literacy Learning Activity System.

ERIC Educational Resources Information Center

Kostogriz, Alexander

This paper explores a number of implications arising from the combination of the New Literacy Studies and cultural-historical psychology--in particular, the concept of literacy as social practice and the psychological category of activity. Placing "social" at the center of literacy and psychological studies, these two perspectives are…

Single Measure and Gated Screening Approaches for Identifying Students At-Risk for Academic Problems: Implications for Sensitivity and Specificity

ERIC Educational Resources Information Center

Van Norman, Ethan R.; Nelson, Peter M.; Klingbeil, David A.

2017-01-01

Educators need recommendations to improve screening practices without limiting students' instructional opportunities. Repurposing previous years' state test scores has shown promise in identifying at-risk students within multitiered systems of support. However, researchers have not directly compared the diagnostic accuracy of previous years' state…

Teachers Exploring Partnership Education and Ways to Transform the K-12 Educational System

ERIC Educational Resources Information Center

Cerda, Marisela Galvan

2012-01-01

The purpose of this study was to engage middle school science teachers in collaborative dialogue to understand the implications of partnership values and principles in the classroom to transform their educational practice. Participants investigated issues which prevent partnership relationships in schools and ways to help transform education and…

Dowry in 21st-century India: the sociocultural face of exploitation.

PubMed

Banerjee, Priya R

2014-01-01

The World Health Organization (2009) implicates deep-rooted cultural and social norms as influential contributing factors toward physical and intimate partner violence against women. The dowry system is a social practice that perpetuates the oppression, torture, and murder of women in India. The practice of dowry is an expected part of marriage in cultures where arranged marriages are the norm. Violence can occur when the dowry or bride-price is deemed unsatisfactory by the recipient. In India, in spite of laws prohibiting the practice, not much has changed over the last 30 years. The National Crime Records Bureau of India, recorded a total of 8,618 female deaths related to dowry disputes in 2011, and the Asian Women's Human Rights Council (2009) estimates that the practice of dowry is implicated in 25,000 deaths and maiming of women between the ages of 15-34 in India every year. The current review of literature reveals that despite efforts on the part of the Indian government, social activists and feminists organizations in India, not much has changed over the past decade, in fact, the problem has increased, resulting in an unprecedented amount of mortality and morbidity among women in India.

Marketing alcohol to young people: implications for industry regulation and research policy.

PubMed

Jackson, M C; Hastings, G; Wheeler, C; Eadie, D; Mackintosh, A M

2000-12-01

This paper focuses on the marketing of alcohol to young people in the United Kingdom, but the lessons that emerge have international significance. Alcohol is a global enterprise and recent consolidation means that it is controlled by a decreasing number of expanding multi-nationals. Alcohol companies are able to allocate significant resources to researching consumer preferences, developing new products and promoting them on an international level. Recent years have seen a growth in the value that youth culture attaches to brand labels and symbols and a move away from the healthy-living ethos. The alcohol industry's response to these trends has been to design alcoholic beverages that appeal to young people, using well-informed and precisely targeted marketing strategies. This has led to growing concerns about the implications for public health and a demand for tighter controls to regulate alcohol marketing practices. In the United Kingdom, controls on alcohol are piecemeal and reactive and the current system of voluntary regulation appears ineffective. This paper argues for more research to establish current industry practice and inform the development of a comprehensive regulatory structure and system of monitoring.

Using Knowledge-Based Systems to Support Learning of Organizational Knowledge: A Case Study

NASA Technical Reports Server (NTRS)

Cooper, Lynne P.; Nash, Rebecca L.; Phan, Tu-Anh T.; Bailey, Teresa R.

2003-01-01

This paper describes the deployment of a knowledge system to support learning of organizational knowledge at the Jet Propulsion Laboratory (JPL), a US national research laboratory whose mission is planetary exploration and to 'do what no one has done before.' Data collected over 19 weeks of operation were used to assess system performance with respect to design considerations, participation, effectiveness of communication mechanisms, and individual-based learning. These results are discussed in the context of organizational learning research and implications for practice.

The future of anesthesiology: implications of the changing healthcare environment.

PubMed

Prielipp, Richard C; Cohen, Neal H

2016-04-01

Anesthesiology is at a crossroad, particularly in the USA. We explore the changing and future roles for anesthesiologists, including the implication of new models of care such as the perioperative surgical home, changes in payment methodology, and the impact other refinements in healthcare delivery will have on practice opportunities and training requirements for anesthesiologists. The advances in the practice of anesthesiology are having a significant impact on patient care, allowing a more diverse and complex patient population to benefit from the knowledge, skills and expertise of anesthesiologists. Expanded clinical opportunities, increased utilization of technology and expansion in telemedicine will provide the foundation to care for more patients in diverse settings and to better monitor patients remotely while ensuring immediate intervention as needed. Although the roles of anesthesiologists have been diverse, the scope of practice varies from one country to another. The changing healthcare needs in the USA in particular are creating new opportunities for American anesthesiologists to define expanded roles in healthcare delivery. To fulfill these evolving needs of patients and health systems, resident training, ongoing education and methods to ensure continued competency must incorporate new approaches of education and continued certification to ensure that each anesthesiologist has the full breadth and depth of clinical skills needed to support patient and health system needs. The scope of anesthesia practice has expanded globally, providing anesthesiologists, particularly those in the USA, with unique new opportunities to assume a broader role in perioperative care of surgical patients.

Ethical dilemmas among nurses as they transition to hospital case management: implications for organizational ethics, part I.

PubMed

O'Donnell, Lolita T

2007-01-01

To describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute hospital setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice in case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the organizations that employ them and the healthcare needs of the patients that they advocate for. 3. Aside from the importance of linking patient care outcomes with accountability, nurse case managers may need to advocate for policy change and system reform.

Social Justice Advocacy in Rural Communities: Practical Issues and Implications

ERIC Educational Resources Information Center

Bradley, Joshua M.; Werth, James L., Jr.; Hastings, Sarah L.

2012-01-01

The professional literature related to social justice has increased, but there has been little discussion of the practical issues and implications associated with social advocacy. However, adding new roles will result in new considerations for counseling psychologists. The need to be attuned to how the practical aspects of advocacy intersect with…

Democratic Schooling in Norway: Implications for Leadership in Practice

ERIC Educational Resources Information Center

Moller, Jorunn

2006-01-01

This article explores the meaning of an education based on democratic values and the implications for school leadership in practice. Based on findings from a case study in a Norwegian upper secondary school, the study describes democratic school leadership in practice, with particular attention to the distribution of power and leadership in the…

Research governance: implications for health library and information professionals.

PubMed

Sen, Barbara A

2003-03-01

The Research Governance Framework for Health and Social Care published by the Department of Health in 2001 provides a model of best practice and a framework for research in the health and social care sector. This article reviews the Department of Health Research Governance Framework, discusses the implications of research governance for library and information professionals undertaking research in the health- and social-care sector and recommends strategies for best practice within the information profession relating to research governance. The scope of the Framework document that covers both clinical and non-clinical research is outlined. Any research involving, amongst other issues, patients, NHS staff and use or access to NHS premises may require ethics committee approval. Particular reference is made to the roles, responsibilities and professional conduct and the systems needed to support effective research practice. Issues such as these combine to encourage the development of a quality research culture which supports best practice. Questions arise regarding the training and experience of researchers, and access to the necessary information and support. The use of the Framework to guide research practice complements the quality issues within the evidence-based practice movement and supports the ongoing development of a quality research culture. Recommendations are given in relation to the document's five domains of ethics, science, information, health and safety and finance and intellectual property. Practical recommendations are offered for incorporating research governance into research practice in ways which conform to the Framework's standards and which are particularly relevant for research practitioners in information science. Concluding comments support the use of the Research Governance Framework as a model for best practice.

Implementation of an attack scheme on a practical QKD system

NASA Astrophysics Data System (ADS)

Lamas-Linares, Antia; Liu, Qin; Gerhardt, Ilja; Makarov, Vadim; Kurtsiefer, Christian

2010-03-01

We report on an experimental implementation of an attack of a practical quantum key distribution system [1], based on a vulnerability of single photon detectors [2]. An intercept/resend-like attack has been carried out which revealed 100% of the raw key generated between the legitimate communication partners. No increase of the error ratio was observed, which is usually considered a reliable witness for any eavesdropping attempt. We also present an experiment which shows that this attack is not revealed by key distribution protocols probing for eavesdroppers by testing a Bell inequality [3], and discuss implications for practical quantum key distribution.[4pt] [1] I. Marcikic, A. Lamas-Linares, C. Kurtsiefer, Appl. Phys. Lett. 89, 101122 (2006); [2] V. Makarov, New J. Phys. 11, 065003 (2009); [3] A. Ling et al., Phys. Rev. A 78, 020301(R), (2008)

Building organizational supports for knowledge sharing in county human service organizations: a cross-case analysis of works-in-progress.

PubMed

Lee, Chris; Austin, Michael J

2012-01-01

Building on the literature related to evidence-based practice, knowledge management, and learning organizations, this cross-case analysis presents twelve works-in-progress in ten local public human service organizations seeking to develop their own knowledge sharing systems. The data for this cross-case analysis can be found in the various contributions to this Special Issue. The findings feature the developmental aspects of building a learning organization that include knowledge sharing systems featuring transparency, self-assessment, and dissemination and utilization. Implications for practice focus on the structure and processes involved in building knowledge sharing teams inside public human service organizations. Copyright © Taylor & Francis Group, LLC

Piercing and Tattoos in Adolescents: Legal and Medico-legal Implications

PubMed Central

Conti, Adelaide; Bin, Paola; Casella, Claudia; Capasso, Emanuele; Fedeli, Piergiorgio; Salzano, Francesco Antonio; Terracciano, Lucia; Piras, Mauro

2018-01-01

Abstract Non-therapeutic body modification interventions are permitted within the limits of the use of one’s own body that can be specified in the legal system. The authors take into consideration Italian regulation on tattooing and piercing, in particular in relation to adolescents. Results In Italy, several regions have therefore issued acts aimed at regulating the activities of tattoo and piercing also in reference to minors. Discussion. With regard to minors, the rules taken into account set precise limits in relation to the age criterion and subordinate the implementation of such practices to the provision of consent by legal representatives. Conclusion If such practices are of an aesthetic nature, we cannot avoid considering the implications they have on health protection, and then adopt appropriate measures to protect the person who intends to undergo them, particularly in the case of minors. PMID:29675481

Elaborating on systems thinking in health promotion practice.

PubMed

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

2009-03-01

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

Building a learning health system using clinical registers: a non-technical introduction.

PubMed

Ovretveit, John; Nelson, Eugene; James, Brent

2016-10-10

Purpose The purpose of this paper is to describe how clinical registers were designed and used to serve multiple purposes in three health systems, in order to contribute practical experience for building learning healthcare systems. Design/methodology/approach Case description and comparison of the development and use of clinical registries, drawing on participants' experience and published and unpublished research. Findings Clinical registers and new software systems enable fact-based decisions by patients, clinicians, and managers about better care, as well as new and more economical research. Designing systems to present the data for users' daily work appears to be the key to effective use of the potential afforded by digital data. Research limitations/implications The case descriptions draw on the experience of the authors who were involved in the development of the registers, as well as on published and unpublished research. There is limited data about outcomes for patients or cost-effectiveness. Practical implications The cases show the significant investments which are needed to make effective use of clinical register data. There are limited skills to design and apply the digital systems to make the best use of the systems and to reduce their disadvantages. More use can be made of digital data for quality improvement, patient empowerment and support, and for research. Social implications Patients can use their data combined with other data to self-manage their chronic conditions. There are challenges in designing and using systems so that those with lower health and computer literacy and incomes also benefit from these systems, otherwise the digital revolution may increase health inequalities. Originality/value The paper shows three real examples of clinical registers which have been developed as part of their host health systems' strategies to develop learning healthcare systems. The paper gives a simple non-technical introduction and overview for clinicians, managers, policy-advisors and improvers of what is possible and the challenges, and highlights the need to shape the design and implementation of digital infrastructures in healthcare services to serve users.

Looking forward and back to relapse: implications for research and practice.

PubMed

Connors, G J; Longabaugh, R; Miller, W R

1996-12-01

In this commentary, the three principal investigators of the Relapse Replication and Extension Project (RREP) reflect on clinical and research implications of study findings from the three collaborating sites. A primary purpose of RREP was to study the reliability and validity of a taxonomy of relapse antecedents originally proposed by Marlatt two decades ago. Under the best of research conditions, with extensive training and practice, it was difficult to achieve reliability of coding with the original three-level system, although with only two levels of classification more reasonable albeit variable reliability was found. Modifications may improve the taxonomy's reliability, but RREP data indicate that a more appropriate strategy is to measure possible antecedents of relapse by continuous scales such as those provided by Annis, Heather and Litman. There is reasonably consistent evidence for two common antecedents of relapse: negative emotional states, and positive emotional states in a social context. Antecedents of relapse show only modest consistency within individuals from one occasion to the next. The causes to which clients attribute relapses may exert a significant effect on future drinking episodes. Stable and internal attributions, such as are commonly associated with a dispositional disease model, may serve to perpetuate relapse. From the RREP studies, the availability of coping skills appears to be a potent protective factor, and ineffective coping a consistent predictor of relapse. Implications for clinical research and practice are considered.

Social construction and materiality: the limits of indeterminacy in therapeutic settings.

PubMed

Lannamann, J W

1998-01-01

By drawing parallels between the courtroom testimony of a Christian Science practitioner and an intersession conversation between systemic family therapists, I critique the abstract idealism of language-centered social constructionism. I argue that social constructionist inquiry that highlights the indeterminacy of meaning without a corresponding emphasis on the responsive embodied practices of family members glosses over the material conditions shaping the politics of interaction. The implications of this problem are discussed as they relate to the setting of family therapy, where social construction theory is often used to guide practical interventions.

Implications of complex adaptive systems theory for interpreting research about health care organizations.

PubMed

Jordon, Michelle; Lanham, Holly Jordan; Anderson, Ruth A; McDaniel, Reuben R

2010-02-01

Data about health care organizations (HCOs) are not useful until they are interpreted. Such interpretations are influenced by the theoretical lenses used by the researcher. Our purpose was to suggest the usefulness of theories of complex adaptive systems (CASs) in guiding research interpretation. Specifically, we addressed two questions: (1) What are the implications for interpreting research observations in HCOs of the fact that we are observing relationships among diverse agents? (2) What are the implications for interpreting research observations in HCOs of the fact that we are observing relationships among agents that learn? We defined diversity and learning and the implications of the non-linear relationships among agents from a CAS perspective. We then identified some common analytical practices that were problematic and may lead to conceptual and methodological errors. Then we described strategies for interpreting the results of research observations. We suggest that the task of interpreting research observations of HCOs could be improved if researchers take into account that the systems they study are CASs with non-linear relationships among diverse, learning agents. Our analysis points out how interpretation of research results might be shaped by the fact that HCOs are CASs. We described how learning is, in fact, the result of interactions among diverse agents and that learning can, by itself, reduce or increase agent diversity. We encouraged researchers to be persistent in their attempts to reason about complex systems and learn to attend not only to structures, but also to processes and functions of complex systems.

Prebiotic and probiotic approaches to improving food safety on the farm and their implications on human health

USDA-ARS?s Scientific Manuscript database

Human health is a broad category that encompasses the entirety of the food production system. Livestock production practices have important impacts on human health because livestock are not only a primary food source, but also can be the source of pathogenic bacteria that may enter the food chain i...

International Trends in the Implementation of Assessment for Learning: Implications for Policy and Practice

ERIC Educational Resources Information Center

Birenbaum, Menucha; DeLuca, Christopher; Earl, Lorna; Heritage, Margaret; Klenowski, Val; Looney, Anne; Smith, Kari; Timperley, Helen; Volante, Louis; Wyatt-Smith, Claire

2015-01-01

This paper discusses the emergence of assessment for learning (AfL) across the globe with particular attention given to Western educational jurisdictions. Authors from Australia, Canada, Ireland, Israel, New Zealand, Norway, and the USA explain the genesis of AfL, its evolution and impact on school systems, and discuss current trends in policy…

The New Hispanic Majority: How Texas Public Schools Are Foreshadowing National Trends

ERIC Educational Resources Information Center

Farmer, Tod Allen

2011-01-01

Texas and other states that border with Mexico have been leading indicators of public school system trends that may manifest themselves in other areas of the United States in the decade to come. Such manifestations of these trends are likely to have both policy and practice implications. Descriptive statistics and longitudinal data from the…

National Efforts to Bring Reform to Scale in High-Poverty Schools: Outcomes and Implications

ERIC Educational Resources Information Center

Borman, Geoffrey D.

2005-01-01

Education in the United States is a decentralized system composed of highly variable practices, programs, and school contexts. The primary technology of education, teaching, is highly complex and is typically designed and implemented by teachers who have traditionally enjoyed a great deal of autonomy and independence from regular inspection. The…

Changes in Reference Question Complexity Following the Implementation of a Proactive Chat System: Implications for Practice

ERIC Educational Resources Information Center

Maloney, Krisellen; Kemp, Jan H.

2015-01-01

There has been longstanding debate about whether the level of complexity of questions received at reference desks and via online chat services requires a librarian's expertise. Continued decreases in the number and complexity of reference questions have all but ended the debate; many academic libraries no longer staff service points with…

Disciplinary Practices in Dallas Contrasted with School Systems with Rules Against Violence Against Children.

ERIC Educational Resources Information Center

Hagebak, Robert

Corporal punishment and its implications are discussed in this speech in Dallas, where corporal punishment is officially sanctioned as a method of school discipline, and in many other parts of the country, the prevailing opinion is that corporal punishment is necessary, effective and harmless. But the effectiveness of such punishment is dubious…

Selecting for Creativity and Innovation Potential: Implications for Practice in Healthcare Education

ERIC Educational Resources Information Center

Patterson, Fiona; Zibarras, Lara Dawn

2017-01-01

The ability to innovate is an important requirement in many organisations. Despite this pressing need, few selection systems in healthcare focus on identifying the potential for creativity and innovation and so this area has been vastly under-researched. As a first step towards understanding how we might select for creativity and innovation, this…

Autism: Assessment and Intervention Practices of School Psychologists and the Implications for Training in the United States

ERIC Educational Resources Information Center

Rasmussen, Jenny Elizabeth

2009-01-01

Autism Spectrum Disorders (ASD) are being diagnosed at alarmingly high rates and school psychologists are charged with evaluating, identifying, and providing interventions for students with ASD in the United States' public school systems. A national survey probed Nationally Certified School Psychologists (NCSP) to determine their level of…

Aesthetic Inquiry into Chinese University Student Fatherly Life Lessons: "Roots" and Their Implications for Educational Contexts

ERIC Educational Resources Information Center

Liu, Laura Blythe

2017-01-01

Globally, teachers are trained to educate and assess children through matrices based on comparative competition, a practice that thrives on ranking. In an era of glocalization, how might educational systems cultivate classroom connections embracing diverse student gifts? This arts-based narrative inquiry explores fatherly life lessons of 17…

Alternative silvicultural practices in Appalachian forest ecosystems: implications for species diversity, ecosystem resilience, and commercial timber production

Treesearch

Thomas R. Fox; Carola A. Haas; David W. Smith; David L. Loftis; Shepard M. Zedaker; Robert H. Jones; A.L. Hammett

2007-01-01

Increasing demands for timber and non-timber forest products often conflict with demands to maintain biodiversity and ecosystem processes. To examine tradeoffs between these goals, we implemented six alternative management systems using a stand-level, replicated experiment. The treatments included four silvicultural regeneration methods designed to sustain timber...

Relative Age Effects on Motor Performance of Seventh-Grade Pupils

ERIC Educational Resources Information Center

Gadžic, Aleksandar; Milojevic, Aleksandar; Stankovic, Veroljub; Vuckovic, Igor

2017-01-01

Annual age grouping of children according to their birth year is a common practice of the educational systems of many countries. This variation in birth dates among children grouped in the same generation is known as relative age and its implications on different developmental outcomes are referred to as relative age effects (RAEs). The previous…

Research on Heritage Spanish Phonetics and Phonology: Pedagogical and Curricular Implications

ERIC Educational Resources Information Center

Rao, Rajiv; Kuder, Emily

2016-01-01

This paper creates a novel link between research on linguistics and education by discussing what we know about the sound system of heritage language users of Spanish and how these findings can inform practices implemented in heritage Spanish courses in the USA. First, we provide an overview of terminology associated with heritage language…

An Investigation of Possible Discriminating Earned Value Variables in Department of Defense Major Acquisition Program Cancellation

DTIC Science & Technology

2013-06-01

distribution is unlimited 12b. DISTRIBUTION CODE A 13. ABSTRACT (maximum 200 words) Some major defense acquisition programs (MDAPs) are cancelled...68 VI. PRACTICAL IMPLICATIONS FOR DEFENSE ACQUISITION .....................73 A . OVERVIEW...Contract Performance Report C /SCSC Cost/Schedule Control Systems Criteria CV Cost Variance CV % Cost Variance Percentage DAE Defense Acquisition

Brain Research, Learning and Emotions: Implications for Education Research, Policy and Practice

ERIC Educational Resources Information Center

Hinton, Christina; Miyamoto, Koji; Della-Chiesa, Bruno

2008-01-01

Recent advancements in neuroscience heighten its relevance to education. Newly developed imaging technologies enable scientists to peer into the working brain for the first time, providing powerful insights into how we learn. Research reveals that the brain is not a stable and isolated entity, but a dynamic system that is keenly responsive to…

Touch and Gesture-Based Language Learning: Some Possible Avenues for Research and Classroom Practice

ERIC Educational Resources Information Center

Reinders, Hayo

2014-01-01

Our interaction with digital resources is becoming increasingly based on touch, gestures, and now also eye movement. Many everyday consumer electronics products already include touch-based interfaces, from e-book readers to tablets, and from the last personal computers to the GPS system in your car. What implications do these new forms of…

The Developmental History of Labor Education in South Korea from a Sociopolitical and Economic Perspective

ERIC Educational Resources Information Center

Kwon, Yangyi

2011-01-01

Although there is a considerable body of research regarding the relationships between the sociopolitical and economic transition and its implications for the education system in South Korea, there is little known about how sociopolitical and economic factors affect labor education practice in South Korea. The premise of the study is that the…

IS/IT the prescription to enable medical group practices attain their goals.

PubMed

Wickramasinghe, Nilmini; Silvers, J B

2003-05-01

The US spends significantly more money as a percentage of GDP on health care than any other OECD country and more importantly, this amount is anticipated to increase exponentially. In this high cost environment, two important trends have occurred: (1) the movement to managed care, and (2) large investments in Information Systems/Information Technology (IS/IT). Managed care has emerged as an attempt to provide good quality yet cost effective health care treatment. Its implications are not well discussed in the literature while, its impact on different types of medical group practices is even less well understood. The repercussions of the large investments in IS/IT on the health care sector in general and on the medical group practice in particular, although clearly of importance, are also largely ignored by the literature. This study attempts to address this significant void in the literature. By analyzing three different types of group practices; an Independent Practice Association (IPA), a Faculty Practice and a Multi Specialty Group Practice in a managed care environment during their implementation of practice management/billing systems, we are able to draw some conclusions regarding the impacts of these two central trends on health care in general as well as on the medical group practice in particular.

Field Birding and Digital Objects: Immaterial Technologies and Their Implications for One Practice of Coming to Know the More-than-Human

ERIC Educational Resources Information Center

Watson, Gavan Peter Longley

2011-01-01

This paper focuses on the implications of two emerging digital technologies on the act of field birding, and the implications of these objects for thinking about wild birds. While the adoption of new immaterial technologies promises to improve the ease with which birding is practiced, their use leads to new ethical considerations. Using the…

Stem cell terminology: practical, theological and ethical implications.

PubMed

Shanner, Laura

2002-01-01

Stem cell policy discussions frequently confuse embryonic and fetal sources of stem cells, and label untested, non-reproductive cloning as "therapeutic." Such misnomers distract attention from significant practical and ethical implications: accelerated research agendas tend to be supported at the expense of physical risks to women, theological implications in a multi-faith community, informed consent for participation in research, and treatment decisions altered by unrealistic expectations.

Looking Back to the Future: Current Issues Facing Nursing Education From the Reflections of a Member of the Silent Generation.

PubMed

Keating, Sarah B

2016-07-01

As a member of the Silent Generation, the author, through her lived experiences, reflects upon the successes and challenges facing nursing education in the mid-20th to 21st centuries. The author looks "back to the future" and reviews current issues that surround four key nursing education milestones. From the early entry-level baccalaureate programs in the 1950s to the current growth of the Doctor of Nursing Practice as entry into advanced practice, milestones in nursing education are linked to the cultural changes and healthcare system demands that took place at the time and their influence on nursing education and the profession. Looking to the future, the author speaks of the implications from the forecasted changes in the healthcare system that will demand interdisciplinary education and practice and the continued need for nursing research to increase the body of scientific knowledge in practice, education, and technology. Keating. © 2015 Wiley Periodicals, Inc.

The Relationship of Genetics, Nursing Practice, and Informatics Tools in 6-Mercaptopurine Dosing in Pediatric Oncology [Formula: see text].

PubMed

Haylett, Wendy J

An antileukemic agent prescribed for pediatric oncology patients during the maintenance phase of therapy for acute lymphoblastic leukemia, 6-mercaptopurine (6-MP), is highly influenced by genetic variations in the thiopurine S-methyltransferase enzyme. As such, 6-MP must be dosed so that patients with 1 or 2 inactive thiopurine S-methyltransferase alleles will not incur an increased risk for myelosuppression or other toxicities. Informatics tools such as clinical decision support systems are useful for the application of this and similar pharmacogenetics information to the realm of nursing and clinical practice for safe and effective patient care. This article will discuss pharmacogenetics and the associated use of 6-MP; present implications for nursing practice; identify informatics tools such as clinical decision support systems, which can greatly enhance the care of patients whose treatment is based on critical genetic information; and examine the relationship of genetics, nursing practice, and informatics for 6-MP dosing in pediatric oncology.

Rapid-Learning System for Cancer Care

PubMed Central

Abernethy, Amy P.; Etheredge, Lynn M.; Ganz, Patricia A.; Wallace, Paul; German, Robert R.; Neti, Chalapathy; Bach, Peter B.; Murphy, Sharon B.

2010-01-01

Compelling public interest is propelling national efforts to advance the evidence base for cancer treatment and control measures and to transform the way in which evidence is aggregated and applied. Substantial investments in health information technology, comparative effectiveness research, health care quality and value, and personalized medicine support these efforts and have resulted in considerable progress to date. An emerging initiative, and one that integrates these converging approaches to improving health care, is “rapid-learning health care.” In this framework, routinely collected real-time clinical data drive the process of scientific discovery, which becomes a natural outgrowth of patient care. To better understand the state of the rapid-learning health care model and its potential implications for oncology, the National Cancer Policy Forum of the Institute of Medicine held a workshop entitled “A Foundation for Evidence-Driven Practice: A Rapid-Learning System for Cancer Care” in October 2009. Participants examined the elements of a rapid-learning system for cancer, including registries and databases, emerging information technology, patient-centered and -driven clinical decision support, patient engagement, culture change, clinical practice guidelines, point-of-care needs in clinical oncology, and federal policy issues and implications. This Special Article reviews the activities of the workshop and sets the stage to move from vision to action. PMID:20585094

Recognition for positive behavior as a critical youth development construct: conceptual bases and implications on youth service development.

PubMed

Law, Ben M F; Siu, Andrew M H; Shek, Daniel T L

2012-01-01

Recognition for positive behavior is an appropriate response of the social environment to elicit desirable external behavior among the youth. Such positive responses, rendered from various social systems, include tangible and intangible reinforcements. The following theories are used to explain the importance of recognizing positive behavior: operational conditioning, observational learning, self-determination, and humanistic perspective. In the current work, culturally and socially desirable behaviors are discussed in detail with reference to Chinese adolescents. Positive behavior recognition is especially important to adolescent development because it promotes identity formation as well as cultivates moral reasoning and social perspective thinking from various social systems. The significance of recognizing positive behavior is illustrated through the support, tutorage, invitation, and subsidy provided by Hong Kong's social systems in recognition of adolescent volunteerism. The practical implications of positive behavior recognition on youth development programs are also discussed in this work.

Recognition for Positive Behavior as a Critical Youth Development Construct: Conceptual Bases and Implications on Youth Service Development

PubMed Central

Law, Ben M. F.; Siu, Andrew M. H.; Shek, Daniel T. L.

2012-01-01

Recognition for positive behavior is an appropriate response of the social environment to elicit desirable external behavior among the youth. Such positive responses, rendered from various social systems, include tangible and intangible reinforcements. The following theories are used to explain the importance of recognizing positive behavior: operational conditioning, observational learning, self-determination, and humanistic perspective. In the current work, culturally and socially desirable behaviors are discussed in detail with reference to Chinese adolescents. Positive behavior recognition is especially important to adolescent development because it promotes identity formation as well as cultivates moral reasoning and social perspective thinking from various social systems. The significance of recognizing positive behavior is illustrated through the support, tutorage, invitation, and subsidy provided by Hong Kong's social systems in recognition of adolescent volunteerism. The practical implications of positive behavior recognition on youth development programs are also discussed in this work. PMID:22666155

Developing an evidence base of best practices for integrating computerized systems into the exam room: a systematic review.

PubMed

Patel, Minal R; Vichich, Jennifer; Lang, Ian; Lin, Jessica; Zheng, Kai

2017-04-01

The introduction of health information technology systems, electronic health records in particular, is changing the nature of how clinicians interact with patients. Lack of knowledge remains on how best to integrate such systems in the exam room. The purpose of this systematic review was to (1) distill "best" behavioral and communication practices recommended in the literature for clinicians when interacting with patients in the presence of computerized systems during a clinical encounter, (2) weigh the evidence of each recommendation, and (3) rank evidence-based recommendations for electronic health record communication training initiatives for clinicians. We conducted a literature search of 6 databases, resulting in 52 articles included in the analysis. We extracted information such as study setting, research design, sample, findings, and implications. Recommendations were distilled based on consistent support for behavioral and communication practices across studies. Eight behavioral and communication practices received strong support of evidence in the literature and included specific aspects of using computerized systems to facilitate conversation and transparency in the exam room, such as spatial (re)organization of the exam room, maintaining nonverbal communication, and specific techniques that integrate the computerized system into the visit and engage the patient. Four practices, although patient-centered, have received insufficient evidence to date. We developed an evidence base of best practices for clinicians to maintain patient-centered communications in the presence of computerized systems in the exam room. Further work includes development and empirical evaluation of evidence-based guidelines to better integrate computerized systems into clinical care. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Parental perceptions of the learner driver log book system in two Australian states.

PubMed

Bates, Lyndel; Watson, Barry; King, Mark Johann

2014-01-01

Though many jurisdictions internationally now require learner drivers to complete a specified number of hours of supervised driving practice before being able to drive unaccompanied, very few require learner drivers to complete a log book to record this practice and then present it to the licensing authority. Learner drivers in most Australian jurisdictions must complete a log book that records their practice, thereby confirming to the licensing authority that they have met the mandated hours of practice requirement. These log books facilitate the management and enforcement of minimum supervised hours of driving requirements. Parents of learner drivers in 2 Australian states, Queensland and New South Wales, completed an online survey assessing a range of factors, including their perceptions of the accuracy of their child's learner log book and the effectiveness of the log book system. The study indicates that the large majority of parents believe that their child's learner log book is accurate. However, they generally report that the log book system is only moderately effective as a system to measure the number of hours of supervised practice a learner driver has completed. The results of this study suggest the presence of a paradox, with many parents possibly believing that others are not as diligent in the use of log books as they are or that the system is too open to misuse. Given that many parents report that their child's log book is accurate, this study has important implications for the development and ongoing monitoring of hours of practice requirements in graduated driver licensing systems.

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

PubMed

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

2006-02-01

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

Auditing audits: use and development of the Oxfordshire Medical Audit Advisory Group rating system.

PubMed Central

Lawrence, M.; Griew, K.; Derry, J.; Anderson, J.; Humphreys, J.

1994-01-01

OBJECTIVES--To assess the value of the Oxfordshire Medical Audit Advisory Group rating system in monitoring and stimulating audit activity, and to implement a development of the system. DESIGN--Use of the rating system for assessment of practice audits on three annual visits in Oxfordshire; development and use of an "audit grid" as a refinement of the system; questionnaire to all medical audit advisory groups in England and Wales. SETTING--All 85 general practices in Oxfordshire; all 95 medical audit advisory groups in England and Wales. MAIN OUTCOME MEASURES--Level of practices' audit activity as measured by rating scale and grid. Use of scale nationally together with perceptions of strengths and weaknesses as perceived by chairs of medical audit advisory groups. RESULTS--After one year Oxfordshire practices more than attained the target standards set in 1991, with 72% doing audit involving setting target standards or implementing change; by 1993 this had risen to 78%. Most audits were confined to chronic disease management, preventive care, and appointments. 38 of 92 medical audit advisory groups used the Oxfordshire group's rating scale. Its main weaknesses were insensitivity in assessing the quality of audits and failure to measure team involvement. CONCLUSIONS--The rating system is effective educationally in helping practices improve and summatively for providing feedback to family health service authorities. The grid showed up weakness in the breadth of audit topics studied. IMPLICATIONS AND ACTION--Oxfordshire practices achieved targets set for 1991-2 but need to broaden the scope of their audits and the topics studied. The advisory group's targets for 1994-5 are for 50% of practices to achieve an audit in each of the areas of clinical care, access, communication, and professional values and for 80% of audits to include setting targets or implementing change. PMID:8086911

Generalist solutions to complex problems: generating practice-based evidence - the example of managing multi-morbidity

PubMed Central

2013-01-01

Background A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Discussion Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a ‘complex intervention’ (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Summary Answers to the complex problem of multi-morbidity won’t come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity. PMID:23919296

Generalist solutions to complex problems: generating practice-based evidence--the example of managing multi-morbidity.

PubMed

Reeve, Joanne; Blakeman, Tom; Freeman, George K; Green, Larry A; James, Paul A; Lucassen, Peter; Martin, Carmel M; Sturmberg, Joachim P; van Weel, Chris

2013-08-07

A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a 'complex intervention' (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Answers to the complex problem of multi-morbidity won't come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity.

Responsive Persistence Part II. Practices of Postmodern Therapists.

PubMed

Sutherland, Olga; Dienhart, Anna; Turner, Jean

2013-10-01

This article, a companion to Part I of this series of articles, discusses how therapists informed by social constructionist and postmodern ideas enact persistence in their work with families. Transcripts and video-recordings of therapy interaction facilitated by selected major champions for three postmodern (collaborative) therapies: Michael White (narrative therapy), Harlene Anderson (collaborative language systems approach), and Bill O'Hanlon (solution-oriented therapy) were examined for persistence practices. The article offers a range of possible ways in which postmodern therapists may enact their influence in facilitating generative and helpful conversations with families and remain responsive to clients' preferences and understandings. Implications for family therapy practice, training, and supervision are discussed. © 2013 American Association for Marriage and Family Therapy.

Is clinician refusal to treat an emerging problem in injury compensation systems?

