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Sample records for advanced practice experience

  1. Organizing a community advanced pharmacy practice experience.

    Science.gov (United States)

    Koenigsfeld, Carrie Foust; Tice, Angela L

    2006-02-15

    Setting up a community advanced pharmacy practice experience can be an overwhelming task for many pharmacy preceptors. This article provides guidance to pharmacist preceptors in developing a complete and effective community advanced pharmacy practice experience (APPE). When preparing for the APPE, initial discussions with the college or school of pharmacy are key. Benefits, training, and requirements should be addressed. Site preparation, including staff education, will assist in the development process. The preceptor should plan orientation day activities and determine appropriate evaluation and feedback methods. With thorough preparation, the APPE will be rewarding for both the student and the pharmacy site.

  2. Clinical Experience in Advanced Practice Nursing: A Canadian Perspective.

    Science.gov (United States)

    Donnelly, Glenn

    2003-01-01

    The role of advanced practice (AP) nurses must be clearly articulated and defined and not overshadowed by medical functions. Consensus on their educational preparation and explication of the nature of expertise in advanced practice are needed if AP nurses are to realize the full scope of their practice. (Contains 35 references.) (SK)

  3. Documenting Student Engagement Using an Intention/Reflection Exercise during an Advanced Pharmacy Practice Experience

    Science.gov (United States)

    Fierke, Kerry K.; Lepp, Gardner A.

    2015-01-01

    The article shares the outcomes of a practice called Intention/Reflection (I/R) when applied to a group of ten students in a five-week course involving an international advanced pharmacy practice experience. Developed by the authors and founded on a combination of theoretical principles, this practice is unique because of the blend of formative…

  4. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Preceptor and Student Considerations.

    Science.gov (United States)

    Dornblaser, Emily K; Ratka, Anna; Gleason, Shaun E; Ombengi, David N; Tofade, Toyin; Wigle, Patricia R; Zapantis, Antonia; Ryan, Melody; Connor, Sharon; Jonkman, Lauren J; Ochs, Leslie; Jungnickel, Paul W; Abrons, Jeanine P; Alsharif, Naser Z

    2016-04-25

    The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students.

  5. The Offering, Scheduling and Maintenance of Elective Advanced Pharmacy Practice Experiences

    Directory of Open Access Journals (Sweden)

    Rex O. Brown

    2015-12-01

    Full Text Available The Accreditation Council for Pharmacy Education (ACPE provides standards for colleges of pharmacy to assist in the provision of pharmacy education to student pharmacists. An integral part of all college educational programs includes the provision of experiential learning. Experiential learning allows students to gain real-world experience in direct patient care during completion of the curriculum. All college of pharmacy programs provide several Advanced Pharmacy Practice Experiences (APPEs, which include a balance between the four required experiences and a number of other required or elective APPEs. Required APPEs include advanced community, advanced institutional, ambulatory care, and general medicine. The elective APPEs include a myriad of opportunities to help provide a balanced education in experiential learning for student pharmacists. These unique opportunities help to expose student pharmacists to different career tracks that they may not have been able to experience otherwise. Not all colleges offer enough elective APPEs to enable the student pharmacist to obtain experiences in a defined area. Such an approach is required to produce skilled pharmacy graduates that are capable to enter practice in various settings. Elective APPEs are scheduled logically and are based upon student career interest and site availability. This article describes the offering, scheduling and maintenance of different elective APPEs offered by The University of Tennessee College of Pharmacy.

  6. Developing Structured-Learning Exercises for a Community Advanced Pharmacy Practice Experience

    OpenAIRE

    Thomas, Renee Ahrens

    2006-01-01

    The recent growth in the number of pharmacy schools across the nation has resulted in the need for high-quality community advanced pharmacy practice experience (APPE) sites. A vital part of a student's education, these APPEs should be structured and formalized to provide an environment conducive to student learning. This paper discusses how to use a calendar, structured-learning activities, and scheduled evaluations to develop students' knowledge, skills, and abilities in a community pharmacy...

  7. Developing structured-learning exercises for a community advanced pharmacy practice experience.

    Science.gov (United States)

    Thomas, Renee Ahrens

    2006-02-15

    The recent growth in the number of pharmacy schools across the nation has resulted in the need for high-quality community advanced pharmacy practice experience (APPE) sites. A vital part of a student's education, these APPEs should be structured and formalized to provide an environment conducive to student learning. This paper discusses how to use a calendar, structured-learning activities, and scheduled evaluations to develop students' knowledge, skills, and abilities in a community pharmacy setting.

  8. [Challenges and opportunities: contributions of the Advanced Practice Nurse in the chronicity. Learning from experiences].

    Science.gov (United States)

    Appleby, Christine; Camacho-Bejarano, Rafaela

    2014-01-01

    Undoubtedly, our society is facing new economic, political, demographic, social and cultural challenges that require healthcare services able to meet the growing health needs of the population, especially in dealing with chronic conditions. In this new context, some countries such as the United Kingdom have made a firm commitment to develop new models for chronic patients care based on the introduction of new figures of Advanced Practice Nurses, which includes 4 cornerstones of professional practice: advanced clinical skills, clinical management, teaching and research. The implementation of this new figures implies a redefinition of professional competencies and has its own accreditation system and a specific catalogue of services adapted to the population requirements, in order to provide chronic care support from Primary Care settings. This trajectory allows us analysing the process of design and implementation of these new models and the organizational structure where it is integrated. In Spain, there are already experiences in some regions such as Andalucia and the Basque Country, focused on the creation of new advanced nursing roles. At present, it is necessary to consider suitable strategic proposals for the complete development of these models and to achieve the best results in terms of overall health and quality of life of patients with chronic conditions, improving the quality of services and cost-effectiveness through a greater cohesion and performance of healthcare teams towards the sustainability of healthcare services and patient satisfaction. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  9. Advanced Practice Nursing in Pediatric Urology: experience report in the Federal District.

    Science.gov (United States)

    Souza, Bruna Marcela Lima de; Salviano, Cristiane Feitosa; Martins, Gisele

    2018-01-01

    To describe the creation and implementation of the extension program Advanced Practice Nursing in Pediatric Urology, developed in the outpatient clinic of a teaching hospital in the Federal District. This is an experience report regarding the implementation of an outpatient service aimed at children and adolescents with symptoms of bladder and bowel dysfunction. Because it is an extension program linked to the university, it follows a different model of care, valuing empowerment, informed and shared decision making, which results in a stronger bond between patients, family and the Pediatric Urology nursing team. It has also become a privileged space for the production and use of scientific knowledge, associated with the principles of evidence-based practice. This project shows a different performance of the nurse-specialist-professor-researcher in Pediatric Urology Nursing, and it has become a reference in the Federal District, mainly for undergraduate and graduate nursing students.

  10. Advanced Practice Nursing in Pediatric Urology: experience report in the Federal District

    Directory of Open Access Journals (Sweden)

    Bruna Marcela Lima de Souza

    Full Text Available ABSTRACT Objective: To describe the creation and implementation of the extension program Advanced Practice Nursing in Pediatric Urology, developed in the outpatient clinic of a teaching hospital in the Federal District. Method: This is an experience report regarding the implementation of an outpatient service aimed at children and adolescents with symptoms of bladder and bowel dysfunction. Results: Because it is an extension program linked to the university, it follows a different model of care, valuing empowerment, informed and shared decision making, which results in a stronger bond between patients, family and the Pediatric Urology nursing team. It has also become a privileged space for the production and use of scientific knowledge, associated with the principles of evidence-based practice. Conclusion: This project shows a different performance of the nurse-specialist-professor-researcher in Pediatric Urology Nursing, and it has become a reference in the Federal District, mainly for undergraduate and graduate nursing students.

  11. Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse.

    Science.gov (United States)

    Eriksson, Irene; Lindblad, Monica; Möller, Ulrika; Gillsjö, Catharina

    2018-02-01

    Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. To describe patients' experiences of health care provided by an APN in primary health care. An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. © 2017 The Authors. International Journal of Nursing Practice Published by John Wiley & Sons Australia, Ltd.

  12. Building to Make a Difference: Advanced Practice Nurses' Experience of Power.

    Science.gov (United States)

    Schoales, Catherine A; Bourbonnais, Frances Fothergill; Rashotte, Judy

    2018-02-01

    Power is necessary for nurses to affect change in patient care and to move the nursing profession forward. Despite the evolving body of nursing research on power, there have been no studies that have investigated the nature of advanced practice nurses' (APNs') power. The purpose of this study was to explore the APNs' lived experience of power. Interpretive phenomenology guided the method and analysis. Eight APNs employed in a single Canadian tertiary care teaching health-care organization engaged in in-depth interviews. The overarching theme, building to make a difference, reflected the APNs' perception of power in their practice, which involved a passion to facilitate change in practice to improve patient care. Building to make a difference involved three themes: building on, building with, and building for. The APNs experienced more power-a process they described as power creep-when they used soft power that was shared with others to affect positive change in health care. These findings contribute to our understanding of how power is perceived and manifested in the APN role, thus further enabling organizations to create working conditions to support the APNs' endeavors to empower others.

  13. Web-based multimedia vignettes in advanced community pharmacy practice experiences.

    Science.gov (United States)

    Flowers, Schwanda K; Vanderbush, Ross E; Hastings, Jan K; West, Donna

    2010-04-12

    To evaluate the effectiveness of Web-based multimedia vignettes on complex drug administration techniques to augment the training of pharmacy students in advanced community pharmacy practice experiences. During the orientation for a community APPE, students were randomly assigned to either a study group or control group After they began their APPE, students in the study group were given an Internet address to access multimedia vignettes which they were required to watch to augment their training and standardize their counseling of patients in the use of inhalers and ear and eye drops. A 12-item questionnaire was administered to students in both groups at the orientation and again on the last day of the APPE to evaluate their knowledge of counseling patients in the use of inhalers and ear and eye drops. The control group did not experience any improvement in their counseling knowledge of the research topics during their month-long experience. Students in the intervention group scored higher on their postintervention test than students in the control group (p < 0.001). Student learning outcomes from experiential training can be improved through the use of Web-based multimedia instructional vignettes.

  14. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations.

    Science.gov (United States)

    Alsharif, Naser Z; Dakkuri, Adnan; Abrons, Jeanine P; Williams, Dennis; Ombengi, David N; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O'Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

    2016-04-25

    International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education.

  15. Impact of advanced pharmacy practice experience placement changes in colleges and schools of pharmacy.

    Science.gov (United States)

    Duke, Lori J; Staton, April G; McCullough, Elizabeth S; Jain, Rahul; Miller, Mindi S; Lynn Stevenson, T; Fetterman, James W; Lynn Parham, R; Sheffield, Melody C; Unterwagner, Whitney L; McDuffie, Charles H

    2012-04-10

    To document the annual number of advanced pharmacy practice experience (APPE) placement changes for students across 5 colleges and schools of pharmacy, identify and compare initiating reasons, and estimate the associated administrative workload. Data collection occurred from finalization of the 2008-2009 APPE assignments throughout the last date of the APPE schedule. Internet-based customized tracking forms were used to categorize the initiating reason for the placement change and the administrative time required per change (0 to 120 minutes). APPE placement changes per institution varied from 14% to 53% of total assignments. Reasons for changes were: administrator initiated (20%), student initiated (23%), and site/preceptor initiated (57%) Total administrative time required per change varied across institutions from 3,130 to 22,750 minutes, while the average time per reassignment was 42.5 minutes. APPE placements are subject to high instability. Significant differences exist between public and private colleges and schools of pharmacy as to the number and type of APPE reassignments made and associated workload estimates.

  16. Examination for the Certificate in Advanced Practice in Cervical Cytology--the first year's experience.

    Science.gov (United States)

    Smith, P A; Hewer, E M

    2003-06-01

    Following the decision to establish an Advanced Biomedical Scientist Practitioner grade for senior biomedical scientists in the NHS Cervical Screening Programme, a conjoint examination board has been appointed by the Royal College of Pathologists and Institute of Biomedical Science to oversee the Certificate in Advanced Practice in Cervical Cytology examination. The examination consists of a multiple-choice paper, short-answer written questions and practical microscopy sections covering screening of unmarked slides, and more complex discussion cases. In the first year there were 58 entries with 29 successful candidates, a pass rate of 50%. The standard of performance in the examination showed a wide range, and some candidates appear to have underestimated the degree of preparation, knowledge or level of microscopy skill required.

  17. A transdisciplinary approach to developing a web-based nursing experiential log system for advanced practice nursing clinical experiences.

    Science.gov (United States)

    Olson, Brandon D; Fauchald, Sally K

    2011-11-01

    This article describes a transdisciplinary project between the computer information systems department and the graduate nursing department of a higher education institution. The project is the planning, development, and implementation of a Web-based nursing experiential log system for advanced practice nursing clinical experiences, which was funded by a Nursing Education Practice and Retention grant from the Health Resources and Services Administration. The article explains the concept and benefits of the transdisciplinary nature of the project. The design team, project leadership, and roles within the team are reviewed, including the role of end-user faculty in the design process. The article describes the focus and scope of the Web-based experiential log system database that is used to document and track advanced practice nursing student clinical experiences, as well as a summary of the design process used to develop the log system and the specific functionality of the database system. The implementation process, including end-user training, pilot implementation, and modifications, lessons learned, and future directions of the project are addressed. The article concludes with the benefits to the clinical experience and graduate nursing program that have been noted since the implementation of the system.

  18. Advancing work practices

    DEFF Research Database (Denmark)

    Noesgaard, Signe Schack

    2016-01-01

    -executed instructional interventions will advance work practices. Design/methodology/approach The paper synthesizes contemporary social-psychological and educational research in the creation of a model of intervention-based change. In addition, the findings from an empirical study of online teacher professional......Purpose The paper aims to discuss the effectiveness of e-Learning in advancing work practices. The paper investigates the assumption that e-Learning is as effective as face-to-face interventions when stimulating change. It also examines the assumption that well-designed and well...... development simultaneously inspire and exemplify the model. Findings The paper suggests that increased attention to individual motivational drivers is needed, especially post intervention, to help ensure meaningful learning transfer and sustainable behavior change. The importance of individualized on...

  19. Impact of Advanced Practice Registered Nurses on Quality Measures: The Missouri Quality Initiative Experience.

    Science.gov (United States)

    Rantz, Marilyn J; Popejoy, Lori; Vogelsmeier, Amy; Galambos, Colleen; Alexander, Greg; Flesner, Marcia; Murray, Cathy; Crecelius, Charles; Ge, Bin; Petroski, Gregory

    2018-06-01

    The purpose of this article is to review the impact of advanced practice registered nurses (APRNs) on the quality measure (QM) scores of the 16 participating nursing homes of the Missouri Quality Initiative (MOQI) intervention. The MOQI was one of 7 program sites in the US, with specific interventions unique to each site tested for the Centers for Medicaid and Medicare Services Innovations Center. While the goals of the MOQI for long-stay nursing home residents did not specifically include improvement of the QM scores, it was anticipated that improvement most likely would occur. Primary goals of the MOQI were to reduce the frequency of avoidable hospital admissions and readmissions; improve resident health outcomes; improve the process of transitioning between inpatient hospitals and nursing facilities; and reduce overall healthcare spending without restricting access to care or choice of providers. A 2-group comparison analysis was conducted using statewide QMs; a matched comparison group was selected from facilities in the same counties as the intervention homes, similar baseline QM scores, similar size and ownership. MOQI nursing homes each had an APRN embedded full-time to improve care and help the facility achieve MOQI goals. Part of their clinical work with residents and staff was to focus on quality improvement strategies with potential to influence healthcare outcomes. Trajectories of QM scores for the MOQI intervention nursing homes and matched comparison group homes were tested with nonparametric tests to examine for change in the desired direction between the 2 groups from baseline to 36 months. A composite QM score for each facility was constructed, and baseline to 36-month average change scores were examined using nonparametric tests. Then, adjusting for baseline, a repeated measures analysis using analysis of covariance as conducted. Composite QM scores of the APRN intervention group were significantly better (P = .025) than the comparison group

  20. Swedish students' and preceptors' perceptions of what students learn in a six-month advanced pharmacy practice experience.

    Science.gov (United States)

    Wallman, Andy; Sporrong, Sofia Kälvemark; Gustavsson, Maria; Lindblad, Asa Kettis; Johansson, Markus; Ring, Lena

    2011-12-15

    To identify what pharmacy students learn during the 6-month advanced pharmacy practice experience (APPE) in Sweden. Semi-structured interviews were conducted with 18 pharmacy APPE students and 17 pharmacist preceptors and analyzed in a qualitative directed content analysis using a defined workplace learning typology for categories. The Swedish APPE provides students with task performance skills for work at pharmacies and social and professional knowledge, such as teamwork, how to learn while in a work setting, self-evaluation, understanding of the pharmacist role, and decision making and problem solving skills. Many of these skills and knowledge are not accounted for in the curricula in Sweden. Using a workplace learning typology to identify learning outcomes, as in this study, could be useful for curricula development. Exploring the learning that takes place during the APPE in a pharmacy revealed a broad range of skills and knowledge that students acquire.

  1. Clinical practice and outcomes in advanced gastrointestinal stromal tumor: Experience from an Indian tertiary care center

    Directory of Open Access Journals (Sweden)

    Subhadeep Bose

    2017-01-01

    Full Text Available Background: Management of advanced Gastrointestinal stromal tumors (GIST has been revolutionized with the use of Imatinib guided by mutation analysis. Data from India remains scarce. Materials and Methods: Patients with metastatic GIST who were treated at Department of Gastro-intestinal & Hepaticopancreaticobiliary Oncology Unit at Tata Memorial Hospital, Mumbai between December, 2004 and December 2015 were included in the analysis. Clinical and radiological data was retrieved from stored medical records and charts. Results: A total of 83 patients with metastatic GIST were available for analysis. Median age was 54 years with a 3:1 male predominance. Stomach was the most common site of primary with liver being the most common site of metastasis. c-Kit mutation analysis results were available for 44 patients with exon 11 mutant being the most common mutation. With a median follow up of 33 months, the 10 years estimated progression free and overall survival (OS was 18% and 51% respectively. Overall response rate to first line imatinib was 37.6% and estimated 3 years OS to first line therapy was significantly better for Exon 11 mutated patients (p=0.016. 34 patients received second line therapy in the form of either sunitinib, pazopanib or increased dose imatinib with a clinical benefit rate of 73.5%. C-Kit mutated patients had a better median OS compared to non mutated patients. Conclusions: GIST diagnosed and treated in the Indian subcontinent appears to show improved outcomes. The importance of c-Kit mutation analysis in determining the prognosis and outcomes of patients with advanced GIST is emphasized.

  2. Comparison of patients' expectations and experiences at traditional pharmacies and pharmacies offering enhanced advanced pharmacy practice experiences.

    Science.gov (United States)

    Kassam, Rosemin; Collins, John B; Berkowitz, Jonathan

    2010-06-15

    To compare patients' expectations and experiences at pharmacies offering traditional APPE learning opportunities with those offering enhanced APPEs that incorporate pharmaceutical care activities. A survey of anchored measures of patient satisfaction was conducted in 2 groups of APPE- affiliated community pharmacies: those participating in an enhanced APPE model versus those participating in the traditional model. The enhanced intervention included preceptor training, a comprehensive student orientation, and an extended experience at a single pharmacy rather than the traditional 2 x 4-week experience at different pharmacies. While patient expectations were similar in both traditional and enhanced APPE pharmacies, patients in enhanced pharmacies reported significantly higher in-store satisfaction and fewer service gaps. Additionally, satisfaction was significantly higher for patients who had received any form of consultation, from either pharmacist or students, than those reporting no consultations. Including provision of pharmaceutical care services as part of APPEs resulted in direct and measurable improvements in patient satisfaction.

  3. Advanced Liquid Feed Experiment

    Science.gov (United States)

    Distefano, E.; Noll, C.

    1993-06-01

    The Advanced Liquid Feed Experiment (ALFE) is a Hitchhiker experiment flown on board the Shuttle of STS-39 as part of the Space Test Payload-1 (STP-1). The purpose of ALFE is to evaluate new propellant management components and operations under the low gravity flight environment of the Space Shuttle for eventual use in an advanced spacecraft feed system. These components and operations include an electronic pressure regulator, an ultrasonic flowmeter, an ultrasonic point sensor gage, and on-orbit refill of an auxiliary propellant tank. The tests are performed with two transparent tanks with dyed Freon 113, observed by a camera and controlled by ground commands and an on-board computer. Results show that the electronic pressure regulator provides smooth pressure ramp-up, sustained pressure control, and the flexibility to change pressure settings in flight. The ultrasonic flowmeter accurately measures flow and detects gas ingestion. The ultrasonic point sensors function well in space, but not as a gage during sustained low-gravity conditions, as they, like other point gages, are subject to the uncertainties of propellant geometry in a given tank. Propellant transfer operations can be performed with liquid-free ullage equalization at a 20 percent fill level, gas-free liquid transfer from 20-65 percent fill level, minimal slosh, and can be automated.

  4. Effect of an Advanced Pharmacy Practice Experience on Medication Therapy Management Services in a Centralized Retail Pharmacy Program.

    Science.gov (United States)

    Vande Griend, Joseph P; Rodgers, Melissa; Nuffer, Wesley

    2017-05-01

    Medication therapy management (MTM) delivery is increasingly important in managed care. Successful delivery positively affects patient health and improves Centers for Medicare & Medicaid Services star ratings, a measure of health plan quality. As MTM services continue to grow, there is an increased need for efficient and effective care models. The primary objectives of this project were to describe the delivery of MTM services by fourth-year Advanced Pharmacy Practice Experience (APPE) students in a centralized retail pharmacy system and to evaluate and quantify the clinical and financial contributions of the students. The secondary objective was to describe the engagement needed to complete comprehensive medication reviews (CMRs) and targeted interventions. From May 2015 to December 2015, thirty-five APPE students from the University of Colorado Skaggs School of Pharmacy provided MTM services at Albertsons Companies using the OutcomesMTM and Mirixa platforms. Students delivered patient care services by phone at the central office and provided face-to-face visits at pharmacies in the region. With implementation of the MTM APPE in 2015, the team consisted of 2 MTM pharmacists and pharmacy students, as compared with 1 MTM pharmacist in 2014. The number of CMRs and targeted interventions completed and the estimated additional revenue generated during the 2015 time period were compared with those completed from May through December 2014. The patient and provider engagement needed to complete the CMRs and targeted interventions was summarized. 125 CMRs and 1,918 targeted interventions were billed in 2015, compared with 13 CMRs and 767 targeted interventions in 2014. An estimated $16,575-$49,272 of additional revenue was generated in 2015. To complete the interventions in 2015, the team engaged in 1,714 CMR opportunities and 4,686 targeted intervention opportunities. In this MTM rotation, students provided real-life care to patients, resulting in financial and clinical

  5. Experimenting with practice

    DEFF Research Database (Denmark)

    Knudsen, Hanne; Adriansen, Hanne Kirstine

    2016-01-01

    Abstract Purpose Teaching executive courses always raises the challenge of how to deal with the tension between theory and practice. The present chapter analyses the use of experiments in practice as a pedagogical approach to deal with this tension in Master’s programmes. Design/methodology/appro......Abstract Purpose Teaching executive courses always raises the challenge of how to deal with the tension between theory and practice. The present chapter analyses the use of experiments in practice as a pedagogical approach to deal with this tension in Master’s programmes. Design...... that it is important to observe the distinction between the role of the manager and the role of the student in order to meet ethical challenges, inevitably raised by experimenting with practice. Finally we argue that the experimental teaching practice can be conceptualised as a monstrous pedagogy, as the pedagogy...... pedagogy they use fort dealing with this tension. Practical implications Many Master’s programmes draw empirical data from the students’ own practice into the teaching. We argue that using experiments is highly useful to identify some of the general challenges inherent in analyses of one’s own practice...

  6. Advanced practice nurses: starting an independent practice.

    Science.gov (United States)

    Lambert, V A; Lambert, C E

    1996-01-01

    Independent or private practice is the delivery of nursing services provided by nurses over which nurses have full control. With a changing healthcare system, nurses are in a prime position to negotiate the delivery of appropriate, acceptable, and cost-effective health care as independent practitioners. This article addresses the mission and goals of independent practice, community need, business structure of the practice, housing the practice, legal considerations, financing the practice, marketing issues, clientele, record keeping, and reimbursement.

  7. Clinical practice: new challenges for the advanced practice nurse.

    Science.gov (United States)

    Bartel, J C; Buturusis, B

    2000-12-01

    This report describes the challenges for advanced practice nurses (APNs) relative to supply and demand issues. The article also includes opportunities with the Balanced Budget Act, physician acceptance of Advanced Practice Nurses, and expanding practice opportunities. The challenges include the nursing shortage (both in nursing students and faculty), the aging of the nursing workforce, and a lag in nursing salaries; increased demand for nursing based on aging baby boomers, increasing patient acuity and technology, and new arenas for practice. The Balanced Budget Act of 1997 provided new opportunities for advanced practice nurses, including enhanced autonomy to provide services and bill independently of physicians. With these changes come new opportunities for advanced practice nurse entrepreneurs in the areas of independent practice, including opportunities to positively impact the health of families and communities in alignment with the Federal government's vision for "Healthy People 2010." As physician acceptance of advanced practice nurses continues to grow and in light of the changes in medical practice and education (residency reduction), opportunities to expand collaborative practice arrangements also exist. APNs are best suited to make the most of these changes. One example of an opportunity for independent practice, a Community Wellness Center, is developed as an entrepreneurial venture benefiting both the APN and the health of a community. Who better than registered nurses (RNs), especially those practicing at the advanced level, can ensure that these opportunities and challenges are addressed in an ethical manner and focused on the needs and health of the community?

  8. Advanced midwifery practice: An evolutionary concept analysis.

    Science.gov (United States)

    Goemaes, Régine; Beeckman, Dimitri; Goossens, Joline; Shawe, Jill; Verhaeghe, Sofie; Van Hecke, Ann

    2016-11-01

    the concept of 'advanced midwifery practice' is explored to a limited extent in the international literature. However, a clear conception of advanced midwifery practice is vital to advance the discipline and to achieve both internal and external legitimacy. This concept analysis aims to clarify advanced midwifery practice and identify its components. a review of the literature was executed using Rodgers' evolutionary method of concept analysis to analyze the attributes, references, related terms, antecedents and consequences of advanced midwifery practice. an international consensus definition of advanced midwifery practice is currently lacking. Four major attributes of advanced midwife practitioners (AMPs) are identified: autonomy in practice, leadership, expertise, and research skills. A consensus was found on the need of preparation at master's level for AMPs. Such midwives have a broad and internationally varied scope of practice, fulfilling different roles such as clinicians, clinical and professional leaders, educators, consultants, managers, change agents, researchers, and auditors. Evidence illustrating the important part AMPs play on a clinical and strategic level is mounting. the findings of this concept analysis support a wide variety in the emergence, titles, roles, and scope of practice of AMPs. Research on clinical and strategic outcomes of care provided by AMPs supports further implementation of these roles. As the indistinctness of AMPs' titles and roles is one of the barriers for implementation, a clear conceptualization of advanced midwifery practice seems essential for successful implementation. an international debate and consensus on the defining elements of advanced midwifery practice could enhance the further development of midwifery as a profession and is a prerequisite for its successful implementation. Due to rising numbers of AMPs, extension of practice and elevated quality requirements in healthcare, more outcomes research exclusively

  9. Advanced practice for therapy radiographers - A discussion paper

    International Nuclear Information System (INIS)

    Eddy, Angela

    2008-01-01

    Purpose: The purpose of this discussion paper is to explore issues related to advanced practice for therapy radiographers. Key themes: The paper will focus on key themes that have impacted on advanced practice for therapy radiographers such as government initiatives and policy, confounding terminology associated with advanced practice such as role extension, role expansion, role development, and expert practice. The theory and development of expert practice is explored and paralleled to existing roles in therapy using the Benner model to define stages of professional development and competence. Evidence for advanced practice, and education and training will also be explored. All of these issues will be considered within the perspective of the current clinical and political environment that therapy radiographers operate in. Conclusions: The application of advanced practice can and should incorporate elements of role extension and role development, with some tangible skills ladder to guide and shape the development of potential consultant practitioners. There is a need to identify the current position of advanced practice nationally, and to monitor existing and emerging roles, possibly though a longitudinal study. The skill mix as a whole within departments need to be part of an ongoing evaluation with close collaboration between the professional body, departmental managers and higher education institutes to develop curricula to support existing and emerging roles. There are also key lessons to be learned from other professions with more experience with advanced practitioners if recruitment and retention is not going to continue to be a problem

  10. Specialty practice entrepreneur: the advanced practice nurse.

    Science.gov (United States)

    Kowal, N

    1998-01-01

    There are many opportunities in the health care arena to make a difference. The structured sense of change is "old school." New "surfers" of the system will be entrepreneurial in spirit, energy, and flexibility. There is no job description for the perfect person, only a sense of excitement and innovation that gives one the feeling energetic change is about to happen. In nursing, the risk takers are abundant in the APN role. It is the reason why they walk the line of provider/nurse. Making a difference to patients is important. Riding the waves of clinical care is the excitement. The final results are "the big waves" of life--a patient's life. A provider who defines the reality of practice creates a vision and skillfully bridges the road between the two. Design the surfboard--catch the wave.

  11. Education of advanced practice nurses in Canada.

    Science.gov (United States)

    Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Donald, Faith; Kaasalainen, Sharon; Carter, Nancy; Kilpatrick, Kelley; DiCenso, Alba

    2010-12-01

    In Canada, education programs for the clinical nurse specialist (CNS) and nurse practitioner (NP) roles began 40 years ago. NP programs are offered in almost all provinces. Education for the CNS role has occurred through graduate nursing programs generically defined as providing preparation for advanced nursing practice. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe the following: (1) history of advanced practice nursing education in Canada, (2) current status of advanced practice nursing education in Canada, (3) curriculum issues, (4) interprofessional education, (5) resources for education and (6) continuing education. Although national frameworks defining advanced nursing practice and NP competencies provide some direction for education programs, Canada does not have countrywide standards of education for either the NP or CNS role. Inconsistency in the educational requirements for primary healthcare NPs continues to cause significant problems and interferes with inter-jurisdictional licensing portability. For both CNSs and NPs, there can be a mismatch between a generalized education and specialized practice. The value of interprofessional education in facilitating effective teamwork is emphasized. Recommendations for future directions for advanced practice nursing education are offered.

  12. Optimizing Team Dynamics: An Assessment of Physician Trainees and Advanced Practice Providers Collaborative Practice.

    Science.gov (United States)

    Foster, Cortney B; Simone, Shari; Bagdure, Dayanand; Garber, Nan A; Bhutta, Adnan

    2016-09-01

    The presence of advanced practice providers has become increasingly common in many ICUs. The ideal staffing model for units that contain both advanced practice providers and physician trainees has not been described. The objectives of this study were to evaluate ICU staffing models that include physician trainees and advanced practice providers and their effects on patient outcomes, resident and fellow education, and training experience. A second aim was to assess strategies to promote collaboration between team members. PubMed, CINAHL, OVID MEDLINE, and Cochrane Review from 2002 to 2015. Experimental study designs conducted in an ICU setting. Two reviewers screened articles for eligibility and independently abstracted data using the identified search terms. We found 21 articles describing ICU team structure and outcomes. Four articles were found describing the impact of advanced practice providers on resident or fellow education. Two articles were found discussing strategies to promote collaboration between advanced practice providers and critical care fellows or residents. Several articles were identified describing the utilization of advanced practice providers in the ICU and the impact of models of care on patient outcomes. Limited data exist describing the impact of advanced practice providers on resident and fellow education and training experience. In addition, there are minimal data describing methods to enhance collaboration between providers. Future research should focus on determining the optimal ICU team structure to improve patient outcomes, education of trainees, and job satisfaction of team members and methods to promote collaboration between advanced practice providers and physicians in training.

  13. Establishing philanthropic funds for advanced practice scholarships.

    Science.gov (United States)

    Neumann, T

    1997-01-01

    Because of decreased tuition assistance at some hospitals, experienced nurses interested in advanced roles may quit rather than stay and expand their roles. This author describes how a hospital based philanthropic community group has helped provide scholarships for nurses interested in advanced practice and how to set up a similar scholarship program that will retain these experienced and motivated nurses.

  14. Advanced practice nursing role delineation in acute and critical care: application of the strong model of advanced practice.

    Science.gov (United States)

    Mick, D J; Ackerman, M H

    2000-01-01

    This purpose of this study was to differentiate between the roles of clinical nurse specialists and acute care nurse practitioners. Hypothesized blending of the clinical nurse specialist and acute care nurse practitioner roles is thought to result in an acute care clinician who integrates the clinical skills of the nurse practitioner with the systems knowledge, educational commitment, and leadership ability of the clinical nurse specialist. Ideally, this role blending would facilitate excellence in both direct and indirect patient care. The Strong Model of Advanced Practice, which incorporates practice domains of direct comprehensive care, support of systems, education, research, and publication and professional leadership, was tested to search for practical evidence of role blending. This descriptive, exploratory, pilot study included subjects (N = 18) solicited from an academic medical center and from an Internet advanced practice listserv. Questionnaires included self-ranking of expertise in practice domains, as well as valuing of role-related tasks. Content validity was judged by an expert panel of advanced practice nurses. Analyses of descriptive statistics revealed that clinical nurse specialists, who had more experience both as registered nurses and in the advanced practice nurse role, self-ranked their expertise higher in all practice domains. Acute care nurse practitioners placed higher importance on tasks related to direct comprehensive care, including conducting histories and physicals, diagnosing, and performing diagnostic procedures, whereas clinical nurse specialists assigned greater importance to tasks related to education, research, and leadership. Levels of self-assessed clinical expertise as well as valuing of role-related tasks differed among this sample of clinical nurse specialists and acute care nurse practitioners. Groundwork has been laid for continuing exploration into differentiation in advanced practice nursing roles. As the clinical

  15. Advanced quantum mechanics a practical guide

    CERN Document Server

    Nazarov, Yuli V

    2013-01-01

    An accessible introduction to advanced quantum theory, this graduate-level textbook focuses on its practical applications and treats real-life examples to equip readers with an operational toolbox of theoretical techniques. It features case studies from different topics and 70 end-of-chapter problems, with solutions for instructors available online.

  16. Transcendental experiences during meditation practice.

    Science.gov (United States)

    Travis, Frederick

    2014-01-01

    This article explores transcendental experiences during meditation practice and the integration of transcendental experiences and the unfolding of higher states of consciousness with waking, dreaming, and sleeping. The subject/object relationship during transcendental experiences is characterized by the absence of time, space, and body sense--the framework that gives meaning to waking experiences. Physiologically, transcendental experiences during Transcendental Meditation practice are marked by slow inhalation, along with autonomic orientation at the onset of breath changes and heightened α1 (8-10 Hz) frontal coherence. The integration of transcendental experiences with waking, dreaming, and sleeping is also marked by distinct subjective and objective markers. This integrated state, called Cosmic Consciousness in the Vedic tradition, is subjectively marked by inner self-awareness coexisting with waking, sleeping, and dreaming. Physiologically, Cosmic Consciousness is marked by the coexistence of α1 electroencephalography (EEG) with delta EEG during deep sleep, and higher brain integration, greater emotional stability, and decreased anxiety during challenging tasks. Transcendental experiences may be the engine that fosters higher human development. © 2013 New York Academy of Sciences.

  17. Advanced radiographic practice - the legal aspects

    International Nuclear Information System (INIS)

    Alderson, C.J.; Hogg, P.

    2003-01-01

    Allied health and nursing professionals are continuing to expand their responsibilities into clinical areas outside their traditional spheres of interest; typically, many of these new responsibilities are found within the medical (doctor) domain. Such responsibilities are often at an advanced clinical level and consequently higher demands are placed upon the professionals, not least in terms of clinical updating, competence to practice and also legal liability. This article explores the legal implications of practising at an advanced clinical level with particular reference to legal claims. The first part of the article commences with an outline of pertinent law in England and Wales. The latter part of the article explores actual cases from which allied health professionals (eg radiographers) can gain valuable information. Throughout the article suggestions for good practice are indicated. Examples of good practice include: the need to base your practice on evidence and peer practice; the need to keep detailed records (protocols) of such practice; the need to know when you are at the limit of your ability; and as such when to ask for advice from a medical practitioner/radiologist

  18. Advancing Work Practices Through Online Professional Development

    DEFF Research Database (Denmark)

    Noesgaard, Signe Schack

    The natural expectation for professional development courses is that they will improve a participant’s work performance, but do they? This PhD research challenges several assumptions underlying the design of online professional development courses, revealing that it is after such interventions...... was not effective and subsequently terminate change that could have advanced their practices. This underlines the need to think beyond the course format to make online professional development interventions continuous, committing, and contextual. The research suggests rethinking online professional development...... as adaptive “just-in-time” technologies and proposes a design theory called “situated online professional development,” entailing six design principles for advancing work practices....

  19. Advanced tokamak burning plasma experiment

    International Nuclear Information System (INIS)

    Porkolab, M.; Bonoli, P.T.; Ramos, J.; Schultz, J.; Nevins, W.N.

    2001-01-01

    A new reduced size ITER-RC superconducting tokamak concept is proposed with the goals of studying burn physics either in an inductively driven standard tokamak (ST) mode of operation, or in a quasi-steady state advanced tokamak (AT) mode sustained by non-inductive means. This is achieved by reducing the radiation shield thickness protecting the superconducting magnet by 0.34 m relative to ITER and limiting the burn mode of operation to pulse lengths as allowed by the TF coil warming up to the current sharing temperature. High gain (Q≅10) burn physics studies in a reversed shear equilibrium, sustained by RF and NB current drive techniques, may be obtained. (author)

  20. Treatment of advanced breast cancer. An experience

    Energy Technology Data Exchange (ETDEWEB)

    Magnoni, G; Corcione, S; Api, P

    1984-01-01

    The Authors report their experience about the efficacy of the association surgery-radiotherapy-polichemotherapy, in the treatment of advanced breast cancer, emphasizing the importance of this association in the survival rate.

  1. Advancing practice relating to SEA alternatives

    International Nuclear Information System (INIS)

    González, Ainhoa; Thérivel, Riki; Fry, John; Foley, Walter

    2015-01-01

    Developing and assessing alternatives is a key and central stage to Strategic Environmental Assessment (SEA). However, research has repeatedly reported this stage as one of the most poorly undertaken aspects of the SEA process. Current practice limitations include belated consideration of reasonable alternatives, narrow scope of alternatives that often include unrealistic or retrofitted options, limited stakeholder and public involvement in their identification, assessment and selection, lack of systematic approaches to their assessment and comparison, and inadequate reporting of the ‘storyline’ on how they were identified, what the potential impacts are and why the preferred alternative was selected. These issues have resulted in objections and judicial reviews. On the positive side, a number of good practice case studies enable extraction of key lessons and formulation of a set of general recommendations to advance practice in SEA alternatives. In this paper, practical guidance on the identification and development of alternatives, their assessment and comparison, selection of the preferred option, and documentation of the process and the reasons for selection is provided and discussed to frame good practice approaches. - Highlights: • Alternatives are one of the most poorly completed aspects of Strategic Environmental Assessment. • Current practice limitations need to be addressed to enhance SEA effectiveness. • A set of recommendations are extracted from good practice case studies. • These recommendations can be applied across jurisdictions and sectors and tailored as necessary

  2. Advancing practice relating to SEA alternatives

    Energy Technology Data Exchange (ETDEWEB)

    González, Ainhoa, E-mail: agonzal@tcd.ie [School of Natural Sciences, Trinity College Dublin, Dublin 2 (Ireland); Thérivel, Riki, E-mail: levett-therivel@phonecoop.coop [Levett-Therivel Sustainability Consultants (United Kingdom); Fry, John, E-mail: john.fry@ucd.ie [School of Agriculture and Food Science, University College Dublin, Dublin 4 (Ireland); Foley, Walter, E-mail: walterfoley@gmail.com [School of Geography, Planning and Environmental Policy, University College Dublin, Dublin 4 (Ireland)

    2015-07-15

    Developing and assessing alternatives is a key and central stage to Strategic Environmental Assessment (SEA). However, research has repeatedly reported this stage as one of the most poorly undertaken aspects of the SEA process. Current practice limitations include belated consideration of reasonable alternatives, narrow scope of alternatives that often include unrealistic or retrofitted options, limited stakeholder and public involvement in their identification, assessment and selection, lack of systematic approaches to their assessment and comparison, and inadequate reporting of the ‘storyline’ on how they were identified, what the potential impacts are and why the preferred alternative was selected. These issues have resulted in objections and judicial reviews. On the positive side, a number of good practice case studies enable extraction of key lessons and formulation of a set of general recommendations to advance practice in SEA alternatives. In this paper, practical guidance on the identification and development of alternatives, their assessment and comparison, selection of the preferred option, and documentation of the process and the reasons for selection is provided and discussed to frame good practice approaches. - Highlights: • Alternatives are one of the most poorly completed aspects of Strategic Environmental Assessment. • Current practice limitations need to be addressed to enhance SEA effectiveness. • A set of recommendations are extracted from good practice case studies. • These recommendations can be applied across jurisdictions and sectors and tailored as necessary.

  3. Win-win-win: collaboration advances critical care practice.

    Science.gov (United States)

    Spence, Deb; Fielding, Sandra

    2002-10-01

    Against a background of increasing interest in education post registration, New Zealand nurses are working to advance their professional practice. Because the acquisition of highly developed clinical capabilities requires a combination of nursing experience and education, collaboration between clinicians and nurse educators is essential. However, the accessibility of relevant educational opportunities has been an ongoing issue for nurses outside the country's main centres. Within the framework of a Master of Health Science, the postgraduate certificate (critical care nursing) developed between Auckland University of Technology and two regional health providers is one such example. Students enrol in science and knowledge papers concurrently then, in the second half of the course, are supported within their practice environment to acquire advanced clinical skills and to analyse, critique and develop practice within their specialty. This paper provides an overview of the structure and pr month, distance education course focused on developing the context of critical care nursing.

  4. The concept of advanced radiographic practice: An international perspective

    International Nuclear Information System (INIS)

    Hardy, Maryann; Legg, Jeffrey; Smith, Tony; Ween, Borgny; Williams, Imelda; Motto, Jenny

    2008-01-01

    Advanced radiographic practice has been the focus of much discussion and debate over the last decade, not only in the United Kingdom where advanced practitioner roles are now recognised within the national career framework, but also internationally. Yet, despite almost simultaneous professional movement towards advanced radiographic practice philosophy and ideals in many countries, international collaboration on this development has been minimal. This paper marks a growing international dialogue in this field. It discusses the theoretical concepts of advanced radiographic practice and the development of advanced practitioner roles, incorporating evidence and ideas from differing international perspectives and debates progress towards a potential unified global advanced practice identity

  5. Workplace discrimination: experiences of practicing physicians.

    Science.gov (United States)

    Coombs, Alice A Tolbert; King, Roderick K

    2005-04-01

    In response to a growing concern regarding physician discrimination in the workplace, this study was developed to: (1) describe the types of discrimination that exist for the practicing physician and (2) determine which groups of physicians are more likely to experience the various forms of discrimination. Surveys were mailed to 1930 practicing physicians in Massachusetts. Participants were asked if they had encountered discrimination, how significant the discrimination was against a specific group, the frequency of personal discrimination, and the type of discrimination. Factor analysis identified four types of discrimination: career advancement, punitive behaviors, practice barriers and hiring barriers. A total of 445 responses were received (a 24% response rate). Sixty-three percent of responding physicians had experienced some form of discrimination. Respondents were women (46%), racial/ethnic minorities (42%) and international medical graduates (IMGs) (40%). In addition, 26% of those classified as white were also IMGs. Over 60% of respondents believed discrimination against IMGs was very or somewhat significant. Almost 27% of males acknowledged that gender bias against females was very or somewhat significant. IMGs were more likely to indicate that discrimination against IMGs was significant in their current organization. Of U.S. medical graduates (USMGs) 44% reported that discrimination against IMGs in their current organization was significant. Nonwhites were more likely to report that discrimination based on race/ethnicity was significant. Nearly 29% of white respondents also believed that such discrimination was very or somewhat significant. Physicians practicing in academic, research, and private practice sectors experience discrimination based on gender, ethnic/racial, and IMG status.

  6. Advanced practice nursing in child maltreatment: practice characteristics.

    Science.gov (United States)

    Hornor, Gail; Herendeen, Pamela

    2014-01-01

    Child maltreatment is a problem of epidemic proportions in the United States. Pediatric nurse practitioners and other advanced practice nurses (APNs) have been caring for maltreated children for decades, yet to date no comprehensive assessment of their practice characteristics or their clinical and academic contributions to the field has been performed. The purpose of this study is to describe the practice characteristics of APNs who care for maltreated children. A descriptive design was used for this study. Child advocacy centers and children's hospitals were contacted to inquire about employment of child maltreatment APNs in their institution, and contact information for the lead APN was obtained. The Nurse Practitioner Survey was then sent to lead APNs by e-mail. The majority of APNs who work primarily in child maltreatment are pediatric nurse practitioners who work in child advocacy centers. They are providing care to children with physical and/or sexual abuse concerns; however, APNs provide care for children with all types of child maltreatment concerns. APNs play a vital role in the care of abused/neglected children. Their important contributions include not only clinical care but also the provision of clinical and didactic education to other professionals, parents, and the public. Research and publication are also essential to their role. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  7. Neonatal resuscitation: advances in training and practice

    Directory of Open Access Journals (Sweden)

    Sawyer T

    2016-12-01

    Full Text Available Taylor Sawyer, Rachel A Umoren, Megan M Gray Department of Pediatrics, Division of Neonatology, Neonatal Education and Simulation-based Training (NEST Program, University of Washington School of Medicine, Seattle, WA, USA Abstract: Each year in the US, some four hundred thousand newborns need help breathing when they are born. Due to the frequent need for resuscitation at birth, it is vital to have evidence-based care guidelines and to provide effective neonatal resuscitation training. Every five years, the International Liaison Committee on Resuscitation (ILCOR reviews the science of neonatal resuscitation. In the US, the American Heart Association (AHA develops treatment guidelines based on the ILCOR science review, and the Neonatal Resuscitation Program (NRP translates the AHA guidelines into an educational curriculum. In this report, we review recent advances in neonatal resuscitation training and practice. We begin with a review of the new 7th edition NRP training curriculum. Then, we examine key changes to the 2015 AHA neonatal resuscitation guidelines. The four components of the NRP curriculum reviewed here include eSim®, Performance Skills Stations, Integrated Skills Station, and Simulation and Debriefing. The key changes to the AHA neonatal resuscitation guidelines reviewed include initial steps of newborn care, positive-pressure ventilation, endotracheal intubation and use of laryngeal mask, chest compressions, medications, resuscitation of preterm newborns, and ethics and end-of-life care. We hope this report provides a succinct review of recent advances in neonatal resuscitation. Keywords: neonatal resuscitation, Neonatal Resuscitation Program, NRP, simulation, deliberate practice, debriefing, eSIM

  8. Kayenta advanced series compensation operational experience

    Energy Technology Data Exchange (ETDEWEB)

    1994-01-01

    The world's first three-phase, thyristor-controlled series compensation scheme with continuously variable impedance has been introduced into a transmission system. Energized and dedicated in September 1992, the installation was placed into commercial operation in January 1993 and has provided over one year of operating experience. This paper describes the 230 kV, 330 MVAr (60 Hz) advanced series compensation (ASC) project, located in north-eastern Arizona at Kayenta Substation on the 320 km Glen Canyon-Shiprock transmission line. The paper describes operating experiences, coordination with phase shifting transformer, phase shifter failure, platform power, system disturbances, and future plans.

  9. An Academic-Practice Partnership Model to Grow and Sustain Advanced Practice Nursing.

    Science.gov (United States)

    Williams, Tracy E; Howard, Patricia B

    2017-12-01

    The aims of this article were to describe the implementation of an academic-practice partnership for healthcare system workforce development and provide preliminary outcomes of the associated pilot study. The demand for cross-continuum healthcare delivery models necessitates creation of workforce development structures for advanced practice nursing. An academic-practice partnership specified enrollment of 5 cohorts of BSN staff nurses in a 3-year DNP program. Qualitative methods were used to explore pilot data at midpoint of cohort 1 student progression to determine learning outcomes and DNP projects with potential for impact on organization goals. Partnership implementation experiences indicate that contractual agreements and an established evaluation plan are keys to academic-practice partnership success. Pilot study findings suggest that curriculum core courses provide a foundation for designing DNP projects congruent with acute and primary care health system goals. Implementing an academic-practice partnership is a strategy for workforce development to increase retention of advanced practice nurses. Academic-practice partnerships can serve as a catalyst for a paradigm shift for changing models of care, thus enhancing workforce development succession planning for sustainable growth in healthcare systems.

  10. Advancing Evaluation Theory and Practice in South Asia ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Advancing Evaluation Theory and Practice in South Asia: Community of ... evidence-based policy development, decision-making, and practice in South Asia. ... International Water Resources Association, in close collaboration with IDRC, ...

  11. Epigenetics: An Emerging Framework for Advanced Practice Psychiatric Nursing.

    Science.gov (United States)

    DeSocio, Janiece E

    2016-07-01

    The aims of this paper are to synthesize and report research findings from neuroscience and epigenetics that contribute to an emerging explanatory framework for advanced practice psychiatric nursing. Discoveries in neuroscience and epigenetics reveal synergistic mechanisms that support the integration of psychotherapy, psychopharmacology, and psychoeducation in practice. Advanced practice psychiatric nurses will benefit from an expanded knowledge base in neuroscience and epigenetics that informs and explains the scientific rationale for our integrated practice. © 2015 Wiley Periodicals, Inc.

  12. The AGREE Enterprise: a decade of advancing clinical practice guidelines.

    Science.gov (United States)

    Makarski, Julie; Brouwers, Melissa C

    2014-08-15

    The original AGREE (Appraisal of Guidelines for REsearch and Evaluation) Instrument was published in 2003, and its revision, the AGREE II, in 2009. Together, they filled an important gap in the guideline and quality of care fields. Ten years later, the AGREE Enterprise reflects on a trajectory of projects and international collaboration that have contributed to advancing the science and quality of practice guidelines and the uptake of AGREE/AGREE II. The AGREE Enterprise has undertaken activities to improve the tool and to develop resources to support its use. Since 2003, the uptake and adoption of AGREE by the international community has been swift and broad. A total of 33 language translations of the original AGREE Instrument and the current AGREE II are available and were initiated by the international community. A recent scan of the published literature identified over 600 articles that referenced the AGREE tools. The AGREE tools have been widely received and applied, with several organizations having incorporated the AGREE as part of their formal practice guideline programs. Since its redevelopment in 2010, the AGREE Enterprise website (www.agreetrust.org) continues to experience steady increases in visitors per month and currently has over 10,000 registered users. The AGREE Enterprise has contributed to the advancements of guidelines through research activities and international participation by scientific and user communities. As we enter a new decade, we look forward to ongoing collaborations and contributing to further advancements to improve quality of care and health care systems.

  13. Management of advanced pancreatic cancer in daily clinical practice.

    Science.gov (United States)

    Giuliani, Jacopo; Piacentini, Paolo; Bonetti, Andrea

    2016-01-01

    The aim of this outcome study was to evaluate the management of advanced pancreatic cancer in a real-world clinical practice; few such experiences have been reported in the literature. A retrospective analysis was performed of all consecutive patients with advanced pancreatic ductal adenocarcinoma followed at our medical oncology unit between January 2003 and December 2013. We evaluated 78 patients, mostly with metastatic disease (64.1%). Median follow-up was 10.77 months, by which time 74 patients (94.9%) had died. Median overall survival was 8.29 months. Median age was 67 years. In univariate analysis, pain at onset (p = 0.020), ECOG performance status (p<0.001), stage (p = 0.047), first-line chemotherapy (p<0.001), second-line chemotherapy (p<0.001) and weight loss at diagnosis (p = 0.029) were factors that had an impact on overall survival. In multivariate analysis, the presence of pain at onset (p = 0.043), stage (p = 0.003) and second-line chemotherapy (p = 0.004) were confirmed as independent prognostic factors. Our data, derived from daily clinical practice, confirmed advanced pancreatic cancer as an aggressive malignant disease with a very short expected survival. Second-line treatment seems to provide an advantage in terms of overall survival in patients who showed a partial response as their best response to first-line treatment.

  14. Cash Advance Accounting: Accounting Regulations and Practices

    Directory of Open Access Journals (Sweden)

    Aristita Rotila

    2012-12-01

    Full Text Available It is known the fact that often the entities offer to staff or third parties certain amounts of money, in order to make payments for the entities, such sums being registered differently in the accounting as cash advances. In the case in which the advances are offered in a foreign currency, there is the problem of the exchange rate used when justifying the advance, for the conversion in lei of payments that were carried out. In this article we wanted to signal the effect that the exchange rate, used in the assessment for reflecting in the accounting operations concerning cash advance reimbursements in a foreign currency, has on the information presented in the financial statement. Therewith, we signal some aspects from the content of the accounting regulations, with reference at defining the cash advances, meaning, and the presentation in the balance sheet of cash advances, which, in our opinion, impose clarifications.

  15. Tokamak advanced pump limiter experiments and analysis

    International Nuclear Information System (INIS)

    Conn, R.W.

    1983-06-01

    Experiments with pump limiter modules on several operating tokamaks establish such limiters as efficient collectors of particles and has demonstrated the importance of ballistic scattering as predicted theoretically. Plasma interaction with recycling neutral gas appears to become important as the plasma density increases and the effective ionization mean free path within the module decreases. In limiters with particle collection but without active internal pumping, the neutral gas pressure is found to vary nonlinearly with the edge plasma density at the highest densities studies. Both experiments and theory indicate that the energy spectrum of gas atoms in the pump ducting is non-thermal, consistent with the results of Monte Carlo neutral atom transport calculations. The distribution of plasma power over the front surface of such modules has been measured and appears to be consistent with the predictions of simple theory. Initial results from the latest experiment on the ISX-B tokamak with an actively pumped limiter module demonstrates that the core plasma density can be controlled with a pump limiter and that the scrape-off layer plasma can partially screen the core plasma from gas injection. The results from module pump limiter experiments and from the theory and design analysis of advanced pump limiters for reactors are used to suggest the major features of a definitive, axisymmetric, toroidal belt pump limiter experiment

  16. Experiment and practice on signal processing

    International Nuclear Information System (INIS)

    2002-11-01

    The contents of this book contains basic practice of CEM Tool, discrete time signal and experiment and practice of system, experiment and practice of discrete time signal sampling, practice of frequency analysis, experiment of digital filter design, application of digital signal processing, project related voice, basic principle of signal processing, the technique of basic image signal processing, biology astronomy and Robot soccer with apply of image signal processing technique, control video signal and project related image. It also has an introduction of CEM Linker I. O in the end.

  17. Experiment and practice on signal processing

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-11-15

    The contents of this book contains basic practice of CEM Tool, discrete time signal and experiment and practice of system, experiment and practice of discrete time signal sampling, practice of frequency analysis, experiment of digital filter design, application of digital signal processing, project related voice, basic principle of signal processing, the technique of basic image signal processing, biology astronomy and Robot soccer with apply of image signal processing technique, control video signal and project related image. It also has an introduction of CEM Linker I. O in the end.

  18. Advanced Reactor Fuels Irradiation Experiment Design Objectives

    International Nuclear Information System (INIS)

    Chichester, Heather Jean MacLean; Hayes, Steven Lowe; Dempsey, Douglas; Harp, Jason Michael

    2016-01-01

    This report summarizes the objectives of the current irradiation testing activities being undertaken by the Advanced Fuels Campaign relative to supporting the development and demonstration of innovative design features for metallic fuels in order to realize reliable performance to ultra-high burnups. The AFC-3 and AFC-4 test series are nearing completion; the experiments in this test series that have been completed or are in progress are reviewed and the objectives and test matrices for the final experiments in these two series are defined. The objectives, testing strategy, and test parameters associated with a future AFC test series, AFC-5, are documented. Finally, the future intersections and/or synergies of the AFC irradiation testing program with those of the TREAT transient testing program, emerging needs of proposed Versatile Test Reactor concepts, and the Joint Fuel Cycle Study program’s Integrated Recycle Test are discussed.

  19. Advanced Reactor Fuels Irradiation Experiment Design Objectives

    Energy Technology Data Exchange (ETDEWEB)

    Chichester, Heather Jean MacLean [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hayes, Steven Lowe [Idaho National Lab. (INL), Idaho Falls, ID (United States); Dempsey, Douglas [Idaho National Lab. (INL), Idaho Falls, ID (United States); Harp, Jason Michael [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-09-01

    This report summarizes the objectives of the current irradiation testing activities being undertaken by the Advanced Fuels Campaign relative to supporting the development and demonstration of innovative design features for metallic fuels in order to realize reliable performance to ultra-high burnups. The AFC-3 and AFC-4 test series are nearing completion; the experiments in this test series that have been completed or are in progress are reviewed and the objectives and test matrices for the final experiments in these two series are defined. The objectives, testing strategy, and test parameters associated with a future AFC test series, AFC-5, are documented. Finally, the future intersections and/or synergies of the AFC irradiation testing program with those of the TREAT transient testing program, emerging needs of proposed Versatile Test Reactor concepts, and the Joint Fuel Cycle Study program’s Integrated Recycle Test are discussed.

  20. Delineating advanced practice nursing in New Zealand: a national survey.

    Science.gov (United States)

    Carryer, J; Wilkinson, J; Towers, A; Gardner, G

    2018-03-01

    A variety of advanced practice nursing roles and titles have proliferated in response to the changing demands of a population characterized by increasing age and chronic illness. Whilst similarly identified as advanced practice roles, they do not share a common practice profile, educational requirements or legislative direction. The lack of clarity limits comparative research that can inform policy and health service planning. To identify advanced practice roles within nursing titles employed in New Zealand and practice differences between advanced practice and other roles. Replicating recent Australian research, 3255 registered nurses/nurse practitioners in New Zealand completed the amended Advanced Practice Delineation survey tool. The mean domain scores of the predominant advanced practice position were compared with those of other positions. Differences between groups were explored using one-way ANOVA and post hoc between group comparisons. Four nursing position bands were identified: nurse practitioner, clinical nurse specialist, domain-specific and registered nurse. Significant differences between the bands were found on many domain scores. The nurse practitioner and clinical nurse specialist bands had the most similar practice profiles, nurse practitioners being more involved in direct care and professional leadership. Similar to the position of clinical nurse consultant in Australia, those practicing as clinical nurse specialists were deemed to reflect the threshold for advanced practice nursing. The results identified different practice patterns for the identified bands and distinguish the advanced practice nursing roles. By replicating the Australian study of Gardener et al. (2016), this NZ paper extends the international data available to support more evidence-based nursing workforce planning and policy development. © 2017 International Council of Nurses.

  1. Cash Advance Accounting: Accounting Regulations and Practices

    OpenAIRE

    Aristita Rotila

    2012-01-01

    It is known the fact that often the entities offer to staff or third parties certain amounts of money, in order to make payments for the entities, such sums being registered differently in the accounting as cash advances. In the case in which the advances are offered in a foreign currency, there is the problem of the exchange rate used when justifying the advance, for the conversion in lei of payments that were carried out. In this article we wanted to signal the effect that the exchange rate...

  2. Testing theory in practice: a simple experiment

    NARCIS (Netherlands)

    Terpstra, R.; Brezocnik, Z.; Kapus, T.; Ferreira Pires, Luis; Heerink, A.W.; Tretmans, G.J.