PubMed Central

Brijnath, Bianca; Mazza, Danielle; Kosny, Agnieszka; Bunzli, Samantha; Singh, Nabita; Ruseckaite, Rasa; Collie, Alex

2016-01-01

Objective The reasons that doctors may refuse or be reluctant to treat have not been widely explored in the medical literature. To understand the ethical implications of reluctance to treat there is a need to recognise the constraints of doctors working in complex systems and to consider how these constraints may influence reluctance. The aim of this paper is to illustrate these constraints using the case of compensable injury in the Australian context. Design Between September and December 2012, a qualitative investigation involving face-to-face semistructured interviews examined the knowledge, attitudes and practices of general practitioners (GPs) facilitating return to work in people with compensable injuries. Setting Compensable injury management in general practice in Melbourne, Australia. Participants 25 GPs who were treating, or had treated a patient with compensable injury. Results The practice of clinicians refusing treatment was described by all participants. While most GPs reported refusal to treat among their colleagues in primary and specialist care, many participants also described their own reluctance to treat people with compensable injuries. Reasons offered included time and financial burdens, in addition to the clinical complexities involved in compensable injury management. Conclusions In the case of compensable injury management, reluctance and refusal to treat is likely to have a domino effect by increasing the time and financial burden of clinically complex patients on the remaining clinicians. This may present a significant challenge to an effective, sustainable compensation system. Urgent research is needed to understand the extent and implications of reluctance and refusal to treat and to identify strategies to engage clinicians in treating people with compensable injuries. PMID:26792215

Unconventional eating practices and their health implications.

PubMed

Hanning, R M; Zlotkin, S H

1985-04-01

The authors discuss a number of unconventional or faddist foods and eating practices and their health implications. Among the topics included are vegetarianism, Zen macrobiotic diets, fast foods, junk foods, megavitamins and their toxicity, health foods, fad diets in infancy, and elimination diets.

Prioritizing lean management practices in public and private hospitals.

PubMed

Hussain, Matloub; Malik, Mohsin

2016-05-16

Purpose - The purpose of this paper is to prioritize 21 healthcare wastes in public and private hospitals of United Arab Emirates (UAE). Design/methodology/approach - Seven healthcare wastes linked with lean management are further decomposed in to sub-criteria and to deal with this complexity of multi criteria decision-making process, analytical hierarchical process (AHP) method is used in this research. Findings - AHP framework for this study resulted in a ranking of 21 healthcare wastes in public and private hospitals of UAE. It has been found that management in private healthcare systems of UAE is putting more emphasis on the inventory waste. On the other hand, over processing waste has got highest weight in public hospitals of UAE. Research limitations/implications - The future directions of this research would be to apply a lean set of tools for the value stream optimization of the prioritized key improvement areas. Practical implications - This is a contribution to the continuing research into lean management, giving practitioners and designers a practical way for measuring and implementing lean practices across health organizations. Originality/value - The contribution of this research, through successive stages of data collection, measurement analysis and refinement, is a set of reliable and valid framework that can be subsequently used in conceptualization, prioritization of the waste reduction strategies in healthcare management.

Implications of domestic food practices for the presence of bioactive components in meats with special reference to meat-based functional foods.

PubMed

Jiménez-Colmenero, Francisco; Cofrades, Susana; Herrero, Ana M; Ruiz-Capillas, Claudia

2017-06-14

Although an essential component of the diet, the consumption of meat is in question. Meat is a major source of beneficial compounds but it also contains other substances with negative health implications. Functional foods, which are leading trends in the food industry, constitute an excellent opportunity for the meat sector to improve healthier meat options. Most studies on meat-based functional foods have focused mainly on the application of different strategies (animal production practices and meat transformation systems) to improve (increase/reduce) the presence of bioactive (healthy/unhealthy) compounds; these have led to the development of numerous products, many of them by the meat industry. However, like other foods, after purchase meats undergo certain processes before they are consumed, and these affect their composition. Although domestic handling practices can significantly alter the make-up of the marketed product in terms of healthy/unhealthy compounds, there are very few studies on their consequences. This paper provides an overview of the influence of different domestic practices (from shopping to eating) habitually followed by consumers on the presence of, and consequently on the levels of exposure to, (healthy and unhealthy) food components associated with the consumption of meats, with special reference to meat-based functional foods.

A Review of Quality Assurance Methods to Assist Professional Record Keeping: Implications for Providers of Interpersonal Violence Treatment

PubMed Central

Bradshaw, Kelsey M.; Donohue, Brad; Wilks, Chelsey

2014-01-01

Errors have been found to frequently occur in the management of case records within mental health service systems. In cases involving interpersonal violence, such errors have been found to negatively impact service implementation and lead to significant trauma and fatalities. In an effort to ensure adherence to specified standards of care, quality assurance programs (QA) have been developed to monitor and enhance service implementation. These programs have generally been successful in facilitating record management. However, these systems are rarely disseminated, and not well integrated. Therefore, within the context of interpersonal violence, we provide an extensive review of evidence supported record keeping practices, and methods to assist in assuring these practices are implemented with adherence. PMID:24976786

Redundancy management of inertial systems.

NASA Technical Reports Server (NTRS)

Mckern, R. A.; Musoff, H.

1973-01-01

The paper reviews developments in failure detection and isolation techniques applicable to gimballed and strapdown systems. It examines basic redundancy management goals of improved reliability, performance and logistic costs, and explores mechanizations available for both input and output data handling. The meaning of redundant system reliability in terms of available coverage, system MTBF, and mission time is presented and the practical hardware performance limitations of failure detection and isolation techniques are explored. Simulation results are presented illustrating implementation coverages attainable considering IMU performance models and mission detection threshold requirements. The implications of a complete GN&C redundancy management method on inertial techniques are also explored.

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

PubMed

Dorwie, Florence M; Pacquiao, Dula F

2014-01-01

Describe practices of traditional birth attendants (TBAs) in assisting women in childbirth and the perceptions of TBAs by mothers and health professionals familiar with their work. Qualitative design using focus groups conducted in urban and rural settings in Sierra Leone. Separate audiotaped focus groups conducted for each group of participants lasting between 45 and 90 minutes. Purposive sample of 20 TBAs, 20 mothers, and 10 health professionals who met the following criteria: (a) at least 18 years of age, (b) TBAs currently practicing, (c) mothers who delivered at least one child assisted by a TBA, and (d) health professionals currently practicing in the hospital and familiar with TBA practices. TBAs are valued by mothers, health professionals, and the community because they provide accessible and affordable care to mothers who may otherwise have no access to health services. TBAs need training, supervision, and resources for effective referral of mothers. Systemic problems in the health care system create enormous barriers to effective care for mothers and children independent of TBA practices that contribute to high maternal and infant mortality rates. The study findings have implications on broad public policy in improving maternal and child health in the country.

Past, present and future challenges in health care priority setting.

PubMed

Hall, William; Williams, Iestyn; Smith, Neale; Gold, Marthe; Coast, Joanna; Kapiriri, Lydia; Danis, M; Mitton, Craig

2018-05-21

Purpose Current conditions have intensified the need for health systems to engage in the difficult task of priority setting. As the search for a "magic bullet" is replaced by an appreciation for the interplay between evidence, interests, culture, and outcomes, progress in relation to these dimensions requires assessment of achievements to date and identification of areas where knowledge and practice require attention most urgently. The paper aims to discuss these issues. Design/methodology/approach An international survey was administered to experts in the area of priority setting. The survey consisted of open-ended questions focusing on notable achievements, policy and practice challenges, and areas for future research in the discipline of priority setting. It was administered online between February and March of 2015. Findings "Decision-making frameworks" and "Engagement" were the two most frequently mentioned notable achievements. "Priority setting in practice" and "Awareness and education" were the two most frequently mentioned policy and practical challenges. "Priority setting in practice" and "Engagement" were the two most frequently mentioned areas in need of future research. Research limitations/implications Sampling bias toward more developed countries. Future study could use findings to create a more concise version to distribute more broadly. Practical implications Globally, these findings could be used as a platform for discussion and decision making related to policy, practice, and research in this area. Originality/value Whilst this study reaffirmed the continued importance of many longstanding themes in the priority setting literature, it is possible to also discern clear shifts in emphasis as the discipline progresses in response to new challenges.

Crosswatch: a System for Providing Guidance to Visually Impaired Travelers at Traffic Intersections

PubMed Central

Coughlan, James M.; Shen, Huiying

2013-01-01

Purpose This paper describes recent progress on the “Crosswatch” project, a smartphone-based system developed for providing guidance to blind and visually impaired travelers at traffic intersections. Building on past work on Crosswatch functionality to help the user achieve proper alignment with the crosswalk and read the status of walk lights to know when it is time to cross, we outline the directions Crosswatch is now taking to help realize its potential for becoming a practical system: namely, augmenting computer vision with other information sources, including geographic information systems (GIS) and sensor data, and inferring the user's location much more precisely than is possible through GPS alone, to provide a much larger range of information about traffic intersections to the pedestrian. Design/methodology/approach The paper summarizes past progress on Crosswatch and describes details about the development of new Crosswatch functionalities. One such functionality, which is required for determination of the user's precise location, is studied in detail, including the design of a suitable user interface to support this functionality and preliminary tests of this interface with visually impaired volunteer subjects. Findings The results of the tests of the new Crosswatch functionality demonstrate that the functionality is feasible in that it is usable by visually impaired persons. Research limitations/implications While the tests that were conducted of the new Crosswatch functionality are preliminary, the results of the tests have suggested several possible improvements, to be explored in the future. Practical implications The results described in this paper suggest that the necessary technologies used by the Crosswatch system are rapidly maturing, implying that the system has an excellent chance of becoming practical in the near future. Originality/value The paper addresses an innovative solution to a key problem faced by blind and visually impaired travelers, which has the potential to greatly improve independent travel for these individuals. PMID:24353745

From Policy to Practice: Supporting Students with Diverse Needs in Thailand: Critical Issues and Implications

ERIC Educational Resources Information Center

Opartkiattikul, Watinee; Arthur-Kelly, Michael; Dempsey, Ian

2014-01-01

A commitment to maximizing learning outcomes for all students is an axiom of most educational systems around the world. However this goal is sometimes compromised by factors that can be complex and difficult to address. Student behavior problems are one of the major issues challenging educators in many countries including Thailand. Recently, laws…

Performance Improvement: Applying a Human Performance Model to Organizational Processes in a Military Training Environment

ERIC Educational Resources Information Center

Aaberg, Wayne; Thompson, Carla J.; West, Haywood V.; Swiergosz, Matthew J.

2009-01-01

This article provides a description and the results of a study that utilized the human performance (HP) model and methods to explore and analyze a training organization. The systemic and systematic practices of the HP model are applicable to military training organizations as well as civilian organizations. Implications of the study for future…

Deanol in the treatment of tardive dyskinesia.

PubMed

Casey, D E; Denny, D

1975-08-01

A patient who developed severe tardive dyskinesia after the termination of long-term phenothiazine therapy was successfully treated with deanol, a possible precursor of acetylcholine. Physiological measurements were obtained to quantify the clinical course. The authors discuss the practical and heuristic implications of these observations and suggest further consideration of therapy directed toward enhancement of cholinergic activity in the central nervous system.

Microcomputer and Bibliographic Information Systems in Latin America: Problems, Experiences and Projections. Proceedings of a Meeting (Santiago, Chile, April 24-27, 1984).

ERIC Educational Resources Information Center

Economic Commission for Latin America and the Caribbean, Santiago (Chile).

In areas such as Latin America and the Caribbean, many institutions are setting up databases using existing computerized information and documentation networks, and relying on new microcomputer equipment for their implementation. Increasing awareness of the implications of this practice prompted this conference, which provided the first step of a…

Too Anxious to Speak? The Implications of Current Research into Selective Mutism for Educational Psychology Practice

ERIC Educational Resources Information Center

Cleave, Hayley

2009-01-01

Selective Mutism is a low incidence disorder but has considerable impact on the school system when it occurs. Over the last decade several research articles have been published which have challenged the understanding of the aetiology of Selective Mutism. Current perceptions about the aetiology of Selective Mutism are considered in order to inform…

The Ethical and Practical Implications of Systems Architecture on Identity in Networked Learning: A Constructionist Perspective

ERIC Educational Resources Information Center

Koole, Marguerite L.; Parchoma, Gale

2012-01-01

Through relational dialogue, learners shape their identities by sharing information about the world and how they see themselves in it. As learners interact, they receive feedback from both the environment and other learners which, in turn, helps them assess and adjust their self-presentations. Although learners retain choice and personal agency,…

Reducing Cognitive Skill Decay and Diagnostic Error: Theory-Based Practices for Continuing Education in Health Care

ERIC Educational Resources Information Center

Weaver, Sallie J.; Newman-Toker, David E.; Rosen, Michael A.

2012-01-01

Missed, delayed, or wrong diagnoses can have a severe impact on patients, providers, and the entire health care system. One mechanism implicated in such diagnostic errors is the deterioration of cognitive diagnostic skills that are used rarely or not at all over a prolonged period of time. Existing evidence regarding maintenance of effective…

Towards Competent Systems in Early Childhood Education and Care. Implications for Policy and Practice

ERIC Educational Resources Information Center

Urban, Mathias; Vandenbroeck, Michel; Van Laere, Katrien; Lazzari, Arianna; Peeters, Jan

2012-01-01

The close connection between the quality of provision for young children and professionalisation of the field has long been supported by international research. That the two are inseparable aspects of one picture is beginning to become accepted at European policy level, as evident in recent high level EU policy documents. This article explores the…

Expanding Agency: Centering Gender Identity in College and University Student Records Systems

ERIC Educational Resources Information Center

Linley, Jodi L.; Kilgo, Cindy Ann

2018-01-01

This article details the process the authors--a doctoral student at the time, and a faculty member--engaged in to change the ways the University of Iowa (UI) asks for and reports student name, gender pronouns, sex, and gender identity. The UI Inclusive Student Records Initiative raises implications for practice and research. Two focus groups--one…

Nurse-midwifery in rural Pakistan.

PubMed

Woods, A B

1991-01-01

Pakistan is a relatively new nation of predominantly Islamic influence. Like many developing countries, it is plagued by extensive communicable diseases, malnutrition, inadequate sewage systems, and illiteracy. Religious beliefs and cultural influences impact heavily on access to health care and on maternal-child health outcomes. This paper examines the major maternal-child health problems encountered, as well as implications for midwifery practice in an Islamic country.

Anthropology, organ transplantation and the immune system: resituating commodity and gift exchange.

PubMed

Kierans, Ciara

2011-11-01

This article reflects on contributions from medical anthropology to our understanding of the bio-social and bio-political implications of renal transplantation. Taking up the idea of transplantation as a 'complex', a vast assemblage of people, places, practices and procedures which intersect medical, social and cultural domains, I point to a reliance in the anthropological literature on overly pre-determined conceptual frameworks, organised around a distinct polarisation between organ giving and receiving, where one side (supply) takes analytical, and indeed moral, precedence over the other (receipt). These frameworks tend to fail us when it comes to thinking about the wider social, cultural and political implications of transplant technologies. In an attempt to offer a less polarised view, I draw attention to the material and symbolic role of the immune system in transplantation and the ways in which it simultaneously shapes opportunities for procurement and the lived realities of recipiency. This helps us see the many complex ways in which suffering and inequality are constituted all along the variegated chains of supply and demand that are internal to, and made possible by, transplantation practices themselves. Copyright © 2011 Elsevier Ltd. All rights reserved.

Traditional healers and perceptions of the causes and treatment of cancer.

PubMed

Nwoga, I A

1994-12-01

The observation that some Nigerian patients use alternative health care services when they perceive that one medical system has failed them provided the impetus for this survey. The purpose of the survey was to understand why some Nigerian patients rely on traditional healers for cure of cancer by exploring the perceptions of Igbo traditional healers from Anambra State of Nigeria about the causes and treatment of cancer. Implications of the different meanings of illness and disease to patients and physicians provided the theoretical framework for understanding the cultural context of the study. Findings have ethical, moral, and cultural implications for professional nursing practice, education, and research.

Ethics of emergency department triage: SAEM position statement. SAEM Ethics Committee (Society for Academic Emergency Medicine).

PubMed

1995-11-01

Emergency department overcrowding, the growth of managed care, and the high cost of emergency care are creating pressures to triage patients away from U.S. EDs. Paradoxically, this pressure to limit patient access to EDs has increased in spite of federal laws that restrict patient triage and transfer. The latter regulations view EDs as the safety net for the U.S. health care system. The SAEM Ethics Committee evaluated the ethical implications of policies that triage patients out of the ED prior to complete evaluation and treatment. The committee used these implications to develop practical guidelines, which are reported.

A computational framework for prime implicants identification in noncoherent dynamic systems.

PubMed

Di Maio, Francesco; Baronchelli, Samuele; Zio, Enrico

2015-01-01

Dynamic reliability methods aim at complementing the capability of traditional static approaches (e.g., event trees [ETs] and fault trees [FTs]) by accounting for the system dynamic behavior and its interactions with the system state transition process. For this, the system dynamics is here described by a time-dependent model that includes the dependencies with the stochastic transition events. In this article, we present a novel computational framework for dynamic reliability analysis whose objectives are i) accounting for discrete stochastic transition events and ii) identifying the prime implicants (PIs) of the dynamic system. The framework entails adopting a multiple-valued logic (MVL) to consider stochastic transitions at discretized times. Then, PIs are originally identified by a differential evolution (DE) algorithm that looks for the optimal MVL solution of a covering problem formulated for MVL accident scenarios. For testing the feasibility of the framework, a dynamic noncoherent system composed of five components that can fail at discretized times has been analyzed, showing the applicability of the framework to practical cases. © 2014 Society for Risk Analysis.

Using Interactive Patient Engagement Technology in Clinical Practice: A Qualitative Assessment of Nurses' Perceptions.

PubMed

Patmon, Frances L; Gee, Perry M; Rylee, Tina L; Readdy, Noriann L

2016-11-11

Research has shown patients who are more engaged in their care are likely to have better health outcomes and reduced health care costs. Health care organizations are now focusing their efforts in finding ways to improve patient engagement. At the forefront of this movement are patient engagement technology systems. In this paper, these emerging systems are described as interactive patient engagement technologies (iPET). The objective of this descriptive study was to gain an understanding of the perceptions of nurses who are integrating these iPET systems into their daily clinical practice. The research team interviewed 38 nurses from 2 California-based hospitals using a focused rapid ethnographic evaluation methodology to gather data. The study participants reported that using iPET systems may enhance clinical nursing practice. The 4 key findings of iPET were that it (1) is effective for distraction therapy, (2) has functionality that affects both patients and nurses, (3) has implications for clinical practice, and (4) may require additional training to improve usage. With sufficient training on the iPET system, nurses believed they could use these technologies as an enhancement to their clinical practice. Additionally, nurses perceived these systems served as distraction therapy for patients. Initial findings suggest that iPET is beneficial, but more research is required to examine the usefulness of iPET systems in the inpatient settings. ©Frances L Patmon, Perry M Gee, Tina L Rylee, Noriann L Readdy. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.11.2016.

Digital radiographic imaging: is the dental practice ready?

PubMed

Parks, Edwin T

2008-04-01

Digital radiographic imaging is slowly, but surely, replacing film-based imaging. It has many advantages over traditional imaging, but the technology also has some drawbacks. The author presents an overview of the types of digital image receptors available, image enhancement software and the range of costs for the new technology. PRACTICE IMPLICATIONS. The expenses associated with converting to digital radiographic imaging are considerable. The purpose of this article is to provide the clinician with an overview of digital radiographic imaging technology so that he or she can be an informed consumer when evaluating the numerous digital systems in the marketplace.

Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice.

PubMed

Patterson, Sue; Freshwater, Kathleen; Goulter, Nicole; Ewing, Julie; Leamon, Boyd; Choudhary, Anand; Moudgil, Vikas; Emmerson, Brett

2016-10-01

Aims and method To describe and explain psychiatrists' responses to metabolic abnormalities identified during screening. We carried out an audit of clinical records to assess rates of monitoring and follow-up practice. Semi-structured interviews with 36 psychiatrists followed by descriptive and thematic analyses were conducted. Results Metabolic abnormalities were identified in 76% of eligible patients screened. Follow-up, recorded for 59%, was variable but more likely with four or more abnormalities. Psychiatrists endorse guidelines but ambivalence about responsibility, professional norms, resource constraints and skills deficits as well as patient factors influences practice. Therapeutic optimism and desire to be a 'good doctor' supported comprehensive follow-up. Clinical implications Psychiatrists are willing to attend to physical healthcare, and obstacles to recommended practice are surmountable. Psychiatrists seek consensus among stakeholders about responsibilities and a systemic approach addressing the social determinants of health inequities. Understanding patients' expectations is critical to promoting best practice.

Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder.

PubMed

Streeter, C C; Gerbarg, P L; Saper, R B; Ciraulo, D A; Brown, R P

2012-05-01

A theory is proposed to explain the benefits of yoga practices in diverse, frequently comorbid medical conditions based on the concept that yoga practices reduce allostatic load in stress response systems such that optimal homeostasis is restored. It is hypothesized that stress induces (1) imbalance of the autonomic nervous system (ANS) with decreased parasympathetic nervous system (PNS) and increased sympathetic nervous system (SNS) activity, (2) underactivity of the gamma amino-butyric acid (GABA) system, the primary inhibitory neurotransmitter system, and (3) increased allostatic load. It is further hypothesized that yoga-based practices (4) correct underactivity of the PNS and GABA systems in part through stimulation of the vagus nerves, the main peripheral pathway of the PNS, and (5) reduce allostatic load. Depression, epilepsy, post traumatic stress disorder (PTSD), and chronic pain exemplify medical conditions that are exacerbated by stress, have low heart rate variability (HRV) and low GABAergic activity, respond to pharmacologic agents that increase activity of the GABA system, and show symptom improvement in response to yoga-based interventions. The observation that treatment resistant cases of epilepsy and depression respond to vagal nerve stimulation corroborates the need to correct PNS underactivity as part of a successful treatment plan in some cases. According to the proposed theory, the decreased PNS and GABAergic activity that underlies stress-related disorders can be corrected by yoga practices resulting in amelioration of disease symptoms. This has far-reaching implications for the integration of yoga-based practices in the treatment of a broad array of disorders exacerbated by stress. Copyright © 2012 Elsevier Ltd. All rights reserved.

Cooperation evolution in random multiplicative environments

NASA Astrophysics Data System (ADS)

Yaari, G.; Solomon, S.

2010-02-01

Most real life systems have a random component: the multitude of endogenous and exogenous factors influencing them result in stochastic fluctuations of the parameters determining their dynamics. These empirical systems are in many cases subject to noise of multiplicative nature. The special properties of multiplicative noise as opposed to additive noise have been noticed for a long while. Even though apparently and formally the difference between free additive vs. multiplicative random walks consists in just a move from normal to log-normal distributions, in practice the implications are much more far reaching. While in an additive context the emergence and survival of cooperation requires special conditions (especially some level of reward, punishment, reciprocity), we find that in the multiplicative random context the emergence of cooperation is much more natural and effective. We study the various implications of this observation and its applications in various contexts.

Renin-angiotensin-aldosterone system (RAAS) pharmacogenomics: implications in heart failure management.

PubMed

Beitelshees, Amber L; Zineh, Issam

2010-05-01

Blockade of the renin-angiotensin-aldosterone system (RAAS) with ACE inhibitors has been a cornerstone of heart failure therapy for over 15 years. More recently, further blockade of RAAS with aldosterone antagonists and angiotensin receptor blockers (ARBs) has been studied. While these therapies have certainly improved outcomes in the treatment of heart failure, morbidity and mortality remain extremely high. Furthermore, polypharmacy and complex regimens of seven medications on average is the norm for management of heart failure. This results in increased costs, patient burden, and uncertainty as to the best course of therapy. The ability to personalize patients' therapeutic regimens using pharmacogenomics has the potential of providing more effective and efficient use of RAAS-modulating medications. This review highlights the implications of major RAAS pharmacogenetic studies, while outlining future directions for translation to practice.

A sustainable system of systems approach: a new HFE paradigm.

PubMed

Thatcher, Andrew; Yeow, Paul H P

2016-01-01

Sustainability issues such as natural resource depletion, pollution and poor working conditions have no geographical boundaries in our interconnected world. To address these issues requires a paradigm shift within human factors and ergonomics (HFE), to think beyond a bounded, linear model understanding towards a broader systems framework. For this reason, we introduce a sustainable system of systems model that integrates the current hierarchical conceptualisation of possible interventions (i.e., micro-, meso- and macro-ergonomics) with important concepts from the sustainability literature, including the triple bottom line approach and the notion of time frames. Two practical examples from the HFE literature are presented to illustrate the model. The implications of this paradigm shift for HFE researchers and practitioners are discussed and include the long-term sustainability of the HFE community and comprehensive solutions to problems that consider the emergent issues that arise from this interconnected world. A sustainable world requires a broader systems thinking than that which currently exists in ergonomics. This study proposes a sustainable system of systems model that incorporates ideas from the ecological sciences, notably a nested hierarchy of systems and a hierarchical time dimension. The implications for sustainable design and the sustainability of the HFE community are considered.

Public Trust in Health Information Sharing: Implications for Biobanking and Electronic Health Record Systems

PubMed Central

Platt, Jodyn; Kardia, Sharon

2015-01-01

Biobanks are made all the more valuable when the biological samples they hold can be linked to health information collected in research, electronic health records, or public health practice. Public trust in such systems that share health information for research and health care practice is understudied. Our research examines characteristics of the general public that predict trust in a health system that includes researchers, health care providers, insurance companies and public health departments. We created a 119-item survey of predictors and attributes of system trust and fielded it using Amazon’s MTurk system (n = 447). We found that seeing one’s primary care provider, having a favorable view of data sharing and believing that data sharing will improve the quality of health care, as well as psychosocial factors (altruism and generalized trust) were positively and significantly associated with system trust. As expected, privacy concern, but counterintuitively, knowledge about health information sharing were negatively associated with system trust. We conclude that, in order to assure the public’s trust, policy makers charged with setting best practices for governance of biobanks and access to electronic health records should leverage critical access points to engage a diverse public in joint decision making. PMID:25654300

Analysing hierarchy in the organization of biological and physical systems.

PubMed

Jagers op Akkerhuis, Gerard A J M

2008-02-01

A structured approach is discussed for analysing hierarchy in the organization of biological and physical systems. The need for a structured approach follows from the observation that many hierarchies in the literature apply conflicting hierarchy rules and include ill-defined systems. As an alternative, we suggest a framework that is based on the following analytical steps: determination of the succession stage of the universe, identification of a specific system as part of the universe, specification of external influences on a system's creation and analysis of a system's internal organization. At the end, the paper discusses practical implications of the proposed method for the analysis of system organization and hierarchy in biology, ecology and physics.

Effective Practices for Sexually Traumatized Girls: Implications for Counseling and Education

ERIC Educational Resources Information Center

Underwood, Lee; Stewart, Sarah E.; Castellanos, Anita M.

2007-01-01

The sexual traumatization of female adolescents is becoming increasingly visible in the counseling field. This paper will outline the prevalence of sexual abuse on female adolescents with emphasis on effective practices used in the field. In addition, implications for counselors and counselor educators will be discussed. Multicultural…

Observations of a Working Class Family: Implications for Self-Regulated Learning Development

ERIC Educational Resources Information Center

Vassallo, Stephen

2012-01-01

Guardians have been implicated in the development of children's academic self-regulation. In this case study, which involved naturalistic observations and interviews, the everyday practices of a working class family were considered in the context of self-regulated learning development. The family's practices, beliefs, dispositions and home…

Educational Psychologists' Constructions of Sexuality and the Implications for Practice

ERIC Educational Resources Information Center

Marks, Chloe

2012-01-01

Despite an underlying inclusion agenda, sexuality equality remains a low priority in education. Review of literature suggests the marginalization of sexual minority young people (SMYP) in schools. This study explores educational psychologists' (EPs') constructions of sexuality and the implications for practice. Discursive psychology was used to…

Teaching and Learning Intuition: Some Implications for HRD and Coaching Practice

ERIC Educational Resources Information Center

Mavor, Penny; Sadler-Smith, Eugene; Gray, David E.

2010-01-01

Purpose: The purpose of this paper is to examine conceptual and theoretical links between intuition and coaching; investigate accomplished coaches' practical experiences of intuition; identify skill set of an intuitive coach; discuss implications of findings for coaches', HRD professionals', and line managers' learning and development.…

Marketing in the Islamic Context.

ERIC Educational Resources Information Center

Hashmi, Mahmud S.

The implications of the Islamic religion and culture for marketing strategies and practices are discussed. An introductory section describes the Islamic population and its segments, and gives some historical background about the religion. A list of the principal tenets and practices of the Islamic faith, and the specific marketing implications of…

Ethical dilemmas among nurses as they transition to hospital case management: implications for organizational ethics, part II.

PubMed

O'Donnell, Lolita T

2007-01-01

The purpose of this study was to describe the experiences of ethical concerns by clinical nurses as they transitioned into their new role in hospital case management. Through this study, an attempt was made to explore experiences of ethical concerns and identify the implications for organizational ethics. In this study, nurse case managers practicing in the acute care setting, military, not-for-profit community, and teaching hospitals were interviewed. The majority of the nurse case manager participants were engaged in hospital discharge planning and utilization review activities. An interpretive phenomenological approach was used to identify the themes inherent in ethical concerns and articulate them within the context of hospital nurse case management. Fifteen participants were interviewed to obtain a qualitative description of the nurse case managers' lived experiences of ethical dilemmas and how they were resolved. Nurse case managers' perceptions of solutions/options to resolve such ethical dilemmas were explored. As nurses transition into the expanded role of case management in the present healthcare delivery system, they frequently face situations demanding ethical choices and judgments to accommodate diverse patient interests and needs. These ethical decisions required in daily practice of case management represent ethical dilemmas to nurses. The insights derived from the analysis of the interviews have implications for nursing practice, education, policy, ethics, and research; recommendations for organizations employing nurse case managers in terms of recruitment, orientation, training, and continued need for educational support are identified. 1. The clinical decisions required in daily practice of case management represented challenges to the nurses. This highlights the critical role of adequate educational orientation to case management for beginning case managers. 2. Nurse case managers should be cognizant of the "disconnect" that could occur between their obligations to the organizations that employ them and the healthcare needs of the patients that they advocate for. 3. Aside from the importance of linking patient care outcomes with accountability, nurse case managers may need to advocate for policy change and system reform.

Embattled and embittered or empowered and evolving: nurse practitioner attitudes toward managed care.

PubMed

Hayes, Eileen F

2007-03-01

To explore the attitudes of nurse practitioners (NPs) toward managed care and to identify the sources of negative attitudes and the factors that may ameliorate them. NPs, members of the Massachusetts Coalition of NPs, participated in in-depth interviews about the impact of managed care on their practice. The sources of NP negativity about managed care for many study participants lay in their not appreciating the importance of the business aspects of practice and the provider's role in controlling healthcare costs, reluctance to work with what they perceived as a rigid "system," and lack of support for them to navigate it. They felt pressured by productivity issues, time constraints, practice restrictions, and documentation demands associated with reimbursement. Those who sustained a more positive attitude were realistic about healthcare economics, were willing and able to negotiate the system, were creative and flexible, and felt empowered by knowledge of the business of practice. Some NPs, however, chose to work in practices where they did not feel as pressured as their counterparts in large, busy primary care practices. IMPLICATIONS FOR NP PRACTICE AND EDUCATION: Understanding experiences that have influenced NP attitudes regarding managed care may assist NP faculty to better prepare NP students for their future roles. NPs must be able to challenge, yet be part of, an evolving system that promotes cost-effective health care for everyone, which was what managed care originally was intended to do.

How do local stakeholders respond to the uncertain implications of an innovative flood infrastructure project?

NASA Astrophysics Data System (ADS)

van den Hoek, Ronald; Brugnach, Marcela; Hoekstra, Arjen

2013-04-01

In the 20th century, flood management was dominated by rigid structures - such as dikes and dams - which intend to strictly regulate and control water systems. Although the application of these rigid structures has been successful in the recent past, their negative implications for ecosystems and natural processes is often not properly taken into account. Therefore, flood management practices are currently moving towards more nature-inclusive approaches. Building with Nature (BwN) is such a new approach of nature-inclusive flood management in the Netherlands, which aims to utilize natural dynamics (e.g., wind and currents) and natural materials (e.g., sediment and vegetation) for the realization of effective flood infrastructure, while providing opportunities for nature development. However, the natural dynamics driving a project based on BwN design principles are inherently unpredictable. Furthermore, our factual knowledge base regarding the socio-ecological system in which the BwN initiative is implemented is incomplete. Moreover, in recent years, it is increasingly aimed for by decision-makers to involve local stakeholders in the development of promising flood management initiatives. These stakeholders and other actors involved can have diverging views regarding the project, can perceive unanticipated implications and could choose unforeseen action paths. In short, while a project based on BwN design principles - like any human intervention - definitely has implications for the socio-ecological system, both the extent to which these particular implications will occur and the response of stakeholders are highly uncertain. In this paper, we study the Safety Buffer Oyster Dam case - a BwN pilot project - and address the interplay between the project's implications, the uncertainties regarding these implications and the action paths chosen by the local stakeholders and project team. We determine how the implications of the Safety Buffer project are viewed by local stakeholders, identify the frames and uncertainties related to these implications, and classify these uncertainties according to their nature and level. We describe which action paths are chosen by the local stakeholders and project team regarding the implications identified. Our research shows that there is a correspondence between the level of uncertainty about the implications identified and the action paths chosen by the actors involved. This suggests that the inherent deep uncertainty in projects based on BwN principles calls for more adaptable and flexible strategies to cope with the implications of these initiatives.

Agricultural Incentives: Implications for Small-Scale and Subsistence Farming in the US Caribbean Islands

NASA Astrophysics Data System (ADS)

Alvarez-Berrios, N.; Parés-Ramos, I.; Gould, W. A.

2017-12-01

The effects of climate change threaten the world's most sensitive agroecosystems and our potential to reach agricultural productivity levels needed to feed a projected global population of 9.7 billion people by 2050. The US Caribbean agriculture is especially vulnerable to the effects of climate change, due to the region's frequent exposure to extreme weather events, its geographic and economic scale, shortage of labor force, and rapid urban expansion. Currently, agriculture contributes less than 1% of the island's GDP, and over 80% of the food consumed in the region is imported. Despite low production levels, there is widespread interest in reinvigorating the agricultural sector's contribution to the economy. Local and federal institutions play a major role strengthening the agricultural sector by providing access to incentives, loans, and education for best management practices. However, many of these efforts conform to agricultural systems of larger scale of production and temperate environments. In this study, we explore agricultural incentives programs and their implication for highly diverse, small-scale, and subsistence operations that characterize agricultural systems in Puerto Rico and the US Virgin Islands. We analyze records and maps from the USDA Farm Service Agency, to typify participating farms, and to track changes in land cover, farm size, crop diversity, practices, and production levels resulting from their enrollment in such programs. Preliminary results indicate that many incentives programs are not tailored to agricultural tropical systems and prescribe alternatives that exclude traditional farming methods employed in small-scale and subsistence farms (e.g. crop insurance that benefit monoculture over intercropped systems). Moreover, many of the incentives are contradictory in their recommendations (e.g., crop insurance benefit sun-grown coffee production, while best agricultural practices recommend agroforestry with shade-grown coffee). Understanding the characteristics that underlie the resilience of traditional agriculture is an urgent matter, as they can serve as the basis for the design of agricultural systems that mitigate projected climate changes.