    1996-01-01

    In this paper we discuss the experiences gained in conducting a simple testing experiment. The goal of this experiment is to apply the abstract, formal testing framework [8] in a practical setting, and to indicate the critical aspects in its application to realistic testing situations. For that

  3. Operating practical experience at Argentina

    International Nuclear Information System (INIS)

    Quihillalt, Oscar

    1997-01-01

    Operating experiences of Atucha-1 and Embalse Nuclear Power Plants were discussed in this work. The technical and economic aspects, such as reliability, availability, personnel training, operating costs, prices and market, which exercise influence upon Argentina nuclear energy policy, mainly on the power electric generation by nuclear power plants were considered. Finally the current status of the nucleoelectric sector in Argentina and forecasting were analysed

  4. Mentoring advanced practice nurses in research: recommendations from a pilot program.

    Science.gov (United States)

    Leung, Doris; Widger, Kimberley; Howell, Doris; Nelson, Sioban; Molassiotis, Alex

    2012-01-01

    Advanced Practice Nurses (APNs) need research skills to develop and advance their practice and, yet, many have limited access to research training and support following completion of their advanced degree. In this paper we report on the development, delivery, and evaluation of an innovative pilot program that combined research training and one-to-one mentorship for nine APNs in conducting research relevant to their practice. The program was organized within an academic institution and its affiliated hospitals in Toronto, Canada. Our experience with this program may assist those in other organizations to plan and deliver a similar program for APN research mentorship.

  5. Advanced divertor experiments on DIII-D

    International Nuclear Information System (INIS)

    Schaffer, M.J.; Mahdavi, M.A.; Osborne, T.; Petrie, T.W.; Stambaugh, R.D.; Buchenauer, D.; Hill, D.N.; Klepper, C.C.

    1991-01-01

    The poloidal divertor is presently favored for next-step, high-power tokamaks. The DIII-D Advanced Divertor Program (ADP) aims to gain increased control over the divertor plasma and tokamak boundary conditions. This paper reports experiments done in the first phase of the ADP. The DIII-D lower divertor was modified by the addition of a toroidally symmetric, graphite-armoured, water-cooled divertor-biasing ring electrode at the entrance to a gas plenum. (In the past DIII-D operated with an open divertor.) The plenum will eventually contain a He cryogenic loop for active divertor pumping. The separatrix 'strike' position is controlled by the lower poloidal field shaping coils and can be varied smoothly from the ring electrode upper surface to the divertor floor far from the entrance aperture. External power, at up to 550 V and 8 kA separately, has been applied to the electrode to date. (author) 5 refs., 5 figs

  6. Advanced divertor experiments on DIII-D

    International Nuclear Information System (INIS)

    Schaffer, M.J.; Mahdavi, M.A.; Osborne, T.; Petrie, T.W.; Stambaugh, R.D.; Buchenauer, D.; Hill, D.N.; Klepper, C.C.

    1991-04-01

    The poloidal divertor is presently favored for next-step, high-power tokamaks. The DIII-D Advanced Divertor Program (ADP) aims to gain increased control over the divertor plasma and tokamak boundary conditions. This paper reports experiments done in the first phase of the ADP. The DIII-D lower divertor was modified by the addition of a toroidally symmetric, graphite-armoured, water-cooled divertor-biasing ring electrode at the entrance to a gas plenum. The plenum will eventually contain a He cryogenic loop for active divertor pumping. The separatrix ''strike'' position is controlled by the lower poloidal field shaping coils and can be varied smoothly from the ring electrode upper surface to the divertor floor far from the entrance aperture. External power, at up to 550 V and 8 kA separately, has been applied to the electrode to date. 5 refs., 5 figs

  7. The Ways of Advanced Human Capital: Discussions from Experiences

    Directory of Open Access Journals (Sweden)

    Rayén Amanda Rovira Rubio

    2015-11-01

    Full Text Available The present research aimed to know the significance of academic training experienced by postgraduate students who are pursuing their studies abroad under the context of a Training Program for Advanced Human Capital promoted by the Government of Chile. A feminist epistemology of situated knowledge was used as methodological framework, and narrative productions were used as technique of data collection. With this approach, the experiences of seven graduate students in Spanish universities, mostly of them beneficiaries of scholarships from Chile, were analyzed. The main findings were: the positive assessment of the experience of studying abroad, the divergent testimonies about these experiences, which based on previous educational trajectories and the socioeconomic level of the professional. These aspects influenced the identifications with the concept of Advanced Human Capital for Chile. Also, for some participants, the Advanced Human Capital is seen as an imposed concept which does not coincide with the real opportunities for the professional practice in the country. Therefore, the participants are sceptical about the possibilities of adequate job insertion in the return to Chile.

  8. Online, directed journaling in community health advanced practice nursing clinical education.

    Science.gov (United States)

    Daroszewski, Ellen Beth; Kinser, Anita G; Lloyd, Susan L

    2004-04-01

    The sharing of experiences in advanced practice nursing clinical courses allows for application of core principals to different facets of practice, with the potential to promote discussions beyond the course objectives, create opportunities for mentoring, foster critical thinking, and facilitate change and socialization into advanced practice. A pilot test of online, directed journaling, an innovative sharing and reflection strategy, was incorporated in a two-quarter community health advanced practice nursing clinical course in an attempt to enhance clinical learning. Six female graduate nursing students completed the journaling. A 10-item evaluation measure demonstrated that the online journaling strategy was highly effective and valuable for the students. An assessment of the journaling entries found multiple examples of discussion, mentoring, critical thinking, and socialization. Innovative online strategies should become the standard for sharing in advanced practice nursing education.

  9. Computational experiment approach to advanced secondary mathematics curriculum

    CERN Document Server

    Abramovich, Sergei

    2014-01-01

    This book promotes the experimental mathematics approach in the context of secondary mathematics curriculum by exploring mathematical models depending on parameters that were typically considered advanced in the pre-digital education era. This approach, by drawing on the power of computers to perform numerical computations and graphical constructions, stimulates formal learning of mathematics through making sense of a computational experiment. It allows one (in the spirit of Freudenthal) to bridge serious mathematical content and contemporary teaching practice. In other words, the notion of teaching experiment can be extended to include a true mathematical experiment. When used appropriately, the approach creates conditions for collateral learning (in the spirit of Dewey) to occur including the development of skills important for engineering applications of mathematics. In the context of a mathematics teacher education program, this book addresses a call for the preparation of teachers capable of utilizing mo...

  10. Impact of Selection Practices on Career Advancement of African American Women in Community College Administration

    Science.gov (United States)

    Yancy-Tooks, Barbara J.

    2012-01-01

    The purpose of this qualitative ethnographic study was to explore the experiences of African American women about their perceptions of factors (i.e. senior administrator selection practices, institutional practices, barriers, and coping strategies) that hinder or facilitate advancement in community college administration. The following questions…

  11. Advanced domestic digital satellite communications systems experiments

    Science.gov (United States)

    Iso, A.; Izumisawa, T.; Ishida, N.

    1984-02-01

    The characteristics of advanced digital transmission systems were measured, using newly developed small earth stations and a K-band and C-band communication satellite. Satellite link performance for data, facsimile, video and packet switching information transmission at bit rates ranging from 6.4 kbit/s to 6.3 Mbit/s have been confirmed, using a small K-band earth station and a demand-assignment time division multiple access system. A low-capacity omni-use C-band terminal experiment has verified a telephone channel transmission performance by spread-spectrum multiple access. Single point to multipoint transmission characteristics of the 64 kbit/s data signals from the computer center were tested, using a receive-only 4 GHz earth terminal. Basic satellite link performance was confirmed under clear-sky conditions. Precise satellite orbit and attitude keeping experiments were carried out to obtain precise satellite antenna pointing accuracy for development of K-band earth stations that do not require satellite tracking equipment. Precise station keeping accuracy of 0.02 degrees was obtained.

  12. Nursing Student Teachers' experiences during teaching practice:

    African Journals Online (AJOL)

    Mary

    Teaching practice experiences of nursing student provide greater insight to develop effective classroom and clinical teaching ... expectations and benefits are significantly derived from teaching practice although contingent on the mode of entry into the ...... Participation in and Leadership of. Continual Improvement.

  13. Advancing nursing practice: redefining the theoretical and practical integration of knowledge.

    Science.gov (United States)

    Christensen, Martin

    2011-03-01

    The aim of this paper is to offer an alternative knowing-how knowing-that framework of nursing knowledge, which in the past has been accepted as the provenance of advanced practice. The concept of advancing practice is central to the development of nursing practice and has been seen to take on many different forms depending on its use in context. To many it has become synonymous with the work of the advanced or expert practitioner; others have viewed it as a process of continuing professional development and skills acquisition. Moreover, it is becoming closely linked with practice development. However, there is much discussion as to what constitutes the knowledge necessary for advancing and advanced practice, and it has been suggested that theoretical and practical knowledge form the cornerstone of advanced knowledge. The design of this article takes a discursive approach as to the meaning and integration of knowledge within the context of advancing nursing practice. A thematic analysis of the current discourse relating to knowledge integration models in an advancing and advanced practice arena was used to identify concurrent themes relating to the knowing-how knowing-that framework which commonly used to classify the knowledge necessary for advanced nursing practice. There is a dichotomy as to what constitutes knowledge for advanced and advancing practice. Several authors have offered a variety of differing models, yet it is the application and integration of theoretical and practical knowledge that defines and develops the advancement of nursing practice. An alternative framework offered here may allow differences in the way that nursing knowledge important for advancing practice is perceived, developed and coordinated. What has inevitably been neglected is that there are various other variables which when transposed into the existing knowing-how knowing-that framework allows for advanced knowledge to be better defined. One of the more notable variables is

  14. Survey of advanced practice registered nurses disciplinary action.

    Science.gov (United States)

    Hudspeth, Randall

    2007-04-02

    The nursing profession continues to struggle to find the most appropriate approach to credentialing Advanced Practice Registered Nurses (APRNs). One early step in addressing this struggle is determining the incidence of APRN disciplinary actions by boards of nursing. This article presents data from 2003 and 2004 describing the incidence of APRN disciplinary actions by United States boards of nursing. Fifty-one boards of nursing, all members of the National Council of State Boards of Nursing, were asked to report the numbers of APRN discipline cases for 2003 and 2004 which had been resolved, using a tool that differentiated disciplinary cases into four data categories: chemical impairment, exceeding scope of practice, unprofessional conduct, and safety or abuse of patients. Thirty-eight (74.5%) of 51 boards of nursing reported discipline data for a total of 125,882 APRNs showing 688 disciplinary actions were taken during 2003 and 2004. This indicates that APRNs experience a low incidence of discipline related to chemical impairment, exceeding scope of practice, unprofessional conduct, and safety or abuse of patients.

  15. Energy Therapies in Advanced Practice Oncology: An Evidence-Informed Practice Approach

    Science.gov (United States)

    Potter, Pamela J.

    2013-01-01

    Advanced practitioners in oncology want patients to receive state-of-the-art care and support for their healing process. Evidence-informed practice (EIP), an approach to evaluating evidence for clinical practice, considers the varieties of evidence in the context of patient preference and condition as well as practitioner knowledge and experience. This article offers an EIP approach to energy therapies, namely, Therapeutic Touch (TT), Healing Touch (HT), and Reiki, as supportive interventions in cancer care; a description of the author’s professional experience with TT, HT, and Reiki in practice and research; an overview of the three energy healing modalities; a review of nine clinical studies related to oncology; and recommendations for EIP. These studies demonstrate a response to previous research design critiques. Findings indicate a positive benefit for oncology patients in the realms of pain, quality of life, fatigue, health function, and mood. Directionality of healing in immune response and cell line studies affirms the usual explanation that these therapies bring harmony and balance to the system in the direction of health. Foremost, the research literature demonstrates the safety of these therapies. In order to consider the varieties of evidence for TT, HT, and Reiki, EIP requires a qualitative examination of patient experiences with these modalities, exploration of where these modalities have been integrated into cancer care and how the practice works in the oncology setting, and discovery of the impact of implementation on provider practice and self-care. Next steps toward EIP require fleshing out the experience of these modalities by patients and health-care providers in the oncology care setting. PMID:25031994

  16. Embodied Experience in Educational Practice and Research

    Science.gov (United States)

    Bengtsson, Jan

    2013-01-01

    The intention of this article is to make an educational analysis of Merleau-Ponty's theory of experience in order to see what it implicates for educational practice as well as educational research. In this way, we can attain an understanding what embodied experience might mean both in schools and other educational settings and in researching…

  17. Simulation and Advanced Practice Nursing Education

    Science.gov (United States)

    Blue, Dawn I.

    2016-01-01

    This quantitative study compared changes in level of confidence resulting from participation in simulation or traditional instructional methods for BSN (Bachelor of Science in Nursing) to DNP (Doctor of Nursing Practice) students in a nurse practitioner course when they entered the clinical practicum. Simulation has been used in many disciplines…

  18. Diagnostics for advanced laser acceleration experiments

    International Nuclear Information System (INIS)

    Misuri, Alessio

    2002-01-01

    The first proposal for plasma based accelerators was suggested by 1979 by Tajima and Dawson. Since then there has been a tremendous progress both theoretically and experimentally. The theoretical progress is particularly due to the growing interest in the subject and to the development of more accurate numerical codes for the plasma simulations (especially particle-in-cell codes). The experimental progress follows from the development of multi-terawatt laser systems based on the chirped-pulse amplification technique. These efforts have produced results in several experiments world-wide, with the detection of accelerated electrons of tens of MeV. The peculiarity of these advanced accelerators is their ability to sustain extremely large acceleration gradients. In the conventional radio frequency linear accelerators (RF linacs) the acceleration gradients are limited roughly to 100 MV/m; this is partially due to breakdown which occurs on the walls of the structure. The electrical breakdown is originated by the emission of the electrons from the walls of the cavity. The electrons cause an avalanche breakdown when they reach other metal parts of the RF linacs structure

  19. Diagnostics for advanced laser acceleration experiments

    Energy Technology Data Exchange (ETDEWEB)

    Misuri, Alessio [Univ. of Pisa (Italy)

    2002-01-01

    The first proposal for plasma based accelerators was suggested by 1979 by Tajima and Dawson. Since then there has been a tremendous progress both theoretically and experimentally. The theoretical progress is particularly due to the growing interest in the subject and to the development of more accurate numerical codes for the plasma simulations (especially particle-in-cell codes). The experimental progress follows from the development of multi-terawatt laser systems based on the chirped-pulse amplification technique. These efforts have produced results in several experiments world-wide, with the detection of accelerated electrons of tens of MeV. The peculiarity of these advanced accelerators is their ability to sustain extremely large acceleration gradients. In the conventional radio frequency linear accelerators (RF linacs) the acceleration gradients are limited roughly to 100 MV/m; this is partially due to breakdown which occurs on the walls of the structure. The electrical breakdown is originated by the emission of the electrons from the walls of the cavity. The electrons cause an avalanche breakdown when they reach other metal parts of the RF linacs structure.

  20. Advanced Colloids Experiment (ACE) Science Overview

    Science.gov (United States)

    Meyer, William V.; Sicker, Ronald J.; Chiaramonte, Francis P.; Luna, Unique J.; Chaiken, Paul M.; Hollingsworth, Andrew; Secanna, Stefano; Weitz, David; Lu, Peter; Yodh, Arjun; hide

    2013-01-01

    The Advanced Colloids Experiment is being conducted on the International Space Station (ISS) using the Light Microscopy Module (LMM) in the Fluids Integrated Rack (FIR). Work to date will be discussed and future plans and opportunities will be highlighted. The LMM is a microscope facility designed to allow scientists to process, manipulate, and characterize colloidal samples in micro-gravity where the absence of gravitational settling and particle jamming enables scientists to study such things as:a.The role that disordered and ordered-packing of spheres play in the phase diagram and equation of state of hard sphere systems,b.crystal nucleation and growth, growth instabilities, and the glass transition, c.gelation and phase separation of colloid polymer mixtures,d.crystallization of colloidal binary alloys,e.competition between crystallization and phase separation,f.effects of anisotropy and specific interactions on packing, aggregation, frustration and crystallization,g.effects of specific reversible and irreversible interactions mediated in the first case by hybridization of complementary DNA strands attached to separate colloidal particles,h.Lock and key interactions between colloids with dimples and spheres which match the size and shape of the dimples,i.finding the phase diagrams of isotropic and interacting particles,j.new techniques for complex self-assembly including scenarios for self-replication, k.critical Casimir forces,l.biology (real and model systems) in microgravity,m.etc. By adding additional microscopy capabilities to the existing LMM, NASA will increase the tools available for scientists that fly experiments on the ISS enabling scientists to observe directly what is happening at the particle level. Presently, theories are needed to bridge the gap between what is being observed (at a macroscopic level when photographing samples) with what is happening at a particle (or microscopic) level. What is happening at a microscopic level will be directly

  1. Experience related to the safety of advanced LMFBR fuel elements

    International Nuclear Information System (INIS)

    Kerrisk, J.F.

    1975-07-01

    Experiments and experience relative to the safety of advanced fuel elements for the liquid metal fast breeder reactor are reviewed. The design and operating parameters and some of the unique features of advanced fuel elements are discussed breifly. Transient and steady state overpower operation and loss of sodium bond tests and experience are discussed in detail. Areas where information is lacking are also mentioned

  2. Radiation protection optimization. Advances in practical implementation

    International Nuclear Information System (INIS)

    1989-01-01

    Within the Community, protection against the dangers of ionizing radiation is regulated in conformity with the provisions of two Council Directives. One is of general application for all activities involving a hazard arising from ionizing radiation and lays down the basic safety standards for the health protection of the general public and workers against the dangers of ionizing radiation. The other is derived from the abovementioned one and lays down the basic measures for the radiation protection of persons undergoing medical examination or treatment. The Commission, in collaboration with the Spanish Ministerio de Sanidad y Consumo, the Consejo de Seguridad Nuclear and the Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas, organized on 12, 13 and 14 September 1988 in Madrid, the third scientific seminar on the optimization principle (Alara) which is a key element of the two abovementioned Council Directives. The seminar allowed an analysis of the progress made since the previous seminars of 1979 and 1983, in the practical implementation of the optimization principle, in relation to the design and operation of nuclear and industrial installations, natural radioactivity, medical practices and countermeasures. The report contains the 20 original contributions presented and some general considerations on the results of the seminar

  3. Analysis instruments for the performance of Advanced Practice Nursing.

    Science.gov (United States)

    Sevilla-Guerra, Sonia; Zabalegui, Adelaida

    2017-11-29

    Advanced Practice Nursing has been a reality in the international context for several decades and recently new nursing profiles have been developed in Spain as well that follow this model. The consolidation of these advanced practice roles has also led to of the creation of tools that attempt to define and evaluate their functions. This study aims to identify and explore the existing instruments that enable the domains of Advanced Practice Nursing to be defined. A review of existing international questionnaires and instruments was undertaken, including an analysis of the design process, the domains/dimensions defined, the main results and an exploration of clinimetric properties. Seven studies were analysed but not all proved to be valid, stable or reliable tools. One included tool was able to differentiate between the functions of the general nurse and the advanced practice nurse by the level of activities undertaken within the five domains described. These tools are necessary to evaluate the scope of advanced practice in new nursing roles that correspond to other international models of competencies and practice domains. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  4. Strategic directions and actions for advanced practice nursing in China

    Directory of Open Access Journals (Sweden)

    Martha N. Hill

    2017-01-01

    Full Text Available There is a need and opportunity for China to develop education and practice innovations given that advance practice nurses (APNs improve health care and outcomes. The China Medical Board (CMB China Nursing Network (CCNN began planning for an Advanced Nursing Practice Program for education and career development that will facilitate CCNN's contributions to meeting national nursing policy priorities. This paper presents the discussion, recommendations and action plans developed at the inaugural planning meeting on June 26, 2015 at Fudan University in Shanghai. The recommendations are: Develop standards for advanced nursing practice; Develop Master's level curricula based on the standards; Commence pilot projects across a number of University affiliated hospitals; and Prepare clinical tutors and faculty. The strategic directions and actions are: Develop a clinical career ladder system; Expand the nursing role from hospital to community; and Build a specialty nurse accreditation system.

  5. Advanced photoinjector experiment photogun commissioning results

    Directory of Open Access Journals (Sweden)

    F. Sannibale

    2012-10-01

    Full Text Available The Advanced Photoinjector Experiment (APEX at the Lawrence Berkeley National Laboratory is dedicated to the development of a high-brightness high-repetition rate (MHz-class electron injector for x-ray free-electron laser (FEL and other applications where high repetition rates and high brightness are simultaneously required. The injector is based on a new concept rf gun utilizing a normal-conducting (NC cavity resonating in the VHF band at 186 MHz, and operating in continuous wave (cw mode in conjunction with high quantum efficiency photocathodes capable of delivering the required charge at MHz repetition rates with available laser technology. The APEX activities are staged in three phases. In phase 0, the NC cw gun is built and tested to demonstrate the major milestones to validate the gun design and performance. Also, starting in phase 0 and continuing in phase I, different photocathodes are tested at the gun energy and at full repetition rate for validating candidate materials to operate in a high-repetition rate FEL. In phase II, a room-temperature pulsed linac is added for accelerating the beam at several tens of MeV to reduce space charge effects and allow the measurement of the brightness of the beam from the gun when integrated in an injector scheme. The installation of the phase 0 beam line and the commissioning of the VHF gun are completed, phase I components are under fabrication, and initial design and specification of components and layout for phase II are under way. This paper presents the phase 0 commissioning results with emphasis on the experimental milestones that have successfully demonstrated the APEX gun capability of operating at the required performance.

  6. Advanced photoinjector experiment photogun commissioning results

    Science.gov (United States)

    Sannibale, F.; Filippetto, D.; Papadopoulos, C. F.; Staples, J.; Wells, R.; Bailey, B.; Baptiste, K.; Corlett, J.; Cork, C.; De Santis, S.; Dimaggio, S.; Doolittle, L.; Doyle, J.; Feng, J.; Garcia Quintas, D.; Huang, G.; Huang, H.; Kramasz, T.; Kwiatkowski, S.; Lellinger, R.; Moroz, V.; Norum, W. E.; Padmore, H.; Pappas, C.; Portmann, G.; Vecchione, T.; Vinco, M.; Zolotorev, M.; Zucca, F.

    2012-10-01

    The Advanced Photoinjector Experiment (APEX) at the Lawrence Berkeley National Laboratory is dedicated to the development of a high-brightness high-repetition rate (MHz-class) electron injector for x-ray free-electron laser (FEL) and other applications where high repetition rates and high brightness are simultaneously required. The injector is based on a new concept rf gun utilizing a normal-conducting (NC) cavity resonating in the VHF band at 186 MHz, and operating in continuous wave (cw) mode in conjunction with high quantum efficiency photocathodes capable of delivering the required charge at MHz repetition rates with available laser technology. The APEX activities are staged in three phases. In phase 0, the NC cw gun is built and tested to demonstrate the major milestones to validate the gun design and performance. Also, starting in phase 0 and continuing in phase I, different photocathodes are tested at the gun energy and at full repetition rate for validating candidate materials to operate in a high-repetition rate FEL. In phase II, a room-temperature pulsed linac is added for accelerating the beam at several tens of MeV to reduce space charge effects and allow the measurement of the brightness of the beam from the gun when integrated in an injector scheme. The installation of the phase 0 beam line and the commissioning of the VHF gun are completed, phase I components are under fabrication, and initial design and specification of components and layout for phase II are under way. This paper presents the phase 0 commissioning results with emphasis on the experimental milestones that have successfully demonstrated the APEX gun capability of operating at the required performance.

  7. ULTRA SCWR+: Practical advanced water reactor concepts

    International Nuclear Information System (INIS)

    Duffey, Romney; Khartabil, Hussam; Kuran, Sermet; Zhou, Tracy; Pioro, Igor

    2008-01-01

    Modern thermal power plants now utilize supercritical steam cycles with thermal efficiencies of over 45%. Recent developments have lead to Ultra-SuperCritical (USC) systems, which adopt reheat turbines that can attain efficiencies of over 50%. Because these turbines are already developed, demonstrated and deployed worldwide, and use existing and traditional steam cycle technology, the simplest nuclear advance is to utilize these proven thermal cycle conditions by coupling this turbine type to a reactor. This development direction is fundamentally counter to the usual approach of adopting high-temperature gas-cooled (helium-cooled) reactor cycles, for which turbines have yet to be demonstrated on commercial scale unlike the supercritical steam turbines. The ULTRA (Ultra-supercritical Light water Thermal ReActor) SCWR+ concept adopts the fundamental design approach of matching a water and steam-cooled reactor to the ultra-supercritical steam cycle, adopting the existing and planned thermal power plant turbines. The HP and IP sections are fed with conditions of 25 MPa/625degC and 7 MPa/700degC, respectively, to achieve operating plant thermal efficiencies in excess of 50%, with a direct turbine cycle. By using such low-pressure reheated steam, this concept also adopts technology that was explored and used many years ago in existing water reactors, with the potential to produce large quantities of low cost heat, which can be used for other industrial and district processes. Pressure-Tube (PT) reactors are suitable for adoption of this design approach and, in addition, have other advantages that will significantly improve water-cooled reactor technology. These additional advantages include enhanced safety and improved resource utilization and proliferation resistance. This paper describes the PT-SCWR+ concept and its potential enhancements. (author)

  8. Beyond competencies: using a capability framework in developing practice standards for advanced practice nursing.

    Science.gov (United States)

    O'Connell, Jane; Gardner, Glenn; Coyer, Fiona

    2014-12-01

    This paper presents a discussion on the application of a capability framework for advanced practice nursing standards/competencies. There is acceptance that competencies are useful and necessary for definition and education of practice-based professions. Competencies have been described as appropriate for practice in stable environments with familiar problems. Increasingly competencies are being designed for use in the health sector for advanced practice such as the nurse practitioner role. Nurse practitioners work in environments and roles that are dynamic and unpredictable necessitating attributes and skills to practice at advanced and extended levels in both familiar and unfamiliar clinical situations. Capability has been described as the combination of skills, knowledge, values and self-esteem which enables individuals to manage change, be flexible and move beyond competency. A discussion paper exploring 'capability' as a framework for advanced nursing practice standards. Data were sourced from electronic databases as described in the background section. As advanced practice nursing becomes more established and formalized, novel ways of teaching and assessing the practice of experienced clinicians beyond competency are imperative for the changing context of health services. Leading researchers into capability in health care state that traditional education and training in health disciplines concentrates mainly on developing competence. To ensure that healthcare delivery keeps pace with increasing demand and a continuously changing context there is a need to embrace capability as a framework for advanced practice and education. © 2014 John Wiley & Sons Ltd.

  9. Pharmacists' experience of conflict in community practice.

    Science.gov (United States)

    Austin, Zubin; Gregory, Paul A M; Martin, J Craig

    2010-03-01

    Interpersonal conflict may be characterized as intellectual disagreement with emotional entanglement. While interpersonal conflict has been studied and described in different health care settings, there is little research that focuses on community pharmacists and the ways in which they experience conflict in professional practice. To describe and characterize the experience of interpersonal conflict within community pharmacy practice. A self-reporting narrative log was developed in which actively recruited pharmacists reported and reflected upon their day-to-day experiences of interpersonal conflict in professional practice. Focus groups of pharmacists were convened following data analysis to provide context and confirmation of identified themes. Based on this analysis, an explanatory model for interpersonal conflict in community pharmacy practice was generated. Participants were actively recruited from community pharmacy settings in the Toronto (Canada) area. A total of 41 community pharmacists participated. Interpersonal conflict in pharmacy practice is ubiquitous and results from diverse triggers. A conflict stance model was developed, based on the worldview and the communication style of the individual pharmacist. Specific conflict stances identified were: imposing, thwarting, settling, and avoiding. Further testing and refinement of this model is required. Crown Copyright 2010. Published by Elsevier Inc. All rights reserved.

  10. Supporting primary care nurses to work at an advanced level through changing practices.

    Science.gov (United States)

    Forsdike, Kirsty; Murphy, Tracy Ann; Hegarty, Kelsey

    2018-04-06

    General practice nurses wishing to develop their careers in general practice are often unsupported, relying on the culture of individual practices. Given the structural diversity of Australian general practice, we qualitatively explored staff experiences of organisational governance, what supports are in place and can be used to assist nurses to advance. Semi-structured interviews with 28 staff (including nurses, GPs, receptions and practice managers) were undertaken across three practices, as part of a case-study approach. It was found that general practice staff know little of organisational governance and how it may be harnessed. Practical and flexible organisational governance were the most important factors in supporting general practice nurses to develop and utilise nursing skills, but advocacy from medical colleagues was necessary to support advancement. Barriers include funding structures, non-supportive cultures and inflexible organisational governance structures. Organisation governance has the potential to assist nurses to work at an advanced level, but significant financial, structural and cultural barriers may be too difficult for organisational governance resources alone to overcome. In addition to utilising resources, it may be useful for general practices to undertake a review of how they function as a team and reflect upon their practice culture.

  11. Profile of advanced nursing practice in Spain: A cross-sectional study.

    Science.gov (United States)

    Sevilla Guerra, Sonia; Miranda Salmerón, Josep; Zabalegui, Adelaida

    2018-03-01

    In this study, we described the profile of advanced nursing practice in Spain. A cross-sectional study design was used to explore the extent and patterns of advanced nursing practice activity within the domains of expert care planning, integrated care, interprofessional collaboration, education, research, evidence-based practice, and professional leadership. Data were collected in 2015/2016. Purposive sampling yielded a sample of 165 specialist and expert nurses employed by a dual tertiary and community hospital in an urban setting. The study included specialist and expert nurses who had a higher practice profile than registered general nurses. The performance of activities according to age, current position, years of experience, nursing grade, and education was compared. Practice domains were more strongly influenced by the predictors of nursing position and professional career ladder. Age and experience predictors were found to be weak predictors of advanced practice domains. This study offers essential information of the nursing workforce, and clarifies both the advanced nursing practice profile and nomenclature in the context of study. © 2017 John Wiley & Sons Australia, Ltd.

  12. Practice and prospect of advanced fuel management and fuel technology application in PWR in China

    International Nuclear Information System (INIS)

    Xiao Min; Zhang Hong; Ma Cang; Bai Chengfei; Zhou Zhou; Wang Lei; Xiao Xiaojun

    2015-01-01

    Since Daya Bay nuclear power plant implemented 18-month refueling strategy in 2001, China has completed a series of innovative fuel management and fuel technology projects, including the Ling Ao Advanced Fuel Management (AFM) project (high-burnup quarter core refueling) and the Ningde 18-month refueling project with gadolinium-bearing fuel in initial core. First, this paper gives brief introduction to China's advanced fuel management and fuel technology experience. Second, it introduces practices of the advanced fuel management in China in detail, which mainly focuses on the implementation and progress of the Ningde 18-month refueling project with gadolinium-bearing fuel in initial core. Finally, the paper introduces the practices of advanced fuel technology in China and gives the outlook of the future advanced fuel management and fuel technology in this field. (author)

  13. Effects of RN Age and Experience on Transformational Leadership Practices.

    Science.gov (United States)

    Herman, Susan; Gish, Mary; Rosenblum, Ruth; Herman, Michael

    2017-06-01

    This study reported the evolution of transformational leadership (TL) practices and behaviors across years of age, management experience, and professional nursing practice within a professional nursing leadership organization. Recent studies of CNO TL found valuations peak near age 60 years. This study reported on a wider range of management positions, correlating years of RN practice and management experience and age to TL metrics. This study used Kouzes and Posner's Leadership Practices Inventory-Self-Assessment (LPI-S) to survey a nursing leadership organization, the Association of California Nurse Leaders (ACNL). Anonymous responses were analyzed to identify leadership trends in age and years of professional service. On average, LPI-S metrics of leadership skills advance through years of management, RN experience, and age. The TL scores are statistically higher in most LPI-S categories for those with more than 30 years of RN or management experience. Decade-averaged LPI-S TL metrics in the ACNL survey evolve linearly throughout age before peaking in the decade from age 60 to 69 years. A similar evolution of TL metrics is seen in decades of either years of management experience or years of RN experience. Transformational leadership increased with nursing maturity particularly for LPI-S categories of "inspire a shared vision," "challenge the process," and "enable others to act." In the ACNL population studied, decade-averaged leadership metrics advanced. Leadership evolution with age in the broader RN population peaked in age bracket 60 to 69 years. The LPI-S averages declined when older than 70 years, coinciding with a shift from full-time work toward retirement and part-time employment.

  14. Practical Implementations of Advanced Process Control for Linear Systems

    DEFF Research Database (Denmark)

    Knudsen, Jørgen K . H.; Huusom, Jakob Kjøbsted; Jørgensen, John Bagterp

    2013-01-01

    This paper describes some practical problems encountered, when implementing Advanced Process Control, APC, schemes on linear processes. The implemented APC controllers discussed will be LQR, Riccati MPC and Condensed MPC controllers illustrated by simulation of the Four Tank Process and a lineari......This paper describes some practical problems encountered, when implementing Advanced Process Control, APC, schemes on linear processes. The implemented APC controllers discussed will be LQR, Riccati MPC and Condensed MPC controllers illustrated by simulation of the Four Tank Process...... on pilot plant equipment on the department of Chemical Engineering DTU Lyngby....

  15. Advanced Undergraduate Experiments in Thermoanalytical Chemistry.

    Science.gov (United States)

    Hill, J. O.; Magee, R. J.

    1988-01-01

    Describes several experiments using the techniques of thermal analysis and thermometric titrimetry. Defines thermal analysis and several recent branches of the technique. Notes most of the experiments use simple equipment and standard laboratory techniques. (MVL)

  16. Development of a conceptual policy framework for advanced practice nursing: an ethnographic study.

    Science.gov (United States)

    Schober, Madrean M; Gerrish, Kate; McDonnell, Ann

    2016-06-01

    To report on a study examining policy development for advanced practice nursing from intent of policy to realization in practice. Inclusion of advanced practice nursing roles in the healthcare workforce is a worldwide trend. Optimal advanced nursing practice requires supportive policies. Little is known about how policy is developed and implemented. Ethnography using an instrumental case study approach was selected to give an in-depth understanding of the experiences of one country (Singapore) to contribute to insight into development elsewhere. The four-phase study was conducted from 2008-2012 and included document analysis (n = 47), interviews with key policy decision makers (n = 12), interviews with nursing managers and medical directors (n = 11), interviews and participant observation with advanced practice nurses (n = 15). Key policymakers in positions of authority were able to promote policy development. However, this was characterized by lack of strategic planning for implementation. A vague understanding by nursing managers and medical directors of policies, the role and its position in the healthcare workforce led to indecision and uncertainty in execution. Advanced practice nurses developed their role based on theory acquired in their academic programme but were unsure what role to assume in practice. Lack of clear guidelines led to unanticipated difficulties for institutions and healthcare systems. Strategic planning could facilitate integration of advanced practice nurses into the healthcare workforce. A Conceptual Policy Framework is proposed as a guide for a coordinated approach to policy development and implementation for advanced practice nursing. © 2016 John Wiley & Sons Ltd.

  17. The Competencies, Roles and Scope of Practice of Advanced Psychiatric Nursing in Indonesia

    Directory of Open Access Journals (Sweden)

    Yulia Wardani

    2014-01-01

    Full Text Available The graduate advanced psychiatric nursing (psychiatric nursing specialist from master degree in Indonesia are about 70 nurses, 67 nurses were graduated from University of Indonesia. They are working at mental health services and educational setting around Indonesia and yet seem not ready to perform some specific advanced competencies in clinical area. The mastery on mental health assessment, neurochemical perspectives, medical management and psychotherapy have not yet performed by the psychiatric nurse specialist in the clinical area or community.To have those competencies and its performances, therefore the curriculum in a psychiatric nursing graduate program must include advanced courses in physiopsychology, psychopathology, advanced psychopharmacology, neurobehavioral science, advanced mental health assessment, and advanced treatment interventions such as psychotherapy and prescription and management of psychotropic medications as their core and major courses in the curriculum. Those courses should be performed in their clinical practice courses or other related learning experiences. When those qualifications are met, then they are competent to be called advanced psychiatric nurse.As advanced practice registered nurses, the advanced psychiatric nurses should be able to demonstrate their direct expertise and roles in advanced mental health assessment, diagnostic evaluation, psychopharmacology management, psychotherapy with individuals, group and families, case management, millieu management, liason and counselling from prevention, promotion until psychiatric rehabilitation. Meanwhile the skill such as psycho-education, teaching, unit management, research and staff development can be added as their indirect roles.

  18. Teaching Staff Advanced Training: European Experience

    Science.gov (United States)

    Kovalchuk, Vasyl

    2015-01-01

    The issue of teaching staff advanced training is paid much attention in many countries. In the Republic of Moldova progressive professional credits system is used. Credits are scored not only in assigning teaching degrees or issuing a certificate of continuing professional education, but also for teachers' evaluation at the educational…

  19. Development of advanced nursing practice in China: Act local and think global

    Directory of Open Access Journals (Sweden)

    Frances Kam Yuet Wong

    2018-04-01

    Full Text Available This paper discusses the development of advanced nursing practice in China in the context of global development. The scope of nursing is evolving over time, with increasing demands for the management of complex healthcare situations at individual, community and system levels. These demands are aggravated by the specialization of medical practice, with advanced treatment plans and patients requiring care in focused areas. The qualifications and competencies of the initial entrants into nursing practice are not adequate to deal with these demands. Advanced nursing practice (ANP developed first in response to service demands, and education programs were introduced to prepare nurses for practicing at a higher level. This paper will first review the historical development of ANP in China, followed by a discussion of the differentiation of competence levels in nursing practice and the classification of specializations. It concludes by exploring how education in combination with experience protected by regulation of practice can support nurses to gradually evolve from registered nurse, specialty nurse to advanced practiced nurse.

  20. Establishing radiation therapy advanced practice in New Zealand

    International Nuclear Information System (INIS)

    Coleman, Karen; Jasperse, Marieke; Herst, Patries; Yielder, Jill

    2014-01-01

    Introduction: Advanced practice (AP) is of increasing interest to many radiation therapists (RTs) both nationally and internationally. In New Zealand, initial research (2005–2008) showed strong support for the development of an AP role for medical radiation technologists (MRTs). Here, we report on a nationwide survey in which RTs validated and prioritised nine AP profiles for future development. Methods: All registered RTs in New Zealand (n = 260) were invited to take part in a survey in December 2011; 73 of whom returned a complete response. Results: RTs supported the implementation of AP roles in New Zealand and the requirement of a Master's degree qualification to underpin clinical knowledge. Most RTs endorsed the criteria attributed to each of the nine proposed AP profiles. The study identified that activities may qualify as either advanced practice or standard practice depending on the department. All participants agreed that an advanced practitioner should be a leader in the field, able to initiate and facilitate future developments within as well as outside this specific role. Acceptance of the AP roles by RTs and other health professionals as well as the availability of resources for successful implementation, were concerns expressed by some RTs. Conclusion: The authors recommend (1) the development of one scope of practice titled ‘advanced practitioner’ with generic and specialist criteria for each profile as the future career pathway, (2) promotion and support for the AP pathway by the New Zealand Institute of Medical Radiation Technology and the New Zealand Medical Radiation Technologists Board

  1. Establishing radiation therapy advanced practice in New Zealand

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, Karen; Jasperse, Marieke; Herst, Patries [Department of Radiation Therapy, University of Otago, Wellington (New Zealand); Yielder, Jill [University of Auckland, Auckland (New Zealand); Department of Radiation Therapy, University of Otago, Wellington (New Zealand)

    2014-02-15

    Introduction: Advanced practice (AP) is of increasing interest to many radiation therapists (RTs) both nationally and internationally. In New Zealand, initial research (2005–2008) showed strong support for the development of an AP role for medical radiation technologists (MRTs). Here, we report on a nationwide survey in which RTs validated and prioritised nine AP profiles for future development. Methods: All registered RTs in New Zealand (n = 260) were invited to take part in a survey in December 2011; 73 of whom returned a complete response. Results: RTs supported the implementation of AP roles in New Zealand and the requirement of a Master's degree qualification to underpin clinical knowledge. Most RTs endorsed the criteria attributed to each of the nine proposed AP profiles. The study identified that activities may qualify as either advanced practice or standard practice depending on the department. All participants agreed that an advanced practitioner should be a leader in the field, able to initiate and facilitate future developments within as well as outside this specific role. Acceptance of the AP roles by RTs and other health professionals as well as the availability of resources for successful implementation, were concerns expressed by some RTs. Conclusion: The authors recommend (1) the development of one scope of practice titled ‘advanced practitioner’ with generic and specialist criteria for each profile as the future career pathway, (2) promotion and support for the AP pathway by the New Zealand Institute of Medical Radiation Technology and the New Zealand Medical Radiation Technologists Board.

  2. Advancing Evaluation Theory and Practice in South Asia : Building a ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Advancing Evaluation Theory and Practice in South Asia : Building a Community of Experts. This grant will allow the Association for ... to other evaluation practitioners in the region. It is expected that the project will help strengthen evaluation in South Asia, leading to more effective and efficient development interventions.

  3. Advancing Empirical Scholarship to Further Develop Evaluation Theory and Practice

    Science.gov (United States)

    Christie, Christina A.

    2011-01-01

    Good theory development is grounded in empirical inquiry. In the context of educational evaluation, the development of empirically grounded theory has important benefits for the field and the practitioner. In particular, a shift to empirically derived theory will assist in advancing more systematic and contextually relevant evaluation practice, as…

  4. International practice experiences in pharmacy education.

    Science.gov (United States)

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

    2013-11-12

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

  5. Experiment-Based Teaching in Advanced Control Engineering

    Science.gov (United States)

    Precup, R.-E.; Preitl, S.; Radac, M.-B.; Petriu, E. M.; Dragos, C.-A.; Tar, J. K.

    2011-01-01

    This paper discusses an experiment-based approach to teaching an advanced control engineering syllabus involving controlled plant analysis and modeling, control structures and algorithms, real-time laboratory experiments, and their assessment. These experiments are structured around the representative case of the longitudinal slip control of an…

  6. Advances in NIF Shock Timing Experiments

    Science.gov (United States)

    Robey, Harry

    2012-10-01

    Experiments are underway to tune the shock timing of capsule implosions on the National Ignition Facility (NIF). These experiments use a modified cryogenic hohlraum geometry designed to precisely match the performance of ignition hohlraums. The targets employ a re-entrant Au cone to provide optical access to multiple shocks as they propagate in the liquid deuterium-filled capsule interior. The strength and timing of all four shocks is diagnosed with VISAR (Velocity Interferometer System for Any Reflector). Experiments are now routinely conducted in a mirrored keyhole geometry, which allows for simultaneous diagnosis of the shock timing at both the hohlraum pole and equator. Further modifications are being made to improve the surrogacy to ignition hohlraums by replacing the standard liquid deuterium (D2) capsule fill with a deuterium-tritium (DT) ice layer. These experiments will remove any possible surrogacy difference between D2 and DT as well as incorporate the physics of shock release from the ice layer, which is absent in current experiments. Experimental results and comparisons with numerical simulation are presented.

  7. Establishing advanced practice for medical imaging in New Zealand

    International Nuclear Information System (INIS)

    Yielder, Jill; Young, Adrienne; Park, Shelley; Coleman, Karen

    2014-01-01

    Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ

  8. Establishing advanced practice for medical imaging in New Zealand

    Energy Technology Data Exchange (ETDEWEB)

    Yielder, Jill, E-mail: j.yielder@auckland.ac.nz [University of Auckland, Auckland (New Zealand); Young, Adrienne; Park, Shelley; Coleman, Karen [University of Otago, Wellington (New Zealand); University of Auckland, Auckland (New Zealand)

    2014-02-15

    Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ.

  9. [Competencies and professional profile of the advanced practice nurse].

    Science.gov (United States)

    del Barrio-Linares, M

    2014-01-01

    The advanced practice nurse can foster the development of innovative approaches in the design of patient, families and community care. This study has aimed to explain the importance of the advanced practice nurse, especially that of the clinical nurse specialist (CNS), within the care setting and to go deeper into the knowledge of this nursing profile. A review of the literature. The following databases were used: CINAHL, PubMed and Medline. Search terms were 'clinical nurse specialist,' 'implementation,' and 'advanced practice nursing.' The sample included 24 publications. A synthesis of the findings generated a summary of the competencies of CNS and their definitions, with some examples in their daily practice and the outcome on its 3 spheres of influences: patients and families, staff and organization. CNS emerges in the health systems in order to improve the outcomes in the patients, staff and the organization per se because of its competence as an agent of change and transformational leader National policies and national strategies are needed to implement CNS on the Master's level in the Spanish National Health System given the evidence-based improvement in the care standards. Copyright © 2012 Elsevier España, S.L. y SEEIUC. All rights reserved.

  10. Experience about the treatment of advanced breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Api, P; Corcione, S; Magnoni, G

    1985-01-01

    The authors report their experience about the efficacy of the association surgery-radiotherapy-polichemotheraphy, in the treatment of advanced breast cancer, emphasizing the importance of this association in the survival rate.

  11. Teacher's experiences in PBL: implications for practice

    Science.gov (United States)

    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.

  12. Implementation strategy for advanced practice nursing in primary health care in Latin America and the Caribbean.

    Science.gov (United States)

    Oldenburger, David; De Bortoli Cassiani, Silvia Helena; Bryant-Lukosius, Denise; Valaitis, Ruta Kristina; Baumann, Andrea; Pulcini, Joyce; Martin-Misener, Ruth

    2017-06-08

    SYNOPSIS Advanced practice nursing (APN) is a term used to describe a variety of possible nursing roles operating at an advanced level of practice. Historically, APN roles haves evolved informally, out of the need to improve access to health care services for at-risk and disadvantaged populations and for those living in underserved rural and remote communities. To address health needs, especially ones related to primary health care, nurses acquired additional skills through practice experience, and over time they developed an expanded scope of practice. More recently, APN roles have been developed more formally through the establishment of graduate education programs to meet agreed-upon competencies and standards for practice. The introduction of APN roles is expected to advance primary health care throughout Latin America and the Caribbean, where few such roles exist. The purpose of the paper is to outline an implementation strategy to guide and support the introduction of primary health care APN roles in Latin America and the Caribbean. The strategy includes the adaptation of an existing framework, utilization of recent research evidence, and application of knowledge from experts on APN and primary health care. The strategy consists of nine steps. Each step includes a national perspective that focuses on direct country involvement in health workforce planning and development and on implementation. In addition, each step incorporates an international perspective on encouraging countries that have established APN programs and positions to collaborate in health workforce development with nations without advanced practice nursing.

  13. Gerontology found me: gaining understanding of advanced practice nurses in geriatrics.

    Science.gov (United States)

    Campbell-Detrixhe, Dia D; Grassley, Jane S; Zeigler, Vicki L

    2013-10-01

    Examining the meanings of the experiences of advanced practice nurses (APNs) who chose to work with older adults and why they continue to work with this population was the focus of this hermeneutic qualitative research study. Twelve geriatric APNs currently practicing in two South Central states were interviewed using an open-ended interview guide. Using Gadamerian hermeneutics, the researchers identified Gerontology Found Me as the significant expression that reflected the fundamental meaning of the experience as a whole. Four themes emerged that further described the meanings of the participants' personal, educational, and professional experiences: Becoming a Gerontology Nurse, Being a Gerontology Nurse, Belonging to Gerontology, and Bringing Others to Gerontology. This study concluded that APNs' personal and professional experiences were more influential than educational experiences to become geriatric nurses, and having these personal and professional experiences of being in relationship with older individuals further contributed to their choice of gerontology.

  14. Value of wireless personal digital assistants for practice: perceptions of advanced practice nurses.

    Science.gov (United States)

    Garrett, Bernard; Klein, Gerri

    2008-08-01

    The aims were to explore advanced practice nurses' perceptions on wireless Personal Digital Assistant technologies, to establish the type and range of tools that would be useful to support their practice and to identify any requirements and limitations that may impact the implementation of wireless Personal Digital Assistants in practice. The wireless Personal Digital Assistant is becoming established as a hand-held computing tool for healthcare professionals. The reflections of advanced practice nurses' about the value of wireless Personal Digital Assistants and its potential to contribute to improved patient care has not been investigated. A qualitative interpretivist design was used to explore advanced practice nurses' perceptions on the value of wireless Personal Digital Assistant technologies to support their practice. The data were collected using survey questionnaires and individual and focus group interviews with nurse practitioners, clinical nurse specialists and information technology managers based in British Columbia, Canada. An open-coding content analysis was performed using qualitative data analysis software. Wireless Personal Digital Assistant's use supports the principles of pervasivity and is a technology rapidly being adopted by advanced practice nurses. Some nurses indicated a reluctance to integrate wireless Personal Digital Assistant technologies into their practices because of the cost and the short technological life cycle of these devices. Many of the barriers which precluded the use of wireless networks within facilities are being removed. Nurses demonstrated a complex understanding of wireless Personal Digital Assistant technologies and gave good rationales for its integration in their practice. Nurses identified improved client care as the major benefit of this technology in practice and the type and range of tools they identified included clinical reference tools such as drug and diagnostic/laboratory reference applications and wireless

  15. The advanced containment experiments (ACE) Project

    International Nuclear Information System (INIS)

    Sehgal, B.R.; Ritzman, R.; Merilo, M.; Rahn, F.; Machiels, A.

    1992-01-01

    The overall structure and content of the ACE Project, which has been obtaining experimental data in four key areas of LWR severe accident technology are described. The key areas consist of filtration systems for vented containment concepts, radioiodine behavior in containment, the interaction of molten core material with structural concrete, and the use of water to terminate the core-concrete interaction process. Experiment procedures used in each phase of the work are summarized and the principal results and conclusions developed to date are discussed

  16. Advanced neutron diagnostics for ITER fusion experiments

    International Nuclear Information System (INIS)

    Kaellne, J.; Giacomelli, L.; Hjalmarsson, A.; Conroy, S.; Ericsson, G.; Johnson, M.G.; Glasser, W.; Henriksson, H.; Ronchi, E.; Sjoestrand, H.; Andersson, E.S.; Thun, J.; Weiszflog, M.; Gorini, G.; Tardocchi, M.; Popovichev, S.; Sousa, J.

    2005-01-01

    Results are presented from the neutron emission spectroscopy (NES) diagnosis of JET plasma performed with the MPR during the DTE1 campaign of 1997 and the recent TTE of 2003. The NES diagnostic capabilities at JET are presently being drastically enhanced by an upgrade of the MPR (MPRu) and a new 2.5-MeV TOF neutron spectrometer (TOFOR). The principles of MPRu and TOFOR are described and illustrated with the diagnostic role they will play in the high performance fusion experiments in the forward program of JET largely aimed at supporting ITER. The importance for the JET NES effort for ITER is discussed. (author)

  17. Advanced silicon sensors for future collider experiments

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00437143; Moll, Michael; Mannelli, Marcello

    In this thesis, we address two key technological challenges: the radiation tolerance assessment and timing performance studies of thin planar diodes to be used as sensing technology in the recently approved CMS forward sampling calorimeter for the HL-LHC operation, the High Granularity Calorimeter (HGCAL); and, complementary, we carried out a detailed study of a novel kind of position sensitive microstrip sensors for ionising particles which implements the well established charge-division method to determine the particle impinging position along the microstrip electrode direction; this technology could become an interesting low-material budget solution for the new generation of tracking detectors to be operated in the future lepton collider experiments.

  18. Phase camera experiment for Advanced Virgo

    Energy Technology Data Exchange (ETDEWEB)

    Agatsuma, Kazuhiro, E-mail: agatsuma@nikhef.nl [National Institute for Subatomic Physics, Amsterdam (Netherlands); Beuzekom, Martin van; Schaaf, Laura van der [National Institute for Subatomic Physics, Amsterdam (Netherlands); Brand, Jo van den [National Institute for Subatomic Physics, Amsterdam (Netherlands); VU University, Amsterdam (Netherlands)

    2016-07-11

    We report on a study of the phase camera, which is a frequency selective wave-front sensor of a laser beam. This sensor is utilized for monitoring sidebands produced by phase modulations in a gravitational wave (GW) detector. Regarding the operation of the GW detectors, the laser modulation/demodulation method is used to measure mirror displacements and used for the position controls. This plays a significant role because the quality of controls affect the noise level of the GW detector. The phase camera is able to monitor each sideband separately, which has a great benefit for the manipulation of the delicate controls. Also, overcoming mirror aberrations will be an essential part of Advanced Virgo (AdV), which is a GW detector close to Pisa. Especially low-frequency sidebands can be affected greatly by aberrations in one of the interferometer cavities. The phase cameras allow tracking such changes because the state of the sidebands gives information on mirror aberrations. A prototype of the phase camera has been developed and is currently tested. The performance checks are almost completed and the installation of the optics at the AdV site has started. After the installation and commissioning, the phase camera will be combined to a thermal compensation system that consists of CO{sub 2} lasers and compensation plates. In this paper, we focus on the prototype and show some limitations from the scanner performance. - Highlights: • The phase camera is being developed for a gravitational wave detector. • A scanner performance limits the operation speed and layout design of the system. • An operation range was found by measuring the frequency response of the scanner.

  19. Phase camera experiment for Advanced Virgo

    International Nuclear Information System (INIS)

    Agatsuma, Kazuhiro; Beuzekom, Martin van; Schaaf, Laura van der; Brand, Jo van den

    2016-01-01

    We report on a study of the phase camera, which is a frequency selective wave-front sensor of a laser beam. This sensor is utilized for monitoring sidebands produced by phase modulations in a gravitational wave (GW) detector. Regarding the operation of the GW detectors, the laser modulation/demodulation method is used to measure mirror displacements and used for the position controls. This plays a significant role because the quality of controls affect the noise level of the GW detector. The phase camera is able to monitor each sideband separately, which has a great benefit for the manipulation of the delicate controls. Also, overcoming mirror aberrations will be an essential part of Advanced Virgo (AdV), which is a GW detector close to Pisa. Especially low-frequency sidebands can be affected greatly by aberrations in one of the interferometer cavities. The phase cameras allow tracking such changes because the state of the sidebands gives information on mirror aberrations. A prototype of the phase camera has been developed and is currently tested. The performance checks are almost completed and the installation of the optics at the AdV site has started. After the installation and commissioning, the phase camera will be combined to a thermal compensation system that consists of CO 2 lasers and compensation plates. In this paper, we focus on the prototype and show some limitations from the scanner performance. - Highlights: • The phase camera is being developed for a gravitational wave detector. • A scanner performance limits the operation speed and layout design of the system. • An operation range was found by measuring the frequency response of the scanner.

  20. Experiences of Supervision at Practice Placement Sites

    Directory of Open Access Journals (Sweden)

    Lesley Diack

    2014-01-01

    Full Text Available Background. Whilst placement supervision and clinical education programmes are of significant value in shaping the behaviours of undergraduate healthcare students, appropriate provisions which are efficacious to the learner are somewhat lacking, particularly for students studying on UK MPharm programmes. Objectives. To explore and explain the value of placement supervision to the personal development and employability of undergraduate pharmacy students. Methods. Students participated in a week long community pharmacy pilot programme, a result of a collaborative effort between the School of Pharmacy and Life Sciences and a small consortium of community pharmacies. Students and stakeholders were asked to evaluate their experiences via separate questionnaires which had been developed to elicit views and attitudes. Key Findings. Feedback from students and stakeholders towards the experience was overwhelmingly positive with multiple benefits being reported. Of particular prominence was the emphasis in student feedback on the value of placement supervision to their professional and personal development. Findings were indicative of a development in clinical practice proficiencies, core skills, and improvement in decision-making practice. Conclusions. The benefits of clinical supervision to the professional and personal development of MPharm students are well documented, although attracting professional pharmacy supervisors is proving a problematic task for educational providers in the UK.

  1. Long-term intended and unintended experiences after Advanced Life Support training

    DEFF Research Database (Denmark)

    Rasmussen, M.B.; Dieckmann, Peter; Issenberg, Berry

    2012-01-01

    Highly structured simulation-based training (SBT) on managing emergency situations can have a significant effect on immediate satisfaction and learning. However, there are some indications of problems when applying learned skills to practice. The aim of this study was to identify long-term intended...... and unintended learner reactions, experiences and reflections after attending a simulation based Advanced Life Support (ALS) course....

  2. Learning to Facilitate Advance Care Planning: The Novice Social Worker's Experience

    Science.gov (United States)

    Washington, Karla; Bowland, Sharon; Mueggenburg, Kay; Pederson, Margaret; Otten, Sheila; Renn, Tanya

    2014-01-01

    Professional leaders have identified clear roles for social workers involved in advance care planning (ACP), a facilitated process whereby individuals identify their preferences for future medical care; yet information about effective teaching practices in this area is scant. This study reports on the experiences of 14 social workers who…

  3. Experience with Fingolimod in Clinical Practice

    Science.gov (United States)

    Hersh, Carrie M.; Hara-Cleaver, Claire; Rudick, Richard A.; Cohen, Jeffrey A.; Bermel, Robert A.; Ontaneda, Daniel

    2015-01-01

    Aim To report experience with fingolimod in clinical practice. Design/Methods Patients in an academic medical center who were prescribed fingolimod from October 2010 to August 2011 were identified through the electronic medical record and followed for 12 months after fingolimod initiation. Adverse effects, clinical measures, MRI data, and quality of life measures were assessed. Results Three hundred seventeen patients started fingolimod. Eleven patients were treatment naïve (3.5%) and 76 (24.0%) had remote disease modifying therapy use prior to fingolimod. One hundred fifty-one (47.6%) switched because of patient preference and 79 (24.9%) switched because of breakthrough disease. About 11.6% transitioned from natalizumab. Follow-up data were available for 306 patients (96.5%) with mean follow-up time 332 days. Fingolimod was discontinued in 76 of 306 patients (24.8%) at mean 248 days after fingolimod start. Discontinuation most often was due to adverse effects (n=40) or breakthrough disease (n=22). Among patients who started fingolimod with available 12 month follow-up data, 267 (87.3%) remained relapse free and 256 (83.7%) had no relapses or gadolinium enhancement. Time to first relapse occurred at mean 282 days after fingolimod initiation. Quality of life measures remained stable at follow-up. Conclusions Fingolimod was discontinued at a higher rate in clinical practice than in clinical trials. Discontinuation was primarily due to adverse effects or breakthrough disease. Disease activity was adequately controlled in most patients who started fingolimod. This clinical practice cohort is consistent with efficacy data from phase 3 trials and describes the most common tolerability issues in clinical practice. PMID:25271798

  4. Developing an advanced practice nurse-led liver clinic.

    Science.gov (United States)

    McAfee, Jean L

    2012-01-01

    End-stage liver disease (ESLD) is a leading cause of digestive disease deaths in the United States and continues to increase exponentially every year. Best practice does not currently recognize or utilize a clinic practice model for ESLD management. Advanced practice registered nurses (APRNs) can impact ESLD disease management by implementing an outpatient clinic care model to focus on treatment compliance, patient education, improvement of patient outcomes, and reduction in hospital admission rates for ESLD patients. A review of 15 research articles was completed to determine the impact APRNs can make on chronic care of ESLD patients. Results from the review support APRN analysis, assessment, diagnosis, treatment, intervention, and evaluation of ESLD patients. The literature reviewed also demonstrates that ESLD patients have improved symptom management when maintained in an outpatient setting, allowing for decreased hospital and insurance expenditures. Following evaluation of the evidence, it was concluded that an APRN-led ESLD clinic merits further study.

  5. Enhancing Research and Practice in Early Childhood through Formative and Design Experiments

    Science.gov (United States)

    Bradley, Barbara A.; Reinking, David

    2011-01-01

    This article describes formative and design experiments and how they can advance research and instructional practices in early childhood education. We argue that this relatively new approach to education research closes the gap between research and practice, and it addresses limitations that have been identified in early childhood research. We…

  6. Does Experience Rating Improve Obstetric Practices?

    DEFF Research Database (Denmark)

    Amaral-Garcia, Sofia; Bertoli, Paola; Grembi, Veronica

    2015-01-01

    is associated with a decrease in the probability of performing a C-section from 2.3 to 3.7 percentage points (7–11.6%) with no consequences for medical complications or neonatal outcomes. The impact can be explained by a reduction in the discretion of obstetric decision-making rather than by patient cream......Using inpatient discharge records from the Italian region of Piedmont, we estimate the impact of an increase in malpractice pressure brought about by experience-rated liability insurance on obstetric practices. Our identification strategy exploits the exogenous location of public hospitals in court...... districts with and without schedules for noneconomic damages. We perform difference-in-differences analysis on the entire sample and on a subsample which only considers the nearest hospitals in the neighborhood of court district boundaries. We find that the increase in medical malpractice pressure...