Using Curriculum-Embedded Assessment for Making Educational Decisions: An Empirical Study with Implications for Including Students with Disabilities in Accountability.

ERIC Educational Resources Information Center

Swisher, Judith D.; Green, Samuel B.; Tollefson, Nona

The focus of this research was to examine the perceived effectiveness of the Practical Assessment Exploration System (PAES) (J. Swisher, 1987) for making educational decisions at the instructional program level for students with disabilities across groups of teachers who have various levels of familiarity with the PAES. The PAES is a functional…

The Influence of Professional Development on Teachers' Attitudes in Differentiation: Implications for Intermediate Elementary Teachers to Improve Student Achievement

ERIC Educational Resources Information Center

Braggs, Lydia M.

2012-01-01

Across the United States, K-12 schools are challenged by rapid growth in the percentage of students of color, culturally and linguistically diverse students, and students from low-income families. A failing practice in the educational system has been to teach these diverse students as if they were the same. This quantitative study examined the…

National Implications for Urban School Systems: Strategic Planning in the Human Resource Management Department in a Large Urban School District

ERIC Educational Resources Information Center

Johnson, Clarence; Kritsonis, William Allan

2007-01-01

This article addresses several key ongoing issues in a large urban school district. Literature focuses on what make a large urban school district effective in Human Resource Management. The effectiveness is addressed through recruitment and retention practices. A comparison of the school district with current research is the main approach to the…

Modelling the resource implications and budget impact of managing cow milk allergy in Australia.

PubMed

Guest, J F; Nagy, E

2009-02-01

To estimate the resource implications and budget impact of current clinical practice for managing cow milk allergy (CMA) in Australia, from the perspective of the publicly funded healthcare system. A decision model was constructed using published clinical outcomes and clinician-derived resource utilisation estimates. The model was used to estimate the expected 6-monthly levels of healthcare resource use and corresponding costs attributable to managing 6150 new CMA sufferers following referral to a specialist. The expected 6-monthly costs of managing 6150 newly-diagnosed infants with CMA following referral to a specialist was an estimated (Australian dollars, AU$) AU$6.5 million at 2006/07 prices. Clinical nutrition preparations were found to be the primary cost driver accounting for 62% of the total 6-monthly cost and clinician visits were the secondary cost driver accounting for up to a further 28% of the total 6-monthly cost. Sensitivity analysis showed there would be fewer visits to hospital-based paediatric gastroenterologists and paediatric immunologists/allergists if all newly-diagnosed patients were prescribed an amino acid formula (AAF) following referral to a specialist, instead of being managed according to current practice. CMA imposes a substantial burden on the publicly funded healthcare system in Australia. However, using an AAF as the initial treatment for CMA can potentially release limited hospital resources for alternative use within the paediatric healthcare system.

Earth Science Informatics Community Requirements for Improving Sustainable Science Software Practices: User Perspectives and Implications for Organizational Action

NASA Astrophysics Data System (ADS)

Downs, R. R.; Lenhardt, W. C.; Robinson, E.

2014-12-01

Science software is integral to the scientific process and must be developed and managed in a sustainable manner to ensure future access to scientific data and related resources. Organizations that are part of the scientific enterprise, as well as members of the scientific community who work within these entities, can contribute to the sustainability of science software and to practices that improve scientific community capabilities for science software sustainability. As science becomes increasingly digital and therefore, dependent on software, improving community practices for sustainable science software will contribute to the sustainability of science. Members of the Earth science informatics community, including scientific data producers and distributers, end-user scientists, system and application developers, and data center managers, use science software regularly and face the challenges and the opportunities that science software presents for the sustainability of science. To gain insight on practices needed for the sustainability of science software from the science software experiences of the Earth science informatics community, an interdisciplinary group of 300 community members were asked to engage in simultaneous roundtable discussions and report on their answers to questions about the requirements for improving scientific software sustainability. This paper will present an analysis of the issues reported and the conclusions offered by the participants. These results provide perspectives for science software sustainability practices and have implications for actions that organizations and their leadership can initiate to improve the sustainability of science software.

Improving care transitions through meaningful use stage 2: continuity of care document.

PubMed

Murphy, Lyn Stankiewicz; Wilson, Marisa L; Newhouse, Robin P

2013-02-01

In this department, Drs Murphy, Wilson, and Newhouse highlight hot topics in nursing outcomes, research, and evidence-based practice relevant to the nurse administrator. The goal is to discuss the practical implications for nurse leaders in diverse healthcare settings. Content includes evidence-based projects and decision making, locating measurement tools for quality improvement and safety projects, using outcome measures to evaluate quality, practice implications of administrative research, and exemplars of projects that demon strate innovative approaches to organizational problems. In this article, the authors describe the elements of continuity of care documentation, how sharing information can improve the quality and safety of care transitions and the implications for nurse executives.

Investigation of Perceptual-Motor Behavior Across the Expert Athlete to Disabled Patient Skill Continuum can Advance Theory and Practical Application.

PubMed

Müller, Sean; Vallence, Ann-Maree; Winstein, Carolee

2017-12-14

A framework is presented of how theoretical predictions can be tested across the expert athlete to disabled patient skill continuum. Common-coding theory is used as the exemplar to discuss sensory and motor system contributions to perceptual-motor behavior. Behavioral and neural studies investigating expert athletes and patients recovering from cerebral stroke are reviewed. They provide evidence of bi-directional contributions of visual and motor systems to perceptual-motor behavior. Majority of this research is focused on perceptual-motor performance or learning, with less on transfer. The field is ripe for research designed to test theoretical predictions across the expert athlete to disabled patient skill continuum. Our view has implications for theory and practice in sports science, physical education, and rehabilitation.

Clinical terminology support for a national ambulatory practice outcomes research network.

PubMed

Ricciardi, Thomas N; Lieberman, Michael I; Kahn, Michael G; Masarie, F E

2005-01-01

The Medical Quality Improvement Consortium (MQIC) is a nationwide collaboration of 74 healthcare delivery systems, consisting of 3755 clinicians, who contribute de-identified clinical data from the same commercial electronic medical record (EMR) for quality reporting, outcomes research and clinical research in public health and practice benchmarking. Despite the existence of a common, centrally-managed, shared terminology for core concepts (medications, problem lists, observation names), a substantial "back-end" information management process is required to ensure terminology and data harmonization for creating multi-facility clinically-acceptable queries and comparable results. We describe the information architecture created to support terminology harmonization across this data-sharing consortium and discuss the implications for large scale data sharing envisioned by proponents for the national adoption of ambulatory EMR systems.

Clinical Terminology Support for a National Ambulatory Practice Outcomes Research Network

PubMed Central

Ricciardi, Thomas N.; Lieberman, Michael I.; Kahn, Michael G.; Masarie, F.E. “Chip”

2005-01-01

The Medical Quality Improvement Consortium (MQIC) is a nationwide collaboration of 74 healthcare delivery systems, consisting of 3755 clinicians, who contribute de-identified clinical data from the same commercial electronic medical record (EMR) for quality reporting, outcomes research and clinical research in public health and practice benchmarking. Despite the existence of a common, centrally-managed, shared terminology for core concepts (medications, problem lists, observation names), a substantial “back-end” information management process is required to ensure terminology and data harmonization for creating multi-facility clinically-acceptable queries and comparable results. We describe the information architecture created to support terminology harmonization across this data-sharing consortium and discuss the implications for large scale data sharing envisioned by proponents for the national adoption of ambulatory EMR systems. PMID:16779116

A see through future: augmented reality and health information systems.

PubMed

Monkman, Helen; Kushniruk, Andre W

2015-01-01

Augmented Reality (AR) is a method whereby virtual objects are superimposed on the real world. AR technology is becoming increasingly accessible and affordable and it has many potential health applications. This paper discusses current research on AR health applications such as medical education and medical practice. Some of the potential future uses for this technology (e.g., health information systems, consumer health applications) will also be presented. Additionally, there will be a discussion outlining some of usability and human factors challenges associated with AR in healthcare. It is expected that AR will become increasingly prevalent in healthcare; however, further investigation is required to demonstrate that they provide benefits over traditional methods. Moreover, AR applications must be thoroughly tested to ensure they do not introduce new errors into practice and have patient safety implications.

Democratization of health care: challenge for nursing.

PubMed

Watts, R J

1990-01-01

One of the key foundational principles of primary health care is community involvement. The implementation of meaningful community involvement requires democratic institutions and processes within the health care system. In this context the meaning of substantive democracy and the implications of this concept for the health care system are briefly discussed. The relationship between the purpose, values, and foundational concepts of democracy and those of nursing is examined in greater detail. Based on the congruency between these, the role of nursing in generating and enhancing democratic processes within the health care system is discussed and a model of nursing practice proposed.

Circuit board accident--organizational dimension hidden by prescribed safety.

PubMed

de Almeida, Ildeberto Muniz; Buoso, Eduardo; do Amaral Dias, Maria Dionísia; Vilela, Rodolfo Andrade Gouveia

2012-01-01

This study analyzes an accident in which two maintenance workers suffered severe burns while replacing a circuit breaker panel in a steel mill, following model of analysis and prevention of accidents (MAPA) developed with the objective of enlarging the perimeter of interventions and contributing to deconstruction of blame attribution practices. The study was based on materials produced by a health service team in an in-depth analysis of the accident. The analysis shows that decisions related to system modernization were taken without considering their implications in maintenance scheduling and creating conflicts of priorities and of interests between production and safety; and also reveals that the lack of a systemic perspective in safety management was its principal failure. To explain the accident as merely non-fulfillment of idealized formal safety rules feeds practices of blame attribution supported by alibi norms and inhibits possible prevention. In contrast, accident analyses undertaken in worker health surveillance services show potential to reveal origins of these events incubated in the history of the system ignored in practices guided by the traditional paradigm.

Role of the registered nurse in primary health care: meeting health care needs in the 21st century.

PubMed

Smolowitz, Janice; Speakman, Elizabeth; Wojnar, Danuta; Whelan, Ellen-Marie; Ulrich, Suzan; Hayes, Carolyn; Wood, Laura

2015-01-01

There is widespread interest in the redesign of primary health care practice models to increase access to quality health care. Registered nurses (RNs) are well positioned to assume direct care and leadership roles based on their understanding of patient, family, and system priorities. This project identified 16 exemplar primary health care practices that used RNs to the full extent of their scope of practice in team-based care. Interviews were conducted with practice representatives. RN activities were performed within three general contexts: episodic and preventive care, chronic disease management, and practice operations. RNs performed nine general functions in these contexts including telephone triage, assessment and documentation of health status, chronic illness case management, hospital transition management, delegated care for episodic illness, health coaching, medication reconciliation, staff supervision, and quality improvement leadership. These functions improved quality and efficiency and decreased cost. Implications for policy, practice, and RN education are considered. Copyright © 2015 Elsevier Inc. All rights reserved.

Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective

PubMed Central

2010-01-01

Background Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h) integration of policy and practice in order to be maximally effective. Discussion This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs. Summary Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children. PMID:20478054

The direct support workforce in community supports to individuals with developmental disabilities: issues, implications, and promising practices.

PubMed

Hewitt, Amy; Larson, Sheryl

2007-01-01

Difficulties in finding, keeping, and ensuring the competence of the direct support workforce in community developmental disability services has long been a challenge for individuals, families, providers, and policy makers. Direct support staff recruitment, retention, and competence are widely reported as one of the most significant barriers to the sustainability, growth, and quality of community services for people with developmental disabilities (ANCOR [2001] State of the states report. Alexandria, VA: ANCOR; Colorado Department of Human Services, [2000] Response to Footnote 106 of the FY 2001 appropriations long bill: Capacity of the community services systems for persons with developmental disabilities in Colorado; Hewitt [2000] Dynamics of the workforce crisis. Presentation at the NASDDDS Fall meeting. Alexandria, VA). While long in existence, these challenges are ones of growing concern because the number of people demanding community services is increasing and the population of people from which to recruit workers is declining (Office of the Assistant Secretary for Planning and Evaluation [2006] The supply of direct support professionals serving individuals with intellectual disabilities and other developmental disabilities: Report to Congress. Washington, DC: Office of Disability, Aging and Long-Term Care Policy, ASPE, U.S. Department of Health and Human Services). As the service system moves towards consumer direction, managed care, and more noncategorical service delivery systems, the difficulties of providing for an adequate and well-prepared workforce to support people with developmental disabilities becomes more complex and multifaceted. The solutions to those challenges are also more complex. This article reviews the literature regarding the complexity of the direct support workforce crisis, the effects of this crisis on various stakeholder groups, promising practices designed to address the challenges, and the related practice and policy implications. (c) 2007 Wiley-Liss, Inc.

Is clinician refusal to treat an emerging problem in injury compensation systems?

PubMed

Brijnath, Bianca; Mazza, Danielle; Kosny, Agnieszka; Bunzli, Samantha; Singh, Nabita; Ruseckaite, Rasa; Collie, Alex

2016-01-20

The reasons that doctors may refuse or be reluctant to treat have not been widely explored in the medical literature. To understand the ethical implications of reluctance to treat there is a need to recognise the constraints of doctors working in complex systems and to consider how these constraints may influence reluctance. The aim of this paper is to illustrate these constraints using the case of compensable injury in the Australian context. Between September and December 2012, a qualitative investigation involving face-to-face semistructured interviews examined the knowledge, attitudes and practices of general practitioners (GPs) facilitating return to work in people with compensable injuries. Compensable injury management in general practice in Melbourne, Australia. 25 GPs who were treating, or had treated a patient with compensable injury. The practice of clinicians refusing treatment was described by all participants. While most GPs reported refusal to treat among their colleagues in primary and specialist care, many participants also described their own reluctance to treat people with compensable injuries. Reasons offered included time and financial burdens, in addition to the clinical complexities involved in compensable injury management. In the case of compensable injury management, reluctance and refusal to treat is likely to have a domino effect by increasing the time and financial burden of clinically complex patients on the remaining clinicians. This may present a significant challenge to an effective, sustainable compensation system. Urgent research is needed to understand the extent and implications of reluctance and refusal to treat and to identify strategies to engage clinicians in treating people with compensable injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective.

PubMed

Maclean, Lynne M; Clinton, Kathryn; Edwards, Nancy; Garrard, Michael; Ashley, Lisa; Hansen-Ketchum, Patti; Walsh, Audrey

2010-05-17

Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h) integration of policy and practice in order to be maximally effective. This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs. Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children.

Nurse practitioner job satisfaction: looking for successful outcomes.

PubMed

Pasarón, Raquel

2013-09-01

To examine overall job satisfaction and its association with extrinsic and intrinsic characteristics of job satisfaction among nurse practitioners at the chosen practice site. The objectives were to identify relevant retention and recruitment strategies, from the nurse practitioners perspective, by examining (1) what role aspects are most satisfying, and (2) approaches for successful, professional development and integration in the role. Supportive professional practice environments are particularly important to nurses' satisfaction with their work and the quality of patient care provided. Hence, research that examines nurse practitioners practice implications and barriers in today's healthcare system is essential. A descriptive-correlational design using survey methodology. A nonprobability sample of convenience was used. The outcome measures were: The Misener Nurse Practitioner Job Satisfaction Scale and two investigator-developed surveys. Participants expressed dissatisfaction with professional and monetary recognition, assertive influence, administrative support and collegial relationships. Interaction of subscale factors on overall job satisfaction and demographic survey findings has important implications for health administrators and nurse practitioners in similar organisations. Stakeholders in healthcare milieus need to be fully engaged in the redesign of the American healthcare system heeding the recommendations of the Institute of Medicine to provide safer health systems to the public. By doing this, issues related to frustration by nurse practitioners related to job satisfaction will be addressed. The need for cooperation, participation, collaboration and instrumental communication are essential in the delivery of safe, quality patient care. A better understanding of intrinsic professional rewards needs to be learned by nurse practitioners who want to seek professional satisfaction and engage in the survival and growth of the profession. Nurse practitioners armed with this translational information have viable agenda items that can be negotiated into extrinsic rewards. © 2013 Blackwell Publishing Ltd.

Understanding Homophobic Behavior and Its Implications for Policy and Practice

ERIC Educational Resources Information Center

Poteat, V. Paul; Russell, Stephen T.

2013-01-01

In this article, we consider recent advances in scholarship on homophobic bullying, and implications for policy and practice. We first consider toward whom homophobic behavior is directed, drawing attention to the nuances among LGBT youth, and the realities of homophobic bullying for heterosexual or straight youth. We review the correlates or…

Awareness of the Social Implications of Clothing in Relation to Fashion Awareness and Clothing Economic Practices.

ERIC Educational Resources Information Center

Horridge, Patricia; Richards, Mary Lynne

1986-01-01

The Sproles Consumer Interests and Priorities questionnaire was administered to 3,036 home economists. Awareness of social implications of clothing, correlated positively with fashion awareness and clothing economic practices. Results suggest that persons exhibiting substantial awareness of social importance of clothing also tend to evidence…

Understanding Parental Grief as a Response to Mental Illness: Implications for Practice

ERIC Educational Resources Information Center

Penzo, Jeanine A.; Harvey, Pat

2008-01-01

Parents who are raising children with mental illness struggle with feelings of grief and loss. Kubler-Ross' (1969) stages of grieving (denial, anger, bargaining, depression, and acceptance) are examined as experienced by parents raising children with chronic mental illness. Practice implications for social workers who are working with children and…

Child Abuse and Neglect in Cambodian Refugee Families: Characteristics and Implications for Practice

ERIC Educational Resources Information Center

Chang, Janet; Rhee, Siyon; Berthold, S. Megan

2008-01-01

This study examines the characteristics and patterns of child maltreatment among Cambodian refugee families in Los Angeles and assesses the implications for child welfare practice with Cambodian refugee families. Data were extracted from 243 active Cambodian case files maintained by the Los Angeles County Department of Children and Family Services…

Family Violence and Migrant Women: Implications for Practice. Migrant Clinicians Network Clinical Supplement.

ERIC Educational Resources Information Center

Rodriguez, Rachel; And Others

1993-01-01

This newsletter supplement is devoted to the theme of domestic violence affecting migrant women. It contains four articles describing programs providing violence prevention education to migrant women and children. "Family Violence and Migrant Women: Implications for Practice" (Rachel Rodriguez) discusses the social isolation of migrant women;…

Attachment Theory and Religiosity: A Summary of Empirical Research with Implications for Counseling Christian Clients

ERIC Educational Resources Information Center

Reinert, Duane F.; Edwards, Carla E.; Hendrix, Rebecca R.

2009-01-01

The authors summarize the growing body of empirical research literature in the area of psychology of religion that has been guided by attachment theory and indicate implications for counseling, including practical suggestions for case conceptualization, possible spiritual interventions, and ethical guidelines for practice. Attachment theory…

Addressing Cross-Cultural Teamwork Barriers: Implications for Industry Practice and Higher Education Curricula

ERIC Educational Resources Information Center

Levitt, Steven R.

2016-01-01

This study explores cultural factors affecting international team dynamics and the implications for industry practice and higher education. Despite decades of studying and experience with cultural diversity, international work groups continue to be challenged by ethnocentrism and prejudices. Central to the context is that cultural differences in…

Capitalism's New Handmaiden: The Biotechnical World Negotiated through Children's Fiction

ERIC Educational Resources Information Center

Sawers, Naarah

2009-01-01

In an era when the merger between capitalism and science becomes an accepted norm, new questions need to be asked about the ethical implications of scientific practices. One such practice is organ transplantation. However, potent debates surround the just distribution and ethical implications of organ transplantation. This paper examines the ways…

Position Statement on Motivations, Methodologies, and Practical Implications of Educational Neuroscience Research: fMRI Studies of the Neural Correlates of Creative Intelligence

ERIC Educational Resources Information Center

Geake, John

2011-01-01

In this position statement it is argued that educational neuroscience must necessarily be relevant to, and therefore have implications for, both educational theory and practice. Consequently, educational neuroscientific research necessarily must embrace educational research questions in its remit.

Guattari's Ecosophy and Implications for Pedagogy

ERIC Educational Resources Information Center

Greenhalgh-Spencer, Heather

2014-01-01

Guattari's ecosophy has implications for many types of pedagogy practiced in the school. While Guattari never explicitly advocated the educational use of ecosophy, I explore in this article how it can be used as a lens to "read" pedagogy in nuanced ways, highlighting oppressive premises and practices. I first discuss Guattari's…

Soviet Psycho-educational Research on Learning Disabilities: Implications for American Research and Practice.

ERIC Educational Resources Information Center

Wozniak, Robert H.

The implications of Soviet psychoeducational research on learning disabilities (LD) and its relevance to American research and practice are discussed. The first section provides an overview of the general perspective of Soviet special education, with particular reference to LD and its relationship to Soviet psychology and philosophy. The second…

Perceptions of Occupational Therapists on the Patient Protection and Affordable Care Act: Five Years After Its Enactment.

PubMed

Yuen, Hon K; Spicher, Hillary S; Semon, Madelyn R; Winwood, Leah M; Dudgeon, Brian J

2017-01-01

This study explored the perceptions of occupational therapists regarding the impact and implications of the Patient Protection and Affordable Care Act (PPACA or ACA) on occupational therapy practice. Fifteen occupational therapists participated in an interview to answer open-ended questions related to their thoughts and perceptions regarding the impact and implications of the ACA on their practice. The participants were practicing in eight different states and worked in five different settings with clinical experience ranging from 3 to 38 years; their positions ranged from staff therapist to owner of a free-standing outpatient clinic. Qualitative content analysis was used to synthesize the interview transcripts. Results showed that therapists did not have sufficient knowledge on the various mandates and provisions of the ACA, or were uncertain about what implications the ACA would have on practice, with the ACA affecting some settings more than others. Data revealed the perceived impacts of the ACA on occupational therapy practice include greater attention on documenting outcome-focused care, external accountability pressures on productivity, conscientiousness about clients' insurance coverage, uncertainty about collaborative care delivery, and survival of small businesses. Findings suggest training regarding knowledge about and implications of different elements of the ACA is needed as well as practices needing to promote the services that occupational therapists can provide to improve cost-effectiveness and outcomes in collaborative care environments.

Assessment of systems for paying health care providers in Vietnam: implications for equity, efficiency and expanding effective health coverage.

PubMed

Phuong, Nguyen Khanh; Oanh, Tran Thi Mai; Phuong, Hoang Thi; Tien, Tran Van; Cashin, Cheryl

2015-01-01

Provider payment arrangements are currently a core concern for Vietnam's health sector and a key lever for expanding effective coverage and improving the efficiency and equity of the health system. This study describes how different provider payment systems are designed and implemented in practice across a sample of provinces and districts in Vietnam. Key informant interviews were conducted with over 100 health policy-makers, purchasers and providers using a structured interview guide. The results of the different payment methods were scored by respondents and assessed against a set of health system performance criteria. Overall, the public health insurance agency, Vietnam Social Security (VSS), is focused on managing expenditures through a complicated set of reimbursement policies and caps, but the incentives for providers are unclear and do not consistently support Vietnam's health system objectives. The results of this study are being used by the Ministry of Health and VSS to reform the provider payment systems to be more consistent with international definitions and good practices and to better support Vietnam's health system objectives.

Implications of leading crop production practices on environmental quality and human health.

PubMed

Udeigwe, Theophilus K; Teboh, Jasper M; Eze, Peter N; Stietiya, M Hashem; Kumar, Vipan; Hendrix, James; Mascagni, Henry J; Ying, Teng; Kandakji, Tarek

2015-03-15

Globally, much weight is currently being placed on agriculture to provide food for the growing population as well as feedstock for the bioenergy industry. Unfortunately, the intensification of agricultural operations to satisfy these growing needs has been associated with a number of environmental and human health risks. A review of publications on the subject was conducted and emphasis was placed on articles focusing on agriculture, environment, and public health as well as their interactions. Supporting information was also gathered from publications of various agricultural and environmental agencies. Agricultural practices with potential negative implications on the environment and human health were identified broadly as: (a) utilization of biosolids and animal manures, (b) use of agricultural chemicals, (c) management of post-harvest residue, (d) irrigation, and (e) tillage operations. Soil, water, and air contamination by nutrients, heavy metals, pathogens, and pesticides, as well as air contamination by particulate matters, noxious gases, and pathogens were among the leading environmental impacts. Some of the human-health impacts identified included neurological and reproductive defects, cardiovascular risks, cancers and other diseases (of kidney, liver, lung, and skin), skin allergies, gastroenteritis, and methemoglobinemia. Continual awareness on the impacts of the reviewed agricultural practices on environmental quality and human health and the implementation of experimentally-backed best management practices in agricultural systems remain indispensable. Copyright © 2014 Elsevier Ltd. All rights reserved.

Global financial crisis and surgical practice: the Greek paradigm.

PubMed

Karidis, Nikolaos P; Dimitroulis, Dimitrios; Kouraklis, Gregory

2011-11-01

Apart from the significant implications of recent financial crisis in overall health indices and mortality rates, the direct effect of health resources redistribution in everyday clinical practice is barely recognized. In the case of Greece, health sector reform and health spending cuts have already had a major impact on costly interventions, particularly in surgical practice. An increase in utilization of public health resources, lack of basic and advanced surgical supplies, salary deductions, and emerging issues in patient management have contributed to serious dysfunction of a public health system unable to sustain current needs. In this context, significant implications arise for the surgeons and patients as proper perioperative management is directly affected by reduced public health funding. The surgical community has expressed concerns about the quality of surgical care and the future of surgical progress in the era of the European Union. Greek surgeons are expected to support reform while maintaining a high level of surgical care to the public. The challenge of cost control in surgical practice provides, nevertheless, an excellent opportunity to reconsider health economics while innovation through a more traditional approach to the surgical patient should not be precluded. A Greek case study on the extent of the current situation is presented with reference to health policy reform, serving as an alarming paradigm for the global community under the pressure of a profound financial recession.

Landscape care of urban vacant properties and implications for health and safety: Lessons from photovoice.

PubMed

Sampson, Natalie; Nassauer, Joan; Schulz, Amy; Hurd, Kathleen; Dorman, Cynthia; Ligon, Khalil

2017-07-01

Care of vacant properties in urban environments is of particular interest to planners and residents alike. We report on a photovoice project completed by community leaders, researchers, and residents in two Detroit neighborhoods experiencing longtime systemic disinvestment. Participants photographed and discussed examples of care in a series of three focus groups in each neighborhood. Analyses highlight how acts of landscape care and visible cues to care contribute to changes in physical and social environments, and explore various links to health. We suggest theoretical and practical applications of residents' perspectives on landscape care and identify implications for well-being and neighborhood stability. Copyright © 2017 Elsevier Ltd. All rights reserved.

Intelligence involves risk-awareness and intellectual disability involves risk-unawareness: implications of a theory of common sense.

PubMed

Greenspan, Stephen; Switzky, Harvey N; Woods, George W

2011-12-01

Survival in the everyday world (in both social and practical functioning) depends on one's ability to recognise and avoid going down the worst possible path, especially when doing so places one at risk of death, injury, or social disaster. Most people possess "common sense" (the ability to recognise obvious risk) but some people lack that ability and thus are at high risk of engaging in "foolish" (i.e., risk-unaware) action. People who have a cognitive impairment are much less able to recognise and avoid risk, and this is what causes them to be seen as needing protection and support. In this paper, we argue that the answer to the question "What is intellectual disability (ID)?" is more likely to come from the question "What is unintelligent behavior?" than "What is intelligence?" The answer which comes from such a question is that "ID is a common sense deficit disorder characterised by unawareness of obvious social and practical risk." Several implications of this answer are explored for the field of intellectual disability. These implications are explored primarily for adults who may have ID, given that the inspiration for this paper came from the way existing ID definitions are applied or misapplied in the US adult criminal justice system.

Implementing people-centred health systems governance in 3 provinces and 11 districts of Afghanistan: a case study.

PubMed

Anwari, Zelaikha; Shukla, Mahesh; Maseed, Basir Ahmad; Wardak, Ghulam Farooq Mukhlis; Sardar, Sakhi; Matin, Javid; Rashed, Ghulam Sayed; Hamedi, Sayed Amin; Sahak, Hedayatullah; Aziz, Abdul Hakim; Boyd-Boffa, Mariah; Trasi, Reshma

2015-01-01

Previous studies show that health systems governance influences health system performance and health outcomes. However, there are few examples of how to implement and monitor good governing practices in fragile and conflict affected environments. Good governance has the potential to make the health system people-centered. More research is needed on implementing a people-centered governance approach in these environments. We piloted an intervention that placed a people-centred health systems governance approach in the hands of multi-stakeholder committees that govern provincial and district health systems. We report the results of this intervention from three provinces and eleven districts in Afghanistan over a six month period. This mixed-methods exploratory case study uses analysis of governance self-assessment scores, health management information system data on health system performance, and focus group discussions. The outcomes of interest are governance scores and health system performance indicators. We document the application of a people-centred health systems governance conceptual model based on applying four effective governing practices: cultivating accountability, engaging with stakeholders, setting a shared strategic direction, and stewarding resources responsibly. We present a participatory approach where health system leaders identify and act on opportunities for making themselves and their health systems more accountable and responsive to the needs of the communities they serve. We found that health systems governance can be improved in fragile and conflict affected environments, and that consistent application of the effective governing practices is key to improving governance. Intervention was associated with a 20% increase in antenatal care visit rate in pilot provinces. Focus group discussions showed improvements across the four governing practices, including: establishment of new sub-committees that oversee financial transparency and governance, collaboration with diverse stakeholders, sharper focus on community health needs, more frequent presentation of service delivery data, and increased use of data for decision making. Our findings have implications for policy and practice within and beyond Afghanistan. Governance is central to making health systems responsive to the needs of people who access and provide services. We provide a practical approach to improving health systems governance in fragile and conflict affected environments.

The roles of integration in molecular systems biology.

PubMed

O'Malley, Maureen A; Soyer, Orkun S

2012-03-01

A common way to think about scientific practice involves classifying it as hypothesis- or data-driven. We argue that although such distinctions might illuminate scientific practice very generally, they are not sufficient to understand the day-to-day dynamics of scientific activity and the development of programmes of research. One aspect of everyday scientific practice that is beginning to gain more attention is integration. This paper outlines what is meant by this term and how it has been discussed from scientific and philosophical points of view. We focus on methodological, data and explanatory integration, and show how they are connected. Then, using some examples from molecular systems biology, we will show how integration works in a range of inquiries to generate surprising insights and even new fields of research. From these examples we try to gain a broader perspective on integration in relation to the contexts of inquiry in which it is implemented. In today's environment of data-intensive large-scale science, integration has become both a practical and normative requirement with corresponding implications for meta-methodological accounts of scientific practice. We conclude with a discussion of why an understanding of integration and its dynamics is useful for philosophy of science and scientific practice in general. Copyright © 2011 Elsevier Ltd. All rights reserved.

Variation in clinical coding lists in UK general practice: a barrier to consistent data entry?

PubMed

Tai, Tracy Waize; Anandarajah, Sobanna; Dhoul, Neil; de Lusignan, Simon

2007-01-01

Routinely collected general practice computer data are used for quality improvement; poor data quality including inconsistent coding can reduce their usefulness. To document the diversity of data entry systems currently in use in UK general practice and highlight possible implications for data quality. General practice volunteers provided screen shots of the clinical coding screen they would use to code a diagnosis or problem title in the clinical consultation. The six clinical conditions examined were: depression, cystitis, type 2 diabetes mellitus, sore throat, tired all the time, and myocardial infarction. We looked at the picking lists generated for these problem titles in EMIS, IPS, GPASS and iSOFT general practice clinical computer systems, using the Triset browser as a gold standard for comparison. A mean of 19.3 codes is offered in the picking list after entering a diagnosis or problem title. EMIS produced the longest picking lists and GPASS the shortest, with a mean number of choices of 35.2 and 12.7, respectively. Approximately three-quarters (73.5%) of codes are diagnoses, one-eighth (12.5%) symptom codes, and the remainder come from a range of Read chapters. There was no readily detectable consistent order in which codes were displayed. Velocity coding, whereby commonly-used codes are placed higher in the picking list, results in variation between practices even where they have the same brand of computer system. Current systems for clinical coding promote diversity rather than consistency of clinical coding. As the UK moves towards an integrated health IT system consistency of coding will become more important. A standardised, limited list of codes for primary care might help address this need.

Understanding the systemic nature of cities to improve health and climate change mitigation.

PubMed

Chapman, Ralph; Howden-Chapman, Philippa; Capon, Anthony

2016-09-01

Understanding cities comprehensively as systems is a costly challenge and is typically not feasible for policy makers. Nevertheless, focusing on some key systemic characteristics of cities can give useful insights for policy to advance health and well-being outcomes. Moreover, if we take a coevolutionary systems view of cities, some conventional assumptions about the nature of urban development (e.g. the growth in private vehicle use with income) may not stand up. We illustrate this by examining the coevolution of urban transport and land use systems, and institutional change, giving examples of policy implications. At a high level, our concern derives from the need to better understand the dynamics of urban change, and its implications for health and well-being. At a practical level, we see opportunities to use stylised findings about urban systems to underpin policy experiments. While it is now not uncommon to view cities as systems, policy makers appear to have made little use so far of a systems approach to inform choice of policies with consequences for health and well-being. System insights can be applied to intelligently anticipate change - for example, as cities are subjected to increasing natural system reactions to climate change, they must find ways to mitigate and adapt to it. Secondly, systems insights around policy cobenefits are vital for better informing horizontal policy integration. Lastly, an implication of system complexity is that rather than seeking detailed, 'full' knowledge about urban issues and policies, cities would be well advised to engage in policy experimentation to address increasingly urgent health and climate change issues. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessing the role of GPs in Nordic health care systems.

PubMed

Quaye, Randolph K

2016-05-03

Purpose This paper examines the changing role of general practitioners (GPs) in Nordic countries of Sweden, Norway and Denmark. It aims to explore the "gate keeping" role of GPs in the face of current changes in the health care delivery systems in these countries. Design/methodology/approach Data were collected from existing literature, interviews with GPs, hospital specialists and representatives of Danish regions and Norwegian Medical Association. Findings The paper contends that in all these changes, the position of the GPs in the medical division of labor has been strengthened, and patients now have increased and broadened access to choice. Research limitations/implications Health care cost and high cancer mortality rates have forced Nordic countries of Sweden, Norway and Denmark to rethink their health care systems. Several attempts have been made to reduce health care cost through market reform and by strenghtening the position of GPs. The evidence suggests that in Norway and Denmark, right incentives are in place to achieve this goal. Sweden is not far behind. The paper has limitations of a small sample size and an exclusive focus on GPs. Practical implications Anecdotal evidence suggests that physicians are becoming extremely unhappy. Understanding the changing status of primary care physicians will yield valuable information for assessing the effectiveness of Nordic health care delivery systems. Social implications This study has wider implications of how GPs see their role as potential gatekeepers in the Nordic health care systems. The role of GPs is changing as a result of recent health care reforms. Originality/value This paper contends that in Norway and Denmark, right incentives are in place to strengthen the position of GPs.

Amenable to reason: Aristotle's rhetoric and the moral psychology of practical ethics.

PubMed

London, A J

2000-12-01

An Aristotelian conception of practical ethics can be derived from the account of practical reasoning that Aristotle articulates in is Rhetoric and this has important implications for the way we understand the nature and limits of practical ethics. an important feature of this conception of practical ethics is its responsiveness to the complex ways in which agents form and maintain moral commitments, and this has important implications for the debate concerning methods of ethics in applied ethics. In particular, this feature enables us to understand casuistry, narrative, and principlism as mutually supportive modes of moral inquiry, rather than divergent and mutually exclusive methods of ethics. As a result, an Aristotelian conception of practical ethics clears the conceptual common ground upon which practical ethicists can forge a stable and realistic self-understanding.

Exploring Current and Future Roles of Non-Dental Professionals: Implications for Dental Hygiene Education.

PubMed

Maxey, Hannah L; Farrell, Christine; Gwozdek, Anne

2017-09-01

The health care system is undergoing transformation in which oral health is not only valued as an aspect of overall health, but health care delivery systems are aligning to better deliver total patient care. As a result of this transformation, education for many non-dental professionals incorporates oral health content to prepare them to practice in comprehensive delivery models. While some non-dental professionals already incorporate oral health care in their service, many opportunities exist for expansion of oral health care delivery by other non-dental professionals, including radiologic technicians, nursing staff, and human services professionals. As non-dental professionals take on expanded roles in oral health care, the dental hygiene workforce must be prepared to practice in settings with new types of professionals. Dental hygiene curricula should prioritize interprofessional education to best prepare these students for practice in evolved delivery models. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

Reflective practice and its implications for pharmacy education.

PubMed

Tsingos, Cherie; Bosnic-Anticevich, Sinthia; Smith, Lorraine

2014-02-12

Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.(1-2) Reflective practice activities encourage learning from the student's own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education.

Reflective Practice and Its Implications for Pharmacy Education

PubMed Central

Bosnic-Anticevich, Sinthia; Smith, Lorraine

2014-01-01

Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.1-2 Reflective practice activities encourage learning from the student’s own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education. PMID:24558286

The Aging Cardiovascular System: Understanding It at the Cellular and Clinical Levels.

PubMed

Paneni, Francesco; Diaz Cañestro, Candela; Libby, Peter; Lüscher, Thomas F; Camici, Giovanni G

2017-04-18

Cardiovascular disease (CVD) presents a great burden for elderly patients, their caregivers, and health systems. Structural and functional alterations of vessels accumulate throughout life, culminating in increased risk of developing CVD. The growing elderly population worldwide highlights the need to understand how aging promotes CVD in order to develop new strategies to confront this challenge. This review provides examples of some major unresolved clinical problems encountered in daily cardiovascular practice as we care for elderly patients. Next, the authors summarize the current understanding of the mechanisms implicated in cardiovascular aging, and the potential for targeting novel pathways implicated in endothelial dysfunction, mitochondrial oxidative stress, chromatin remodeling, and genomic instability. Lastly, the authors consider critical aspects of vascular repair, including autologous transplantation of bone marrow-derived stem cells in elderly patients. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Tourism-Induced Livelihood Changes at Mount Sanqingshan World Heritage Site, China

NASA Astrophysics Data System (ADS)

Su, Ming Ming; Wall, Geoffrey; Xu, Kejian

2016-05-01

Although tourism has the potential to improve the wellbeing of residents, it may also disrupt livelihood systems, social processes, and cultural traditions. The livelihood changes at three rural villages at Mount Sanqingshan World Heritage Site, China, are assessed to determine the extent to which tourism strategies are contributing to local livelihoods. A sustainable livelihood framework is adopted to guide the analysis. The three villages exhibit different development patterns due to institutional, organizational, and location factors. New strategies involving tourism were constructed and incorporated into the traditional livelihood systems and they resulted in different outcomes for residents of different villages. Village location, including the relationship to the site tourism plan, affected the implications for rural livelihoods. High dependence on tourism as the single livelihood option can reduce sustainability. Practical implications are suggested to enhance livelihood sustainability at such rural heritage tourism sites.

Tourism-Induced Livelihood Changes at Mount Sanqingshan World Heritage Site, China.

PubMed

Su, Ming Ming; Wall, Geoffrey; Xu, Kejian

2016-05-01

Although tourism has the potential to improve the wellbeing of residents, it may also disrupt livelihood systems, social processes, and cultural traditions. The livelihood changes at three rural villages at Mount Sanqingshan World Heritage Site, China, are assessed to determine the extent to which tourism strategies are contributing to local livelihoods. A sustainable livelihood framework is adopted to guide the analysis. The three villages exhibit different development patterns due to institutional, organizational, and location factors. New strategies involving tourism were constructed and incorporated into the traditional livelihood systems and they resulted in different outcomes for residents of different villages. Village location, including the relationship to the site tourism plan, affected the implications for rural livelihoods. High dependence on tourism as the single livelihood option can reduce sustainability. Practical implications are suggested to enhance livelihood sustainability at such rural heritage tourism sites.

The impact of corporate practices on health: implications for health policy.

PubMed

Freudenberg, Nicholas; Galea, Sandro

2008-04-01

Although corporate practices play a substantial role in shaping health and health behavior, public health researchers have rarely systematically studied these practices as a social determinant of health. We consider case studies of three products - trans fat, a food additive and a preservative; Vioxx, a pain killer; and sports utility vehicles - to illustrate the role of corporate policies and practices in the production of health and disease and the implications for health policy. In recent years, public health advocates, researchers, and lawyers have used strategies to reduce the adverse health impact of corporate practices. Systematic analysis of these experiences yields insights that can guide the development of health policies that increase opportunities for primary prevention by discouraging harmful corporate practices.

Cultural competency assessment tool for hospitals: Evaluating hospitals’ adherence to the culturally and linguistically appropriate services standards

PubMed Central

Weech-Maldonado, Robert; Dreachslin, Janice L.; Brown, Julie; Pradhan, Rohit; Rubin, Kelly L.; Schiller, Cameron; Hays, Ron D.

2016-01-01

Background The U.S. national standards for culturally and linguistically appropriate services (CLAS) in health care provide guidelines on policies and practices aimed at developing culturally competent systems of care. The Cultural Competency Assessment Tool for Hospitals (CCATH) was developed as an organizational tool to assess adherence to the CLAS standards. Purposes First, we describe the development of the CCATH and estimate the reliability and validity of the CCATH measures. Second, we discuss the managerial implications of the CCATH as an organizational tool to assess cultural competency. Methodology/Approach We pilot tested an initial draft of the CCATH, revised it based on a focus group and cognitive interviews, and then administered it in a field test with a sample of California hospitals. The reliability and validity of the CCATH were evaluated using factor analysis, analysis of variance, and Cronbach’s alphas. Findings Exploratory and confirmatory factor analyses identified 12 CCATH composites: leadership and strategic planning, data collection on inpatient population, data collection on service area, performance management systems and quality improvement, human resources practices, diversity training, community representation, availability of interpreter services, interpreter services policies, quality of interpreter services, translation of written materials, and clinical cultural competency practices. All the CCATH scales had internal consistency reliability of .65 or above, and the reliability was .70 or above for 9 of the 12 scales. Analysis of variance results showed that not-for-profit hospitals have higher CCATH scores than for-profit hospitals in five CCATH scales and higher CCATH scores than government hospitals in two CCATH scales. Practice Implications The CCATH showed adequate psychometric properties. Managers and policy makers can use the CCATH as a tool to evaluate hospital performance in cultural competency and identify and target improvements in hospital policies and practices that undergird the provision of CLAS. PMID:21934511

Furthering the Understanding of Parent–Child Relationships: A Nursing Scholarship Review Series. Part 3: Interaction and the Parent–Child Relationship—Assessment and Intervention Studies

PubMed Central

Pridham, Karen A.; Lutz, Kristin F.; Anderson, Lori S.; Riesch, Susan K.; Becker, Patricia T.

2010-01-01

PURPOSE This integrative review concerns nursing research on parent–child interaction and relationships published from 1980 through 2008 and includes assessment and intervention studies in clinically important settings (e.g., feeding, teaching, play). CONCLUSIONS Directions for research include development of theoretical frameworks, valid observational systems, and multivariate and longitudinal data analytic strategies. PRACTICE IMPLICATIONS Observation of social–emotional as well as task-related interaction qualities in the context of assessing parent–child relationships could generate new questions for nursing research and for family-centered nursing practice. PMID:20074112

Abuse, Neglect, and Violence Against Elderly Women in Ghana: Implications for Social Justice and Human Rights.

PubMed

Sossou, Marie-Antoinette; Yogtiba, Joseph A

2015-01-01

This article discusses abuse and neglect of elderly women in Ghana and the traditional practices that adversely affect their human rights. Their situation is characterized by pervasive poverty, illiteracy, widowhood, predominantly rural dwelling, and subjection to insidious cultural practices and superstitious beliefs. Increase in life expectancy and population trends point to significant increases in the numbers of the elderly women. Breakdown of the extended family support system and the waning of filial obligations are factors affecting their welfare. Accurate data on these abuses is lacking due to cultural inhibitions and non-reporting. Legislations and NGO programs are addressed to combat abuses.

Framing nursing practice within a forensic outpatient service.

PubMed

Encinares, M; Lorbergs, K A

2001-09-01

The role of the outpatient forensic nurse is evolving as a specialized area of nursing practice in the community. Nurses must have comprehensive knowledge of the patients, keen intuition, and sound judgment in the continuous clinical assessment of the criminogenic factors that help determine the patients' level of risk. In addition, it is crucial to know and understand the court system, the process of the ORB, and the implications of the disposition order. The comprehensive, client-centered care provided by the Forensic Outpatient Service encompasses multifunctional and complex roles and responsibilities and clearly demonstrates the importance of the forensic outpatient nurse in working with this group of patients.

Safeguarding and Protecting Children in Maternity Services: Implications for Practice

ERIC Educational Resources Information Center

Lazenbatt, Anne; Greer, Jean

2009-01-01

This article debates the issues involved in safeguarding and protecting children in maternity services and offers implications for professional practice. Midwives and other staff who work as members of the maternity team have a safeguarding role to play in the identification of babies and children who have been abused, or are at risk of abuse, and…

SOME IMPLICATIONS OF A CONCEPT OF GROWTH MOTIVATION FOR ADULT EDUCATION THEORY AND PRACTICE.

ERIC Educational Resources Information Center

NOREEN, DAVID SHELDON

THIS STUDY EXAMINED GROWTH MOTIVATION AS A DEVELOPING CONCEPT AND AS A THEORETICAL CONSTRUCT, AND THE IMPLICATIONS OF THIS THEORY FOR ADULT EDUCATION THEORY AND PRACTICE. SPECIAL ATTENTION WAS GIVEN TO THE THEORETICAL CONSTRUCTS OF ABRAHAM MASLOW, TO THE NATURE OF GROWTH MOTIVATION CONCEPTS IN GENERAL, AND TO FORMS OF SELF UNDERSTANDING AND…

Code Switching in English Language Teaching (ELT) Teaching Practice in Turkey: Student Teacher Practices, Beliefs and Identity

ERIC Educational Resources Information Center

Bilgin, Sezen Seymen

2016-01-01

Code switching involves the interplay of two languages and as well as serving linguistic functions, it has social and psychological implications. In the context of English language teaching, these psychological implications reveal themselves as teachers' thought processes. While the nature of code switching in language classrooms has been widely…

Youth Work Transitions: A Review with Implications for Counselling and Career Practice

ERIC Educational Resources Information Center

Parada, Filomena; Young, Richard A.

2013-01-01

We critically review studies highlighting youth's work transitions and derive some implications for career and counselling theory and practice. We first discuss today's hypermodern world, specifically the meanings being conveyed by today's complex social realities and their impact on individuals' (work) lives. An overview of…

The Control-Value Theory of Achievement Emotions: Assumptions, Corollaries, and Implications for Educational Research and Practice

ERIC Educational Resources Information Center

Pekrun, Reinhard

2006-01-01

This article describes the control-value theory of achievement emotions and its implications for educational research and practice. The theory provides an integrative framework for analyzing the antecedents and effects of emotions experienced in achievement and academic settings. It is based on the premise that appraisals of control and values are…

Access to Print Literacy for Children and Young People with Visual Impairment: Implications for Policy and Practice

ERIC Educational Resources Information Center

Douglas, Graeme; McLinden, Mike; Farrell, Ann Marie; Ware, Jean; McCall, Steve; Pavey, Sue

2011-01-01

This article considers the concept of access in the education of visually impaired children and young people, with particular reference to print literacy. The article describes implications for teaching and policy at various levels of the educational process: classroom practice; broader teaching and curriculum requirements (including service…

Commentary--Sorting It Out: Thoughts on "Does Sorting Students Improve Scores? An Analysis of Class Composition" by Courtney A. Collins and Li Gan

ERIC Educational Resources Information Center

Coleman, Mary Ruth Blackwell

2016-01-01

One of the most challenging decisions made by school system administrators each year is how to assign students to teachers. This decision, usually guided by the administrator's beliefs and values, has major implications for the teacher and the student. Collins and Gan undertook a complex study to examine the impact of grouping practices on student…

Microbiology, philosophy and education.

PubMed

O'Malley, Maureen A

2016-09-01

There are not only many links between microbiological and philosophical topics, but good educational reasons for microbiologists to explore the philosophical issues in their fields. I examine three broad issues of classification, causality and model systems, showing how these philosophical dimensions have practical implications. I conclude with a discussion of the educational benefits for recognising the philosophy in microbiology. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Compressor Stability and Control: Review and Practical Implications

DTIC Science & Technology

2001-06-01

and control technology is being built. 1. INTRODUCTION The concept of a ’smart engine ’, which utilizes augmented sensing, actuation, and computational...research mix. Concentration has been primarily on combustion control, and on stability and control of compressors and compression systems. The latter...at least a functional description of the processes at work during stall inception can effective control Paper presented at the RTO A VT Symposium on

Psychosocial treatments for schizophrenia.

PubMed

Mueser, Kim T; Deavers, Frances; Penn, David L; Cassisi, Jeffrey E

2013-01-01

The current state of the literature regarding psychosocial treatments for schizophrenia is reviewed within the frameworks of the recovery model of mental health and the expanded stress-vulnerability model. Interventions targeting specific domains of functioning, age groups, stages of illness, and human service system gaps are classified as evidence-based practices or promising practices according to the extent to which their efficacy is currently supported by meta-analyses and individual randomized controlled trials (RCTs). Evidence-based practices include assertive community treatment (ACT), cognitive behavior therapy (CBT) for psychosis, cognitive remediation, family psychoeducation, illness self-management training, social skills training, and supported employment. Promising practices include cognitive adaptive therapy, CBT for posttraumatic stress disorder, first-episode psychosis intervention, healthy lifestyle interventions, integrated treatment for co-occurring disorders, interventions targeting older individuals, peer support services, physical disease management, prodromal stage intervention, social cognition training, supported education, and supported housing. Implications and future directions are discussed.

Patient Perspectives on the Learning Health System: The Importance of Trust and Shared Decision Making.

PubMed

Kelley, Maureen; James, Cyan; Alessi Kraft, Stephanie; Korngiebel, Diane; Wijangco, Isabelle; Rosenthal, Emily; Joffe, Steven; Cho, Mildred K; Wilfond, Benjamin; Lee, Sandra Soo-Jin

2015-01-01

We conducted focus groups to assess patient attitudes toward research on medical practices in the context of usual care. We found that patients focus on the implications of this research for their relationship with and trust in their physicians. Patients view research on medical practices as separate from usual care, demanding dissemination of information and in most cases, individual consent. Patients expect information about this research to come through their physician, whom they rely on to identify and filter associated risks. In general, patients support this research, but worry that participation in research involving randomization may undermine individualized care that acknowledges their unique medical histories. These findings suggest the need for public education on variation in practice among physicians and the need for a collaborative approach to the governance of research on medical practices that addresses core values of trust, transparency, and partnership.

Internet use by physicians and its impact on medical practice-an exploratory study.

PubMed

Kwon, Ik-Whan G; Xie, Henry Yu

2003-01-01

Internet use by physicians has played a vital role in medical practices for many years. A number of related studies have emerged to examine the impact of Internet use on medical practice. However, there is yet to be a comprehensive study on the impact of Internet use by physicians on their medical practice. This study examines a preliminary step to explore the major implications of physicians' Internet use on the traditional areas, such as health education and learning, physician-patient relationship, and medical marketing. Barriers to Internet use are also investigated. Implication of use of the Internet in the medical practice and limitations of this study are discussed as well.

Globalisation, economics and professionalism.

PubMed

Tan, Chay-Hoon; Macneill, Paul

2015-01-01

This paper presents an analysis of the effect of globalisation and attendant economic factors on the global practice of medicine, medical education, medical ethics and medical professionalism. The authors discuss the implications of these trends, citing case scenarios in the healthcare insurance, medical tourism, pharmaceutical industries, and the educational systems as well as in clinical practice, to illustrate the impact of globalisation and economics on professionalism. Globalisation, on the one hand, offers benefits for the global practice of medicine and for medical education. On the other, globalisation can have negative effects, particularly when the main driver is to maximise profitability across national boundaries rather than concern for human well-being. Appraising the effect of globalisation on professionalism involves assessing its effects at the intrapersonal, interpersonal, and institutional levels, and its effect on society at large.

Practice makes transfer of motor skills imperfect.

PubMed

Boutin, Arnaud; Badets, Arnaud; Salesse, Robin N; Fries, Udo; Panzer, Stefan; Blandin, Yannick

2012-09-01

We investigated the practice-effects on motor skill transfer and the associated representational memory changes that occur during the within-practice and between-practice phases. In two experiments, participants produced extension-flexion movements with their dominant right arm for a limited or prolonged practice session arranged in either a single- or multi-session format. We tested the ability of participants to transfer the original pattern (extrinsic transformation) or the mirrored one (intrinsic transformation) to the non-dominant left arm, 10 min and 24 h after the practice sessions. Results showed that practice induces rapid motor skill improvements that are non-transferable irrespective of the amount of acquisition trials. Furthermore, the extrinsic component of the skill develops early and remains the dominant coding system during practice. Conversely, we found distinct between-practice memory changes: a limited practice induces an off-line development of the extrinsic component, whereas a prolonged practice session subserves the off-line development of the intrinsic component (experiment 2). We provided further evidence that the long-term representation of the motor skill also depends on the nature of the practice session itself: the parsing of practice into multiple sessions narrows the effector-transfer capacities in comparison to a single session (experiment 1). These findings yield theoretical and practical implications that are discussed in the context of recent motor skill learning models.

Examining the impact of succession management practices on organizational performance: A national study of U.S. hospitals.

PubMed

Groves, Kevin S

2017-08-03

Spearheaded by the industry's transition from volume- to value-based care, the health care reform movement has spurred both unprecedented challenges and opportunities for developing more effective and sustainable health care delivery organizations. Whereas the formidable challenges of leading hospitals and health systems have been widely discussed, including reimbursement degradation, the rapidly aging workforce, and the imminent wave of executive retirements, the opportunity to leverage succession management and talent development capabilities to overcome these challenges has been largely overlooked. To address this key research and practice need, this multiphase study develops and validates an assessment of succession management practices for health care organizations. Utilizing data collected from two national samples of hospital organizations, the results provide a 32-item succession management assessment comprising seven distinct sets of succession management practices. The results indicate that succession management practices are strongly associated with multiple hospital performance metrics, including patient satisfaction and Medicare Spending per Beneficiary, leadership bench strength, and internal/external placement rate for executive level positions. The author concludes this article with a discussion of several practical implications for health care executives and boards, including employing the succession management assessment for diagnosing development opportunities, benchmarking succession planning and talent development practices against similar hospitals or health systems, and elevating the profile of succession management as a strategic priority in today's increasingly uncertain health care landscape.

Negotiating markets for health: an exploration of physicians' engagement in dual practice in three African capital cities.

PubMed

Russo, Giuliano; McPake, Barbara; Fronteira, Inês; Ferrinho, Paulo

2014-09-01

Scarce evidence exists on the features, determinants and implications of physicians' dual practice, especially in resource-poor settings. This study considered dual practice patterns in three African cities and the respective markets for physician services, with the objective of understanding the influence of local determinants on the practice. Forty-eight semi-structured qualitative interviews were conducted in the three cities to understand features of the practice and the respective markets. A survey was carried out in a sample of 331 physicians to explore their characteristics and decisions to work in public and private sectors. Descriptive analysis and inferential statistics were employed to explore differences in physicians' engagement in dual practice across the three locations. Different forms of dual practice were found to exist in the three cities, with public physicians engaging in private practice outside but also inside public facilities, in regulated as well as unregulated ways. Thirty-four per cent of the respondents indicated that they worked in public practice only, and 11% that they engaged exclusively in private practice. The remaining 55% indicated that they engaged in some form of dual practice, 31% 'outside' public facilities, 8% 'inside' and 16% both 'outside' and 'inside'. Local health system governance and the structure of the markets for physician services were linked to the forms of dual practice found in each location, and to their prevalence. Our analysis suggests that physicians' decisions to engage in dual practice are influenced by supply and demand factors, but also by how clearly separated public and private markets are. Where it is possible to provide little-regulated services within public infrastructure, less incentive seems to exist to engage in the formal private sector, with equity and efficiency implications for service provision. The study shows the value of analysing health markets to understand physicians' engagement in professional activities, and contributes to an evidence base for its regulation. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013.

Achieving excellence in community health centers: implications for health reform.

PubMed

Gurewich, Deborah; Capitman, John; Sirkin, Jenna; Traje, Diana

2012-02-01

Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs. Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance. Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity. In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.

Achieving best outcomes of patients with cardiovascular diseases in China by enhancing the quality of medical care and establishing a learning health care system

PubMed Central

Jiang, Lixin; Krumholz, Harlan M; Li, Xi; Li, Jing; Hu, Shengshou

2016-01-01

Summary China faces the immediate need of addressing the rapidly growing population with cardiovascular disease (CVD) events and the increasing numbers who are living with CVD. Despite progress in increasing access to services, China faces the dual challenge of addressing gaps in quality of care and producing more evidence to support clinical practice. In this article, we address opportunities to strengthen performance measurement, programs to improve quality of care and national capacity to produce high impact knowledge for clinical practice. Moreover, we propose recommendations, with implications for other conditions, for how China can immediately leverage its Hospital Quality Monitoring System and other existing national platforms to evaluate and improve performance, as well as generate new knowledge to inform clinical decisions and national policies. PMID:26466053

Rehabilitation as "destination triage": a critical examination of discharge planning.

PubMed

Durocher, Evelyne; Gibson, Barbara E; Rappolt, Susan

2017-06-01

In this paper we examine how the intersection of various social and political influences shapes discharge planning and rehabilitation practices in ways that may not meet the espoused aims of rehabilitation programs or the preferences of older adults and their families. Taking a critical bioethics perspective, we used microethnographic case study methods to examine discharge-planning processes in a well-established older adult inpatient rehabilitation setting in Canada. The data included observations of discharge-planning family conferences and semi-structured interviews conducted with older adults facing discharge, their family members and rehabilitation professionals involved in discharge planning. From the time of admission, a contextual push to focus on discharge superseded program aims of providing interventions to increase older adults' functional capabilities. Professionals' primary commitment to safety limited consideration of discharge options and resulted in costly and potentially unnecessary recommendations for 24-hour care. The resulting "rehabilitation" stay was more akin to an extended process of "destination triage" biased towards the promotion of physical safety than optimizing functioning. The resulting reduction of rehabilitation into "destination triage" has significant social, financial and occupational implications for older adults and their families, and broader implications for healthcare services and overarching healthcare systems. Implications for Rehabilitation Current trends promoting consideration of discharge planning from the point of admission and prioritizing physical safety are shifting the focus of rehabilitation away from interventions to maximize recovery of function, which are the stated aims of rehabilitation. Such practices furthermore promote assessments to determine prognosis early in the rehabilitation stay when accurate prognosis is difficult, which can lead to overly conservative recommendations for discharge from rehabilitation services, thus further negating the impact of rehabilitation. Further work is required to examine the social, occupational and functional implications of superseding rehabilitation interventions to maximize capabilities with practices that prioritize safety over quality of life for older adults and their family members.

Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice

PubMed Central

Patterson, Sue; Freshwater, Kathleen; Goulter, Nicole; Ewing, Julie; Leamon, Boyd; Choudhary, Anand; Moudgil, Vikas; Emmerson, Brett

2016-01-01

Aims and method To describe and explain psychiatrists' responses to metabolic abnormalities identified during screening. We carried out an audit of clinical records to assess rates of monitoring and follow-up practice. Semi-structured interviews with 36 psychiatrists followed by descriptive and thematic analyses were conducted. Results Metabolic abnormalities were identified in 76% of eligible patients screened. Follow-up, recorded for 59%, was variable but more likely with four or more abnormalities. Psychiatrists endorse guidelines but ambivalence about responsibility, professional norms, resource constraints and skills deficits as well as patient factors influences practice. Therapeutic optimism and desire to be a ‘good doctor’ supported comprehensive follow-up. Clinical implications Psychiatrists are willing to attend to physical healthcare, and obstacles to recommended practice are surmountable. Psychiatrists seek consensus among stakeholders about responsibilities and a systemic approach addressing the social determinants of health inequities. Understanding patients' expectations is critical to promoting best practice. PMID:27752343

Some Implications for Moral Education of the Confucian Principle of Harmony: Learning from Sustainability Education Practice in China

ERIC Educational Resources Information Center

Feng, Ling; Newton, Derek

2012-01-01

The concept of "harmony" was taught by the Chinese sages as the practice of acceptance, tolerance, mutual respect, equality and patience, and is now given great importance by the Chinese government in its attempts to promote the stability and sustainability of the country. The concept could have significant implications for moral…

How the Government Defines "Rural" Has Implications for Education Policies and Practices. Issues & Answers. REL 2007-010

ERIC Educational Resources Information Center

Arnold, Michael L.; Biscoe, Belinda; Farmer, Thomas W.; Robertson, Dylan L.; Shapley, Kathy L.

2007-01-01

Clearly defining what rural means has tangible implications for public policies and practices in education, from establishing resource needs to achieving the goals of No Child Left Behind in rural areas. The word "rural" has many meanings. It has been defined in reference to population density, geographic features, and level of economic…

In the "Best Interest" of the Student: Perceptions and Implications for Leadership Practices in Secondary Schools in Kenya

ERIC Educational Resources Information Center

Jwan, Julius Ouma

2011-01-01

This paper discusses the contrasting views of what constitutes the "best interests" of students and the implications of such perceptions for leadership practices in secondary schools in Kenya. The paper is based on a study conducted to establish the students', teachers' and principals' perceptions of democratic school leadership--in line…

When Duty Calls: The Implications of Social Justice Work for Policy, Education, and Practice in the Mental Health Professions. Reactions

ERIC Educational Resources Information Center

Kiselica, Mark S.

2004-01-01

In reaction to the pioneering model of social justice education in counseling psychology described by Goodman, Liang, Helms, Latta, Sparks, and Weintraub, several implications of social justice work for policy, education, and practice in the mental health professions are suggested. Specifically, it is recommended that mental health scientists and…

Kindergartners' Mental Models of the Day and Night Cycle: Implications for Instructional Practices in Early Childhood Classrooms

ERIC Educational Resources Information Center

Saçkes, Mesut

2015-01-01

This study aims to examine kindergarten children's mental models of the day and night cycle and provide implications for pedagogical practices targeting space science concepts in early childhood classrooms. A total of 46 kindergartners participated in the study, their age ranging from 60 to 75 months, including 22 boys and 24 girls.…

"Forest Grove School District v. T.A." Supreme Court Case: Implications for School Psychology Practice

ERIC Educational Resources Information Center

Dixon, Shauna G.; Eusebio, Eleazar C.; Turton, William J.; Wright, Peter W. D.; Hale, James B.

2011-01-01

The 2009 "Forest Grove School District v. T.A." United States Supreme Court case could have significant implications for school psychology practice. The Court ruled that the parents of a student with a disability were entitled to private school tuition reimbursement even though T.A. had not been identified with a disability or previously…

Healthcare reform: implications for knowledge translation in primary care

PubMed Central

2013-01-01

Background The primary care sector represents the linchpin of many health systems. However, the translation of evidence-based practices into patient care can be difficult, particularly during healthcare reform. This can have significant implications for patients, their communities, and the public purse. This is aptly demonstrated in the area of sexual health. The aim of this paper is to determine what works to facilitate evidence-based sexual healthcare within the primary care sector. Methods 431 clinicians (214 general practitioners and 217 practice nurses) in New South Wales, Australia, were surveyed about their awareness, their use, the perceived impact, and the factors that hindered the use of six resources to promote sexual healthcare. Descriptive statistics were calculated from the responses to the closed survey items, while responses to open-ended item were thematically analyzed. Results All six resources were reported to improve the delivery of evidence-based sexual healthcare. Two resources – both double-sided A4-placards – had the greatest reach and use. Barriers that hindered resource-use included limited time, limited perceived need, and limited access to, or familiarity with the resources. Furthermore, the reorganization of the primary care sector and the removal of particular medical benefits scheme items may have hampered clinician capacity to translate evidence-based practices into patient care. Conclusions Findings reveal: (1) the translation of evidence-based practices into patient care is viable despite reform; (2) the potential value of a multi-modal approach; (3) the dissemination of relatively inexpensive resources might influence clinical practices; and (4) reforms to governance and/or funding arrangements may widen the void between evidence-based practices and patient care. PMID:24274773

Connectivity as a multiple: In, with and as "nature".

PubMed

Hodgetts, Timothy

2018-03-01

Connectivity is a central concept in contemporary geographies of nature, but the concept is often understood and utilised in plural ways. This is problematic because of the separation, rather than the confusion, of these different approaches. While the various understandings of connectivity are rarely considered as working together, the connections between them have significant implications. This paper thus proposes re-thinking connectivity as a "multiple". It develops a taxonomy of existing connectivity concepts from the fields of biogeography and landscape ecology, conservation biology, socio-economic systems theory, political ecology and more-than-human geography. It then considers how these various understandings might be re-thought not as separate concerns, but (following Annemarie Mol) as "more than one, but less than many". The implications of using the connectivity multiple as an analytic for understanding conservation practices are demonstrated through considering the creation of wildlife corridors in conservation practice. The multiple does not just serve to highlight the practical and theoretical linkages between ecological theories, social inequities and affectual relationships in more-than-human worlds. It is also suggestive of a normative approach to environmental management that does not give temporal priority to biological theories, but considers these as always already situated in these social, often unequal, always more-than-human ecologies.

Heat transfer in the coolant channel of a heat-exchanger system based on fluctuation theories

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

Diaz-Guilera, A.; Rodriguez, M.A.; Rubi, J.M.

1988-11-01

We present a model to study the heat transfer in the coolant channel of a heat-exchanger system. Such a model introduces thermal fluctuations as well as external noises due to different mechanisms of heat interchange. A unified treatment of both kinds of noise is carried out. The stationary mean value of the channel temperature is studied, obtaining effective transport coefficients which affect the stability of the system. The effects of the different noises are visualized in a correlation length obtained from the temperature correlation function. The model has practical implications in the field of nuclear-reactor noise theory.

An augmented reality (AR)-based vocational task prompting system for people with cognitive impairments.

PubMed

Chang, Yao-Jen; Kang, Ya-Shu; Huang, Po-Chiao

2013-10-01

This study assessed the possibility of training three people with cognitive impairments using an augmented reality (AR)-based task prompting system. Using AR technology, the system provided picture cues, identified incorrect task steps on the fly, and helped users make corrections. Based on a multiple baseline design, the data showed that the three participants considerably increased their target response, which improved their vocational job skills during the intervention phases and enabled them to maintain the acquired job skills after intervention. The practical and developmental implications of the results are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sustainable urban systems: Co-design and framing for transformation.

PubMed

Webb, Robert; Bai, Xuemei; Smith, Mark Stafford; Costanza, Robert; Griggs, David; Moglia, Magnus; Neuman, Michael; Newman, Peter; Newton, Peter; Norman, Barbara; Ryan, Chris; Schandl, Heinz; Steffen, Will; Tapper, Nigel; Thomson, Giles

2018-02-01

Rapid urbanisation generates risks and opportunities for sustainable development. Urban policy and decision makers are challenged by the complexity of cities as social-ecological-technical systems. Consequently there is an increasing need for collaborative knowledge development that supports a whole-of-system view, and transformational change at multiple scales. Such holistic urban approaches are rare in practice. A co-design process involving researchers, practitioners and other stakeholders, has progressed such an approach in the Australian context, aiming to also contribute to international knowledge development and sharing. This process has generated three outputs: (1) a shared framework to support more systematic knowledge development and use, (2) identification of barriers that create a gap between stated urban goals and actual practice, and (3) identification of strategic focal areas to address this gap. Developing integrated strategies at broader urban scales is seen as the most pressing need. The knowledge framework adopts a systems perspective that incorporates the many urban trade-offs and synergies revealed by a systems view. Broader implications are drawn for policy and decision makers, for researchers and for a shared forward agenda.

Nurses' Satisfaction With Using Nursing Information Systems From Technology Acceptance Model and Information Systems Success Model Perspectives: A Reductionist Approach.

PubMed

Lin, Hsien-Cheng

2017-02-01

Nursing information systems can enhance nursing practice and the efficiency and quality of administrative affairs within the nursing department and thus have been widely considered for implementation. Close alignment of human-computer interaction can advance optimal clinical performance with the use of information systems. However, a lack of introduction of the concept of alignment between users' perceptions and technological functionality has caused dissatisfaction, as shown in the existing literature. This study provides insight into the alignment between nurses' perceptions and how technological functionality affects their satisfaction with Nursing Information System use through a reductionist perspective of alignment. This cross-sectional study collected data from 531 registered nurses in Taiwan. The results indicated that "perceived usefulness in system quality alignment," "perceived usefulness in information quality alignment," "perceived ease of use in system quality alignment," "perceived ease of use in information quality alignment," and "perceived ease of use in service quality alignment" have significantly affected nurses' satisfaction with Nursing Information System use. However, "perceived usefulness in service quality alignment" had no significant effect on nurses' satisfaction. This study also provides some meaningful implications for theoretical and practical aspects of design.

Does capitation affect the delivery of oral healthcare and access to services? Evidence from a pilot contact in Northern Ireland.

PubMed

Hill, Harry; Birch, Stephen; Tickle, Martin; McDonald, Ruth; Donaldson, Michael; O'Carolan, Donncha; Brocklehurst, Paul

2017-03-06

In May 2009, the Northern Ireland government introduced General Dental Services (GDS) contracts based on capitation in dental practices newly set up by a corporate dental provider to promote access to dental care in populations that had previously struggled to secure service provision. Dental service provision forms an important component of general health services for the population, but the implications of health system financing on care delivered and the financial cost of services has received relatively little attention in the research literature. The aim of this study is to evaluate the policy effect capitation payment in recently started corporate practices had on the delivery of primary oral healthcare in Northern Ireland and access to services. We analysed the policy initiative in Northern Ireland as a natural experiment to find the impact on healthcare delivery of the newly set up corporate practices that use a prospective capitation system to remunerate primary care dentists. Data was collected from GDS claim forms submitted to the Business Services Organisation (BSO) between April 2011 and October 2014. Health and Social Care Board (HSCB) practices operating within a capitation system were matched to a control group, who were remunerated using a retrospective fee-for-service system. No evidence of patient selection was found in the HSCB practices set up by a corporate provider and operated under capitation. However, patients were less likely to visit the dentist and received less treatment when they did attend, compared to those belonging to the control group (P < 0.05). The extent of preventive activity offered and the patient payment charge revenue did not differ between the two practice groups. Although remunerating NHS primary care dentists in newly set up corporate practices using a prospective capitation system managed costs within healthcare, there is evidence that this policy may have reduced access to care of registered patients.