  7. Safety Assurance for Irradiating Experiments in the Advanced Test Reactor

    Energy Technology Data Exchange (ETDEWEB)

    T. A. Tomberlin; S. B. Grover

    2004-11-01

    The Advanced Test Reactor (ATR), located at the Idaho National Engineering and Environmental Laboratory (INEEL), was specifically designed to provide a high neutron flux test environment for conducting a variety of experiments. This paper addresses the safety assurance process for two general types of experiments conducted in the ATR facility and how the safety analyses for experiments are related to the ATR safety basis. One type of experiment is more routine and generally represents greater risks; therefore, this type of experiment is addressed in more detail in the ATR safety basis. This allows the individual safety analysis for this type of experiment to be more standardized. The second type of experiment is defined in more general terms in the ATR safety basis and is permitted under more general controls. Therefore, the individual safety analysis for the second type of experiment tends to be more unique and is tailored to each experiment.

  8. Safety Assurance for Irradiating Experiments in the Advanced Test Reactor

    International Nuclear Information System (INIS)

    T. A. Tomberlin; S. B. Grover

    2004-01-01

    The Advanced Test Reactor (ATR), located at the Idaho National Engineering and Environmental Laboratory (INEEL), was specifically designed to provide a high neutron flux test environment for conducting a variety of experiments. This paper addresses the safety assurance process for two general types of experiments conducted in the ATR facility and how the safety analyses for experiments are related to the ATR safety basis. One type of experiment is more routine and generally represents greater risks; therefore, this type of experiment is addressed in more detail in the ATR safety basis. This allows the individual safety analysis for this type of experiment to be more standardized. The second type of experiment is defined in more general terms in the ATR safety basis and is permitted under more general controls. Therefore, the individual safety analysis for the second type of experiment tends to be more unique and is tailored to each experiment

  9. Research for Foreign Advanced Ports for Protection and Development Experience

    Science.gov (United States)

    Zhang, Lu; Tian, Mingjing; Zhao, Junjie; Shou, Youping; Wang, Ning; Qiao, Jianzhe; Li, Guanglou

    2018-04-01

    Into the twenty-first century, the process globalization of economic and trade is getting faster and faster, As of 2014, China's annual port trading amount topped the world, But in the port of environmental protection sustainable development approach with foreign advanced port environmental management concept has a big gap. Combined with the present situation of modern ports in China. Drawing lessons from foreign advanced environmental protection idea of port, in order to promote the protection of port environment in our country. The experience of protection and development of foreign advanced port environment will be discussed and discussed.

  10. Blending work-integrated learning with distance education in an Australian radiation therapy advanced practice curriculum

    International Nuclear Information System (INIS)

    Matthews, Kristie; Wright, Caroline; Osborne, Catherine

    2014-01-01

    Advanced practice for radiation therapists has been a part of the international landscape for several years; however formal implementation into the Australian health care system is yet to happen. Despite this, three short course radiation therapy advanced practitioner programs have been established by an Australian tertiary institution in response to clinical service needs at several organisations. This paper describes the rationale for curriculum design and development of the program materials, the small-scale implementation of the programs at pilot sites, and the evolution of the curriculum to be available to registered radiation therapists nationally. Each program has been designed around a specific clinical role, where flexibility of delivery to busy practitioners was central to the decision to offer them via distance education. The curriculum comprises theoretical units of study which run in parallel to and underpin clinical practice units, where advanced competence in the specific area of practice is overseen by an experienced radiation oncologist mentor. Given the nature of the disparate clinical services requiring an advanced radiation therapy practitioner, the workplace learning component of the course is individually negotiated at a local level. Outcomes suggest that the flexible clinically based training underpinned by a distance education academic curriculum is able to support the development of advanced radiation therapy practitioners responsive to local service need, and ultimately may improve the patient experience

  11. Procedure competencies and job functions of the urologic advanced practice nurse.

    Science.gov (United States)

    Kleier, Jo Ann

    2009-01-01

    A 2-round modified Delphi study recruited a panel urologic advanced practice nurse experts to identify the procedure competencies and job functions unique to the role of the advanced practice nurse specializing in the care of urology patients.

  12. Doctor of Nursing Practice: The Role of the Advanced Practice Nurse.

    Science.gov (United States)

    Walker, Deborah Kirk; Polancich, Shea

    2015-11-01

    To explore the evolution and emerging roles of the Doctor of Nursing Practice (DNP) Advanced Practice Nurse (APN). Published peer reviewed literature, cancer-related professional resources, and Web-based resources. The DNP education has prepared the APN for process improvement initiatives, providing quality care, and evidence-based practice translation, which are critical with the emerging trends in this complex health care environment. DNP-prepared APNs have the opportunity to impact oncology care across the cancer trajectory, in various settings, and in various innovative roles as entrepreneurs. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Experience Practices on Decontamination Activity in NPP Decommissioning

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Suk Bon; Kim, Jeongju; Sohn, Wook [Korea Hydro and Nuclear Power Co., Daejeon (Korea, Republic of)

    2016-10-15

    Decommissioning of a nuclear power plant (NPP) involves various technical and administrative activities for a utility to terminate its license, which allows the plant site to be released from the regulatory control (site release). Decontamination activity in NPP decommissioning is one of the main technical activities to be performed during the decommissioning. The decontamination at decommissioning sites is usually performed due to several reasons such as reducing personnel dose and disposal costs, and cleanup to meet license termination requirements by using physical or chemical removal techniques proven through the previous experience practices. This paper introduces the best and worst practices for the decontamination activities collected from the decommissioning operational experiences through the implementation of nuclear decommissioning projects around the world. Review of the experiences of decontamination shows that it is important to conduct an advanced planning for optimized implementation of decontamination taking into considering site specific conditions such as operating time, reactor type, system, and so on. Also, a review of newer decontamination methods is necessary to safely and economically decommission the nuclear facility.

  14. An Academic-Practice Partnership to Advance DNP Education and Practice.

    Science.gov (United States)

    Howard, Patricia B; Williams, Tracy E

    During the past decade, the growth of doctor of nursing practice (DNP) programs in the United States has been phenomenal, with most focusing on the preparation of advanced practice registered nurses. Simultaneously, academic-practice partnerships have been a frequent subject of discussion for nursing's leading academic, administrative, and practice organizations. Numerous reports about academic-practice partnerships concerning aspects of baccalaureate nursing education exist, but partnership accounts for DNP programs are essentially nonexistent. The purpose of this article is to describe the initial phase of an academic-practice partnership between a multisystem health care organization and a college of nursing in a public land-grant university in the southeastern United States. The 7-year partnership agreement between Norton Healthcare and the University of Kentucky College of Nursing was designed to prepare 5 cohorts of 20 to 30 baccalaureate-prepared staff nurses as DNP graduates for advanced practice registered nurse eligibility. The description of partnering institution characteristics frames an emphasis on elements of the partnership proposal, contractual agreement, and partner responsibilities along with the logic model evaluation plan. Lessons learned include the importance of proposals and contracts to sustain the partnership, frequent communication to build trust, and strategic analysis for rapid response to challenging situations. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Advanced detection techniques for educational experiments in cosmic ray physics

    International Nuclear Information System (INIS)

    Aiola, Salvatore; La-Rocca, Paola; Riggi, Francesco; Riggi, Simone

    2013-06-01

    In this paper we describe several detection techniques that can be employed to study cosmic ray properties and carry out training activities at high school and undergraduate level. Some of the proposed devices and instrumentation are inherited from professional research experiments, while others were especially developed and marketed for educational cosmic ray experiments. The educational impact of experiments in cosmic ray physics in high-school or undergraduate curricula will be exploited through various examples, going from simple experiments carried out with small Geiger counters or scintillation devices to more advanced detection instrumentation which can offer starting points for not trivial research work. (authors)

  16. Advanced Tools for Smartphone-Based Experiments: Phyphox

    Science.gov (United States)

    Staacks, S.; Hütz, S.; Stampfer, C.; Heinke, H.

    2018-01-01

    The sensors in modern smartphones are a promising and cost-effective tool for experimentation in physics education, but many experiments face practical problems. Often the phone is inaccessible during the experiment and the data usually needs to be analyzed subsequently on a computer. We address both problems by introducing a new app, called…

  17. Integrating advanced practice providers into medical critical care teams.

    Science.gov (United States)

    McCarthy, Christine; O'Rourke, Nancy C; Madison, J Mark

    2013-03-01

    Because there is increasing demand for critical care providers in the United States, many medical ICUs for adults have begun to integrate nurse practitioners and physician assistants into their medical teams. Studies suggest that such advanced practice providers (APPs), when appropriately trained in acute care, can be highly effective in helping to deliver high-quality medical critical care and can be important elements of teams with multiple providers, including those with medical house staff. One aspect of building an integrated team is a practice model that features appropriate coding and billing of services by all providers. Therefore, it is important to understand an APP's scope of practice, when they are qualified for reimbursement, and how they may appropriately coordinate coding and billing with other team providers. In particular, understanding when and how to appropriately code for critical care services (Current Procedural Terminology [CPT] code 99291, critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 min; CPT code 99292, critical care, each additional 30 min) and procedures is vital for creating a sustainable program. Because APPs will likely play a growing role in medical critical care units in the future, more studies are needed to compare different practice models and to determine the best way to deploy this talent in specific ICU settings.

  18. Reflective practice in sport coaching: an autoethnographic exploration into the lived experiences of one coach

    OpenAIRE

    Ang, Denis

    2017-01-01

    This study seeks to contribute to the growing pool of knowledge on the use of alternative representation of lived experiences to advance practical understandings in sport coaching. Documenting a self-inquiry into my coaching practice, this study demonstrates the value of autoethnography as a methodology to deepen knowledge from experiences. By illuminating my coach-researcher voice through a self-narrative, this study shows how autoethnography is able to immerse the sport researcher in his or...

  19. Oncology Gold Standard™ practical consensus recommendations 2016 for treatment of advanced clear cell renal cell carcinoma.

    Science.gov (United States)

    Batra, U; Parikh, P M; Prabhash, K; Tongaonkar, H B; Chibber, P; Dabkara, D; Deshmukh, C; Ghadyalpatil, N; Hingmire, S; Joshi, A; Raghunath, S K; Rajappa, S; Rajendranath, R; Rawal, S K; Singh, Manisha; Singh, R; Somashekhar, S P; Sood, R

    2016-01-01

    The Oncology Gold Standard (OGS) Expert Group on renal cell carcinoma (RCC) developed the consensus statement to provide community oncologists practical guidelines on the management of advanced clear cell (cc) RCC using published evidence, practical experience of experts in real life management, and results of a nationwide survey involving 144 health-care professionals. Six broad question categories containing 33 unique questions cover major situations in the routine management of RCC. This document serves as a ready guide for the standard of care to optimize outcome. The table of "Take Home Messages" at the end is a convenient tool for busy practitioners.

  20. Oncology Gold Standard™ practical consensus recommendations 2016 for treatment of advanced clear cell renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    U Batra

    2016-01-01

    Full Text Available The Oncology Gold Standard (OGS Expert Group on renal cell carcinoma (RCC developed the consensus statement to provide community oncologists practical guidelines on the management of advanced clear cell (cc RCC using published evidence, practical experience of experts in real life management, and results of a nationwide survey involving 144 health-care professionals. Six broad question categories containing 33 unique questions cover major situations in the routine management of RCC. This document serves as a ready guide for the standard of care to optimize outcome. The table of "Take Home Messages" at the end is a convenient tool for busy practitioners.

  1. Advanced Smart Structures Flight Experiments for Precision Spacecraft

    Science.gov (United States)

    Denoyer, Keith K.; Erwin, R. Scott; Ninneman, R. Rory

    2000-07-01

    This paper presents an overview as well as data from four smart structures flight experiments directed by the U.S. Air Force Research Laboratory's Space Vehicles Directorate in Albuquerque, New Mexico. The Middeck Active Control Experiment $¯Flight II (MACE II) is a space shuttle flight experiment designed to investigate modeling and control issues for achieving high precision pointing and vibration control of future spacecraft. The Advanced Controls Technology Experiment (ACTEX-I) is an experiment that has demonstrated active vibration suppression using smart composite structures with embedded piezoelectric sensors and actuators. The Satellite Ultraquiet Isolation Technology Experiment (SUITE) is an isolation platform that uses active piezoelectric actuators as well as damped mechanical flexures to achieve hybrid passive/active isolation. The Vibration Isolation, Suppression, and Steering Experiment (VISS) is another isolation platform that uses viscous dampers in conjunction with electromagnetic voice coil actuators to achieve isolation as well as a steering capability for an infra-red telescope.

  2. Gender Creative or Transgender Youth and Advanced Nursing Practice.

    Science.gov (United States)

    Kirouac, Nicole; Tan, Mabel

    2017-06-01

    The World Professional Association for Transgender Health (WPATH) defines gender dysphoria as "Discomfort or distress that is caused by a discrepancy between a person's gender identity and that person's sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics)" (WPATH, 2016). Gender creative (GC) and transgender (TG) youth are at high risk for severe mental health disparities if they don't receive competent and timely gender transitioning care. Although awareness and early care of TG youth in specialty clinics is improving and increasing, there is still much effort that is required to eliminate barriers to care at many levels and thus improve outcomes. Nurses, particularly advanced practice nurses, are poised to lead the way in creating safe, inclusive, family centered spaces for TG and GC children, youth and their families as well as acting as vital mentors for other nurses. The purpose of this paper is to discuss the increasing prevalence of GC and TG youth, the significance of inclusive care for GC and TG youth, treatment guidelines, and the impact parents and advanced practice nurses can have on the journey of these youth as they explore and find their place on the gender spectrum. Copyright© of YS Medical Media ltd.

  3. Advanced gamma ray balloon experiment ground checkout and data analysis

    Science.gov (United States)

    Blackstone, M.

    1976-01-01

    A software programming package to be used in the ground checkout and handling of data from the advanced gamma ray balloon experiment is described. The Operator's Manual permits someone unfamiliar with the inner workings of the software system (called LEO) to operate on the experimental data as it comes from the Pulse Code Modulation interface, converting it to a form for later analysis, and monitoring the program of an experiment. A Programmer's Manual is included.

  4. Advanced tools for smartphone-based experiments: phyphox

    OpenAIRE

    Staacks, Sebastian; Hütz, Simon; Heinke, Heidrun; Stampfer, Christoph

    2018-01-01

    The sensors in modern smartphones are a promising and cost-effective tool for experimentation in physics education, but many experiments face practical problems. Often the phone is inaccessible during the experiment and the data usually needs to be analyzed subsequently on a computer. We address both problems by introducing a new app, called "phyphox", which is specifically designed for utilizing experiments in physics teaching. The app is free and designed to offer the same set of features o...

  5. Unpacking University-Community Partnerships to Advance Scholarship of Practice.

    Science.gov (United States)

    Suarez-Balcazar, Yolanda; Mirza, Mansha Parven; Hansen, Anne Marie Witchger

    2015-01-01

    Today, more than ever, occupational therapists are engaged in close partnerships with community organizations and community settings such as service agencies, refugee and immigrant enclaves, and faith-based organizations, to name a few, for the purpose of engaging in scholarship of practice. However, we know little about the views of community partners regarding the development and sustainability of university-community partnerships. The purpose of this article is twofold: First, we will describe a pilot study in which we gathered qualitative data from community partners engaged in scholarship of practice with faculty and students, regarding their views about benefits of partnerships, challenges, and characteristics of sustainable partnerships. Second, based on this pilot study and extensive experience of the authors, we propose a revised version of a partnerships model available in the literature. We illustrate the model through examples of the authors' collective experiences developing and sustaining successful university-community partnerships.

  6. [Advanced nursing practice: a must for the quality of care and mental health services].

    Science.gov (United States)

    Ricard, Nicole; Page, Claire; Laflamme, France

    2014-01-01

    supported the development of new models of advanced practice in mental health. These developments have been particularly significant in the United States and Australia. In United States, during the 1990s, at least four models of advanced practice in mental health nursing have been developed leading to wide variations in the roles, education, job titles, scope of practice and legal authorizations. Consequently, a consensus model of uniform standards of practice, accreditation and education has been proposed. This LACE model (Licensure, Accreditation, Certification, Education) will be in effect in 2015. Australia has adopted a more systematic approach, unified and progressive to facilitate the development of advanced mental health nursing practice. Australia who, through their many publications, retains more attention since a clear definition of the role of the nurse practitioner in mental health and a legal framework has been adopted at the national level. The Australian experience and the finding from studies suggest that mental health nurse practitioners and nurses who are specialized in mental health have the potential to make a significant contribution to enhancing access to and quality of mental health care through flexible an innovative approaches. So there are more and more evidence and indications that Quebec should invest in enhancing the skills of mental health nurses through the development of advanced nursing practice and integration of this new model in primary care. In addition, researches, funded by the Canadian Services Research Foundation (CHSRF, 2010), shows that the contribution of advanced nursing practice has never been stronger and there is a broad consensus to its value for the Canadian health care system (Dicenso.et Lukosius-Briant, 2010). The implementation of advanced practice nursing role in mental health is part of best practices required to improve care and mental health services and should be taken into account in future Action Plan 2014-2020.

  7. Advanced practice nurses core competencies: a framework for developing and testing an advanced practice nurse discharge intervention.

    Science.gov (United States)

    Cooke, Liz; Gemmill, Robin; Grant, Marcia

    2008-01-01

    The purpose of this paper was to describe evidenced-based interventions as implemented by advanced practice nurses (APNs) conducting intervention research with a vulnerable population of blood and marrow transplant patients. In addition, each of the 6 core competencies of the APN role identified by Hamric are outlined and applied using a patient case study. These competencies are the following: direct clinical practice, expert coaching and advice, consultation, research skills, clinical and professional leadership, collaboration, and ethical decision making. This article chronicles a typical patient's journey through a post-hospital discharge nursing research study involving APNs as "intervention nurses" and discusses the various aspects of the APN core competencies throughout the process.

  8. An American and Dutch partnership for psychiatric mental health advance nursing practice: nurturing a relationship across the ocean.

    Science.gov (United States)

    Maas, Lillian; Ezeobele, I Ezebuiro; Tetteroo, Marieke

    2012-07-01

    The purpose of this article is to discuss the challenges and rewards of developing and nurturing an international clinical psychiatric mental health advanced nursing practice exchange between the Netherlands and the United States. Since 1997, Rotterdam University of Applied Sciences in the Netherlands has been participating in international clinical experiences for their psychiatric mental health (PMH) advanced practice nursing students. The international experience is mandatory prior to graduation and is the first of its kind in Europe to mandate such a unique experience. This study sample included eight Dutch PMH advanced practice nursing students enrolled in a full-time master's in advanced nursing practice program. The descriptive study included reflective reports and one-on-one discussions over a 3-year period. With proper planning, an international nursing experience provides a unique opportunity for nurses to think beyond their own culture and healthcare system. Solving problems together through different perspectives creates opportunities for creative solutions. International partnerships within PMH advanced practice nursing promotes sharing of knowledge and solutions as patients and diseases have no border. © 2011 Wiley Periodicals, Inc.

  9. Leadership and management skills of general practice nurses: experience or education?

    Science.gov (United States)

    Lau, Rosalind; Cross, Wendy; Moss, Cheryle; Campbell, Annie; De Castro, Magali; Oxley, Victoria

    2014-12-01

    A key finding of this qualitative exploratory descriptive study into advanced nursing for general practice nurses (Australian setting) revealed that participants viewed leadership and management as best learnt 'apprenticeship' style on the job by years of experience. Participants (48) comprised of general practice nurses, practice managers and general practitioners from metropolitan Melbourne were interviewed. Other findings demonstrated that the participants generally had limited awareness that postgraduate education can assist in the development of leadership and management in advanced nursing practice. The participants lacked clarity about professional competencies and generally did not connect these to leadership and management. Professional bodies need to take the opportunity to promote awareness of the national competency standards. All three groups of participants expressed hopes about the future provision of professional development opportunities and support by the Medicare Local for leadership and management aspirations within advanced practice nursing.

  10. Framework for Evaluating the Impact of Advanced Practice Nursing Roles.

    Science.gov (United States)

    Bryant-Lukosius, Denise; Spichiger, Elisabeth; Martin, Jacqueline; Stoll, Hansruedi; Kellerhals, Sabine Degen; Fliedner, Monica; Grossmann, Florian; Henry, Morag; Herrmann, Luzia; Koller, Antje; Schwendimann, René; Ulrich, Anja; Weibel, Lukas; Callens, Betty; De Geest, Sabina

    2016-03-01

    To address the gap in evidence-based information required to support the development of advanced practice nursing (APN) roles in Switzerland, stakeholders identified the need for guidance to generate strategic evaluation data. This article describes an evaluation framework developed to inform decisions about the effective utilization of APN roles across the country. A participatory approach was used by an international group of stakeholders. Published literature and an evidenced-based framework for introducing APN roles were analyzed and applied to define the purpose, target audiences, and essential elements of the evaluation framework. Through subsequent meetings and review by an expert panel, the framework was developed and refined. A framework to evaluate different types of APN roles as they evolve to meet dynamic population health, practice setting, and health system needs was created. It includes a matrix of key concepts to guide evaluations across three stages of APN role development: introduction, implementation, and long-term sustainability. For each stage, evaluation objectives and questions examining APN role structures, processes, and outcomes from different perspectives (e.g., patients, providers, managers, policy-makers) were identified. A practical, robust framework based on well-established evaluation concepts and current understanding of APN roles can be used to conduct systematic evaluations. The evaluation framework is sufficiently generic to allow application in developed countries globally, both for evaluation as well as research purposes. © 2016 Sigma Theta Tau International.

  11. Educational Changes to Support Advanced Practice Nursing Education.

    Science.gov (United States)

    LeFlore, Judy L; Thomas, Patricia E

    2016-01-01

    Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas. Determining competency based on the number of clinical hours can be inefficient, ineffective, and costly and limits the ability to increase capacity. Little research exists in graduate nursing education to support the effectiveness and efficiency of current hours of clinical required for nurse practitioner students. Simulation and academic-practice partnership models can offer innovative approaches to nurse practitioner education for clinical training, with the goal of producing graduates who can provide safe, quality care within the complex practice-based environment of the nation's evolving healthcare system.

  12. A definition, description, and framework for advanced practice in dietetics.

    Science.gov (United States)

    Wildish, Deborah Ellen Boyko; Evers, Susan

    2010-01-01

    We explored advanced practice (AP) across the diversity of dietetics to develop a definition, description, and framework for guiding future education, research agendas, and policy development. The process began with a literature review and discussion with dietitians exploring AP in other countries. Various concepts were identified, and these informed the phase 1 survey questions. Phase 1 was a 36-item survey created in SurveyMonkey, engaging a purposeful sample of key stakeholders (n=136). A modified Delphi approach, involving seven dietitians from different geographical locations and practice areas, finalized the phase 2 survey. An e-mail link to this 50-item survey was sent to a random sample of dietitians (n=885). The proposed AP framework entailed an iterative approach, integrating survey results with AP literature. Response rates were 40% for phase 1 and 35% for phase 2. In phase 1, 83% of respondents agreed that a depth and breadth definition captured all dietetic job roles, and 95% agreed that it differentiated AP from entry-level practice. Descriptive statistics are presented to provide demographic information and level of agreement with themes relevant to AP. A framework is presented, and discrepancies with phase 2 results indicate areas for professional development, such as leadership, mentorship, and outcome measurement.

  13. Neighborhood geographical factors and the presence of advanced community pharmacy practice sites in Greater Chicago.

    Science.gov (United States)

    Johnson, Charisse L; Crawford, Stephanie Y; Lin, Swu-Jane; Salmon, J Warren; Smith, Miriam Mobley

    2009-02-19

    To determine the availability of experiential learning opportunities in culturally diverse areas and to identify opportunities and barriers to attract and sustain sites for the University of Illinois at Chicago College of Pharmacy. Utilizing variables of census tract income, racial/ethnicity composition and crime index, data analyses included descriptive statistics and multivariate logistic regression. Faculty members involved in experiential education were interviewed to identify other factors influencing site placement and selection for community-based advanced pharmacy practice experiences (APPEs). Median family income and Asian population were significantly higher and black population was significantly lower in census tracts with community APPE sites than in census tracts without APPE sites (p managers, and strategic initiatives were critical considerations in site establishment and overall sustainability. Advanced community pharmacy practice sites were fairly well distributed across metropolitan Chicago, indicating that exposure to diverse populations during the advanced community practice experiences parallels with strategic College objectives of expanding and diversifying experiential sites to enhance pharmacy students' abilities to meet emerging patient care challenges and opportunities.

  14. A Practice-Based Theory of Healing Through Therapeutic Touch: Advancing Holistic Nursing Practice.

    Science.gov (United States)

    Hanley, Mary Anne; Coppa, Denise; Shields, Deborah

    2017-08-01

    For nearly 50 years, Therapeutic Touch (TT) has contributed to advancing holistic nursing practice and has been recognized as a uniquely human approach to healing. This narrative explores the development of a practice-based theory of healing through TT, which occurred between 2010 and 2016. Through the in-depth self-inquiry of participatory reflective dialogue in concert with constant narrative analysis, TT practitioners revealed the meaning of healing within the context of their TT practice. As the community of TT experts participated in an iterative process of small group and community dialogues with analysis and synthesis of emerging themes, the assumptions and concepts central to a theory of healing emerged, were clarified and verified. Exemplars of practice illustrate the concepts. A model of the theory of healing illuminates the movement and relationship among concepts and evolved over time. Feedback from nursing and inter-professional practitioners indicate that the theory of healing, while situated within the context of TT, may be useful in advancing holistic nursing practice, informing healing and caring approaches, stimulating research and education, and contributing to future transformations in health care.

  15. Advancing the practice of systems engineering at JPL

    Science.gov (United States)

    Jansma, Patti A.; Jones, Ross M.

    2006-01-01

    In FY 2004, JPL launched an initiative to improve the way it practices systems engineering. The Lab's senior management formed the Systems Engineering Advancement (SEA) Project in order to "significantly advance the practice and organizational capabilities of systems engineering at JPL on flight projects and ground support tasks." The scope of the SEA Project includes the systems engineering work performed in all three dimensions of a program, project, or task: 1. the full life-cycle, i.e., concept through end of operations 2. the full depth, i.e., Program, Project, System, Subsystem, Element (SE Levels 1 to 5) 3. the full technical scope, e.g., the flight, ground and launch systems, avionics, power, propulsion, telecommunications, thermal, etc. The initial focus of their efforts defined the following basic systems engineering functions at JPL: systems architecture, requirements management, interface definition, technical resource management, system design and analysis, system verification and validation, risk management, technical peer reviews, design process management and systems engineering task management, They also developed a list of highly valued personal behaviors of systems engineers, and are working to inculcate those behaviors into members of their systems engineering community. The SEA Project is developing products, services, and training to support managers and practitioners throughout the entire system lifecycle. As these are developed, each one needs to be systematically deployed. Hence, the SEA Project developed a deployment process that includes four aspects: infrastructure and operations, communication and outreach, education and training, and consulting support. In addition, the SEA Project has taken a proactive approach to organizational change management and customer relationship management - both concepts and approaches not usually invoked in an engineering environment. This paper'3 describes JPL's approach to advancing the practice of

  16. [Advance directives in clinical practice : Living will, healthcare power of attorney and care directive].

    Science.gov (United States)

    Hack, J; Buecking, B; Lopez, C L; Ruchholtz, S; Kühne, C A

    2017-06-01

    In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e.g. living will, healthcare power of attorney and care directive) and the possible (legal) applications and limitations in the routine clinical practice.

  17. Challenges to implementation of advance directives of will in hospital practice.

    Science.gov (United States)

    Cogo, Silvana Bastos; Lunardi, Valéria Lerch; Quintana, Alberto Manuel; Girardon-Perlini, Nara Marilene Oliveira; Silveira, Rosemary Silva da

    2016-01-01

    to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context. qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles. the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication. limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients' wishes.

  18. Advanced nursing practice and Newton's three laws of motion.

    Science.gov (United States)

    Sturgeon, David

    This article considers the reasons for the development of advanced practice roles among nurses and other healthcare professions. It explores the implications of financial constraints, consumer preferences and the development of new healthcare services on the reorganization of professional boundaries. It makes use of Sir Isaac Newton's three laws of motion to demonstrate how professional development in nursing has taken place in response to a number of external influences and demands. It also considers the significance of skill mix for the nursing profession, in particular the development and likely expansion of the physician assistant role. The application of different professionals and grades within a healthcare team or organization is central to the Government's Agenda for Change proposals and nurses have successfully adopted a number of roles traditionally performed by doctors. Nurses have demonstrated that they are capable of providing high quality care and contributing directly to positive patient outcome. Advanced nursing roles should not only reflect the changing nature of healthcare work, they should also be actively engaged in reconstructing healthcare boundaries.

  19. Advanced Communication Technology Satellite (ACTS) multibeam antenna technology verification experiments

    Science.gov (United States)

    Acosta, Roberto J.; Larko, Jeffrey M.; Lagin, Alan R.

    1992-01-01

    The Advanced Communication Technology Satellite (ACTS) is a key to reaching NASA's goal of developing high-risk, advanced communications technology using multiple frequency bands to support the nation's future communication needs. Using the multiple, dynamic hopping spot beams, and advanced on board switching and processing systems, ACTS will open a new era in communications satellite technology. One of the key technologies to be validated as part of the ACTS program is the multibeam antenna with rapidly reconfigurable hopping and fixed spot beam to serve users equipped with small-aperature terminals within the coverage areas. The proposed antenna technology experiments are designed to evaluate in-orbit ACTS multibeam antenna performance (radiation pattern, gain, cross pol levels, etc.).

  20. Advancing technician practice: Deliberations of a regulatory board.

    Science.gov (United States)

    Adams, Alex J

    2018-01-01

    In 2016, the Idaho State Board of Pharmacy (U.S.) undertook a major rulemaking initiative to advance pharmacy practice by broadening the ability of pharmacists to delegate tasks to pharmacy technicians. The new rules of the Board thus moved the locus of control in technician scope of practice from law to pharmacist delegation. Pharmacist delegation is individualistic and takes into account the individual technician's capabilities, the pharmacist's comfort level, facility policies, and the risk mitigation strategies present at the facility, among other factors. State law limits, by contrast, are rigid and can mean that pharmacists are unable to delegate tasks that are or could otherwise be within the abilities of their technicians. The expanded technician duties are in two domains: 1) medication dispensing support (e.g., tech-check-tech, accepting verbal prescriptions, transferring prescriptions, and performing remote data entry); and 2) technical support for pharmacist clinical services (e.g., administering immunizations). This commentary reviews the evidence behind these expanded duties, as well as the key regulatory decision points for each task. The Board's rules and approach may prove useful to other states and even other governing bodies outside the U.S. as they consider similar issues. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Advanced and extended scope practice of radiographers: The Scottish perspective

    International Nuclear Information System (INIS)

    Henderson, I.; Mathers, S.A.; McConnell, J.; Minnoch, D.

    2016-01-01

    Purpose: The impact of changing roles, skill mix and a shortage of consultant radiologists on the profession of diagnostic radiography is not clearly understood in Scotland although the anecdotal perspective suggests the situation in many areas does not equate to that of England. Method: A questionnaire survey was administered to ‘lead diagnostic radiographers’ across all Health Boards in Scotland and this was supplemented with telephone interviews. Results: The implementation of skill mix initiatives and particularly advanced/extended scope practice was found to be geographically variable with limited evidence of change in some areas. Lack of effective funding and backfill for training was found to be a major barrier to change, although it was also acknowledged that opposition from some professional groups could be a major factor. Conclusion: Although there is some optimism and evidence of accelerating change, development of the radiographic workforce in Scotland does not in general compare favourably to the findings of Price et al., in 2007. The reasons are multi-factorial including fiscal, professional and geographical elements. - Highlights: • Implementation of extended scope practice is geographically inconsistent. • AfC banding of radiographers in extended scope roles is inconsistent. • Funding and backfill for training is a recognised difficulty for many managers. • Professional opposition, primarily from radiologists is a barrier to implementation. • Extended scope roles make a notable contribution to enhanced outcomes.

  2. Palliative radiation therapy practice for advanced esophageal carcinoma in Africa.

    Science.gov (United States)

    Sharma, V; Gaye, P M; Wahab, S A; Ndlovu, N; Ngoma, T; Vanderpuye, V; Sowuhami, A; Dawotola, D A; Kigula-Mugambe, J; Jeremic, B

    2010-04-01

    While numerous surveys of pattern of practices of palliative radiotherapy (RT) in advanced esophageal cancers have been published in developed countries, there is no such survey in African countries. During and after a regional training course by the International Atomic Energy Agency (IAEA) in palliative cancer care, a questionnaire was distributed to African RT centers to gather information about infrastructure and human resources available, and the pattern of practice of palliative RT for esophageal cancers. Twenty-four of the 35 centers (60%) completed the questionnaire. Twenty out of 23 (87%) centers treat patients with esophageal cancer presenting with dysphagia using external beam RT (16 centers external beam RT alone and 4 centers also use brachytherapy as a boost). Twelve (60%) centers prescribe RT doses of 30 Gy in 10 fractions and 2 centers 20 Gy in 5 fractions. Eighteen centers (78%) have low dose rate (LDR) brachytherapy, and 9 (39%) centers have high dose rate (HDR) brachytherapy. One center only used HDR brachytherapy alone to a dose of 16 Gy in 2 fractions over 8 days. RT remains a major component of treatment of patients with esophageal cancers in African countries. Still, there is a great variety among centers in both indications for RT and its characteristics for a treatment indication.

  3. Description and evaluation of an initiative to develop advanced practice nurses in mainland China.

    Science.gov (United States)

    Wong, Frances Kam Yuet; Peng, Gangyi; Kan, Eva C; Li, Yajie; Lau, Ada T; Zhang, Liying; Leung, Annie F; Liu, Xueqin; Leung, Vilna O; Chen, Weiju; Li, Ming

    2010-05-01

    This paper describes an initiative to develop Advanced Practice Nurses (APNs) in mainland China and evaluation of the outcomes of the described programme. The pioneer project was an APN postgraduate programme involving 38 students conducted in Guangzhou, China during 2004-2005. Data related to curriculum content and process, student performance, self-reported competence and programme effects were collected. Quantitative data such as demographic data, student performance were analysed using descriptive statistics and the pre and post self-reported practice of competence was compared using chi-square test. Qualitative data such as case reports and interviews were examined using thematic analyses. Reflective journals and case studies revealed the attributes of APNs in managing clinical cases at advanced level, applying theory into practice and exercising evidence-based practice. The relatively modest self-reported practice of competence suggested that the graduates were novice APNs and needed continued development after the completion of the programme. This study reports the experience of an initiative in China and suggests a useful curriculum framework for educating APNs. Copyright 2009 Elsevier Ltd. All rights reserved.

  4. Advanced plant design recommendations from Cook Nuclear Plant experience

    International Nuclear Information System (INIS)

    Zimmerman, W.L.

    1993-01-01

    A project in the American Electric Power Service Corporation to review operating and maintenance experience at Cook Nuclear Plant to identify recommendations for advanced nuclear plant design is described. Recommendations so gathered in the areas of plant fluid systems, instrument and control, testing and surveillance provisions, plant layout of equipment, provisions to enhance effective maintenance, ventilation systems, radiological protection, and construction, are presented accordingly. An example for a design review checklist for effective plant operations and maintenance is suggested

  5. Advance Care Planning: Experience of Women With Breast Cancer

    Science.gov (United States)

    2006-07-01

    recorded along with other characteristics. Inclusion criteria for the primary studies required that women with breast cancer be at least 21 years of age; cog ...W81XWH-04-1-0469 TITLE: Advance Care Planning: Experience of Women with Breast Cancer PRINCIPAL INVESTIGATOR: Ardith Z. Doorenbos...with Breast Cancer 5b. GRANT NUMBER W81XWH-04-1-0469 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Ardith Z. Doorenbos, Ph.D

  6. Harnessing competence and confidence: Dimensions in education and development for advanced and consultant practice

    International Nuclear Information System (INIS)

    Price, Richard C.; Edwards, Hazel M.

    2008-01-01

    Consultant and advanced practice are relatively new concepts in radiography. There is evidence to show that as the career progression framework is being adopted the numbers of consultant and advanced practitioners in radiography are growing with the latter growing at a faster rate. The article considers the concept of advanced and consultant practice and the education requirements to support development. Preparation for an advanced practice role begins at the practitioner stage. Masters' level programmes are available to support the development of advanced practice. Education needs to be flexible as new advanced practice roles emerge. It is necessary to take practitioners beyond a defined modality to include leadership and people skills. These are essential for those aspiring to become consultants. Consultants require a high level of clinical knowledge for expert practice but also strategic vision and interpersonal intelligence to facilitate leadership and practice innovation. A model for developing leadership skills for consultants focussing on competence, confidence and capacity is proposed

  7. Clinical Engineering: Experiences of assisted professional practices

    International Nuclear Information System (INIS)

    Langone, Luis; Vanetta, Marcos; Vazquez, Marcelo; Rotger, Viviana I; Olivera, Juan Manuel

    2007-01-01

    In the curricula of the Biomedical Engineering career of the Facultad de Ciencias Exactas y TecnologIa of the Universidad Nacional de Tucuman, Argenitna, there are the Assisted Professional Practices. Within this framework, the students have the possibility of performing practices in the clinic Sanatorio 9 de Julio. One of the objectives of these practices is to apply the concepts, methods and procedures studied along the career in the field work under real work conditions. From the point of view of the host institution, the objective is to improve the performance of the different services and areas applying the tools of Biomedical Engineering. The present work shows an example of such practices where an equipment preliminary analysis was made, its use and maintenance corresponding to the surgical unit of the clinic

  8. Previous Experience a Model of Practice UNAE

    OpenAIRE

    Ormary Barberi Ruiz; María Dolores Pesántez Palacios

    2017-01-01

    The statements presented in this article represents a preliminary version of the proposed model of pre-professional practices (PPP) of the National University of Education (UNAE) of Ecuador, an urgent institutional necessity is revealed in the descriptive analyzes conducted from technical support - administrative (reports, interviews, testimonials), pedagogical foundations of UNAE (curricular directionality, transverse axes in practice, career plan, approach and diagnostic examination as subj...

  9. Previous Experience a Model of Practice UNAE

    Directory of Open Access Journals (Sweden)

    Ormary Barberi Ruiz

    2017-02-01

    Full Text Available The statements presented in this article represents a preliminary version of the proposed model of pre-professional practices (PPP of the National University of Education (UNAE of Ecuador, an urgent institutional necessity is revealed in the descriptive analyzes conducted from technical support - administrative (reports, interviews, testimonials, pedagogical foundations of UNAE (curricular directionality, transverse axes in practice, career plan, approach and diagnostic examination as subject nature of the pre professional practice and the demand of socio educational contexts where the practices have been emerging to resize them. By relating these elements allowed conceiving the modeling of the processes of the pre-professional practices for the development of professional skills of future teachers through four components: contextual projective, implementation (tutoring, accompaniment (teaching couple and monitoring (meetings at the beginning, during and end of practice. The initial training of teachers is inherent to teaching (academic and professional training, research and links with the community, these are fundamental pillars of Ecuadorian higher education.

  10. Nursing care dependence in the experiences of advanced cancer inpatients.

    Science.gov (United States)

    Piredda, Michela; Bartiromo, Chiara; Capuzzo, Maria Teresa; Matarese, Maria; De Marinis, Maria Grazia

    2016-02-01

    Increasing burden of cancer in Europe and socio-demographic trends imply that more cancer patients will face high levels of dependency. Care dependency is often perceived as a distressing experience by cancer patients who are concerned about becoming a burden to others. The experience of care dependence has been scarcely investigated in advanced cancer patients, especially in the hospital setting. This study aimed at describing advanced cancer patients' experiences of care dependence in hospital and of the factors perceived by them as contributing to decrease or increase this dependence. The study used a descriptive phenomenological approach based on Husserl's (1913) life world perspective. Data collection and analysis followed Giorgi's (1997) five basic methodological steps. Data were gathered by semi-structured interviews with thirteen advanced cancer adult inpatients of a teaching hospital. The interviews were audio-recorded and the recordings transcribed word for word. Three themes emerged: 'dependency discovers new meanings of life', 'active coping with dependency' and 'the care cures the dependent person'. The essential meaning of care dependency was the possibility to become aware of being a person as both an object and subject of care. Dependence appears as an experience with strong relational connotations, which enable patients to see differently their life, themselves, the world and others. Dependency is revealed as a natural experience, only partly in accordance with previous studies. Deeper insight into the meaning patients attach to care dependency can enable nurses to better meet the patient's needs, e.g. by improving caring relationships with patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Advanced nursing experience is beneficial for lowering the peritonitis rate in patients on peritoneal dialysis.

    Science.gov (United States)

    Yang, Zhikai; Xu, Rong; Zhuo, Min; Dong, Jie

    2012-01-01

    We explored the relationship between the experience level of nurses and the peritonitis risk in peritoneal dialysis (PD) patients. Our observational cohort study followed 305 incident PD patients until a first episode of peritonitis, death, or censoring. Patients were divided into 3 groups according to the work experience in general medicine of their nurses-that is, least experience (biochemistry, and residual renal function were also recorded. Multivariate Cox regression was used to analyze the association of risks for all-cause and gram-positive peritonitis with patient training provided by nurses at different experience levels. Of the 305 patients, 91 were trained at the initiation of PD by nurses with advanced experience, 100 by nurses with moderate experience, and 114 by nurses with the least experience. Demographic and clinical variables did not vary significantly between the groups. During 13 582 patient-months of follow-up, 129 first episodes of peritonitis were observed, with 48 episodes being attributed to gram-positive organisms. Kaplan-Meier analysis showed that training by nurses with advanced experience predicted the longest period free of first-episode gram-positive peritonitis. After adjustment for some recognized confounders, the advanced experience group was still associated with the lowest risk for first-episode gram-positive peritonitis. The level of nursing experience was not significantly correlated with all-cause peritonitis risk. The experience in general medicine of nurses might help to lower the risk of gram-positive peritonitis among PD patients. These data are the first to indicate that nursing experience in areas other than PD practice can be vital in the training of PD patients.

  12. Nursing Student Teachers' experiences during teaching practice:

    African Journals Online (AJOL)

    Mary

    STUDENTS: A COMPARISON BETWEEN DIRECT ENTRY ... clinical decision making in nursing practice using a mixed research design. ... Quantitative analysis revealed significant (**p<0.001) chi square rejecting the null .... that many students during this exercise report .... face opportunity to give the consent letters. A.

  13. Experiences of environmental professionals in practice

    NARCIS (Netherlands)

    Bootsma, M.C.; Vermeulen, W.J.V.

    2011-01-01

    Purpose: The purpose of this paper is to explore the labor market position of environmental science graduates and the core competencies of these environmental professionals related to their working practice. Design/methodology/approach: The authors carried out two surveys amongst alumni of the

  14. Optimal utilization of a breast care advanced practice clinician.

    Science.gov (United States)

    Russell, Katie W; Mone, Mary C; Serpico, Victoria J; Ward, Cori; Lynch, Joanna; Neumayer, Leigh A; Nelson, Edward W

    2014-12-01

    Incorporation of "lean" business philosophy within health care has the goal of adding value by reducing cost and improving quality. Applying these principles to the role of Advance Practice Clinicians (APCs) is relevant because they have become essential members of the healthcare team. An independent surgical breast care clinic directed by an APC was created with measurements of success to include the following: time to obtain an appointment, financial viability, and patient/APC/MD satisfaction. During the study period, there was a trend toward a decreased median time to obtain an appointment. Monthly APC charges increased from $388 to $30,800. The mean provider satisfaction score by Press Ganey was 96% for the APC and 95.8% for the surgeon. Both clinicians expressed significant satisfaction with clinic development. Overall, initiation of an APC breast clinic met the proposed goals of success. The use of lean philosophy demonstrates that implementation of change can result in added value in patient care. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. The role of advanced practice providers in pediatric otolaryngology academic practices.

    Science.gov (United States)

    Reilly, Brian K; Brandon, Gretchen; Shah, Rahul; Preciado, Diego; Zalzal, George

    2013-01-01

    The goal of this study was to examine the roles of Physician Assistants (PAs) and Nurse Practitioners (NPs) in pediatric academic otolaryngology programs to provide a better understanding of their scope of practice, levels of autonomy, clinical duties, teaching opportunities and research participation. An anonymous web-based electronic survey tool was sent to all pediatric otolaryngology fellowship program directors in the United States. Nurse Practitioners and Physician Assistants are utilized in approximately 3 out of every 4 pediatric otolaryngology practices. The top three job activities of both the PA and NP were: (1) seeing patients independently, (2) working alongside doctors in clinic, and (3) answering phone lines/parental calls. A higher percentage of PAs (83%), worked alongside doctors in clinic, as compared to NPs, where only 55% work alongside MDs. Over half of PAs round with the in-patient team and see consults as compared to just over one third of NPs who participate in such activities. Twenty-five percent of practices reported that PAs cover call and assist in the OR. Most PAs/NPs saw between 11 and 15 patients per clinic which provides a clear productivity advantage when looking to screen patients, provide medical care, generate surgical cases, and maximize billings. NPs and PAs have complimentary skill sets ideal for the pediatric otolaryngology workplace, although job activities and "best fit" are hospital and practice dependent. Our study suggests that the use of PAs and NPs will continue to grow to meet increased demand for services in the field of pediatric otolaryngology. Employing advanced practice providers enables academic centers to improve access, provide additional financial remuneration, reduce wait times for new patients, and allow attending physicians to meet increased practice demands. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. Random Assignment: Practical Considerations from Field Experiments.

    Science.gov (United States)

    Dunford, Franklyn W.

    1990-01-01

    Seven qualitative issues associated with randomization that have the potential to weaken or destroy otherwise sound experimental designs are reviewed and illustrated via actual field experiments. Issue areas include ethics and legality, liability risks, manipulation of randomized outcomes, hidden bias, design intrusiveness, case flow, and…

  17. Practical experience of monitoring patient dose

    Energy Technology Data Exchange (ETDEWEB)

    McDonnell, C.; Shrimpton, P. (National Radiological Protection Board, Chilton (United Kingdom)); O' Mahoney, M. (National Radiological Protection Board, Leeds (United Kingdom)); Foster, J. (Nuffield Hospitals, Surbiton (United Kingdom))

    1994-05-01

    NRPB recommends the use of reference dose levels for diagnostic medical exposures as an aid to patient dose reduction, but is this approach effective This article describes the broadly encouraging experiences of one large group of hospitals in carrying out measurements of entrance surface dose on patients undergoing some common types of x-ray examination. (author).

  18. Primary care providers' lived experiences of genetics in practice.

    Science.gov (United States)

    Harding, Brittany; Webber, Colleen; Ruhland, Lucia; Dalgarno, Nancy; Armour, Christine M; Birtwhistle, Richard; Brown, Glenn; Carroll, June C; Flavin, Michael; Phillips, Susan; MacKenzie, Jennifer J

    2018-04-26

    To effectively translate genetic advances into practice, engagement of primary care providers (PCPs) is essential. Using a qualitative, phenomenological methodology, we analyzed key informant interviews and focus groups designed to explore perspectives of urban and rural PCPs. PCPs endorsed a responsibility to integrate genetics into their practices and expected advances in genetic medicine to expand. However, PCPs reported limited knowledge and difficulties accessing resources, experts, and continuing education. Rural practitioners' additional concerns included cost, distance, and poor patient engagement. PCPs' perspectives are crucial to develop relevant educational and systems-based interventions to further expand genetic medicine in primary care.

  19. Update on Common-Cause Failure Experience and Mitigation Practices

    Energy Technology Data Exchange (ETDEWEB)

    Wood, Richard Thomas [ORNL; Muhlheim, Michael David [ORNL; Pullum, Laura L [ORNL; Smith, Cyrus M [ORNL; Holcomb, David Eugene [ORNL; Korsah, Kofi [ORNL

    2014-04-01

    Experience in other industries has shown that digital technology can provide substantial benefits in terms of performance and reliability. However, the U.S. nuclear power industry has been slow to adopt the technology extensively in its instrumentation and control (I&C) applications because of inhibiting factors such as regulatory uncertainty, insufficient technological experience base, implementation complexity, limited availability of nuclear-qualified products and vendors, and inadequate definition of modernization cost recapture. Although there have been examples of digital technology usage in the nuclear power industry, challenges to the qualification of digital technology for high-integrity nuclear power plant (NPP) applications have severely constrained more widespread progress in achieving the benefits that are possible through the transition to digital. The U.S. Department of Energy (DOE) Office of Nuclear Energy (NE) established the Advanced Sensors and Instrumentation (ASI) technology area under the Nuclear Energy Enabling Technologies (NEET) Program to coordinate the instrumentation and controls (I&C) research across DOE NE and to identify and lead efforts to address common needs. As part of the NEET ASI research program, the Digital Technology Qualification project was established. Under this project, the Oak Ridge National Laboratory (ORNL) is leading the investigation into mitigation of digital common-cause failure (CCF) vulnerabilities for nuclear-qualified applications. This technical report documents updated and expanded findings from research activities by ORNL. Specifically, the report describes CCF experience in the nuclear and nonnuclear industries, identifies the state of the practice for CCF mitigation through key examples, and presents conclusions from the determination of knowledge gaps.

  20. Does Experience Rating Improve Obstetric Practices?

    DEFF Research Database (Denmark)

    Amaral-Garcia, Sofia; Bertoli, Paola; Grembi, Veronica

    We provide an assessment of the introduction of experience rating for medical malpractice insurance using 2002-2009 inpatient discharge records data on deliveries from the Italian Region of Piedmont. Considering experience rating as an increase in medical malpractice pressure, we show that such i...... specification. We show that our results are robust to the different methodologies, and they can be explained in terms of a reduction in the discretion over obstetric decisions ratherthan a change in the risk profile of the patients....... schedules of non economic damages to set compensations for personal injuries and 6 do not. We use this ex-ante policy conditions to distinguish treated from control and implement first a difference in difference analysis, the robustness of which we test through a basic difference in discontinuities...

  1. Airborne ground penetrating radar: practical field experiments

    CSIR Research Space (South Africa)

    Van Schoor, Michael

    2013-10-01

    Full Text Available 1. All the radargrams were processed by applying basic GPR processing steps, which included a time zero correction, a dewow filter and the application of an automatic gain control (AGC) function. No migration was applied so as to preserve.... Suitable automatic detection algorithm could potentially be employed if target responses with specific characteristics are being sought. The results from this experiment are likely to be frequency independent. If so, a low frequency GPR system – say...

  2. Intimate partner violence: advanced practice nurses clinical stories of success and challenge.

    Science.gov (United States)

    Brykczynski, Karen A; Crane, Patricia; Medina, Cindy K; Pedraza, Dora

    2011-03-01

    This qualitative study presents knowledge from clinical experiences of advanced practice nurses (APNs) working with women who have experienced intimate partner violence (IPV). Face-to-face interviews were conducted with ten APNs to discover their ways of being with, supporting, and helping women who have experienced IPV. Interviews were transcribed and analyzed using interpretive phenomenology. Analysis proceeded from whole to parts and back to whole with ongoing attention to maintaining the situational context to guide interpretation of meanings. APNs experience both challenges and successes in caring for women who live with IPV. Findings consist of interpretations of clinical stories to uncover knowledge embedded in practice. Healing practices and ways of being survival facilitators for women and children are identified and described. APNs are in a unique position to help families who live with abuse, but may lack resources and knowledge about the most effective interventions. They may become cynical and frustrated with feelings of futility when faced with the repeating patterns associated with the cycle of violence. The goals of this study are to promote more comprehensive understanding of IPV and stimulate changes in education, practice, research, and health policy. ©2011 The Author(s) Journal compilation © 2011 American Academy of Nurse Practitioners.

  3. Advances in shock timing experiments on the National Ignition Facility

    International Nuclear Information System (INIS)

    Robey, H F; Celliers, P M; Moody, J D; Sater, J; Parham, T; Kozioziemski, B; Dylla- Spears, R; Ross, J S; LePape, S; Ralph, J E; Hohenberger, M; Dewald, E L; Berzak Hopkins, L; Kroll, J J; Yoxall, B E; Hamza, A V; Landen, O L; Edwards, M J; Boehly, T R; Nikroo, A

    2016-01-01

    Recent advances in shock timing experiments and analysis techniques now enable shock measurements to be performed in cryogenic deuterium-tritium (DT) ice layered capsule implosions on the National Ignition Facility (NIF). Previous measurements of shock timing in inertial confinement fusion (ICF) implosions were performed in surrogate targets, where the solid DT ice shell and central DT gas were replaced with a continuous liquid deuterium (D2) fill. These previous experiments pose two surrogacy issues: a material surrogacy due to the difference of species (D2 vs. DT) and densities of the materials used and a geometric surrogacy due to presence of an additional interface (ice/gas) previously absent in the liquid-filled targets. This report presents experimental data and a new analysis method for validating the assumptions underlying this surrogate technique. (paper)

  4. Advances in shock timing experiments on the National Ignition Facility

    Science.gov (United States)

    Robey, H. F.; Celliers, P. M.; Moody, J. D.; Sater, J.; Parham, T.; Kozioziemski, B.; Dylla-Spears, R.; Ross, J. S.; LePape, S.; Ralph, J. E.; Hohenberger, M.; Dewald, E. L.; Berzak Hopkins, L.; Kroll, J. J.; Yoxall, B. E.; Hamza, A. V.; Boehly, T. R.; Nikroo, A.; Landen, O. L.; Edwards, M. J.

    2016-03-01

    Recent advances in shock timing experiments and analysis techniques now enable shock measurements to be performed in cryogenic deuterium-tritium (DT) ice layered capsule implosions on the National Ignition Facility (NIF). Previous measurements of shock timing in inertial confinement fusion (ICF) implosions were performed in surrogate targets, where the solid DT ice shell and central DT gas were replaced with a continuous liquid deuterium (D2) fill. These previous experiments pose two surrogacy issues: a material surrogacy due to the difference of species (D2 vs. DT) and densities of the materials used and a geometric surrogacy due to presence of an additional interface (ice/gas) previously absent in the liquid-filled targets. This report presents experimental data and a new analysis method for validating the assumptions underlying this surrogate technique.

  5. The Experience Factory: Strategy and Practice

    Science.gov (United States)

    Basili, Victor R.; Caldiera, Gianluigi

    1995-01-01

    The quality movement, that has had in recent years a dramatic impact on all industrial sectors, has recently reached the system and software industry. Although some concepts of quality management, originally developed for other product types, can be applied to software, its specificity as a product which is developed and not produced requires a special approach. This paper introduces a quality paradigm specifically tailored on the problem of the systems and software industry. Reuse of products, processes and experiences originating from the system life cycle is seen today as a feasible solution to the problem of developing higher quality systems at a lower cost. In fact, quality improvement is very often achieved by defining and developing an appropriate set of strategic capabilities and core competencies to support them. A strategic capability is, in this context, a corporate goal defined by the business position of the organization and implemented by key business processes. Strategic capabilities are supported by core competencies, which are aggregate technologies tailored to the specific needs of the organization in performing the needed business processes. Core competencies are non-transitional, have a consistent evolution, and are typically fueled by multiple technologies. Their selection and development requires commitment, investment and leadership. The paradigm introduced in this paper for developing core competencies is the Quality Improvement Paradigm which consists of six steps: (1) Characterize the environment, (2) Set the goals, (3) Choose the process, (4) Execute the process, (5) Analyze the process data, and (6) Package experience. The process must be supported by a goal oriented approach to measurement and control, and an organizational infrastructure, called Experience Factory. The Experience Factory is a logical and physical organization distinct from the project organizations it supports. Its goal is development and support of core competencies

  6. Advanced test reactor testing experience-past, present and future

    International Nuclear Information System (INIS)

    Marshall, Frances M.

    2006-01-01

    The Advanced Test Reactor (ATR), at the Idaho National Laboratory (INL), is one of the world's premier test reactors for providing the capability for studying the effects of intense neutron and gamma radiation on reactor materials and fuels. The physical configuration of the ATR, a 4-leaf clover shape, allows the reactor to be operated at different power levels in the corner 'lobes' to allow for different testing conditions for multiple simultaneous experiments. The combination of high flux (maximum thermal neutron fluxes of 1E15 neutrons per square centimeter per second and maximum fast [E>1.0 MeV] neutron fluxes of 5E14 neutrons per square centimeter per second) and large test volumes (up to 122 cm long and 12.7 cm diameter) provide unique testing opportunities. The current experiments in the ATR are for a variety of test sponsors - US government, foreign governments, private researchers, and commercial companies needing neutron irradiation services. There are three basic types of test configurations in the ATR. The simplest configuration is the sealed static capsule, which places the capsule in direct contact with the primary coolant. The next level of experiment complexity is an instrumented lead experiment, which allows for active control of experiment conditions during the irradiation. The most complex experiment is the pressurized water loop, in which the test sample can be subjected to the exact environment of a pressurized water reactor. For future research, some ATR modifications and enhancements are currently planned. This paper provides more details on some of the ATR capabilities, key design features, experiments, and future plans

  7. Advanced practice nursing in Latin America and the Caribbean: regulation, education and practice.

    Science.gov (United States)

    Zug, Keri Elizabeth; Cassiani, Silvia Helena De Bortoli; Pulcini, Joyce; Garcia, Alessandra Bassalobre; Aguirre-Boza, Francisca; Park, Jeongyoung

    2016-08-08

    to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. identificar o estado atual da regulação, educação e prática do enfermeiro de prática avançada na América Latina e no Caribe e a percepção de líderes de enfermagem na região quanto ao papel da enfermagem de prática avançada na atenção primaria à saúde em apoio às iniciativas de Acesso Universal à Saúde e Cobertura Universal de Saúde. o estudo descritivo transversal utilizou um survey online com 173 líderes de enfermagem questionando suas percepções sobre o estado atual da pr

  8. Information on the Advanced Plant Experiment (APEX) Test Facility

    International Nuclear Information System (INIS)

    Smith, Curtis Lee

    2015-01-01

    The purpose of this report provides information related to the design of the Oregon State University Advanced Plant Experiment (APEX) test facility. Information provided in this report have been pulled from the following information sources: Reference 1: R. Nourgaliev and et.al, 'Summary Report on NGSAC (Next-Generation Safety Analysis Code) Development and Testing,' Idaho National Laboratory, 2011. Note that this is report has not been released as an external report. Reference 2: O. Stevens, Characterization of the Advanced Plant Experiment (APEX) Passive Residual Heat Removal System Heat Exchanger, Master Thesis, June 1996. Reference 3: J. Reyes, Jr., Q. Wu, and J. King, Jr., Scaling Assessment for the Design of the OSU APEX-1000 Test Facility, OSU-APEX-03001 (Rev. 0), May 2003. Reference 4: J. Reyes et al, Final Report of the NRC AP600 Research Conducted at Oregon State University, NUREG/CR-6641, July 1999. Reference 5: K. Welter et al, APEX-1000 Confirmatory Testing to Support AP1000 Design Certification (non-proprietary), NUREG-1826, August 2005.

  9. Does Experience Rating Improve Obstetric Practices?

    DEFF Research Database (Denmark)

    Amaral-Garcia, Sofia; Bertoli, Paola; Grembi, Veronica

    strategy exploits the exogenous location of public hospitals in court districts with and without schedules for noneconomic damages. We perform difference-in-differences and difference-in-discontinuities analyses. We find that the increase in medical malpractice pressure is associated with a decrease...... by the introduction of experience-rated malpractice liability insurance. Our identification strategy exploits the exogenous location of public hospitals in court districts with and without schedules for noneconomic damages. We perform difference-in-differences and difference-in-discontinuities analyses. We find...

  10. Personal Pervasive Environments: Practice and Experience

    Directory of Open Access Journals (Sweden)

    Enrique Soriano

    2012-05-01

    Full Text Available In this paper we present our experience designing and developing two different systems to enable personal pervasive computing environments, Plan B and the Octopus. These systems were fully implemented and have been used on a daily basis for years. Both are based on synthetic (virtual file system interfaces and provide mechanisms to adapt to changes in the context and reconfigure the system to support pervasive applications. We also present the main differences between them, focusing on architectural and reconfiguration aspects. Finally, we analyze the pitfalls and successes of both systems and review the lessons we learned while designing, developing, and using them.