Four Levels of Moral Conflict in ISD

NASA Astrophysics Data System (ADS)

Vartiainen, Tero

This study introduces a literature-based classification of moral conflicts in information systems development (ISD). The classification describes what moral conflicts an IS professional confronts in ISD as a whole and includes intentional, functional, managerial, and societal levels. The internal structure of moral conflicts is exemplified by means of a philosophical and a business ethics theory. The limitations of the study are considered and practical implications for the teaching of computer ethics are discussed.

Results of SEI Independent Research and Development Projects

DTIC Science & Technology

2011-02-01

ft’s Bit- poten- hout a ut de- r for CMU/SEI-2011-TR-002 | 8 more systems to install them. The implication to the Department of Defense and...Computing, June 2011. 2.7.1 Bibliography Challener, David; Yoder, K.; Catherman, R .; Saford, D.; & Van Doom, L. A Practical Guide to Trusted...number of publications and presentations: Brown, N.; Nord, R .; & Ozkaya, I. “Enabling Agility Through Architecture.” CrossTalk 23, 6 (November

Using systems thinking to support clinical system transformation.

PubMed

Best, Allan; Berland, Alex; Herbert, Carol; Bitz, Jennifer; van Dijk, Marlies W; Krause, Christina; Cochrane, Douglas; Noel, Kevin; Marsden, Julian; McKeown, Shari; Millar, John

2016-05-16

Purpose - The British Columbia Ministry of Health's Clinical Care Management initiative was used as a case study to better understand large-scale change (LSC) within BC's health system. Using a complex system framework, the purpose of this paper is to examine mechanisms that enable and constrain the implementation of clinical guidelines across various clinical settings. Design/methodology/approach - Researchers applied a general model of complex adaptive systems plus two specific conceptual frameworks (realist evaluation and system dynamics mapping) to define and study enablers and constraints. Focus group sessions and interviews with clinicians, executives, managers and board members were validated through an online survey. Findings - The functional themes for managing large-scale clinical change included: creating a context to prepare clinicians for health system transformation initiatives; promoting shared clinical leadership; strengthening knowledge management, strategic communications and opportunities for networking; and clearing pathways through the complexity of a multilevel, dynamic system. Research limitations/implications - The action research methodology was designed to guide continuing improvement of implementation. A sample of initiatives was selected; it was not intended to compare and contrast facilitators and barriers across all initiatives and regions. Similarly, evaluating the results or process of guideline implementation was outside the scope; the methods were designed to enable conversations at multiple levels - policy, management and practice - about how to improve implementation. The study is best seen as a case study of LSC, offering a possible model for replication by others and a tool to shape further dialogue. Practical implications - Recommended action-oriented strategies included engaging local champions; supporting local adaptation for implementation of clinical guidelines; strengthening local teams to guide implementation; reducing change fatigue; ensuring adequate resources; providing consistent communication especially for front-line care providers; and supporting local teams to demonstrate the clinical value of the guidelines to their colleagues. Originality/value - Bringing a complex systems perspective to clinical guideline implementation resulted in a clear understanding of the challenges involved in LSC.

Decline in Soluble Phosphorus Mobility from Land-Applied Dairy Manure - Modeling and Practical Applications

NASA Astrophysics Data System (ADS)

Archibald, J. A.; Walter, M. T.; Peterson, M.; Richards, B. K.; Giri, S. K.

2014-12-01

Non-point source transport of soluble-reactive phosphorus (SRP) from agricultural systems to freshwater ecosystems is a significant water quality concern. Although farmers are encouraged to avoid manure or fertilizer application before runoff events, the implications of these management choices remain largely unquantified. We conducted soil box experiments to test how manure application timing and temperature or moisture conditions impact SRP concentration in runoff. We found that SRP concentrations dropped off exponentially over time, and that higher temperatures accelerated the decline in SRP in overland runoff over time. During the first runoff events after manure application, infiltration depth prior to runoff was not a primary driver of SRP concentrations. This research has implications for incorporating manure spreading timing into watershed models.

Local IRBs vs. federal agencies: shifting dynamics, systems, and relationships.

PubMed

Klitzman, Robert L

2012-07-01

How IRBs relate to federal agencies, and the implications of these relationships, have received little, if any, systematic study. I interviewed 46 IRB chairs, directors, administrators, and members, contacting the leadership of 60 U.S. IRBs (every fourth one in the list of the top 240 institutions by NIH funding), interviewing IRB leaders from 34 (response rate=55%). IRBs describe complex direct and indirect relationships with federal agencies that affect IRBs through audits, guidance documents, and other communications, and can generate problems and challenges. Researchers often blame IRBs for frustrations, but IRBs often serve as the "local face" of federal regulations and agencies and are "stuck in the middle." These data have critical implications for policy, practice, and research.

Decoding the Disciplines as a Hermeneutic Practice

ERIC Educational Resources Information Center

Yeo, Michelle

2017-01-01

This chapter argues that expert practice is an inquiry that surfaces a hermeneutic relationship between theory, practice, and the world, with implications for new lines of questioning in the Decoding interview.

Analysing reduced tillage practices within a bio-economic modelling framework.

PubMed

Townsend, Toby J; Ramsden, Stephen J; Wilson, Paul

2016-07-01

Sustainable intensification of agricultural production systems will require changes in farm practice. Within arable cropping systems, reducing the intensity of tillage practices (e.g. reduced tillage) potentially offers one such sustainable intensification approach. Previous researchers have tended to examine the impact of reduced tillage on specific factors such as yield or weed burden, whilst, by definition, sustainable intensification necessitates a system-based analysis approach. Drawing upon a bio-economic optimisation model, 'MEETA', we quantify trade-off implications between potential yield reductions, reduced cultivation costs and increased crop protection costs. We extend the MEETA model to quantify farm-level net margin, in addition to quantifying farm-level gross margin, net energy, and greenhouse gas emissions. For the lowest intensity tillage system, zero tillage, results demonstrate financial benefits over a conventional tillage system even when the zero tillage system includes yield penalties of 0-14.2% (across all crops). Average yield reductions from zero tillage literature range from 0 to 8.5%, demonstrating that reduced tillage offers a realistic and attainable sustainable intensification intervention, given the financial and environmental benefits, albeit that yield reductions will require more land to compensate for loss of calories produced, negating environmental benefits observed at farm-level. However, increasing uptake of reduced tillage from current levels will probably require policy intervention; an extension of the recent changes to the CAP ('Greening') provides an opportunity to do this.

Measuring healthcare productivity - from unit to system level.

PubMed

Kämäräinen, Vesa Johannes; Peltokorpi, Antti; Torkki, Paulus; Tallbacka, Kaj

2016-04-18

Purpose - Healthcare productivity is a growing issue in most Western countries where healthcare expenditure is rapidly increasing. Therefore, accurate productivity metrics are essential to avoid sub-optimization within a healthcare system. The purpose of this paper is to focus on healthcare production system productivity measurement. Design/methodology/approach - Traditionally, healthcare productivity has been studied and measured independently at the unit, organization and system level. Suggesting that productivity measurement should be done in different levels, while simultaneously linking productivity measurement to incentives, this study presents the challenges of productivity measurement at the different levels. The study introduces different methods to measure productivity in healthcare. In addition, it provides background information on the methods used to measure productivity and the parameters used in these methods. A pilot investigation of productivity measurement is used to illustrate the challenges of measurement, to test the developed measures and to prove the practical information for managers. Findings - The study introduces different approaches and methods to measure productivity in healthcare. Practical implications - A pilot investigation of productivity measurement is used to illustrate the challenges of measurement, to test the developed measures and to prove the practical benefits for managers. Originality/value - The authors focus on the measurement of the whole healthcare production system and try to avoid sub-optimization. Additionally considering an individual patient approach, productivity measurement is examined at the unit level, the organizational level and the system level.

Beyond Positivism: Understanding and addressing childhood obesity disparities through a Critical Theory perspective

PubMed Central

Schroeder, Krista; Kulage, Kristine M.; Lucero, Robert

2016-01-01

Purpose We apply Critical Theory to examine menu labeling with the aim of uncovering important implications for nursing practice, research, and policy. Conclusions Our critical analysis uncovers barriers to menu labeling's effectiveness, particularly for vulnerable populations. Nurses must work to minimize the impact of these barriers and optimize the effectiveness of menu labeling, in order to strengthen the fight against obesity. Practice implications We suggest changes, guided by this critical analysis,that can be implemented by nurses working in clinical practice, research, and policy. PMID:26112774

The down syndrome behavioral phenotype: implications for practice and research in occupational therapy.

PubMed

Daunhauer, Lisa A; Fidler, Deborah J

2011-01-01

ABSTRACT Down syndrome (DS) is the most common chromosomal cause of intellectual disability. The genetic causes of DS are associated with characteristic outcomes, such as relative strengths in visual-spatial skills and relative challenges in motor planning. This profile of outcomes, called the DS behavioral phenotype, may be a critical tool for intervention planning and research in this population. In this article, aspects of the DS behavioral phenotype potentially relevant to occupational therapy practice are reviewed. Implications and challenges for etiology-informed research and practice are discussed.

Practical and Scholarly Implications of Information Behaviour Research: A Pilot Study of Research Literature

ERIC Educational Resources Information Center

Koh, Kyungwon; Rubenstein, Ellen; White, Kelvin

2015-01-01

Introduction: This pilot study examined how current information behaviour research addresses the implications and potential impacts of its findings. The goal was to understand what implications and contributions the field has made and how effectively authors communicate implications of their findings. Methods: We conducted a content analysis of 30…

A Neurophysiological and Neuropsychological Consideration of Mindful Movement: Clinical and Research Implications

PubMed Central

Russell, Tamara Anne; Arcuri, Silvia Maria

2015-01-01

In this article, we present ideas related to three key aspects of mindfulness training: the regulation of attention via noradrenaline, the importance of working memory and its various components (particularly the central executive and episodic buffer), and the relationship of both of these to mind-wandering. These same aspects of mindfulness training are also involved in the preparation and execution of movement and implicated in the pathophysiology of psychosis. We argue that by moving in a mindful way, there may be an additive effect of training as the two elements of the practice (mindfulness and movement) independently, and perhaps synergistically, engage common underlying systems (the default mode network). We discuss how working with mindful movement may be one route to mindfulness training for individuals who would struggle to sit still to complete the more commonly taught mindfulness practices. Drawing on our clinical experience working with individuals with severe and enduring mental health conditions, we show the real world application of these ideas and how they can be used to help those who are suffering and for whom current treatments are still far from adequate. PMID:26074800

Threat Assessment and Targeted Violence at Institutions of Higher Education: Implications for Policy and Practice Including Unique Considerations for Community Colleges

ERIC Educational Resources Information Center

Bennett, Laura; Bates, Michael

2015-01-01

This article provides an overview of the research on targeted violence, including campus violence, and the implications for policy and practice at institutions of higher education. Unique challenges of threat assessment in the community college setting are explored, and an overview of an effective threat assessment policy and team at William…

Integrating Behavioral Health into Pediatric Primary Care: Implications for Provider Time and Cost.

PubMed

Gouge, Natasha; Polaha, Jodi; Rogers, Rachel; Harden, Amy

2016-12-01

Integrating a behavioral health consultant (BHC) into primary care is associated with improved patient outcomes, fewer medical visits, and increased provider satisfaction; however, few studies have evaluated the feasibility of this model from an operations perspective. Specifically, time and cost have been identified as barriers to implementation. Our study aimed to examine time spent, patient volume, and revenue generated during days when the on-site BHC was available compared with days when the consultant was not. Data were collected across a 10-day period when a BHC provided services and 10 days when she was not available. Data included time stamps of patient direct care; providers' direct reports of problems raised; and a review of medical and administrative records, including billing codes and reimbursement. This study took place in a rural, stand-alone private pediatric primary care practice. The participants were five pediatric primary care providers (PCPs; two doctors of medicine, 1 doctor of osteopathy, 2 nurse practitioners) and two supervised doctoral students in psychology (BHCs). Pediatric patients (N = 668) and their parents also participated. On days when a BHC was present, medical providers spent 2 fewer minutes on average for every patient seen, saw 42% more patients, and collected $1142 more revenue than on days when no consultant was present. The time savings demonstrated on days when the consultant was available point to the efficiency and potential financial viability of this model. These results have important implications for the feasibility of hiring behavioral health professionals in a fee-for-service system. They have equally useful implications for the utility of moving to a bundled system of care in which collaborative practice is valued.

Manifestations of metacognitive activity during the collaborative planning of chemistry practical investigations

NASA Astrophysics Data System (ADS)

Mathabathe, Kgadi Clarrie; Potgieter, Marietjie

2017-07-01

This paper elaborates a process followed to characterise manifestations of cognitive regulation during the collaborative planning of chemistry practical investigations. Metacognitive activity was defined as the demonstration of planning, monitoring, control and evaluation of cognitive activities by students while carrying out the chemistry task. Inherent in collaborative learning is the social aspect of metacognition, which in this study was evidenced in social cognitive regulation (notably of intra- and interpersonal metacognitive regulations) as groups of students went about planning their practical investigations. Discussions of two of the learning groups (n = 4; n = 3) as they planned the extended practical investigation were recorded, transcribed and analysed for indicators of any inherent metacognitive activity. The process of characterising the manifestations of metacognition resulted in the development of a coding system which specifies not only the regulatory strategies at play but the type of regulation (self or other), the area of regulation (cognition, task performance or behaviour) as well as the depth of regulatory contributions (high or low). The fine-grained coding system allowed for a finer theoretical elucidation of the social nature of metacognition. The implications of this study for metacognition and chemistry education research are highlighted.

Neuroethics and fMRI: Mapping a Fledgling Relationship

PubMed Central

Garnett, Alex; Whiteley, Louise; Piwowar, Heather; Rasmussen, Edie; Illes, Judy

2011-01-01

Human functional magnetic resonance imaging (fMRI) informs the understanding of the neural basis of mental function and is a key domain of ethical enquiry. It raises questions about the practice and implications of research, and reflexively informs ethics through the empirical investigation of moral judgments. It is at the centre of debate surrounding the importance of neuroscience findings for concepts such as personhood and free will, and the extent of their practical consequences. Here, we map the landscape of fMRI and neuroethics, using citation analysis to uncover salient topics. We find that this landscape is sparsely populated: despite previous calls for debate, there are few articles that discuss both fMRI and ethical, legal, or social implications (ELSI), and even fewer direct citations between the two literatures. Recognizing that practical barriers exist to integrating ELSI discussion into the research literature, we argue nonetheless that the ethical challenges of fMRI, and controversy over its conceptual and practical implications, make this essential. PMID:21526115

Practices and health perception of preparation of Brassica vegetables: translating survey data to technological and nutritional implications.

PubMed

Nugrahedi, Probo Y; Hantoro, Inneke; Verkerk, Ruud; Dekker, Matthijs; Steenbekkers, Bea

2015-01-01

Food preparation practices are known to have large nutritional implications on the final product. This article describes survey data on preparation practices of Brassica vegetables and the translation of these data into technological and nutritional implications using knowledge on the mechanisms of changes in the content of phytochemicals. The survey on preparation practices was performed with food service establishments (n = 123) and households (n = 477) in Semarang, Indonesia, and assessed the food handlers' perception of the health benefits of these vegetables. Boiling and stir-frying are the most frequently applied techniques to prepare Brassicas. The respondents perceive that steaming, boiling, and stir-frying result in vegetables with a high health benefit. White cabbage and choysum are the most frequently prepared Brassicas. However, broccoli is perceived as the healthiest. The consequences of the various applied preparation techniques on the content of alleged health promoting phytochemicals (glucosinolates) in dishes containing Brassica vegetables are discussed.

Ideology and community social psychology: theoretical considerations and practical implications.

PubMed

Montenegro, Marisela

2002-08-01

This paper addresses the importance of the concept of ideology in community work. The implications of a Marxist approach to ideology in community practice are analyzed in terms of the concepts of problematization (P. Freire, 1979) and consciousness-raising (J. Barreiro, 1976), illustrating the point with some examples. The traditional Marxist perspective is also examined in relation to the perspectives of social constructionism (I. Ibáñez, 1996), cultural studies (A. McRobbie, 1992), post-Marxism (E. Laclau & C. Mouffe, 1985), and feminism (D. Haraway, 1991). It is argued that the concepts of hegemony and habitus (P. Bourdieu, 1985) can be useful to community social psychology theory and practice. A "situated perspective"--in which it is possible to dialogue from different "subject positions," and articulate transformation and political action--is argued. The implications of this shifting in the concept of ideology by means of theoretical developments outside social communitypsychology can help to define the external (outside) agent's position in community practice.

The Policy Implications of College and Career Assessment Findings.

ERIC Educational Resources Information Center

Lenning, Oscar T.

This paper considers social policy and institutional practice policy implications of findings reported by Ernest Pascarella and Patrick Terenzini concerning student career choice and economic benefits of college. Sixteen social policy implications are identified. These include: beating the Japanese; overcoming the "pipeline mentality"; revising…

SUBSTANCE USE SCREENING AND INTERVENTIONS IN DENTAL CLINICS: SURVEY OF PRACTICE-BASED RESEARCH NETWORK DENTISTS ON CURRENT PRACTICES, POLICIES, AND BARRIERS

PubMed Central

Wright, Shana; Matthews, Abigail G.; Rotrosen, John; Shelley, Donna; Buchholz, Matthew P.; Curro, Frederick A.

2013-01-01

Background Dental visits represent an opportunity to identify and assist patients with substance use, but little is known about how dentists are addressing tobacco, alcohol and illicit drugs. We surveyed dentists to learn about the role their practices might play in providing substance use screening and interventions. Methods A 41-item, web-based survey was distributed to all 210 dentists active in the PEARL dental practice-based research network. The questionnaire assessed clinic policies and current practices, attitudes, and perceived barriers to providing services for tobacco, alcohol, and illicit drug use. Results 143 dentists completed the survey (68% response rate). While screening was common, fewer were providing follow-up counseling or referrals for substance use. Insufficient knowledge/training was the most frequently cited barrier to intervention. Many dentists said they would offer assistance for tobacco (67%) or alcohol or illicit drugs (52%) if reimbursed; an affirmative response was more likely among those who saw publicly insured patients. Conclusions Dentists recognize the importance of screening for substance use, but lack clinical training and systems that could facilitate intervention. Practice Implications If barriers were reduced through changes in reimbursement, education, and systems-level support, our findings indicate that dentists may be willing to address substance use, including use of alcohol and illicit drugs as well as tobacco. PMID:23729460

Update in perioperative medicine: practice changing evidence published in 2016.

PubMed

Regan, Dennis W; Kashiwagi, Deanne; Dougan, Brian; Sundsted, Karna; Mauck, Karen

2017-10-01

This summary reviews 18 key articles published in 2016 which have significant practice implications for the perioperative medical care of surgical patients. Due to the multi-disciplinary nature of the practice of perioperative medicine, important new evidence is published in journals representing a variety of medical and surgical specialties. Keeping current with the evidence that drives best practice in perioperative medicine is therefore challenging. We set out to identify, critically review, and summarize key evidence which has the most potential for practice change. We integrated the new evidence into the existing body of medical knowledge and identified practical implications for real world patient care. The articles address issues related to anticoagulation, transfusion threshold, immunosuppressive medications, postoperative delirium, myocardial injury after noncardiac surgery, postoperative pain management, perioperative management of antihypertensives, perioperative fasting, and perioperative diabetic control.

What Influences Social Workers’ Attitudes Toward Working With Clients With Severe Mental Illness?

PubMed Central

Eack, Shaun M.; Newhill, Christina E.

2013-01-01

A national random survey of 2000 NASW members in post-master’s practice in mental health was conducted to investigate their experiences with and attitudes about working with individuals with severe and persistent mental illness (SPMI). Through a series of structural equation models, we examined the influence of different frustrations reported by the respondents on their attitudes toward working with individuals with SPMI. Results suggest that social workers’ attitudes toward working with individuals with SPMI are primarily influenced by their frustrations related to client behaviors and treatment issues, rather than frustrations with system related issues. Implications for social work practice and directions for future research are discussed. (105 words) PMID:24353397

The forensic evaluation and report: an agenda for research.

PubMed

Buchanan, Alec; Norko, Michael

2013-01-01

The written report is a central component of forensic psychiatric practice. In the report, an evaluator assembles and organizes data, interprets results of an evaluation, and offers an opinion in response to legal questions. The past 30 years have seen substantial development in principles and practice of forensic report writing. Drawing on recent advances in the psychiatric report, the authors explore topics including narrative, forensic ethics, coercion within the justice system, and implications of limitations on data in forming forensic opinions. They offer an analysis of unanswered questions in these areas, suggesting opportunities for further empirical study and theoretical development. This proposed agenda is important in training, in the development of policy, and in establishing professional guidelines.

Information technology from novice to expert: implementation implications.

PubMed

Courtney, Karen L; Alexander, Gregory L; Demiris, George

2008-09-01

This paper explores how the Novice-to-Expert Nursing Practice framework can illuminate the challenges of and opportunities in implementing information technology (IT), such as clinical decision support systems (CDSS), in nursing practice. IT implementation in health care is increasing; however, substantial costs and risks remain associated with these projects. The theoretical framework of Novice-to-Expert Nursing Practice was applied to current design and implementation literature for CDSS. Organizational policies and CDSS design affect implementation and user adoption. Nursing CDSS can improve the overall quality of care when designed for the appropriate end-user group and based on a knowledge base reflecting nursing expertise. Nurse administrators can positively influence CDSS function and end-user acceptance by participating in and facilitating staff nurse involvement in IT design, planning and implementation. Specific steps for nurse administrators and managers are included in this paper.

Big Data and Nursing: Implications for the Future.

PubMed

Topaz, Maxim; Pruinelli, Lisiane

2017-01-01

Big data is becoming increasingly more prevalent and it affects the way nurses learn, practice, conduct research and develop policy. The discipline of nursing needs to maximize the benefits of big data to advance the vision of promoting human health and wellbeing. However, current practicing nurses, educators and nurse scientists often lack the required skills and competencies necessary for meaningful use of big data. Some of the key skills for further development include the ability to mine narrative and structured data for new care or outcome patterns, effective data visualization techniques, and further integration of nursing sensitive data into artificial intelligence systems for better clinical decision support. We provide growth-path vision recommendations for big data competencies for practicing nurses, nurse educators, researchers, and policy makers to help prepare the next generation of nurses and improve patient outcomes trough better quality connected health.

Vaccines and Disease-Modifying Antirheumatic Drugs: Practical Implications for the Rheumatologist.

PubMed

Friedman, Marcia A; Winthrop, Kevin L

2017-02-01

Patients with rheumatoid arthritis are highly vulnerable to infections because of abnormalities in their immune system, and because of immunosuppressive effects of their medications. Vaccinations in this population are complicated by disease-modifying antirheumatic drugs, which also modulate or suppress the immune system and potentially decrease the immunogenicity and efficacy of the vaccines. We review the available data regarding the impact of rheumatoid arthritis therapy on the immunogenicity of various common vaccines. We also review rheumatoid arthritis-specific vaccination recommendations, live vaccine safety concerns, and current gaps in our understanding of these issues." Published by Elsevier Inc.

Health system factors affecting communication with pediatricians: gendered work culture in primary care.

PubMed

Lynch, Sean

2011-01-01

This qualitative study examined the roles that practice setting, education level, and gender may play in social workers' communication satisfaction with pediatricians. Taking an ethnographic approach, the researcher interviewed social workers and pediatricians who worked together to provide mental health services in primary care. The results suggested that gender at the health system level may be an issue and that gendered work culture in primary care was a factor in communication. In particular, reimbursement, an aspect of the gendered work culture, was a substantial communication barrier, and the implications for Medicaid billing are discussed.

[Social representations on HIV/AIDS among adolescentes: implications for nursing care].

PubMed

Thiengo, Maria Aparecida; de Oliveira, Denize Cristina; Rodrigues, Benedita Maria Rêgo Deusdará

2005-03-01

With the objective of discussing the implications of the social representations of HIV/AIDS for the interpersonal relations and the practices for protection among adolescents, 15 semidirective interviews were carried out with adolescents, both with and without HIV, assisted at a Hospital School in Rio de Janeiro. The software ALCESTE 4.5 was used for the data analysis. It was observed that the social representation of AIDS is structured around cognitions connected to prevention, revealing a contradiction between the knowledge and the practices reported by the group. It is suggested that the nursing practices should be directed towards the reduction of the distance between practices, representations and scientific knowledge.

Survey of handwriting instruction practices of elementary teachers and educational programs: implications for occupational therapy.

PubMed

Donica, Denise K; Larson, Michelle H; Zinn, Abbey A

2012-01-01

ABSTRACT The purpose of this study was to investigate perceptions of elementary school teachers on training in handwriting instruction received during their education, as well as their current classroom practices. The quantity and quality of training in handwriting instruction provided by baccalaureate degree-granting teacher education programs in North Carolina was also examined. An online survey was administered to each population identified to inquire about handwriting instruction practices. Results from 505 teachers and 16 professors indicated that while handwriting instruction content is valued by both teachers and professors, varied levels of training were provided to the teachers. Implications for occupational therapy practice are discussed including strategies for school-based therapists.

Waiting to see the doctor. The impact of organizational structure on medical practice.

PubMed

Wolinsky, F D; Marder, W D

1983-05-01

In this article it is assessed whether or not the scheduling and office visit queues a patient faces depend upon the organizational structure of the physician's practice (i.e., does the physician practice in the fee-for-service system or in a health maintenance organization [HMO], and if in an HMO, in what type of an HMO). Data pooled from two national studies (N = 2448) reveal two major findings. First, although scheduling queues may be predicted from the organizational structure of physicians' practices and other factors, office queues appear to be more of a random phenomenon. Second, a distinct pattern emerges among the effects of the organizational structure of physicians' practices on patient queues, including 1) physicians in solo practice offer their patients the shortest queues, 2) physicians in group model HMOs maximize scheduling queues but minimize waiting room queues, 3) patient queues for physicians practicing in IPAs are no different from those of their counterparts in group-practice fee-for-service settings, and 4) patient queues for salaried physicians practicing in a predominantly salaried environment are among the longest. The implications of these findings are discussed with special reference to extent and future studies of the effects of organizational structure on medical practice.

Low-frequency 1/f noise in graphene devices

NASA Astrophysics Data System (ADS)

Balandin, Alexander A.

2013-08-01

Low-frequency noise with a spectral density that depends inversely on frequency has been observed in a wide variety of systems including current fluctuations in resistors, intensity fluctuations in music and signals in human cognition. In electronics, the phenomenon, which is known as 1/f noise, flicker noise or excess noise, hampers the operation of numerous devices and circuits, and can be a significant impediment to the development of practical applications from new materials. Graphene offers unique opportunities for studying 1/f noise because of its two-dimensional structure and widely tunable two-dimensional carrier concentration. The creation of practical graphene-based devices will also depend on our ability to understand and control the low-frequency noise in this material system. Here, the characteristic features of 1/f noise in graphene and few-layer graphene are reviewed, and the implications of such noise for the development of graphene-based electronics including high-frequency devices and sensors are examined.

The tacit dimension of clinical judgment.

PubMed Central

Goldman, G. M.

1990-01-01

Two distinct views of the nature of clinical judgment are identified and contrasted. The dominant view that clinical judgment is a fully explicit process is compared to the relatively neglected view that tacit knowledge plays a substantial role in the clinician's mental operations. The tacit dimension of medical thinking is explored at length. The discussion suggests severe limits when applying decision analysis, expert systems, and computer-aided cost-benefit review to medicine. The goals and practices of postgraduate medical education are also examined from this perspective, as are various other implications for the clinician. The paper concludes that it is valuable to explore the nature of medical thinking in order to improve clinical practice and education. Such explorations should, however, take cognizance of the often overlooked tacit dimension of clinical judgment. Possible constraints on the medical applicability of both formal expert systems and heavily didactic instructional programs are considered. PMID:2356625

Low-frequency 1/f noise in graphene devices.

PubMed

Balandin, Alexander A

2013-08-01

Low-frequency noise with a spectral density that depends inversely on frequency has been observed in a wide variety of systems including current fluctuations in resistors, intensity fluctuations in music and signals in human cognition. In electronics, the phenomenon, which is known as 1/f noise, flicker noise or excess noise, hampers the operation of numerous devices and circuits, and can be a significant impediment to the development of practical applications from new materials. Graphene offers unique opportunities for studying 1/f noise because of its two-dimensional structure and widely tunable two-dimensional carrier concentration. The creation of practical graphene-based devices will also depend on our ability to understand and control the low-frequency noise in this material system. Here, the characteristic features of 1/f noise in graphene and few-layer graphene are reviewed, and the implications of such noise for the development of graphene-based electronics including high-frequency devices and sensors are examined.

Achieving best outcomes for patients with cardiovascular disease in China by enhancing the quality of medical care and establishing a learning health-care system.

PubMed

Jiang, Lixin; Krumholz, Harlan M; Li, Xi; Li, Jing; Hu, Shengshou

2015-10-10

China has an immediate need to address the rapidly growing population with cardiovascular disease events and the increasing number of people living with this illness. Despite progress in increasing access to services, China faces the dual challenge of addressing gaps in quality of care and producing more evidence to support clinical practice. In this Review, we address opportunities to strengthen performance measurement, programmes to improve quality of care, and national capacity to produce high-impact knowledge for clinical practice. Moreover, we propose recommendations, with implications for other diseases, for how China can immediately make use of its Hospital Quality-Monitoring System and other existing national platforms to assess and improve performance of medical care, and to generate new knowledge to inform clinical decisions and national policies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Implications of workforce and financing changes for primary care practice utilization, revenue, and cost: a generalizable mathematical model for practice management.

PubMed

Basu, Sanjay; Landon, Bruce E; Song, Zirui; Bitton, Asaf; Phillips, Russell S

2015-02-01

Primary care practice transformations require tools for policymakers and practice managers to understand the financial implications of workforce and reimbursement changes. To create a simulation model to understand how practice utilization, revenues, and expenses may change in the context of workforce and financing changes. We created a simulation model estimating clinic-level utilization, revenues, and expenses using user-specified or public input data detailing practice staffing levels, salaries and overhead expenditures, patient characteristics, clinic workload, and reimbursements. We assessed whether the model could accurately estimate clinic utilization, revenues, and expenses across the nation using labor compensation, medical expenditure, and reimbursements databases, as well as cost and revenue data from independent practices of varying size. We demonstrated the model's utility in a simulation of how utilization, revenue, and expenses would change after hiring a nurse practitioner (NP) compared with hiring a part-time physician. Modeled practice utilization and revenue closely matched independent national utilization and reimbursement data, disaggregated by patient age, sex, race/ethnicity, insurance status, and ICD diagnostic group; the model was able to estimate independent revenue and cost estimates, with highest accuracy among larger practices. A demonstration analysis revealed that hiring an NP to work independently with a subset of patients diagnosed with diabetes or hypertension could increase net revenues, if NP visits involve limited MD consultation or if NP reimbursement rates increase. A model of utilization, revenue, and expenses in primary care practices may help policymakers and managers understand the implications of workforce and financing changes.

Autoantibodies Associated With Connective Tissue Diseases: What Meaning for Clinicians?

PubMed Central

Didier, Kevin; Bolko, Loïs; Giusti, Delphine; Toquet, Segolene; Robbins, Ailsa; Antonicelli, Frank; Servettaz, Amelie

2018-01-01

Connective tissue diseases (CTDs) such as systemic lupus erythematosus, systemic sclerosis, myositis, Sjögren’s syndrome, and rheumatoid arthritis are systemic diseases which are often associated with a challenge in diagnosis. Autoantibodies (AAbs) can be detected in these diseases and help clinicians in their diagnosis. Actually, pathophysiology of these diseases is associated with the presence of antinuclear antibodies. In the last decades, many new antibodies were discovered, but their implication in pathogenesis of CTDs remains unclear. Furthermore, the classification of these AAbs is nowadays misused, as their targets can be localized outside of the nuclear compartment. Interestingly, in most cases, each antibody is associated with a specific phenotype in CTDs and therefore help in better defining either the disease subtypes or diseases activity and outcome. Because of recent progresses in their detection and in the comprehension of their pathogenesis implication in CTD-associated antibodies, clinicians should pay attention to the presence of these different AAbs to improve patient’s management. In this review, we propose to focus on the different phenotypes and features associated with each autoantibody used in clinical practice in those CTDs. PMID:29632529

Biosimilar Products in the Modern U.S. Health Care and Regulatory Landscape.

PubMed

Peterson, Jesse; Budlong, Holly; Affeldt, Tim; Skiermont, Kyle; Kyllo, Gregg; Heaton, Al

2017-12-01

Biosimilars have the potential to greatly reduce medication costs in the United States. As of July 1, 2017, 5 biosimilars have been approved by the FDA, but only 2 are available for purchase. This commentary outlines the efforts of an integrated health system to ensure biosimilar accessibility and discusses the current challenges and future implications. We highlight the implementation of a health plan policy and how a health system's formulary committee can encourage use while considering provider perceptions and operational challenges. In addition, we provide our perspective on potential implications for pricing, site of care, and pharmacy dispensing practices based on our experience with regulatory hurdles and market trends. Overall, we believe biosimilars are a good thing for the health care system, but their expected benefit may not be realized for years to come. No outside funding supported this work. Affeldt reports advisory board membership with Janssen, and Skiermont reports membership with Amgen and McKesson. The other authors have nothing to disclose. Peterson and Budlong contributed the study concept and design and wrote the manuscript. Affeldt, Skiermont, Kyllo, and Heaton reviewed and revised the manuscript.

Practical Implications of the Use of Aluminide Coatings for the Corrosion Protection of Superalloys in Gas Turbines

DTIC Science & Technology

1984-04-01

Strategic Materials Usage. Practical Implications of the Use of Aluminide Coatings for the Corrosion Protection of Superalloys in Gas Turbines. Coatings...requirements of using aluminide coatings, the processes currently commercially available, the compatabi1ity of aluminide coatings with...components, it is the intention of this paper to concentrate on those ed by reaction or diffusion type processes, In particular the aluminides

The Implications of the National Minimum Wage for Training Practices and Skill Utilisation in the United Kingdom Hospitality Industry

ERIC Educational Resources Information Center

Norris, Gill; Williams, Steve; Adam-Smith, Derek

2003-01-01

Two key issues thrown up by the 1999 introduction of the National Minimum Wage (NMW) in the United Kingdom are its likely impact on employers' training practices in low paying sectors of the economy and the implications for skills. Based on a study of the hospitality industry, this article assesses the limited significance of the differential,…

Importance of relationship quality in the success of data warehouse systems

NASA Astrophysics Data System (ADS)

Almabhouh, Alaaeddin; Saleh, Abdul; Ahmad, Azizah

2011-10-01

Increased organizational dependence on data warehouse (DW) systems drives management attention towards improving DW systems success. However, the successful implementation rate of DW systems is low and many firms did not achieve intended goals. A recent studies show that improves and evaluates DW success is one of the top concerns facing IT/DW executives. Existing information system (IS) research has studied DW success more from information quality and system quality. Researchers argue in this study that we should also take the relationship quality, which has significant research and practical implications in that it connects to IS success directly. As our first attempt, this study, referring to both IS and marketing literature, examines how communication, coordination, cooperation, commitment, and trust can be achieved to some degrees by high quality relationships between DW parties.

Live fire testing requirements - Assessing the impact

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

O'Bryon, J.F.

1992-08-01

Full-up live-fire testing (LFT) of aircraft configured for combat is evaluated in terms of the practical implications of the technique. LFT legislation requires the testing of tactical fighters, helicopters, and other aircraft when they are loaded with the flammables and explosives associated with combat. LFT permits the study of damage mechanisms and battle-damage repair techniques during the design phase, and probability-of-kill estimates and novel systems designs can be developed based on LFT data.

Nonreassuring Status: Improving Obstetrician-Gynecologist Wellness.

PubMed

Winkel, Abigail Ford; Hughes, Francine; Blank, Stephanie V

2017-11-01

Physician wellness directly affects patient and physician health and has broader implications for our health systems. A summary of what is known about physician wellness in medicine, and obstetrics and gynecology in particular, identifies several areas for future focus. To change our culture and the structure of our academic health centers in a way that promotes resilience, we suggest greater attention to preparedness for practice and attention to work-life integration as well as mentoring and professional development.

The effects of local culture on hospital administration in West Sumatra, Indonesia.

PubMed

Semiarty, Rima; Fanany, Rebecca

2017-02-06

Purpose Problems in health-care leadership are serious in West Sumatra, Indonesia, especially in hospitals, which are controlled locally. The purpose of this paper is to present the experience of three hospitals in balancing the conflicting demands of the national health-care system and the traditional model of leadership in the local community. Design/methodology/approach Three case studies of the hospital leadership dynamic in West Sumatra were developed from in-depth interviews with directors, senior administrators and a representative selection of employees in various professional categories. Findings An analysis of findings shows that traditional views about leadership remain strong in the community and color the expectations of hospital staff. Hospital directors, however, are bound by the modern management practices of the national system. This conflict has intensified since regional autonomy which emphasizes the local culture much more than in the past. Research limitations/implications The research was carried out in one Indonesian province and was limited to three hospitals of different types. Practical implications The findings elucidate a potential underlying cause of problems in hospital management in Indonesia and may inform culturally appropriate ways of addressing them. Originality/value The social and cultural contexts of management have not been rigorously studied in Indonesia. The relationship between local and national culture reported here likely has a similar effect in other parts of the country.

Screening for diabetes in unconventional locations: resource implications and economics of screening in optometry practices.

PubMed

Howse, Jennifer H; Jones, Steve; Hungin, A Pali S

2011-10-01

Unconventional locations outwith general medical practice may prove opportunities for screening. The aim was to determine the resource implications and economics of a screening service using random capillary blood glucose (rCBG) tests to detect raised blood glucose levels in the "at risk" population attending high street optometry practices. A screening service was implemented in optometry practices in North East England: the cost of the service and the implication of different screening strategies was estimated. The cost of a screening test was £5.53-£11.20, depending on the screening strategy employed and who carried out the testing. Refining the screening strategy to target those ≥40 years with BMI of ≥25 kg/m(2) and/or family history of diabetes resulted in a cost per case referred to the GP of £14.38-£26.36. Implementing this strategy in half of optometric practices in England would have the potential to identify up to 150,000 new cases of diabetes and prediabetes a year. Optometry practices provide an effective way of identifying people who would benefit from further investigation for diabetes. Effectiveness could be improved further by improving cooperation and communication between optometrists and medical practitioners. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Incorporating organisational safety culture within ergonomics practice.

PubMed

Bentley, Tim; Tappin, David

2010-10-01

This paper conceptualises organisational safety culture and considers its relevance to ergonomics practice. Issues discussed in the paper include the modest contribution that ergonomists and ergonomics as a discipline have made to this burgeoning field of study and the significance of safety culture to a systems approach. The relevance of safety culture to ergonomics work with regard to the analysis, design, implementation and evaluation process, and implications for participatory ergonomics approaches, are also discussed. A potential user-friendly, qualitative approach to assessing safety culture as part of ergonomics work is presented, based on a recently published conceptual framework that recognises the dynamic and multi-dimensional nature of safety culture. The paper concludes by considering the use of such an approach, where an understanding of different aspects of safety culture within an organisation is seen as important to the success of ergonomics projects. STATEMENT OF RELEVANCE: The relevance of safety culture to ergonomics practice is a key focus of this paper, including its relationship with the systems approach, participatory ergonomics and the ergonomics analysis, design, implementation and evaluation process. An approach to assessing safety culture as part of ergonomics work is presented.

Implications of the "My School" Website for Disadvantaged Communities: A Bourdieuian Analysis

ERIC Educational Resources Information Center

Mills, Carmen

2015-01-01

Drawing on the theoretical constructs of Pierre Bourdieu, this article explores implications of the Australian "My School" website for schools located in disadvantaged communities. These implications flow from the legitimisation of certain cultural practices through the hidden linkages between scholastic aptitude and cultural heritage…

Impact of green supply chain management practices on firms' performance: an empirical study from the perspective of Pakistan.

PubMed

Khan, Syed Abdul Rehman; Qianli, Dong

2017-07-01

This article investigates the impact of five determinants of the green supply chain practices on organizational performance in the context of Pakistan manufacturing firms. A sample of 218 firms was collected from the manufacturing industry. The green supply chain practices were measured through five independent variables including green manufacturing, green purchasing, green information systems, cooperation with customers, and eco-design. By using exploratory factor and simultaneous regression analysis, the results indicate that except green purchasing, rests of the four independent variables have been found statistically significant to predict organizational performance. However, the eco-design of green practices followed by green information systems has revealed the greatest impact on organizational performance. Therefore, the managers of the manufacturing firms should not only implement eco-design in their supply chain but also concentrate on proper monitoring and implementation of green information systems to increase their firms' performance. A main contribution of this research from theoretical side is that it is possible to notice a negative effect of "green purchasing" towards organizational performance particularly in the scenario of Pakistan manufacturing industry. Another valuable result is that green purchasing is an important antecedent of firms economic performance in the US manufacturing firms (Green et al. 2012), although not significantly related to organizational performance in our study. In addition, we also discussed research limitations, areas for future research, and implications for practitioners.

Mainstreaming AYUSH: an ethical analysis.

PubMed

Gopichandran, Vijayaprasad; Satish Kumar, Ch

2012-01-01

The National Rural Health Mission has stated as one of its key mandates the mainstreaming of the Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy (AYUSH) systems in order to help solve the human resource shortage in Indian healthcare. This has been planned at the primary level by providing training to AYUSH practitioners on primary care and national health programmes; at the secondary level by establishing departments of AYUSH in the district and taluka level hospitals; and at the tertiary level  by establishing AYUSH centres of excellence as referral centres, and research, development and supervision points. The practical challenges to be considered include a gross divergence in the basic philosophy of practice; disparities in approach to specific clinical conditions; differences in their normative approach in decision making; an unclear policy for cross referral and problems of cross practice that could potentially rise in this condition. Mainstreaming of AYUSH into the existing public health system can have certain ethical implications: not doing good by failing to concentrate on the community value judgments about AYUSH; doing harm by a confusing plurality in approach and unhealthy segregation of practices without healthy dialogue between practitioners of either system; not disclosing which type of practitioners (AYUSH or allopathy) the patient is seeing; lack of proper public accountability mechanisms at the primary care and grassroots levels; and, finally, lack of social justice. These ethical issues have to be considered while mainstreaming AYUSH.

A network of networks.

PubMed

Iedema, Rick; Verma, Raj; Wutzke, Sonia; Lyons, Nigel; McCaughan, Brian

2017-04-10

Purpose To further our insight into the role of networks in health system reform, the purpose of this paper is to investigate how one agency, the NSW Agency for Clinical Innovation (ACI), and the multiple networks and enabling resources that it encompasses, govern, manage and extend the potential of networks for healthcare practice improvement. Design/methodology/approach This is a case study investigation which took place over ten months through the first author's participation in network activities and discussions with the agency's staff about their main objectives, challenges and achievements, and with selected services around the state of New South Wales to understand the agency's implementation and large system transformation activities. Findings The paper demonstrates that ACI accommodates multiple networks whose oversight structures, self-organisation and systems change approaches combined in dynamic ways, effectively yield a diversity of network governances. Further, ACI bears out a paradox of "centralised decentralisation", co-locating agents of innovation with networks of implementation and evaluation expertise. This arrangement strengthens and legitimates the role of the strategic hybrid - the healthcare professional in pursuit of change and improvement, and enhances their influence and impact on the wider system. Research limitations/implications While focussing the case study on one agency only, this study is unique as it highlights inter-network connections. Contributing to the literature on network governance, this paper identifies ACI as a "network of networks" through which resources, expectations and stakeholder dynamics are dynamically and flexibly mediated and enhanced. Practical implications The co-location of and dynamic interaction among clinical networks may create synergies among networks, nurture "strategic hybrids", and enhance the impact of network activities on health system reform. Social implications Network governance requires more from network members than participation in a single network, as it involves health service professionals and consumers in a multi-network dynamic. This dynamic requires deliberations and collaborations to be flexible, and it increasingly positions members as "strategic hybrids" - people who have moved on from singular taken-as-given stances and identities, towards hybrid positionings and flexible perspectives. Originality/value This paper is novel in that it identifies a critical feature of health service reform and large system transformation: network governance is empowered through the dynamic co-location of and collaboration among healthcare networks, particularly when complemented with "enabler" teams of people specialising in programme implementation and evaluation.

Oral contraception and adolescent women with insulin-dependent diabetes mellitus: risks, benefits, and implications for practice.

PubMed

Betschart, J

1996-01-01

Healthcare providers who work with adolescents with diabetes are in an ideal position to provide education and support regarding contraceptive issues. Diabetes educators and other health professionals who counsel teens focus on other aspects of diabetes care and management but frequently do not address sexual issues or assess contraceptive practices. The purpose of this paper is to review oral contraceptive issues for teens with diabetes and to provide practice implications for health professionals who are in a favorable position to influence the quality of diabetes and general health care for these adolescents.

Breaking the rules of the game: Ethical implications for nursing practice and education.

PubMed

Milton, Constance L

2006-07-01

Rules in games are fundamental to the ethics of practice. Rules provide a context or space where a game is defined and played. Throughout human life, games may be formalized with written and unwritten rules. Imaginations may be sparked in the creative structuring of new, informal games. Formal and informal rules can serve to provide direction for what may be viewed as decorum and appropriate behavior with professional groups. In this column, the author illuminates possible ethical meanings for rule-making and breaking with implications for nursing practice and education from a nursing theoretical perspective.

The Clinical Health Economics System Simulation (CHESS): a teaching tool for systems- and practice-based learning.

PubMed

Voss, John D; Nadkarni, Mohan M; Schectman, Joel M

2005-02-01

Academic medical centers face barriers to training physicians in systems- and practice-based learning competencies needed to function in the changing health care environment. To address these problems, at the University of Virginia School of Medicine the authors developed the Clinical Health Economics System Simulation (CHESS), a computerized team-based quasi-competitive simulator to teach the principles and practical application of health economics. CHESS simulates treatment costs to patients and society as well as physician reimbursement. It is scenario based with residents grouped into three teams, each team playing CHESS using differing (fee-for-service or capitated) reimbursement models. Teams view scenarios and select from two or three treatment options that are medically justifiable yet have different potential cost implications. CHESS displays physician reimbursement and patient and societal costs for each scenario as well as costs and income summarized across all scenarios extrapolated to a physician's entire patient panel. The learners are asked to explain these findings and may change treatment options and other variables such as panel size and case mix to conduct sensitivity analyses in real time. Evaluations completed in 2003 by 68 (94%) CHESS resident and faculty participants at 19 U.S. residency programs preferred CHESS to a traditional lecture-and-discussion format to learn about medical decision making, physician reimbursement, patient costs, and societal costs. Ninety-eight percent reported increased knowledge of health economics after viewing the simulation. CHESS demonstrates the potential of computer simulation to teach health economics and other key elements of practice- and systems-based competencies.

Public health advocacy to change corporate practices: implications for health education practice and research.

PubMed

Freudenberg, Nicholas

2005-06-01

Corporate practices, such as advertising, public relations, lobbying, litigation, and sponsoring scientific research, have a significant impact on the health of the people in the United States. Recently, health professionals and advocates have created a new scope of practice that aims to modify corporate practices that harm health. This article describes how corporate policies influence health and reviews recent health campaigns aimed at changing corporate behavior in six industries selected for their central role in the U.S. economy and their influence on major causes of mortality and morbidity. These are the alcohol, automobile, food, gun, pharmaceutical, and tobacco industries. The article defines corporate disease promotion and illustrates the range of public health activities that have emerged to counter such corporate behaviors. It analyzes the role of health professionals, government, and advocacy groups in these campaigns and assesses the implications of this domain for health education practice and research.

Social Justice for Crossover Youth: The Intersection of the Child Welfare and Juvenile Justice Systems.

PubMed

Kolivoski, Karen M; Goodkind, Sara; Shook, Jeffrey J

2017-10-01

Social workers are critical to promoting racial and social justice. "Crossover youth," a term used to describe youths who have contact with both the child welfare and juvenile justice systems, are an especially vulnerable but often overlooked population with whom social workers engage. A disproportionate number of crossover youth are African American. Empirical research on crossover youth is growing, but such scholarship rarely engages with a human rights and social justice perspective. African American children and youths have a distinct place within the history and current context of the child welfare and juvenile justice systems. These systems have historically excluded them or treated them differently; now, African American youths are overrepresented in each of them, and evidence suggests they are more likely to cross over. The purpose of this article is to describe the historical and current context of crossover youth, with a particular focus on African American youths, to provide the foundation for a discussion of what social workers can do to promote racial and social justice for crossover youth, including specific implications for practice and policy, as well as broader implications for human and civil rights. © 2017 National Association of Social Workers.

Improvement attributes in healthcare: implications for integrated care.

PubMed

Harnett, Patrick John

2018-04-16

Purpose Healthcare quality improvement is a key concern for policy makers, regulators, carers and service users. Despite a contemporary consensus among policy makers that integrated care represents a means to substantially improve service outcomes, progress has been slow. Difficulties achieving sustained improvement at scale imply that methods employed are not sufficient and that healthcare improvement attributes may be different when compared to prior reference domains. The purpose of this paper is to examine and synthesise key improvement attributes relevant to a complex healthcare change process, specifically integrated care. Design/methodology/approach This study is based on an integrative literature review on systemic improvement in healthcare. Findings A central theme emerging from the literature review indicates that implementing systemic change needs to address the relationship between vision, methods and participant social dynamics. Practical implications Accommodating personal and professional network dynamics is required for systemic improvement, especially among high autonomy individuals. This reinforces the need to recognise the change process as taking place in a complex adaptive system where personal/professional purpose/meaning is central to the process. Originality/value Shared personal/professional narratives are insufficiently recognised as a powerful change force, under-represented in linear and rational empirical improvement approaches.

Care delivery for Filipino Americans using the Neuman systems model.

PubMed

Angosta, Alona D; Ceria-Ulep, Clementina D; Tse, Alice M

2014-04-01

Filipino Americans are at risk of coronary heart disease due to the presence of multiple cardiometabolic factors. Selecting a framework that addresses the factors leading to coronary heart disease is vital when providing care for this population. The Neuman systems model is a comprehensive and wholistic framework that offers an innovative method of viewing clients, their families, and the healthcare system across multiple dimensions. Using the Neuman systems model, advanced practice nurses can develop and implement interventions that will help reduce the potential cardiovascular problems of clients with multiple risk factors. The authors in this article provides insight into the cardiovascular health of Filipino Americans and has implications for nurses and other healthcare providers working with various Southeast Asian groups in the United States.

Practicality of electronic beam steering for MST/ST radars, part 6.2A

NASA Technical Reports Server (NTRS)

Clark, W. L.; Green, J. L.

1984-01-01

Electronic beam steering is described as complex and expensive. The Sunset implementation of electronic steering is described, and it is demonstrated that such systems are cost effective, versatile, and no more complex than fixed beam alternatives, provided three or more beams are needed. The problem of determining accurate meteorological wind components in the presence of spatial variation is considered. A cost comparison of steerable and fixed systems allowing solution of this problem is given. The concepts and relations involved in phase steering are given, followed by the description of the Sunset ST radar steering system. The implications are discussed, references to the competing SAD method are provided, and a recommendation concerning the design of the future Doppler ST/MST systems is made.

[Incorporation of the Hazard Analysis and Critical Control Point system (HACCP) in food legislation].

PubMed

Castellanos Rey, Liliana C; Villamil Jiménez, Luis C; Romero Prada, Jaime R

2004-01-01

The Hazard Analysis and Critical Control Point system (HACCP), recommended by different international organizations as the Codex Alimentarius Commission, the World Trade Organization (WTO), the International Office of Epizootics (OIE) and the International Convention for Vegetables Protection (ICPV) amongst others, contributes to ensuring the innocuity of food along the agro-alimentary chain and requires of Good Manufacturing Practices (GMP) for its implementation, GMP's which are legislated in most countries. Since 1997, Colombia has set rules and legislation for application of HACCP system in agreement with international standards. This paper discusses the potential and difficulties of the legislation enforcement and suggests some policy implications towards food safety.

Meeting patient expectations: healthcare professionals and service re-engineering.

PubMed

Laing, Angus

2002-08-01

A central theme underpinning the reform of healthcare systems in western economies since the 1980s has been the emphasis on reorienting service provision around the patient. Healthcare organizations have been forced to re-appraise the design of the service delivery process, specifically the service encounter, to take account of these changing patient expectations. This reorientation of healthcare services around the patient has fundamental implications for healthcare professionals, specifically challenging the dominance of service professionals in the design and delivery of health services. Utilizing a qualitative methodological framework, this paper explores the responses of healthcare professionals to service redesign initiatives implemented in acute NHS hospitals in Scotland and considers the implications of such professional responses for the development of patient-focused service delivery. Within this, it specifically examines evolving professional perspectives on the place of a service user focus in a publicly funded healthcare system, professional attitudes towards private sector managerial practices, and the dynamics of changing professional behaviour.

Software Engineering Laboratory Ada performance study: Results and implications

NASA Technical Reports Server (NTRS)

Booth, Eric W.; Stark, Michael E.

1992-01-01

The SEL is an organization sponsored by NASA/GSFC to investigate the effectiveness of software engineering technologies applied to the development of applications software. The SEL was created in 1977 and has three organizational members: NASA/GSFC, Systems Development Branch; The University of Maryland, Computer Sciences Department; and Computer Sciences Corporation, Systems Development Operation. The goals of the SEL are as follows: (1) to understand the software development process in the GSFC environments; (2) to measure the effect of various methodologies, tools, and models on this process; and (3) to identify and then to apply successful development practices. The activities, findings, and recommendations of the SEL are recorded in the Software Engineering Laboratory Series, a continuing series of reports that include the Ada Performance Study Report. This paper describes the background of Ada in the Flight Dynamics Division (FDD), the objectives and scope of the Ada Performance Study, the measurement approach used, the performance tests performed, the major test results, and the implications for future FDD Ada development efforts.

Repeat prescribing of medications: A system‐centred risk management model for primary care organisations

PubMed Central

Price, Julie; Man, Shu Ling; Bartlett, Stephen; Taylor, Kate; Dinwoodie, Mark

2017-01-01

Abstract Rationale, aims and objectives Reducing preventable harm from repeat medication prescriptions is a patient safety priority worldwide. In the United Kingdom, repeat prescriptions items issued has doubled in the last 20 years from 5.8 to 13.3 items per patient per annum. This has significant resource implications and consequences for avoidable patient harms. Consequently, we aimed to test a risk management model to identify, measure, and reduce repeat prescribing system risks in primary care. Methods All 48 general medical practices in National Health Service (NHS) Lambeth Clinical Commissioning Group (an inner city area of south London in England) were recruited. Multiple interventions were implemented, including educational workshops, a web‐based risk monitoring system, and external reviews of repeat prescribing system risks by clinicians. Data were collected via documentation reviews and interviews and subject to basic thematic and descriptive statistical analyses. Results Across the 48 participating general practices, 62 unique repeat prescribing risks were identified on 505 occasions (eg, practices frequently experiencing difficulty interpreting medication changes on hospital discharge summaries), equating to a mean of 8.1 risks per practice (range: 1‐33; SD = 7.13). Seven hundred sixty‐seven system improvement actions were recommended across 96 categories (eg, alerting hospitals to illegible writing and delays with discharge summaries) with a mean of 15.6 actions per practice (range: 0‐34; SD = 8.0). Conclusions The risk management model tested uncovered important safety concerns and facilitated the development and communication of related improvement recommendations. System‐wide information on hazardous repeat prescribing and how this could be mitigated is very limited. The approach reported may have potential to close this gap and improve the reliability of general practice systems and patient safety, which should be of high interest to primary care organisations internationally. PMID:28370904

Evidence-based health care: its place within clinical governance.

PubMed

McSherry, R; Haddock, J

This article explores the principles of evidence-based practice and its role in achieving quality improvements within the clinical governance framework advocated by the recent White Papers 'The New NHS: Modern, Dependable' (Department of Health (DoH), 1997) and 'A First Class Service: Quality in the New NHS' (DoH, 1998a). Within these White Papers there is an emphasis on improving quality of care, treatment and services through employing the principles of clinical governance. A major feature of clinical governance is guaranteeing quality to the public and the NHS, and ensuring that clinical, managerial and educational practice is based on scientific evidence. This article also examines what evidence-based practice is and what processes are required to promote effective healthcare interventions. The authors also look at how clinical governance relates to other methods/systems involved in clinical effectiveness. Finally, the importance for nurses and other healthcare professionals of familiarizing themselves with the development of critical appraisal skills, and their implications for developing evidence-based practice, is emphasized.

Prenuptial dental extractions in Acadian women: first report of a cultural tradition.

PubMed

Gordon, Sara C; Kaste, Linda M; Barasch, Andrei; Safford, Monika M; Foong, W Choong; ElGeneidy, Adry

2011-12-01

Prenuptial tooth extractions, extractions of all teeth in at least one dental arch before marriage, are not identified in the dental literature. Driven by a professional encounter, the purpose of this study was to confirm the existence of this practice among Acadian women. An 8-item survey instrument with space for comments was mailed to 182 dentists from traditionally Acadian regions of Canada. The survey was provided in English and French. Ninety dentists responded (50.3%); 8 of them (9%) had been asked to perform prenuptial extractions, and an additional 9 volunteered awareness of this practice. Awareness and requests were associated with dental practice in a county with a ≥20% French-speaking population. Prenuptial extractions in this population have been confirmed by the current cohort of dentists. The potential public health, clinical, and systemic health research implications for women who are edentulous for most of their adult life merit further study. Additionally, it is important to determine if interventions are needed to curtail cultural expectations of such practices.

Tissue adaptation to physical stress: a proposed "Physical Stress Theory" to guide physical therapist practice, education, and research.

PubMed

Mueller, Michael J; Maluf, Katrina S

2002-04-01

The purpose of this perspective is to present a general theory--the Physical Stress Theory (PST). The basic premise of the PST is that changes in the relative level of physical stress cause a predictable adaptive response in all biological tissue. Specific thresholds define the upper and lower stress levels for each characteristic tissue response. Qualitatively, the 5 tissue responses to physical stress are decreased stress tolerance (eg, atrophy), maintenance, increased stress tolerance (eg, hypertrophy), injury, and death. Fundamental principles of tissue adaptation to physical stress are described that, in the authors' opinion, can be used to help guide physical therapy practice, education, and research. The description of fundamental principles is followed by a review of selected literature describing adaptation to physical stress for each of the 4 main organ systems described in the Guide to Physical Therapist Practice (ie, cardiovascular/pulmonary, integumentary, musculoskeletal, neuromuscular). Limitations and implications of the PST for practice, research, and education are presented.

Human Rights: Its Meaning and Practice in Social Work Field Settings.

PubMed

Steen, Julie A; Mann, Mary; Restivo, Nichole; Mazany, Shellene; Chapple, Reshawna

2017-01-01

The goal of the study reported in this article was to explore the conceptualizations of human rights and human rights practice among students and supervisors in social work field settings. Data were collected from 35 students and 48 supervisors through an online survey system that featured two open-ended questions regarding human rights issues in their agency and human rights practice tasks. Responses suggest that participants encountered human rights issues related to poverty, discrimination, participation/self-determination/autonomy, violence, dignity/respect, privacy, and freedom/liberty. They saw human rights practice as encompassing advocacy, service provision, assessment, awareness of threats to clients' rights, and the nature of the worker-client relationship. These results have implications for the social work profession, which has an opportunity to focus more intently on change efforts that support clients' rights. The study points to the possibilities of expanding the scope of the human rights competency within social work education and addressing the key human rights issues in field education. © 2016 National Association of Social Workers.

Psychosocial aspects of drug dependence: the Nigerian experience.

PubMed

Pela, O A

1984-01-01

This paper provides an operational definition and lists some psychosocial questions usually asked about drug dependence. It then reviews the literature on drug abuse in Nigeria, extracting some of the psychosocial variables involved. The review indicates that drug abuse is associated with polygamous or large monogamous families, which may be suggestive of "stressful sibling rivalry." Other factors included defiance of or rebellion against parental control, the facilitation of social intercourse, and harmful early childhood experiences. The social factors implicated include urbanization, Westernization, and migration which may weaken the traditional African support system. An important out-growth of the review is that the psychosocial variables implicated are not different from those observed in other cultures. However, an important social dimension is the prescribing and dispensing practices of Nigerian medical doctors and pharmacists which encourage drug abuse.

Numerical results on noise-induced dynamics in the subthreshold regime for thermoacoustic systems

NASA Astrophysics Data System (ADS)

Gupta, Vikrant; Saurabh, Aditya; Paschereit, Christian Oliver; Kabiraj, Lipika

2017-03-01

Thermoacoustic instability is a serious issue in practical combustion systems. Such systems are inherently noisy, and hence the influence of noise on the dynamics of thermoacoustic instability is an aspect of practical importance. The present work is motivated by a recent report on the experimental observation of coherence resonance, or noise-induced coherence with a resonance-like dependence on the noise intensity as the system approaches the stability margin, for a prototypical premixed laminar flame combustor (Kabiraj et al., Phys. Rev. E, 4 (2015)). We numerically investigate representative thermoacoustic models for such noise-induced dynamics. Similar to the experiments, we study variation in system dynamics in response to variations in the noise intensity and in a critical control parameter as the systems approach their stability margins. The qualitative match identified between experimental results and observations in the representative models investigated here confirms that coherence resonance is a feature of thermoacoustic systems. We also extend the experimental results, which were limited to the case of subcritical Hopf bifurcation, to the case of supercritical Hopf bifurcation. We identify that the phenomenon has qualitative differences for the systems undergoing transition via subcritical and supercritical Hopf bifurcations. Two important practical implications are associated with the findings. Firstly, the increase in noise-induced coherence as the system approaches the onset of thermoacoustic instability can be considered as a precursor to the instability. Secondly, the dependence of noise-induced dynamics on the bifurcation type can be utilised to distinguish between subcritical and supercritical bifurcation prior to the onset of the instability.

Protecting personal information: Implications of the Protection of Personal Information (POPI) Act for healthcare professionals.

PubMed

Buys, M

2017-10-31

Careless handling of patient information in daily medical practice can result in Health Professions Council of South Africa sanction, breach of privacy lawsuits and, in extreme cases, serious monetary penalty or even imprisonment. This review will focus on the Protection of Personal Information (POPI) Act (No. 4 of 2013) and the implications thereof for healthcare professionals in daily practice. Recommendations regarding the safeguarding of information are made.

Teacher's experiences in PBL: implications for practice

NASA Astrophysics Data System (ADS)

Alves, Anabela C.; Sousa, Rui M.; Fernandes, Sandra; Cardoso, Elisabete; Carvalho, Maria Alice; Figueiredo, Jorge; Pereira, Rui M. S.

2016-03-01

Project-Based Learning (PBL) has been implemented in the first year of the Industrial Engineering and Management programme at the University of Minho, Portugal, since 2004/2005. The purpose of this paper is to analyse and discuss teachers' experiences in PBL in this programme and to explore its implications for student learning and for teaching practices in higher education. For data collection, the research method used was written narratives to these teachers, at the end of the PBL semester. Findings suggest that teachers express a positive view of PBL as a learning approach. They identify student motivation and engagement, along with a better understanding of the application of concepts in real-life situations, as important outcomes of the project for students. Besides this, teachers also highlight the importance of the development of transversal skills by students throughout the project. Recommendations for future work and implications for practice will also be discussed.

A question of dissemination: Assessing the practices and implications of research in tropical landscapes.

PubMed

Toomey, Anne H; Alvaro, María Eugenia Copa; Aiello-Lammens, Matthew; Loayza Cossio, Oscar; Barlow, Jos

2018-04-24

Current debates in the conservation sciences argue for better integration between research and practice, often citing the importance of the diffusion, dissemination and implementation of scientific knowledge for environmental management and policy. This paper focuses on a relatively well-researched protected area (Madidi National Park) in Bolivia in order to present different interpretations and understandings of the implications and availability of research findings. We draw on findings from quantitative and qualitative methods to determine the extent to which research carried out in the region was disseminated and/or implemented for management actions, and to understand subsequent implications for how local actors perceive the value of research and its role in management and conservation. We discuss the critical consequences of these findings for the future of conservation science and practice in biologically and culturally diverse landscapes, with an explicit call to action for academic institutions to support researchers in developing appropriate dissemination strategies.

'Who's actually gonna read this?' An evaluation of staff experiences of the value of information contained in written care plans in supporting care in three different dementia care settings.

PubMed

Drummond, C; Simpson, A

2017-08-01

WHAT IS KNOWN ON THE SUBJECT?: A written plan is designed to improve communication and co-ordinate care between mental health inpatient wards and community settings. Reports of care plan quality issues and staff and service user dissatisfaction with healthcare bureaucracy have focused on working age mental health or general hospital settings. Little is known about mental health staff perspectives on the value of written care plans in supporting dementia care. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Competing demands on staff time and resources to meet administrative standards for care plans caused a tension with their own professional priorities for supporting care. Mental health staff face difficulties using electronic records alongside other systems of information sharing. Further exploration is needed of the gap between frontline staff values and those of the local organization and managers when supporting good dementia care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Frontline staff should be involved in designing new information systems including care plans. Care plan documentation needs to be refocused to ensure it is effective in enabling staff to communicate amongst themselves and with others to support people with dementia. Practice-based mentors could be deployed to strengthen good practice in effective information sharing. Background Reports of increased healthcare bureaucracy and concerns over care plan quality have emerged from research and surveys into staff and service user experiences. Little is known of mental health staff perspectives on the value of written care plans in supporting dementia care. Aim To investigate the experiences and views of staff in relation to care planning in dementia services in one National Health Service (NHS) provider Trust in England. Method Grounded Theory methodology was used. A purposive sample of 11 multidisciplinary staff were interviewed across three sites in one NHS Trust. Interviews were transcribed, coded and analysed using the constant comparative method. Findings Five themes were identified and are explored in detail below: (1) Repetition; (2) the impact of electronic records on practice; (3) ambivalence about the value of paperwork; (4) time conflicts; and (5) alternative sources of information to plan care. Discussion Participants perceived that written care plans did not help staff with good practice in planning care or to support dementia care generally. Staff were frustrated by repetitive documentation, inflexible electronic records and conflicting demands on their time. Implications for practice Frontline staff should be involved in designing new information systems including care plans. © 2017 John Wiley & Sons Ltd.

EPR spectroscopy of complex biological iron-sulfur systems.

PubMed

Hagen, Wilfred R

2018-02-21

From the very first discovery of biological iron-sulfur clusters with EPR, the spectroscopy has been used to study not only purified proteins but also complex systems such as respiratory complexes, membrane particles and, later, whole cells. In recent times, the emphasis of iron-sulfur biochemistry has moved from characterization of individual proteins to the systems biology of iron-sulfur biosynthesis, regulation, degradation, and implications for human health. Although this move would suggest a blossoming of System-EPR as a specific, non-invasive monitor of Fe/S (dys)homeostasis in whole cells, a review of the literature reveals limited success possibly due to technical difficulties in adherence to EPR spectroscopic and biochemical standards. In an attempt to boost application of System-EPR the required boundary conditions and their practical applications are explicitly and comprehensively formulated.

Parents' Perceptions and Practices in Homework: Implications for School-Teacher-Parent Partnerships

ERIC Educational Resources Information Center

Fan, Qian

2012-01-01

This study examined parents' perceptions and practices of parental involvement in their children's homework process to explore how variations in parents' perceptions might explain differences in their practices. Understanding parents' perceptions and practices of involvement is essential to increasing the effectiveness of parental involvement in…

Imagining Literacy Equity: Theorizing Flows of Community Practices

ERIC Educational Resources Information Center

González, Norma

2016-01-01

Theorizing flows of community practices implicates three interrelated themes: (1) theorizing practices rather than practicing theories, (2) theorizing our stories, and (3) research as responsibility to the communities in which we work. One way to claim literacy research as a principled epistemological stance is to confront the real-life effects of…

The Oncology Care Model: Perspectives From the Centers for Medicare & Medicaid Services and Participating Oncology Practices in Academia and the Community.

PubMed

Kline, Ron; Adelson, Kerin; Kirshner, Jeffrey J; Strawbridge, Larissa M; Devita, Marsha; Sinanis, Naralys; Conway, Patrick H; Basch, Ethan

2017-01-01

Cancer care delivery in the United States is often fragmented and inefficient, imposing substantial burdens on patients. Costs of cancer care are rising more rapidly than other specialties, with substantial regional differences in quality and cost. The Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMIS) recently launched the Oncology Care Model (OCM), which uses payment incentives and practice redesign requirements toward the goal of improving quality while controlling costs. As of March 2017, 190 practices were participating, with approximately 3,200 oncologists providing care for approximately 150,000 unique beneficiaries per year (approximately 20% of the Medicare Fee-for-Service population receiving chemotherapy for cancer). This article provides an overview of the program from the CMS perspective, as well as perspectives from two practices implementing OCM: an academic health system (Yale Cancer Center) and a community practice (Hematology Oncology Associates of Central New York). Requirements of OCM, as well as implementation successes, challenges, financial implications, impact on quality, and future visions, are provided from each perspective.

The neural mediators of kindness-based meditation: a theoretical model

PubMed Central

Mascaro, Jennifer S.; Darcher, Alana; Negi, Lobsang T.; Raison, Charles L.

2015-01-01

Although kindness-based contemplative practices are increasingly employed by clinicians and cognitive researchers to enhance prosocial emotions, social cognitive skills, and well-being, and as a tool to understand the basic workings of the social mind, we lack a coherent theoretical model with which to test the mechanisms by which kindness-based meditation may alter the brain and body. Here, we link contemplative accounts of compassion and loving-kindness practices with research from social cognitive neuroscience and social psychology to generate predictions about how diverse practices may alter brain structure and function and related aspects of social cognition. Contingent on the nuances of the practice, kindness-based meditation may enhance the neural systems related to faster and more basic perceptual or motor simulation processes, simulation of another’s affective body state, slower and higher-level perspective-taking, modulatory processes such as emotion regulation and self/other discrimination, and combinations thereof. This theoretical model will be discussed alongside best practices for testing such a model and potential implications and applications of future work. PMID:25729374

Higher Education for Everybody? Issues and Implications.