  11. Advances in endodontics: Potential applications in clinical practice

    Science.gov (United States)

    Kishen, Anil; Peters, Ove A.; Zehnder, Matthias; Diogenes, Anibal R.; Nair, Madhu K.

    2016-01-01

    Contemporary endodontics has seen an unprecedented advance in technology and materials. This article aimed to review some of the challenges and advances in the following sections: (1) endodontic imaging, (2) root canal preparation, (3) root canal disinfection, (4) root canal filling, and (4) regenerative endodontic procedures (REPs). Jointly, these advances are aimed at improving the state of the art and science of root canal treatment. PMID:27217630

  12. Management of advanced pancreatic cancer with gemcitabine plus erlotinib: efficacy and safety results in clinical practice.

    Science.gov (United States)

    Diaz Beveridge, Robert; Alcolea, Vicent; Aparicio, Jorge; Segura, Ángel; García, Jose; Corbellas, Miguel; Fonfría, María; Giménez, Alejandra; Montalar, Joaquin

    2014-01-10

    The combination of gemcitabine and erlotinib is a standard first-line treatment for unresectable, locally advanced or metastatic pancreatic cancer. We reviewed our single centre experience to assess its efficacy and toxicity in clinical practice. Clinical records of patients with unresectable, locally advanced or metastatic pancreatic cancer who were treated with the combination of gemcitabine and erlotinib were reviewed. Univariate survival analysis and multivariate analysis were carried out to indentify independent predictors factors of overall survival. Our series included 55 patients. Overall disease control rate was 47%: 5% of patients presented complete response, 20% partial response and 22% stable disease. Median overall survival was 8.3 months). Cox regression analysis indicated that performance status and locally advanced versus metastatic disease were independent factors of overall survival. Patients who developed acne-like rash toxicity, related to erlotinib administration, presented a higher survival than those patients who did not develop this toxicity. Gemcitabine plus erlotinib doublet is active in our series of patients with advanced pancreatic cancer. This study provides efficacy and safety results similar to those of the pivotal phase III clinical trial that tested the same combination.

  13. Preservice teachers’ objectives and their experience of practical work

    Directory of Open Access Journals (Sweden)

    V. Nivalainen

    2013-01-01

    Full Text Available This study explores third-year preservice physics teachers’ (n=32 views concerning the objectives of practical work at school and university. Content analysis of their essays about practical work revealed not only the objectives of the practical work undertaken but also how they had experienced teaching as school and university students. The objectives most commonly referred to were related to the connections between theory and practice, motivation, understanding phenomena, learning how to observe, and learning how to report. In contrast, some objectives were recognized only rarely, which is an important issue for discussion as a future challenge. Preservice teachers’ positive experiences of practical work resulted from the successful implementation of practical work. According to our findings, practical work can in many cases be regarded as successful, especially when the participants understand the objectives of the teaching. In contrast, negative experiences reflected failures or difficulties in implementation. We conclude by suggesting that preservice teachers should be offered opportunities to reflect on their previous experiences and to see and experience in practice the advantages of practical work.

  14. The practical Einstein experiments, patents, inventions

    CERN Document Server

    Illy, József

    2012-01-01

    Albert Einstein may be best known as the wire-haired whacky physicist who gave us the theory of relativity, but that's just one facet of this genius' contribution to human knowledge and modern science. As Jozsef Illy expertly shows in this book, Einstein had an eminently practical side as well. As a youth, Einstein was an inveterate tinkerer in the electrical supply factory his father and uncle owned and operated. His first paid job was as a patent examiner. Later in life, Einstein contributed to many inventions, including refrigerators, microphones, and instruments for aviation. In published papers, Einstein often provided ways to test his theories and fundamental problems of the scientific community of his times. He delved deeply into a variety of technological innovations, most notably the gyrocompass, and consulted for industry in patent cases and on other legal matters. Einstein also provided explanations for common and mundane phenomena, such as the meandering of rivers. In these and other hands-on exam...

  15. Advancing Knowledge and Practice to Systems Thinking to ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Extrants. Articles de revue. Advancing the application of systems thinking in health: advice seeking behavior among primary health care physicians in Pakistan. Articles de revue. Advancing the application of systems thinking in health : a realist evaluation of a capacity building programme for district managers in Tumkur, ...

  16. Listening Instruction and Practice for Advanced ESL Students.

    Science.gov (United States)

    Godfrey, Dennis

    This paper attempts to enact Rivers' (1971 and 1972) urgings to base ESL listening instruction on both psychological and linguistic findings and contends that advanced ESL students' listening needs call for improvement in processing spoken English discourse. Psychological data on memory span is cited to demonstrate that advanced ESL students…

  17. The Design, Experience and Practice of Networked Learning

    DEFF Research Database (Denmark)

    . The Design, Experience and Practice of Networked Learning will prove indispensable reading for researchers, teachers, consultants, and instructional designers in higher and continuing education; for those involved in staff and educational development, and for those studying post graduate qualifications...

  18. Connecting to Experience: High-Impact Practices for Leadership Development.

    Science.gov (United States)

    Priest, Kerry L; Clegorne, Nicholas A

    2015-01-01

    Leadership educators can leverage high-impact experiences to enhance student leadership development. This chapter describes three key practices--sociocultural conversations with peers, mentoring, and membership in off-campus organizations--as levers of leadership learning. Illustrations of the practice in context and reflections from practitioners and students are also included. The chapter concludes with considerations of context, developmental readiness, and best practices of experiential education. © 2015 Wiley Periodicals, Inc., A Wiley Company.

  19. Medical student attachments in private practice – The experience ...

    African Journals Online (AJOL)

    Background: Medical student attachments with family/general practitioners (GPs) in non-academic or private practice are a valued resource in the undergraduate teaching of Family Medicine. This study describes the experience and views of GPs in private practice with final-year medical student attachments from the ...

  20. Experiences of Practice-Based Learning in Phenomenographic Perspective

    Science.gov (United States)

    Rovio-Johansson, Airi

    2018-01-01

    Purpose: The paper aims to examine, within the context of professional practice and learning, how designers collaboratively working in international teams experience practice-based learning and how such occasions contribute to professional development. Design/methodology/approach: The paper introduces the cooperation project between Tibro Training…

  1. Experience, theory, and practical wisdom in teaching and teacher education

    NARCIS (Netherlands)

    Lunenberg, Mieke; Korthagen, Fred

    In this contribution, we discuss what it means to be a professional teacher with practical wisdom, and how practical wisdom is related to theory and experience. These questions are especially relevant as nowadays, in many countries, teacher education becomes more school?based. Building on theories

  2. Experience, theory, and practical wisdom in teaching and teacher education

    NARCIS (Netherlands)

    Lunenberg, Mieke; Korthagen, Fred

    2009-01-01

    In this contribution, we discuss what it means to be a professional teacher with practical wisdom, and how practical wisdom is related to theory and experience. These questions are especially relevant as nowadays, in many countries, teacher education becomes more school-based. Building on theories

  3. Experiments with radioactive samples at the Advanced Photon Source

    International Nuclear Information System (INIS)

    Veluri, V. R.; Justus, A.; Glagola, B.; Rauchas, A.; Vacca, J.

    2000-01-01

    The Advanced Photon Source (APS) at Argonne National Laboratory is a national synchrotron-radiation light source research facility. The 7 GeV electron Storage Ring is currently delivering intense high brilliance x-ray beams to a total of 34 beamlines with over 120 experiment stations to members of the international scientific community to carry out forefront basic and applied research in several scientific disciplines. Researchers come to the APS either as members of Collaborative Access Teams (CATs) or as Independent Investigators (IIs). Collaborative Access Teams comprise large number of investigators from universities, industry, and research laboratories with common research objectives. These teams are responsible for the design, construction, finding, and operation of beamlines. They are the owners of their experimental enclosures (''hutches'') designed and built to meet their specific research needs. Fig. 1 gives a plan view of the location of the Collaborative Access Teams by Sector and Discipline. In the past two years, over 2000 individual experiments were conducted at the APS facility. Of these, about 60 experiments involved the use of radioactive samples, which is less than 3% of the total. However, there is an increase in demand for experiment stations to accommodate the use of radioactive samples in different physical forms embedded in various matrices with activity levels ranging from trace amounts of naturally occurring radionuclides to MBq (mCi) quantities including transuranics. This paper discusses in some detail the steps in the safety review process for experiments involving radioactive samples and how ALARA philosophy is invoked at each step and implemented

  4. Stakeholder experiences with general practice pharmacist services: a qualitative study.

    Science.gov (United States)

    Tan, Edwin C K; Stewart, Kay; Elliott, Rohan A; George, Johnson

    2013-09-11

    To explore general practice staff, pharmacist and patient experiences with pharmacist services in Australian general practice clinics within the Pharmacists in Practice Study. Qualitative study. Two general practice clinics in Melbourne, Australia, in which pharmacists provided medication reviews, patient and staff education, medicines information and quality assurance services over a 6-month period. Patients, practice staff and pharmacists. Semi-structured telephone interviews with patients, focus groups with practice staff and semi-structured interviews and periodic narrative reports with practice pharmacists. Data were analysed thematically and theoretical frameworks used to explain the findings. 34 participants were recruited: 18 patients, 14 practice staff (9 general practitioners, 4 practice nurses, 1 practice manager) and 2 practice pharmacists. Five main themes emerged: environment; professional relationships and integration; pharmacist attributes; staff and patient benefits and logistical challenges. Participants reported that colocation and the interdisciplinary environment of general practice enabled better communication and collaboration compared to traditional community and consultant pharmacy services. Participants felt that pharmacists needed to possess certain attributes to ensure successful integration, including being personable and proactive. Attitudinal, professional and logistical barriers were identified but were able to be overcome. The findings were explained using D'Amour's structuration model of collaboration and Roger's diffusion of innovation theory. This is the first qualitative study to explore the experiences of general practice staff, pharmacists and patients on their interactions within the Australian general practice environment. Participants were receptive of colocated pharmacist services, and various barriers and facilitators to integration were identified. Future research should investigate the feasibility and sustainability of

  5. How does uncertainty shape patient experience in advanced illness? A secondary analysis of qualitative data.

    Science.gov (United States)

    Etkind, Simon Noah; Bristowe, Katherine; Bailey, Katharine; Selman, Lucy Ellen; Murtagh, Fliss Em

    2017-02-01

    Uncertainty is common in advanced illness but is infrequently studied in this context. If poorly addressed, uncertainty can lead to adverse patient outcomes. We aimed to understand patient experiences of uncertainty in advanced illness and develop a typology of patients' responses and preferences to inform practice. Secondary analysis of qualitative interview transcripts. Studies were assessed for inclusion and interviews were sampled using maximum-variation sampling. Analysis used a thematic approach with 10% of coding cross-checked to enhance reliability. Qualitative interviews from six studies including patients with heart failure, chronic obstructive pulmonary disease, renal disease, cancer and liver failure. A total of 30 transcripts were analysed. Median age was 75 (range, 43-95), 12 patients were women. The impact of uncertainty was frequently discussed: the main related themes were engagement with illness, information needs, patient priorities and the period of time that patients mainly focused their attention on (temporal focus). A typology of patient responses to uncertainty was developed from these themes. Uncertainty influences patient experience in advanced illness through affecting patients' information needs, preferences and future priorities for care. Our typology aids understanding of how patients with advanced illness respond to uncertainty. Assessment of these three factors may be a useful starting point to guide clinical assessment and shared decision making.

  6. Factors influencing advanced practice nurses' ability to promote evidence-based practice among frontline nurses.

    Science.gov (United States)

    Gerrish, Kate; Nolan, Mike; McDonnell, Ann; Tod, Angela; Kirshbaum, Marilyn; Guillaume, Louise

    2012-02-01

    Advanced practice nurses (APNs) have an important role in promoting evidence-based practice (EBP) among frontline nurses (FLNs). Factors influencing FLNs' engagement with EBP are well documented but little is known about factors that affect APNs' ability to facilitate evidence in practice. To identify factors that influence APNs' ability to promote EBP among FLNs. A multiple case study of 23 APNs from hospital and primary care settings across seven English health authorities was undertaken. Data collection comprised interviews and observation of APNs and interviews with FLNs and other healthcare professionals. Data were analysed using the Framework approach. Four groups of influencing factors were identified: (1) Personal attributes of APNs included knowledge and skills in EBP, clinical credibility with frontline staff and leadership style. (2) Relationships with stakeholders included APNs' interactions with FLNs and the level of support from managers and medical colleagues. (3) Aspects of the APN role included their sphere of responsibility and workload. (4) Organisational context included the organisational culture, FLNs' workload, professional networks and available resources. Educational preparation for APNs should enable them to develop expertise in EBP plus interpersonal and leadership skills to manage relational dynamics in clinical settings. APN role specifications should provide the opportunity to promote EBP. The organisational culture should be conducive to enabling EBP with managers supportive of this aspect of the APNs' role. APNs need to be supported to address the individual, interpersonal and organisational factors, which influence their ability to promote EBP. Organisational commitment at the highest level is key to APNs' ability to fulfil this aspect of their role. ©2011 Sigma Theta Tau International.

  7. Professional Learning Experiences and Administrator Practice: Is There a Connection?

    Science.gov (United States)

    Bickmore, Dana L.

    2012-01-01

    This study identified the formal and informal professional learning experiences in which school administrators engaged and the relationship between these professional learning experiences and administrator practice. The researcher developed an instrument that solicited school administrators' engagement and perceived value of formal and informal…

  8. Introducing Advanced Practice Nurses / Nurse Practitioners in health care systems: a framework for reflection and analysis.

    Science.gov (United States)

    De Geest, Sabina; Moons, Philip; Callens, Betty; Gut, Chris; Lindpaintner, Lyn; Spirig, Rebecca

    2008-11-01

    An increasing number of countries are exploring the option of introducing Advanced Practice Nurses (APN), such as Nurse Practitioners (NP), as part of the health care workforce. This is particular relevant in light of the increase of the elderly and chronically ill. It is crucial that this introduction is preceded by an in depth understanding of the concept of advanced practice nursing as well as an analysis of the context. Firstly, a conceptual clarification of Advanced Practice Nurses and Nurse Practitioners is provided. Secondly, a framework is introduced that assists in the analysis of the introduction and development of Advanced Practice Nurse roles in a particular health care system. Thirdly, outcomes research on Advanced Practice Nursing is presented. Argumentation developed using data based papers and policy reports on Advanced Practice Nursing. The proposed framework consists of five drivers: (1) the health care needs of the population, (2) education, (3) workforce, (4) practice patterns and (5) legal and health policy framework. These drivers act synergistically and are dynamic in time and space. Outcomes research shows that nurse practitioners show clinical outcomes similar to or better than those of physicians. Further examples demonstrate favourable outcomes in view of the six Ds of outcome research; death, disease, disability, discomfort, dissatisfaction and dollars, for models of care in which Advanced Practice Nurses play a prominent role. Advanced Practice Nurses such as Nurse Practitioners show potential to contribute favourably to guaranteeing optimal health care. Advanced Practice Nurses will wield the greatest influence on health care by focusing on the most pressing health problems in society, especially the care of the chronically ill.

  9. Nurse leaders' experiences of implementing regulatory changes in sexual health nursing practice in British Columbia, Canada.

    Science.gov (United States)

    Bungay, Vicky; Stevenson, Janine

    2013-05-01

    Most research about regulatory policy change concerning expanded nursing activities has emphasized advanced practice roles and acute care settings. This study is a contribution to the small pool of research concerned with regulatory policy implementation for nurses undertaking expanded nursing practice activities in a public health context. Using the regulatory changes in certified nursing practice in one Canadian province as our starting point, we investigated the experiences of nurse leaders in implementing this change. Using a qualitative interpretive descriptive approach informed by tenets of complexity theory, we examined the experiences of 16 nurse leaders as situated within the larger public health care system in which nurses practice. Two interrelated themes, (a) preparing for certification and (b) the certification process, were identified to illustrate how competing and contrasting demands between health care and regulatory organizations created substantial barriers to policy change. Implications for health service delivery and future research are discussed.

  10. Does radiography advanced practice improve patient outcomes and health service quality? A systematic review.

    Science.gov (United States)

    Hardy, Maryann; Johnson, Louise; Sharples, Rachael; Boynes, Stephen; Irving, Donna

    2016-06-01

    To investigate the impact of radiographer advanced practice on patient outcomes and health service quality. Using the World Health Organization definition of quality, this review followed the Centre for Reviews and Dissemination guidance for undertaking reviews in healthcare. A range of databases were searched using a defined search strategy. Included studies were assessed for quality using a tool specifically developed for reviewing studies of diverse designs, and data were systematically extracted using electronic data extraction pro forma. 407 articles were identified and reviewed against the inclusion/exclusion criteria. Nine studies were included in the final review, the majority (n = 7) focusing on advanced radiography practice within the UK. Advanced practice activities considered were radiographer reporting, leading patient review clinics and barium enema examinations. The articles were generally considered to be of low-to-moderate quality, with most evaluating advanced practice within a single centre. With respect to specific quality dimensions, the included studies considered cost reduction, patient morbidity, time to treatment and patient satisfaction. No articles reported data relating to time to diagnosis, time to recovery or patient mortality. Radiographer advanced practice is an established activity both in the UK and internationally. However, evidence of the impact of advanced practice in terms of patient outcomes and service quality is limited. This systematic review is the first to examine the evidence base surrounding advanced radiography practice and its impact on patient outcomes and health service quality.

  11. Impact of postgraduate education on advanced practice nurse activity - a national survey.

    Science.gov (United States)

    Wilkinson, J; Carryer, J; Budge, C

    2018-03-22

    There is a wealth of international evidence concerning the contribution post-registration master's level education makes to advancing the discipline of nursing. There are approximately 277 nurse practitioners registered in NZ, but they account for only a small portion of nurses who have undertaken master's level education. The additional contribution these nurses make to the work environment through advanced practice activities has not, hitherto, been documented. To report the extent of advanced practice nurse activity associated with various levels of nursing education in a sample of nurses working in clinical practice in New Zealand. A replication of recent Australian research was done via a national cross-sectional survey of 3255 registered nurses and nurse practitioners in New Zealand using an online questionnaire to collect responses to the amended Advanced Practice Delineation survey tool. In addition, demographic data were collected including position titles and levels of postgraduate education. A positive association was found between postgraduate education at any level and more time spent in advanced practice activities. Independent of level of postgraduate education, the role a nurse holds also effects the extent of involvement in advanced practice activities. There is an additional contribution made to the work environment by nurses with master's level education which occurs even when they are not employed in an advanced practice role. These findings are of significance to workforce policy and planning across the globe as countries work to sustain health services by increasing nursing capacity effectively within available resources. © 2018 International Council of Nurses.

  12. Effects of Different Practice Conditions on Advanced Instrumentalists' Performance Accuracy.

    Science.gov (United States)

    Rosenthal, Roseanne K.; And Others

    1988-01-01

    Examines the relative effects of the five practice conditions of modeling, singing, silent analysis, free practice, and control on instrumentalists' performance. Finds significant differences in subjects' performance of correct rhythms, phrasing or dynamics, and tempo, and insignificant differences among performances of correct notes and…

  13. Does Volunteering Experience Influence Advance Care Planning in Old Age?

    Science.gov (United States)

    Shen, Huei-Wern; Khosla, Nidhi

    2016-07-01

    Advance care planning (ACP) increases the likelihood patients will receive end-of-life care that is congruent with their preferences and lowers stress among both patients and caregivers. Previous efforts to increase ACP have mainly focused on information provision in the very late stage of life. This study examines whether a relationship exists between volunteering and ACP, and whether this relationship is associated with social support. The sample comprises 877 individuals who were aged 55+ in 2008, and were deceased before 2010. The sample is derived from seven waves (1998-2010) of data from the Health and Retirement Study. Logistic regression results showed that overall ACP and durable power of attorney for health care (DPAHC) were both higher (OR = 1.61 and 1.71, respectively) for older adults with volunteering experience in the past 10 years than those without such experience. Available social support (relatives and friends living nearby) was not associated with the relationship between volunteering and ACP. Other factors related to ACP included poorer health, death being expected, death due to cancer, older age, and being a racial minority. Involving older people in volunteer work may help to increase ACP. Future research is encouraged to identify reasons for the association between volunteering and ACP.

  14. Advanced technologies related to a high temperature superconductor for small laboratory experiments

    International Nuclear Information System (INIS)

    Ogawa, Yuichi; Mito, Toshiyuki; Yanagi, Nagato

    2006-01-01

    Advanced technologies related to a high temperature superconductor materials and small refrigerator are reviewed. Mini-RT/RT-1 is designed and constructed as a plasma examination device. The element technology of low temperature apparatus, the results of performance tests and application examples are explained. The superconductors such as Bi 2 Sr 2 CaCu 2 O 8 (Bi-2212) for the low temperature phase, Bi 2 Sr 2 Ca 2 Cu 3 O 10 (Bi-2223) for the high temperature phase, and YBa 2 Cu 3 O y (YBCO or Y123) are described. Advanced 4K-Giford-Mcmahon (GM) refrigerator on the market put superconductor coil made of low temperature superconductor metals to practical use and extends its application field. Small laboratory is able to experiment on the high temperature superconductor materials. (S.Y.)

  15. Advanced Receiver/Converter Experiments for Laser Wireless Power Transmission

    Science.gov (United States)

    Howell, Joe T.; ONeill, Mark; Fork, Richard

    2004-01-01

    For several years NASA Marshall Space Flight Center, UAH and ENTECH have been working on various aspects of space solar power systems. The current activity was just begun in January 2004 to further develop this new photovoltaic concentrator laser receiver/converter technology. During the next few months, an improved prototype will be designed, fabricated, and thoroughly tested under laser illumination. The final paper will describe the new concept, present its advantages over other laser receiver/converter approaches (including planar photovoltaic arrays), and provide the latest experiment results on prototype hardware (including the effects of laser irradiance level and cell temperature). With NASA's new human exploration plans to first return to the Moon, and then to proceed to Mars, the new photovoltaic concentrator laser receiver/converter technology could prove to be extremely useful in providing power to the landing sites and other phases of the missions. For example, to explore the scientifically interesting and likely resource-rich poles of the Moon (which may contain water) or the poles of Mars (which definitely contain water and carbon dioxide), laser power beaming could represent the simplest means of providing power to these regions, which receive little or no sunlight, making solar arrays useless there. In summary, the authors propose a paper on definition and experimental results of a novel photovoltaic concentrator approach for collecting and converting laser radiation to electrical power. The new advanced photovoltaic concentrator laser receiver/converter offers higher performance, lighter weight, and lower cost than competing concepts, and early experimental results are confirming the expected excellent Performance levels. After the small prototypes are successfully demonstrated, a larger array with even better performance is planned for the next phase experiments and demonstrations. Thereafter, a near-term flight experiment of the new technology

  16. Advanced spot quality analysis in two-colour microarray experiments

    Directory of Open Access Journals (Sweden)

    Vetter Guillaume

    2008-09-01

    Full Text Available Abstract Background Image analysis of microarrays and, in particular, spot quantification and spot quality control, is one of the most important steps in statistical analysis of microarray data. Recent methods of spot quality control are still in early age of development, often leading to underestimation of true positive microarray features and, consequently, to loss of important biological information. Therefore, improving and standardizing the statistical approaches of spot quality control are essential to facilitate the overall analysis of microarray data and subsequent extraction of biological information. Findings We evaluated the performance of two image analysis packages MAIA and GenePix (GP using two complementary experimental approaches with a focus on the statistical analysis of spot quality factors. First, we developed control microarrays with a priori known fluorescence ratios to verify the accuracy and precision of the ratio estimation of signal intensities. Next, we developed advanced semi-automatic protocols of spot quality evaluation in MAIA and GP and compared their performance with available facilities of spot quantitative filtering in GP. We evaluated these algorithms for standardised spot quality analysis in a whole-genome microarray experiment assessing well-characterised transcriptional modifications induced by the transcription regulator SNAI1. Using a set of RT-PCR or qRT-PCR validated microarray data, we found that the semi-automatic protocol of spot quality control we developed with MAIA allowed recovering approximately 13% more spots and 38% more differentially expressed genes (at FDR = 5% than GP with default spot filtering conditions. Conclusion Careful control of spot quality characteristics with advanced spot quality evaluation can significantly increase the amount of confident and accurate data resulting in more meaningful biological conclusions.

  17. Collaborative learning through advanced Web2.0 practices

    DEFF Research Database (Denmark)

    Tambouris, Efthimios; Panopoulou, Eleni; Tarabanis, Konstantinos

    2010-01-01

    Latest advances in ICT have started impacting also the field of education and training. Social computing and Web2.0 technologies have brought vigorous opportunities for learning and have realised a shift of the web‟s role in learning from an information carrier to a facilitator for the creation...

  18. Knowledge and practice of new advances in occlusal caries ...

    African Journals Online (AJOL)

    Conclusion: Overall knowledge and utilisation of advanced diagnostic methods for occlusal caries among dentists in Nairobi was low. Sticky fissures with evidence of demineralised enamel or discoloration of underlying dentine were identified as main indicators for operative treatment for early carious lesions while resin ...

  19. A Survey of Optometry Graduates to Determine Practice Patterns: Part II: Licensure and Practice Establishment Experiences.

    Science.gov (United States)

    Bleimann, Robert L.; Smith, Lee W.

    1985-01-01

    A summary of Part II of a two-volume study of optometry graduates conducted by the Association of Schools and Colleges of Optometry is presented. Part II includes the analysis of the graduates' licensure and practice establishment experiences. (MLW)

  20. Student and Preceptor Advancement in a Dedicated Education Site: Innovation in Clinical Education for Advanced Practice Nurses.

    Science.gov (United States)

    Hall, Katherine C; Diffenderfer, Sandy K; Stidham, April; Mullins, Christine M

    2018-04-19

    In the 1990s, dedicated education units transformed undergraduate preceptorships, but graduate preceptorships remain static. The dyadic nurse practitioner preceptorship model supports an environment where faculty, students, and preceptors may overlook nuances that affect the teaching-learning process. This article describes an innovative clinical education model, Student and Preceptor Advancement in a Dedicated Education Site, designed to improve preceptorships for advanced practice nurses. The focus is on adaptations made to facilitate use in advanced practice nursing programs.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  1. Adopting an Advanced Community Pharmacy Practice Experiential Educational Model Across Colleges of Pharmacy

    Directory of Open Access Journals (Sweden)

    Jennifer L. Rodis

    2011-01-01

    Full Text Available Objective: To discuss the experience of sharing an experiential model of education and practice development between two colleges of pharmacy and to provide a framework to guide faculty in this type of collaboration. Case Study: The Ohio State University College of Pharmacy (OSU COP Partner for Promotion (PFP program was developed in response to the need for advancing practice in the community pharmacy setting. After successful implementation of this program, the PFP program design and materials were shared, adapted, and implemented at the University of Utah College of Pharmacy (Utah COP. Collaborating faculty developed a framework based on lessons learned through this experience which proposes key guiding strategies as considerations to address prior to embarking on sharing any aspect of an educational program or model between institutions. Each step of the framework is described and applied to the process followed by The OSU COP and Utah COP in sharing the PFP program. Additional considerations related to transfer of educational models are discussed. Results/Conclusion: Sharing the education model and materials associated with the PFP program between institutions has enhanced experiential opportunities for students and helped develop residency training sites in the community setting. In addition, the relationship between the two colleges has contributed to faculty development, as well as an increase in community pharmacy service development with community pharmacy partners at each institution. It is hoped this experience will help guide collaborations between other colleges of pharmacy to enhance education of future pharmacists while positively impacting pharmacy practice, teaching, and research by faculty.   Type: Case Study

  2. Adopting an Advanced Community Pharmacy Practice Experiential Educational Model Across Colleges of Pharmacy

    Directory of Open Access Journals (Sweden)

    Jennifer L. Rodis, Pharm.D., BCPS

    2011-01-01

    Full Text Available Objective: To discuss the experience of sharing an experiential model of education and practice development between two colleges of pharmacy and to provide a framework to guide faculty in this type of collaboration.Case Study: The Ohio State University College of Pharmacy (OSU COP Partner for Promotion (PFP program was developed in response to the need for advancing practice in the community pharmacy setting. After successful implementation of this program, the PFP program design and materials were shared, adapted, and implemented at the University of Utah College of Pharmacy (Utah COP. Collaborating faculty developed a framework based on lessons learned through this experience which proposes key guiding strategies as considerations to address prior to embarking on sharing any aspect of an educational program or model between institutions. Each step of the framework is described and applied to the process followed by The OSU COP and Utah COP in sharing the PFP program. Additional considerations related to transfer of educational models are discussed.Results/Conclusion: Sharing the education model and materials associated with the PFP program between institutions has enhanced experiential opportunities for students and helped develop residency training sites in the community setting. In addition, the relationship between the two colleges has contributed to faculty development, as well as an increase in community pharmacy service development with community pharmacy partners at each institution. It is hoped this experience will help guide collaborations between other colleges of pharmacy to enhance education of future pharmacists while positively impacting pharmacy practice, teaching, and research by faculty.

  3. A System Approach to Advanced Practice Clinician Standardization and High Reliability.

    Science.gov (United States)

    Okuno-Jones, Susan; Siehoff, Alice; Law, Jennifer; Juarez, Patricia

    Advanced practice clinicians (APCs) are an integral part of the health care team. Opportunities exist within Advocate Health Care to standardize and optimize APC practice across the system. To enhance the role and talents of APCs, an approach to role definition and optimization of practice and a structured approach to orientation and evaluation are shared. Although in the early stages of development, definition and standardization of accountabilities in a framework to support system changes are transforming the practice of APCs.

  4. Advances and Best Practices in Airborne Gravimetry from the U.S. GRAV-D Project

    Science.gov (United States)

    Diehl, Theresa; Childers, Vicki; Preaux, Sandra; Holmes, Simon; Weil, Carly

    2013-04-01

    The Gravity for the Redefinition of the American Vertical Datum (GRAV-D) project, an official policy of the U.S. National Geodetic Survey as of 2007, is working to survey the entire U.S. and its holdings with high-altitude airborne gravimetry. The goal of the project is to provide a consistent, high-quality gravity dataset that will become the cornerstone of a new gravimetric geoid and national vertical datum in 2022. Over the last five years, the GRAV-D project has surveyed more than 25% of the country, accomplishing almost 500 flights on six different aircraft platforms and producing more than 3.7 Million square km of data thus far. This wealth of experience has led to advances in the collection, processing, and evaluation of high-altitude (20,000 - 35,000 ft) airborne gravity data. This presentation will highlight the most important practical and theoretical advances of the GRAV-D project, giving an introduction to each. Examples of innovation include: 1. Use of navigation grade inertial measurement unit data and precise lever arm measurements for positioning; 2. New quality control tests and software for near real-time analysis of data in the field; 3. Increased accuracy of gravity post-processing by reexamining assumptions and simplifications that were inconsistent with a goal of 1 mGal precision; and 4. Better final data evaluation through crossovers, additional statistics, and inclusion of airborne data into harmonic models that use EGM08 as a base model. The increases in data quality that resulted from implementation of the above advances (and others) will be shown with a case study of the GRAV-D 2008 southern Alaska survey near Anchorage, over Cook Inlet. The case study's statistics and comparisons to global models illustrate the impact that these advances have had on the final airborne gravity data quality. Finally, the presentation will summarize the best practices identified by the project from its last five years of experience.

  5. How Quality Improvement Practice Evidence Can Advance the Knowledge Base.

    Science.gov (United States)

    OʼRourke, Hannah M; Fraser, Kimberly D

    2016-01-01

    Recommendations for the evaluation of quality improvement interventions have been made in order to improve the evidence base of whether, to what extent, and why quality improvement interventions affect chosen outcomes. The purpose of this article is to articulate why these recommendations are appropriate to improve the rigor of quality improvement intervention evaluation as a research endeavor, but inappropriate for the purposes of everyday quality improvement practice. To support our claim, we describe the differences between quality improvement interventions that occur for the purpose of practice as compared to research. We then carefully consider how feasibility, ethics, and the aims of evaluation each impact how quality improvement interventions that occur in practice, as opposed to research, can or should be evaluated. Recommendations that fit the evaluative goals of practice-based quality improvement interventions are needed to support fair appraisal of the distinct evidence they produce. We describe a current debate on the nature of evidence to assist in reenvisioning how quality improvement evidence generated from practice might complement that generated from research, and contribute in a value-added way to the knowledge base.

  6. Innovative practice: exploring acculturation theory to advance rehabilitation from pediatric to adult "cultures" of care.

    Science.gov (United States)

    Nguyen, Tram; Baptiste, Sue

    2015-01-01

    This perspective paper explores the application of acculturation and the inherent concepts and ideas associated with this theory in rehabilitation to provide a framework for interpreting patient circumstances, responses and behaviours as they move from one culture to the next. Traditionally acculturation theory has been use to examine changes in culture in an ethnic or country sense, however, this paper is among the first to apply acculturation theory to the rehabilitation service cultures from pediatric to adult care for youth with chronic health conditions. The objectives of this paper are threefold: (1) to critically appraise key literature in the development of acculturation theory, (2) to discuss how acculturation theory can be applied in rehabilitation practice through a clinical vignette, and finally (3) to discuss how acculturation theory can advance rehabilitation by enhancing client-centered practice. Acculturation theory can provide insight into how patients are experiencing a change in health care "cultures", in the context of their overarching life circumstances. This, coming from a broader societal perspective can in turn inform an optimal approach to client-centered practice, and the application of rehabilitation-specific team inputs. This theoretical framework can heighten practitioners' awareness of patients' unique worldviews related to their expectations for care and treatment thus reducing fear of diversity to establish positive partnerships between patients and clinicians. An understanding of patients' acculturation processes will add new insight into how we can best deliver services and supports to optimise health, opportunities and experiences for youth with chronic conditions.

  7. HIGH PERFORMANCE ADVANCED TOKAMAK REGIMES FOR NEXT-STEP EXPERIMENTS

    International Nuclear Information System (INIS)

    GREENFIELD, C.M.; MURAKAMI, M.; FERRON, J.R.; WADE, M.R.; LUCE, T.C.; PETTY, C.C.; MENARD, J.E; PETRIE, T.W.; ALLEN, S.L.; BURRELL, K.H.; CASPER, T.A; DeBOO, J.C.; DOYLE, E.J.; GAROFALO, A.M; GORELOV, Y.A; GROEBNER, R.J.; HOBIRK, J.; HYATT, A.W; JAYAKUMAR, R.J; KESSEL, C.E; LA HAYE, R.J; JACKSON, G.L; LOHR, J.; MAKOWSKI, M.A.; PINSKER, R.I.; POLITZER, P.A.; PRATER, R.; STRAIT, E.J.; TAYLOR, T.S; WEST, W.P.

    2003-01-01

    OAK-B135 Advanced Tokamak (AT) research in DIII-D seeks to provide a scientific basis for steady-state high performance operation in future devices. These regimes require high toroidal beta to maximize fusion output and poloidal beta to maximize the self-driven bootstrap current. Achieving these conditions requires integrated, simultaneous control of the current and pressure profiles, and active magnetohydrodynamic (MHD) stability control. The building blocks for AT operation are in hand. Resistive wall mode stabilization via plasma rotation and active feedback with non-axisymmetric coils allows routine operation above the no-wall beta limit. Neoclassical tearing modes are stabilized by active feedback control of localized electron cyclotron current drive (ECCD). Plasma shaping and profile control provide further improvements. Under these conditions, bootstrap supplies most of the current. Steady-state operation requires replacing the remaining Ohmic current, mostly located near the half-radius, with noninductive external sources. In DIII-D this current is provided by ECCD, and nearly stationary AT discharges have been sustained with little remaining Ohmic current. Fast wave current drive is being developed to control the central magnetic shear. Density control, with divertor cryopumps, of AT discharges with edge localized moding (ELMing) H-mode edges facilitates high current drive efficiency at reactor relevant collisionalities. A sophisticated plasma control system allows integrated control of these elements. Close coupling between modeling and experiment is key to understanding the separate elements, their complex nonlinear interactions, and their integration into self-consistent high performance scenarios. Progress on this development, and its implications for next-step devices, will be illustrated by results of recent experiment and simulation efforts

  8. Enabling the publication of practice based experiences and projects

    Directory of Open Access Journals (Sweden)

    Jan Dewing

    2017-05-01

    to do so as it was unlikely I would ever be published. This may well have influenced my belief that there is a writer in each and all of us and my determination to support new authors. Writing is one of the mediums we use to tell stories to ourselves and to share them with others; we are storied beings through and through. So it is that this issue of IPDJ – without any significant advance planning on our part – has a focus on critical or in-depth reflective accounts. The first section has two strong original research articles and the remainder of the issue is richly populated by reflections and commentaries. Once again, it is our pleasure to publish an issue that highlights how useful reflections on practice development can be in adding to our knowledge about person-centred experience and person-centred cultures. Developing knowledge from and in practice contexts is at the heart of applied and person-based professions such as nursing and other healthcare disciplines. At IPDJ we are committed to facilitating potential authors to achieve a publication wherever possible. We will support and mentor new authors to get through the system and we will provide constructive and essentially person-centred reviews and feedback in a timely way to all authors. I trust you will see the proof of our processes in the articles in this issue. Perhaps as a result of reading this editorial and this issue, you might now consider yourself as a potential author and get in touch about something you have to share.

  9. The practical equity implications of advanced metering infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Felder, Frank A.

    2010-07-15

    Reductions in advanced metering costs and the efficiency benefits of dynamic pricing make a compelling case to adopt both, particularly for industrial and commercial facilities. Regulators should seriously consider such policies for residential households as well. Regulators can take meaningful steps to mitigate, if not entirely offset, the possibility that some low-income ratepayers may have higher electricity bills with AM and DP. (author)

  10. Constructing an Ethical Training for Advanced Nursing Practice: An Interactionist and Competency-Based Approach.

    Science.gov (United States)

    Pariseau-Legault, Pierre; Lallier, Melisa

    2016-07-01

    Advanced practice nurses are working in a highly interdisciplinary and political context. Such situations can influence the deliberative and ethical decision-making processes in which they are also involved. This can subsequently compromise their abilities to protect their moral integrity, to find innovative and nondualistic solutions to complex ethical problems, and to collaborate with other health professionals. The authors constructed a training program inspired by discourse and narrative ethics. The objective pursued was to develop advanced practice nurses' moral integrity, highlight the ethical component of their clinical judgement, and foster the development of their deliberative competencies. The pedagogical process proposed exposes how an ethical curriculum adapted to the context in which advanced practice nurses evolve can address power relationships inherent in ethical decision making. The authors suggest that this pedagogical approach has the potential to optimize the consolidation of ethical, reflective, and deliberative competencies among advanced practice nurses. [J Nurs Educ. 2016;55(7):399-402.]. Copyright 2016, SLACK Incorporated.

  11. From challenges to advanced practice registered nursing role development: Qualitative interview study.

    Science.gov (United States)

    Jokiniemi, Krista; Haatainen, Kaisa; Pietilä, Anna-Maija

    2015-12-01

    The aim of this study is to describe the factors hindering and facilitating the implementation of the advanced practice registered nurses role at Finnish university hospitals, and to examine the implications for its future development. A descriptive qualitative approach, using thematic individual interviews, was conducted in 2011 with a sample of 11 advanced practice registered nurses. The data were analysed using qualitative content analysis. The advanced practice registered nurses role barriers had an impact on the role development needs. In turn, the facilitating factors helped encounter the challenges of the role, therefore having an impact on both the current role achievement, as well as contributing to the future role development. The factors hindering and facilitating the advanced practice registered nurses role need to be acknowledged to support the role implementation and planning of the future of the role. © 2014 Wiley Publishing Asia Pty Ltd.

  12. A healthful experience? A patient practice development journey

    Directory of Open Access Journals (Sweden)

    Erna Snelgrove Clarke

    2016-05-01

    Full Text Available While facilitating the first practice development school for our local healthcare authorities in Nova Scotia, Canada, recently, I was simultaneously preparing for my second hip replacement. Focusing workshop participants on the principles of practice development, collaboration, inclusion and participation, I wondered if, in my upcoming journey through the healthcare system, I would experience the processes and outcomes we were promoting in the school. I would like to share this commentary as a reflection of my practice development experience as a patient. Overall, I received care that was inclusive and collaborative – as well as care that was provider focused and system driven. It goes without saying that as a patient, I felt valued when I was included and felt part of the team when my wishes and expectations were taken into consideration. For me, inclusion in care correlates with valuing that patient as a participant in their care journey, as set out by practice development principle 6 (Manley, McCormack and Wilson, 2008 (Table 1. My recent healthcare experience has led me to reflect further on the principles of practice development and its implications and challenges for local healthcare authorities. For example, my anaesthetist comes to mind as embodying practice development principles 2, 4, 6 and 8. The anaesthetist supported my wishes surrounding narcotics, and provided research- and practice-based evidence for each of his actions. Although the offering of additional narcotics is routine practice in hip surgery, I did not want this, so we discussed my expectations and developed a plan together that reflected my wishes. He actually chatted throughout the entire two-hour procedure. I was pleasantly surprised when he told me he provides care that focuses on the patient (practice development principle 1. Nevertheless, inconsistencies in the attention to person-centred practices across the microsystem reminded me that the system is not yet set

  13. Planned Experiments on the Princeton Advanced Test Stand

    Science.gov (United States)

    Stepanov, A.; Gilson, E. P.; Grisham, L.; Kaganovich, I.; Davidson, R. C.

    2010-11-01

    The Princeton Advanced Test Stand (PATS) device is an experimental facility based on the STS-100 high voltage test stand transferred from LBNL. It consists of a multicusp RF ion source, a pulsed extraction system capable of forming high-perveance 100keV ion beams, and a large six-foot-long vacuum with convenient access for beam diagnostics. This results in a flexible system for studying high perveance ion beams relevant to NDCX-I/II, including experiments on beam neutralization by ferroelectric plasma sources (FEPS) being developed at PPPL. Research on PATS will concern the basic physics of beam-plasma interactions, such as the effects of volume neutralization on beam emittance, as well as optimizing technology of the FEPS. PATS combines the advantage of an ion beam source and a large-volume plasma source in a chamber with ample access for diagnostics, resulting in a robust setup for investigating and improving relevant aspects of neutralized drift. There are also plans for running the ion source with strongly electro-negative gases such as chlorine, making it possible to extract positive or negative ion beams.

  14. Perturbative transport experiments in JET Advanced Tokamak plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Mantica, P.; Gorini, G.; Sozzi, C. [Istituto di Fisica del Plasma, EURATOM-ENEA-CNR Association, Milan (Italy); Imbeaux, F.; Sarazin, Y.; Garbet, X. [Association Euratom-CEA, St. Paul-lez-Durance Cedex (France); Kinsey, J. [Lehigh Univ., Bethlehem, Pennsylvania (United States); Budny, R. [Princeton Plasma Physics Lab, New Jersey (United States); Coffey, I.; Parail, V.; Walden, A. [Euratom/UKAEA Fusion Association, Abingdon, Oxon (United Kingdom); Dux, R. [Max-Planck-Institut fuer Plasmaphysik, Garching (Germany); Garzotti, L. [Istituto Gas Ionizzati, Padova (Italy); Ingesson, C. [FOM-Instituut voor Plasmafysica, Nieuwegein (Netherlands); Kissick, M. [University of California, Los Angeles (United States)

    2003-07-01

    Perturbative transport experiments have been performed in JET Advanced Tokamak plasmas either in conditions of fully developed Internal Transport Barrier (ITB) or during a phase where an ITB was not observed. Transient peripheral cooling was induced by either Laser Ablation or Shallow Pellet Injection and the ensuing travelling cold pulse was used to probe the plasma transport in the electron and, for the first time, also in the ion channel. Cold pulses travelling through ITBs are observed to erode the ITB outer part, but, if the inner ITB portion survives, it strongly damps the propagating wave. The result is discussed in the context of proposed possible pictures for ITB formation. In the absence of an ITB, the cold pulse shows a fast propagation in the outer plasma half, which is consistent with a region of stiff transport, while in the inner half it slows down but shows the peculiar feature of amplitude growing while propagating. The data are powerful tests for the validation of theoretical transport models. (author)

  15. Babelomics: advanced functional profiling of transcriptomics, proteomics and genomics experiments

    Science.gov (United States)

    Al-Shahrour, Fátima; Carbonell, José; Minguez, Pablo; Goetz, Stefan; Conesa, Ana; Tárraga, Joaquín; Medina, Ignacio; Alloza, Eva; Montaner, David; Dopazo, Joaquín

    2008-01-01

    We present a new version of Babelomics, a complete suite of web tools for the functional profiling of genome scale experiments, with new and improved methods as well as more types of functional definitions. Babelomics includes different flavours of conventional functional enrichment methods as well as more advanced gene set analysis methods that makes it a unique tool among the similar resources available. In addition to the well-known functional definitions (GO, KEGG), Babelomics includes new ones such as Biocarta pathways or text mining-derived functional terms. Regulatory modules implemented include transcriptional control (Transfac, CisRed) and other levels of regulation such as miRNA-mediated interference. Moreover, Babelomics allows for sub-selection of terms in order to test more focused hypothesis. Also gene annotation correspondence tables can be imported, which allows testing with user-defined functional modules. Finally, a tool for the ‘de novo’ functional annotation of sequences has been included in the system. This allows using yet unannotated organisms in the program. Babelomics has been extensively re-engineered and now it includes the use of web services and Web 2.0 technology features, a new user interface with persistent sessions and a new extended database of gene identifiers. Babelomics is available at http://www.babelomics.org PMID:18515841

  16. Advance care planning for nursing home residents with dementia: policy vs. practice.

    Science.gov (United States)

    Ampe, Sophie; Sevenants, Aline; Smets, Tinne; Declercq, Anja; Van Audenhove, Chantal

    2016-03-01

    The aims of this study were: to evaluate the advance care planning policy for people with dementia in nursing homes; to gain insight in the involvement of residents with dementia and their families in advance care planning, and in the relationship between the policy and the actual practice of advance care planning. Through advance care planning, nursing home residents with dementia are involved in care decisions, anticipating their reduced decision-making capacity. However, advance care planning is rarely realized for this group. Prevalence and outcomes have been researched, but hardly any research has focused on the involvement of residents/families in advance care planning. Observational cross-sectional study in 20 nursing homes. The ACP audit assessed the views of the nursing homes' staff on the advance care planning policy. In addition, individual conversations were analysed with 'ACP criteria' (realization of advance care planning) and the 'OPTION' instrument (involvement of residents/families). June 2013-September 2013. Nursing homes generally met three quarters of the pre-defined criteria for advance care planning policy. In almost half of the conversations, advance care planning was explained and discussed substantively. Generally, healthcare professionals only managed to involve residents/families on a baseline skill level. There were no statistically significant correlations between policy and practice. The evaluations of the policy were promising, but the actual practice needs improvement. Future assessment of both policy and practice is recommended. Further research should focus on communication interventions for implementing advance care planning in the daily practice. © 2015 John Wiley & Sons Ltd.

  17. Subjective Experiences of Older Adults Practicing Taiji and Qigong

    Directory of Open Access Journals (Sweden)

    Yang Yang

    2011-01-01

    Full Text Available This article presents a qualitative study following a 6-month Taiji (T'ai Chi/Qigong (Ch'i Kung intervention for older adults. The researchers conducted in-depth interviews of eight selected participants who elected to continue practicing Taiji after the intervention ended, in order to explore their subjective experiences of Taiji's effects and their motivations for continuing to practice. We created a Layers Model to capture the significance and meaning of the multidimensionality of their reported experiences. Participants not only reported simple benefits along five dimensions of experience (physical, mental, emotional, social and spiritual but also described complex multidimensional experiences. Overall findings indicate that participants derived a very wide variety of perceived benefits, the most meaningful being a felt sense of body-mind-spirit integration. Our results support the important role of qualitative studies in researching the effects of Taiji and Qigong.

  18. The Effect of Advanced Management Accounting Practices on the Competitive Strategies and Performance

    OpenAIRE

    Rahmi Yücel; Kayhan Ahmetoğulları

    2015-01-01

    This study is based on a sample of 300 managers from the production industry of West Marmara Region. The goal of this study is to examine the interaction among advanced management accounting practices, competitive strategies and company performance. As a result of study, it is found that advanced accounting management practices have a positive effect on the company performance and competitive strategies. In addition, competitive strategies have an effect on the company performance positively....

  19. Practical Implementation of Cooperative RRM for IMT-Advanced Systems

    DEFF Research Database (Denmark)

    Mihovska, Albena D.; Tragos, Elias; Kyriazakos, Sofoklis

    2008-01-01

    This paper describes a practical implementation of a radio resource management (RRM) framework for support of cooperation between radio access networks (RANs). The platform supports the inter-working between a next generation RAN and legacy systems (i.e., WLAN, UMTS). The platform is based on rea...

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

    Science.gov (United States)

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

    2018-03-01

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

  1. Advancement in Sensing Technology New Developments and Practical Applications

    CERN Document Server

    Jayasundera, Krishanthi; Fuchs, Anton

    2013-01-01

    The book presents the recent advancements in the area of sensors and sensing technology, specifically in environmental monitoring, structural health monitoring, dielectric, magnetic, electrochemical, ultrasonic, microfluidic, flow, surface acoustic wave, gas, cloud computing and bio-medical.   This book will be useful to a variety of readers, namely, Master and PhD degree students, researchers, practitioners, working on sensors and sensing technology. The book will provide an opportunity of a dedicated and a deep approach in order to improve their knowledge in this specific field.

  2. Interim Service ISDN Satellite (ISIS) hardware experiment development for advanced ISDN satellite designs and experiments

    Science.gov (United States)

    Pepin, Gerard R.

    1992-01-01

    The Interim Service Integrated Service Digital Network (ISDN) Satellite (ISIS) Hardware Experiment Development for Advanced Satellite Designs describes the development of the ISDN Satellite Terminal Adapter (ISTA) capable of translating ISDN protocol traffic into Time Division Multiple Access (TDMA) signals for use by a communications satellite. The ISTA connects the Type 1 Network Termination (NT1) via the U-interface on the line termination side of the CPE to the RS-499 interface for satellite uplink. The same ISTA converts in the opposite direction the RS-499 to U-interface data with a simple switch setting.

  3. Interim Service ISDN Satellite (ISIS) hardware experiment design for advanced ISDN satellite design and experiments

    Science.gov (United States)

    Pepin, Gerard R.

    1992-01-01

    The Interim Service Integrated Services Digital Network (ISDN) Satellite (ISIS) Hardware Experiment Design for Advanced Satellite Designs describes the design of the ISDN Satellite Terminal Adapter (ISTA) capable of translating ISDN protocol traffic into time division multiple access (TDMA) signals for use by a communications satellite. The ISTA connects the Type 1 Network Termination (NT1) via the U-interface on the line termination side of the CPE to the V.35 interface for satellite uplink. The same ISTA converts in the opposite direction the V.35 to U-interface data with a simple switch setting.

  4. Simulation training in neurosurgery: advances in education and practice

    Science.gov (United States)

    Konakondla, Sanjay; Fong, Reginald; Schirmer, Clemens M

    2017-01-01

    The current simulation technology used for neurosurgical training leaves much to be desired. Significant efforts are thoroughly exhausted in hopes of developing simulations that translate to give learners the “real-life” feel. Though a respectable goal, this may not be necessary as the application for simulation in neurosurgical training may be most useful in early learners. The ultimate uniformly agreeable endpoint of improved outcome and patient safety drives these investments. We explore the development, availability, educational taskforces, cost burdens and the simulation advancements in neurosurgical training. The technologies can be directed at achieving early resident milestones placed by the Accreditation Council for Graduate Medical Education. We discuss various aspects of neurosurgery disciplines with specific technologic advances of simulation software. An overview of the scholarly landscape of the recent publications in the realm of medical simulation and virtual reality pertaining to neurologic surgery is provided. We analyze concurrent concept overlap between PubMed headings and provide a graphical overview of the associations between these terms. PMID:28765716

  5. Simulation training in neurosurgery: advances in education and practice

    Directory of Open Access Journals (Sweden)

    Konakondla S

    2017-07-01

    Full Text Available Sanjay Konakondla, Reginald Fong, Clemens M Schirmer Department of Neurosurgery and Neuroscience Institute, Geisinger Medical Center, Geisinger Health System, Danville, PA, USA Abstract: The current simulation technology used for neurosurgical training leaves much to be desired. Significant efforts are thoroughly exhausted in hopes of developing simulations that translate to give learners the “real-life” feel. Though a respectable goal, this may not be necessary as the application for simulation in neurosurgical training may be most useful in early learners. The ultimate uniformly agreeable endpoint of improved outcome and patient safety drives these investments. We explore the development, availability, educational taskforces, cost burdens and the simulation advancements in neurosurgical training. The technologies can be directed at achieving early resident milestones placed by the Accreditation Council for Graduate Medical Education. We discuss various aspects of neurosurgery disciplines with specific technologic advances of simulation software. An overview of the scholarly landscape of the recent publications in the realm of medical simulation and virtual reality pertaining to neurologic surgery is provided. We analyze concurrent concept overlap between PubMed headings and provide a graphical overview of the associations between these terms. Keywords: residency education, simulation, neurosurgery training, virtual reality, haptic feedback, task analysis, ACGME 

  6. Practical experiences with granular activated carbon (GAC) at the ...

    African Journals Online (AJOL)

    Practical experiences with granular activated carbon (GAC) at the Rietvlei Water Treatment Plant. ... The porosity was found to be 0.69 for the 12 x 40 size carbon and 0.66 for the 8 x 30 size carbon. By using a ... The third part of the study measured the physical changes of the GAC found at different points in the GAC cycle.

  7. Practical Applications and Experiences in K-20 Blended Learning Environments

    Science.gov (United States)

    Kyei-Blankson, Lydia, Ed.; Ntuli, Esther, Ed.

    2014-01-01

    Learning environments continue to change considerably and is no longer confined to the face-to-face classroom setting. As learning options have evolved, educators must adopt a variety of pedagogical strategies and innovative technologies to enable learning. "Practical Applications and Experiences in K-20 Blended Learning Environments"…

  8. Simulation Experiments in Practice : Statistical Design and Regression Analysis

    NARCIS (Netherlands)

    Kleijnen, J.P.C.

    2007-01-01

    In practice, simulation analysts often change only one factor at a time, and use graphical analysis of the resulting Input/Output (I/O) data. Statistical theory proves that more information is obtained when applying Design Of Experiments (DOE) and linear regression analysis. Unfortunately, classic

  9. The role of practical wisdom in nurse manager practice: why experience matters.

    Science.gov (United States)

    Cathcart, Eloise Balasco; Greenspan, Miriam

    2013-10-01

    To illustrate through the interpretation of one representative nurse manager's narrative how the methodology of practice articulation gives language to the ways practical wisdom develops in leadership practice and facilitates learning. Patricia Benner's corpus of research has demonstrated that reflection on clinical narratives comes closer than other pedagogical methods to replicating and enhancing the experiential learning required for the development of practical wisdom. Using Benner's methodology of practice articulation, 91 nurse managers wrote and read to a peer group a narrative of their lived experience in the role. The groups interpreted the narratives to extract the skilled knowledge and ethics embedded in the practice of the nurse manager authors. One narrative was chosen for this paper because it is a particularly clear exemplar of how practical wisdom develops in nurse manager practice. Articulating and reflecting on experiential learning led to an understanding of how practical wisdom developed in one nurse manager's practice. Interpretation of the narrative of one nurse manager illustrated how reflection on a complex ethical dilemma was a source of character development for the individual and the peer group. Describing and interpreting how practical wisdom develops for individual nurse managers can be a source of learning for the narrative author and other role incumbents who need to make sound decisions and take prudent action in ethically challenging situations. © 2013 John Wiley & Sons Ltd.

  10. HIV testing and counseling: test providers' experiences of best practices.

    Science.gov (United States)

    Myers, Ted; Worthington, Catherine; Haubrich, Dennis J; Ryder, Karen; Calzavara, Liviana

    2003-08-01

    Although education is central to HIV testing and counseling, little is known about the educational processes within the testing experience. This study investigated test providers' understandings of testing and counseling best practices. Interviews with a purposive sample of 24 test providers were thematically analyzed. Analysis revealed five best practices specific to HIV education and public health--ensuring information and education for HIV risk reduction, individualization of risk assessment, ensuring test results are given in person, providing information and referrals, and facilitating partner notification--and six practices not specific to HIV counseling relationship building. The latter were building trust and rapport; maintaining professional boundaries; ensuring a comfortable, safe environment; ensuring confidentiality; imparting nonjudgmntal attitude; and self-determination. The identified best practices demonstrated remarkable consistency across respondent subgroups. Although counseling was seen as largely educational and with a preventive focus, it included individualized messages based on assessments of risk, knowledge, and social and cultural characteristics.

  11. Correlates of Teacher Practices Influencing Student Outcomes in Reading Instruction for Advanced Readers

    Science.gov (United States)

    Hunsaker, Scott L.; Nielsen, Aubree; Bartlett, Brianne

    2010-01-01

    In a professional development project, six teaching practices were posited as necessary for improving affective and cognitive outcomes for identified advanced readers. These practices were identification, organization for instruction, content, instructional strategies, continuous improvement assessment, and ambassadorship. Sixty-one teachers…

  12. Integrating Social Neuroscience and Social Work: Innovations for Advancing Practice-Based Research

    Science.gov (United States)

    Matto, Holly C.; Strolin-Goltzman, Jessica

    2010-01-01

    Throughout the social work profession, there is ongoing interest in building a social science agenda that can address the complex practice-based questions faced by social work professionals today. Methodological innovations and unique funding opportunities have already significantly advanced research on social work practice. Still, there is…

  13. The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

    Science.gov (United States)

    Schoonover, Heather

    The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.

  14. Sensors advancements in modeling, design issues, fabrication and practical applications

    CERN Document Server

    Mukhopadhyay, Subhash Chandra

    2008-01-01

    Sensors are the most important component in any system and engineers in any field need to understand the fundamentals of how these components work, how to select them properly and how to integrate them into an overall system. This book has outlined the fundamentals, analytical concepts, modelling and design issues, technical details and practical applications of different types of sensors, electromagnetic, capacitive, ultrasonic, vision, Terahertz, displacement, fibre-optic and so on. The book: addresses the identification, modeling, selection, operation and integration of a wide variety of se

  15. Paradigms for adaptive statistical information designs: practical experiences and strategies.

    Science.gov (United States)

    Wang, Sue-Jane; Hung, H M James; O'Neill, Robert

    2012-11-10

    design. We highlight the substantial risk of planning the sample size for confirmatory trials when information is very uninformative and stipulate the advantages of adaptive statistical information designs for planning exploratory trials. Practical experiences and strategies as lessons learned from more recent adaptive design proposals will be discussed to pinpoint the improved utilities of adaptive design clinical trials and their potential to increase the chance of a successful drug development. Published 2012. This article is a US Government work and is in the public domain in the USA.

  16. Measuring the impact of the advanced practitioner role: a practical approach.

    Science.gov (United States)

    Neville, Lillian; Swift, Juliette

    2012-04-01

    This paper aims to illuminate difficulties in evaluating the advanced practitioner role and to offer a practical solution. The advanced practice role has been part of the workforce strategy in the Northwest of England since 2005. However capturing hard evidence of the impact of this role has been problematic. Current restrictions on resources require the provision of evidence of the value of roles and services. Critical analysis of literature has identified challenges in evaluating the advanced practice role. The case study design takes account of current policy initiatives, notably QIPP. There is no common approach to evaluating the role of advanced practitioners. The case study has the potential to be a useful tool to organise evidence of the impact of advanced practitioner roles. Advanced practitioners need to have appropriate knowledge and skills to provide evidence of the impact of their role. There is potential for this work to be applied to other roles across the NHS. Managers need to work in partnership with workforce planners and educationalists to support advanced practitioners to utilise their skills in methods of providing evidence that they do work of value. Clear strategic direction for advanced practitioners is advised as part of the workforce strategy. © 2012 Blackwell Publishing Ltd.

  17. Using advanced mobile devices in nursing practice--the views of nurses and nursing students.

    Science.gov (United States)

    Johansson, Pauline; Petersson, Göran; Saveman, Britt-Inger; Nilsson, Gunilla

    2014-09-01

    Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research. © The Author(s) 2013.

  18. Advances and controversies in neonatal ICU platelet transfusion practice.

    Science.gov (United States)

    Christensen, Robert D

    2008-01-01

    Some of the platelet transfusions currently given to NICU patients are unnecessary and convey no benefits. Although ordered with good intentions, unnecessary platelet transfusions carry known and unknown risks. Identifying and eliminating any unnecessary platelet transfusions in NICUs would be a step toward better care, lower costs, and more careful preservation of blood component resources. A renewed interest in platelet transfusion studies is needed, if essential data is to be gathered to improve NICU platelet transfusion practice. Retrospective studies can be of value: for instance, seeking associations between bleeding events and platelet counts can suggest the possibility of cause and effect relationships. Such studies might identify approximate platelet count levels that convey high hemorrhagic risk and might help focus future prospective trials. Prospective indirect studies also can be of value, for instance, measuring the template bleeding time and the PFA-100 closure time as a function of platelet count and perhaps as a function of circulating platelet mass, and would provide new information with relevance to platelet transfusion benefits. Such studies might give a better awareness of how low the platelet count can fall before platelet plug formation is impaired. It seems inescapable, however, that new, multicentered, randomized, prospective studies are needed, where NICU patients are assigned different platelet transfusion triggers and then carefully tracked for bleeding events and long-term neurodevelopmental outcomes. Only that type of study is likely to generate the evidence base needed for widespread implementation of improvements in NICU platelet transfusion practice.

  19. Advancing the Practice of CRCs: Why Professional Development Matters.

    Science.gov (United States)

    Behar-Horenstein, Linda S; Prikhidko, Alena; Kolb, H Robert

    2018-01-01

    Clinical research coordinators (CRCs) assume critical responsibilities central to the success of the research team. The complexity of their role requires essential professional qualifications. One barrier to professionalization, however, has been the inconsistent, or absent, competency-based training. This study explored participants' perceptions of training experiences designed to prepare them for the national certification exam. Focus group methodology was used to document their experiences. The findings showed that sustainable mentoring relationships developed, participant confidence levels increased, and anxiety about performance capacity diminished. Cognitive reframing of the work environment and CRC roles was facilitated by training that fostered sharing and social reinforcement of professional and personal identities. Findings from this study suggest that access to meaningful training and quality instruction supports the professionalization of CRCs.

  20. Exploring nursing students’ experience of peer learning in clinical practice

    Science.gov (United States)

    Ravanipour, Maryam; Bahreini, Masoud; Ravanipour, Masoumeh

    2015-01-01

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

  1. Developing advanced clinical practice skills in gastrointestinal consequences of cancer treatment.

    Science.gov (United States)

    Gee, Caroline; Andreyev, Jervoise; Muls, Ann

    2018-03-08

    This article explores the transition from a clinical nurse specialist (CNS) towards developing advanced clinical practice skills within a gastrointestinal consequences of cancer clinic. It presents data on the first 50 patients assessed by the CNS from a prospective service evaluation, demonstrating how this informed the nurse's future learning. There is high demand for advanced clinical practice skills to address unmet health needs and improve the quality, efficiency, and sustainability of healthcare services. However, a literature review found no literature on developing advanced clinical practice skills in this setting. Emerging themes from the service evaluation focused on barriers and enablers, ongoing support, organisational commitment and working in a multidisciplinary team. Blended learning provided both structured and opportunistic learning, embedding both formal and tacit knowledge, as roles require increasing flexibility. Clinical supervision and reflective practice were key in maintaining professional and peer support.

  2. Building research capacity and productivity among advanced practice nurses: an evaluation of the Community of Practice model.

    Science.gov (United States)

    Gullick, Janice G; West, Sandra H

    2016-03-01

    The aim of this study was to evaluate Wenger's Community of Practice as a framework for building research capacity and productivity. While research productivity is an expected domain in influential models of advanced nursing practice, internationally it remains largely unmet. Establishment of nursing research capacity precedes productivity and consequently, there is a strong imperative to identify successful capacity-building models for nursing-focussed research in busy clinical environments. Prospective, longitudinal, qualitative descriptive design was used in this study. Bruyn's participant observation framed evaluation of a Community of Practice comprising 25 advanced practice nurses. Data from focus groups, education evaluations, blog/email transcripts and field observations, collected between 2007 and 2014, were analysed using a qualitative descriptive method. The Community of Practice model invited differing levels of participation, allowed for evolution of the research community and created a rhythm of research-related interactions and enduring research relationships. Participants described the value of research for their patients and families and the significance of the developing research culture in providing richness to their practice and visibility of their work to multidisciplinary colleagues. Extensive examples of research dissemination and enrolment in doctoral programmes further confirmed this value. A Community of Practice framework is a powerful model enabling research capacity and productivity evidenced by publication. In developing a solid foundation for a nursing research culture, it should be recognized that research skills, confidence and growth develop over an extended period of time and success depends on skilled coordination and leadership. © 2015 John Wiley & Sons Ltd.

  3. Advance market commitment for pneumococcal vaccines: putting theory into practice.

    Science.gov (United States)

    Cernuschi, Tania; Furrer, Eliane; Schwalbe, Nina; Jones, Andrew; Berndt, Ernst R; McAdams, Susan

    2011-12-01

    Markets for life-saving vaccines do not often generate the most desired outcomes from a public health perspective in terms of product quantity, quality, affordability, programmatic suitability and/or sustainability for use in the lowest income countries. The perceived risks and uncertainties about sustainably funded demand from developing countries often leads to underinvestment in development and manufacturing of appropriate products. The pilot initiative Advance Market Commitment (AMC) for pneumococcal vaccines, launched in 2009, aims to remove some of these market risks by providing a legally binding forward commitment to purchase vaccines according to predetermined terms. To date, 14 countries have already introduced pneumococcal vaccines through the AMC with a further 39 countries expected to introduce before the end of 2013.This paper describes early lessons learnt on the selection of a target disease and the core design choices for the pilot AMC. It highlights the challenges faced with tailoring the AMC design to the specific supply situation of pneumococcal vaccines. It points to the difficulty - and the AMC's apparent early success - in establishing a long-term, credible commitment in a constantly changing unpredictable environment. It highlights one of the inherent challenges of the AMC: its dependence on continuous donor funding to ensure long-term purchases of products. The paper examines alternative design choices and aims to provide a starting point to inform discussions and encourage debate about the potential application of the AMC concept to other fields.

  4. Advancing the Practice of Health Coaching: Differentiation From Wellness Coaching.

    Science.gov (United States)

    Huffman, Melinda H

    2016-09-01

    The increasing demand for health coaches and wellness coaches in worksite health promotion and the marketplace has resulted in a plethora of training programs with wide variations in coaching definitions, content, attributes, and eligibility of those who may train. It is in the interest of public awareness and safety that those in clinical practice take the lead in this discussion and offer a reasonable contrast and comparison focusing on the risks and responsibilities of health coaching in particular. With the endorsement of the American Association of Occupational Health Nurses (AAOHN), the National Society of Health Coaches, whose membership is primarily nurses, discusses the issue and states its position here. © 2016 The Author(s).

  5. Informatics for Health 2017: Advancing both science and practice

    Directory of Open Access Journals (Sweden)

    Philip J. Scott

    2017-04-01

    Full Text Available Introduction: The Informatics for Health congress, 24-26 April 2017, in Manchester, UK, brought together the Medical Informatics Europe (MIE conference and the Farr Institute International Conference. This special issue of the Journal of Innovation in Health Informatics contains 113 presentation abstracts and 149 poster abstracts from the congress. Discussion: The twin programmes of “Big Data” and “Digital Health” are not always joined up by coherent policy and investment priorities. Substantial global investment in health IT and data science has led to sound progress but highly variable outcomes. Society needs an approach that brings together the science and the practice of health informatics. The goal is multi-level Learning Health Systems that consume and intelligently act upon both patient data and organizational intervention outcomes. Conclusions: Informatics for Health demonstrated the art of the possible, seen in the breadth and depth of our contributions. We call upon policy makers, research funders and programme leaders to learn from this joined-up approach.

  6. Translating advances in reading comprehension research to educational practice

    Directory of Open Access Journals (Sweden)

    Danielle S. McNamara

    2011-07-01

    Full Text Available The authors review five major findings in reading comprehension and their implications for educational practice. First, research suggests that comprehension skills are separable from decoding processes and important at early ages, suggesting that comprehension skills should be targeted early, even before the child learns to read. Second, there is an important distinction between reading processes and products, as well as their causal relationship: processes lead to certain products. Hence, instructional approaches and strategies focusing on processes are needed to improve students’ reading performance (i.e., product. Third, inferences are a crucial component of skilled comprehension. Hence, children need scaffolding and remediation to learn to generate inferences, even when they know little about the text topic. Fourth, comprehension depends on a complex interaction between the reader, the characteristics of the text, and the instructional task, highlighting the need for careful selection of instructional materials for individual students and specific groups of students. Finally, educators may benefit from heightened awareness of the limitations and inadequacies of standardized reading comprehension assessments, as well as the multidimensionality of comprehension to better understand their students’ particular strengths and weaknesses.

  7. Translating advances in reading comprehension research to educational practice

    Directory of Open Access Journals (Sweden)

    Danielle S. McNAMARA

    2011-11-01

    Full Text Available The authors review five major findings in reading comprehension and their implications for educational practice. First, research suggests that comprehension skills are separable from decodingprocesses and important at early ages, suggesting that comprehension skills should be targeted early, even before the child learns to read. Second, there is an important distinction between readingprocesses and products, as well as their causal relationship: processes lead to certain products. Hence, instructional approaches and strategies focusing on processes are needed to improve students’reading performance (i.e., product. Third, inferences are a crucial component of skilled comprehension. Hence, children need scaffolding and remediation to learn to generate inferences, even when they know little about the text topic. Fourth, comprehension depends on a complex interaction between the reader, the characteristics of the text, and the instructional task, highlighting the need for careful selection of instructional materials for individual students and specific groups of students. Finally, educators may benefit from heightened awareness of the limitations and inadequacies of standardized reading comprehension assessments, as well as the multidimensionality of comprehension to better understand their students’ particular strengths and weaknesses.

  8. Gender integration in coeducational classrooms: Advancing educational research and practice.

    Science.gov (United States)

    Fabes, Richard A; Martin, Carol Lynn; Hanish, Laura D; DeLay, Dawn

    2018-06-01

    Despite the fact that most boys and girls are in classrooms together, there is considerable variation in the degree to which their classrooms reflect gender integration (GI). In some classrooms, boys' and girls' relationships with each other are generally positive and harmonious. However, in other classes, students tend to only work with classmates of the same gender (i.e., gender segregation, GS), and cross-gender interactions seldom occur or, when they do, they may not be positive. As such, the coeducational context of schools provides no assurance that boys and girls work effectively together to learn, solve academic problems, and support one another in their academic efforts. The purpose of this perspective paper is to call attention to the importance of studying and understanding the role of GI in contemporary U.S. coeducational classrooms. Some of the costs associated with the failure to consider GI also are identified, as are implications for future research and educational practice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  9. Advanced psychiatric nurse practitioners' ideas and needs for supervision in private practice in South Africa.

    Science.gov (United States)

    Temane, Annie M; Poggenpoel, Marie; Myburgh, Chris P H

    2014-04-07

    Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field. The aim of this study was to explore and describe advanced psychiatric nursepractitioners' ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa. A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch's method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature. The data analysis generated the following themes - that the supervisor should have or possess: (a) professional competencies, (b) personal competencies and (c) specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa. This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.

  10. Experiences from introduction of peer-to-peer teaching methods in Advanced Biochemistry E2010

    DEFF Research Database (Denmark)

    Brodersen, Ditlev; Etzerodt, Michael; Rasmussen, Jan Trige

    2012-01-01

    During the autumn semester 2010, we experimented with a range of active teaching methods on the course, Advanced Biochemistry, at the Department of Molecular Biology and Genetics.......During the autumn semester 2010, we experimented with a range of active teaching methods on the course, Advanced Biochemistry, at the Department of Molecular Biology and Genetics....

  11. Nurse Leaders? Experiences of Implementing Career Advancement Programs for Nurses in Iran

    OpenAIRE

    Sheikhi, Mohammad Reza; Khoshknab, Masoud Fallahi; Mohammadi, Farahnaz; Oskouie, Fatemeh

    2015-01-01

    Background and purpose: Career advancement programs are currently implemented in many countries. In Iran, the first career advancement program was Nurses? Career Advancement Pathway. The purpose of this study was to explore nurse leaders? experiences about implementing the Nurses? Career Advancement Pathway program in Iran. Methods: This exploratory qualitative study was conducted in 2013. Sixteen nurse managers were recruited from the teaching hospitals affiliated to Shahid Behesthi, Qazvin,...

  12. Technologies for adaptation. Perspectives and practical experiences; Climate change

    Energy Technology Data Exchange (ETDEWEB)

    Christiansen, Lars; Olhoff, A; Traerup, S

    2011-11-15

    The present report is the second volume of the UNEP Risoe Centre Technology Transfer Perspectives Series. The report is related to the global Technology Needs Assessment (TNA) project, financed by the Global Environment Facility (GEF) and implemented by UNEP Risoe Centre. The nine articles in this volume discuss issues like: a) the concepts and context of technologies for adaptation; b) assessments of adaptation technology needs; c) practical experiences from working with technologies for adaptation. (LN)

  13. Applying thematic analysis theory to practice: a researcher's experience.

    Science.gov (United States)

    Tuckett, Anthony G

    2005-01-01

    This article describes an experience of thematic analysis. In order to answer the question 'What does analysis look like in practice?' it describes in brief how the methodology of grounded theory, the epistemology of social constructionism, and the theoretical stance of symbolic interactionism inform analysis. Additionally, analysis is examined by evidencing the systematic processes--here termed organising, coding, writing, theorising, and reading--that led the researcher to develop a final thematic schema.

  14. Student Teachers' Experiences of Relation Building in Teaching Practice

    DEFF Research Database (Denmark)

    Nielsen, Anne Maj; Laursen, Per Fibæk

    The study explores how 22 student teachers in a Danish college of education experience and interpret their own becoming a teacher and the implied attitudes to pupils. The student teachers attending mainstream teacher education and a course in mindful awareness and relational competencies have...... – to a larger extend than the mainstream educated student teachers - learned a reflexive attitude to their state of being in teaching practice and to their relational interaction with children in class....

  15. Simulation Experiments in Practice: Statistical Design and Regression Analysis

    OpenAIRE

    Kleijnen, J.P.C.

    2007-01-01

    In practice, simulation analysts often change only one factor at a time, and use graphical analysis of the resulting Input/Output (I/O) data. The goal of this article is to change these traditional, naïve methods of design and analysis, because statistical theory proves that more information is obtained when applying Design Of Experiments (DOE) and linear regression analysis. Unfortunately, classic DOE and regression analysis assume a single simulation response that is normally and independen...

  16. Nursing Practice in Primary Care and Patients' Experience of Care.

    Science.gov (United States)

    Borgès Da Silva, Roxane; Brault, Isabelle; Pineault, Raynald; Chouinard, Maud-Christine; Prud'homme, Alexandre; D'Amour, Danielle

    2018-01-01

    Nurses are identified as a key provider in the management of patients in primary care. The objective of this study was to evaluate patients' experience of care in primary care as it pertained to the nursing role. The aim was to test the hypothesis that, in primary health care organizations (PHCOs) where patients are systematically followed by a nurse, and where nursing competencies are therefore optimally used, patients' experience of care is better. Based on a cross-sectional analysis combining organizational and experience of care surveys, we built 2 groups of PHCOs. The first group of PHCOs reported having a nurse who systematically followed patients. The second group had a nurse who performed a variety of activities but did not systematically follow patients. Five indicators of care were constructed based on patient questionnaires. Bivariate and multivariate linear mixed models with random intercepts and with patients nested within were used to analyze the experience of care indicators in both groups. Bivariate analyses revealed a better patient experience of care in PHCOs where a nurse systematically followed patients than in those where a nurse performed other activities. In multivariate analyses that included adjustment variables related to PHCOs and patients, the accessibility indicator was found to be higher. Results indicated that systematic follow-up of patients by nurses improved patients' experience of care in terms of accessibility. Using nurses' scope of practice to its full potential is a promising avenue for enhancing both patients' experience of care and health services efficiency.

  17. Technology advances in hospital practices: robotics in treatment of patients.

    Science.gov (United States)

    Rosiek, Anna; Leksowski, Krzysztof

    2015-06-01

    Laparoscopic cholecystectomy is widely considered as the treatment of choice for acute cholecystitis. The safety of the procedure and its minimal invasiveness made it a valid treatment option for a patient not responding to antibiotic therapy. Our research shows that patients positively assess this treatment method, but the world's tendency is to turn to a more sophisticated method utilizing robot-assisted surgery as a gold standard. Providing patient with minimally invasive surgical procedures that utilize the state-of-the-art equipment like the da Vinci Robotic Surgical System underscores the commitment to high-quality patient care while enhancing patient safety. The advantages include minimal invasive scarring, less pain and bleeding, faster recovery time, and shorter hospital stay. The move toward less invasive and less morbid procedures and a need to re-create the true open surgical experience have paved the way for the development and application of robotic and computer-assisted systems in surgery in Poland as well as the rest of the world. © The Author(s) 2014.

  18. Clinical experience with intraoperative radiotherapy for locally advanced colorectal cancer

    International Nuclear Information System (INIS)

    Shibamoto, Yuta; Takahashi, Masaharu; Abe, Mitsuyuki

    1988-01-01

    Intraoperative radiotherapy (IORT) was performed on 20 patients with colorectal cancer. IORT with a single dose of 20 to 40 Gy was delivered to the residual tumor, tumor bed, and/or lymphnode regions. Although most of the patients had advanced lesions, local control was achieved in 67 % of the patients when IORT was combined with tumor resection, and 4 patients survived more than 5 years. There were no serious complications, except for contracture or atrophy of the psoas muscle seen in 2 patients. IORT combined with external beam radiotherapy should be a useful adjuvant therapy to surgery for locally advanced colorectal cancer. (author)

  19. Advances in cyber security technology, operations, and experiences

    CERN Document Server

    Hsu, D Frank

    2013-01-01

    Advances in Cyber Security provides, in a technical yet easy to understand fashion, a real life story of the evolving cyberspace ecosystem from the perspectives of structure, function, and application. It also provides ways and means to secure and sustain this ecosystem by the collective wisdom of professionals and practitioners from government, academia, and industry across national and international boundaries.

  20. Oxidation Phenomena in Advanced High Strength Steels : Modelling and Experiment

    NARCIS (Netherlands)

    Mao, W.

    2018-01-01

    Galvanized advanced high strength steels (AHSS) will be the most competitive structural material for automotive applications in the next decade. Oxidation of AHSS during the recrystalization annealing process in a continuous galvanizing line to a large extent influences the quality of zinc coating

  1. Nurse Leaders' Experiences of Implementing Career Advancement Programs for Nurses in Iran.

    Science.gov (United States)

    Sheikhi, Mohammad Reza; Fallahi Khoshknab, Masoud; Mohammadi, Farahnaz; Oskouie, Fatemeh

    2015-02-24

    Career advancement programs are currently implemented in many countries. In Iran, the first career advancement program was Nurses' Career Advancement Pathway. The purpose of this study was to explore nurse leaders' experiences about implementing the Nurses' Career Advancement Pathway program in Iran. This exploratory qualitative study was conducted in 2013. Sixteen nurse managers were recruited from the teaching hospitals affiliated to Shahid Behesthi, Qazvin, and Iran Universities of Medical Sciences in Iran. Participants were recruited using purposive sampling method. Study data were collected through in-depth semi-structured interviews. The conventional content analysis approach was used for data analysis. participants' experiences about implementing the Nurses' Career Advancement Pathway fell into three main categories including: a) the shortcomings of performance evaluation, b) greater emphasis on point accumulation, c) the advancement-latitude mismatch. The Nurses' Career Advancement pathway has several shortcomings regarding both its content and its implementation. Therefore, it is recommended to revise the program.

  2. Simulated learning environment experience in nursing students for paediatric practice.

    Science.gov (United States)

    Mendoza-Maldonado, Yessy; Barría-Pailaquilén, René Mauricio

    The training of health professionals requires the acquisition of clinical skills in a safe and efficient manner, which is facilitated by a simulated learning environment (SLE). It is also an efficient alternative when there are limitations for clinical practice in certain areas. This paper shows the work undertaken in a Chilean university in implementing paediatric practice using SLE. Over eight days, the care experience of a hospitalized infant was studied applying the nursing process. The participation of a paediatrician, resident physician, nursing technician, and simulated user was included in addition to the use of a simulation mannequin and equipment. Simulation of care was integral and covered interaction with the child and family and was developed in groups of six students by a teacher. The different phases of the simulation methodology were developed from a pedagogical point of view. The possibility of implementing paediatric clinical practice in an efficient and safe way was confirmed. The experience in SLE was highly valued by the students, allowing them to develop different skills and abilities required for paediatric nursing through simulation. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  3. Lifelong learning and advancement in a company: Experience from Serbia

    Directory of Open Access Journals (Sweden)

    Mllutinović Olivera

    2014-01-01

    Full Text Available Lifelong learning concept is the concept that brings humanism in both everyday and business life of people. It promotes education, learning, cooperation and advancement in people's lives. During last two decades it became obvious that it is important to implement this concept, particularly in the field of economy in order to achieve better economic results. The aim of this paper is to find out if there is an actual implementation of lifelong learning concept in Serbia. Besides that it will also show if there are instances of advancement for employees in the companies that are implementing lifelong learning concept. The paper contains empirical research that was conducted in 15 companies in Serbia, primarily state-owned. This research gathered the opinion of 492 individuals, both female and male, with every type of education possible in Serbia. By analyzing the given results, the authors of this paper will give a proposal for future improved implementation of lifelong learning concept in Serbia.

  4. Doctors' experience with handheld computers in clinical practice: qualitative study.

    Science.gov (United States)

    McAlearney, Ann Scheck; Schweikhart, Sharon B; Medow, Mitchell A

    2004-05-15

    To examine doctors' perspectives about their experiences with handheld computers in clinical practice. Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns. Six practice settings across the United States and two additional focus group sessions held at a national meeting of general internists. 54 doctors who did or did not use handheld computers. Doctors who used handheld computers in clinical practice seemed generally satisfied with them and reported diverse patterns of use. Users perceived that the devices helped them increase productivity and improve patient care. Barriers to use concerned the device itself and personal and perceptual constraints, with perceptual factors such as comfort with technology, preference for paper, and the impression that the devices are not easy to use somewhat difficult to overcome. Participants suggested that organisations can help promote handheld computers by providing advice on purchase, usage, training, and user support. Participants expressed concern about reliability and security of the device but were particularly concerned about dependency on the device and over-reliance as a substitute for clinical thinking. Doctors expect handheld computers to become more useful, and most seem interested in leveraging (getting the most value from) their use. Key opportunities with handheld computers included their use as a stepping stone to build doctors' comfort with other information technology and ehealth initiatives and providing point of care support that helps improve patient care.

  5. The emergence of forensic nursing and advanced nursing practice in Switzerland: an innovative case study consultation.

    Science.gov (United States)

    Romain-Glassey, Nathalie; Ninane, Françoise; de Puy, Jacqueline; Abt, Maryline; Mangin, Patrice; Morin, Diane

    2014-01-01

    The objectives of this article were to systematically describe and examine the novel roles and responsibilities assumed by nurses in a forensic consultation for victims of violence at a University Hospital in French-speaking Switzerland. Utilizing a case study methodology, information was collected from two main sources: (a) discussion groups with nurses and forensic pathologists and (b) a review of procedures and protocols. Following a critical content analysis, the roles and responsibilities of the forensic nurses were described and compared with the seven core competencies of advanced nursing practice as outlined by Hamric, Spross, and Hanson (2009). Advanced nursing practice competencies noted in the analysis included "direct clinical practice," "coaching and guidance," and "collaboration." The role of the nurse in terms of "consultation," "leadership," "ethics," and "research" was less evident in the analysis. New forms of nursing are indeed practiced in the forensic clinical setting, and our findings suggest that nursing practice in this domain is following the footprints of an advanced nursing practice model. Further reflections are required to determine whether the role of the forensic nurse in Switzerland should be developed as a clinical nurse specialist or that of a nurse practitioner.

  6. Mountain Plains Learning Experience Guide: Marketing. Course: Advanced Salesmanship.

    Science.gov (United States)

    Preston, T.; Egan, B.

    One of thirteen individualized courses included in a marketing curriculum, this course covers wholesale and retail selling techniques, sales performance analysis, and intensive sales presentation practice. The course is comprised of four units: (1) Sales Preparation, (2) The Selling Process, (3) Special Selling Techniques, and (4) Sales…

  7. Development of Inflation Probe Technologies for the Advanced ACT Experiment

    Data.gov (United States)

    National Aeronautics and Space Administration — The Inflationary Model of the universe has provided a theoretical platform for modern observational experiments in the field of cosmology. A well-defined method of...

  8. Practical methods of target preparation for use in nuclear experiments

    International Nuclear Information System (INIS)

    Sugai, Isao.

    1976-01-01

    This is the fifth report on the practical methods of target preparation for use in nuclear experiments following the previous one (INS-J-152, 1975). Electro-deposition is a very powerful technique well suited to the preparation of self-supporting targets of Ni, Cr, Zn, Rh, Cd, Sb and Pb metals over a wide range of thickness from 1 to 20 mg/cm 2 . The uniformities of the thicknesses of Cr, Zn, Rh, Cd and Pb targets were measured with α- and β-ray thickness gauges. The impurities in Cr target were checked by the measurement of elastically scattered protons, and by a optical spectrometer. (auth.)

  9. Practice parameters facilitating adoption of advanced technologies for enhancing neuropsychological assessment paradigms.

    Science.gov (United States)

    Parsons, Thomas D; McMahan, Timothy; Kane, Robert

    2018-01-01

    Clinical neuropsychologists have long underutilized computer technologies for neuropsychological assessment. Given the rapid advances in technology (e.g. virtual reality; tablets; iPhones) and the increased accessibility in the past decade, there is an on-going need to identify optimal specifications for advanced technologies while minimizing potential sources of error. Herein, we discuss concerns raised by a joint American Academy of Clinical Neuropsychology/National Academy of Neuropsychology position paper. Moreover, we proffer parameters for the development and use of advanced technologies in neuropsychological assessments. We aim to first describe software and hardware configurations that can impact a computerized neuropsychological assessment. This is followed by a description of best practices for developers and practicing neuropsychologists to minimize error in neuropsychological assessments using advanced technologies. We also discuss the relevance of weighing potential computer error in light of possible errors associated with traditional testing. Throughout there is an emphasis on the need for developers to provide bench test results for their software's performance on various devices and minimum specifications (documented in manuals) for the hardware (e.g. computer, monitor, input devices) in the neuropsychologist's practice. Advances in computerized assessment platforms offer both opportunities and challenges. The challenges can appear daunting but are a manageable and require informed consumers who can appreciate the issues and ask pertinent questions in evaluating their options.

  10. Specific problems and practical experience of regulatory inspection during commissioning in the United Kingdom

    International Nuclear Information System (INIS)

    Lewis, G.

    1977-01-01

    The commissioning of nine Magnox and two Advanced Gas-cooled Reactor Nuclear Power Plants in the United Kingdom during the last sixteen years under the regulatory control of the Nuclear Installations Inspectorate of the Health and Safety Executive has been based on a Stage Approval Philosophy starting with proof-testing of the primary gas circuit and concluding with tests on the reactor at full power. The practical experience gained during this period has enabled the Nuclear Installations Inspectorate to rationalise the procedures and test requirements without comporomising safety standards. The Operating Rules and Maintenance Schedules are approved for commissioning and during this period are reviewed for their adequacy for future power operation of the plant. The organisation, documentation, test procedures and the commissioning programme used for the Advanced Gas-cooled Reactors are briefly explained. (author)

  11. Advancing innovation in health care leadership: a collaborative experience.

    Science.gov (United States)

    Garcia, Victor H; Meek, Kevin L; Wilson, Kimburli A

    2011-01-01

    The changing framework of today's health care system requires leaders to be increasingly innovative in how they approach their daily functions and responsibilities. Sustaining and advancing a level of innovation that already exists can be challenging for health care administrators with the demands of time and resource limitations. Using collaboration to bring new-age teaching and disciplines to front-line leadership, one hospital was able to reinvigorate a culture of innovation through multiple levels and disciplines of the organization. The Innovation Certification Course provided nursing leaders and other managers' an evidence-drive approach, new principles and useful strategies of innovative leadership and graduate program education.

  12. Advancing general practice nursing in Australia: roles and responsibilities of primary healthcare organisations.

    Science.gov (United States)

    Lane, Riki; Halcomb, Elizabeth; McKenna, Lisa; Zwar, Nicholas; Naccarella, Lucio; Davies, Gawaine Powell; Russell, Grant

    2017-05-01

    Objectives Given increased numbers and enhanced responsibilities of Australian general practice nurses, we aimed to delineate appropriate roles for primary health care organisations (PHCOs) to support this workforce. Methods A two-round online Delphi consensus process was undertaken between January and June 2012, informed by literature review and key informant interviews. Participants were purposively selected and included decision makers from government and professional organisations, educators, researchers and clinicians from five Australian states and territories Results Of 56 invited respondents, 35 (62%) and 31 (55%) responded to the first and second invitation respectively. Participants reached consensus on five key roles for PHCOs in optimising nursing in general practice: (1) matching workforce size and skills to population needs; (2) facilitating leadership opportunities; (3) providing education and educational access; (4) facilitating integration of general practice with other primary care services to support interdisciplinary care; and (5) promoting advanced nursing roles. National concerns, such as limited opportunities for postgraduate education and career progression, were deemed best addressed by national nursing organisations, universities and peak bodies. Conclusions Advancement of nursing in general practice requires system-level support from a range of organisations. PHCOs play a significant role in education and leadership development for nurses and linking national nursing organisations with general practices. What is known about the topic? The role of nurses in Australian general practice has grown in the last decade, yet they face limited career pathways and opportunities for career advancement. Some nations have forged interprofessional primary care teams that use nurses' skills to the full extent of their scope of practice. PHCOs have played important roles in the development of general practice nursing in Australia and internationally

  13. Advanced I and C systems for nuclear power plants feedback of experience

    International Nuclear Information System (INIS)

    Prehler Heinz Josef

    2001-01-01

    Advanced I and C systems for nuclear power plants have to meet increasing demands for safety and availability. Additionally specific requirements arising from nuclear qualification have to be fulfilled. To meet both subjects adequately in the future, Siemens has developed advanced I and C technology consisting of the two complementary I and C systems TELEPERM XP and TELEPERM XS. TELEPERM XP is primarily oriented to automation of the non safety related part of the power plant process. Such applications involve extensive open and closed loop control systems and encompass all tasks required for process control via the man-machine interface. Therefore the TELEPERM XP system consists of the AS 620 automation system, the OM 690 process control and management system, the ES 680 engineering system, the DS 670 diagnostic system and the SIMATIC NET bus system. Three versions of automation systems are available: for standard automation, for fail safe automation of safety related tasks and for turbine automation. TELEPERM XS is designed to meet all the requirements on I and C important to safety in nuclear power plants. Typical applications include reactor protection (RPS) and Engineered Safety Features Actuation System functions (ESFAS). TELEPERM XS has been rapidly accepted by the market and has accumulated an extensive operational experience. The expected advantages, namely, reduced space requirements, consistent documentation, improved ergonomics, reduced testing effort, less repair have been confirmed by the operation. The new possibilities to apply intelligent diagnostic methods have been only applied in few cases. Very good service records from a broad field of safety application prove that it is right to use digital I and C systems for safety tasks. The expected advantages such as reduced space requirements, less repairs and less effort for periodic tests, have been confirmed by practical experience. For the future, use of digital I and C systems for safety

  14. Advanced practice physiotherapy-led triage in Irish orthopaedic and rheumatology services: national data audit.

    LENUS (Irish Health Repository)

    Fennelly, Orna

    2018-06-01

    Many people with musculoskeletal (MSK) disorders wait several months or years for Consultant Doctor appointments, despite often not requiring medical or surgical interventions. To allow earlier patient access to orthopaedic and rheumatology services in Ireland, Advanced Practice Physiotherapists (APPs) were introduced at 16 major acute hospitals. This study performed the first national evaluation of APP triage services.

  15. An Experimental Study of Advanced Receivers in a Practical Dense Small Cells Network

    DEFF Research Database (Denmark)

    Assefa, Dereje; Berardinelli, Gilberto; Tavares, Fernando Menezes Leitão

    2016-01-01

    leads to significant limitations on the network throughput in such deployments. In addition, network densification introduces difficulty in network deployment. This paper presents a study on the benefits of advanced receiver in a practical uncoordinated dense small cells deployment. Our aim is to show...

  16. Delta's Key to the TOEFL iBT[R]: Advanced Skill Practice. Revised Edition

    Science.gov (United States)

    Gallagher, Nancy

    2012-01-01

    Delta's Key to the TOEFL iBT: Advanced Skill Practice is a revised and updated edition of Delta's Key to the Next Generation TOEFL Test. Since the introduction of the TOEFL iBT in 2005, there have been significant changes to some of the test questions, particularly the integrated writing and integrated speaking tasks. The new 2011 edition of…

  17. Advance care planning with individuals experiencing homelessness: Literature review and recommendations for public health practice.

    Science.gov (United States)

    Hubbell, Sarah A

    2017-09-01

    Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet health care needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to communicate end-of-life preferences. This paper includes a narrative literature review of advance care planning interventions and qualitative investigations into end-of-life concerns among people experiencing homelessness. Trials of clinician-guided interventions with homeless individuals demonstrated effectiveness in achieving advance directive completion and surrogate decision-maker designation. End-of-life concerns among homeless persons included fears of dying alone, dying unnoticed, or remaining unidentified after death. Research participants also reported concerns regarding burial and notification of family members. Public health practitioners should facilitate advance care planning for people who are homeless by providing opportunities for education and discussion on care options and advance directives. © 2017 Wiley Periodicals, Inc.

  18. Does advanced practice in radiography benefit the healthcare system? A literature review.

    Science.gov (United States)

    Thom, S E

    2018-02-01

    With ever-increasing demands on the National Health Service (NHS), members of staff are blurring their professional boundaries in the attempt to benefit the healthcare system. This review aims to establish whether advancing practice within radiography does benefit the healthcare system by examining published literature. Key words were input into databases such as: CINAHL, Science Direct and PubMed. Various filters were applied to narrow down the articles. Key themes were identified within the literature: cost, job satisfaction, patient benefits, restrictions and workload. Having advanced practitioners undertake some of the radiologists' workload was potentially cost effective whilst continuing/increasing the standard of quality. Patients benefitted from the quality of their examinations, the high accuracy of their reports and the speed those reports were attained. Evidence within the literature emphasises that advanced practice does benefit the healthcare system by means of: cost reduction, job satisfaction, patient benefits and workload. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  19. Advancing Small Satellite Electronics Heritage for Microfluidic Biological Experiments

    Science.gov (United States)

    White, Bruce; Mazmanian, Edward; Tapio, Eric

    2016-01-01

    DLR's Eu:CROPIS (Euglena and Combined Regenerative Organic-Food Production in Space) mission, launching in 2017, will carry multiple biological payloads into a sun-synchronous orbit, including NASA Ames' PowerCell experiment. PowerCell will attempt to characterize the viability of synthetic biology at micro-g, Lunar, and Martian gravity levels. PowerCell experiment requirements demand an electronic system similar to previous microfluidic biology payloads, but with an expanded feature set. As such, the system was based on PharmaSat (Diaz-Aguado et al. 2009), a previous successful biology payload from NASA Ames, and improved upon. Newer, more miniaturized electronics allow for greater capability with a lower part count and smaller size. Two identical PowerCell enclosures will fly. Each enclosure contains two separate and identical experiments with a 48-segment optical density measurement system, grow light system, microfluidic system for nutrient delivery and waste flushing, plus thermal control and environmental sensing/housekeeping including temperature, pressure, humidity, and acceleration. Electronics consist of a single Master PCB that interfaces to the spacecraft bus and regulates power and communication, plus LED, Detector, and Valve Manifold PCBs for each experiment. To facilitate ease of reuse on future missions, experiment electronics were designed to be compatible with a standard 3U small sat form factor and power bus, or to interface with a Master power/comm PCB for use in a larger satellite as in the case of PowerCell's flight on Eu:CROPIS.

  20. Thermal-hydraulic Experiments for Advanced Physical Model Development

    International Nuclear Information System (INIS)

    Song, Chulhwa

    2012-04-01

    The improvement of prediction models is needed to enhance the safety analysis capability through experimental database of local phenomena. To improve the two-phase interfacial area transport model, the various experiments were carried out with local two-phase interfacial structure test facilities. 2 Χ 2 and 6 Χ 6 rod bundle test facilities were used for the experiment on the droplet behavior. The experiments on the droplet behavior inside a heated rod bundle geometry. The experiments used GIRLS and JICO and CFD analysis were carried out to comprehend the local condensation of steam jet, turbulent jet induced by condensation and the thermal mixing in a pool. In order to develop a model for key phenomena of newly adapted safety system, experiments for boiling inside a pool and condensation in horizontal channel have been performed. An experimental database of the CHF (Critical Heat Flux) and PDO (Post-dryout) was constructed. The mechanism of the heat transfer enhancement by surface modifications in nano-fluid was investigated in boiling mode and rapid quenching mode. The special measurement techniques were developed. They are Double-sensor optical void probe, Optic Rod, PIV technique and UBIM system

  1. Comparison of Quality Oncology Practice Initiative (QOPI) Measure Adherence Between Oncology Fellows, Advanced Practice Providers, and Attending Physicians.

    Science.gov (United States)

    Zhu, Jason; Zhang, Tian; Shah, Radhika; Kamal, Arif H; Kelley, Michael J

    2015-12-01

    Quality improvement measures are uniformly applied to all oncology providers, regardless of their roles. Little is known about differences in adherence to these measures between oncology fellows, advance practice providers (APP), and attending physicians. We investigated conformance across Quality Oncology Practice Initiative (QOPI) measures for oncology fellows, advance practice providers, and attending physicians at the Durham Veterans Affairs Medical Center (DVAMC). Using data collected from the Spring 2012 and 2013 QOPI cycles, we abstracted charts of patients and separated them based on their primary provider. Descriptive statistics and the chi-square test were calculated for each QOPI measure between fellows, advanced practice providers (APPs), and attending physicians. A total of 169 patients were reviewed. Of these, 31 patients had a fellow, 39 had an APP, and 99 had an attending as their primary oncology provider. Fellows and attending physicians performed similarly on 90 of 94 QOPI metrics. High-performing metrics included several core QOPI measures including documenting consent for chemotherapy, recommending adjuvant chemotherapy when appropriate, and prescribing serotonin antagonists when prescribing emetogenic chemotherapies. Low-performing metrics included documentation of treatment summary and taking action to address problems with emotional well-being by the second office visit. Attendings documented the plan for oral chemotherapy more often (92 vs. 63%, P=0.049). However, after the chart audit, we found that fellows actually documented the plan for oral chemotherapy 88% of the time (p=0.73). APPs and attendings performed similarly on 88 of 90 QOPI measures. The quality of oncology care tends to be similar between attendings and fellows overall; some of the significant differences do not remain significant after a second manual chart review, highlighting that the use of manual data collection for QOPI analysis is an imperfect system, and there may

  2. Advanced clinical practice for radiographers in Great Britain: professional roles, accountability and the educational provision

    International Nuclear Information System (INIS)

    Hogg, P.

    2004-01-01

    A change in British health care has resulted in a broadening of roles and responsibilities beyond 'traditional boundaries' for a range of health care professionals. This has occurred because of staff shortages (particularly within the medical profession) and the recognition that many 'non-doctor' health care staff can make safe, competent and effective contributions outside their 'normal' sphere of responsibilities. In the context of advanced clinical practice, this paper will explain the current arrangements for radiographers' roles and responsibilities, their accountability and the educational provision that underpins the development of competencies at these higher clinical levels. Some advanced roles that British radiographers perform, within their current normal responsibilities, will be identified and some British legislation and professional body guidance that make role advancement possible will be outlined. The article will conclude with an indication of the educational level at which the advanced competencies are learned and assessed. (author)

  3. Thermal-hydraulic Experiments for Advanced Physical Model Development

    International Nuclear Information System (INIS)

    Song, Chul Hwa; Baek, W. P.; Yoon, B. J.

    2010-04-01

    The improvement of prediction models is needed to enhance the safety analysis capability through the fine measurements of local phenomena. To improve the two-phase interfacial area transport model, the various experiments were carried out used SUBO and DOBO. 2x2 and 6x6 rod bundle test facilities were used for the experiment on the droplet behavior. The experiments on the droplet behavior inside a heated rod bundle were focused on the break-up of droplets induced by a spacer grid in a rod bundle geometry. The experiments used GIRLS and JICO and CFD analysis were carried out to comprehend the local condensation of steam jet, turbulent jet induced by condensation and the thermal mixing in a pool. An experimental database of the CHF (Critical Heat Flux) and PDO (Post-dryout) had been constructed. The mechanism of the heat transfer enhancement by surface modifications in nano-fluid was investigated in boiling mode and rapid quenching mode. The special measurement techniques were developed. They are Double -sensor optical void probe, Optic Rod, PIV technique and UBIM system

  4. Equipping simulators with an advanced thermal hydraulics model EDF's experience

    International Nuclear Information System (INIS)

    Soldermann, R.; Poizat, F.; Sekri, A.; Faydide, B.; Dumas, J.M.

    1997-01-01

    The development of an accelerated version of the advanced CATHARe-1 thermal hydraulics code designed for EDF training simulators (CATHARE-SIMU) was successfully completed as early as 1991. Its successful integration as the principal model of the SIPA Post-Accident Simulator meant that its use could be extended to full-scale simulators as part of the renovation of the stock of existing simulators. In order to further extend the field of application to accidents occurring in shutdown states requiring action and to catch up with developments in respect of the CATHARE code, EDF initiated the SCAR Project designed to adapt CATHARE-2 to simulator requirements (acceleration, parallelization of the computation and extension of the simulation range). In other respects, the installation of SIPA on workstations means that the authors can envisage the application of this remarkable training facility to the understanding of thermal hydraulics accident phenomena

  5. Experience with advanced driver fuels in EBR-II

    International Nuclear Information System (INIS)

    Lahm, C.E.; Koenig, J.F.; Pahl, R.G.; Porter, D.L.; Crawford, D.C.

    1992-01-01

    This paper discusses several metallic fuel element designs which have been tested and used as driver fuel in Experimental Breeder Reactor II (EBR-II). The most recent advanced designs have all performed acceptably in EBR-H and can provide reliable performance to high burnups. Fuel elements tested have included use of U-l0Zr metallic fuel with either D9, 316 or HT9 stainless steel cladding; the D9 and 316-clad designs have been used as standard driver fuel. Experimental data indicate that fuel performance characteristics are very similar for the various designs tested. Cladding materials can be selected that optimize performance based on reactor design and operational goals

  6. Interim Service ISDN Satellite (ISIS) network model for advanced satellite designs and experiments

    Science.gov (United States)

    Pepin, Gerard R.; Hager, E. Paul

    1991-01-01

    The Interim Service Integrated Services Digital Network (ISDN) Satellite (ISIS) Network Model for Advanced Satellite Designs and Experiments describes a model suitable for discrete event simulations. A top-down model design uses the Advanced Communications Technology Satellite (ACTS) as its basis. The ISDN modeling abstractions are added to permit the determination and performance for the NASA Satellite Communications Research (SCAR) Program.

  7. Laser Light Scattering, from an Advanced Technology Development Program to Experiments in a Reduced Gravity Environment

    Science.gov (United States)

    Meyer, William V.; Tscharnuter, Walther W.; Macgregor, Andrew D.; Dautet, Henri; Deschamps, Pierre; Boucher, Francois; Zuh, Jixiang; Tin, Padetha; Rogers, Richard B.; Ansari, Rafat R.

    1994-01-01

    Recent advancements in laser light scattering hardware are described. These include intelligent single card correlators; active quench/active reset avalanche photodiodes; laser diodes; and fiber optics which were used by or developed for a NASA advanced technology development program. A space shuttle experiment which will employ aspects of these hardware developments is previewed.

  8. Power and promise of narrative for advancing physical therapist education and practice.

    Science.gov (United States)

    Greenfield, Bruce H; Jensen, Gail M; Delany, Clare M; Mostrom, Elizabeth; Knab, Mary; Jampel, Ann

    2015-06-01

    This perspective article provides a justification for and an overview of the use of narrative as a pedagogical tool for educators to help physical therapist students, residents, and clinicians develop skills of reflection and reflexivity in clinical practice. The use of narratives is a pedagogical approach that provides a reflective and interpretive framework for analyzing and making sense of texts, stories, and other experiences within learning environments. This article describes reflection as a well-established method to support critical analysis of clinical experiences; to assist in uncovering different perspectives of patients, families, and health care professionals involved in patient care; and to broaden the epistemological basis (ie, sources of knowledge) for clinical practice. The article begins by examining how phronetic (ie, practical and contextual) knowledge and ethical knowledge are used in physical therapy to contribute to evidence-based practice. Narrative is explored as a source of phronetic and ethical knowledge that is complementary but irreducible to traditional objective and empirical knowledge-the type of clinical knowledge that forms the basis of scientific training. The central premise is that writing narratives is a cognitive skill that should be learned and practiced to develop critical reflection for expert practice. The article weaves theory with practical application and strategies to foster narrative in education and practice. The final section of the article describes the authors' experiences with examples of integrating the tools of narrative into an educational program, into physical therapist residency programs, and into a clinical practice. © 2015 American Physical Therapy Association.

  9. Midwives' perceptions and experiences of health promotion practice in Ghana.

    Science.gov (United States)

    Owusu-Addo, Ebenezer

    2015-09-01

    This research explores midwives' perceptions and experiences of health promotion practice in Ghana. A qualitative descriptive exploratory design was used in order to gain better insight into midwives' perceptions and experiences of health promotion practice. A total of 21 midwives took part in the study. Data were collected by individual in-depth semi-structured interviews. Thematic analysis was used to analyse the transcript. Five dominant themes emerged from the interview transcripts, namely: health promotion as education, health promotion activities, the value of health promotion, client participation, and midwives' barriers to promoting health. Although midwives underscored the importance of health promotion to their work, their reports indicated that, in practice, midwives mostly delivered health education and behaviour change communication rather than health promotion. The midwives expressed the view that by way of their close association with women, they were in a better position to influence women's health. Health promotion activities engaged by the midwives included weight management, healthy eating, infection prevention, personal hygiene, counselling on family planning, and screening for hazardous and harmful substance use such as alcohol and smoking. All the midwives mentioned that clients participated in their health promotion activities. Factors that were identified by the midwives to enhance client participation were trust, attitude of the midwife, building rapport, creating enabling environment, listening and paying attention to clients and using simple language. The barriers to health promotion identified by the midwives included time, stress, culture, lack of training and inadequate health educational materials. Midwives in this study had limited knowledge about health promotion, yet could play a significant role in influencing health; thus there is a need for on-going in-service training for midwives to focus on health promotion. © The Author

  10. Family practice residents' maternity leave experiences and benefits.

    Science.gov (United States)

    Gjerdingen, D K; Chaloner, K M; Vanderscoff, J A

    1995-09-01

    A growing number of residents are having babies during residency training. While many businesses are working to improve maternity conditions and benefits for their employees, residency programs are often not prepared to accommodate pregnant residents. This study was conducted to examine the maternity leave experiences of women who delivered infants during their family practice residency training. Program directors from each of the 394 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs were asked to distribute surveys to female residents who gave birth during their residency training and had returned to work by the time of the study. Of 199 known eligible residents, 171 (86%) completed surveys; these women represented 127 programs located in 36 states and Puerto Rico. Only 56.8% of women were aware of their program having a written maternity leave policy. The average length of maternity leave was 8 weeks; 76% had leaves of 10 weeks or less. For many, the maternity leave was derived from more than one source, including vacation, sick time, or a mother-child elective. Nearly all (88.3%) the women breast-fed, and the mean duration of breast-feeding was more than 19 weeks. In general, participants believed that having a baby during residency was somewhat difficult. Problems frequently encountered by women after their return to work included sleep deprivation and tiredness, difficulty arranging for child care, guilt about child care, and breast-feeding. Factors that detracted most from the childbirth experience were too little sleep, problems arranging for child care, and lack of support from the partner, residency faculty, and other residents. Having a baby during residency is somewhat difficult for the average female resident. Factors that may ease this difficulty include getting adequate sleep and receiving support from one's partner, faculty, and other residents.

  11. Cervical cancer screening in adolescents: an evidence-based internet education program for practice improvement among advanced practice nurses.

    Science.gov (United States)

    Choma, Kim; McKeever, Amy E

    2015-02-01

    The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.

  12. Healthcare Provider Views on Transitioning From Task Shifting to Advanced Practice Nursing in Tanzania.

    Science.gov (United States)

    Mboineki, Joanes Faustine; Zhang, Weihong

    The Tanzanian health sector suffers from shortages of healthcare workers as well as uneven distribution of healthcare workers in urban and rural areas. Task shifting-delegation of tasks from professionals to other healthcare team members with less training, such as medical attendants-is practiced, compromising quality of care. Advanced practice nursing is underutilized. The purpose of this study was to explore the views of nurses and physicians on current responses to shortages of healthcare workers and the potential for utilization of advanced practice nurses. A descriptive, qualitative design was used. Purposeful sampling was used to select 20 participants. An in-depth interview guide was used to obtain information. Interviews were conducted in Swahili or English. Content analysis was used to identify themes. Shortage of human resources in rural primary healthcare facilities was identified as a major rationale for implementation of the advanced practice nurse practitioner role because the current health providers in rural health facilities are less trained and doctors are not ready to work in these settings. Opposition from physicians is expected during the course of implementing the nurse practitioner role. Professional bodies and government should reach consensus before the implementation of this role in such a way that they should agree on scope and standards of practice of nurse practitioners in Tanzania. Shortage of human resources for health is greater in rural primary healthcare facilities. Task shifting in Tanzania is neither effective nor legally recognized. Transition to advanced practice nursing roles-particularly the nurse practitioner role-can facilitate provision of optimal care. Nurse practitioners should be prepared to work in rural primary healthcare facilities.

  13. Developing clinical leaders: the impact of an action learning mentoring programme for advanced practice nurses.

    Science.gov (United States)

    Leggat, Sandra G; Balding, Cathy; Schiftan, Dan

    2015-06-01

    To determine whether a formal mentoring programme assists nurse practitioner candidates to develop competence in the clinical leadership competencies required in their advanced practice roles. Nurse practitioner candidates are required to show evidence of defined clinical leadership competencies when they apply for endorsement within the Australian health care system. Aiming to assist the candidates with the development or enhancement of these leadership skills, 18 nurse practitioner candidates participated in a mentoring programme that matched them with senior nurse mentors. A pre-postlongitudinal intervention study. Eighteen nurse practitioner candidates and 17 senior nurses participated in a voluntary mentoring programme that incorporated coaching and action learning over 18 months in 2012 and 2013. Participants completed a pen and paper questionnaire to document baseline measures of self-reported leadership practices prior to commencement of the programme and again at the end of the programme. The mentors and the nurse practitioner candidates qualitatively evaluated the programme as successful and quantitative data illustrated significant improvement in self-reported leadership practices among the nurse practitioner candidates. In particular, the nurse practitioner candidates reported greater competence in the transformational aspects of leadership, which is directly related to the nurse practitioner candidate clinical leadership standard. A formal, structured mentoring programme based on principles of action learning was successful in assisting Australian advanced practice nurses enhance their clinical leadership skills in preparation for formal endorsement as a nurse practitioner and for success in their advanced practice role. Mentoring can assist nurses to transition to new roles and develop knowledge and skills in clinical leadership essential for advanced practice roles. Nurse managers should make greater use of mentoring programmes to support nurses in

  14. Determination of the Performance Parameters of a Spectrophotometer: An Advanced Experiment.

    Science.gov (United States)

    Cope, Virgil W.

    1978-01-01

    Describes an advanced analytical chemistry laboratory experiment developed for the determination of the performance parameters of a spectrophotometer. Among the parameters are the baseline linearity with wavelength, wavelength accuracy and respectability, stray light, noise level and pen response time. (HM)

  15. Perceptions of the benefits and challenges of the role of advanced practice nurses in nurse-led out-of-hours care in Hong Kong: a questionnaire study.

    Science.gov (United States)

    Christiansen, Angela; Vernon, Veronica; Jinks, Annette

    2013-04-01

    The aim of the study was to identify the factors that nurses perceive may facilitate or hinder the development of advanced practice nurse roles in Hong Kong. Advanced practice nurses are increasingly prominent in nurse-led out-of-hours care in Hong Kong in response to changes to junior doctors' hours of work. Three five-day workshops for Hong Kong-based advanced practice nurses were offered in partnership with UK clinicians. The aim of the workshops was to share UK experiences of implementation of the 'Hospital at Night' model of care delivery. The questionnaire study undertaken was not part of the workshop programme. However, the workshops gave the authors a unique opportunity to access relatively large numbers of Hong Kong-based advanced practice nurses. The workshops were attended by experienced nurses who had been or were about to be appointed as advanced practice nurses. All nurses who attended one of the three workshops (n=120) agreed to participate in the study. Responses to two open questions posed in the questionnaire were the subject of a content analysis. A prominent finding of the study was that respondents viewed the benefits of introducing advanced practice nurse roles in Hong Kong as outweighing any challenges. One of the main features of the perceived benefits relates to improving the quality and safety of patient care. The greatest challenges associated with the role related to acceptance of the role by other healthcare professionals, and difficulties associated with the general public's traditional attitudes to healthcare provision in Hong Kong. Education of the public concerning the implementation of such roles is of crucial importance. Findings from this study enhance understanding of the factors that hinder or facilitate advanced practice roles in out-of-hours care in Hong Kong. © 2012 Blackwell Publishing Ltd.

  16. Ergonomics in dentistry: experiences of the practice by dental students.

    Science.gov (United States)

    Garcia, P P N S; Gottardello, A C A; Wajngarten, D; Presoto, C D; Campos, J A D B

    2017-08-01

    The aim of this study was to qualitatively evaluate the experiences of students enrolled in the last year of dentistry school with ergonomic practice. This is a qualitative, observational and cross-sectional study, with a non-probabilistic sample design. The sample comprised students enrolled in the last year of dentistry in Araraquara-UNESP (n = 29). The data were collected by means of open semi-structured and individual interviews, captured by a digital voice recorder. The students were interviewed in their own university at a time that was previously scheduled, and care was taken to provide a private and welcoming environment to carry out the interviews. A script containing questions related to practices in ergonomics was prepared at the university. Data analysis was carried out using the qualitative-quantitative Collective Subject Discourse technique with the aid of Qualiquantisoft ® software program. It was found that more than half of the students (58.6%) believe that adopting an ergonomic posture is important to prevent future problems, pain and occupational diseases, and 62.1% of the students confirm having difficulties in adopting ergonomic postures due to the types of treatment required and the regions of the mouth being treated. The main reasons stated for the fact that their colleagues do not adopt ergonomic postures are lack of attention, practice and forgetfulness (44.8%) and difficulty in visualising the operatory field or the procedure performed (27.6%). It is possible to conclude that the students interviewed know ergonomic principles and their importance in occupational health. However, they found it difficult to put these principles into practice. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Patient experience of source isolation: lessons for clinical practice.

    Science.gov (United States)

    Barratt, Ruth Linda; Shaban, Ramon; Moyle, Wendy

    2011-10-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is now the leading antimicrobial-resistant organism of concern to clinicians worldwide. Preventing and controlling the increase and spread of MRSA within the health-care environment is therefore an important function of the infection control team. The prevention and control of MRSA requires strict use of both Standard and Additional Precautions, which include good hand hygiene practices, judicious antimicrobial prescribing, and source isolation. While few would dispute the need for these precautions for preventing the spread of MRSA and other infections, their use may result in adverse physical and psychological effects for the patient. In an age of quality and safety of health care, ensuring infection control practice such as source isolation and contact precautions adhere to fundamental human rights is paramount. This paper presents a review of the literature on the patient experience of source isolation for MRSA or other infectious diseases. The review yielded five major interconnected themes: (1) psychological effects of isolation; (2) coping with isolation; (3) social isolation; (4) communication and information provision; and (5) physical environment and quality of care. It found that the experience of isolation by patients has both negative and positive elements. Isolation may result in detrimental psychological effects including anxiety, stress and depression, but may also result in the patient receiving less or substandard care. However, patients may also benefit from the quietness and privacy of single rooms. Nurses and other healthcare workers must look for ways to improve the experience of isolation and contact precautions of patients in source isolation. Opportunities exist in particular in improving the environment and the patient's self-control of the situation and in providing adequate information.

  18. Quality of experience advanced concepts, applications and methods

    CERN Document Server

    Raake, Alexander

    2014-01-01

    This pioneering book develops definitions and concepts related to Quality of Experience in the context of multimedia- and telecommunications-related applications, systems and services, and applies these to various fields of communication and media technologies. The editors bring together numerous key-protagonists of the new discipline “Quality of Experience” and combine the state-of-the-art knowledge in one single volume. 

  19. The Role of the Advanced Practice Nurse in Geriatric Oncology Care.

    Science.gov (United States)

    Morgan, Brianna; Tarbi, Elise

    2016-02-01

    To describe how the Advanced Practice Nurse (APN) is uniquely suited to meet the needs of older adults throughout the continuum of cancer, to explore the progress that APNs have made in gero-oncology care, and make suggestions for future directions. Google Scholar, PubMed, and CINAHL. Search terms included: "gero-oncology," "geriatric oncology," "Advanced Practice Nurse," "Nurse Practitioner," "older adult," "elderly," and "cancer." Over the last decade, APNs have made advances in caring for older adults with cancer by playing a role in prevention, screening, and diagnosis; through evidence-based gero-oncology care during cancer treatment; and in designing tailored survivorship care models. APNs must combat ageism in treatment choice for older adults, standardize comprehensive geriatric assessments, and focus on providing person-centered care, specifically during care transitions. APNs are well-positioned to help understand the complex relationship between risk factors, geriatric syndromes, and frailty and translate research into practice. Palliative care must expand beyond specialty providers and shift toward APNs with a focus on early advanced care planning. Finally, APNs should continue to establish multidisciplinary survivorship models across care settings, with a focus on primary care. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Experiences and Trends of Manufacturing Technology of Advanced Nuclear Fuels

    International Nuclear Information System (INIS)

    2012-08-01

    The 'Atoms for Peace' mission initiated in the mid-1950s paved the way for the development and deployment of nuclear fission reactors as a source of heat energy for electricity generation in nuclear power reactors and as a source of neutrons in non-power reactors for research, materials irradiation, and testing and production of radioisotopes. The fuels for nuclear reactors are manufactured from natural uranium (∼99.3% 238 U + ∼0.7% 235 U) and natural thorium (∼100% 232 Th) resources. Currently, most power and research reactors use 235 U, the only fissile isotope found in nature, as fuel. The fertile isotopes 238 U and 232 Th are transmuted in the reactor to human-made 239 Pu and 233 U fissile isotopes, respectively. Likewise, minor actinides (MA) (Np, Am and Cm) and other plutonium isotopes are also formed by a series of neutron capture reactions with 238 U and 235 U. Long term sustainability of nuclear power will depend to a great extent on the efficient, safe and secure utilization of fissile and fertile materials. Light water reactors (LWRs) account for more than 82% of the operating reactors, followed by pressurized heavy water reactors (PHWRs), which constitute ∼10% of reactors. LWRs will continue to dominate the nuclear power market for several decades, as long as economically viable natural uranium resources are available. Currently, the plutonium obtained from spent nuclear fuel is subjected to mono recycling in LWRs as uranium-plutonium mixed oxide (MOX), containing up to 12% PuO 2 , in a very limited way. The reprocessed uranium (RepU) is also re-enriched and recycled in LWRs in a few countries. Unfortunately, the utilization of natural uranium resources in thermal neutron reactors is 2 and MOX fuel technology has matured during the past five decades. These fuels are now being manufactured, used and reprocessed on an industrial scale. Mixed uranium- plutonium monocarbide (MC), mononitride (MN) and U-Pu-Zr alloys are recognized as advanced fuels

  1. Aerospace Engineering Systems and the Advanced Design Technologies Testbed Experience

    Science.gov (United States)

    VanDalsem, William R.; Livingston, Mary E.; Melton, John E.; Torres, Francisco J.; Stremel, Paul M.