ERIC Educational Resources Information Center

American Council on Education, Washington, DC.

The theme of the 1970 Annual Meeting of the American Council of Education was "Higher Education for Everybody? Issues and Implications." The papers in this volume address themselves to the question of universal higher education and to the implications of this goal on institutional goals and practices as these relate to a student population that…

A conceptual model for generating and validating in-session clinical judgments

PubMed Central

Jacinto, Sofia B.; Lewis, Cara C.; Braga, João N.; Scott, Kelli

2016-01-01

Objective Little attention has been paid to the nuanced and complex decisions made in the clinical session context and how these decisions influence therapy effectiveness. Despite decades of research on the dual-processing systems, it remains unclear when and how intuitive and analytical reasoning influence the direction of the clinical session. Method This paper puts forth a testable conceptual model, guided by an interdisciplinary integration of the literature, that posits that the clinical session context moderates the use of intuitive versus analytical reasoning. Results A synthesis of studies examining professional best practices in clinical decision-making, empirical evidence from clinical judgment research, and the application of decision science theories indicate that intuitive and analytical reasoning may have profoundly different impacts on clinical practice and outcomes. Conclusions The proposed model is discussed with respect to its implications for clinical practice and future research. PMID:27088962

Burnout and Doctors: Prevalence, Prevention and Intervention

PubMed Central

Kumar, Shailesh

2016-01-01

Doctors are exposed to high levels of stress in the course of their profession and are particularly susceptible to experiencing burnout. Burnout has far-reaching implications on doctors; patients and the healthcare system. Doctors experiencing burnout are reported to be at a higher risk of making poor decisions; display hostile attitude toward patients; make more medical errors; and have difficult relationships with co-workers. Burnout among doctors also increases risk of depression; anxiety; sleep disturbances; fatigue; alcohol and drug misuse; marital dysfunction; premature retirement and perhaps most seriously suicide. Sources of stress in medical practice may range from the emotions arising in the context of patient care to the environment in which doctors practice. The extent of burnout may vary depending on the practice setting; speciality and changing work environment. Understanding dynamic risk factors associated with burnout may help us develop strategies for preventing and treating burnout. Some of these strategies will be reviewed in this paper. PMID:27417625

The Evolution of Gero-Oncology Nursing

PubMed Central

Bond, Stewart M.; Bryant, Ashley Leak; Puts, Martine

2016-01-01

Objectives This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Data Sources Peer-reviewed literature, position statements, clinical practice guidelines, web-based materials, and professional organizations’ resources. Conclusion Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gerooncology and to develop a body of evidence, nurses and healthcare systems remain under-prepared to provide high quality care for older adults with cancer. Implications for Nursing Practice Nurses need to take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. PMID:26830263

The role of locally-designed organizational artifacts in supporting nurses’ work: an ethnographic study on the wards

PubMed

Talamo, Alessandra; Mellini, Barbara; Barbieri, Barbara

2017-01-01

This paper aims to describe how nurses' planning and coordination work is performed through the use of locally designed tools (i.e., diaries, planners, reminders, and organizers). These tools are investigated as the materialization of organizational work, thus offering a complementary perspective on nursing practice to that proposed by the professional mandate and supported by official artifacts in use. Ethnographic study. By analyzing locally designed artifacts, the rationale that enables nurses to make the flow of activities work is highlighted and explained. Evidence is provided by a description of how nurses' tacit knowledge is reified and embedded into objects produced by the nurses themselves. Implications for the design of digital systems supporting nursing practice are discussed. The analysis of these artifacts has allowed an understanding of practices used by the nurses to manage the workflow in the wards.

Factorial and construct validity of the revised short form integrative psychotherapy alliance scales for family, couple, and individual therapy.

PubMed

Pinsof, William M; Zinbarg, Richard; Knobloch-Fedders, Lynne M

2008-09-01

The Integrative Psychotherapy Alliance model brought an interpersonal and systemic perspective to bear on theory, research, and practice on the psychotherapeutic alliance. Questions have been raised about the independence of the theoretical factors in the model and their operationalization in the Individual, Couple, and Family Therapy Alliance Scales. This paper presents results of a confirmatory factor analysis of the scales that delineated at least three distinct interpersonal factors as well as shorter versions of the three scales to facilitate their use in research and practice. The paper also presents the results of a study testing each factor's association with client retention and progress over the first eight sessions in individual and couple therapy. At least two of the interpersonal factors were uniquely associated with progress in individual and couple functioning. Implications of the results for theory, research, practice, and training in individual, couple, and family therapy are elaborated.

Role for Occupational Therapy in Community Mental Health: Using Policy to Advance Scholarship of Practice.

PubMed

Mahaffey, Lisa; Burson, Kathrine A; Januszewski, Celeste; Pitts, Deborah B; Preissner, Katharine

2015-01-01

Occupational therapists must be aware of professional and policy trends. More importantly, occupational therapists must be involved in efforts to influence policy both for the profession and for the people they serve (Bonder, 1987). Using the state of Illinois as an example, this article reviews the policies and initiatives that impact service decisions for persons with psychiatric disabilities as well as the rationale for including occupational therapy in community mental health service provision. Despite challenges in building a workforce of occupational therapists in the mental health system, this article makes the argument that the current climate of emerging policy and litigation combined with the supporting evidence provides the impetus to strengthen mental health as a primary area of practice. Implications for scholarship of practice related to occupational therapy services in community mental health programs for individuals with psychiatric disability are discussed.

Public Health Advocacy to Change Corporate Practices: Implications for Health Education Practice and Research

ERIC Educational Resources Information Center

Freudenberg, Nicholas

2005-01-01

Corporate practices, such as advertising, public relations, lobbying, litigation, and sponsoring scientific research, have a significant impact on the health of the people in the United States. Recently, health professionals and advocates have created a new scope of practice that aims to modify corporate practices that harm health. This article…

Toward an Ontology of Practices in Educational Administration: Theoretical Implications for Research and Practice

ERIC Educational Resources Information Center

Newton, Paul; Riveros, Augusto

2015-01-01

In this article, we argue for a study of educational administration centered on an "ontology of practices." This is an initial proposal for thinking about and conceptualizing practices in educational administration. To do this, first, we explore how practices are constituted and how they configure the social realities of practitioners.…

Adult Literacy Practices in Rural Families and Communities. Research into Practice Series No. 1.

ERIC Educational Resources Information Center

Bull, Geoff; Anstey, Michele

This booklet, which was written for literacy educators in Australia, examines selected research on adult literacy practices in rural families and communities and the implications of that research for adult literacy practice. The booklet begins with a discussion of literacy as social practice. The role of case studies in identifying factors…

Worker, workplace or families: What influences family focused practices in adult mental health?

PubMed

Maybery, D; Goodyear, M; Reupert, A E; Grant, A

2016-04-01

WHAT IS KNOWN ON THE SUBJECT?: Family focused practice leads to positive outcomes for parents and children. There are barriers and enablers for practitioners being family focused. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Worker skill, knowledge and confidence about family work are the most important factors associated with family focused practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses require specific skill training in family focused practices, time to engage with clients on parenting issues and that there are adequate services to refer family members to. Introduction Family focused practice is thought to lead to positive outcomes for all family members. However, there are multiple barriers and enablers in adult mental health services to practitioners undertaking these actions. Aim The aim of this study was to examine the relative importance of worker, workforce and family factors to predict family focused practices (FFPs) in adult mental health services. Method Three hundred and seven adult mental health workers completed a 45 items family focused practice measure of 16 family focused practices. Thesis It was found that worker skill and knowledge about family work and an ability to assess the degree of parental insight into the child's connections to other family members and the community were important predictors of FFP, along with the closely related-worker confidence. While aspects of the worker, workplace and family each contribute to FFPs, this study highlighted the importance of worker skill, knowledge and confidence as central issues for adult mental health workers. Implications for practice Study implications include the need for training in specific FFPs, the provision of time to engage with clients on parenting issues and the need 5 to ensure that there are adequate services for workers to refer family members to. © 2016 John Wiley & Sons Ltd.

Combinatorial Mathematics: Research into Practice

ERIC Educational Resources Information Center

Sriraman, Bharath; English, Lyn D.

2004-01-01

Implications and suggestions for using combinatorial mathematics in the classroom through a survey and synthesis of numerous research studies are presented. The implications revolve around five major themes that emerge from analysis of these studies.

General practice registrars' intentions for future practice: implications for rural medical workforce planning.

PubMed

Harding, Catherine; Seal, Alexa; McGirr, Joe; Caton, Tim

2016-11-01

The models of practice that general practice registrars (GPRs) envisage undertaking will affect workforce supply. The aim of this research was to determine practice intentions of current GPRs in a regional general practice training program (Coast City Country General Practice Training). Questionnaires were circulated to 220 GPRs undertaking general practice placements to determine characteristics of ideal practice models and intentions for future practice. Responses were received for 99 participants (45%). Current GPRs intend to work an average of less than eight half-day sessions/week, with male participants intending to work more hours (t(91)=3.528, P=0.001). More than one-third of this regional cohort intends to practice in metropolitan centres. Proximity to family and friends was the most important factor influencing the choice of practice location. Men ranked remuneration for work as more important (t (88)=-4.280, P<0.001) and women ranked the ability to work part-time higher (t(94)=3.697, P<0.001). Fee-for-service payment alone, or in combination with capitation, was the preferred payment system. Only 22% of Australian medical graduates intend to own their own practice compared with 52% of international medical graduates (χ 2 (1)=8.498, P=0.004). Future general practitioners (GPs) intend to work fewer hours than current GPs. Assumptions about lifestyle factors, practice models and possible professional roles should be carefully evaluated when developing strategies to recruit GPs and GPRs into rural practice.

Integrative intervention: a new perspective and brief review in aphasia.

PubMed

Marshall, Rebecca Shisler; Mohapatra, Bijoyaa

2017-09-01

While integrative treatment practices have become a popular treatment in different areas of study, its use in the field of aphasiology is still limited. The following paper is an attempt to address the different alternative practices that could potentially be used to remediate aphasia. A narrative review was completed regarding integrative intervention that could potentially apply to aphasia population. Through this article we have explored various treatment options for integrative health care in aphasiology. Integrative treatments including brain specific antioxidants, progesterone and estradiol therapy, nutrition, synbiotic treatment, exercise, yoga, meditation and positive mood states have demonstrated positive changes in health and behavior in healthy aging or disorders such as stroke and aphasia. Offering integrative treatment for people with aphasia allows potential for high impact gains when combined with current speech language therapeutic practices. This paper highlights the rehabilitation possibilities for aphasia therapy. Combining complementary and traditional treatment approaches could be viewed as one of the contemporary approaches to clinical practice and research for practitioners and health care systems. Implications for Rehabilitation There has been very little research that explores the potential of various types of integrative treatment for individuals with aphasia. An integrative approach to the treatment of aphasia has potential for future clinical application. Combining treatment approaches could be viewed as a viable approach to clinical practice and in the health care system.

What schools are doing around career development: implications for policy and practice.

PubMed

Perry, Justin C; Wallace, Eric W

2012-01-01

This article describes the role that schools are playing in supporting career development for young people. It examines the history of career-related programming in schools, including school-to-work programs, career and technical education, the college and career readiness movement, and current school reform initiatives. This understanding of schools' history, roles, opportunities, and constraints can help practitioners and policymakers think about how to build a system that supports youth development. Copyright © 2012 Wiley Periodicals, Inc., A Wiley Company.

Physician customary charges and Medicare payment experience: Study findings

PubMed Central

Kowalczyk, George I.; Harden, Stephen D.

1991-01-01

Customary charges have had significant impacts in determining reasonable prices under the historic Medicare physician payment system. This article contains new, comprehensive information on customary charges as well as data aggregated at the physician level. These baseline data have some important policy implications, such as the study findings, that indicate that the Medicare fee schedule is likely to have significant impacts on individual physician practices. The study is based on data for medical, surgical, and consultation services for nine States. PMID:10122362

In silico cancer modeling: is it ready for primetime?

PubMed Central

Deisboeck, Thomas S; Zhang, Le; Yoon, Jeongah; Costa, Jose

2011-01-01

SUMMARY At the dawn of the era of personalized, systems-driven medicine, computational or in silico modeling and the simulation of disease processes is becoming increasingly important for hypothesis generation and data integration in both experiment and clinics alike. Arguably, this is nowhere more visible than in oncology. To illustrate the field’s vast potential as well as its current limitations we briefly review selected works on modeling malignant brain tumors. Implications for clinical practice, including trial design and outcome prediction are also discussed. PMID:18852721

Malfunctions of robotic system in surgery: role and responsibility of surgeon in legal point of view.

PubMed

Ferrarese, Alessia; Pozzi, Giada; Borghi, Felice; Marano, Alessandra; Delbon, Paola; Amato, Bruno; Santangelo, Michele; Buccelli, Claudio; Niola, Massimo; Martino, Valter; Capasso, Emanuele

2016-01-01

Robotic surgery (RS) technology has undergone rapid growth in the surgical field since its approval. In clinical practice, failure of robotic procedures mainly results from a surgeon's inability or to a device malfunction. We reviewed the literature to estimate the impact of this second circumstance in RS and its consequent legal implications. According to data from the literature, device malfunction is rare. We believe it is necessary to complement surgical training with a technical understanding of RS devices.

How sweet the sound: research evidence for the use of music in Alzheimer's dementia.

PubMed

Witzke, Jan; Rhone, Rebecca A; Backhaus, Diane; Shaver, Nanette A

2008-10-01

The purpose of this article is to provide an evidence-based synthesis of the research literature on music intervention for agitated behavior in Alzheimer's dementia. A qualitative review of the literature supported music as a low-cost, simple alternative to traditional methods of management, with minimal risk to the client. A rating system assigning levels of evidence to support these interventions was used, and implications for nursing practice innovations and further research are discussed.

Medical talent management: a model for physician deployment.

PubMed

Brightman, Baird

2007-01-01

This article aims to provide a focused cost-effective method for triaging physicians into appropriate non-clinical roles to benefit both doctors and healthcare organizations. Reviews a validated career-planning process and customize it for medical talent management. A structured career assessment can differentiate between different physician work styles and direct medical talent into best-fit positions. This allows healthcare organizations to create a more finely tuned career ladder than the familiar "in or out" binary choice. PRACTICAL IMPLICATIONS--Healthcare organizations can invest in cost-effective processes for the optimal utilization of their medical talent. Provides a new use for a well-validated career assessment and planning system. The actual value of this approach should be studied using best-practices in ROI research.

A Practitioner-Driven Research Agenda for Syndromic Surveillance.

PubMed

Hopkins, Richard S; Tong, Catherine C; Burkom, Howard S; Akkina, Judy E; Berezowski, John; Shigematsu, Mika; Finley, Patrick D; Painter, Ian; Gamache, Roland; Vilas, Victor J Del Rio; Streichert, Laura C

Syndromic surveillance has expanded since 2001 in both scope and geographic reach and has benefited from research studies adapted from numerous disciplines. The practice of syndromic surveillance continues to evolve rapidly. The International Society for Disease Surveillance solicited input from its global surveillance network on key research questions, with the goal of improving syndromic surveillance practice. A workgroup of syndromic surveillance subject matter experts was convened from February to June 2016 to review and categorize the proposed topics. The workgroup identified 12 topic areas in 4 syndromic surveillance categories: informatics, analytics, systems research, and communications. This article details the context of each topic and its implications for public health. This research agenda can help catalyze the research that public health practitioners identified as most important.

Untangling nociceptive, neuropathic and neuroplastic mechanisms underlying the biological domain of back pain.

PubMed

Hush, Julia M; Stanton, Tasha R; Siddall, Philip; Marcuzzi, Anna; Attal, Nadine

2013-05-01

SUMMARY Current clinical practice guidelines advocate a model of diagnostic triage for back pain, underpinned by the biopsychosocial paradigm. However, limitations of this clinical model have become apparent: it can be difficult to classify patients into the diagnostic triage categories; patients with 'nonspecific back pain' are clearly not a homogenous group; and mean effects of treatments based on this approach are small. In this article, it is proposed that the biological domain of the biopsychosocial model needs to be reconceptualized using a neurobiological mechanism-based approach. Recent evidence about nociceptive and neuropathic contributors to back pain is outlined in the context of maladaptive neuroplastic changes of the somatosensory system. Implications for clinical practice and research are discussed.

Humanistic psychotherapy research 1990-2015: from methodological innovation to evidence-supported treatment outcomes and beyond.

PubMed

Angus, Lynne; Watson, Jeanne Cherry; Elliott, Robert; Schneider, Kirk; Timulak, Ladislav

2015-01-01

Over the past 25 years, humanistic psychotherapy (HP) researchers have actively contributed to the development and implementation of innovative practice-informed research measures and coding systems. Qualitative and quantitative research findings, including meta-analyses, support the identification of HP approaches as evidence-based treatments for a variety of psychological conditions. Implications for future psychotherapy research, training, and practice are discussed in terms of addressing the persistent disjunction between significant HP research productivity and relatively low support for HP approaches in university-based clinical training programs, funding agencies, and government-supported clinical guidelines. Finally, specific recommendations are provided to further enhance and expand the impact of HP research for clinical training programs and the development of treatment guidelines.

Investigating probation strategies with juvenile offenders: the influence of officers' attitudes and youth characteristics.

PubMed

Schwalbe, Craig S; Maschi, Tina

2009-10-01

Probation officers are the focal point for most interventions with delinquent youths in the juvenile justice system. The present study examines probation strategies and interventions in a sample of 308 probation officers who completed the Probation Practices Assessment Survey (PPAS) in a web-based survey. The PPAS measures six probation approaches: deterrence, restorative justice, treatment, confrontation, counseling, and behavioral tactics. Structural equation models and latent class analyses showed that probation officers use multiple approaches with delinquent youths consistent with the balanced and restorative justice movement. Younger youths, high-risk youths, and youths with prior social service involvements are likely to receive more intensive interventions. The implications of these findings for improving probation practices with delinquent youth are discussed.

Understanding the factors which promote registered nurses' intent to stay in emergency and critical care areas.

PubMed

Van Osch, Mary; Scarborough, Kathy; Crowe, Sarah; Wolff, Angela C; Reimer-Kirkham, Sheryl

2018-03-01

To explore the influential factors and strategies that promote an experienced nurse's intent to stay in their emergency or critical care area. Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance. This qualitative study used an interpretive descriptive design to understand nurses' perceptions of the current factors and strategies that promote them staying in emergency or critical care settings for two or more years. Focus groups were conducted with 13 emergency and critical care nurses. Data analysis involved thematic analysis that evolved from codes to categories to themes. Four themes were identified: leadership, interprofessional relationships, job fit and practice environment. In addition, the ideas of feeling valued, respected and acknowledged were woven throughout. Factors often associated with nurse attrition such as burnout and job stresses were not emphasised by the respondents in our study as critical to their intent to stay in their area of practice. This study has highlighted positive aspects that motivate nurses to stay in their specialty areas. To ensure quality care for patients, retention of experienced emergency and critical care nurses is essential to maintaining specialty expertise in these practice settings. © 2017 John Wiley & Sons Ltd.

Learning from Decoding across Disciplines and within Communities of Practice

ERIC Educational Resources Information Center

Miller-Young, Janice; Boman, Jennifer

2017-01-01

This final chapter synthesizes the findings and implications derived from applying the Decoding the Disciplines model across disciplines and within communities of practice. We make practical suggestions for teachers and researchers who wish to apply and extend this work.

Drug product distribution systems and departmental operations.

PubMed

Hynniman, C E

1991-10-01

Technologies affecting institutional pharmacy practice and the operation of pharmacy departments are reviewed, future developments are outlined, and implications of these developments for pharmacy education are proposed. Computer technology, especially as applied to areas such as artificial intelligence, online information databases, electronic bulletin boards, hospital information systems, and point-of-care systems, will have a strong impact on pharmacy practice and management in the 1990s. Other areas in which growth is likely to be active include bar-code technology, robotics, and automated drug dispensing. The applications of these technologies are described, with particular attention placed on the effects of increased automation on the drug-dispensing function. Technological advances may effect marked reductions in dispensing and medication errors; questions concerning the cost-effectiveness of these new systems remain to be answered. These advances also create new opportunities for clinical involvement by pharmacists; however, a fundamental understanding of computer systems is essential. Current practitioners can benefit from attending seminars, participating in users' groups, and keeping current with the computer literature. Many students now acquire the needed skills in computer laboratories and in the classroom. Technological advances will offer the opportunity for pharmacists to expand their clinical role.

Financial implications of choice of dialysis type of the revised Medicare payment system: an economic analysis.

PubMed

Hornberger, John; Hirth, Richard A

2012-08-01

In 2011, the Medicare Improvements for Patients and Providers Act replaced the case-mix-adjusted composite payment system for Medicare outpatient dialysis facilities with a bundled end-stage renal disease prospective payment system (PPS). We assessed the economic implications for modality choice of the revised Medicare payment system. Microeconomic analyses. Patients eligible for dialysis in the United States. The perspective of this analysis is that of a financial administrator of a representative dialysis center in the United States. Data were obtained from the Medicare Payment Advisory Commission, the US Renal Data System, the DOPPS (Dialysis Outcomes and Practice Patterns Study) Practice Monitor, the US Bureau of Labor Statistics, and Medicare fee schedules. Recently implemented end-stage renal disease PPS versus the prior case-mix composite payment system. Medicare payment per month, center fixed and variable costs per month, net difference in revenue and variable costs (direct contribution), and net difference in revenue and total costs (operating margin). The direct contribution and operating margin for in-center hemodialysis and peritoneal dialysis are expected to be positive under the new bundled PPS. For Medicare fiscal intermediaries/administrators, paid treatments for home hemodialysis vary from 3.2 to more than 4.8 per week. The direct contribution and operating margin are expected to be negative for home hemodialysis if the number of paid treatments is similar between in-center and home hemodialysis; they are almost identical when the number of paid treatments increases for home hemodialysis by approximately 1 per week. Experience across centers and intermediaries/administrators may vary. Sensitivity analyses were conducted to assess the robustness of findings and determine which variables most influenced results. The new bundled PPS created a financial incentive for increased use of peritoneal dialysis. Use of home hemodialysis may be influenced by number of paid treatments per week. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Mutilating Procedures, Management Practices, and Housing Conditions That May Affect the Welfare of Farm Animals: Implications for Welfare Research.

PubMed

Nordquist, Rebecca E; van der Staay, Franz Josef; van Eerdenburg, Frank J C M; Velkers, Francisca C; Fijn, Lisa; Arndt, Saskia S

2017-02-21

A number of mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are common in farm animal husbandry systems in an attempt to prevent or solve problems, such as injuries from horns or feather pecking. These procedures and other practices, such as early maternal separation, overcrowding, and barren housing conditions, raise concerns about animal welfare. Efforts to ensure or improve animal welfare involve adapting the animal to its environment, i.e., by selective breeding (e.g., by selecting "robust" animals) adapting the environment to the animal (e.g., by developing social housing systems in which aggressive encounters are reduced to a minimum), or both. We propose adapting the environment to the animals by improving management practices and housing conditions, and by abandoning mutilating procedures. This approach requires the active involvement of all stakeholders: veterinarians and animal scientists, the industrial farming sector, the food processing and supply chain, and consumers of animal-derived products. Although scientific evidence about the welfare effects of current practices in farming such as mutilating procedures, management practices, and housing conditions is steadily growing, the gain in knowledge needs a boost through more scientific research. Considering the huge number of animals whose welfare is affected, all possible effort must be made to improve their welfare as quickly as possible in order to ban welfare-compromising procedures and practices as soon as possible.

Implementing Comprehensive Reform: Implications for Practice

ERIC Educational Resources Information Center

Stout, Karen A.

2016-01-01

This chapter describes the challenges and practical barriers community colleges face when implementing comprehensive reform, exploring how reforms are leading to some improvements but not often scaled improvements.

"If we're going to change things, it has to be systemic:" systems change in children's mental health.

PubMed

Hodges, Sharon; Ferreira, Kathleen; Israel, Nathaniel

2012-06-01

Communities that undertake systems change in accordance with the system of care philosophy commit to creating new systems entities for children and adolescents with serious emotional disturbance. These new entities are values-based, voluntary, and cross-agency alliances that include formal child-serving entities, youth, and families. Describing the scope and intent of one such implementation of systems of care, a mental health administrator commented, "If we're going to change things, it has to be systemic" (B. Baxter, personal communication, December 2, 2005). This paper explores the concept of "systemic" in the context of systems of care. Systems theory is used to understand strategies of purposeful systems change undertaken by stakeholders in established system of care communities. The paper presents a conceptual model of systems change for systems of care that is grounded in data from a national study of system of care implementation (Research and Training Center for Children's Mental Health in Case Studies of system implementation: Holistic approaches to studying community-based systems of care: Study 2, University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health, Tampa, FL, 2004). The model is based on Soft Systems Methodology, an application of systems theory developed to facilitate practical action around systems change in human systems (Checkland in Systems thinking, systems practice, Wiley, Chichester, 1999). The implications of these findings to real world actions associated with systems change in systems of care are discussed.

Medication adherence monitoring: implications for patients and providers.

PubMed

Gheorghiu, Bobby; Nayani, Seema

2018-05-01

Non-adherence to medication is a key worldwide issue and can lead to adverse patient outcomes and increased health system costs. Would a process facilitating notification of non-adherence infringe upon the autonomy of individuals or breach expectations of privacy? In contrast, patients who are not taking their medication could unknowingly be putting themselves at risk and all the while prescribers are unaware and without the opportunity to intervene. With the advent of electronic methods of medication adherence monitoring, this ethical dilemma now involves a new layer of complexity. We present two scenarios encountered in clinical practice that reflect issues occurring regularly in the Canadian healthcare system.

Nonlinear normal modes modal interactions and isolated resonance curves

DOE PAGES

Kuether, Robert J.; Renson, L.; Detroux, T.; ...

2015-05-21

The objective of the present study is to explore the connection between the nonlinear normal modes of an undamped and unforced nonlinear system and the isolated resonance curves that may appear in the damped response of the forced system. To this end, an energy balance technique is used to predict the amplitude of the harmonic forcing that is necessary to excite a specific nonlinear normal mode. A cantilever beam with a nonlinear spring at its tip serves to illustrate the developments. Furthermore, the practical implications of isolated resonance curves are also discussed by computing the beam response to sine sweepmore » excitations of increasing amplitudes.« less

Ancient Ethical Practices of Dualism and Ethical Implications for Future Paradigms in Nursing.

PubMed

Milton, Constance L

2016-07-01

Paradigms contain theoretical structures to guide scientific disciplines. Since ancient times, Cartesian dualism has been a prominent philosophy incorporated in the practice of medicine. The discipline of nursing has continued the body-mind emphasis with similar paradigmatic thinking and theories of nursing that separate body and mind. Future trends for paradigm and nursing theory development are harkening to former ways of thinking. In this article the author discusses the origins of Cartesian dualism and implications for its current usage. The author shall illuminate what it potentially means to engage in dualism in nursing and discuss possible ethical implications for future paradigm and theory development in nursing. © The Author(s) 2016.

Values in health care professional socialization: implications for geriatric education in interdisciplinary teamwork.

PubMed

Clark, P G

1997-08-01

The development of an identity and pattern of practice in the health care professions is based on a process of socialization into the roles and norms of a particular discipline and has important implications for clinical practice with elderly persons. Presented is a model for understanding the socialization process of physicians, nurses, and social workers as the development of professional meaning ("voice") based on the acquisition of value orientations or themes intrinsic to their education and training. The implications of these patterns for the abilities of different professions to work together collaboratively in the care of older persons are highlighted as a framework for developing new interdisciplinary curricular models in gerontological and geriatric education.

Overcoming barriers in care for the dying: Theoretical analysis of an innovative program model.

PubMed

Wallace, Cara L

2016-08-01

This article explores barriers to end-of-life (EOL) care (including development of a death denying culture, ongoing perceptions about EOL care, poor communication, delayed access, and benefit restrictions) through the theoretical lens of symbolic interactionism (SI), and applies general systems theory (GST) to a promising practice model appropriate for addressing these barriers. The Compassionate Care program is a practice model designed to bridge gaps in care for the dying and is one example of a program offering concurrent care, a recent focus of evaluation though the Affordable Care Act. Concurrent care involves offering curative care alongside palliative or hospice care. Additionally, the program offers comprehensive case management and online resources to enrollees in a national health plan (Spettell et al., 2009).SI and GST are compatible and interrelated theories that provide a relevant picture of barriers to end-of-life care and a practice model that might evoke change among multiple levels of systems. These theories promote insight into current challenges in EOL care, as well as point to areas of needed research and interventions to address them. The article concludes with implications for policy and practice, and discusses the important role of social work in impacting change within EOL care.

Good practice statements on safe laboratory testing: A mixed methods study by the LINNEAUS collaboration on patient safety in primary care.

PubMed

Bowie, Paul; Forrest, Eleanor; Price, Julie; Verstappen, Wim; Cunningham, David; Halley, Lyn; Grant, Suzanne; Kelly, Moya; Mckay, John

2015-09-01

The systems-based management of laboratory test ordering and results handling is a known source of error in primary care settings worldwide. The consequences are wide-ranging for patients (e.g. avoidable harm or poor care experience), general practitioners (e.g. delayed clinical decision making and potential medico-legal implications) and the primary care organization (e.g. increased allocation of resources to problem-solve and dealing with complaints). Guidance is required to assist care teams to minimize associated risks and improve patient safety. To identify, develop and build expert consensus on 'good practice' guidance statements to inform the implementation of safe systems for ordering laboratory tests and managing results in European primary care settings. Mixed methods studies were undertaken in the UK and Ireland, and the findings were triangulated to develop 'good practice' statements. Expert consensus was then sought on the findings at the wider European level via a Delphi group meeting during 2013. We based consensus on 10 safety domains and developed 77 related 'good practice' statements (≥ 80% agreement levels) judged to be essential to creating safety and minimizing risks in laboratory test ordering and subsequent results handling systems in international primary care. Guidance was developed for improving patient safety in this important area of primary care practice. We need to consider how this guidance can be made accessible to frontline care teams, utilized by clinical educators and improvement advisers, implemented by decision makers and evaluated to determine acceptability, feasibility and impacts on patient safety.

Managing health and safety risks: Implications for tailoring health and safety management system practices.

PubMed

Willmer, D R; Haas, E J

2016-01-01

As national and international health and safety management system (HSMS) standards are voluntarily accepted or regulated into practice, organizations are making an effort to modify and integrate strategic elements of a connected management system into their daily risk management practices. In high-risk industries such as mining, that effort takes on added importance. The mining industry has long recognized the importance of a more integrated approach to recognizing and responding to site-specific risks, encouraging the adoption of a risk-based management framework. Recently, the U.S. National Mining Association led the development of an industry-specific HSMS built on the strategic frameworks of ANSI: Z10, OHSAS 18001, The American Chemistry Council's Responsible Care, and ILO-OSH 2001. All of these standards provide strategic guidance and focus on how to incorporate a plan-do-check-act cycle into the identification, management and evaluation of worksite risks. This paper details an exploratory study into whether practices associated with executing a risk-based management framework are visible through the actions of an organization's site-level management of health and safety risks. The results of this study show ways that site-level leaders manage day-to-day risk at their operations that can be characterized according to practices associated with a risk-based management framework. Having tangible operational examples of day-to-day risk management can serve as a starting point for evaluating field-level risk assessment efforts and their alignment to overall company efforts at effective risk mitigation through a HSMS or other processes.

Model Based Mission Assurance in a Model Based Systems Engineering (MBSE) Framework: State-of-the-Art Assessment

NASA Technical Reports Server (NTRS)

Cornford, Steven L.; Feather, Martin S.

2016-01-01

This report explores the current state of the art of Safety and Mission Assurance (S&MA) in projects that have shifted towards Model Based Systems Engineering (MBSE). Its goal is to provide insight into how NASA's Office of Safety and Mission Assurance (OSMA) should respond to this shift. In MBSE, systems engineering information is organized and represented in models: rigorous computer-based representations, which collectively make many activities easier to perform, less error prone, and scalable. S&MA practices must shift accordingly. The "Objective Structure Hierarchies" recently developed by OSMA provide the framework for understanding this shift. Although the objectives themselves will remain constant, S&MA practices (activities, processes, tools) to achieve them are subject to change. This report presents insights derived from literature studies and interviews. The literature studies gleaned assurance implications from reports of space-related applications of MBSE. The interviews with knowledgeable S&MA and MBSE personnel discovered concerns and ideas for how assurance may adapt. Preliminary findings and observations are presented on the state of practice of S&MA with respect to MBSE, how it is already changing, and how it is likely to change further. Finally, recommendations are provided on how to foster the evolution of S&MA to best fit with MBSE.

Assessing advantages and barriers to telemedicine adoption in the practice setting: A MyCareTeam(TM) exemplar.

PubMed

L'Esperance, Shaun T; Perry, Donna J

2016-06-01

Telemedicine is an evolving field that holds great potential to improve patient outcomes. The National Organization of Nurse Practitioner Faculties core competencies now require all nurse practitioners (NPs) to be competent utilizing telemedicine to address various patient and healthcare system needs. While telemedicine offers advantages to patient care, adoption of new technologies can be challenging. An assessment of perceived advantages and barriers to MyCareTeam, an online diabetes management system, was conducted at an adult diabetes clinic. Two survey questionnaires were developed based on the Diffusion of Innovations (DOI) theory. The surveys were administered to patients in the clinic waiting room and sent to all clinical staff via an e-mail link. The findings of this project suggested a novel way to classify patients with regard to their use of the technology with implications for practice. Recommendations include outreach to enhance knowledge and awareness of MyCareTeam, reinforcing the full scope of the system, and improved technical support. DOI theory is a framework that may be utilized by NPs as a tool for assessing advantages and barriers to telemedicine applications in the practice setting in order to identify strategies to promote adoption and use. ©2015 American Association of Nurse Practitioners.

Should dentistry be part of the National Health Information Infrastructure?

PubMed

Schleyer, Titus K L

2004-12-01

The National Health Information Infrastructure, or NHII, proposes to improve the effectiveness, efficiency and overall quality of health in the United States by establishing a national, electronic information network for health care. To date, dentistry's integration into this network has not been discussed widely. The author reviews the NHII and its goals and structure through published reports and background literature. The author evaluates the advantages and disadvantages of the NHII regarding their implications for the dental care system. The NHII proposes to implement computer-based patient records, or CPRs, for most Americans by 2014, connect personal health information with other clinical and public health information, and enable different types of care providers to access CPRs. Advantages of the NHII include transparency of health information across health care providers, potentially increased involvement of patients in their care, better clinical decision making through connecting patient-specific information with the best clinical evidence, increased efficiency, enhanced bioterrorism defense and potential cost savings. Challenges in the implementation of the NHII in dentistry include limited use of CPRs, required investments in information technology, limited availability and adoption of standards, and perceived threats to privacy and confidentiality. The implementation of the NHII is making rapid strides. Dentistry should become an active participant in the NHII and work to ensure that the needs of dental patients and the profession are met. Practice Implications. The NHII has far-reaching implications on dental practice by making it easier to access relevant patient information and by helping to improve clinical decision making.