    1999-01-01

    Continuous improvement of aerospace product development processes is a driving requirement across much of the aerospace community. As up to 90% of the cost of an aerospace product is committed during the first 10% of the development cycle, there is a strong emphasis on capturing, creating, and communicating better information (both requirements and performance) early in the product development process. The community has responded by pursuing the development of computer-based systems designed to enhance the decision-making capabilities of product development individuals and teams. Recently, the historical foci on sharing the geometrical representation and on configuration management are being augmented: 1) Physics-based analysis tools for filling the design space database; 2) Distributed computational resources to reduce response time and cost; 3) Web-based technologies to relieve machine-dependence; and 4) Artificial intelligence technologies to accelerate processes and reduce process variability. The Advanced Design Technologies Testbed (ADTT) activity at NASA Ames Research Center was initiated to study the strengths and weaknesses of the technologies supporting each of these trends, as well as the overall impact of the combination of these trends on a product development event. Lessons learned and recommendations for future activities are reported.

  2. Recent Advances In Science Support For Isolated Droplet Combustion Experiments

    Science.gov (United States)

    Dryer, F. L.; Kazakov, A.; Urban, B. D.; Kroenlein, K.

    2003-01-01

    In a joint program involving Prof. F.A. Williams of the University of California, San Diego and Dr. V. Nayagam of the National Center for Microgravity Research, the combustion characteristics of isolated liquid fuel droplets of n-heptane, n-decane, methanol, methanol-water, ethanol and ethanol-water having initial diameters between about 1 mm and 6 mm continues to be investigated. The objectives of the work are to improve fundamental knowledge of droplet combustion dynamics for pure fuels and fuel-water mixtures through microgravity experiments and theoretical analyses. The Princeton contributions support the engineering design, data analysis, and data interpretation requirements for the study of initially single component, spherically symmetric, isolated droplet combustion studies through experiments and numerical modeling. UCSD contributions are described in a companion communication in this conference. The Princeton effort also addresses the analyses of Fiber Supported Droplet Combustion (FSDC) experiments conducted with the above fuels and collaborative work with others who are investigating droplet combustion in the presence of steady convection. A thorough interpretation of droplet burning behavior for n-heptane and n-decane over a relatively wide range of conditions also involves the influences of sooting on the combustion behavior, and this particular aspect on isolated burning of droplets is under consideration in a collaborative program underway with Drexel University. This collaboration is addressed in another communication at this conference. The one-dimensional, time-dependent, numerical modeling approach that we have continued to evolve for analyzing isolated, quiescent droplet combustion data has been further applied to investigate several facets of isolated droplet burning of simple alcohols, n-heptane, and n-decane. Some of the new results are described below.

  3. Analysis advanced methods of data bases of industrial experience return

    International Nuclear Information System (INIS)

    Lannoy, A.; Procaccia, H.

    1994-05-01

    This is a presentation, through different conceptions of data bases on industrial experience return, of the principal methods for treatments and analyses of the collected data, going from the frequency statistic and factorial analysis, to the the Bayesian statistical decision theory, which is a real decision assistance tool for responsibles, conceivers and operators. Examples in various fields are given (OREDA: Offshore REliability DAta bank for marine drilling platforms, CEDB: Component Event Data Bank for european electric power industry, RDF 93: reliability of electronic components of ''France Telecom'', EVT: failure EVenTs data bank in the french nuclear power plants by ''EDF''). (A.B.). refs., figs., tabs

  4. Advancing intercultural competency: Canadian engineering employers' experiences with immigrant engineers

    Science.gov (United States)

    Friesen, Marcia; Ingram, Sandra

    2013-05-01

    This paper explores Canadian engineering employers' perceptions of and experiences with internationally educated engineers (recent immigrants to Canada) employed in their organisations for varying lengths of time. Qualitative data were collected from employers using focus group methodology. Findings reflected employers' observations of culturally different behaviours and characteristics in their internationally educated employees, employers' reactions to cultural differences ranging from negative attributions to tolerance, and the implementation of largely ad hoc intra-organisational strategies for managing cultural differences in employer-employee relationships. Findings exposed the lack of corporate intercultural competency in the Canadian engineering profession. Equity and gatekeeping implications are discussed.

  5. Advance Power Technology Experiment for the Starshine 3 Satellite

    Science.gov (United States)

    Jenkins, Phillip; Scheiman, David; Wilt, David; Raffaelle, Ryne; Button, Robert; Smith, Mark; Kerslake, Thomas; Miller, Thomas; Bailey, Sheila (Technical Monitor); Hepp, A. (Technical Monitor)

    2001-01-01

    The Starshine 3 satellite will carry several power technology demonstrations. Since Starshine 3 is primarily a passive experiment and does not need electrical power to successfully complete its mission, the requirement for a highly reliable power system is greatly reduced. This creates an excellent opportunity to test new power technologies. Several government and commercial interests have teamed up to provide Starshine 3 with a small power system using state-of-the-art components. Starshine 3 will also fly novel integrated microelectronic power supplies (IWS) for evaluation.

  6. Progress towards advanced practice roles in Australia, New Zealand and the Western Pacific

    International Nuclear Information System (INIS)

    Smith, Tony; Yielder, Jill; Ajibulu, Olusegun; Caruana, Edward

    2008-01-01

    This paper describes the evolution and current status of advanced practice in medical imaging and radiation therapy in the Oceania region. To date development has been slow, largely ad hoc and based on local needs. Most advanced practice is informal or is regarded as part of the core skills of some individual practitioners. However, recently, there have been signs of change taking place, with a more coordinated and collaborative approach to role development becoming evident. In Australia, although a number of reports and papers have discussed extended clinical roles, especially for diagnostic Radiographers, no concrete action has yet taken place in either discipline. Stakeholders apparently agree that existing extended roles should be formalised, however, and that continuing education must underpin future role extension initiatives. A three-level professional structure, including an advanced practitioner level, has been accepted by the New Zealand Institute of Medical Radiation Technology (NZIMRT), with the support of the District Health Boards of New Zealand (DHBNZ). Implementation is expected to begin before the end of 2008. Meanwhile, recognition of the serious lack of Radiologists in Western Pacific Island Nations led to the training of some Radiographers in radiological interpretation of images between 2004 and 2006. The aim was to up-skill the Radiographers so that they could more reliably flag abnormalities to doctors, a model that may be applicable elsewhere. It is argued that future practice models must include advanced practice roles in order to safely meet the growing demand for medical radiation services. Local factors, such as the structure of the health care system and the depth of engagement of the key stakeholders in planning and implementation, however, are expected to influence the evolution of new clinical practice models in the region

  7. Drivers Advancing Oral Health in a Large Group Dental Practice Organization.

    Science.gov (United States)

    Simmons, Kristen; Gibson, Stephanie; White, Joel M

    2016-06-01

    Three change drivers are being implemented to high standards of patient centric and evidence-based oral health care within the context of a large multispecialty dental group practice organization based on the commitment of the dental hygienist chief operating officer and her team. A recent environmental scan elucidated 6 change drivers that can impact the provision of oral health care. Practitioners who can embrace and maximize aspects of these change drivers will move dentistry forward and create future opportunities. This article explains how 3 of these change drivers are being applied in a privately held, accountable risk-bearing entity that provides individualized treatment programs for more than 417,000 members. To facilitate integration of the conceptual changes related to the drivers, a multi-institutional, multidisciplinary, highly functioning collaborative work group was formed. The document Dental Hygiene at a Crossroads for Change(1) inspired the first author, a dental hygienist in a unique position as chief operating officer of a large group practice, to pursue evidence-based organizational change and to impact the quality of patient care. This was accomplished by implementing technological advances including dental diagnosis terminology in the electronic health record, clinical decision support, standardized treatment guidelines, quality metrics, and patient engagement to improve oral health outcomes at the patient and population levels. The systems and processes used to implement 3 change drivers into a large multi-practice dental setting is presented to inform and inspire others to implement change drivers with the potential for advancing oral health. Technology implementing best practices and improving patient engagement are excellent drivers to advance oral health and are an effective use of oral health care dollars. Improved oral health can be leveraged through technological advances to improve clinical practice. Copyright © 2016 Elsevier Inc

  8. Surgeons' Emotional Experience of Their Everyday Practice - A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Massimiliano Orri

    Full Text Available Physicians' emotions affect both patient care and personal well-being. Surgeons appear at particularly high risk, as evidenced by the high rate of burnout and the alarming consequences in both their personal lives and professional behavior. The aim of this qualitative study is to explore the emotional experiences of surgeons and their impact on their surgical practice.27 purposively selected liver and pancreatic surgeons from 10 teaching hospitals (23 men, 4 women participated. Inclusion took place until data saturation was reached. Data were collected through individual interviews and thematically analyzed independently by 3 researchers (a psychologist, a psychiatrist, and a surgeon. 7 themes emerged from the analysis, categorized in 3 main or superordinate themes, which described surgeons' emotional experience before, during, and after surgery. Burdensome emotions are present throughout all 3 periods (and invade life outside the hospital-surgeons' own emotions, their perception of patients' emotions, and their entwinement. The interviewees described the range of emotional situations they face (with patients, families, colleagues, the influence of the institutional framework (time pressure and fatigue, cultural pressure to satisfy the ideal image of a surgeon, as well as the emotions they feel (including especially anxiety, fear, distress, guilt, and accountability.Emotions are ubiquitous in surgeons' experience, and their exposure to stress is chronic rather than acute. Considering emotions only in terms of their relations to operative errors (as previous studies have done is limiting. Although complications are quite rare events, the concern for possible complications is an oppressive experience, regardless of whether or not they actually occur.

  9. Volvo drivers' experiences with advanced crash avoidance and related technologies.

    Science.gov (United States)

    Eichelberger, Angela H; McCartt, Anne T

    2014-01-01

    Crash avoidance technologies can potentially prevent or mitigate many crashes, but their success depends in part on driver acceptance. Owners of 2010-2012 model Volvo vehicles with several technologies were interviewed about their experiences. Interviews were conducted in summer 2012 with 155 owners of vehicles with City Safety as a standard feature; 145 owners with an optional technology package that included adaptive cruise control, distance alert, collision warning with full auto brake (and pedestrian detection on certain models), driver alert control, and lane departure warning; and 172 owners with both City Safety and the technology package. The survey response rates were 21 percent for owners with City Safety, 30 percent for owners with the technology package, and 27 percent for owners with both. Ten percent of owners opted out before the telephone survey began, and 18 percent declined to participate when called. Despite some annoyance, most respondents always leave the systems on, although fewer do so for lane departure warning (59%). For each of the systems, at least 80 percent of respondents with the system would want it on their next vehicle. Many respondents reported safer driving habits with the systems (e.g., following less closely with adaptive cruise control, using turn signals more often with lane departure warning). Fewer respondents reported potentially unsafe behavior, such as allowing the vehicle to brake for them at least some of the time. About one third of respondents experienced autonomous braking when they believed they were at risk of crashing, and about one fifth of respondents thought it had prevented a crash. About one fifth of respondents with the technology package reported that they were confused or misunderstood which safety system had activated in their vehicle. Consistent with the results for early adopters in the previous survey of Volvo and Infiniti owners, the present survey found that driver acceptance of the technologies

  10. Parents’ experiences of child protection practice in Denmark

    DEFF Research Database (Denmark)

    Petersen, Stina Krogh

    2018-01-01

    Not much research focuses on how parents perceive and experience child protection practice although the voices of service users are important in the development of social work within Child Welfare Services. This article contributes to a growing body of research that takes the user perspective...... as its point of departure when conducting research in social work. Drawing on a qualitative study, this article explores how 17 parents have experienced assessment processes in Denmark. Several studies indicate that parents who by themselves initiate child protection assessment have a greater chance...... (referral or the parents' own initiative) and suggests that time (in the sense of progression in the assessment) is an important dimension to take into account particularly when it comes to parents who wish to engage in child protection assessments....

  11. Experience Studies on Determining Life Premium Insurance Ratings: Practical Approaches

    Directory of Open Access Journals (Sweden)

    Mirela CRISTEA

    2008-01-01

    Full Text Available The focus of this article is to present the modelling tehcniques used on international practice in the evaluation of right life premiums based. The knowledge and models obtained have a common element of mortality risk indicators but these are varied in different parts of the world. The common elements of these studies and models are generally based on a series of indicators which mainly point out their probability of survival and they are named the mortality indicators. These indicators represent the basis for the calculation of the premiums quotes and for the elaboration by the insurers of premium tables. The benefit for the policyholder is to obtain insurance at a fair and competitive price and for the insurer, to maintain the experience of its portfolio in line with mortality assumptions.

  12. Multisectoral Strategies for Advancing Girls' Education: Principles and Practice. SAGE Technical Report.

    Science.gov (United States)

    Williams, Howard

    This paper describes issues, experiences, and strategies used in developing successful multisectoral partnerships to advance girls' education, using Guinea and Morocco as examples. Chapter 1 introduces the issue, discussing barriers to girls' education and describing the multisectoral response to interrelated barriers. Chapter 2 defines the…

  13. Recent advances in the HL-2A tokamak experiments

    International Nuclear Information System (INIS)

    Liu, Y.; Ding, X.T.; Yang, Q.W.; Yan, L.W.; Liu, D.Q.; Xuan, W.M.; Chen, L.Y.; Song, X.M.; Cao, Z.; Zhang, J.H.; Mao, W.C.; Zhou, C.P.; Li, X.D.; Wang, S.J.; Yan, J.C.; Bu, M.N.; Chen, Y.H.; Cui, C.H.; Cui, Z.Y.; Deng, Z.C.; Hong, W.Y.; Hu, H.T.; Huang, Y.; Kang, Z.H.; Li, B.; Li, W.; Li, F.Z.; Li, G.S.; Li, H.J.; Li, Q.; Li, Y.G.; Li, Z.J.; Liu, Yi; Liu, Z.T.; Luo, C.W.; Mao, X.H.; Pan, Y.D.; Rao, J.; Shao, K.; Song, X.Y.; Wang, M.; Wang, M.X.; Wang, Q.M.; Xiao, Z.G.; Xie, Y.F.; Yao, L.H.; Yao, L.Y.; Zheng, Y.J.; Zhong, G.W.; Zhou, Y.; Pan, C.H.

    2005-01-01

    Two experiment campaigns were conducted on the HL-2A tokamak in 2003 and 2004 after the first plasma was obtained at the end of 2002. Progresses in many aspects have been made, especially in the divertor discharge and feedback control of plasma configuration. Up to now, the following operation parameters have been achieved: I p = 320 kA, B t = 2.2 T and discharge duration T d = 1580 ms. With the feedback control of plasma current and horizontal position, an excellent repeatability of the discharge has been achieved. The tokamak has been operated at both limiter configuration and single null (SN) divertor configuration. The HL-2A SN divertor configuration is simulated with the MHD equilibrium code SWEQU. When the divertor configuration is formed, the impurity radiation in the main plasma decreases remarkably

  14. LOFT advanced densitometer for nuclear loss-of-coolant experiments

    International Nuclear Information System (INIS)

    Johnson, L.O.; Lassahn, G.D.; Wood, D.B.

    1979-01-01

    A ''nuclear hardened'' gamma densitometer, a device which uses radiation attenuation to measure fluid density in the presence of a background radiation field, is described. Data from the nuclear hardened gamma densitometer are acquired by time sampling the coolant fluid piping and fluid attenuated source energy spectrum. The data are used to calculate transient coolant fluid cross sectional average density to analyze transient mass flow and other thermal-hydraulic characteristics during the Loss-of-Fluid Test (LOFT) loss-of-coolant experiments. The nuclear hardened gamma densitometer uses a pulse height analysis or energy discrimination, pulse counting technique which makes separation of the gamma radiation source signal from the reactor generated gamma radiation background noise signal possible by processing discrete pulses which retain their pulse amplitude information

  15. Advanced Scale Conditioning Agent (ASCA) Applications: 2012 Experience Update

    International Nuclear Information System (INIS)

    Little, Michael-J.; Varrin, Robert-D.; Pellman, Aaron-T.; Kreider, Marc A.

    2012-09-01

    ASCAs are a group of dilute chemical treatments for removing deposited corrosion products from the secondary side of PWR steam generators (SGs). Each ASCA formulation is customized to achieve plant-specific goals that can include: - Partial dissolution and structural modification of the tube scale present on free span surfaces through full bundle treatment, lowering the deposit loading and enhancing SG thermal performance levels through creation of a scale structure marked by increased boiling efficiency, - Softening and partial removal of deposits present in the broached flow holes in the tube support plates, reducing the risks of level oscillations and flow-induced vibration (FIV), - Chemical removal of copper from tube scale and tube sheet deposits, reducing the risk of rapid tube corrosion caused by the oxidized conditions promoted by some copper species, and - Dissolution of hardness species from consolidated top-of-tube sheet (TTS) collars to enhance collar removal through water-jetting and other mechanical cleaning techniques. Regardless of the cleaning objectives for a particular plant, all ASCA processes are designed to minimize corrosion, waste disposal costs, and impact on the outage schedule. To date, about 40 ASCA applications have been carried out in four (4) countries. This paper provides an update of the industry experience gained during these applications, including results demonstrating the ability of ASCA processes to meet the goals outlined above. Experience at multiple units, including several repeat ASCA applications, has demonstrated significant heat-transfer benefits (i.e., steam pressure increases of up to 1-2 bar (15-30 psi)). ASCA applications also regularly achieve significant reductions in TSP blockage (i.e., up to 30% absolute increases in available flow area in broached flow holes) and have been successful in eliminating level oscillations caused by excessive broached-hole blockage. (authors)

  16. An investigation of nurse educator's perceptions and experiences of undertaking clinical practice.

    Science.gov (United States)

    Williams, Angela; Taylor, Cathy

    2008-11-01

    Educational policy (DOH, 1999. Making a difference: strengthening the nursing, midwifery and health visiting contribution to health and healthcare. Department of Health, London; UKCC, 1999. Fitness for Practice. United Kingdom Central Council for Nursing, Midwifery and Health Visiting, London; Nursing and Midwifery Council, 2006. Standards to support learning and assessment in practice. Nursing and Midwifery Council, London) and current nursing literature (Griscti, O., Jacono, B., Jacono, J., 2005. The nurse educator's clinical role. Journal of Advanced Nursing 50 (1), 84-92; Owen, S., Ferguson, K., Baguley, I., 2005. The clinical activity of mental health nurse lecturers. Journal of Psychiatric and Mental Health Nursing 12, 310-316), place increasing emphasis on nurse educators undertaking clinical practice to facilitate their clinical confidence and competence. This study investigated nurse educators' perceptions and experiences of undertaking clinical practice. A qualitative design and descriptive, exploratory approach were used. A purposive sample of 11 nurse educators in one nursing department, took part in two focus group interviews, one with 5 and the other with 6 respondents, to identify and discuss their perceptions and experiences of undertaking clinical practice. A process of thematic content analysis revealed three broad themes relating to the meaning and importance of clinical practice, perceived benefits and barriers which are examined and discussed. The paper concludes that despite policy recommendations, barriers highlighted in this study such as insufficient time, heavy workload and a lack of valuing of the clinical role have been raised over the past few decades. The effect of undertaking clinical practice, particularly on the quality of teaching is argued to be valuable armoury in the battle to secure sufficient resources to support engagement in clinical practice. Financial and organisational commitment; valuing of clinical practice and research

  17. Merger and Acquisition Market: from World Experience to National Practice

    Directory of Open Access Journals (Sweden)

    Hrechana Svitlana I.

    2014-03-01

    Full Text Available The goal of the article lies in identification of tendencies and prospects of development of the merger and acquisition market of Ukraine in the context of influence of the world M and A experience upon this process under conditions of globalisation. In the result of the study the article analyses the most significant merger and acquisition operations that took place in the world practice and in Ukraine in recent years. The article reveals and deeply assesses the variety of motives and mechanisms of their realisation from the position of practice of developed countries and trans-national corporations and also domestic associations of enterprises. It shows that transactions of tough or forced character of acquisition prevail in Ukraine, specific features of which are not only the reduced cost but also direct belonging of buyers to oligarchic-political structures. It explains negative influence of these specific features upon volume and activity of the national M and A market. It formulates and offers a system of state and economic subjects measures, immediate application of which would allow creation of favourable conditions for development of the national merger and acquisition market.

  18. Advancing Hospice and Palliative Care Social Work Leadership in Interprofessional Education and Practice.

    Science.gov (United States)

    Blacker, Susan; Head, Barbara A; Jones, Barbara L; Remke, Stacy S; Supiano, Katherine

    2016-01-01

    The importance of interprofessional collaboration in achieving high quality outcomes, improving patient quality of life, and decreasing costs has been growing significantly in health care. Palliative care has been viewed as an exemplary model of interprofessional care delivery, yet best practices in both interprofessional education (IPE) and interprofessional practice (IPP) in the field are still developing. So, too, is the leadership of hospice and palliative care social workers within IPE and IPP. Generating evidence regarding best practices that can prepare social work professionals for collaborative practice is essential. Lessons learned from practice experiences of social workers working in hospice and palliative care can inform educational efforts of all professionals. The emergence of interprofessional education and competencies is a development that is relevant to social work practice in this field. Opportunities for hospice and palliative social workers to demonstrate leadership in IPE and IPP are presented in this article.

  19. Optimizing Music Learning: Exploring How Blocked and Interleaved Practice Schedules Affect Advanced Performance.

    Science.gov (United States)

    Carter, Christine E; Grahn, Jessica A

    2016-01-01

    Repetition is the most commonly used practice strategy by musicians. Although blocks of repetition continue to be suggested in the pedagogical literature, work in the field of cognitive psychology suggests that repeated events receive less processing, thereby reducing the potential for long-term learning. Motor skill learning and sport psychology research offer an alternative. Instead of using a blocked practice schedule, with practice completed on one task before moving on to the next task, an interleaved schedule can be used, in which practice is frequently alternated between tasks. This frequent alternation involves more effortful processing, resulting in increased long-term learning. The finding that practicing in an interleaved schedule leads to better retention than practicing in a blocked schedule has been labeled the "contextual interference effect." While the effect has been observed across a wide variety of fields, few studies have researched this phenomenon in a music-learning context, despite the broad potential for application to music practice. This study compared the effects of blocked and interleaved practice schedules on advanced clarinet performance in an ecologically valid context. Ten clarinetists were given one concerto exposition and one technical excerpt to practice in a blocked schedule (12 min per piece) and a second concerto exposition and technical excerpt to practice in an interleaved schedule (3 min per piece, alternating until a total of 12 min of practice were completed on each piece). Participants sight-read the four pieces prior to practice and performed them at the end of practice and again one day later. The sight-reading and two performance run-throughs of each piece were recorded and given to three professional clarinetists to rate using a percentage scale. Overall, whenever there was a ratings difference between the conditions, pieces practiced in the interleaved schedule were rated better than those in the blocked schedule

  20. Optimizing Music Learning: Exploring How Blocked and Interleaved Practice Schedules Affect Advanced Performance

    Science.gov (United States)

    Carter, Christine E.; Grahn, Jessica A.

    2016-01-01

    Repetition is the most commonly used practice strategy by musicians. Although blocks of repetition continue to be suggested in the pedagogical literature, work in the field of cognitive psychology suggests that repeated events receive less processing, thereby reducing the potential for long-term learning. Motor skill learning and sport psychology research offer an alternative. Instead of using a blocked practice schedule, with practice completed on one task before moving on to the next task, an interleaved schedule can be used, in which practice is frequently alternated between tasks. This frequent alternation involves more effortful processing, resulting in increased long-term learning. The finding that practicing in an interleaved schedule leads to better retention than practicing in a blocked schedule has been labeled the “contextual interference effect.” While the effect has been observed across a wide variety of fields, few studies have researched this phenomenon in a music-learning context, despite the broad potential for application to music practice. This study compared the effects of blocked and interleaved practice schedules on advanced clarinet performance in an ecologically valid context. Ten clarinetists were given one concerto exposition and one technical excerpt to practice in a blocked schedule (12 min per piece) and a second concerto exposition and technical excerpt to practice in an interleaved schedule (3 min per piece, alternating until a total of 12 min of practice were completed on each piece). Participants sight-read the four pieces prior to practice and performed them at the end of practice and again one day later. The sight-reading and two performance run-throughs of each piece were recorded and given to three professional clarinetists to rate using a percentage scale. Overall, whenever there was a ratings difference between the conditions, pieces practiced in the interleaved schedule were rated better than those in the blocked schedule

  1. Optimizing music learning: Exploring how blocked and interleaved practice schedules affect advanced performance

    Directory of Open Access Journals (Sweden)

    Christine E Carter

    2016-08-01

    Full Text Available Repetition is the most commonly used practice strategy by musicians. Although blocks of repetition continue to be suggested in the pedagogical literature, work in the field of cognitive psychology suggests that repeated events receive less processing, thereby reducing the potential for long-term learning. Motor skill learning and sport psychology research offer an alternative. Instead of using a blocked practice schedule, with practice completed on one task before moving on to the next task, an interleaved schedule can be used, in which practice is frequently alternated between tasks. This frequent alternation involves more effortful processing, resulting in increased long-term learning. The finding that practicing in an interleaved schedule leads to better retention than practicing in a blocked schedule has been labeled the contextual interference effect. While the effect has been observed across a wide variety of fields, few studies have researched this phenomenon in a music-learning context, despite the broad potential for application to music practice. This study compared the effects of blocked and interleaved practice schedules on advanced clarinet performance in an ecologically valid context. Ten clarinetists were given one concerto exposition and one technical excerpt to practice in a blocked schedule (twelve minutes per piece and a second concerto exposition and technical excerpt to practice in an interleaved schedule (three minutes per piece, alternating until a total of twelve minutes of practice were completed on each piece. Participants sight-read the four pieces prior to practice and performed them at the end of practice and again one day later. The sight-reading and two performance run-throughs of each piece were recorded and given to three professional clarinetists to rate using a percentage scale. Overall, whenever there was a ratings difference between the conditions, pieces practiced in the interleaved schedule were rated

  2. Developing a professional poster: four "ps" for advanced practice nurses to consider.

    Science.gov (United States)

    Bindon, Susan L; Davenport, Joan M

    2013-01-01

    Professional posters play an important role in the dissemination of knowledge and the professional development of advanced practice nurses, graduate students, and clinical faculty. Posters should be considered an integral component in communication of professional work in practice, research, and education. The invitation to submit a poster abstract is an important opportunity for clinicians and faculty alike to consider. Though sometimes misperceived as less prestigious than a podium presentation, posters add a unique element to professional and academic events. The argument is made for posters as an equal among scholarly presentation formats. The poster serves as a tremendous opportunity for collaboration between partners and a way to communicate important findings and advertise the presenters' work. For the advanced practice nurse who is a novice in presenting best practice or evidence from research trials, the poster format may be less intimidating while allowing the invaluable sharing of results. Four critical elements of professional poster development are deciding on a clear Purpose, targeting the right People, outlining key steps in the Process, and delivering a memorable Presentation. Using the "4 Ps" as cornerstones for the work of developing, preparing, and delivering the poster to an audience, the authors aim to help organize the entire process into these essential considerations. The poster, as a means of scholarly work, is a viable and essential activity, as interdisciplinary collaboration and sharing of best practice becomes the expectation for all professional development.

  3. Advancing the practice of health impact assessment in Canada: Obstacles and opportunities

    Energy Technology Data Exchange (ETDEWEB)

    McCallum, Lindsay C., E-mail: lindsay.mccallum@mail.utoronto.ca [University of Toronto, Department of Physical and Environmental Sciences, 1265 Military Trail, Toronto, Ontario M1C 1A4 (Canada); Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Ollson, Christopher A., E-mail: collson@intrinsik.com [Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Stefanovic, Ingrid L., E-mail: fenvdean@sfu.ca [Simon Fraser University, Faculty of Environment, 8888 University Drive, Burnaby, British Columbia V5A 1S6 (Canada)

    2015-11-15

    Health Impact Assessment (HIA) is recognized as a useful tool that can identify potential health impacts resulting from projects or policy initiatives. Although HIA has become an established practice in some countries, it is not yet an established practice in Canada. In order to enable broader support for HIA, this study provides a comprehensive review and analysis of the peer-reviewed and gray literature on the state of HIA practice. The results of this review revealed that, although there is an abundance of publications relating to HIA, there remains a lack of transparent, consistent and reproducible approaches and methods throughout the process. Findings indicate a need for further research and development on a number of fronts, including: 1) the nature of HIA triggers; 2) consistent scoping and stakeholder engagement approaches; 3) use of evidence and transparency of decision-making; 4) reproducibility of assessment methods; 5) monitoring and evaluation protocols; and, 6) integration within existing regulatory frameworks. Addressing these issues will aid in advancing the more widespread use of HIA in Canada. - Highlights: • Reviewed current state of practice in the field of HIA • Identified key obstacles and opportunities for HIA advancement • Major issues include lack of consistent approach and methodology. • No national regulatory driver hinders opportunity for widespread use of HIA. • Identified research opportunities vital to developing HIA practice in Canada.

  4. The role of the nurse executive in fostering and empowering the advanced practice registered nurse.

    Science.gov (United States)

    Talbert, Tukea L

    2012-06-01

    The nurse executive plays a critical role in the design, oversight, and outcomes of the delivery of care and a key role in the success of the integration of advanced practice registered nurses (APRNs) into an organization. The critical areas that nurse executives must consider to foster and empower APRNs are: (1) knowledge and self preparation, especially of political initiatives that affect the role, (2) visionary leadership and development of clear role expectations and appropriate credentialing, (3) strategies to reduce disconnection between the APRN and their practice setting, and (4) appropriate education and marketing of the role to stakeholders. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Advanced unambiguous state discrimination attack and countermeasure strategy in a practical B92 QKD system

    Science.gov (United States)

    Ko, Heasin; Choi, Byung-Seok; Choe, Joong-Seon; Youn, Chun Ju

    2018-01-01

    Even though unconditional security of B92 quantum key distribution (QKD) system is based on the assumption of perfect positive-operator-valued measures, practical B92 systems only utilize two projective measurements. Unfortunately, such implementation may degrade the security of the B92 QKD system due to Eve's potential attack exploiting the imperfection of system. In this paper, we propose an advanced attack strategy with an unambiguous state discrimination (USD) measurement which makes practical B92 QKD systems insecure even under a lossless channel. In addition, we propose an effective countermeasure against the advanced USD attack model by monitoring double-click events. We further address a fundamental approach to make the B92 QKD system tolerable to attack strategies with USD measurements using a multi-qubit scheme.

  6. Motivational interviewing: a valuable tool for the psychiatric advanced practice nurse.

    Science.gov (United States)

    Karzenowski, Abby; Puskar, Kathy

    2011-01-01

    Motivational Interviewing (MI) is well known and respected by many health care professionals. Developed by Miller and Rollnick (2002) , it is a way to promote behavior change from within and resolve ambivalence. MI is individualized and is most commonly used in the psychiatric setting; it is a valuable tool for the Psychiatric Advanced Nurse Practice Nurse. There are many resources that talk about what MI is and the principles used to apply it. However, there is little information about how to incorporate MI into a clinical case. This article provides a summary of articles related to MI and discusses two case studies using MI and why advanced practice nurses should use MI with their patients.

  7. A structured architecture for advanced plasma control experiments

    International Nuclear Information System (INIS)

    Penaflor, B.G.; Ferron, J.R.; Walker, M.L.

    1996-10-01

    Recent new and improved plasma control regimes have evolved from enhancements to the systems responsible for managing the plasma configuration on the DIII-D tokamak. The collection of hardware and software components designed for this purpose is known at DIII-D as the Plasma Control System or PCS. Several new user requirements have contributed to the rapid growth of the PCS. Experiments involving digital control of the plasma vertical position have resulted in the addition of new high performance processors to operate in real-time. Recent studies in plasma disruptions involving the use of neural network based software have resulted in an increase in the number of input diagnostic signals sampled. Better methods for estimating the plasma shape and position have brought about numerous software changes and the addition of several new code modules. Furthermore, requests for performing multivariable control and feedback on the current profile are continuing to add to the demands being placed on the PCS. To support all of these demands has required a structured yet flexible hardware and software architecture for maintaining existing capabilities and easily adding new ones. This architecture along with a general overview of the DIII-D Plasma Control System is described. In addition, the latest improvements to the PCS are presented

  8. Advances in target design and fabrication for experiments on NIF

    Directory of Open Access Journals (Sweden)

    Obrey K.

    2013-11-01

    Full Text Available The ability to build target platforms for National Ignition Facility (NIF is a key feature in LANL's (Los Alamos National Laboratory Target Fabrication Program. We recently built and manufactured the first LANL targets to be fielded on NIF in March 2011. Experiments on NIF require precision component manufacturing and accurate knowledge of the materials used in the targets. The characterization of foams and aerogels, the Be ignition capsule, and machining unique components are of main material focus. One important characterization metric the physics' have determined is that the knowledge of density gradients in foams is important. We are making strides in not only locating these density gradients in aerogels and foams as a result of how they are manufactured and machined but also quantifying the density within the foam using 3D confocal micro x-ray fluorescence (μXRF imaging and 3D x-ray computed tomography (CT imaging. In addition, collaborative efforts between General Atomics (GA and LANL in the characterization of the NIF Ignition beryllium capsule have shown that the copper in the capsule migrates radially from the capsule center.

  9. Implementation of a professional portfolio: a tool to demonstrate professional development for advanced practice.

    Science.gov (United States)

    Chamblee, Tracy B; Dale, Juanita Conkin; Drews, Barbie; Spahis, Joanna; Hardin, Teri

    2015-01-01

    The literature has a gap related to professional development for APRNs. In the United States, many health care organizations use clinical advancement programs for registered nurses, but APRNs are not often included in these programs. If APRNs are included, advancement opportunities are very limited. At CMC, implementation of a professional portfolio resulted in increased satisfaction among APPs regarding their ability to showcase professional growth and expertise, as well as the uniqueness of their advanced practice. Use of the professional portfolio led to improved recognition by APS and organizational leaders of APP performance excellence during the annual performance evaluation, as well as improved recognition among APP colleagues in terms of nominations for honors and awards.

  10. Postural and Object-Oriented Experiences Advance Early Reaching, Object Exploration, and Means-End Behavior

    Science.gov (United States)

    Lobo, Michele A.; Galloway, James C.

    2008-01-01

    The effects of 3 weeks of social (control), postural, or object-oriented experiences on 9- to 21-week-old infants' (N = 42) reaching, exploration, and means-end behaviors were assessed. Coders recorded object contacts, mouthing, fingering, attention, and affect from video. Postural and object-oriented experiences advanced reaching, haptic…

  11. Advanced Life Support Project: Crop Experiments at Kennedy Space Center

    Science.gov (United States)

    Sager, John C.; Stutte, Gary W.; Wheeler, Raymond M.; Yorio, Neil

    2004-01-01

    Crop production systems provide bioregenerative technologies to complement human crew life support requirements on long duration space missions. Kennedy Space Center has lead NASA's research on crop production systems that produce high value fresh foods, provide atmospheric regeneration, and perform water processing. As the emphasis on early missions to Mars has developed, our research focused on modular, scalable systems for transit missions, which can be developed into larger autonomous, bioregenerative systems for subsequent surface missions. Components of these scalable systems will include development of efficient light generating or collecting technologies, low mass plant growth chambers, and capability to operate in the high energy background radiation and reduced atmospheric pressures of space. These systems will be integrated with air, water, and thermal subsystems in an operational system. Extensive crop testing has been done for both staple and salad crops, but limited data is available on specific cultivar selection and breadboard testing to meet nominal Mars mission profiles of a 500-600 day surface mission. The recent research emphasis at Kennedy Space Center has shifted from staple crops, such as wheat, soybean and rice, toward short cycle salad crops such as lettuce, onion, radish, tomato, pepper, and strawberry. This paper will review the results of crop experiments to support the Exploration Initiative and the ongoing development of supporting technologies, and give an overview of capabilities of the newly opened Space Life Science (SLS) Lab at Kennedy Space Center. The 9662 square m (104,000 square ft) SLS Lab was built by the State of Florida and supports all NASA research that had been performed in Hanger-L. In addition to NASA research, the SLS Lab houses the Florida Space Research Institute (FSRI), responsible for co-managing the facility, and the University of Florida (UF) has established the Space Agriculture and Biotechnology Research and

  12. Advanced practice nursing for enduring health needs management: a global perspective.

    Science.gov (United States)

    Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis

    2012-07-01

    Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Student nurses' experiences of community-based practice placement learning: a qualitative exploration.

    Science.gov (United States)

    Baglin, M R; Rugg, Sue

    2010-05-01

    United Kingdom (UK) health policy has adopted an increasing community and primary care focus over recent years (Department of Health, 1997; Department of Health, 1999. Making a Difference: Strengthening the Nursing, Midwifery and Health Visitor Contribution to Health and Health Care. Department of Health, London; Department of Health, 2004. The NHS Knowledge and Skills Framework (NHS KSF). Department of Health, London). Nursing practice, education and workforce planning are called upon to adapt accordingly (Department of Health, 2004. The NHS Knowledge and Skills Framework (NHS KSF). Department of Health, London; Kenyon, V., Smith, E., Hefty, L., Bell, M., Martaus, T., 1990. Clinical competencies for community health nursing. Public Health Nursing 7(1), 33-39; United Kingdom Central Council for Nursing, Midwifery and Health Visiting, 1986. Project 2000: A New Preparation for Practice. UKCC, London). Such changes have major implications for pre-registration nursing education, including its practice placement element. From an educational perspective, the need for increased community nursing capacity must be balanced with adequate support for student nurses' learning needs during community-based placements. This qualitative study explored six second year student nurses' experiences of 12 week community-based practice placements and the extent to which these placements were seen to meet their perceived learning needs. The data came from contemporaneous reflective diaries, completed by participants to reflect their 'lived experience' during their practice placements (Landeen, J., Byrne, Brown, B., 1995. Exploring the lived experiences of psychiatric nursing students through self-reflective journals. Journal of Advanced Nursing 21(5), 878-885; Kok, J., Chabeli, M.M., 2002. Reflective journal writing: how it promotes reflective thinking in clinical nursing education: a students' perspective. Curationis 25(3), 35-42; Löfmark, A., Wikblad, K., 2001. Facilitating and

  14. Randomized clinical trial to evaluate mental practice in enhancing advanced laparoscopic surgical performance.

    Science.gov (United States)

    Louridas, M; Bonrath, E M; Sinclair, D A; Dedy, N J; Grantcharov, T P

    2015-01-01

    Mental practice, the cognitive rehearsal of a task without physical movement, is known to enhance performance in sports and music. Investigation of this technique in surgery has been limited to basic operations. The purpose of this study was to develop mental practice scripts, and to assess their effect on advanced laparoscopic skills and surgeon stress levels in a crisis scenario. Twenty senior surgical trainees were randomized to either conventional training or mental practice groups, the latter being trained by an expert performance psychologist. Participants' skills were assessed while performing a porcine laparoscopic jejunojejunostomy as part of a crisis scenario in a simulated operating room, using the Objective Structured Assessment of Technical Skill (OSATS) and bariatric OSATS (BOSATS) instruments. Objective and subjective stress parameters were measured, as well as non-technical skills using the Non-Technical Skills for Surgeons rating tool. An improvement in OSATS (P = 0.003) and BOSATS (P = 0.003) scores was seen in the mental practice group compared with the conventional training group. Seven of ten trainees improved their technical performance during the crisis scenario, whereas four of the ten conventionally trained participants deteriorated. Mental imagery ability improved significantly following mental practice training (P = 0.011), but not in the conventional group (P = 0.083). No differences in objective or subjective stress levels or non-technical skills were evident. Mental practice improves technical performance for advanced laparoscopic tasks in the simulated operating room, and allows trainees to maintain or improve their performance despite added stress. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  15. Assessing the Spread and Uptake of a Framework for Introducing and Evaluating Advanced Practice Nursing Roles.

    Science.gov (United States)

    Boyko, Jennifer A; Carter, Nancy; Bryant-Lukosius, Denise

    2016-08-01

    Health system researchers must ensure that the products of their work meet the needs of various stakeholder groups (e.g., patients, practitioners, and policy makers). Evidence-based frameworks can support the uptake and spread of research evidence; however, their existence as knowledge translation tools does not ensure their uptake and it is difficult to ascertain their spread into research, practice, and policy using existing methods. The purpose of this article is to report results of a study on the spread and uptake of an evidence-based framework (i.e., the participatory, evidence-based, patient-focused process for advanced practice nursing [PEPPA] framework) into research, practice, and policies relevant to the introduction and evaluation of advanced practice nursing roles. We also reflect on the utility of using a modified citation methodology to evaluate knowledge translation efforts. We searched four databases for literature published between 2004 and 2014 citing the original paper in which the PEPPA framework was published, and carried out an Internet search for grey literature using keywords. Relevant data were extracted from sources and organized using NVivo software. We analysed results descriptively. Our search yielded 164 unique sources of which 69.5% were from published literature and the majority (83.4%) of these were published in nursing journals. Most frequently (71.5%), the framework was used by researchers and students in research studies. A smaller number of citations (11.3%) reflected use of the PEPPA framework in practice settings with a focus on role development, implementation, evaluation, or a combination of these. This study demonstrates that the PEPPA framework has been used to varying degrees as intended, and provides guidance on how to evaluate the spread and uptake of research outputs (e.g., theoretical frameworks). Further research is needed about ways to determine whether evidence-informed research tools such as frameworks have been

  16. Can the Institute of Medicine trump the dominant logic of nursing? Leading change in advanced practice education.

    Science.gov (United States)

    Dreher, Melanie C; Clinton, Patricia; Sperhac, Arlene

    2014-01-01

    The Institute of Medicine (IOM; 2010) has called for a transformation of the nursing profession to lead the redesign of health care in the United States. It acknowledges the need for profound change in nursing education, particularly advanced practice education, to produce the next generation of leaders in sufficient quantity to expand access, improve quality, and reduce cost. Although the IOM provides welcome validation of nursing's significant role, most of the recommendations are not new and have been advocated by nurse educators for decades. What has prevented us from creating the nimble and responsive educational programs that would ensure a sufficient corpus of advanced practice nurses with the relevant knowledge and skill to transform our ailing health system? Conceptualizing nursing as a complex, adaptive system (J.W. Begun and K. White, 1997), this article explores three examples of the dominant logic, grounded in a historical legacy that has kept the nursing profession from realizing its promise as a potent force: (a) the continuing preference for experience over education, (b) the belief that only nurses can teach nurses, and (c) the hegemony of the research doctorate. © 2014.

  17. Nurse Leaders’ Experiences of Implementing Career Advancement Programs for Nurses in Iran

    Science.gov (United States)

    Sheikhi, Mohammad Reza; Khoshknab, Masoud Fallahi; Mohammadi, Farahnaz; Oskouie, Fatemeh

    2015-01-01

    Background and purpose: Career advancement programs are currently implemented in many countries. In Iran, the first career advancement program was Nurses’ Career Advancement Pathway. The purpose of this study was to explore nurse leaders’ experiences about implementing the Nurses’ Career Advancement Pathway program in Iran. Methods: This exploratory qualitative study was conducted in 2013. Sixteen nurse managers were recruited from the teaching hospitals affiliated to Shahid Behesthi, Qazvin, and Iran Universities of Medical Sciences in Iran. Participants were recruited using purposive sampling method. Study data were collected through in-depth semi-structured interviews. The conventional content analysis approach was used for data analysis. Results: participants’ experiences about implementing the Nurses’ Career Advancement Pathway fell into three main categories including: a) the shortcomings of performance evaluation, b) greater emphasis on point accumulation, c) the advancement-latitude mismatch. Conclusion: The Nurses’ Career Advancement pathway has several shortcomings regarding both its content and its implementation. Therefore, it is recommended to revise the program. PMID:26156907

  18. Pain experiences of patients with advanced cancer: A qualitative descriptive study.

    Science.gov (United States)

    Erol, Ozgul; Unsar, Serap; Yacan, Lale; Pelin, Meryem; Kurt, Seda; Erdogan, Bülent

    2018-04-01

    Uncontrolled pain, especially in patients with advanced cancer, affects quality of life negatively and causes negative physical and psychological conditions. The aim of this study was to explore the pain experiences of patients with advanced cancer and how they manage with pain, and to present a view of pain management approaches of nurses from the perspectives of the patients. This was a qualitative descriptive study of sixteen hospitalized patients with advanced cancer. Data were collected using semi-structured interviews with patients. Data were analysed by Colaizzi's phenomenological method. This study found that patients with advanced cancer who had pain experienced anxiety, helplessness, hopelessness and many restrictions in daily life as well as inability to manage with pain. Most of the patients with advanced cancer were not satisfied with their nursing care with regard to pain management. The themes that emerged were pain perception and experiences, effects of pain on daily life, pain management and management strategies and the patients' perspectives about nursing approaches to pain. This study demonstrated the difficulties of patients with advanced cancer who experienced pain in their daily lives, yet lack pain management strategies. Furthermore, nurses' caring approaches to patients with advanced cancer who experienced pain was found inadequate. Oncology nurses should provide educational interventions in order to enhance knowledge and skills about pain assessment and non-pharmacologic and pharmacologic strategies used in pain management. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Modes of relating to contingency: An exploration of experiences in advanced cancer patients.

    Science.gov (United States)

    Kruizinga, Renske; Hartog, Iris D; Scherer-Rath, Michael; Schilderman, Hans; Van Laarhoven, Hanneke

    2017-08-01

    Throughout their lives, people are confronted with unexpected life events, which can be difficult to incorporate into their life narratives. Such a confrontation can result in an experience of contingency. Different ways of relating to contingency have been described by Wuchterl: denying, acknowledging, and "encounter with the Other." In the present article, we aim to trace these theoretical distinctions in real-life experiences of patients. We analyzed 45 interviews using the constant comparative method with a directed content analysis approach in the Atlas.ti coding program. The interviews originated from a randomized controlled trial evaluating an assisted reflection on life events and ultimate life goals. Seven spiritual counselors from six hospitals in the Netherlands conducted the interviews from July of 2014 to March of 2016. All 45 patients had advanced cancer. We found four different modes into which relating to contingency can be classified: denying, acknowledging, accepting, and receiving. With denying, patients did not mention any impact of the life event on their lives. In acknowledging, the impact was recognized and a start was made to incorporate the event into their life. In accepting, patients went through a process of reinterpretation of the event. In receiving, patients talked about receiving insights from their illness and living a more conscious life. Our study is the first to investigate the different ways of relating to contingency in clinical practice. The defined modes will improve our understanding of the various ways in which cancer patients relate to their disease, allowing caregivers to better target and shape individual care.

  20. Innovative Approach to the Organization of Future Social Workers' Practical Training: Foreign Experience

    Science.gov (United States)

    Polishchuk, Vira; Slozanska, Hanna

    2014-01-01

    Innovative approaches to practical training of future social workers in higher educational establishments have been defined. Peculiarities of foreign experience of social workers' practical training in higher educational establishments have been analyzed. Experience of organizing practice for bachelor students studying at "Social Work"…

  1. User Experience in Mobile Augmented Reality: Emotions, Challenges, Opportunities and Best Practices

    Directory of Open Access Journals (Sweden)

    Amir Dirin

    2018-05-01

    Full Text Available Mobile Augmented Reality (MAR is gaining a strong momentum to become a major interactive technology that can be applied across domains and purposes. The rapid proliferation of MAR applications in global mobile application markets has been fueled by a range of freely-available MAR software development kits and content development tools, some of which enable the creation of MAR applications even without programming skills. Despite the recent advances of MAR technology and tools, there are still many challenges associated with MAR from the User Experience (UX design perspective. In this study, we first define UX as the emotions that the user encounters while using a service, a product or an application and then explore the recent research on the topic. We present two case studies, a commercial MAR experience and our own Virtual Campus Tour MAR application, and evaluate them from the UX perspective, with a focus on emotions. Next, we synthesize the findings from previous research and the results of the case study evaluations to form sets of challenges, opportunities and best practices related to UX design of MAR applications. Based on the identified best practices, we finally present an updated version of the Virtual Campus Tour. The results can be used for improving UX design of future MAR applications, thus making them emotionally engaging.

  2. An ethnographic study of nurses' experience with nursing research and its integration in practice.

    Science.gov (United States)

    Dupin, Cécile Marie; Borglin, Gunilla; Debout, Christophe; Rothan-Tondeur, Monique

    2014-09-01

    To report from a study aimed at illuminating how French Registered Nurses experience and engage in nursing research in clinical practice. Nursing research in France is mainly conducted by nurses working at clinical research units rather than by dedicated nurse researchers. Education, i.e. advanced degrees, in the field of nursing research is still in its infancy and not yet consistent with the international context. Outside France, the general perception is that nursing research is a unified part of professional nursing. Consequently, in-depth knowledge about how nurses in a French clinical context might experience and engage in nursing research is still lacking. The design of this study was influenced by an ethnographic approach as described by the French anthropologists Beaud and Weber. Data, participatory observations, field notes and interviews (n = 6) were collected in a teaching hospital between April-August 2012. The field consisted of a wound-care unit and clinical research units. Collected data were analysed based on Beaud and Weber's description of analysis. Three beliefs were identified: being a unified part of a research team, being an integral part of 'crosswise - across' activities and being part of research activities. Commitment to nursing research was strengthened by patient-related issues. Based on this context, nursing research would likely benefit from the support of a naturalized reciprocity between clinical practice and research. © 2014 John Wiley & Sons Ltd.

  3. Goals and potential career advancement of licensed practical nurses in Japan.

    Science.gov (United States)

    Ikeda, Mari; Inoue, Katsuya; Kamibeppu, Kiyoko

    2008-10-01

    To investigate the effects of personal and professional variables on career advancement intentions of working Licensed Practical Nurses (LPNs). In Japan, two levels of professional nursing licensures, the LPN and the registered nurse (RN), are likely to be integrated in the future. Therefore, it is important to know the career advancement intentions of LPNs. Questionnaires were sent to a sample of 356 LPNs. Analysis of variance (anova) and discriminative analysis were used. We found that those who had a positive image of LPNs along with a positive image of RNs were identified as showing interest in career advancement. The results of anova showed that age had a negative effect; however, discriminative analysis suggested that age is not as significant compared with other variables. Our results indicate that the 'image of RNs', and 'role-acceptance factors' have an effect on career advancement intentions of LPNs. Our results suggest that Nursing Managers should create a supportive working environment where the LPN would feel encouraged to carry out the nursing role, thereby creating a positive image of nursing in general which would lead to career motivation and pursuing RN status.

  4. Focused development of advanced practice nurse roles for specific patient groups in a Swiss university hospital

    Science.gov (United States)

    Spichiger, Elisabeth; Zumstein-Shaha, Maya; Schubert, Maria; Herrmann, Luzia

    2018-02-01

    Background: To cover future health care needs of the population, new care models are necessary. The development of advanced nursing practice (ANP) offers the opportunity to meet these challenges with novel services. At the Inselspital, Bern University Hospital, ANP services and corresponding advanced practice nurse (APN) roles have been developed since 2011. Purpose: The aim is to develop innovative and evidence based ANP services to supplement health care for specific patient groups and their family members with the goal to improve safety and achieve better outcomes. Methods: Project-based ANP services are developed in close collaboration of clinical departments and the Nursing Development Unit (NDU) of the Directorate of Nursing. Structure, process and outcome data are collected for evaluation. Findings: Currently, five ANP services are established and running, eight more are in the developmental phase. Most services address the long term care of patients with chronic illnesses and their family members. Ten APNs work between 10 % and 80 %, three are leading an ANP-team. APNs work over 50 % in direct clinical practice, primarily in counselling. An ANP network connects APNs and NDU, promoting synergy and exchange. Conclusions: The available resources often constitute a challenge for the development of ANP services. Vital for the long-term success are an adequate extent of the position, the support by department directorate, the conceptual framework that is implemented across the whole hospital, and the development within project structures.

  5. The experiences of student nurses on placements with practice nurses : a pilot study

    OpenAIRE

    Gale, Julia; Ooms, Ann; Sharples, Kath; Marks-Maran, Di

    2016-01-01

    To prepare the registered nurse of tomorrow in the United Kingdom (UK) to care for patients in general practice (GP)-led services, today's student nurses need to have the opportunity to experience placements with practice nurses to enable them to make positive career choices to become practice nurses in the future. The role of the practice nurse is described in the article. As a pilot project, seventeen students undertook placements with practice nurses in one of seven GP practices selected b...

  6. Human Factors Engineering (HFE) insights for advanced reactors based upon operating experience

    International Nuclear Information System (INIS)

    Higgins, J.; Nasta, K.

    1997-01-01

    The NRC Human Factors Engineering Program Review Model (HFE PRM, NUREG-0711) was developed to support a design process review for advanced reactor design certification under 10CFR52. The HFE PRM defines ten fundamental elements of a human factors engineering program. An Operating Experience Review (OER) is one of these elements. The main purpose of an OER is to identify potential safety issues from operating plant experience and ensure that they are addressed in a new design. Broad-based experience reviews have typically been performed in the past by reactor designers. For the HFE PRM the intent is to have a more focussed OER that concentrates on HFE issues or experience that would be relevant to the human-system interface (HSI) design process for new advanced reactors. This document provides a detailed list of HFE-relevant operating experience pertinent to the HSI design process for advanced nuclear power plants. This document is intended to be used by NRC reviewers as part of the HFE PRM review process in determining the completeness of an OER performed by an applicant for advanced reactor design certification. 49 refs

  7. The universal, collaborative and dynamic model of specialist and advanced nursing and midwifery practice: A way forward?

    Science.gov (United States)

    O'Connor, Laserina; Casey, Mary; Smith, Rita; Fealy, Gerard M; Brien, Denise O'; O'Leary, Denise; Stokes, Diarmuid; McNamara, Martin S; Glasgow, Mary Ellen; Cashin, Andrew

    2018-03-01

    To inform and guide the development of a future model of specialist and advanced nursing and midwifery practice. There is a sizable body of empirical literature supporting the unique contributions of specialist and advanced practice roles to health care. However, there is very little international evidence to inform the integration of a future model for advanced or specialist practice in the Irish healthcare system. A qualitative study was conducted to initiate this important area of inquiry. Purposive sampling was used to generate a sample of informants (n = 15) for the interviews. Nurses and midwives working in specialist and advanced practice and participants from other areas such as legislative, regulatory, policy, medicine and education were included in the sampling frame. Arguments for a new model of specialist and advanced practice were voiced. A number of participants proposed that flexibility within specialist and advanced practitioner career pathways was essential. Otherwise, there existed the possibility of being directed into specialised "silos," precluding movement to another area of integrated practice. Future specialist and advanced practice education programmes need to include topics such as the development of emotional and political intelligence. The contribution of specialist and advanced practice roles to the health service includes providing rapid access to care, seamless patient flow across services, early discharge and lead coordinator of the patient's care trajectory. There was a recommendation of moving towards a universal model to cultivate specialist and advanced nurse and midwife practitioners. The model design has Universal application in a range of contexts "U." It is Collaborative in its inclusivity of all key stakeholders "C." The model is Dynamic pertinent to accommodating movement of nurses and midwives across health continua rather than plateauing in very specialised "silos" "D." © 2017 John Wiley & Sons Ltd.

  8. Rural general practice training: experience of a rural general practice team and a postgraduate year two registrar

    Directory of Open Access Journals (Sweden)

    Scott-Jones J

    2013-09-01

    Full Text Available INTRODUCTION: Undertaking training in rural areas is a recognised way of helping recruit staff to work in rural communities. Postgraduate year two medical doctors in New Zealand have been able to undertake a three-month placement in rural practice as part of their pre-vocational training experience since November 2010. AIM: To describe the experience of a rural general practice team providing training to a postgraduate year two medical trainee, and to describe the teaching experience and range of conditions seen by the trainee. METHODS: A pre- and post-placement interview with staff, and analysis of a logbook of cases and teaching undertaken in the practice. RESULTS: The practice team's experience of having the trainee was positive, and the trainee was exposed to a wide range of conditions over 418 clinical encounters. The trainee received 22.5 hours of formal training over the three-month placement. DISCUSSION: Rural general practice can provide a wide range of clinical experience to a postgraduate year two medical trainee. Rural practices in New Zealand should be encouraged to offer teaching placements at this training level. Exposure to rural practice at every level of training is important to encourage doctors to consider rural practice as a career.

  9. Rural general practice training: experience of a rural general practice team and a postgraduate year two registrar.

    Science.gov (United States)

    Scott-Jones, Joseph; Lucas, Sarah

    2013-09-01

    Undertaking training in rural areas is a recognised way of helping recruit staff to work in rural communities. Postgraduate year two medical doctors in New Zealand have been able to undertake a three-month placement in rural practice as part of their pre-vocational training experience since November 2010. To describe the experience of a rural general practice team providing training to a postgraduate year two medical trainee, and to describe the teaching experience and range of conditions seen by the trainee. A pre- and post-placement interview with staff, and analysis of a logbook of cases and teaching undertaken in the practice. The practice team's experience of having the trainee was positive, and the trainee was exposed to a wide range of conditions over 418 clinical encounters. The trainee received 22.5 hours of formal training over the three-month placement. Rural general practice can provide a wide range of clinical experience to a postgraduate year two medical trainee. Rural practices in New Zealand should be encouraged to offer teaching placements at this training level. Exposure to rural practice at every level of training is important to encourage doctors to consider rural practice as a career.

  10. Patient acceptability and practical implications of pharmacokinetic studies in patients with advanced cancer.

    Science.gov (United States)

    Dobbs, N A; Twelves, C J; Ramirez, A J; Towlson, K E; Gregory, W M; Richards, M A

    1993-01-01

    We have studied the practical implications and acceptability to patients of pharmacokinetic studies in 34 women receiving anthracyclines for advanced breast cancer. The following parameters were recorded: age, ECOG performance status, psychological state (Rotterdam Symptom Checklist), cytotoxic drug and dose, number of venepunctures for treatment and sampling, and time when the sampling cannula was removed. Immediately after finishing pharmacokinetic sampling, patients completed a questionnaire which revealed that (i) all patients understood sampling was for research, (ii) 35% of patients experienced problems with sampling, (iii) benefits from participation were perceived by 56% of patients. Of 20 patients later questioned after completion of their treatment course, 40% recalled difficulties with blood sampling. Factors identifying in advance those patients who tolerate pharmacokinetic studies poorly were not identified but the number of venepunctures should be minimised. Patients may also perceive benefits from 'non-therapeutic' research.

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

    Directory of Open Access Journals (Sweden)

    Biserka Bergman-Markovi_

    2007-09-01

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

  12. A practical appreciation of the implementation of a fully computerized monitoring and control system in N4 NFP series: An advanced instrumentation and control system

    Energy Technology Data Exchange (ETDEWEB)

    DaCruz, P. [Atos Origin, 4, Triton Square, Regent' s Place, London NW1 3HG (United Kingdom)

    2006-07-01

    Sema Group (acquired in February 2004 by Atos Origin) was selected by EDF to design, develop and supply this system, based on their product Advanced Data Acquisition and Control System (ADACS). The purpose of this paper is to give a practical appreciation from both the demand and supply perspectives of the implementation of the fully computerized Monitoring and Control systems. This is a joint presentation by EDF and Atos Origin based on their experiences of the N4 programme.

  13. AWAKE, The Advanced Proton Driven Plasma Wakefield Acceleration Experiment at CERN

    CERN Document Server

    Gschwendtner, E.; Amorim, L.; Apsimon, R.; Assmann, R.; Bachmann, A.M.; Batsch, F.; Bauche, J.; Berglyd Olsen, V.K.; Bernardini, M.; Bingham, R.; Biskup, B.; Bohl, T.; Bracco, C.; Burrows, P.N.; Burt, G.; Buttenschon, B.; Butterworth, A.; Caldwell, A.; Cascella, M.; Chevallay, E.; Cipiccia, S.; Damerau, H.; Deacon, L.; Dirksen, P.; Doebert, S.; Dorda, U.; Farmer, J.; Fedosseev, V.; Feldbaumer, E.; Fiorito, R.; Fonseca, R.; Friebel, F.; Gorn, A.A.; Grulke, O.; Hansen, J.; Hessler, C.; Hofle, W.; Holloway, J.; Huther, M.; Jaroszynski, D.; Jensen, L.; Jolly, S.; Joulaei, A.; Kasim, M.; Keeble, F.; Li, Y.; Liu, S.; Lopes, N.; Lotov, K.V.; Mandry, S.; Martorelli, R.; Martyanov, M.; Mazzoni, S.; Mete, O.; Minakov, V.A.; Mitchell, J.; Moody, J.; Muggli, P.; Najmudin, Z.; Norreys, P.; Oz, E.; Pardons, A.; Pepitone, K.; Petrenko, A.; Plyushchev, G.; Pukhov, A.; Rieger, K.; Ruhl, H.; Salveter, F.; Savard, N.; Schmidt, J.; Seryi, A.; Shaposhnikova, E.; Sheng, Z.M.; Sherwood, P.; Silva, L.; Soby, L.; Sosedkin, A.P.; Spitsyn, R.I.; Trines, R.; Tuev, P.V.; Turner, M.; Verzilov, V.; Vieira, J.; Vincke, H.; Wei, Y.; Welsch, C.P.; Wing, M.; Xia, G.; Zhang, H.

    2016-01-01

    The Advanced Proton Driven Plasma Wakefield Acceleration Experiment (AWAKE) aims at studying plasma wakefield generation and electron acceleration driven by proton bunches. It is a proof-of-principle R&D experiment at CERN and the world's first proton driven plasma wakefield acceleration experiment. The AWAKE experiment will be installed in the former CNGS facility and uses the 400 GeV/c proton beam bunches from the SPS. The first experiments will focus on the self-modulation instability of the long (rms ~12 cm) proton bunch in the plasma. These experiments are planned for the end of 2016. Later, in 2017/2018, low energy (~15 MeV) electrons will be externally injected to sample the wakefields and be accelerated beyond 1 GeV. The main goals of the experiment will be summarized. A summary of the AWAKE design and construction status will be presented.

  14. Reflections on evaluative practice in higher education: an experience collaborative

    Directory of Open Access Journals (Sweden)

    Suênya Marley Mourão Batista

    2016-12-01

    Full Text Available This article aims to reflect on the evaluation practice of higher education teachers generated from research conducted as part of a private higher education institution. The objective of this study is to characterize the assessment practices of teachers who work in higher education and collaborate in order to facilitate the expansion of dynamic assessment practices were used as theoretical and methodological support the studies of Vygotsky (2007, Liberali (2008, Ibiapina (2007, 2008, Meier (2007, Campione (2002 and Hoffmann (2011. Field research was conducted in a qualitative approach to collaborative type with 3 (three in higher education using the reflective interview as data collection tool to promote critical thinking about assessment practices to develop. The results showed the prevalence of use of traditional assessment practices by teachers and the possibility of performing dynamic assessment practices from the understanding of these nurtured by the research and training process.

  15. Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance; Grocery Stores (Revised) (Book)

    Energy Technology Data Exchange (ETDEWEB)

    Hendron, B.

    2013-07-01

    The U.S. Department of Energy developed the Advanced Energy Retrofit Guides (AERGs) to provide specific methodologies, information, and guidance to help energy managers and other stakeholders successfully plan and execute energy efficiency improvements. Detailed technical discussion is fairly limited in these guides. Instead, we emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluations of the most promising retrofit measures for each building type. A series of AERGs is under development, addressing key segments of the commercial building stock. Grocery stores were selected as one of the highest priority sectors, because they represent one of the most energy-intensive market segments.

  16. Advancing Research and Practice: The Revised APA Division 30 Definition of Hypnosis.

    Science.gov (United States)

    Elkins, Gary R; Barabasz, Arreed F; Council, James R; Spiegel, David

    2015-04-01

    This article describes the history, rationale, and guidelines for developing a new definition of hypnosis by the Society of Psychological Hypnosis, Division 30 of the American Psychological Association. The definition was developed with the aim of being concise, being heuristic, and allowing for alternative theories of the mechanisms (to be determined in empirical scientific study). The definition of hypnosis is presented as well as definitions of the following related terms: hypnotic induction, hypnotizability, and hypnotherapy. The implications for advancing research and practice are discussed. The definitions are presented within the article.

  17. Culture care theory: a major contribution to advance transcultural nursing knowledge and practices.

    Science.gov (United States)

    Leininger, Madeleine

    2002-07-01

    This article is focused on the major features of the Culture Care Diversity and Universality theory as a central contributing theory to advance transcultural nursing knowledge and to use the findings in teaching, research, practice, and consultation. It remains one of the oldest, most holistic, and most comprehensive theories to generate knowledge of diverse and similar cultures worldwide. The theory has been a powerful means to discover largely unknown knowledge in nursing and the health fields. It provides a new mode to assure culturally competent, safe, and congruent transcultural nursing care. The purpose, goal, assumptive premises, ethnonursing research method, criteria, and some findings are highlighted.

  18. Innovative Practice in Advancement of Academic Nurse Educator Careers: Developing Scholarship From Program Grants.

    Science.gov (United States)

    Eddy, Linda L; Hoeksel, Renee; Fitzgerald, Cindy; Doutrich, Dawn

    We describe an innovative practice in advancing careers of academic nurse educators: demonstrating scholarly productivity from program grants. Scholarly productivity is often narrowly defined, especially in research-intensive institutions. The expectation may be a career trajectory based on the traditional scholarship of discovery. However, nurse educators, especially at the associate and full professor ranks, are often involved in leadership activities that include writing and managing program grants. We encourage the academy to value and support the development of program grants that include significant scholarly components, and we offer exemplars of associate and full professor scholarship derived from these projects.

  19. Conditions for building a community of practice in an advanced physics laboratory

    Science.gov (United States)

    Irving, Paul W.; Sayre, Eleanor C.

    2014-06-01

    We use the theory of communities of practice and the concept of accountable disciplinary knowledge to describe how a learning community develops in the context of an upper-division physics laboratory course. The change in accountable disciplinary knowledge motivates students' enculturation into a community of practice. The enculturation process is facilitated by four specific structural features of the course and supported by a primary instructional choice. The four structural features are "paucity of instructor time," "all in a room together," "long and difficult experiments," and "same experiments at different times." The instructional choice is the encouragement of the sharing and development of knowledge and understanding by the instructor. The combination of the instructional choice and structural features promotes the development of the learning community in which students engage in authentic practices of a physicist. This results in a classroom community that can provide students with the opportunity to have an accelerated trajectory towards being a more central participant of the community of a practice of physicists. We support our claims with video-based observations of laboratory classroom interactions and individual, semistructured interviews with students about their laboratory experiences and physics identity.

  20. Fourth Workshop on Sustainable Software for Science: Practice and Experiences (WSSSPE4)

    NARCIS (Netherlands)

    Katz, Daniel S; Niemeyer, Kyle E; Gesing, Sandra; Hwang, Lorraine; Bangerth, Wolfgang; Hettrick, Simon; Idaszak, Ray; Salac, Jean; Chue Hong, Neil; Núñez-Corrales, Santiago; Allen, Alice; Geiger, R Stuart; Miller, Jonah; Chen, Emily; Dubey, Anshu; Lago, Patricia

    2018-01-01

    This article summarizes motivations, organization, and activities of the Fourth Workshop on Sustainable Software for Science: Practice and Experiences (WSSSPE4). The WSSSPE series promotes sustainable research software by positively impacting principles and best practices, careers, learning, and

  1. Advancing community stakeholder engagement in biomedical HIV prevention trials: principles, practices and evidence.

    Science.gov (United States)

    Newman, Peter A; Rubincam, Clara

    2014-12-01

    Community stakeholder engagement is foundational to fair and ethically conducted biomedical HIV prevention trials. Concerns regarding the ethical engagement of community stakeholders in HIV vaccine trials and early terminations of several international pre-exposure prophylaxis trials have fueled the development of international guidelines, such as UNAIDS' good participatory practice (GPP). GPP aims to ensure that stakeholders are effectively involved in all phases of biomedical HIV prevention trials. We provide an overview of the six guiding principles in the GPP and critically examine them in relation to existing social and behavioral science research. In particular, we highlight the challenges involved in operationalizing these principles on the ground in various global contexts, with a focus on low-income country settings. Increasing integration of social science in biomedical HIV prevention trials will provide evidence to advance a science of community stakeholder engagement to support ethical and effective practices informed by local realities and sociocultural differences.

  2. Technological advances in the treatment of trauma: a review of promising practices.

    Science.gov (United States)

    Paul, Lisa A; Hassija, Christina M; Clapp, Joshua D

    2012-11-01

    Given the availability of empirically supported practices for addressing posttraumatic stress disorder and other forms of trauma-related distress, the development and implementation of new technology to deliver these treatments is exciting. Technological innovations in this literature aim to expand availability of empirically based intervention, increase treatment adherence and acceptability, and overcome barriers commonly encountered with conventional trauma-focused treatment. Much of the current research on these technological developments consists of brief reviews and case studies of the separate therapy modalities. Although this work serves to document the appeal and utility of these innovations, it does not provide comprehensive information about the host of options available. To that end, the three general categories of technological advances in trauma therapy (i.e., videoconferencing, e-Health, virtual reality) are reviewed here, including information regarding their empirical support and suggestions for future research and clinical practice.

  3. Advanced Test Reactor (ATR) Facility 10CFR830 Safety Basis Related to Facility Experiments

    International Nuclear Information System (INIS)

    Tomberlin, T.A.

    2002-01-01

    The Idaho National Engineering and Environmental Laboratory (INEEL) Advanced Test Reactor (ATR), a DOE Category A reactor, was designed to provide an irradiation test environment for conducting a variety of experiments. The ATR Safety Analysis Report, determined by DOE to meet the requirements of 10 CFR 830, Subpart B, provides versatility in types of experiments that may be conducted. This paper addresses two general types of experiments in the ATR facility and how safety analyses for experiments are related to the ATR safety basis. One type of experiment is more routine and generally represents greater risks; therefore this type of experiment is addressed with more detail in the safety basis. This allows individual safety analyses for these experiments to be more routine and repetitive. The second type of experiment is less defined and is permitted under more general controls. Therefore, individual safety analyses for the second type of experiment tend to be more unique from experiment to experiment. Experiments are also discussed relative to ''major modifications'' and DOE-STD-1027-92. Application of the USQ process to ATR experiments is also discussed

  4. The Effect of Conceptual Advancement in Jazz Music Selections and Jazz Experience on Musicians' Aesthetic Response

    Science.gov (United States)

    Coggiola, John C.

    2004-01-01

    This study is an investigation of what musicians consider to be their aesthetic experience with jazz music selections that vary in level of conceptual advancement (melodic complexity during improvised solos). Music major participants (N = 128) were assigned to either the jazz musician (n = 64) or nonjazz musician (n = 64) group. Data were gathered…

  5. Career Advancement Experiences of Hispanic Secondary Principals in Suburban School Districts: A Phenomenological Study

    Science.gov (United States)

    Fernandez, Rick

    2013-01-01

    Purpose: The purpose of this study was to examine the perceptions and experiences of Hispanic secondary school principals who work in suburban school districts regarding their career advancement. Moreover, the objective of this research was to understand these Hispanic principals' motivational drivers and barriers regarding their career choices,…

  6. Trispyrazolylborate Complexes: An Advanced Synthesis Experiment Using Paramagnetic NMR, Variable-Temperature NMR, and EPR Spectroscopies

    Science.gov (United States)

    Abell, Timothy N.; McCarrick, Robert M.; Bretz, Stacey Lowery; Tierney, David L.

    2017-01-01

    A structured inquiry experiment for inorganic synthesis has been developed to introduce undergraduate students to advanced spectroscopic techniques including paramagnetic nuclear magnetic resonance and electron paramagnetic resonance. Students synthesize multiple complexes with unknown first row transition metals and identify the unknown metals by…

  7. Book Review "Advances on remote laboratories and e-learning experiences"

    Directory of Open Access Journals (Sweden)

    Jesús A. del Alamo

    2007-08-01

    Full Text Available Book Review "Advances on remote laboratories and e-learning experiences", book editors: Luís Gomes and Javier García-Zubía, University of Deusto, Spain. Reviewed by Jesús A. del Alamo, Massachusetts Institute of Technology, M.I.T.

  8. Experience of developments and implementation of advanced fuel cycles of WWER-440 reactors

    International Nuclear Information System (INIS)

    Gagarinski, A.A.; Lizorkin, M.P.; Novikov, A.N.; Proselkov, V.N.; Saprykin, V.V.

    2000-01-01

    The paper presents the experience of development and implementation of advanced four- and five-year fuel cycles in the WWER-440 reactors, the results of experimental operation of the new fuel design and the main neutronic characteristics of the core. (Authors)

  9. Advanced practice nursing students' knowledge, self-efficacy, and attitudes related to depression in older adults: teaching holistic depression care.

    Science.gov (United States)

    Delaney, Colleen; Barrere, Cynthia

    2012-01-01

    The aim of this study was to examine the knowledge, attitudes, and self-efficacy of advanced practice nursing students toward depression in older adults. Findings suggest that advanced practice nursing students are interested in caring for the whole person and desired more information on the physical and emotional-spiritual needs of older patients with depression. Suggestions for holistic nursing depression care education are presented.

  10. Joint crisis plans and psychiatric advance directives in German psychiatric practice.

    Science.gov (United States)

    Radenbach, Katrin; Falkai, Peter; Weber-Reich, Traudel; Simon, Alfred

    2014-05-01

    This study explores the attitude of German psychiatrists in leading positions towards joint crisis plans and psychiatric advance directives. This topic was examined by contacting 473 medical directors of German psychiatric hospitals and departments. They were asked to complete a questionnaire developed by us. That form contained questions about the incidence and acceptance of joint crisis plans and psychiatric advance directives and previous experiences with them. 108 medical directors of psychiatric hospitals and departments responded (response rate: 22.8%). Their answers demonstrate that in their hospitals these documents are rarely used. Among the respondents, joint crisis plans are more accepted than psychiatric advance directives. There is a certain uncertainty when dealing with these instruments. Our main conclusion is that German psychiatry needs an intensified discussion on the use of instruments for patients to constitute procedures for future critical psychiatric events. For this purpose it will be helpful to collect more empirical data. Furthermore, the proposal of joint crisis plans in psychiatric hospitals and departments should be discussed as well as the possibility of consulting an expert during the preparation of a psychiatric advance directive.

  11. A pilot study of the experience of family caregivers of patients with advanced pancreatic cancer using a mixed methods approach.

    Science.gov (United States)

    Sherman, Deborah W; McGuire, Deborah B; Free, David; Cheon, Joo Young

    2014-09-01

    Pancreatic cancer presents a wide spectrum of significant symptomatology. The high symptom burden, coupled with a rapidly fatal diagnosis, limits preparation or time for adjustment for both patients and their family caregivers. From the initial diagnosis and throughout the illness experience, the physical and emotional demands of caregiving can predispose caregivers themselves to illness and a greater risk of mortality. Understanding the negative and positive aspects of caregiving for patients with advanced pancreatic cancer will inform interventions that promote positive caregiver outcomes and support caregivers in their role. To provide feasibility data for a larger, mixed methods, longitudinal study focused on the experience of family caregivers of patients with advanced pancreatic cancer and preliminary qualitative data to substantiate the significance of studying this caregiver population. This was a mixed methods study guided by the Stress Process Model. Eight family caregivers of patients with advanced pancreatic cancer from oncology practices of a university-affiliated medical center were surveyed. The pilot results supported the ability to recruit and retain participants and informed recruitment and data collection procedures. The qualitative results provided preliminary insights into caregiver experiences during the diagnosis and treatment phases. Key findings that substantiated the significance of studying these caregivers included the caregiving context of the history of sentinel symptoms, the crisis of diagnosis, the violation of assumptions about life and health, recognition of the circle of association, and contextual factors, as well as primary and secondary stressors, coping strategies, resources, discoveries, gains and growth, associated changes/transitions, and unmet caregiver needs. Findings indicated caregivers' willingness to participate in research, highlighted the negative and positive aspects of the caregiver experience, and reinforced the

  12. Research for the advancement of green chemistry practice: Studies in atmospheric and educational chemistry

    Science.gov (United States)

    Cullipher, Steven Gene

    Green chemistry is a philosophy of chemistry that emphasizes a decreasing dependence on limited non-renewable resources and an increasing focus on preventing pollution byproducts of the chemical industry. In short, it is the discipline of chemistry practiced through the lens of environmental stewardship. In an effort to advance the practice of green chemistry, three studies will be described that have ramifications for the practice. The first study examines the atmospheric oxidation of a hydrofluorinated ether, a third-generation CFC replacement compound with primarily unknown atmospheric degradation products. Determination of these products has the potential to impact decisions on refrigerant usage in the future. The second study examines chemistry students' development of understanding benefits-costs-risks analysis when presented with two real-world scenarios: refrigerant choice and fuel choice. By studying how benefits-costs-risks thinking develops, curricular materials and instructional approaches can be designed to better foster the development of an ability that is both necessary for green chemists and important in daily decision-making for non-chemists. The final study uses eye tracking technology to examine students' abilities to interpret molecular properties from structural information in the context of global warming. Such abilities are fundamental if chemists are to appropriately assess risks and hazards of chemistry practice.

  13. Empirical and pragmatic adequacy of grounded theory: Advancing nurse empowerment theory for nurses' practice.

    Science.gov (United States)

    Udod, Sonia A; Racine, Louise

    2017-12-01

    To draw on the findings of a grounded theory study aimed at exploring how power is exercised in nurse-manager relationships in the hospital setting, this paper examines the empirical and pragmatic adequacy of grounded theory as a methodology to advance the concept of empowerment in the area of nursing leadership and management. The evidence on staff nurse empowerment has highlighted the magnitude of individual and organisational outcomes, but has not fully explicated the micro-level processes underlying how power is exercised, shared or created within the nurse-manager relationship. Although grounded theory is a widely adopted nursing research methodology, it remains less used in nursing leadership because of the dominance of quantitative approaches to research. Grounded theory methodology provides the empirical and pragmatic relevance to inform nursing practice and policy. Grounded theory is a relevant qualitative approach to use in leadership research as it provides a fine and detailed analysis of the process underlying complexity and bureaucracy. Discursive paper. A critical examination of the empirical and pragmatic relevance of grounded theory by (Corbin & Strauss, , ) as a method for analysing and solving problems in nurses' practice is provided. This paper provides evidence to support the empirical and pragmatic adequacy of grounded theory methodology. Although the application of the ontological, epistemological and methodological assumptions of grounded theory is challenging, this methodology is useful to address real-life problems in nursing practice by developing theoretical explanations of nurse empowerment, or lack thereof, in the workplace. Grounded theory represents a relevant methodology to inform nursing leadership research. Grounded theory is anchored in the reality of practice. The strength of grounded theory is to provide results that can be readily applied to clinical practice and policy as they arise from problems that affect practice and that

  14. The Next Generation Nuclear Plant/Advanced Gas Reactor Fuel Irradiation Experiments in the Advanced Test Reactor

    International Nuclear Information System (INIS)

    Grover, S. Blaine

    2009-01-01

    The United States Department of Energy's Next Generation Nuclear Plant (NGNP) Program will be irradiating eight separate low enriched uranium (LEU) tri-isotopic (TRISO) particle fuel (in compact form) experiments in the Advanced Test Reactor (ATR) located at the Idaho National Laboratory (INL). The ATR has a long history of irradiation testing in support of reactor development and the INL has been designated as the new United States Department of Energy's lead laboratory for nuclear energy development. The ATR is one of the world's premiere test reactors for performing long term, high flux, and/or large volume irradiation test programs. These irradiations and fuel development are being accomplished to support development of the next generation reactors in the United States, and will be irradiated over the next ten years to demonstrate and qualify new particle fuel for use in high temperature gas reactors. The goals of the irradiation experiments are to provide irradiation performance data to support fuel process development, to qualify fuel for normal operating conditions, to support development and validation of fuel performance and fission product transport models and codes, and to provide irradiated fuel and materials for post irradiation examination (PIE) and safety testing. The experiments, which will each consist of at least six separate capsules, will be irradiated in an inert sweep gas atmosphere with individual on-line temperature monitoring and control of each capsule. The sweep gas will also have on-line fission product monitoring on its effluent to track performance of the fuel in each individual capsule during irradiation. The first experiment (designated AGR-1) started irradiation in December 2006, and the second experiment (AGR-2) is currently in the design phase. The design of test trains, as well as the support systems and fission product monitoring system that will monitor and control the experiment during irradiation will be discussed. In

  15. [Interdisciplinary teleconsultation: first practical experiences with 100 patients].

    Science.gov (United States)

    Gollnick, I; Frehiwot, M; Krause, E M; Schaller, S; Limpert, E; Strauß, G; Lipp, T; Scherz, M; Injac, Z

    2013-06-01

    PROBLEM DEFINITION: Increasing specialization can be observed in the various medical fields and as a consequence there is little professional exchange between ear nose and throat (ENT) specialists and general practitioners. At the same time there has been significant technological development in telemedicine over the last 5 years; however, this potential is not being sufficiently exploited. The objective of this project is to implement a practicable solution for teleconsulation between ENT specialists and general practitioners. The connection is based on a secure broadband internet connection, the corresponding server structure and a video endoscopic system. In the period from 01 January 2011 to 30 June 2012 (18 months) a total of 102 patients were included in the study in which 4 general practitioners and 5 ENT specialists participated. The protocol comprised the following parameters: indications and typical questions, number of patients presenting to the ENT specialist due to the available teleconsultation service (CBO), number of patients referred to the ENT specialist after teleconsultation (CIO), assessment of the quality of the additional expert opinion (LOQ GP), assessment of the accuracy of the specialist physician tele-diagnosis (TDS-FA) and assessment of the impact of the expert physician diagnosis on the general medical treatment (COS). Teleconsultation was most frequently used for diagnostics on tonsils (37% of the presented cases), the external auditory canal (32%) and the inner nose (15%). Of the patients analyzed were 53.9% presented to the ENT specialist only because the teleconsultation service provided an effortless opportunity and after teleconsultation 40.1% of the patients were referred to the ENT specialist. General practitioners assessed the benefit from the specialist opinion with 64 points. Diagnostic certainty of the specialist opinion, i.e. the validity scale of the diagnosis made, was on average 2.0. In approximately 35.3% of the cases

  16. Attributes of advanced practice registered nurse care coordination for children with medical complexity.

    Science.gov (United States)

    Cady, Rhonda G; Kelly, Anne M; Finkelstein, Stanley M; Looman, Wendy S; Garwick, Ann W

    2014-01-01

    Care coordination is an essential component of the pediatric health care home. This study investigated the attributes of relationship-based advanced practice registered nurse care coordination for children with medical complexity enrolled in a tertiary hospital-based health care home. Retrospective review of 2,628 care coordination episodes conducted by telehealth over a consecutive 3-year time period for 27 children indicated that parents initiated the majority of episodes and the most frequent reason was acute and chronic condition management. During this period, care coordination episodes tripled, with a significant increase (p < .001) between years 1 and 2. The increased episodes could explain previously reported reductions in hospitalizations for this group of children. Descriptive analysis of a program-specific survey showed that parents valued having a single place to call and assistance in managing their child's complex needs. The advanced practice registered nurse care coordination model has potential for changing the health management processes for children with medical complexity. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  17. Advanced Reactor Licensing: Experience with Digital I&C Technology in Evolutionary Plants

    Energy Technology Data Exchange (ETDEWEB)

    Wood, RT

    2004-09-27

    This report presents the findings from a study of experience with digital instrumentation and controls (I&C) technology in evolutionary nuclear power plants. In particular, this study evaluated regulatory approaches employed by the international nuclear power community for licensing advanced l&C systems and identified lessons learned. The report (1) gives an overview of the modern l&C technologies employed at numerous evolutionary nuclear power plants, (2) identifies performance experience derived from those applications, (3) discusses regulatory processes employed and issues that have arisen, (4) captures lessons learned from performance and regulatory experience, (5) suggests anticipated issues that may arise from international near-term deployment of reactor concepts, and (6) offers conclusions and recommendations for potential activities to support advanced reactor licensing in the United States.

  18. Advanced Reactor Licensing: Experience with Digital I and C Technology in Evolutionary Plants

    International Nuclear Information System (INIS)

    Wood, RT

    2004-01-01

    This report presents the findings from a study of experience with digital instrumentation and controls (I and C) technology in evolutionary nuclear power plants. In particular, this study evaluated regulatory approaches employed by the international nuclear power community for licensing advanced l and C systems and identified lessons learned. The report (1) gives an overview of the modern l and C technologies employed at numerous evolutionary nuclear power plants, (2) identifies performance experience derived from those applications, (3) discusses regulatory processes employed and issues that have arisen, (4) captures lessons learned from performance and regulatory experience, (5) suggests anticipated issues that may arise from international near-term deployment of reactor concepts, and (6) offers conclusions and recommendations for potential activities to support advanced reactor licensing in the United States

  19. Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study

    NARCIS (Netherlands)

    Smeulers, Marian; Onderwater, Astrid T.; van Zwieten, Myra C. B.; Vermeulen, Hester

    2014-01-01

    To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative

  20. 15 year experience of tacrolimus application in medical practice

    Directory of Open Access Journals (Sweden)

    Y. S. Kondratyeva

    2016-01-01

    Full Text Available The review presents modern literature data on the use of tacrolimus in medical practice. The results of national and international research on the effectiveness and safety of the drug at various dermatoses are presented.

  1. Medical student attachments in private practice – The experience ...

    African Journals Online (AJOL)

    doctors in full-time governmental practice. However, since 2000, final year students spend one week of ... Background: Medical student attachments with family/general practitioners (GPs) in non-academic .... Giving the patient a free choice to.

  2. Integrating Occupational Therapy Specific Assessments in Practice: Exploring Practitioner Experiences

    Directory of Open Access Journals (Sweden)

    Eric Asaba

    2017-01-01

    Full Text Available Background. Occupational therapists sometimes find it challenging to integrate client-centered and occupational therapy specific assessments in practice. The aim of this study was to explore the use of occupational therapy specific assessments such as the Assessment of Motor and Process Skills (AMPS among occupational therapists in Sweden and Japan. Methods. Interviews and qualitative thematic analyses were utilized. Findings. Four themes are reported: (1 use it or lose it, (2 simply no space until after hours, (3 biggest barriers can be colleagues, and (4 being more specific: communication. Conclusion. In keeping with previous studies, occupational therapists often find it challenging to implement client-centered and occupation-based assessment tools into practice. However, more work is needed to understand how best practices can be incorporated into a changing occupational therapy daily practice.

  3. Paramedics' experiences of financial medicine practices in the pre ...

    African Journals Online (AJOL)

    Craig Vincent-Lambert

    African Paramedics with regard to the practicing of financial medicine in the local pre- hospital emergency .... These are Basic Life Support (BLS), Intermediate life Support. (ILS) or ... reports by members of the profession have highlighted cir-.

  4. Integrating virtual reality video games into practice: clinicians' experiences.

    Science.gov (United States)

    Levac, Danielle E; Miller, Patricia A

    2013-10-01

    The Nintendo Wii is a popular virtual reality (VR) video gaming system in rehabilitation practice and research. As evidence emerges related to its effectiveness as a physical therapy training method, clinicians require information about the pragmatics of its use in practice. The purpose of this descriptive qualitative study is to explore observations and insights from a sample of physical therapists (PTs) working with children with acquired brain injury regarding practical implications of using the Wii as a physical therapy intervention. Six PTs employed at a children's rehabilitation center participated in semi-structured interviews, which were transcribed and analyzed using content analysis. Two themes summarize the practical implications of Wii use: 1) technology meets clinical practice; and 2) onus is on the therapist. Therapists described both beneficial and challenging implications arising from the intersection of technology and practice, and reported the personal commitment required to orient oneself to the gaming system and capably implement this intervention. Findings include issues that may be relevant to professional development in a broader rehabilitation context, including suggestions for the content of educational initiatives and the need for institutional support from managers in the form of physical resources for VR implementation.

  5. Beyond image interpretation: Capturing the impact of radiographer advanced practice through activity diaries

    International Nuclear Information System (INIS)

    Snaith, B.; Milner, R.C.; Harris, M.A.

    2016-01-01

    Background: There is limited evidence of the impact of radiographers working in advanced roles beyond task substitution. This study reviews the contribution of advanced (and consultant) practitioner radiographers to service delivery whilst reporting radiographs and demonstrates the impact this has on patients and staff, both internal and external to the imaging department. Method: The study was a prospective exploratory study using activity diaries to allow interval sampling when individuals were rostered to report. Data was coded using a compiled list of activities and recorded in 15-min intervals over the period of one week. Thirteen radiographers who independently report radiographs participated across 6 locations in a busy multisite English National Health Service (NHS) Trust. Results: Radiographers reported the majority of the examinations during the study period (n = 4512/5671; 79.6%). The total number of coded activities recorded over the study period was 1527, equating to 380.5 relative hours. The majority of available time was spent reporting, including dictating and verifying the reports of colleagues or trainees, although 69.5% of reporting time was interrupted. Based upon the hours of reporting there was an average of 19.3 reports (patient episodes) produced per hour. Direct patient care tasks and support for staff in decision making were regularly documented. Supplementary tasks included administrative activity, amendments to rotas, preparing presentations and documenting incidents identified during reporting. Conclusion: This study has demonstrated the breadth and complexity of the activities performed by advanced practice radiographers. The findings confirm their role in supporting service delivery beyond image interpretation. - Highlights: • Radiographers can make a significant contribution to reporting workloads. • The range of activities undertaken when reporting is complex and varied. • Reporting radiographers impact on staff, patients

  6. Findings: Sector-Leading and Innovative Practice in Advancing Equality and Diversity. Report to HEFCE by the Equality Challenge Unit

    Science.gov (United States)

    Higher Education Funding Council for England, 2017

    2017-01-01

    Following our "Call for evidence of sector-leading and innovative practice in advancing equality and diversity" (HEFCE Circular letter 16/2016), HEFCE commissioned the Equality Challenge Unit (ECU) to report back on the range of equality and diversity practice undertaken across the higher education sector. Of 120 submissions received,…

  7. U.S. Experience and practices associated with the use of centralized rad waste processing centers

    International Nuclear Information System (INIS)

    Gibson, James D.

    1994-01-01

    This paper presents the experience and current practices employed within the United States (US) associated with the use of Centralized Rad waste Processing Centers for the processing of Low Level Radioactive Wastes (LLRW). Information is provided on the methods, technologies, and practices employed by Scientific Ecology Group, Inc. (SEG), which is the worlds largest processor of LLRW. SEG processes over 80,000 cubic meters of waste annually and achieves an overall volume reduction of 12 : 1. LLRW processing in the United States is currently performed primarily at Centralized Rad waste Processing Centers, such as SEG's Central Volume Reduction Facility (CVRF) in Oak Ridge, Tennessee. This is primarily due to the superior economical application of advanced waste processing technologies, equipment, and personnel maintained at these centers. Information is provided on how SEG uses supercompaction, incineration, metals recycling, vitrification, and various other waste processing techniques to process both dry and wet wastes from over 90 commercial nuclear power plants, government operated facilities, hospitals, universities, and various small generators of radioactive waste

  8. Practical experience with digital I and C retrofit projects gathered by independent experts

    International Nuclear Information System (INIS)

    Zeck, Kurt; Schildheuer, Reinhard; Weich, Alfred

    2005-01-01

    As independent experts, we have accompanied a series of major projects where plant control systems have been retrofitted with digital I and C technology. As General Expert Inspectors of our authority, we have investigated, inspected and certified such projects - from defining the tasks at hand trough planning, approving, implementing and commissioning down to the regular operation of the equipment. Our special focus has been on the proper adherence to the relevant safety issues in nuclear plants in accordance with the current state-of-the-art in science and technology, and to the applicable codes of practice. In September 2004, at the international 'Nuclear Plant Instrumentation, Control and Human Machine Interface Technology' meeting in Columbus/Ohio, we presented some major retrofit projects and reported about how we, as independent official experts, accompany and monitor the activities of retrofitting plants with advanced digital safety I and C equipment, from the safety point of view. With current report, we would like to provide more detailed information about the practical experience gained with digital safety I and C retrofits and the conclusions drawn for currently ongoing retrofit projects. We will look at both the technical and licensing aspects of implementing such projects

  9. Economic benefits of less restrictive regulation of advanced practice nurses in North Carolina.

    Science.gov (United States)

    Conover, Chris; Richards, Robert

    2015-01-01

    With looming provider shortages and increased demand for health care, many states are looking for low-cost ways to alleviate the shortages. The purpose of this study was to assess the economic impact of less restrictive regulations for advanced practice registered nurses (APRNs) in North Carolina. We use economic impact analysis to demonstrate the economic impacts of making state scope-of-practice regulations on APRNs less restrictive in North Carolina. Outcomes include economic output, value-added, payroll compensation, employment, and tax revenue for North Carolina and for various subregions. If North Carolina adopted the same approach to APRN regulation as the least restrictive states, its economy will benefit from substantial increases in economic output and employment. The state will also see increases in tax revenue. In addition to substantially shrinking the size of projected physician shortages, allowing full scope-of-practice for APRNs will bring significant economic benefits to the state of North Carolina. Our analysis should be helpful to policy makers considering ways to deal with provider shortages. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Lessons learned from testing the quality cost model of Advanced Practice Nursing (APN) transitional care.

    Science.gov (United States)

    Brooten, Dorothy; Naylor, Mary D; York, Ruth; Brown, Linda P; Munro, Barbara Hazard; Hollingsworth, Andrea O; Cohen, Susan M; Finkler, Steven; Deatrick, Janet; Youngblut, JoAnne M

    2002-01-01

    To describe the development, testing, modification, and results of the Quality Cost Model of Advanced Practice Nurses (APNs) Transitional Care on patient outcomes and health care costs in the United States over 22 years, and to delineate what has been learned for nursing education, practice, and further research. The Quality Cost Model of APN Transitional Care. Review of published results of seven randomized clinical trials with very low birth-weight (VLBW) infants; women with unplanned cesarean births, high risk pregnancies, and hysterectomy surgery; elders with cardiac medical and surgical diagnoses and common diagnostic related groups (DRGs); and women with high risk pregnancies in which half of physician prenatal care was substituted with APN care. Ongoing work with the model is linking the process of APN care with the outcomes and costs of care. APN intervention has consistently resulted in improved patient outcomes and reduced health care costs across groups. Groups with APN providers were rehospitalized for less time at less cost, reflecting early detection and intervention. Optimal number and timing of postdischarge home visits and telephone contacts by the APNs and patterns of rehospitalizations and acute care visits varied by group. To keep people well over time, APNs must have depth of knowledge and excellent clinical and interpersonal skills that are the hallmark of specialist practice, an in-depth understanding of systems and how to work within them, and sufficient patient contact to effect positive outcomes at low cost.

  11. Feedback from practical experience with large sodium fire accidents

    International Nuclear Information System (INIS)

    Luster, V.P.; Freudenstein, K.F.

    1996-01-01

    The paper reviews the important feedback from the practical experience from two large sodium fires; the first at ALMERIA in Spain and the second in the Na laboratories at Bensberg, Germany. One of the most important sodium fire accidents was the ALMERIA spray fire accident. The origin of this accident was the repair of a valve when about 14 t of sodium was spilled in the plant room over a period of 1/2 hour. The event has been reported (IAEA/IWGFR meeting in 1988) and this presentation gives a short review of important feedback. The Almeria accident was one of the reasons that from that time spray fires had to be taken into account in the safety analyses of nuclear power plants. Due to the fact that spray fire codes were not available in a sufficiently validated state, safety analyses were provisionally based on the feedback from sodium fire tests and also from the Almeria accident itself. The behaviour of spray fires showed that severe destruction, up to melting of metallic structures may occur, but even with a large spray fire is limited roughly within the spray fire zone itself. This could be subsequently be predicted by codes like NABRAND in Germany and FEUMIX in France. Almeria accident has accelerated R and D and code development with respect to spray fires. As example for a code validation some figures are given for the NABRAND code. Another large sodium fire accident happened in 1992 in the test facility at Bensberg in Germany (ILONA). This accident occurred during preheating of a sodium filled vessel which was provisionally installed in the basement of the ILONA test facility at Bensberg. Due to failure of a pressure relief valve the pressure in the vessel increased. As a consequence the plug in a dip tube for draining the vessel failed and about 4,5 t of sodium leaked slowly from the vessel. The plant room was not cladded with steel liners or collecting pans (it was not designed for permanent sodium plant operation). So leaking sodium came directly in

  12. Master’s programs in advanced nursing practice: new strategies to enhance course design for subspecialty training in neonatology and pediatrics

    Directory of Open Access Journals (Sweden)

    Morgan C

    2012-12-01

    Full Text Available Colin Morgan,1,2 Catherine Barry,1,2 Katie Barnes2,31Liverpool Women’s Hospital, Crown Street, Liverpool, UK; 2Liverpool John Moores University, Liverpool, UK; 3Liverpool Community Health, Liverpool, UKAbstract: The advanced nurse practitioner (ANP role first developed in the USA in the 1960s in primary care. Since then, it has evolved in many different countries and subspecialties, creating a variety of challenges for those designing and implementing master’s programs for this valuable professional group. We focus on ANPs in the neonatal and pediatric intensive care setting to illustrate the complexity of issues faced by both faculty and students in such a program. We review the impact of limited resources, faculty recruitment/accreditation, and the relationship with the medical profession in establishing a curriculum. We explore the evidence for the importance of ANP role definition, supervision, and identity among other health professionals to secure a successful role transition. We describe how recent advances in technology can be used to innovate with new styles of teaching and learning to overcome some of the difficulties in running master’s programs for small subspecialties. We illustrate, through our own experience, how a thorough assessment of the available literature can be used to innovate and develop strategies to create an individual MSc programs that are designed to meet the needs of highly specialized advanced neonatal and pediatric nursing practice.Keywords: master’s program, advanced nurse practitioner, advanced practice, neonatal, pediatric, intensive care

  13. Identity and home: Understanding the experience of people with advanced cancer.

    Science.gov (United States)

    Maersk, Jesper Larsen; Cutchin, Malcolm P; la Cour, Karen

    2018-05-01

    The purpose of this study was to explore how the identity of people with advanced cancer is influenced by their experiences of living at home. A total of 28 in-depth interviews were conducted with 22 people with advanced cancer and four spouses. Grounded theory guided the collection and analysis of data. Home tours and associated field notes augmented the interview data. The analysis revealed that support of participants' identity was reflected in their abilities to live and occupy the home during daily activities, and in the ways the home and objects functioned as referents to themselves and their past. Threats to their identity ensued as the home environment became unmanageable during daily activities and as homecare professionals and assistive devices entered the home. By supporting people with advanced cancer in maintaining daily activities in the home and reducing changes in the home caused by homecare it is possible to reduce loss of identity. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Interim Service ISDN Satellite (ISIS) simulator development for advanced satellite designs and experiments

    Science.gov (United States)

    Pepin, Gerard R.

    1992-01-01

    The simulation development associated with the network models of both the Interim Service Integrated Services Digital Network (ISDN) Satellite (ISIS) and the Full Service ISDN Satellite (FSIS) architectures is documented. The ISIS Network Model design represents satellite systems like the Advanced Communications Technology Satellite (ACTS) orbiting switch. The FSIS architecture, the ultimate aim of this element of the Satellite Communications Applications Research (SCAR) Program, moves all control and switching functions on-board the next generation ISDN communications satellite. The technical and operational parameters for the advanced ISDN communications satellite design will be obtained from the simulation of ISIS and FSIS engineering software models for their major subsystems. Discrete event simulation experiments will be performed with these models using various traffic scenarios, design parameters, and operational procedures. The data from these simulations will be used to determine the engineering parameters for the advanced ISDN communications satellite.

  15. Advanced training for primary care and general practice nurses: enablers and outcomes of postgraduate education.

    Science.gov (United States)

    Hallinan, Christine M; Hegarty, Kelsey L

    2016-01-01

    The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the

  16. School Counselors' Professional Experience and Practices Working with Students Who Self-Harm: A Qualitative Study

    Science.gov (United States)

    Roberts, Ellen Adams

    2013-01-01

    The professional experiences and practices of school counselors and the interventions they employ while working with adolescent students who self-harm is an underrepresented area within current research. This generic qualitative study provides a rich description and a deeper understanding of the professional experiences and practices of school…

  17. Review of ICRF antenna development and heating experiments up to advanced experiment I, 1989 on the JT-60 tokamak

    International Nuclear Information System (INIS)

    Fujii, Tsuneyuki

    1992-03-01

    Two main subjects of ion cyclotron range of frequencies (ICRF) heating on JT-60 are described in this paper from development phase of the JT-60 ICRF heating system up to advanced experiment I, 1989. One is antenna design and development for the high power JT-60 ICRF heating system (6 MW for 10 s at a frequency range of 108 - 132 MHz). The other is the experimental investigation of characteristics of second harmonic ICRF heating in a large tokamak. (J.P.N.)

  18. In-School Suspension Practices and the Prison Hospital Experience

    Science.gov (United States)

    Wiles, David K.; Rockoff, Edward

    1977-01-01

    Explores the legal implications of in-school suspension practices through consideration of individual versus institutional rights within a special punitive-rehabilitative setting. Argues that the prison hospital model is applicable to in-school suspension programs and discusses a number of legal questions raised by the prison hospital model.…

  19. The Violet Experience: Social Interaction through Eclectic Music Learning Practices

    Science.gov (United States)

    Dakon, Jacob M.; Cloete, Elene

    2018-01-01

    In this qualitative case study, we used participant observation and interviews to examine Violet, a Flemish string youth orchestra. In doing so, we identify the qualities that constitute an 'eclectic' ensemble space, herein defined as a musical environment that uses a blend of informal and formal learning practices. Moreover, we emphasize how…

  20. Paramedics' experiences of financial medicine practices in the pre ...

    African Journals Online (AJOL)

    Examples included Over-servicing, Selective Patient Treatment, Fraudulent Billing Practices, Eliciting of kickbacks, incentives or benefits and Deliberate Time Wasting. Conclusion: The results of this study are concerning as the actions of service providers described by the participants constitute gross violations of the ethical ...

  1. Teacher Education and Inclusionary Practices: Sharing Delhi University Experiences

    Science.gov (United States)

    Raina, Jyoti

    2016-01-01

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

  2. Positive experiences with a specialist as facilitator in general practice

    DEFF Research Database (Denmark)

    Kousgaard, Marius Brostrøm; Thorsen, Thorkil

    2012-01-01

    The use of facilitators for quality improvement in general practice has accelerated during the past decade. As general practitioners (GPs) or pharmacists have typically been used as facilitators, there is a lack of knowledge of how other professionals function as facilitators. This article explores...

  3. Simulation Experiments in Practice : Statistical Design and Regression Analysis

    NARCIS (Netherlands)

    Kleijnen, J.P.C.

    2007-01-01

    In practice, simulation analysts often change only one factor at a time, and use graphical analysis of the resulting Input/Output (I/O) data. The goal of this article is to change these traditional, naïve methods of design and analysis, because statistical theory proves that more information is

  4. Researching Design, Experience and Practice of Networked Learning

    DEFF Research Database (Denmark)

    Hodgson, Vivien; de Laat, Maarten; McConnell, David

    2014-01-01

    and final section draws attention to a growing topic of interest within networked learning: that of networked learning in informal practices. In addition, we provide a reflection on the theories, methods and settings featured in the networked learning research of the chapters. We conclude the introduction...

  5. Subtitles and language learning principles, strategies and practical experiences

    CERN Document Server

    Mariotti, Cristina; Caimi, Annamaria

    2014-01-01

    The articles collected in this publication combine diachronic and synchronic research with the description of updated teaching experiences showing the educational role of subtitled audiovisuals in various foreign language learning settings.

  6. ANALYSIS OF DOMESTIC AND INTERNATIONAL APPROACHES TO THE ADVANCED EDUCATIONAL PRACTICES IN THE ELECTRONIC NETWORK ENVIRONMENT

    Directory of Open Access Journals (Sweden)

    Tatiana N. Noskova

    2016-12-01

    Full Text Available Introduction: human activities related to the use of information are being transformed under the influence of computer technology. Variable solutions to information problems are emerging; demands and require¬ments for the competence are changing on the labour market. Educational practices are destined to form a new learning behaviour for the 21st century, adopting lifelong learning strategy. The main purpose of the article is to answer the question as to how to transform existing pedagogical theory and practice under current conditions of electronic environment. Publishing of this article is coherent with concept of the journal Integration of Education, analyzing Russian and world experience in the development of education systems. This approach is important for dissemination and implementation in practice. This article explores the challenges of information technology and technical support of the educational process in universities and schools. The study of these issues is in the field of view of the journa l. Materials and Methods: the paper elaborates on the results of domestic and international educational theory and practice, comparison methods, drawing on student’s survey in the framework of international research in the field of e-learning in higher education institutions. Results: the main approaches, applied to the formulation of educational practices in the electronic environ-ment, were analyzed. The most topical national approaches include system, activity, polysubject (dialogical, context, and dialogical ones. Among international approaches self-directed learning, educational communication strategies, experiential learning, training in partnership, collaborative learning, learning in online communities, situational training were analyzed. Specifics of electronic educational interactions with distributed in time and space activities of teachers and students, create the preconditions for the implementation of new educational

  7. Geographic Medical History: Advances in Geospatial Technology Present New Potentials in Medical Practice

    Science.gov (United States)

    Faruque, F. S.; Finley, R. W.

    2016-06-01

    Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes) and lifestyle of the patient (behaviour), but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, "Airs, Waters, Places", yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient's medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient's "Geographic Medical History". In order to accomplish this we need information on: a) relevant spatiotemporal environmental variables, and b) location of the individual in that person's dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual's location can be tracked in real time if

  8. GEOGRAPHIC MEDICAL HISTORY: ADVANCES IN GEOSPATIAL TECHNOLOGY PRESENT NEW POTENTIALS IN MEDICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    F. S. Faruque

    2016-06-01

    Full Text Available Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes and lifestyle of the patient (behaviour, but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, “Airs, Waters, Places”, yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient’s medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient’s “Geographic Medical History”. In order to accomplish this we need information on: a relevant spatiotemporal environmental variables, and b location of the individual in that person’s dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual’s location

  9. Paramedics experiences and expectations concerning advance directives: a prospective, questionnaire-based, bi-centre study.

    Science.gov (United States)

    Taghavi, Mahmoud; Simon, Alfred; Kappus, Stefan; Meyer, Nicole; Lassen, Christoph L; Klier, Tobias; Ruppert, David B; Graf, Bernhard M; Hanekop, Gerd G; Wiese, Christoph H R

    2012-10-01

    Advance directives and palliative crisis cards are means by which palliative care patients can exert their autonomy in end-of-life decisions. To examine paramedics' attitudes towards advance directives and end-of-life care. Questionnaire-based investigation using a self-administered survey instrument. Paramedics of two cities (Hamburg and Goettingen, Germany) were included. Participants were questioned as to (1) their attitudes about advance directives, (2) their clinical experiences in connection with end-of-life situations (e.g. resuscitation), (3) their suggestions in regard to advance directives, 'Do not attempt resuscitation' orders and palliative crisis cards. Questionnaires were returned by 728 paramedics (response rate: 81%). The majority of paramedics (71%) had dealt with advance directives and end-of-life decisions in emergency situations. Most participants (84%) found that cardiopulmonary resuscitation in end-of-life patients is not useful and 75% stated that they would withhold cardiopulmonary resuscitation in the case of legal possibility. Participants also mentioned that more extensive discussion of legal aspects concerning advance directives should be included in paramedic training curricula. They suggested that palliative crisis cards should be integrated into end-of-life care. Decision making in prehospital end-of-life care is a challenge for all paramedics. The present investigation demonstrates that a dialogue bridging emergency medical and palliative care issues is necessary. The paramedics indicated that improved guidelines on end-of-life decisions and the termination of cardiopulmonary resuscitation in palliative care patients may be essential. Participants do not feel adequately trained in end-of-life care and the content of advance directives. Other recent studies have also demonstrated that there is a need for training curricula in end-of-life care for paramedics.

  10. Advanced Practice Nursing Committee on Process Improvement in Trauma: An Innovative Application of the Strong Model.

    Science.gov (United States)

    West, Sarah Katherine

    2016-01-01

    This article aims to summarize the successes and future implications for a nurse practitioner-driven committee on process improvement in trauma. The trauma nurse practitioner is uniquely positioned to recognize the need for clinical process improvement and enact change within the clinical setting. Application of the Strong Model of Advanced Practice proves to actively engage the trauma nurse practitioner in process improvement initiatives. Through enhancing nurse practitioner professional engagement, the committee aims to improve health care delivery to the traumatically injured patient. A retrospective review of the committee's first year reveals trauma nurse practitioner success in the domains of direct comprehensive care, support of systems, education, and leadership. The need for increased trauma nurse practitioner involvement has been identified for the domains of research and publication.

  11. Capturing reimbursement for advanced practice nurse services in acute and critical care: legal and business considerations.

    Science.gov (United States)

    Buppert, Carolyn

    2005-01-01

    Advanced practice nurses (APNs) have been affected positively and negatively by recent changes in the way hospitals are financed. Among these changes are the shift from cost-based reimbursement to a prospective payment system and increased opportunities for billing APN services under the physician payment system. Positive effects include the need for hospitals to decrease the length of stay of hospitalized patients, leading to jobs for APNs who make the hospital course and discharge more efficient. Negative effects include budget shortfalls that lead to layoffs. This article explains the current financial landscape, including phenomena that are impeding the billing of APN services, and recommends adjustments so that the APN role will be on firm financial footing.

  12. Practical decommissioning experience with nuclear installations in the European Community

    International Nuclear Information System (INIS)

    Skupinski, E.

    1992-01-01

    Initiated by the Commission of the European Communities (CEC), this seminar was jointly organized by the AEA, BNFL and the CEC at Windermere and the sites of Windscale/Sellafield, where the former Windscale advanced gas-cooled reactor and the Windscale piles are currently being dismantled. The meeting aimed at gathering a limited number of European experts for the presentation and discussion of operations, results and conclusions on techniques and procedures currently applied in the dismantling of large scale nuclear installations in the European Community

  13. Training for my Life: Lived Experiences of Dislocated Workers in an Advanced Manufacturing Training Program

    OpenAIRE

    Marquita R. Walker

    2012-01-01

    This qualitative paper explores the lived experiences of one group of workers dislocated because of globalized trade policies who completed a hybrid Advanced Manufacturing Training Program (AMTP) by taking advantage of Trade Adjustment Assistance (TAA), a federally-funded program for retraining workers dislocated because of trade policies. The research questions focus on how satisfied these workers are with the services and programs provided by TAA. Focus groups and survey instrument results ...

  14. Support systems for optics in the experiment stations at the Advanced Photon Source

    International Nuclear Information System (INIS)

    Barraza, J.; Shu, D.; Kuzay, T.M.

    1994-01-01

    Support systems have been designed for optics in the experiment stations of the Advanced Photon Source at Argonne National Laboratory. These systems utilize modular precision positioning slides and stages arranged in 3-point kinematic mount fashion for optimum mechanical stability. Through the use of novel configurations, these systems can achieve large linear motions, six degree-of-freedom motion, and large load capacities without sacrificing valuable experimental station space. This paper will discuss the designs and specifications of the positioning systems developed

  15. Operating experience with Exxon nuclear advanced fuel assembly and fuel cycle designs in PWRs

    International Nuclear Information System (INIS)

    Skogen, F.B.; Killgore, M.R.; Holm, J.S.; Brown, C.A.

    1986-01-01

    Exxon Nuclear Company (ENC) has achieved a high standard of performance in its supply of fuel reloads for both BWRs and PWRs, while introducing substantial innovations aimed at realization of improved fuel cycle costs. The ENC experience with advanced design features such as the bi-metallic spacer, the dismountable upper tie plate, natural uranium axial blankets, optimized water-to-fuel designs, annular pellets, gadolinia burnable absorbers, and improved fuel management scenarios, is summarized

  16. Combine EPR and two-slit experiments: Interference of advanced waves

    Science.gov (United States)

    Klyshko, D. N.

    1988-10-01

    A nonclassical interference effect, using two-photon correlations in nonlinear optical interactions, is discussed. The apparent nonlocality could be conveniently interpreted in terms of advanced waves, emitted by one detector toward the other. A new Bell-type experiment is proposed, in which the measured photon's parameter is the wave-vector (instead of the polarisation), so that the observable can take more than two possible values.

  17. Qualitative Content Analysis of Coworkers' Safety Reports of Unprofessional Behavior by Physicians and Advanced Practice Professionals.

    Science.gov (United States)

    Martinez, William; Pichert, James W; Hickson, Gerald B; Braddy, Casey H; Brown, Amy J; Catron, Thomas F; Moore, Ilene N; Stampfle, Morgan R; Webb, Lynn E; Cooper, William O

    2018-03-15

    The aims of the study were to develop a valid and reliable taxonomy of coworker reports of alleged unprofessional behavior by physicians and advanced practice professionals and determine the prevalence of reports describing particular types of unprofessional conduct. We conducted qualitative content analysis of coworker reports of alleged unprofessional behavior by physicians and advanced practice professionals to create a standardized taxonomy. We conducted a focus group of experts in medical professionalism to assess the taxonomy's face validity. We randomly selected 120 reports (20%) of the 590 total reports submitted through the medical center's safety event reporting system between June 2015 and September 2016 to measure interrater reliability of taxonomy codes and estimate the prevalence of reports describing particular types of conduct. The initial taxonomy contained 22 codes organized into the following four domains: competent medical care, clear and respectful communication, integrity, and responsibility. All 10 experts agreed that the four domains reflected essential elements of medical professionalism. Interrater reliabilities for all codes and domains had a κ value greater than the 0.60 threshold for good reliability. Most reports (60%, 95% confidence interval = 51%-69%) described disrespectful or offensive communication. Nine codes had a prevalence of less than 1% and were folded into their respective domains resulting in a final taxonomy composed of 13 codes. The final taxonomy represents a useful tool with demonstrated validity and reliability, opening the door for reliable analysis and systems to promote accountability and behavior change. Given the safety implications of unprofessional behavior, understanding the typology of coworker observations of unprofessional behavior may inform organization strategies to address this threat to patient safety.

  18. Thermal-Hydraulic Experiments and Modelling for Advanced Nuclear Reactor Systems

    International Nuclear Information System (INIS)

    Song, C. H.; Baek, W. P.; Chung, M. K.

    2007-06-01

    The objectives of the project are to study thermal hydraulic characteristics of advanced nuclear reactor system for evaluating key thermal-hydraulic phenomena relevant to new safety concepts. To meet the research goal, several thermal hydraulic experiments were performed and related thermal hydraulic models were developed with the experimental data which were produced through the thermal hydraulic experiments. The Followings are main research topics: - Multi-dimensional Phenomena in a Reactor Vessel Downcomer - Condensation-induced Thermal Mixing in a Pool - Development of Thermal-Hydraulic Models for Two-Phase Flow - Construction of T-H Data Base

  19. q=1 advanced tokamak experiments in JET and comparison with ASDEX Upgrade

    International Nuclear Information System (INIS)

    Joffrin, E.; Wolf, R.; Alper, B.

    2002-01-01

    The ASDEX Upgrade advanced tokamak scenario with central q close to 1 has been reproduced on JET. For almost identical q profiles, the comparative analysis does show similar features like the fishbone activity and the current profile evolution. In JET, transport analyses indicates that an internal transport barrier (ITB) has been produced. Gradient length criterions based on the ion temperature gradient turbulence stabilization are used to characterize the ITBs in both devices. The trigger of ITBs is associated with rational surfaces in both devices although the underlying physics for this triggering seems different. This experiment has the prospect to get closer to identity experiments between the two tokamaks. (author)

  20. Advanced Energy Retrofit Guide (AERG): Practical Ways to Improve Energy Performance; Healthcare Facilities (Book)

    Energy Technology Data Exchange (ETDEWEB)

    Hendron, R.; Leach, M.; Bonnema, E.; Shekhar, D.; Pless, S.

    2013-09-01

    The Advanced Energy Retrofit Guide for Healthcare Facilities is part of a series of retrofit guides commissioned by the U.S. Department of Energy. By presenting general project planning guidance as well as detailed descriptions and financial payback metrics for the most important and relevant energy efficiency measures (EEMs), the guides provide a practical roadmap for effectively planning and implementing performance improvements in existing buildings. The Advanced Energy Retrofit Guides (AERGs) are intended to address key segments of the U.S. commercial building stock: retail stores, office buildings, K-12 schools, grocery stores, and healthcare facilities. The guides' general project planning considerations are applicable nationwide; the energy and cost savings estimates for recommended EEMs were developed based on energy simulations and cost estimates for an example hospital tailored to five distinct climate regions. These results can be extrapolated to other U.S. climate zones. Analysis is presented for individual EEMs, and for packages of recommended EEMs for two project types: existing building commissioning projects that apply low-cost and no-cost measures, and whole-building retrofits involving more capital-intensive measures.

  1. A call to improve practice concerning cultural sensitivity in advance directives: a review of the literature.

    Science.gov (United States)

    Zager, B Sue; Yancy, Margaret

    2011-12-01

    The Patient Self Determination Act of 1990 mandates healthcare providers (HCP) to speak with patients about end-of-life preferences and advance directives (AD). HCP work with patients of varying cultures, and standard ADs do not address cultural differences. In order to understand various cultural beliefs, cultural sensitivity is important especially when discussing advance care planning (ACP). Individuals from differing ethnic backgrounds are likely to turn to their traditional norms of practice when ill or treatment choices must be made. An AD that addresses varying cultural values and beliefs was sought. A comprehensive review of the literature was conducted. Articles selected for review included qualitative and quantitative studies. The evidence was evaluated and synthesized for information related to cultural sensitivity and ADs. Three common themes emerged related to ACP discussions and culture. Healthcare provider awareness, communication, and education concerning cultural differences and ACP assisted in meeting the needs for end-of-life planning in the current era of increased globalization. Education for HCP on cultural differences and how to lead discussions promoted ACP. ADs are an essential part of health care and promote patient-centered care. (HCP) should be able to recognize differing cultural values and beliefs in order to initiate conversations about end of life. Initiating conversations about ACP can be facilitated by using open-ended questions that respect the values and beliefs of various cultures. Copyright ©2011 Sigma Theta Tau International.

  2. Towards an Inclusive Pedagogical Culture: Experiences from University Practice

    Directory of Open Access Journals (Sweden)

    Iliana María Fernández-Fernández

    2016-09-01

    Full Text Available In this paper, we deal with conceptual and methodological elements to develop the pedagogical inclusive competence of the professors of higher education in Ecuador. We analyze the current conceptions and the main drawbacks related to the inclusion process in the university environment nowadays. We support a theoretical procedural model, and from the practical standpoint, we implemented the methodological procedures structured in a map of processes to reach an inclusive formative process. The main results are given in the development of the pedagogical inclusive competence and the increase of the inclusion culture at the university, and revealed in the improvement of university curriculum from an inclusive approach, the betterment of the physical and technological infrastructure, the permanent upgrading of professors and putting into practice policies of affirmative action.

  3. Thinking strategically: academic-practice relationships: one health system's experience.

    Science.gov (United States)

    Wurmser, Teri; Bliss-Holtz, Jane

    2011-01-01

    Strategic planning and joint leverage of the strengths inherent in the academic and practice arenas of nursing are imperative to confront the challenges facing the profession of nursing and its place within the healthcare team of the future. This article presents a description and discussion of the implementation of several academic-practice partnership initiatives by Meridian Health, a health system located in central New Jersey. Included in the strategies discussed are creation of a support program for nonprofessional employees to become registered nurses; active partnership in the development of an accelerated BSN program; construction of support systems and academic partnerships for staff participation in RN-to-BSN programs; construction of on-site clinical simulation laboratories to foster interprofessional learning; and the implementation of a new BSN program, the first and only generic BSN program in two counties of the state. Outcomes of these academic-practice partnerships also are presented, including number of participants; graduation and NCLEX-RN pass rates; MH nurse vacancy rates; and nurse retention rates after first employment. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Achieving Full Scope of Practice Readiness Using Evidence for Psychotherapy Teaching in Web and Hybrid Approaches in Psychiatric Mental Health Advanced Practice Nursing Education.