Democratic Practices in Education: Implications for Teacher Education

ERIC Educational Resources Information Center

Pearl, Art, Ed.; Pryor, Caroline R., Ed.

2005-01-01

This book presents the findings of eleven teacher educators as they examine the meaning of democracy and its application to classroom practice. There is a shared belief among all contributors to this volume: that incorporating democratic practice into teacher education is an essential requirement to introducing democratic practices in K-12…

SLT Beliefs about Collaborative Practice: Implications for Education and Learning

ERIC Educational Resources Information Center

Jago, Suzanne; Radford, Julie

2017-01-01

Effective collaborative practice is expected of newly qualified speech and language therapists (SLTs) in order to achieve the best outcomes for clients. Research into collaborative practice has identified a number of barriers to and facilitators of collaborative practice, but there has been limited research into how well prepared newly qualified…

Practicing Teachers' Perceptions of Teacher Trainees: Implications for Teacher Education

ERIC Educational Resources Information Center

Kagoda, Alice Merab; Sentongo, John

2015-01-01

Practicing teachers are partners in preparation of teacher trainees. However, little is known about their perceptions of the teacher trainees they receive every year in their schools. Ninety three practicing teachers from twenty schools participated in this study. The objectives were to find out the practicing teachers' perceptions of teacher…

Exploring Science Teachers' Perceptions of Experimentation: Implications for Restructuring School Practical Work

ERIC Educational Resources Information Center

Wei, Bing; Li, Xiaoxiao

2017-01-01

It is commonly recognised that practical work has a distinctive and central role in science teaching and learning. Although a large number of studies have addressed the definitions, typologies, and purposes of practical work, few have consulted practicing science teachers. This study explored science teachers' perceptions of experimentation for…

The kelvin redefined

NASA Astrophysics Data System (ADS)

Machin, Graham

2018-02-01

On 20 May 2019 it is anticipated that the most radical revision of the International System of Units (the SI), since its inception, will come into force. From that point, all the SI units will be based on defined values of fundamental constants of nature. In this paper the redefinition of the kelvin and its implications are considered. The topic will be introduced by discussing how the wording of the new definition of the kelvin developed. The kelvin redefinition is reliant on a secure low-uncertainty value of the Boltzmann constant; its determination by different physical methods and how the final definitive value for the kelvin redefinition was arrived at is discussed. The redefined kelvin will be implemented through a document known as the mise en pratique (i.e. the ‘practical realisation’) for the definition of the kelvin (MeP-K). The development and contents of the MeP-K will be described. There follows a discussion of contemporary primary thermometry, which is the bedrock on which a secure kelvin redefinition will be founded. Finally the paper ends with a discussion of the implications of the redefinition, for traceability, and, more widely, the practice of thermometry in general.

Future Organization of Oral Health Services Delivery: From 2012 to 2042.

PubMed

Brown, L Jackson

2017-09-01

The United States is currently experiencing a vortex of change in both general health and oral health care delivery, the ultimate outcome of which is still not well understood. The specific focus of this article is to examine the future organization of the oral health services delivery system (OHSDS) in the U.S., with special attention given to the role of large group dental practices (LGDPs) in that future. The article describes the various types of LGDPs and their ability to change the economic characteristics of the OHSDS. Large geographically distributed corporate group dental practices (LGDCGDPs) are the type that may expand their market share to the extent that they could change the economic characteristics of the OHSDS. A wide range of scenarios is used to project the expansion of LGDCGDPs into the future. The scenarios modeled are not intended as predictions but rather to present a range of possible OHSDS market structures that may emerge over the next 30 years. The implications of each scenario for the economic competition within the OHSDS are described. Possible implications of these trends for dental education are also discussed. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

Women's self-perception and self-care practice: implications for health care delivery.

PubMed

Mendias, E P; Clark, M C; Guevara, E B

2001-01-01

Mexican American women experience unique health care needs related to integration of Mexican and American cultures. To learn how to better promote self-care practices and service utilization in women of Mexican origin living in Texas, researchers used a qualitative approach to interview a convenience sample of 11 low-income women attending a health clinic. Researchers collected narrative data about the women's perceptions of health, wellness, and self-care. Using the matrix approach described by Miles and Huberman, we organized findings around women's roles, including participants' descriptions of themselves, their health and wellness awareness, self-care practices for health/illness and wellness/nonwellness, barriers to self-care, origin of self-care practices, and perceptions of life control. Implications for health planning and service delivery are presented.

[A framework for evaluating ethical issues of public health initiatives: practical aspects and theoretical implications].

PubMed

Petrini, Carlo

2015-01-01

The "Framework for the Ethical Conduct of Public Health Initiatives", developed by Public Health Ontario, is a practical guide for assessing the ethical implications of evidence-generating public health initiatives, whether research or non-research activities, involving people, their biological materials or their personal information. The Framework is useful not only to those responsible for determining the ethical acceptability of an initiative, but also to investigators planning new public health initiatives. It is informed by a theoretical approach that draws on widely shared bioethical principles. Two considerations emerge from both the theoretical framework and its practical application: the line between practice and research is often blurred; public health ethics and biomedical research ethics are based on the same common heritage of values.

Science, practice and mythology: a definition and examination of the implications of scientism in medicine.

PubMed

Loughlin, Michael; Lewith, George; Falkenberg, Torkel

2013-06-01

Scientism is a philosophy which purports to define what the world 'really is'. It adopts what the philosopher Thomas Nagel called 'an epistemological criterion of reality', defining what is real as that which can be discovered by certain quite specific methods of investigation. As a consequence all features of experience not revealed by those methods are deemed 'subjective' in a way that suggests they are either not real, or lie beyond the scope of meaningful rational inquiry. This devalues capacities that (we argue) are in fact essential components of good reasoning and virtuous practice. Ultimately, the implications of scientism for statements of value undermine value-judgements essential for science itself to have a sound basis. Scientism has implications, therefore, for ontology, epistemology and also for which claims we can assert as objective truths about the world. Adopting scientism as a world view will have consequences for reasoning and decision-making in clinical and other contexts. We analyse the implications of this approach and conclude that we need to reject scientism if we are to avoid stifling virtuous practice and to develop richer conceptions of human reasoning.

An augmented reality system for upper-limb post-stroke motor rehabilitation: a feasibility study.

PubMed

Assis, Gilda Aparecida de; Corrêa, Ana Grasielle Dionísio; Martins, Maria Bernardete Rodrigues; Pedrozo, Wendel Goes; Lopes, Roseli de Deus

2016-08-01

To determine the clinical feasibility of a system based on augmented reality for upper-limb (UL) motor rehabilitation of stroke participants. A physiotherapist instructed the participants to accomplish tasks in augmented reality environment, where they could see themselves and their surroundings, as in a mirror. Two case studies were conducted. Participants were evaluated pre- and post-intervention. The first study evaluated the UL motor function using Fugl-Meyer scale. Data were compared using non-parametric sign tests and effect size. The second study used the gain of motion range of shoulder flexion and abduction assessed by computerized biophotogrammetry. At a significance level of 5%, Fugl-Meyer scores suggested a trend for greater UL motor improvement in the augmented reality group than in the other. Moreover, effect size value 0.86 suggested high practical significance for UL motor rehabilitation using the augmented reality system. System provided promising results for UL motor rehabilitation, since enhancements have been observed in the shoulder range of motion and speed. Implications for Rehabilitation Gain of range of motion of flexion and abduction of the shoulder of post-stroke patients can be achieved through an augmented reality system containing exercises to promote the mental practice. NeuroR system provides a mental practice method combined with visual feedback for motor rehabilitation of chronic stroke patients, giving the illusion of injured upper-limb (UL) movements while the affected UL is resting. Its application is feasible and safe. This system can be used to improve UL rehabilitation, an additional treatment past the traditional period of the stroke patient hospitalization and rehabilitation.

Why there is no cookbook approach to palliative care: implications of the P450 enzyme system.

PubMed

Kuebler, Kim K; Varga, James; Mihelic, Ronald A

2003-01-01

A plethora of literature describes the impact of the P450 enzyme system, but this information is limited regarding its relevancy to nursing practice. However, oncology nurses providing palliative symptom management must have a working knowledge of the P450 enzyme system to recognize the variability that exists among individual medication reactions or why a "cookbook approach" to symptom management is not always effective and appropriate. This article describes the variations associated with medication metabolism with reference to ethnic differences. Having a basic understanding of the P450 enzyme system and, more specifically, the CYP2D6 influence on the metabolism of common medications used in palliative symptom management can help to prevent medication toxicity or underdosing, which interferes with patients' quality of life.

Bioregulatory systems medicine: an innovative approach to integrating the science of molecular networks, inflammation, and systems biology with the patient's autoregulatory capacity?

PubMed Central

Goldman, Alyssa W.; Burmeister, Yvonne; Cesnulevicius, Konstantin; Herbert, Martha; Kane, Mary; Lescheid, David; McCaffrey, Timothy; Schultz, Myron; Seilheimer, Bernd; Smit, Alta; St. Laurent, Georges; Berman, Brian

2015-01-01

Bioregulatory systems medicine (BrSM) is a paradigm that aims to advance current medical practices. The basic scientific and clinical tenets of this approach embrace an interconnected picture of human health, supported largely by recent advances in systems biology and genomics, and focus on the implications of multi-scale interconnectivity for improving therapeutic approaches to disease. This article introduces the formal incorporation of these scientific and clinical elements into a cohesive theoretical model of the BrSM approach. The authors review this integrated body of knowledge and discuss how the emergent conceptual model offers the medical field a new avenue for extending the armamentarium of current treatment and healthcare, with the ultimate goal of improving population health. PMID:26347656

Care Delivery for Filipino Americans Using the Neuman Systems Model

PubMed Central

Angosta, Alona D.; Ceria-Ulep, Clementina D.; Tse, Alice M.

2016-01-01

Filipino Americans are at risk of coronary heart disease due to the presence of multiple cardiometabolic factors. Selecting a framework that addresses the factors leading to coronary heart disease is vital when providing care for this population. The Neuman systems model is a comprehensive and wholistic framework that offers an innovative method of viewing clients, their families, and the healthcare system across multiple dimensions. Using the Neuman systems model, advanced practice nurses can develop and implement interventions that will help reduce the potential cardiovascular problems of clients with multiple risk factors. The authors in this article provides insight into the cardiovascular health of Filipino Americans and has implications for nurses and other healthcare providers working with various Southeast Asian groups in the United States. PMID:24740949

Educational Marketing: A Review and Implications for Supporting Practice in Tertiary Education

ERIC Educational Resources Information Center

Stachowski, Christopher Allen

2011-01-01

This article reviews the existing educational marketing literature in the leading tertiary educational management journals. A discussion of the implications for supporting practitioners in non-university settings is presented. (Contains 1 table.)

Nanotechnology: the coming revolution and its implications for consumers, clinicians, and informatics.

PubMed

Staggers, Nancy; McCasky, Teresa; Brazelton, Nancy; Kennedy, Rosemary

2008-01-01

Nanotechnology promises to revolutionize manufactured materials as we know them, creating a vast array of new products, drug delivery devices, and monitoring mechanisms. The promise of these products and devices is tremendous. Likewise, the implications of this technology are immense, ranging across consumers, clinicians, and the practice of informatics. Specific implications include opportunities for education of health care consumers and clinicians about the safe and ethical use of nanomaterials, a requirement for new policies and regulations, potential radical role changes for both consumers and clinicians, and new demands in the practice of informatics. The most pressing concern for health applications is the safe use of nanomaterials. Given the promise of nanomaterials and the implications across at least these 3 areas, nurses need to understand the capabilities and limitations of nanomaterials, proceed with reasoned caution, and plan now for its wide-ranging impacts.

The Epistemology of Moral Bioenhancement.

PubMed

Crutchfield, Parker

2016-07-01

Moral bioenhancement is the potential practice of manipulating individuals' moral behaviors by biological means in order to help resolve pressing moral issues such as climate change and terrorism. This practice has obvious ethical implications, and these implications have been and continue to be discussed in the bioethics literature. What have not been discussed are the epistemological implications of moral bioenhancement. This article details some of these implications of engaging in moral bioenhancement. The argument begins by making the distinction between moral bioenhancement that manipulates the contents of mental states (e.g. beliefs) and that which manipulates other, non-representational states (e.g. motivations). Either way, I argue, the enhanced moral psychology will fail to conform to epistemic norms, and the only way to resolve this failure and allow the moral bioenhancement to be effective in addressing the targeted moral issues is to make the moral bioenhancement covert. © 2015 John Wiley & Sons Ltd.

Professional Satisfaction and Dissatisfaction among Practicing Counselors: Implications for Counselor Education.

ERIC Educational Resources Information Center

Jaeger, Richard M.; Tesh, Anita S.

This study examined the degree and dimensions of professional satisfaction among a large, nationally-representative sample of practicing counselors. The objectives of the study included estimating the distribution of global professional satisfaction among practicing counselors; examining the relationships between counselors' global professional…

Applications of Reflective Practice. UCEA Monograph Series.

ERIC Educational Resources Information Center

Wendel, Frederick C., Ed.

The implications of reflective practices for educational leadership are examined in this publication, which contains three papers originally presented at the 1990 Convention of the University Council for Educational Administration. Ann Hart, Nancy Sorensen, and Kerri Naylor report on applications of reflective practice to educational…

Development of the Supported Decision Making Inventory System.

PubMed

Shogren, Karrie A; Wehmeyer, Michael L; Uyanik, Hatice; Heidrich, Megan

2017-12-01

Supported decision making has received increased attention as an alternative to guardianship and a means to enable people with intellectual and developmental disabilities to exercise their right to legal capacity. Assessments are needed that can used by people with disabilities and their systems of supports to identify and plan for needed supports to enable decision making. This article describes the steps taken to develop such an assessment tool, the Supported Decision Making Inventory System (SDMIS), and initial feedback received from self-advocates with intellectual disability. The three sections of the SDMIS (Supported Decision Making Personal Factors Inventory, Supported Decision Making Environmental Demands Inventory, and Decision Making Autonomy Inventory) are described and implications for future research, policy, and practice are discussed.

Kidney transplantation in the elderly.

PubMed

Singh, Neeraj; Nori, Uday; Pesavento, Todd

2009-08-01

Recent outcome data, ongoing organ shortage and proposed changes in allocation policies are driving the need to review current practices and possible future course of kidney transplantation in the elderly patients. A proposed new kidney allocation system based on matching donor and recipient characteristics to enable 'age-matched' kidney allocation is currently being discussed in the USA. While this system benefits younger recipients, implications for elderly recipients receiving older grafts remain a matter of debate. Despite improved outcomes, there remain significant challenges to kidney transplantation in the elderly, including organ shortage, poor transplant rate, evolving allocation policies, high wait-list mortality and nonstandardized immunosuppression. Prospective studies are needed to evaluate the strategies to meet these challenges and to study the impact of proposed new allocation system.

Internationally Educated Health Professionals in Canada: Navigating Three Policy Subsystems Along the Pathway to Practice.

PubMed

Paul, Robert; Martimianakis, Maria Athina Tina; Johnstone, Julie; McNaughton, Nancy; Austin, Zubin

2017-05-01

The integration of internationally educated health professionals (IEHPs) into the health workforces of their adopted countries is an issue that has challenged policy makers and policy scholars for decades. In this article, the authors explore the implications of the ideological underpinnings of the policy subsystems that IEHPs must navigate in seeking employment in Canada, with a focus on Ontario.Using a policy subsystem approach, in 2015 the authors analyzed a large preexisting data set composed of articles, governmental reports, Web sites, and transcripts of interviews and focus groups conducted in Ontario with IEHPs, health care executives, human resource managers, and job counselors to IEHPs. Through this analysis, they identified three policy subsystems-the immigration system, the educational and licensure/regulatory system, and the health human resources system-that conflict ideologically and, as a result, create barriers to IEHP integration.To make substantive progress on IEHP integration in Canada, four questions should be considered. First, how can researchers bring new research methods to bear to explore why no jurisdiction has been able to create an integrated pathway to practice for IEHPs? Second, how and to what end are the institutions within the three policy subsystems regulating the IEHP pathway to practice? Third, how might the educational and licensure/regulatory policy subsystem create alternative health care employment options for IEHPs? Finally, how might health professions educators pursue a leadership role in the creation of an overarching institution to manage the pathway to practice for IEHPs?

Information technology, the internet, and the future of neurology.

PubMed

Maulden, Sarah A

2003-05-01

This review addresses the impact of information technology and the Internet on the current and future practice of neurology. Information technology is influencing medical practice in ways that could be both beneficial and harmful. Scenarios are presented to depict some of the ways in which the practice of neurology is being influenced by the growth of technology. First, the advantages and disadvantages of e-mail as a means of doctor-patient communication are presented. Some of the ethical and legal issues arising in this context are discussed.Second, the Internet is changing neurologists' relationships to other professionals in the health care industry. Geographical isolation is less problematic than in the past. Telemedicine, including remote consulting via the Web, has special implications for neurologists in several areas, including stroke management, movement disorders, and epilepsy.Third, the growing availability of large databases, powerful search engines, and online full-text journals is discussed. Skill in navigating and managing these resources will become increasingly important. New computer-assisted decision support systems will continue to be implemented. Applications exist or are being developed for use by clinicians for many specific neurologic disorders.Finally, some of the problematic issues concerning medical use of the Internet are discussed, including availability, portability, security, quality, and outcomes. Medical information systems, with their attendant advantages and limitations, will become increasingly significant in the practice of neurology. Despite overall improvement in access to information, major barriers still exist to the proper implementation and utilization of truly integrated information systems.

Healthcare Reform and Preparing the Future Clinical Child and Adolescent Psychology Workforce.

PubMed

Janicke, David M; Fritz, Alyssa M; Rozensky, Ronald H

2015-01-01

The healthcare environment is undergoing important changes for both patients and providers, in part due to the Patient Protection and Affordable Care Act (ACA). Ultimately the healthcare delivery system will function very differently by the end of this decade. These changes will have important implications for the education, training, scientific inquiry, and practice of clinical child and adolescent psychologists. In this article we provide a brief description of the fundamental features of the ACA, with a specific focus on critical components of the act that have important, specific implications for clinical child and adolescents psychologists. We then provide recommendations to help position our field to thrive in the evolving healthcare environment to help facilitate further awareness and promote discussion of both challenges and opportunities that face our field in this evolving health care environment.

Not afraid to blame: the neglected role of blame attribution in medical consumerism and some implications for health policy.

PubMed

Rosenthal, Marsha; Schlesinger, Mark

2002-01-01

A crucial aspect of medical consumerism has been overlooked in past research and policymaking: how consumers decide whom to "blame" for bad outcomes. This study explores how, in a system increasingly dominated by managed care, these attributions affect consumers' attitudes and behavior. Using data from the experiences of people with serious mental illness, hypotheses are tested regarding the origins and consequences of blaming for medical consumerism. Blame was allocated to health plans in a manner similar, but not identical, to the way in which blame was allocated to health care professionals. Both allocations are shaped by enrollment in managed care, with blame allocation affecting consumers' subsequent willingness to talk about adverse events. Policy implications include the need for more finely tuned grievance procedures and better consumer education about managed care practices.

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

Borges, Raymond Charles; Beaver, Justin M; Buckner, Mark A

Power system disturbances are inherently complex and can be attributed to a wide range of sources, including both natural and man-made events. Currently, the power system operators are heavily relied on to make decisions regarding the causes of experienced disturbances and the appropriate course of action as a response. In the case of cyber-attacks against a power system, human judgment is less certain since there is an overt attempt to disguise the attack and deceive the operators as to the true state of the system. To enable the human decision maker, we explore the viability of machine learning as amore » means for discriminating types of power system disturbances, and focus specifically on detecting cyber-attacks where deception is a core tenet of the event. We evaluate various machine learning methods as disturbance discriminators and discuss the practical implications for deploying machine learning systems as an enhancement to existing power system architectures.« less

Strategic issues in performance appraisal: theory and practice.

PubMed

Fombrun, C J; Laud, R L

1983-01-01

Performance appraisal systems have tremendous strategic potential for governing employee behavior and thus corporate direction through their links to selection, training and career planning, and reward systems. Authors Charles J. Fombrun, assistant professor of management at the University of Pennsylvania's Wharton School, and Robert P. Laud, senior vice-president of Drake Beam Morin, Inc., surveyed appraisal systems of Fortune 1300 corporations to find out how well companies are realizing this potential. Among their conclusions: (1) In most organizations, the typical performance appraisal system is focused on short-term goals. Strengthening the linkage between the appraisal system and the long-term implications of strategic planning could improve organizational effectiveness in the future. (2) The performance appraisal system's most prevalent use is as a feedback mechanism rather than as a management tool. Thus, the authors conclude, the role of the performance appraisal system as a strategic organizational tool is largely unappreciated by U.S. organizations.

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

PubMed

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

2018-01-01

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

Bioenergy Development Policy and Practice Must Recognize Potential Hydrologic Impacts: Lessons from the Americas.

PubMed

Watkins, David W; de Moraes, Márcia M G Alcoforado; Asbjornsen, Heidi; Mayer, Alex S; Licata, Julian; Lopez, Jose Gutierrez; Pypker, Thomas G; Molina, Vivianna Gamez; Marques, Guilherme Fernandes; Carneiro, Ana Cristina Guimaraes; Nuñez, Hector M; Önal, Hayri; da Nobrega Germano, Bruna

2015-12-01

Large-scale bioenergy production will affect the hydrologic cycle in multiple ways, including changes in canopy interception, evapotranspiration, infiltration, and the quantity and quality of surface runoff and groundwater recharge. As such, the water footprints of bioenergy sources vary significantly by type of feedstock, soil characteristics, cultivation practices, and hydro-climatic regime. Furthermore, water management implications of bioenergy production depend on existing land use, relative water availability, and competing water uses at a watershed scale. This paper reviews previous research on the water resource impacts of bioenergy production-from plot-scale hydrologic and nutrient cycling impacts to watershed and regional scale hydro-economic systems relationships. Primary gaps in knowledge that hinder policy development for integrated management of water-bioenergy systems are highlighted. Four case studies in the Americas are analyzed to illustrate relevant spatial and temporal scales for impact assessment, along with unique aspects of biofuel production compared to other agroforestry systems, such as energy-related conflicts and tradeoffs. Based on the case studies, the potential benefits of integrated resource management are assessed, as is the need for further case-specific research.

Clinical implications of basic science discoveries: nociceptive neurons as targets to control immunity--potential relevance for transplantation.

PubMed

Larregina, A T; Divito, S J; Morelli, A E

2015-06-01

Increasing evidence indicates the existence of a complex cross-regulation between the most important biosensors of the human body: The immune and nervous systems. Cytokines control body temperature and trigger autoimmune disorders in the central nervous system, whereas neuropeptides released in peripheral tissues and lymphoid organs modulate inflammatory (innate) and adaptive immune responses. Surprisingly, the effects of nerve fibers and the antidromic release of its pro-inflammatory neuropeptides on the leukocytes of the immune system that mediate graft rejection are practically unknown. In the transplantation field, such area of research remains practically unexplored. A recent study by Riol-Blanco et al has revealed new details on how nociceptive nerves regulate the pro-inflammatory function of leukocytes in peripheral tissues. Although the mechanism(s) by which neuroinflammation affects the immune response against the allograft remains unknown, recent data suggest that this new area of research is worth exploring for potential development of novel complementary therapies for prevention/treatment of graft rejection. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Bioenergy Development Policy and Practice Must Recognize Potential Hydrologic Impacts: Lessons from the Americas

NASA Astrophysics Data System (ADS)

Watkins, David W.; de Moraes, Márcia M. G. Alcoforado; Asbjornsen, Heidi; Mayer, Alex S.; Licata, Julian; Lopez, Jose Gutierrez; Pypker, Thomas G.; Molina, Vivianna Gamez; Marques, Guilherme Fernandes; Carneiro, Ana Cristina Guimaraes; Nuñez, Hector M.; Önal, Hayri; da Nobrega Germano, Bruna

2015-12-01

Large-scale bioenergy production will affect the hydrologic cycle in multiple ways, including changes in canopy interception, evapotranspiration, infiltration, and the quantity and quality of surface runoff and groundwater recharge. As such, the water footprints of bioenergy sources vary significantly by type of feedstock, soil characteristics, cultivation practices, and hydro-climatic regime. Furthermore, water management implications of bioenergy production depend on existing land use, relative water availability, and competing water uses at a watershed scale. This paper reviews previous research on the water resource impacts of bioenergy production—from plot-scale hydrologic and nutrient cycling impacts to watershed and regional scale hydro-economic systems relationships. Primary gaps in knowledge that hinder policy development for integrated management of water-bioenergy systems are highlighted. Four case studies in the Americas are analyzed to illustrate relevant spatial and temporal scales for impact assessment, along with unique aspects of biofuel production compared to other agroforestry systems, such as energy-related conflicts and tradeoffs. Based on the case studies, the potential benefits of integrated resource management are assessed, as is the need for further case-specific research.

Convergence of service, policy, and science toward consumer-driven mental health care.

PubMed

Carroll, Christopher D; Manderscheid, Ronald W; Daniels, Allen S; Compagni, Amelia

2006-12-01

A common theme is emerging in sentinel reports on the United States health care system. Consumer relevance and demands on service systems and practices are influencing how mental health care is delivered and how systems will be shaped in the future. The present report seeks to assemble a confluence of consumer-driven themes from noteworthy reports on the state of the mental health system in the U.S. It also explores innovative efforts, promising practices, collaborative efforts, as well as identification of barriers to consumer-directed care, with possible solutions. The report reviews the relevant public mental health policy and data used in published work. The findings indicate an increasing public and private interest in promoting consumer-driven care, even though historical systems of care predominate, and often create, barriers to wide-spread redesign of a consumer-centered mental health care system. Innovative consumer-driven practices are increasing as quality, choice, and self-determination become integral parts of a redesigned U.S. mental health care system. The use of consumer-driven approaches in mental health is limited at best. These programs challenge industry norms and traditional practices. Limitations include the need for additional and thorough evaluations of effectiveness (cost and clinical) and replicability of consumer-directed programs. Consumer-driven services indicate that mental health consumers are expecting to be more participative in their mental health care. This expectation will influence how traditional mental health services and providers become more consumer-centric and meet the demand. Public and private interest in consumer-driven health care range from creating cost-conscious consumers to individualized control of recovery. The health care sector should seek to invest more resources in the provision of consumer-driven health care programs. The results of this study have implications and are informative for other countries where consumer-directed care is delivered in either the private or public health care systems. More research is needed to obtain further evidence on the use of consumer-driven services and their overall effectiveness.

Public Health's Approach to Systemic Racism: a Systematic Literature Review.

PubMed

Castle, Billie; Wendel, Monica; Kerr, Jelani; Brooms, Derrick; Rollins, Aaron

2018-05-04

Recently, public health has acknowledged racism as a social determinant of health. Much evidence exists on the impact of individual-level racism and discrimination, with little to no examination of racism from the standpoint of systems and structures. The purpose of this systematic literature review is to analyze the extent to which public health currently addresses systemic racism in the published literature. Utilizing the PRISMA guidelines, this review examines three widely used databases to examine published literature covering the topic as well as implications for future research and practice. A total of 85 articles were included in the review analysis after meeting study criteria. Across numerous articles, the terms racism and systemic racism are largely absent. A critical need exists for an examination of the historical impact of systemic racism on the social determinants of health and health of marginalized populations.

A Descriptive Study of First-Year College Students' Non-Academic Digital Literacy Practices with Implications for College Writing Education

ERIC Educational Resources Information Center

Amicucci, Ann N.

2013-01-01

In this qualitative research study, the author investigated first-year college students' non-academic digital literacy practices, the audiences for these practices, and students' preferences for enacting these practices in the first-year college writing classroom. Methods of data collection included surveying 177 students, conducting…

Examining How Proactive Management and Culturally Responsive Teaching Relate to Student Behavior: Implications for Measurement and Practice

ERIC Educational Resources Information Center

Larson, Kristine E.; Pas, Elise T.; Bradshaw, Catherine P.; Rosenberg, Michael S.; Day-Vines, Norma L.

2018-01-01

The discipline gap between White students and African American students has increased demand for teacher training in culturally responsive and behavior management practices. Extant research, however, is inconclusive about how culturally responsive teaching practices relate to student behavior or how to assess using such practices in the classroom.…

Designing for adaptation to novelty and change: functional information, emergent feature graphics, and higher-level control.

PubMed

Hajdukiewicz, John R; Vicente, Kim J

2002-01-01

Ecological interface design (EID) is a theoretical framework that aims to support worker adaptation to change and novelty in complex systems. Previous evaluations of EID have emphasized representativeness to enhance generalizability of results to operational settings. The research presented here is complementary, emphasizing experimental control to enhance theory building. Two experiments were conducted to test the impact of functional information and emergent feature graphics on adaptation to novelty and change in a thermal-hydraulic process control microworld. Presenting functional information in an interface using emergent features encouraged experienced participants to become perceptually coupled to the interface and thereby to exhibit higher-level control and more successful adaptation to unanticipated events. The absence of functional information or of emergent features generally led to lower-level control and less success at adaptation, the exception being a minority of participants who compensated by relying on analytical reasoning. These findings may have practical implications for shaping coordination in complex systems and fundamental implications for the development of a general unified theory of coordination for the technical, human, and social sciences. Actual or potential applications of this research include the design of human-computer interfaces that improve safety in complex sociotechnical systems.

Innovative grassland management systems for environmental and livelihood benefits.

PubMed

Kemp, David R; Guodong, Han; Xiangyang, Hou; Michalk, David L; Fujiang, Hou; Jianping, Wu; Yingjun, Zhang

2013-05-21

Grasslands occupy 40% of the world's land surface (excluding Antarctica and Greenland) and support diverse groups, from traditional extensive nomadic to intense livestock-production systems. Population pressures mean that many of these grasslands are in a degraded state, particularly in less-productive areas of developing countries, affecting not only productivity but also vital environmental services such as hydrology, biodiversity, and carbon cycles; livestock condition is often poor and household incomes are at or below poverty levels. The challenge is to optimize management practices that result in "win-win" outcomes for grasslands, the environment, and households. A case study is discussed from northwestern China, where it has been possible to reduce animal numbers considerably by using an energy-balance/market-based approach while improving household incomes, providing conditions within which grassland recovery is possible. This bottom-up approach was supported by informing and working with the six layers of government in China to build appropriate policies. Further policy implications are considered. Additional gains in grassland rehabilitation could be fostered through targeted environmental payment schemes. Other aspects of the livestock production system that can be modified are discussed. This work built a strategy that has implications for many other grassland areas around the world where common problems apply.

Policy Implications of Education Informatics

ERIC Educational Resources Information Center

Carr, Jo Ann; O'Brien, Nancy P.

2010-01-01

Background/Context: This concluding article identifies the policy implications of education informatics and explores impacts of current copyright laws, legislative structures, publishing practices, and education organizations. Synthesizing the discussions in the preceding articles, this article highlights the importance of designing information…

Safety implications from design exceptions.

DOT National Transportation Integrated Search

2002-03-01

The objectives of this study were to: a) summarize past design exceptions to document their frequency and reason for their use and b) determine if any adverse safety implications can be related to adopting design policies and practices related to des...

Advancing Early Literacy Learning for All Children: Implications of the NELP Report for Dual-Language Learners

ERIC Educational Resources Information Center

Gutierrez, Kris D.; Zepeda, Marlene; Castro, Dina C.

2010-01-01

The authors examine the implications and limitations of the National Early Literacy Panel report on the early care of young children who are dual-language learners (DLLs).They examine the relevance of the report for DLLs, particularly the practice in this and other national synthesis reports of extrapolating implications for the education of young…

The 20th-Year Anniversary of Critical Race Theory in Education: Implications for Leading to Eliminate Racism

ERIC Educational Resources Information Center

Capper, Colleen A.

2015-01-01

Purpose: Though the first published application of critical race theory (CRT) to education occurred 20 years ago, implications of CRT for educational leadership did not occur until López conducted a CRT analysis of the politics of education literature in 2003. No publications explicitly identify the implications of CRT for leadership practice.…

Spiritual Needs and Practices of Counselor Education Students

ERIC Educational Resources Information Center

Osborn, Debra; Street, Sue; Bradham-Cousar, Michelle

2012-01-01

This study examined the self-reported value of spirituality, types of spiritual practices, and values of 69 counselor education students. It also examined counseling students' ideas for how to increase their comfort with incorporating spirituality into counseling practice. Implications for implementing spirituality training in counselor education…

Convolving engineering and medical pedagogies for training of tomorrow's health care professionals.

PubMed

Lee, Raphael C

2013-03-01

Several fundamental benefits justify why biomedical engineering and medicine should form a more convergent alliance, especially for the training of tomorrow's physicians and biomedical engineers. Herein, we review the rationale underlying the benefits. Biological discovery has advanced beyond the era of molecular biology well into today's era of molecular systems biology, which focuses on understanding the rules that govern the behavior of complex living systems. This has important medical implications. To realize cost-effective personalized medicine, it is necessary to translate the advances in molecular systems biology to higher levels of biological organization (organ, system, and organismal levels) and then to develop new medical therapeutics based on simulation and medical informatics analysis. Higher education in biological and medical sciences must adapt to a new set of training objectives. This will involve a shifting away from reductionist problem solving toward more integrative, continuum, and predictive modeling approaches which traditionally have been more associated with engineering science. Future biomedical engineers and MDs must be able to predict clinical response to therapeutic intervention. Medical education will involve engineering pedagogies, wherein basic governing rules of complex system behavior and skill sets in manipulating these systems to achieve a practical desired outcome are taught. Similarly, graduate biomedical engineering programs will include more practical exposure to clinical problem solving.

Practices and Policies of Clinical Exome Sequencing Providers: Analysis and Implications

PubMed Central

Jamal, Seema M.; Yu, Joon-Ho; Chong, Jessica X.; Dent, Karin M.; Conta, Jessie H.; Tabor, Holly K.; Bamshad, Michael J.

2013-01-01

Exome and whole genome sequencing (ES/WGS) offer potential advantages over traditional approaches to diagnostic genetic testing. Consequently, use of ES/WGS in clinical settings is rapidly becoming commonplace. Yet there are myriad moral, ethical, and perhaps legal implications attached to the use of ES and health care professionals and institutions will need to consider these implications in the context of the varied practices and policies of ES service providers. We developed “core elements” of content and procedures for informed consent, data sharing, and results management and a quantitative scale to assess the extent to which research protocols met the standards established by these core elements. We then used these tools to evaluate the practices and policies of each of the 6 U.S. CLIA-certified labs offering clinical ES. Approaches toward informed consent, data sharing, and results return vary widely among ES providers as do the overall potential merits and disadvantages of each, and more importantly, the balance between the two. PMID:23610049

Exploring accountability of clinical ethics consultants: practice and training implications.

PubMed

Weise, Kathryn L; Daly, Barbara J

2014-01-01

Clinical ethics consultants represent a multidisciplinary group of scholars and practitioners with varied training backgrounds, who are integrated into a medical environment to assist in the provision of ethically supportable care. Little has been written about the degree to which such consultants are accountable for the patient care outcome of the advice given. We propose a model for examining degrees of internally motivated accountability that range from restricted to unbounded accountability, and support balanced accountability as a goal for practice. Finally, we explore implications of this model for training of clinical ethics consultants from diverse academic backgrounds, including those disciplines that do not have a formal code of ethics relating to clinical practice.