    Science.gov (United States)

    McCoy, Kathleen T

    2018-01-01

    Radical changes in role, education, and practice have affected how education of advance practice nurses and practice deliverables occur. This article examines the effects of distance education upon the teaching/learning of psychotherapy in integrating Web-based technology and platforms. With the advent and proliferation of online programs of study, the question begs: How do distance-linked programs successfully introduce, practice, and supervise one-to-one and group psychotherapy training? By employing evidence-based education strategies, technology, and strong interpersonal skills and evidence-based therapies, a charter Psychiatric Mental Health Nurse Practitioner Doctor of Nursing Practice program paved an innovative and successful path. In that program, they prepared their students for full scope of practice, upon graduation, inclusive of psychotherapy as well as the other highly demanding and compressed requirements of the 3-year program. This article explores that journey and its recommendations for application derived from this 2010 cohort. © 2017 Wiley Periodicals, Inc.

  5. Head First Physics A learner's companion to mechanics and practical physics (AP Physics B - Advanced Placement)

    CERN Document Server

    Lang, Heather

    2008-01-01

    Wouldn't it be great if there were a physics book that showed you how things work instead of telling you how? Finally, with Head First Physics, there is. This comprehensive book takes the stress out of learning mechanics and practical physics by providing a fun and engaging experience, especially for students who "just don't get it." Head First Physics offers a format that's rich in visuals and full of activities, including pictures, illustrations, puzzles, stories, and quizzes -- a mixed-media style proven to stimulate learning and retention. One look will convince you: This isn't mere theo

  6. Modelling Digital Knowledge Transfer: Nurse Supervisors Transforming Learning at Point of Care to Advance Nursing Practice

    Directory of Open Access Journals (Sweden)

    Carey Mather

    2017-05-01

    Full Text Available Limited adoption of mobile technology for informal learning and continuing professional development within Australian healthcare environments has been explained primarily as an issue of insufficient digital and ehealth literacy of healthcare professionals. This study explores nurse supervisors’ use of mobile technology for informal learning and continuing professional development both for their own professional practice, and in their role in modelling digital knowledge transfer, by facilitating the learning and teaching of nursing students in the workplace. A convenience sample of 27 nurse supervisors involved with guiding and supporting undergraduate nurses participated in one of six focus groups held in two states of Australia. Expanding knowledge emerged as the key theme of importance to this group of clinicians. Although nurse supervisors regularly browsed Internet sources for learning and teaching purposes, a mixed understanding of the mobile learning activities that could be included as informal learning or part of formal continuing professional development was detected. Participants need educational preparation and access to mobile learning opportunities to improve and maintain their digital and ehealth literacy to appropriately model digital professionalism with students. Implementation of mobile learning at point of care to enable digital knowledge transfer, augment informal learning for students and patients, and support continuing professional development opportunities is necessary. Embedding digital and ehealth literacy within nursing curricula will promote mobile learning as a legitimate nursing function and advance nursing practice.

  7. Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance, K-12 Schools (Book)

    Energy Technology Data Exchange (ETDEWEB)

    2013-12-01

    The U.S. Department of Energy developed the Advanced Energy Retrofit Guides (AERGs) to provide specific methodologies, information, and guidance to help energy managers and other stakeholders plan and execute energy efficiency improvements. Detailed technical discussion is fairly limited. Instead, we emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluations of the most promising retrofit energy efficiency measures for each building type. A series of AERGs is under development, addressing key segments of the commercial building stock. K-12 schools were selected as one of the highest priority building sectors, because schools affect the lives of most Americans. They also represent approximately 8% of the energy use and 10% of the floor area in commercial buildings nationwide. U.S. K-12 school districts spend more than $8 billion each year on energy - more than they spend on computers and textbooks combined. Most occupy older buildings that often have poor operational performance - more than 30% of schools were built before 1960. The average age of a school is about 42 years - which is nearly the expected serviceable lifespan of the building. K-12 schools offer unique opportunities for deep, cost-effective energy efficiency improvements, and this guide provides convenient and practical guidance for exploiting these opportunities in the context of public, private, and parochial schools.

  8. Advancing Psychologically Informed Practice for Patients With Persistent Musculoskeletal Pain: Promise, Pitfalls, and Solutions.

    Science.gov (United States)

    Keefe, Francis J; Main, Chris J; George, Steven Z

    2018-05-01

    There has been growing interest in psychologically oriented pain management over the past 3 to 4 decades, including a 2011 description of psychologically informed practice (PIP) for low back pain. PIP requires a broader focus than traditional biomechanical and pathology-based approaches that have been traditionally used to manage musculoskeletal pain. A major focus of PIP is addressing the behavioral aspects of pain (ie, peoples' responses to pain) by identifying individual expectations, beliefs, and feelings as prognostic factors for clinical and occupational outcomes indicating progression to chronicity. Since 2011, the interest in PIP seems to be growing, as evidenced by its use in large trials, inclusion in scientific conferences, increasing evidence base, and expansion to other musculoskeletal pain conditions. Primary care physicians and physical therapists have delivered PIP as part of a stratified care approach involving screening and targeting of treatment for people at high risk for continued pain-associated disability. Furthermore, PIP is consistent with recent national priorities emphasizing nonpharmacological pain management options. In this perspective, PIP techniques that range in complexity are described, considerations for implementation in clinical practice are offered, and future directions that will advance the understanding of PIP are outlined.

  9. Profile and results of frail patient assessed by advanced practice nursing in an Emergency Department.

    Science.gov (United States)

    Solé-Casals, Montserrat; Chirveches-Pérez, Emilia; Puigoriol-Juvanteny, Emma; Nubó-Puntí, Núria; Chabrera-Sanz, Carolina; Subirana-Casacuberta, Mireia

    2017-06-02

    To describe the profile of patients evaluated by Nurse Care Management in an Emergency Department and identify the type of alternative healthcare resource assigned and report the results of clinical practice. Prospective follow-up, on admission to the Emergency Department in an acute hospital and on discharge from the alternative healthcare resource, of patients assessed by Nurse Care Management, from July to December 2015. The patient characteristics, social environment and results of clinical practice were studied. 190 patients were included of whom 13 were readmitted (6.8%). 122 (59.8%) cases from the Emergency Department were referred to to intermediate care facilities, 71 (34.8%) cases for domiciliary care, 10 (4.9%) cases were referred to an acute care hospital and 1 (0.5%) died. Patients referred to intermediate care were more complex, presented geriatric syndromes as their reason for admission and diagnosed with dementia, while those referred to home care presented more respiratory and cardiovascular illnesses (p <0.05). The mean Barthel Index and polypharmacy before emergency admission were higher than at the time of discharge from the alternative healthcare resource (p <0.05). Patients presenting with advanced age, complexity, comorbidity, are referred to intermediate care facilities or domiciliary care, they are admitted to acute care hospitasl and are readmitted less than other patients. After being discharged from the alternative resource, they lose functional capacity and present less polypharmacy. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  10. Non-physician practitioners in radiation oncology: advanced practice nurses and physician assistants

    International Nuclear Information System (INIS)

    Kelvin, Joanne Frankel; Moore-Higgs, Giselle J.; Maher, Karen E.; Dubey, Ajay K.; Austin-Seymour, Mary M.; Daly, Nancy Riese; Mendenhall, Nancy Price; Kuehn, Eric F.

    1999-01-01

    Purpose: With changes in reimbursement and a decrease in the number of residents, there is a need to explore new ways of achieving high quality patient care in radiation oncology. One mechanism is the implementation of non-physician practitioner roles, such as the advanced practice nurse (APN) and physician assistant (PA). This paper provides information for radiation oncologists and nurses making decisions about: (1) whether or not APNs or PAs are appropriate for their practice, (2) which type of provider would be most effective, and (3) how best to implement this role. Methods: Review of the literature and personal perspective. Conclusions: Specific issues addressed regarding APN and PA roles in radiation oncology include: definition of roles, regulation, prescriptive authority, reimbursement, considerations in implementation of the role, educational needs, and impact on resident training. A point of emphasis is that the non-physician practitioner is not a replacement or substitute for either a resident or a radiation oncologist. Instead, this role is a complementary one. The non-physician practitioner can assist in the diagnostic work-up of patients, manage symptoms, provide education to patients and families, and assist them in coping. This support facilitates the physician's ability to focus on the technical aspects of prescribing radiotherapy

  11. WebLab-Deusto-CPLD: A Practical Experience

    Directory of Open Access Journals (Sweden)

    Veronica Canivell

    2012-01-01

    Full Text Available This paper shows the experience at the University of Deusto with the WebLab-Deusto-CPLD in the subject “Programmable Logic” of the Faculty of Engineering in the field of Digital Electronics. Presented herein is a technical overview of the laboratory, and its characteristics.

  12. HVO applications and practical experiences; HVO Anwendungen und Praxiserfahrungen

    Energy Technology Data Exchange (ETDEWEB)

    Doerr, Sebastian [Neste Oil Corporation, Espoo (Finland); Honkanen, Markku; Mikkonen, Seppo

    2012-07-01

    Since 2007 Neste Oil Finland is producing renewable Diesel based on vegetable oils. The key process step is hydro treatment, products are called HVO = Hydrotreated Vegetable Oils. Process and main product performance will be introduced. Main focus is on applications and experience from several field tests. The presentation will give an overview and short outlook to future applications and challenges. (orig.)

  13. Relative Binding Free Energy Calculations in Drug Discovery: Recent Advances and Practical Considerations.

    Science.gov (United States)

    Cournia, Zoe; Allen, Bryce; Sherman, Woody

    2017-12-26

    Accurate in silico prediction of protein-ligand binding affinities has been a primary objective of structure-based drug design for decades due to the putative value it would bring to the drug discovery process. However, computational methods have historically failed to deliver value in real-world drug discovery applications due to a variety of scientific, technical, and practical challenges. Recently, a family of approaches commonly referred to as relative binding free energy (RBFE) calculations, which rely on physics-based molecular simulations and statistical mechanics, have shown promise in reliably generating accurate predictions in the context of drug discovery projects. This advance arises from accumulating developments in the underlying scientific methods (decades of research on force fields and sampling algorithms) coupled with vast increases in computational resources (graphics processing units and cloud infrastructures). Mounting evidence from retrospective validation studies, blind challenge predictions, and prospective applications suggests that RBFE simulations can now predict the affinity differences for congeneric ligands with sufficient accuracy and throughput to deliver considerable value in hit-to-lead and lead optimization efforts. Here, we present an overview of current RBFE implementations, highlighting recent advances and remaining challenges, along with examples that emphasize practical considerations for obtaining reliable RBFE results. We focus specifically on relative binding free energies because the calculations are less computationally intensive than absolute binding free energy (ABFE) calculations and map directly onto the hit-to-lead and lead optimization processes, where the prediction of relative binding energies between a reference molecule and new ideas (virtual molecules) can be used to prioritize molecules for synthesis. We describe the critical aspects of running RBFE calculations, from both theoretical and applied perspectives

  14. Simple Chaotic Oscillator: From Mathematical Model to Practical Experiment

    Directory of Open Access Journals (Sweden)

    S. Hanus

    2006-04-01

    Full Text Available This paper shows the circuitry implementation and practical verification of the autonomous nonlinear oscillator. Since it is described by a single third-order differential equation, its state variables can be considered as the position, velocity and acceleration and thus have direct connection to a real physical system. Moreover, for some specific configurations of internal system parameters, it can exhibit a period doubling bifurcation leading to chaos. Two different structures of the nonlinear element were verified by a comparison of numerically integrated trajectory with the oscilloscope screenshots .

  15. Needs assessment for developing a program to help train advanced-practice pharmacists for research.

    Science.gov (United States)

    Bulkley, Christina F; Miller, Michael J; Bush, Colleen G; Nussbaum, Barbara B; Draugalis, JoLaine R

    2017-12-01

    Results of a needs assessment to determine priority topics and preferred formats for research training in pharmacy residency programs are reported. For pharmacists seeking advanced-practice positions in academia, the ability to conduct practice-based research is expected. Pharmacy residency programs are a primary recruitment source for these positions, but research training varies by residency site and available expertise. To help define the optimal content and format of resident research training, ASHP and the ASHP Research and Education Foundation conducted a needs assessment targeting postgraduate year 1 (PGY1) pharmacy residency directors (RPDs). The response rate was 36.5% (271 of 743 invitees); the information obtained was used to guide development of a Web-based training series. Only 12% of the RPDs who participated in the survey indicated that currently available research training resources within their residency programs were sufficient. Sixty-seven percent of surveyed RPDs agreed that a Web-based training program would be a useful resource, and 81% agreed that the target audience should be pharmacy residents. Training topics of greatest interest to RPDs included (1) components of a resident research plan, (2) identifying research questions, (3) study design and sample selection, (4) project management, (5) data acquisition, cleaning, management, and analysis, and (6) presenting and publishing project results. This needs assessment clearly identified opportunities for improving the infrastructure and content of PGY1 residency research training. At a minimum, training programs should focus on practice-based research concepts using readily accessible health-system data systems and provide universal accessibility and sufficient flexibility to allow residency programs to integrate the training in a manner that works best for the program. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  16. The gamification and the enrichment of innovation practices in the firm: an analysis of experiences

    Directory of Open Access Journals (Sweden)

    Cristina Gallego Gomez

    2013-09-01

    Full Text Available Purpose: Description of gamification practices in the company and the analysis of its influence on firm’s results by comparing experiences. Design/methodology: Analysis of experiences from different firm’s experiences. Findings: To show through real examples that the gamification leads to the achievement of better results in the organizations. Research limitations/implications: Access to the information of the few cases that we can find in our context. It is a quite new a yet unusual practice for most organizations. Practical implications: Reformulation of business communication strategies from best practices, where the gaming industry is an interesting precedent, which proofs that these practices improve business results. Social implications: Socialization of the innovation process at firms Originality/value: Provide an overview of the gamification as a practice that helps to pursue the strategy of collaboration with the client to improve results.

  17. Patient and Oncology Nurse Preferences for the Treatment Options in Advanced Melanoma: A Discrete Choice Experiment.

    Science.gov (United States)

    Liu, Frank Xiaoqing; Witt, Edward A; Ebbinghaus, Scot; DiBonaventura Beyer, Grace; Basurto, Enrique; Joseph, Richard W

    2017-10-25

    Understanding the perceptions of patients and oncology nurses about the relative importance of benefits and risks associated with newer treatments of advanced melanoma can help to inform clinical decision-making. The aims of this study were to quantify and compare the views of patients and oncology nurses regarding the importance of attributes of treatments of advanced melanoma. A discrete choice experiment (DCE) was conducted in US-based oncology nurses and patients diagnosed with advanced melanoma. Patients and nurses were enlisted through online panels. In a series of scenarios, respondents had to choose between 2 hypothetical treatments, each with 7 attributes: mode of administration (MoA), dosing schedule (DS), median duration of therapy (DoT), objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and grade 3 or 4 adverse events (AEs). Hierarchical Bayesian logistic regression models were used to estimate preference weights. A total of 200 patients with advanced melanoma and 150 oncology nurses participated. The relative importance estimates of attributes by patients and nurses, respectively, were as follows: OS, 33% and 28%; AEs, 29% and 26%; ORR, 25% and 27%; PFS, 12% and 15%; DS, 2% and 3%; DoT, 0% and 0%; and MoA, 0% and 0%. Both patients and oncology nurses valued OS, ORR, and AEs as the most important treatment attributes for advanced melanoma, followed by PFS, whereas DS, DoT, and MoA were given less value in their treatment decisions. Oncology nurses and patients have similar views on important treatment considerations for advanced melanoma, which can help build trust in shared decision-making.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  18. How is brand experience designed in practice? : Results of a multiple-case study

    NARCIS (Netherlands)

    Bakker-Wu, S.; Calabretta, G.; Hultink, H.J.; Bohemia, E.; de Bont, C.; Svengren Holm, L.

    2017-01-01

    Brand experience is an important concept in marketing because it can affect brand loyalty, brand recall, and brand attitude. Brand experience design is therefore an important practice for companies to create favourable and meaningful experiences, through the design of various touchpoints that are in

  19. Practical choices for infobutton customization: experience from four sites.

    Science.gov (United States)

    Cimino, James J; Overby, Casey L; Devine, Emily B; Hulse, Nathan C; Jing, Xia; Maviglia, Saverio M; Del Fiol, Guilherme

    2013-01-01

    Context-aware links between electronic health records (EHRs) and online knowledge resources, commonly called "infobuttons" are being used increasingly as part of EHR "meaningful use" requirements. While an HL7 standard exists for specifying how the links should be constructed, there is no guidance on what links to construct. Collectively, the authors manage four infobutton systems that serve 16 institutions. The purpose of this paper is to publish our experience with linking various resources and specifying particular criteria that can be used by infobutton managers to select resources that are most relevant for a given situation. This experience can be used directly by those wishing to customize their own EHRs, for example by using the OpenInfobutton infobutton manager and its configuration tool, the Librarian Infobutton Tailoring Environment.

  20. Practical experiences with new types of highly modified asphalt binders

    Science.gov (United States)

    Špaček, Petr; Hegr, Zdeněk; Beneš, Jan

    2017-09-01

    As a result of steadily increasing traffic load on the roads in the Czech Republic, we should be focused on the innovative technical solutions, which will lead to extending the life time of asphalt pavements. One of these ways could be the future use of bitumen with a higher degree of polymer modification. This paper discusses experience with comparison of new highly polymer modified asphalt binder type with conventional polymer modified asphalt binder and unmodified binder with penetration grade 50/70. There are compared the results of various types laboratory tests of asphalt binders, as well as the results of asphalt mixtures laboratory tests. The paper also mentions the experience with workability and compactability of asphalt mixture with highly polymer modified asphalt binder during the realization of the experimental reference road section by the Skanska company in the Czech Republic.

  1. Bits of Experience in the Oral Practice of Teaching Grammar

    Institute of Scientific and Technical Information of China (English)

    王敏

    2002-01-01

    English learners may have such experience that most of them can't be able to speak English apropriately and fluently even if they have gained a lot of grammar knowledge. The approach of teaching grammar discussed in this paper focuses on training students' communicative ability. And it is benefical to stimulating the activeness and interest of students and fostering the ability to solve the problems independently.

  2. Practical experience and economic aspects of small wind turbines

    Energy Technology Data Exchange (ETDEWEB)

    1984-01-01

    Workshop proceedings presented cover operating experience and development of wind turbines installed in the UK by Northern Engineering Industries plc companies, the Howden aerogenerator installed in Orkney, and the commissioning of a vertical-axis generator in a remote location. The National Wind Turbine Test Centre, the Caithness Wind Project, the South of Scotland Electricity Board's activities, economics of small scale wind power and commercialisation are discussed.

  3. Summary of thermocouple performance during advanced gas reactor fuel irradiation experiments in the advanced test reactor and out-of-pile thermocouple testing in support of such experiments

    Energy Technology Data Exchange (ETDEWEB)

    Palmer, A. J.; Haggard, DC; Herter, J. W.; Swank, W. D.; Knudson, D. L.; Cherry, R. S. [Idaho National Laboratory, P.O. Box 1625, MS 4112, Idaho Falls, ID, (United States); Scervini, M. [University of Cambridge, Department of Material Science and Metallurgy, 27 Charles Babbage Road, CB3 0FS, Cambridge, (United Kingdom)

    2015-07-01

    High temperature gas reactor experiments create unique challenges for thermocouple-based temperature measurements. As a result of the interaction with neutrons, the thermoelements of the thermocouples undergo transmutation, which produces a time-dependent change in composition and, as a consequence, a time-dependent drift of the thermocouple signal. This drift is particularly severe for high temperature platinum-rhodium thermocouples (Types S, R, and B) and tungsten-rhenium thermocouples (Type C). For lower temperature applications, previous experiences with Type K thermocouples in nuclear reactors have shown that they are affected by neutron irradiation only to a limited extent. Similarly, Type N thermocouples are expected to be only slightly affected by neutron fluence. Currently, the use of these nickel-based thermocouples is limited when the temperature exceeds 1000 deg. C due to drift related to phenomena other than nuclear irradiation. High rates of open-circuit failure are also typical. Over the past 10 years, three long-term Advanced Gas Reactor experiments have been conducted with measured temperatures ranging from 700 deg. C - 1200 deg. C. A variety of standard Type N and specialty thermocouple designs have been used in these experiments with mixed results. A brief summary of thermocouple performance in these experiments is provided. Most recently, out-of-pile testing has been conducted on a variety of Type N thermocouple designs at the following (nominal) temperatures and durations: 1150 deg. C and 1200 deg. C for 2,000 hours at each temperature, followed by 200 hours at 1250 deg. C and 200 hours at 1300 deg. C. The standard Type N design utilizes high purity, crushed MgO insulation and an Inconel 600 sheath. Several variations on the standard Type N design were tested, including a Haynes 214 alloy sheath, spinel (MgAl{sub 2}O{sub 4}) insulation instead of MgO, a customized sheath developed at the University of Cambridge, and finally a loose assembly

  4. Summary of Thermocouple Performance During Advanced Gas Reactor Fuel Irradiation Experiments in the Advanced Test Reactor and Out-of-Pile Thermocouple Testing in Support of Such Experiments

    Energy Technology Data Exchange (ETDEWEB)

    A. J. Palmer; DC Haggard; J. W. Herter; M. Scervini; W. D. Swank; D. L. Knudson; R. S. Cherry

    2011-07-01

    High temperature gas reactor experiments create unique challenges for thermocouple based temperature measurements. As a result of the interaction with neutrons, the thermoelements of the thermocouples undergo transmutation, which produces a time dependent change in composition and, as a consequence, a time dependent drift of the thermocouple signal. This drift is particularly severe for high temperature platinum-rhodium thermocouples (Types S, R, and B); and tungsten-rhenium thermocouples (Types C and W). For lower temperature applications, previous experiences with type K thermocouples in nuclear reactors have shown that they are affected by neutron irradiation only to a limited extent. Similarly type N thermocouples are expected to be only slightly affected by neutron fluxes. Currently the use of these Nickel based thermocouples is limited when the temperature exceeds 1000°C due to drift related to phenomena other than nuclear irradiation. High rates of open-circuit failure are also typical. Over the past ten years, three long-term Advanced Gas Reactor (AGR) experiments have been conducted with measured temperatures ranging from 700oC – 1200oC. A variety of standard Type N and specialty thermocouple designs have been used in these experiments with mixed results. A brief summary of thermocouple performance in these experiments is provided. Most recently, out of pile testing has been conducted on a variety of Type N thermocouple designs at the following (nominal) temperatures and durations: 1150oC and 1200oC for 2000 hours at each temperature, followed by 200 hours at 1250oC, and 200 hours at 1300oC. The standard Type N design utilizes high purity crushed MgO insulation and an Inconel 600 sheath. Several variations on the standard Type N design were tested, including Haynes 214 alloy sheath, spinel (MgAl2O4) insulation instead of MgO, a customized sheath developed at the University of Cambridge, and finally a loose assembly thermocouple with hard fired alumina

  5. Advances in participatory occupational health aimed at good practices in small enterprises and the informal sector.

    Science.gov (United States)

    Kogi, Kazutaka

    2006-01-01

    Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential.

  6. Incorporating full-scale experience into advanced limestone wet FGD designs

    International Nuclear Information System (INIS)

    Rader, P.C.; Bakke, E.

    1992-01-01

    Utilities choosing flue gas desulfurization as a strategy for compliance with Phase I of the 1990 Clean Air Act Amendments will largely turn to limestone wet scrubbing as the most cost-effective, least-risk option. State-of-the-art single absorber wet scrubbing systems can be designed to achieve: SO 2 removal efficiencies in excess of 95 %, system availabilities in excess of 98%, and byproducts which can be marketed or land filled. As a result of varying fuel characteristics, site considerations, and owner preferences, FGD plants for large central power stations are typically custom-designed. To avoid the risks associated with new, first-of-a-kind technologies, utilities have preferred to purchase FGD systems from suppliers with proven utility experience and reference plants as close as possible to the design envisioned. As the market for FGD systems is regulatory driven, the demand has shifted geographically in response to national environmental policies. Although limestone wet scrubbing has emerged as the overwhelming choice for SO 2 emission control in coal-fired power stations, the technology has evolved and been adapted to suit local and regional technical and economic situations. Global suppliers are able to benefit from experience and technological advances in the world market. With market units in the U.S., Denmark, Italy, Sweden, and Germany active in the design and supply of wet FGD plants, ABB has a unique ability to incorporate knowledge and experience gained throughout the industrialized world to acid rain retrofit projects in the U.S. This paper describes the design of advanced limestone wet scrubbing systems for application to acid rain retrofits. Specifically, the evolution of advanced design concepts from a global experience base is discussed

  7. Best practices for basic and advanced skills in health care service recovery: a case study of a re-admitted patient.

    Science.gov (United States)

    Hayden, Anna C; Pichert, James W; Fawcett, Jodi; Moore, Ilene N; Hickson, Gerald B

    2010-07-01

    Service recovery refers to an organizations entire process for facilitating resolution of dissatisfactions, whether or not visible to patients and families. Patients are an important resource for reporting miscommunications, provider inattention, rudeness, or delays, especially if they perceive a connection to misdiagnosis or failed treatment. Health systems that encourage patients to be "the eyes and ears" of individual and team performance capitalize on a rich source of data for quality improvement and risk prevention. Effective service recovery requires organizations (1) to learn about negative perceptions and experiences and (2) to create an infrastructure that supports staff's ability to respond. Service recovery requires the exercise of both basic and advanced skills. We term certain skills as advanced because of the significant variation in their use or endorsement among 30 health care organizations in the United States. On the basis of our work with the 30 organizations, a mnemonic, HEARD, incorporates best practices for basic service recovery processes: Hearing the person's concern; Empathizing with the person raising the issue; Acknowledging, expressing appreciation to the person for sharing, and Apologizing when warranted; Responding to the problem, setting time lines and expectations for follow-up; and Documenting or Delegating the documentation to the appropriate person. Impartiality, chain of command, setting boundaries, and Documentation represent four advanced service recovery skills critical for addressing challenging situations. Using best practices in service recovery enables the organization to do its best to make right what patients and family members experience as wrong.

  8. Information Ergonomics A theoretical approach and practical experience in transportation

    CERN Document Server

    Sandl, Peter

    2012-01-01

    The variety and increasing availability of hypermedia information systems, which are used in stationary applications like operators’ consoles as well as mobile systems, e.g. driver information and navigation systems in automobiles form a foundation for the mediatization of the society. From the human engineering point of view this development and the ensuing increased importance of information systems for economic and private needs require careful deliberation of the derivation and application of ergonomics methods particularly in the field of information systems. This book consists of two closely intertwined parts. The first, theoretical part defines the concept of an information system, followed by an explanation of action regulation as well as cognitive theories to describe man information system interaction. A comprehensive description of information ergonomics concludes the theoretical approach. In the second, practically oriented part of this book authors from industry as well as from academic institu...

  9. Telemedicine: Its Importance in Cardiology Practice. Experience in Chile

    Directory of Open Access Journals (Sweden)

    Edgardo Escobar, MD, FACC, FAHA

    2017-05-01

    Full Text Available There is a growing need worldwide to take medical care to distant locations far from the main urban centers, particularly to rural areas. Furthermore, there is the ethical imperative to provide equal access to medical care to all patients, regardless of their place of residence, so as to satisfy an increasingly demanding population. A widespread problem, from which cardiology is not excepted, is the insufficient number of specialists and their uneven distribution. The upsurge in information and communications technology has made available a large collection of tools, mainly computers, smartphones, e-mail, and the Internet, to name just a few, to meet the needs of communication between individuals and organizations. This article defines telemedicine and describes its application in the practice of cardiology and its impact in Chile.

  10. Optimization and practical implementation of ultrafast 2D NMR experiments

    Energy Technology Data Exchange (ETDEWEB)

    Queiroz Junior, Luiz H. K., E-mail: professorkeng@gmail.com [Universidade Federal de Sao Carlos (UFSC), SP (Brazil). Departamento de Quimica; Universidade Federal de Goias (UFGO), Goiania, GO (Brazil). Inst. de Quimica; Ferreira, Antonio G. [Universidade Federal de Sao Carlos (UFSC), SP (Brazil). Departamento de Quimica; Giraudeau, Patrick [Universite de Nantes (France). CNRS, Chimie et Interdisciplinarite: Synthese, Analyse, Modelisation

    2013-09-01

    Ultrafast 2D NMR is a powerful methodology that allows recording of a 2D NMR spectrum in a fraction of second. However, due to the numerous non-conventional parameters involved in this methodology its implementation is no trivial task. Here, an optimized experimental protocol is carefully described to ensure efficient implementation of ultrafast NMR. The ultrafast spectra resulting from this implementation are presented based on the example of two widely used 2D NMR experiments, COSY and HSQC, obtained in 0.2 s and 41 s, respectively. (author)

  11. Experience in the application of IAEA inspection practices

    International Nuclear Information System (INIS)

    Haginoya, T.; Ferraris, M.; Frenzel, W.; Kiss, I.; Klik, F.; Poroykov, V.; Thorne, L.; Thorstensen, S.

    1979-01-01

    In 1977, more than 700 times Agency inspectors visited nuclear installations in 45 States throughout the world to verify nuclear material through record audits and material characterization or measurements. The experience during the three years since the last symposium proved that there are only a few types of facilities at which the Agency can fully base its statements on quantitative verification of material, while there are many areas where the inspector must rely on semi-quantitative information like γ-spectroscopy, or qualitative information like containment and surveillance measures. Techniques have been improved, but a number of procedures to be further developed were identified by the inspectorate. (author)

  12. Practical experience with a data collection project: the OREDA project

    International Nuclear Information System (INIS)

    Sandtorv, Helge A.; Hokstad, Per; Thompson, David W.

    1996-01-01

    Experience data on the reliability of equipment has become vital to many types of engineering and maintenance analyses. The consequences of incorrect design or poor maintenance may adversely affect: safety, the environment or cost in most categories of process industries, and, in particular, offshore exploration and production industries. The OREDA project is a data collection programme for the offshore industry which has been operating since the early 80's. A high level of knowledge has been gained from this programme on: specification of data, data collection methods and the utilization of data. Some of the results and the knowledge gained from this project are presented in this paper

  13. Practical experience with phaseout-oriented execution of law

    International Nuclear Information System (INIS)

    Hellenschmidt, J.G.

    1991-01-01

    The result of two years of experience with phaseout-oriented execution of law is that the original political target of the new head of the authorities - abandonment of the peaceful uses of nuclear energy in Schleswig-Holstein within 2 years on the basis of the law in force - was unachievable despite considerable efforts. This interim result can be seen as positive for the operators of nuclear power plants in Schleswig-Holstein, because despite the stringency of the nuclear supervisory authorities, which could hardly be more severe, no deficits in safety, which would have warranted decommissioning, have appeared to become obvious. (orig./HSCH) [de

  14. Wind and Solar Curtailment: International Experience and Practices

    DEFF Research Database (Denmark)

    Lew, Debra; Bird, Lori; Milligan, Michael

    2013-01-01

    High penetrations of wind and solar generation on power systems are resulting in increasing curtailment. Wind and solar integration studies predict increased curtailment as penetration levels grow. This paper examines experiences with curtailment on bulk power systems internationally. It discusses...... how much curtailment is occurring, how it is occurring, why it is occurring, and what is being done to reduce curtailment. This summary is produced as part of the International Energy Agency Wind Task 25 on Design and Operation of Power Systems with Large Amounts of Wind Power....

  15. Refugee experiences of general practice in countries of resettlement: a literature review.

    Science.gov (United States)

    Cheng, I-Hao; Drillich, Ann; Schattner, Peter

    2015-03-01

    Refugees and asylum seekers often struggle to use general practice services in resettlement countries. To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement. Literature review using systematic search and narrative data extraction and synthesis methodologies. International, peer-reviewed literature published in English language between 1990 and 2013. Embase, Ovid MEDLINE, PsycINFO, CSA Sociological Abstracts, and CINAHL databases were searched using the terms: refugee, asylum seeker, experience, perception, doctor, physician, and general practitioner. Titles, abstracts and full texts were reviewed and were critically appraised. Narrative themes describing the refugee or asylum seeker's personal experiences of general practice services were identified, coded, and analysed. From 8722 papers, 85 were fully reviewed and 23 included. These represented the experiences of approximately 864 individuals using general practice services across 11 countries. Common narrative themes that emerged were: difficulties accessing general practice services, language barriers, poor doctor-patient relationships, and problems with the cultural acceptability of medical care. The difficulties refugees and asylum seekers experience accessing and using general practice services could be addressed by providing practical support for patients to register, make appointments, and attend services, and through using interpreters. Clinicians should look beyond refugee stereotypes to focus on the needs and expectations of the individual. They should provide clear explanations about unfamiliar clinical processes and treatments while offering timely management. © British Journal of General Practice 2015.

  16. Advances in integration of photovoltaic power and energy production in practical systems

    Science.gov (United States)

    Fartaria, Tomas Oliveira

    This thesis presents advances in integration of photovoltaic (PV) power and energy in practical systems, such as existing power plants in buildings or directly integrated in the public electrical grid. It starts by providing an analyze of the current state of PV power and some of its limitations. The work done in this thesis begins by providing a model to compute mutual shading in large PV plants, and after provides a study of the integration of a PV plant in a biogas power plant. The remainder sections focus on the work done for project PVCROPS, which consisted on the construction and operation of two prototypes composed of a PV system and a novel battery connected to a building and to the public electrical grid. These prototypes were then used to test energy management strategies and validate the suitability of the two advanced batteries (a lithium-ion battery and a vanadium redox ow battery) for households (BIPV) and PV plants. This thesis is divided in 7 chapters: Chapter 1 provides an introduction to explain and develop the main research questions studied for this thesis; Chapter 2 presents the development of a ray-tracing model to compute shading in large PV elds (with or without trackers); Chapter 3 shows the simulation of hybridizing a biogas plant with a PV plant, using biogas as energy storage; Chapters 4 and 5 present the construction, programming, and initial operation of both prototypes (Chapter 4), EMS testing oriented to BIPV systems (Chapter 5). Finally, Chapters 6 provides some future lines of investigation that can follow this thesis, and Chapter 7 shows a synopsis of the main conclusions of this work.

  17. Semantics-Driven Migration of Java Programs: a Practical Experience

    Directory of Open Access Journals (Sweden)

    Artyom O. Aleksyuk

    2017-01-01

    Full Text Available The purpose of the study is to demonstrate the feasibility of automated code migration to a new set of programming libraries. Code migration is a common task in modern software projects. For example, it may arise when a project should be ported to a more secure or feature-rich library, a new platform or a new version of an already used library. The developed method and tool are based on the previously created by the authors a formalism for describing libraries semantics. The formalism specifies a library behaviour by using a system of extended finite state machines (EFSM. This paper outlines the metamodel designed to specify library descriptions and proposes an easy to use domainspecific language (DSL, which can be used to define models for particular libraries. The mentioned metamodel directly forms the code migration procedure. A process of migration is split into five steps, and each step is also described in the paper. The procedure uses an algorithm based on the breadth- first search extended for the needs of the migration task. Models and algorithms were implemented in the prototype of an automated code migration tool. The prototype was tested by both artificial code examples and a real-world open source project. The article describes the experiments performed, the difficulties that have arisen in the process of migration of test samples, and how they are solved in the proposed procedure. The results of experiments indicate that code migration can be successfully automated. 

  18. Workplace culture and the practice experience of midwifery students: A meta-synthesis.

    Science.gov (United States)

    Arundell, Fiona; Mannix, Judy; Sheehan, Athena; Peters, Kath

    2018-04-01

    To describe midwifery students' practice experience and to explore facilitators and barriers to positive clinical learning experiences. Practice experience is a vital component of every midwifery course. Course dissatisfaction and attrition of midwifery students has been attributed to sub-optimal practice experiences. Events or actions experienced by midwifery students that trigger dissatisfaction and attrition need to be identified. A meta-synthesis was based on that developed by Noblit and Hare. Students perceive workplaces as poorly prepared for their arrival and subsequent support. Students' experience in the practice setting is influenced by the existing workplace culture. Workplace culture influences institutional functioning and individuals within the culture. Enculturation of students into the midwifery culture and subsequent learning is affected by the support received. The practice experience of midwifery students was profoundly influenced by workplace culture. Students tended to have polarized accounts of their experience that were predominantly negative. To provide an optimal environment for midwifery students; midwifery managers and individual midwives need to be aware of the facilitators and barriers to midwifery student development in the practice setting. © 2017 John Wiley & Sons Ltd.

  19. Taxes and free economic zones: Russian practice and China experience

    Directory of Open Access Journals (Sweden)

    V. E. Shibanov

    2016-01-01

    Full Text Available Special economic zone – the tool of regional policy of the state used in regions where increase of an economic and social level of development is required, and questions of application of tax benefits and preferences in the territory of a special economic zone acquire special relevance. The purpose of this article is research of the questions concerning the mode of the taxation of special economic zones. In Russia still there is no consensus about the sizes and the special economic zone types, the mechanism of their activity and approach to management. Development of uniform methodology is necessary for the Russian legislation for effective creation of activity of special economic zones taking into account features of a territorial arrangement. This methodology can be developed on the basis of positive experience of functioning of free economic zones of the different countries of the world. In the real work with the help of economic and statistical methods data on development and results of activity of a special economic zone in the territory of the Russian Federation and the China are collected and considered. As an example of successful functioning of the Russian special economic zone the special economic zone "Alabuga" is considered, as an example of functioning in the territory of the China special economic zone Shenzhen and joint industrial park of China and Singapore in the city of Suzhou are considered. The analysis of experience of the China has allowed to draw conclusions on efficiency of development of certain territories of the China through introduction of special economic zones. This fact substantially depends on efficiency of mechanisms of creation and development of economic educations, a possibility of self-government and financial independence in these territories, attraction of the foreign investment capital. There aren't enough these mechanisms in functioning of the Russian special economic zones where concept special

  20. Laguna Verde nuclear power plant: an experience to consider in advanced BWR design

    International Nuclear Information System (INIS)

    Fuentes Marquez, L.

    2001-01-01

    Laguna Verde is a BWR 5 containment Mark II. Designed by GE, two external re-circulation loops, each of them having two speed re-circulation pump and a flow control valve to define the drive flow and consequently the total core flow an power control by total core flow. Laguna Verde Design and operational experience has shown some insights to be considering in design for advanced BRW reactors in order to improve the potential of nuclear power plants. NSSS and Balance of plant design, codes used to perform nuclear core design, margins derived from engineering judgment, at the time Laguna Verde designed and constructed had conducted to have a plant with an operational license, generating with a very good performance and availability. Nevertheless, some design characteristics and operational experience have shown that potential improvements or areas of opportunity shall be focused in the advanced BWR design. Computer codes used to design the nuclear core have been evolved relatively fast. The computers are faster and powerful than those used during the design process, also instrumentation and control are becoming part of this amazing technical evolution in the industry. The Laguna Verde experience is the subject to share in this paper. (author)

  1. Initial experience with golimumab in clinical practice for ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Luisa Castro-Laria

    Full Text Available Background: Golimumab is a TNF-blocking agent indicated as a second-line therapy in ulcerative colitis. Purpose: To research the effectiveness and safety of golimumab in patients with ulcerative colitis in clinical practice. Methods: Retrospective study of the effectiveness and safety of golimumab in patients with ulcerative colitis. All patients received golimumab 200 mg subcutaneously at week 0, and golimumab 100 mg subcutaneously at week 2. After the induction treatment, each patient received 50 mg sc. every 4 weeks in patients with body weight less than 80 kg, and 100 mg every 4 weeks in patients with body weight greater than or equal to 80 kg. Results: Study of a group of 23 ulcerative colitis patients, 7 of whom were naive to any anti-TNF therapy, and 16 patients who had previously been treated with an anti-TNF agent other than golimumab (non-naive patients. The average treatment time with golimumab was 14.3 weeks. Globally, withdrawal of corticosteroids was observed in 74% of cases. Clinical response was observed in 85.5% of patients who had not received biological treatment previously, and in patients who had previously received biological treatment the response rate was 75%. Conclusions: In this short study, golimumab seems to be an alternative treatment in naive and non-naive anti-TNF ulcerative colitis patients. It is also a safe therapy, given that there were no adverse effects in the patients studied.

  2. Practical experience with the fuel monitoring at Dukovany NPP

    International Nuclear Information System (INIS)

    Kment, J.; Svoboda, R.; Valach, M.

    1994-01-01

    A brief description of the following activities of Dukovany NPP is given: fuel state monitoring during cycles; fuel state inspection during outages; fuel damage predictions and reality; prevention against fuel damage caused by PCI. The fuel state monitoring during cycles is conducted by on-line gamma spectrometer located under the by-pass pipelines of the water cleaning system. The system enables to carry out determination of the equilibrium activities of practically all significant gaseous fission products for energies from 80 KeV to 2 MeV. On-line activity measurements give reliable indication of a defect origin with the 133 Xe activity level of the order of tens k Bk/l. The gamma spectroscopy data are processed by KGO and PEPA software packages installed into the chemistry information system. KGO estimates the number of the damaged fuel elements and the extent of their damage. The activities of 133 Xe, 135 Xe, 137 Xe, 138 Xe, 87 Kr, 88 Kr and 89 Kr are used for evaluation of the number of 'leakers'. PEPA code predicts radiation set-up development, i.e. the activity levels of cca 20 radiologically significant nuclides in the primary coolant for the assumed reactor power mode. The fuel damage predictions during cycles are illustrated on two examples from the operational history of the Dukovany NPP. The utilization of the KGO-PEPA software contributes to a more high exploitation culture of the core from the point of view of fuel integrity maintenance. 3 refs

  3. Solar sorptive cooling. Technologies, user requirements, practical experience, future prospects

    Energy Technology Data Exchange (ETDEWEB)

    Treffinger, P. [DLR Deutsches Zentrum fuer Luft- und Raumfahrt e.V., Hardthausen (Germany); Hertlein, H.P. [eds.] [Forschungsverbund Sonnenenergie, Koeln (Germany)

    1998-09-01

    Sorptive cooling techniques permit the use of low-temperature solar heat, i.e. a renewable energy of low cost and world-wide availability. The Forschungsverbund Sonnenenergie intends to develop solar sorptive cooling technologies to the prototype stage and, in cooperation with the solar industry and its end users, to promote practical application in air conditioning of buildings and cold storage of food. The workshop presents an outline of the state of development of solar sorptive cooling from the view of users and developers. Exemplary solar cooling systems are described, and the potential of open and closed sorptive processes is assessed. Future central activities will be defined in an intensive discussion between planners, producers, users and developers. [German] Der Einsatz von Sorptionstechniken zur Kaelteerzeugung erlaubt es, als treibende Solarenergie Niedertemperatur-Solarwaerme einzusetzen, also eine regenerative Energie mit sehr geringen Kosten und weltweiter Verfuegbarkeit. Der Forschungsverbund Sonnenenergie hat sich als Aufgabe gestellt, die Techniken der solaren Sorptionskuehlung bis zum Prototyp zu entwickeln und mit Industrie und Nutzern die praktische Anwendung voranzubringen. Die Anwendungsfelder sind die Klimatisierung von Gebaeuden und die Kaltlagerung von Lebensmitteln. Der Workshop gibt einen Ueberblick zum Entwicklungsstand der solaren Sorptionskuehlung aus der Sicht der Anwender und Entwickler. Bereits ausgefuehrte Beispiele zur solaren Kuehlung werden vorgestellt und das Potential geschlossener und offener Sorptionsverfahren angegeben. In intensiver Diskussion zwischen Planern, Herstellern, Nutzern und Entwicklern sollen kuenftige Arbeitsschwerpunkte herausgearbeitet werden. (orig.)

  4. Multiagent Systems and Applications Volume 1Practice and Experience

    CERN Document Server

    Jain, Lakhmi

    2013-01-01

    The focus of the book is on completed implementations of agent-based software systems. Here, agent technology is considered broadly, starting from development of agent platforms, all the way through systems actually implemented. The covered topics also include lessons learned during implementation of agent platforms and the reflection on the process of development and application of agent-based systems.   The book includes 10 chapters where interested reader can find discussion of important issues encountered during development of well-known agent platforms such as JADE and Jadex as well as some interesting experiences in developing a new platform that combines software agent and Web Services. Furthermore, the book shows readers several valuable examples of applications based on multi-agent systems including simulations, agents in autonomous negotiations and agents in public administration modelling. We believe that the book will prove useful to the researchers, professors and the practitioners in all discip...

  5. Health physics practices and experience at Duke Power Company

    International Nuclear Information System (INIS)

    Lewis, L.

    1986-01-01

    The history and development of the health physics and as-low-as-reasonably-achievable (ALARA) program at Duke Power Company's Oconee Nuclear Station is described as are the fundamental elements of the program and how the program works. The benefits of this health physics/ALARA program have been determined to be (a) improved quality of manpower planning and scheduling, (b) increased efficiency of shutdown activities, (c) reduced cost of shutdown, (d) immediate awareness of adverse job exposure trends, (e) better management information on exposure-related problems, (f) improved accuracy of personnel and job dose records, and (g) in general, improved outage performance and subsequent plant operation. Experience with the health physics/ALARA program is discussed in terms of (a) savings of critical path time, (b) maintaining ALARA personnel doses, and (c) record capacity factors

  6. Tourism and international business: The theoretical approach and practical experiences

    Directory of Open Access Journals (Sweden)

    Jovičić Dobrica

    2011-01-01

    Full Text Available The paper discusses the relationships between tourism and international business. The research is based upon combining various theoretical concepts, significant empirical experiences and own attitudes of the authors. The key conclusion of the paper is that, despite of the partial progress in understanding tourism businesses, the relationships between tourism and international business need additional stimulus. In other words, more complete research in the related domains is needed in future. Any understanding of tourism is inadequate without appreciating the contributions that international business might bring, yet at the same time international business is incomplete in its coverage of international trade unless tourism is considered. The consumption-driven agenda of much tourism research has been favoured over supply-side discourses of the production process it self. That is why the role of major transnational companies, setting the trends that other types of firms in the tourism sector follow is focused in the paper.

  7. Wind turbines and aviation interests - European experience and practice

    Energy Technology Data Exchange (ETDEWEB)

    Jago, P.; Taylor, N.

    2002-07-01

    The approach of other European countries to the effects of wind turbines on civil and military aviation has been studied in order to determine the applicability of these experiences to UK stakeholders. The background to the study is traced, and the restriction on the siting of turbines due to the hazards posed to aviation and defence interests, and the potential effects on radar for air traffic control, defence and low flying aircraft are examined. The planning and siting issues in different European countries, the planning system in the UK, and the safeguarding of aerodromes and military sites are discussed along with issues involved in low flying aircraft and search and rescue operations, and the marking and illumination of wind farms.

  8. Practical experience in spent fuel management for German nuclear power plants

    International Nuclear Information System (INIS)

    Althaus, D.; Luehrmann, A.; Seepolt, R.; Springer, K.

    1999-01-01

    The paper describes the practical experience in spent fuel management gained in the past by using the traditional route of reprocessing and, since the amendment to the Atomic Law in 1994, by using also direct disposal via interim storage. (author)

  9. Seamless learning: Technology-enhanced learning from practical experiences across contexts

    NARCIS (Netherlands)

    Rusman, Ellen

    2018-01-01

    Rusman, E. (2018, 8th of June). Seamless learning: Technology-enhanced learning from practical experiences across contexts. Keynote presentation at the Seamless learning conference, Maastricht, The Netherlands. http://www.ou.nl/slc

  10. Educational experiment for students using natural radioactivity. 2. Practical example of radiochemical experiment conducted at Tottori University

    International Nuclear Information System (INIS)

    Nakamura, Mariko; Esaka, Takao; Kamata, Masahiro

    1999-01-01

    This paper presents a practical example of educational experiment conducted at Tottori University, whose theme is to separate 214 Bi(+ 214 Pb) from superphosphate of lime or the soil sampled at Ningyo-Touge mountain pass. The results of this experiment are quantitative enough for educational purpose, although the amount of radioactivity is so small that it is free from any regulation in Japan. (author)

  11. Advertising of medical devices: foreign experience and Ukrainian practice.

    Science.gov (United States)

    Pashkov, Vitalii; Harkusha, Andrii; Bytiak, Oleksii

    Chosen European foreign policy vector for Ukraine establishes its obligation to enforce the process of adaptation of the EU law regulations in the internal legal policy. The approximation of Ukrainian law to the European Union (EU) "acquis communautaire" is not only the instrument for deepening our economic cooperation with the European Union, but also the important measure to enhance further development of Ukraine in general. National legislation, which regulate advertising and promotion of medical devices (MD), is not an exception. Some key points on legal regulation of abovementioned sphere is a base of this study. Ukrainian legislation, European Union`s Law Acts, EU's member-states law, WHO Acts and Recommendations, European Medical Technology Industry Association (EUCOMED) Acts. Article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. In accordance with Ukrainian legislation, there is no special law that concerns advertising on MD in Ukraine, this sphere is regulated by general law that named ≪About advertisement≫, but it doesn't take into account even main characteristics of such a special object as medical devices (MD). Moreover, the law ≪About advertisement≫ contain discrepancies in terms that are used, these contradictions, in our opinion, must be eliminated by appropriate law reforms. The advertising and promotion of MD in EU is regulated by a combination of EU and national legislation of EU Member States, national advertising and promotion of MD are not harmonized with the EU MDD for now, resulting in a fragmented legal landscape that differs from one EU Member State to the other. Practice of adopting different codes and guides that regulate advertising, including advertising of MD, is widespread in EU and EU Member States and thus must be used in Ukraine with appropriate reformation of national law.

  12. Practical experience with the fuel monitoring at Dukovany NPP

    Energy Technology Data Exchange (ETDEWEB)

    Kment, J [Jaderna Elektrarna, Dukovany (Czech Republic); Svoboda, R; Valach, M [Ustav Jaderneho Vyzkumu a.s., Rez (Czech Republic)

    1994-12-31

    A brief description of the following activities of Dukovany NPP is given: fuel state monitoring during cycles; fuel state inspection during outages; fuel damage predictions and reality; prevention against fuel damage caused by PCI. The fuel state monitoring during cycles is conducted by on-line gamma spectrometer located under the by-pass pipelines of the water cleaning system. The system enables to carry out determination of the equilibrium activities of practically all significant gaseous fission products for energies from 80 KeV to 2 MeV. On-line activity measurements give reliable indication of a defect origin with the {sup 133}Xe activity level of the order of tens k Bk/l. The gamma spectroscopy data are processed by KGO and PEPA software packages installed into the chemistry information system. KGO estimates the number of the damaged fuel elements and the extent of their damage. The activities of {sup 133}Xe, {sup 135}Xe, {sup 137}Xe, {sup 138}Xe, {sup 87}Kr, {sup 88}Kr and {sup 89}Kr are used for evaluation of the number of `leakers`. PEPA code predicts radiation set-up development, i.e. the activity levels of cca 20 radiologically significant nuclides in the primary coolant for the assumed reactor power mode. The fuel damage predictions during cycles are illustrated on two examples from the operational history of the Dukovany NPP. The utilization of the KGO-PEPA software contributes to a more high exploitation culture of the core from the point of view of fuel integrity maintenance. 3 refs.

  13. Practical decommissioning experience with nuclear installations in the European Community

    International Nuclear Information System (INIS)

    Skupinski, E.

    1993-01-01

    Initiated by the Commission of the European Communities (CEC), this seminar was jointly organized by Kernkraftwerke RWE Bayernwerk GmbH (KRB) and the CEC at Gundremmingen-Guenzburg (D), where the former KRB-A BWR is presently being dismantled. The meeting aimed at gathering a limited number of European experts for the presentation and discussion of operations, the results and conclusions on techniques and procedures presently applied in the dismantling of large-scale nuclear installations in the European Community. Besides the four pilot dismantling projects of the presently running third R and D programme (1989-93) of the European Community on decommissioning of nuclear installations (WAGR, BR-3 PWR, KRB-A BWR and AT-1 FBR fuel reprocessing), the organizers selected the presentation of topics on the following facilities which have a significant scale and/or representative features and are presently being dismantled: the Magnox reprocessing pilot plant at Sellafield, the HWGCR EL4 at Monts d'Arree, the operation of an on-site melting furnace for G2/G3 GCR dismantling waste at Marcoule, an EdF confinement conception of shut-down LWRs for deferred dismantling, and the technical aspects of the Greifswald WWER type NPPs decommissioning. This was completed by a presentation on the decommissioning of material testing reactors in the United Kingdom and by an overview on the conception and implementation of two EC databases on tools, costs and job doses. The seminar concluded with a guided visit of the KRB-A dismantling site. This meeting was attended by managers concerned by the decommissioning of nuclear installations within the European Community, either by practical dismantling work or by decision-making functions. Thereby, the organizers expect to have contributed to the achievement of decommissioning tasks under optimal conditions - with respect to safety and economics - by making available a complete and updated insight into on-going dismantling projects and by

  14. A pilot study of the experience of participating in a Therapeutic Touch practice group.

    Science.gov (United States)

    Moore, Theresa; Ting, Brigid; Rossiter-Thornton, Maria

    2008-09-01

    This pilot study explored the experience of participating in a Therapeutic Touch practice group. A qualitative descriptive-exploratory method was used, involving 12 members of practice groups in Ontario and British Columbia, Canada. Analysis of the data using an extraction-synthesis process yielded four themes: (a) learning with others through sharing and hands-on experience is valued; (b) connecting with a network of supportive relationships that sustain self and Therapeutic Touch practice; (c) comfort-discomfort arising with self, others, or ideas; and (d) meaningful changes emerge while experiencing group energy and Therapeutic Touch. The findings expand current knowledge about the positive aspects of participating in practice groups and provide a beginning understanding of member discomfort, which had not been previously reported. This knowledge will be useful to Therapeutic Touch organizations, practice group leaders, and group members. It will also guide health care agencies and practitioners of other healing modalities who may be considering establishing practice groups.

  15. ETA-II experiments for determining advanced radiographic capabilities of induction linacs

    International Nuclear Information System (INIS)

    Weir, J.T.; Caporaso, G.J.; Clark, J.C.; Kirbie, H.C.; Chen, Y.J.; Lund, S.M.; Westenskow, G.A.; Paul, A.C.

    1997-05-01

    LLNL has proposed a multi-pulsed, multi-line of sight radiographic machine based on induction linac technology to be the core of the advanced hydrotest facility (AHF) being considered by the Department of Energy. In order to test the new technologies being developed for AHF we have recommissioned the Experimental Test Accelerator (ETA II). We will conduct our initial experiments using kickers and large angle bending optics at the ETA II facility. Our current status and our proposed experimental schedule will be presented

  16. Practical experiences with irradiation of laboratory animals' feed

    International Nuclear Information System (INIS)

    Adamiker, D.

    1979-01-01

    The increasing need for well-defined, standardized experimental animals for research has led to the development of many new methods of keeping the animals free from pathogenic microorganisms. In this connection the problem of contaminated food has taken on ever greater significance. The methods most commonly used today, namely chemical treatment and heat treatment of the fodder, have many disadvantages and interest in the use of radiation sterilization has accordingly increased. The author discusses the various aspects of this method in relation to SPF animals and reports on the three years' experience of the Research Institute for Experimental Animal Breeding (University of Vienna) in Himberg with the use of exclusively radiation-treated diets in the rearing of rats and mice. The ease of handling irradiated fodder, the reliability of the method from the microbiological point of view and the excellent breeding results already obtained make this process - despite its somewhat higher cost - the best possible method of pasteurizing the feed of experimental animals. (author)

  17. Graph processing platforms at scale: practices and experiences

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seung-Hwan [ORNL; Lee, Sangkeun (Matt) [ORNL; Brown, Tyler C [ORNL; Sukumar, Sreenivas R [ORNL; Ganesh, Gautam [ORNL

    2015-01-01

    Graph analysis unveils hidden associations of data in many phenomena and artifacts, such as road network, social networks, genomic information, and scientific collaboration. Unfortunately, a wide diversity in the characteristics of graphs and graph operations make it challenging to find a right combination of tools and implementation of algorithms to discover desired knowledge from the target data set. This study presents an extensive empirical study of three representative graph processing platforms: Pegasus, GraphX, and Urika. Each system represents a combination of options in data model, processing paradigm, and infrastructure. We benchmarked each platform using three popular graph operations, degree distribution, connected components, and PageRank over a variety of real-world graphs. Our experiments show that each graph processing platform shows different strength, depending the type of graph operations. While Urika performs the best in non-iterative operations like degree distribution, GraphX outputforms iterative operations like connected components and PageRank. In addition, we discuss challenges to optimize the performance of each platform over large scale real world graphs.

  18. Engaging academia to advance the science and practice of environmental public health tracking.

    Science.gov (United States)

    Strosnider, Heather; Zhou, Ying; Balluz, Lina; Qualters, Judith

    2014-10-01

    Public health agencies at the federal, state, and local level are responsible for implementing actions and policies that address health problems related to environmental hazards. These actions and policies can be informed by integrating or linking data on health, exposure, hazards, and population. The mission of the Centers for Disease Control and Prevention׳s National Environmental Public Health Tracking Program (Tracking Program) is to provide information from a nationwide network of integrated health, environmental hazard, and exposure data that drives actions to improve the health of communities. The Tracking Program and federal, state, and local partners collect, integrate, analyze, and disseminate data and information to inform environmental public health actions. However, many challenges exist regarding the availability and quality of data, the application of appropriate methods and tools to link data, and the state of the science needed to link and analyze health and environmental data. The Tracking Program has collaborated with academia to address key challenges in these areas. The collaboration has improved our understanding of the uses and limitations of available data and methods, expanded the use of existing data and methods, and increased our knowledge about the connections between health and environment. Valuable working relationships have been forged in this process, and together we have identified opportunities and improvements for future collaborations to further advance the science and practice of environmental public health tracking. Published by Elsevier Inc.

  19. The Expanding Role of Advanced Practice Providers in Urologic Procedural Care.

    Science.gov (United States)

    Langston, Joshua P; Duszak, Richard; Orcutt, Venetia L; Schultz, Heather; Hornberger, Brad; Jenkins, Lawrence C; Hemingway, Jennifer; Hughes, Danny R; Pruthi, Raj S; Nielsen, Matthew E

    2017-08-01

    To understand the role of Advanced Practice Providers (APPs) in urologic procedural care and its change over time. As the population ages and the urologic workforce struggles to meet patient access demands, the role of APPs in the provision of all aspects of urologic care is increasing. However, little is currently known about their role in procedural care. Commonly performed urologic procedures were linked to Current Procedural Terminology (CPT) codes from 1994 to 2012. National Medicare Part B beneficiary claims frequency was identified using Physician Supplier Procedure Summary Master Files. Trends were studied for APPs, urologists, and all other providers nationally across numerous procedures spanning complexity, acuity, and technical skill set requirements. Between 1994 and 2012, annual Medicare claims for urologic procedures by APPs increased dramatically. Cystoscopy increased from 24 to 1820 (+7483%), transrectal prostate biopsy from 17 to 834 (+4806%), complex Foley catheter placement from 471 to 2929 (+522%), urodynamics testing from 41 to 9358 (+22,727%), and renal ultrasound from 18 to 4500 (+24,900%) CONCLUSION: We found dramatic growth in the provision of urologic procedural care by APPs over the past 2 decades. These data reinforce the known expansion of the APP role in urology and support the timeliness of ongoing collaborative multidisciplinary educational efforts to address unmet needs in education, training, and guideline formation to maximize access to urologic procedural services. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

    Directory of Open Access Journals (Sweden)

    Denise Bryant-Lukosius

    Full Text Available ABSTRACT Objective: to examine advanced practice nursing (APN roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries.