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Sample records for care skills 5th

  1. Physical activity levels and motor skills of 5 th to 7 th grade students ...

    African Journals Online (AJOL)

    The physical activity (PA) and motor skill levels (MS) (flexibility, balance, speed, sit-up, hand grip strength, standing long jump) were determined for 5th to 7th grade students from central schools in Nigde Province, Turkey according to age and gender and to investigate the relationships. PAL was determined by means of ...

  2. Measuring Listening Comprehension Skills of 5th Grade School Students with the Help of Web Based System

    Science.gov (United States)

    Acat, M. Bahaddin; Demiral, Hilmi; Kaya, Mehmet Fatih

    2016-01-01

    The main purpose of this study is to measure listening comprehension skills of 5th grade school students with the help of web based system. This study was conducted on 5th grade students studying at the primary schools of Eskisehir. The scale used in the process of the study is "Web Based Listening Scale". In the process of the study,…

  3. Measuring Listening Comprehension Skills of 5th Grade School Students with the Help of Web Based System

    Directory of Open Access Journals (Sweden)

    M. Bahaddin Acat

    2016-01-01

    Full Text Available The main purpose of this study is to measure listening comprehension skills of 5th grade school students with the help of web based system. This study was conducted on 5th grade students studying at the primary schools of Eskisehir. The scale used in the process of the study is “Web Based Listening Scale”. In the process of the study, it was investigated that the level of differentiation listening skill and educational level of mother and father, family income level, Turkish Course grading note, the most popular and listened music genre. According to the results obtained that significant difference was found with listening skills and educational level of mother and father, family income level and the most popular and listened music genre. Also it was found that there is powerful relationship between listening skills and Turkish Course grading note. In the process of the research, it was observed the students used the web based system more attentive and motivated. Nevertheless, personalized measuring environment was provided by the web based system. Finally, it can be said that the web based systems can be used positively for language learning, teaching, and instruction, improving, measuring and assessing process.

  4. Research Methods for Business : A Skill Building Approach (5th Edition)

    NARCIS (Netherlands)

    Sekaran, U.; Bougie, J.R.G.

    2009-01-01

    Research Methods for Business: A Skill-Building Approach is a concise and straightforward introduction for students to the world of business research. The skill-building approach provides students with practical perspectives on how research can be applied in real business situations. Maintaining Uma

  5. Effectiveness of Motor Skills Development in 5th-7th Grade Girls at Different Modes of Physical Exercises

    Directory of Open Access Journals (Sweden)

    Olga Ivashchenko

    2017-12-01

    Full Text Available The objective is to determine the influence of the physical exercises modes on effectiveness of motor skills development in 5th-7th grade girls.  Materials and methods. The study involved 5th grade girls (n = 28, 6th grade girls (n = 28 and 7th grade girls (n = 24. To solve the tasks set, the study relied on general scientific and special research methods, methods of mathematical experiment-planning. Studying the influence of different variants of the educational process structure, namely: the number of repetitions (x1 and the rest intervals (x2 on acquisition of the technique of physical exercises performance, provided for achieving the objective. A full 22 type factorial experiment was conducted. The 5th-7th graders were divided into training groups according to the experiment plan. In total, there were twelve experimental groups organized, four in each class. Results. The analysis of the regression equations shows that the rest interval between repetitions (x2 has the greatest influence on teaching 5th-7th grade girls physical exercises, with the number of repetitions (x1 being of somewhat less significant influence. The relation between these factors (x1x2 has a considerable weight in teaching to “rope climb in two or three sets” and to do a “pullover mount with a swing of one and a push-off with the other leg”. Conclusions. To increase the effectiveness of teaching 5th-7th grade girls physical exercises, the number of repetitions in throwing exercises should be increased to twelve times, and the rest interval reduced to 60 seconds. In the 7th grade, the number of repetitions should be reduced to six times, and the rest interval – to 60 seconds. The rest intervals in the exercises: “pullover mount with a swing of one and a push-off with the other leg” and “rope climbing in two or three sets”, should be reduced to 60 seconds and the number of repetitions – to six.

  6. Improving the 5th Formers’ Continuous Writing Skills through the Creative Writing Module

    Directory of Open Access Journals (Sweden)

    Mohana Ram Murugiah

    2013-07-01

    Full Text Available Writing is a complex task. The development of students’ writing skill depends on the teacher’s teaching strategy and also the materials used in the writing lesson. In the present study, the effectiveness of a creative writing module was examined that was designed to improve the writing skill of a group of excellent students. It was added with explicit teaching strategies. The selected group of students were students who were in the excellent group but lacked creativity and vocabulary in their writing. The creative writing module was designed to help these students. Students’ improvement was observed through observation in the classrooms during the lessons and through writing task as well as interviews. Two observations were made. One was before the creative writing project was started and another after the completion of the entire task of the module. The interview was carried out to learn about the students’ perception of the module and how do they find the module has helped them.  The result of the research showed that students have shown a great level of improvement in their writing skills. The outcome of this present study could be useful to assist language instructors in helping proficient learners to undergo a more effective second language learning experience.

  7. 5th International Conference on Advancements of Medicine and Health Care through Technology

    CERN Document Server

    Roman, Nicolae

    2017-01-01

    This volume presents the contributions of the fifth International Conference on Advancements of Medicine and Health Care through Technology (Meditech 2016), held in in Cluj-Napoka, Romania. The papers of this Proceedings volume present new developments in - Health Care Technology, - Medical Devices, Measurement and Instrumentation, - Medical Imaging, Image and Signal Processing, - Modeling and Simulation, - Molecular Bioengineering, - Biomechanics.

  8. Integrating critical Web skills and content knowledge: Development and evaluation of a 5th grade educational program

    NARCIS (Netherlands)

    Kuiper, E.; Volman, M.L.L.; Terwel, J.

    2008-01-01

    Although the Web is almost omnipresent in many children's lives, most children lack adequate Web searching skills as well as skills to process and critically evaluate Web information. In this article, we describe and evaluate an educational program that aimed at acquiring Web skills in the context

  9. 5th August 2008 - British Secretary of State for Innovation, Universities and Skills J. Denham MP visiting LHCb experimental area with Collaboration Spokesperson A. Golutvin and users T. Bowcock and U. Egede.

    CERN Multimedia

    Claudia Marcelloni

    2008-01-01

    5th August 2008 - British Secretary of State for Innovation, Universities and Skills J. Denham MP visiting LHCb experimental area with Collaboration Spokesperson A. Golutvin and users T. Bowcock and U. Egede.

  10. Perioperative care of patients with epidermolysis bullosa: proceedings of the 5th international symposium on epidermolysis bullosa, Santiago Chile, December 4-6, 2008.

    Science.gov (United States)

    Goldschneider, Kenneth; Lucky, Anne W; Mellerio, Jemima E; Palisson, Francis; del Carmen Viñuela Miranda, Maria; Azizkhan, Richard G

    2010-09-01

    Epidermolysis bullosa (EB) has become recognized as a multisystem disorder that poses a number of pre-, intra-, and postoperative challenges. While anesthesiologists have long appreciated the potential difficult intubation in patients with EB, other systems can be affected by this disorder. Hematologic, cardiac, skeletal, gastrointestinal, nutritional, and metabolic deficiencies are foci of preoperative medical care, in addition to the airway concerns. Therefore, multidisciplinary planning for operative care is imperative. A multinational, interdisciplinary panel of experts assembled in Santiagio, Chile to review the best practices for perioperative care of patients with EB. This paper presents guidelines that represent a synthesis of evidence-based approaches and the expert consensus of this panel and are intended to aid physicians new to caring for patients with EB when operative management is indicated. With proper medical optimization and attention to detail in the operating room, patients with EB can have an uneventful perioperative course.

  11. Global Emergency Care Skills. Does it work?

    Directory of Open Access Journals (Sweden)

    Jean O’Sullivan

    2012-09-01

    Discussion: Comparison of results in each country separately and cumulatively demonstrated a statistically significant improvement in participant’s knowledge after completing a Global Emergency Care Skills course. This improvement mirrors the qualitative improvement in psychomotor skills, knowledge and attitudes seen in candidates who participated in the course.

  12. Screening for Underage Drinking and Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Alcohol Use Disorder in Rural Primary Care Practice.

    Science.gov (United States)

    Clark, Duncan B; Martin, Christopher S; Chung, Tammy; Gordon, Adam J; Fiorentino, Lisa; Tootell, Mason; Rubio, Doris M

    2016-06-01

    To examine the National Institute on Alcohol Abuse and Alcoholism Youth Guide alcohol frequency screening thresholds when applied to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnostic criteria, and to describe alcohol use patterns and alcohol use disorder (AUD) characteristics in rural youth from primary care settings. Adolescents (n = 1193; ages 12 through 20 years) visiting their primary care practitioner for outpatient visits in six rural primary care clinics were assessed prior to their practitioner visit. A tablet computer collected youth self-report of past-year frequency and quantity of alcohol use and DSM-5 AUD symptoms. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. For early adolescents (ages 12 through 14 years), 1.9% met DSM-5 criteria for past-year AUD and ≥3 days with alcohol use in the past year yielded a screen for DSM-5 with optimal psychometric properties (sensitivity: 89%; specificity: 95%; PPV: 37%; NPV: 100%). For middle adolescents (ages 15 through 17 years), 9.5% met DSM-5 AUD criteria, and ≥3 past year drinking days showed optimal screening results (sensitivity: 91%; specificity: 89%; PPV: 50%; NPV: 99%). For late adolescents (ages 18 through 20 years), 10.0% met DSM-5 AUD criteria, and ≥12 past year drinking days showed optimal screening results (sensitivity: 92%; specificity: 75%; PPV: 31%; NPV: 99%). The age stratified National Institute on Alcohol Abuse and Alcoholism frequency thresholds also produced effective results. In rural primary care clinics, 10% of youth over age 14 years had a past-year DSM-5 AUD. These at-risk adolescents can be identified with a single question on alcohol use frequency. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Ambulatory Care Skills: Do Residents Feel Prepared?

    Directory of Open Access Journals (Sweden)

    Denise Bonds

    2002-10-01

    Full Text Available Objective: To determine resident comfort and skill in performing ambulatory care skills. Methods: Descriptive survey of common ambulatory care skills administered to internal medicine faculty and residents at one academic medical center. Respondents were asked to rate their ability to perform 12 physical exam skills and 6 procedures, and their comfort in performing 7 types of counseling, and obtaining 6 types of patient history (4 point Likert scale for each. Self-rated ability or comfort was compared by gender, status (year of residency, faculty, and future predicted frequency of use of the skill. Results: Residents reported high ability levels for physical exam skills common to both the ambulatory and hospital setting. Fewer felt able to perform musculoskeletal, neurologic or eye exams easily alone. Procedures generally received low ability ratings. Similarly, residents’ comfort in performing common outpatient counseling was also low. More residents reported feeling very comfortable in obtaining history from patients. We found little variation by gender, year of training, or predicted frequency of use. Conclusion: Self-reported ability and comfort for many common ambulatory care skills is low. Further evaluation of this finding in other training programs is warranted.

  14. The 2014 updated version of the Confusion Assessment Method for the Intensive Care Unit compared to the 5th version of the Diagnostic and Statistical Manual of Mental Disorders and other current methods used by intensivists.

    Science.gov (United States)

    Chanques, Gérald; Ely, E Wesley; Garnier, Océane; Perrigault, Fanny; Eloi, Anaïs; Carr, Julie; Rowan, Christine M; Prades, Albert; de Jong, Audrey; Moritz-Gasser, Sylvie; Molinari, Nicolas; Jaber, Samir

    2018-03-01

    One third of patients admitted to an intensive care unit (ICU) will develop delirium. However, delirium is under-recognized by bedside clinicians without the use of delirium screening tools, such as the Intensive Care Delirium Screening Checklist (ICDSC) or the Confusion Assessment Method for the ICU (CAM-ICU). The CAM-ICU was updated in 2014 to improve its use by clinicians throughout the world. It has never been validated compared to the new reference standard, the Diagnostic and Statistical Manual of Mental Disorders 5th version (DSM-5). We made a prospective psychometric study in a 16-bed medical-surgical ICU of a French academic hospital, to measure the diagnostic performance of the 2014 updated CAM-ICU compared to the DSM-5 as the reference standard. We included consecutive adult patients with a Richmond Agitation Sedation Scale (RASS) ≥ -3, without preexisting cognitive disorders, psychosis or cerebral injury. Delirium was independently assessed by neuropsychological experts using an operationalized approach to DSM-5, by investigators using the CAM-ICU and the ICDSC, by bedside clinicians and by ICU patients. The sensitivity, specificity, positive and negative predictive values were calculated considering neuropsychologist DSM-5 assessments as the reference standard (primary endpoint). CAM-ICU inter-observer agreement, as well as that between delirium diagnosis methods and the reference standard, was summarized using κ coefficients, which were subsequently compared using the Z-test. Delirium was diagnosed by experts in 38% of the 108 patients included for analysis. The CAM-ICU had a sensitivity of 83%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 91%. Compared to the reference standard, the CAM-ICU had a significantly (p DSM-5 criteria and reliable regarding inter-observer agreement in a research setting. Delirium remains under-recognized by bedside clinicians.

  15. Kids & Family Reading Report™. 5th Edition

    Science.gov (United States)

    Scholastic Inc., 2015

    2015-01-01

    This report presents the 5th Edition of Scholastic's biannual study of children's and parents' attitudes and behaviors about reading. The latest research touches on reading aloud to children of all ages, the impact of reading independently for fun at school and at home, the importance of frequent reading, and the books children want most to read.…

  16. BMC Medicine celebrates its 5th anniversary

    Science.gov (United States)

    Appleford, Joanne M; Cassady-Cain, Robin L; Patel, Jigisha; Norton, Melissa L

    2009-01-01

    In November 2008, BMC Medicine passed the landmark of its first 5 years of publishing. When we launched the journal with the aim of publishing high quality research of general interest and special importance, we had no idea what the future would bring. To mark the occasion of our 5th anniversary, we consider the achievements of the last 5 years and discuss our plans for the future.

  17. 5th International Conference on Cryocoolers

    CERN Document Server

    1989-01-01

    The Cryocoolers 5 proceedings archives the contributions of leading international experts at the 5th International Cryocooler Conference that was held in Monterey, California on August 18-19, 1988. The authors submitted twenty six papers describing advancements and applications of cryocoolers in the temperature range below 80K. This year's conference was hosted by the U.S. Naval Postgraduate School in Monterey, California, and the conference proceedings reproduced here were published by the Wright-Patterson AFB in Ohio.

  18. 5th Total System Performance Assessment Workshop

    International Nuclear Information System (INIS)

    Hwang, Yong Soo; Lee, Youn Myoung; Kang, Chul Hyung; Lee, Sung Ho

    2009-07-01

    Research items on safety assessment of high-level waste repository have been proposed by external invited experts outside KAERI and discussed extensively during the annual 5th performance assessment workshop prepared by safety assessment group in KAERI. This could be useful to set up R and D plans necessary for the next phase of mid- and long-term reaserch area regarding the safety assessment of high-level waste repository. Through the research and the presentation, HLW-related research and development area including such specific research items as current status of HLW safety assessment research, current requirement for the licensing of the repository system, priority on research area, data base building for the safety assessment, source-term modeling as well as safety case, among many others, have been discussed and summarized

  19. 5th International Robotic Sailing Conference

    CERN Document Server

    Finnis, James

    2013-01-01

    Robotic sailing offers the potential of wind propelled vehicles which are sufficiently autonomous to remain at sea for months at a time. These could replace or augment existing oceanographic sampling systems, be used in border surveillance and security or offer a means of carbon neutral transportation. To achieve this represents a complex, multi-disciplinary challenge to boat designers and naval architects, systems/electrical engineers and computer scientists.  Since 2004 a series of competitions in the form of the Sailbot, World Robotic Sailing Championship and Microtransat competitions have sparked an explosion in the number of groups working on autonomous sailing robots. Despite this interest the longest distance sailed autonomously remains only a few hundred miles. Many of the challenges in building truly autonomous sailing robots still remain unsolved. These proceedings present the cutting edge of work in a variety of fields related to robotic sailing. They will be presented during the 5th International...

  20. 5th International Symposium on Positive Systems

    CERN Document Server

    Farina, Lorenzo; Setola, Roberto; Germani, Alfredo

    2017-01-01

    This book presents high-quality original contributions on positive systems, including topics such as: monotone dynamical systems in mathematical biology and game theory; mathematical developments for networked systems in biology, chemistry and the social sciences; linear and nonlinear positive operators; dynamical analysis, observation and control of positive distributed parameter systems; stochastic realization theory; biological systems with positive variables and positive controls; iterated function systems; nonnegative dynamic processes; and dimensioning problems for collaborative systems. The book comprises a selection of the best papers presented at the POSTA 2016, the 5th International Symposium on Positive Systems, which was held in Rome, Italy, in September 2016. This conference series represents a targeted response to the growing need for research that reports on and critically discusses a wide range of topics concerning the theory and applications of positive systems.

  1. Skilled antenatal care service utilization and its association with the ...

    African Journals Online (AJOL)

    Data were entered into EPI info version 7 statistical software and exported to STATA ... Conclusions: Skilled ANC service utilization is the joint effect of individual and ... analysis, skilled antenatal care service, women's health development team ...

  2. Increasing Women's Access to Skilled Pregnancy Care in Nigeria ...

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

    Home · What we do ... Less than one-third of Nigerian women receive skilled care during delivery. ... the supply and demand factors that influence improved access to maternal health care services in Nigeria, particularly for rural women.

  3. Antenatal Care and Skilled Birth Attendance in Three Communities ...

    African Journals Online (AJOL)

    Antenatal Care and Skilled Birth Attendance in Three Communities in Kaduna State, Nigeria. ... Most importantly, safer delivery options that would be acceptable in communities where women traditionally birth at home need to be explored (Afr. J. Reprod. Health 2010; 14[3]: 89-96). Key words: Antenatal care, skilled birth ...

  4. 5th Annual Provider Software Buyer's Guide.

    Science.gov (United States)

    1995-03-01

    To help long term care providers find new ways to improve quality of care and efficiency, PROVIDER presents the fifth annual listing of software firms marketing computer programs for all areas of long term care operations. On the following five pages, more than 70 software firms display their wares, with programs such as minimum data set and care planning, dietary, accounting and financials, case mix, and medication administration records. The guide also charts compatible hardware, integration ability, telephone numbers, company contacts, and easy-to-use reader service numbers.

  5. The Critical Care Communication project: improving fellows' communication skills.

    Science.gov (United States)

    Arnold, Robert M; Back, Anthony L; Barnato, Amber E; Prendergast, Thomas J; Emlet, Lillian L; Karpov, Irina; White, Patrick H; Nelson, Judith E

    2015-04-01

    The aim of this study was to develop an evidence-based communication skills training workshop to improve the communication skills of critical care fellows. Pulmonary and critical care fellows (N = 38) participated in a 3-day communication skills workshop between 2008 and 2010 involving brief didactic talks, faculty demonstration of skills, and faculty-supervised small group skills practice sessions with simulated families. Skills included the following: giving bad news, achieving consensus on goals of therapy, and discussing the limitations of life-sustaining treatment. Participants rated their skill levels in a pre-post survey in 11 core communication tasks using a 5-point Likert scale. Of 38 fellows, 36 (95%) completed all 3 days of the workshop. We compared pre and post scores using the Wilcoxon signed rank test. Overall, self-rated skills increased for all 11 tasks. In analyses by participant, 95% reported improvement in at least 1 skill; with improvement in a median of 10 of 11 skills. Ninety-two percent rated the course as either very good/excellent, and 80% recommended that it be mandatory for future fellows. This 3-day communication skills training program increased critical care fellows' self-reported family meeting communication skills. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. 5th International Conference on Soft Computing for Problem Solving

    CERN Document Server

    Deep, Kusum; Bansal, Jagdish; Nagar, Atulya; Das, Kedar

    2016-01-01

    This two volume book is based on the research papers presented at the 5th International Conference on Soft Computing for Problem Solving (SocProS 2015) and covers a variety of topics, including mathematical modelling, image processing, optimization methods, swarm intelligence, evolutionary algorithms, fuzzy logic, neural networks, forecasting, medical and health care, data mining, etc. Mainly the emphasis is on Soft Computing and its applications in diverse areas. The prime objective of this book is to familiarize the reader with the latest scientific developments in various fields of Science, Engineering and Technology and is directed to the researchers and scientists engaged in various real-world applications of ‘Soft Computing’.

  7. Kangaroo Care Education Effects on Nurses' Knowledge and Skills Confidence.

    Science.gov (United States)

    Almutairi, Wedad Matar; Ludington-Hoe, Susan M

    2016-11-01

    Less than 20% of the 996 NICUs in the United States routinely practice kangaroo care, due in part to the inadequate knowledge and skills confidence of nurses. Continuing education improves knowledge and skills acquisition, but the effects of a kangaroo care certification course on nurses' knowledge and skills confidence are unknown. A pretest-posttest quasi-experiment was conducted. The Kangaroo Care Knowledge and Skills Confidence Tool was administered to 68 RNs at a 2.5-day course about kangaroo care evidence and skills. Measures of central tendency, dispersion, and paired t tests were conducted on 57 questionnaires. The nurses' characteristics were varied. The mean posttest Knowledge score (M = 88.54, SD = 6.13) was significantly higher than the pretest score (M = 78.7, SD = 8.30), t [54] = -9.1, p = .000), as was the posttest Skills Confidence score (pretest M = 32.06, SD = 3.49; posttest M = 26.80, SD = 5.22), t [53] = -8.459, p = .000). The nurses' knowledge and skills confidence of kangaroo care improved following continuing education, suggesting a need for continuing education in this area. J Contin Educ Nurs. 2016;47(11):518-524. Copyright 2016, SLACK Incorporated.

  8. Fundamentals of analytical chemistry, 5th edition

    International Nuclear Information System (INIS)

    Skoog, D.A.; West, D.M.; Holler, F.J.

    1988-01-01

    Fundamentals of Analytical Chemistry is divided into three roughly equal parts. The first 14 chapters cover classical methods of analysis, including titrimetry and gravimetry as well as solution equilibria and statistical analysis. The next 11 chapters address electroanalytical, optical, and chromatographic methods of analysis. The remainder of the text is devoted to discussions of sample manipulation and pretreatment, good laboratory practices, and detailed directions for performing examples of 17 different types of classical and instrumental analyses. Like its predecessors, this fifth edition provides comprehensive coverage of classical analytical methods and the major instrumental ones in a literary style that is clear, straightforward, and readable. New terms are carefully defined as they are introduced, and each term is italicized for emphasis and for ease of relocation by the student who may forget its meaning. The chapters on analyses of real-world samples, on avoiding interferences, and on techniques for sample preparation should prove especially useful for the practicing chemist

  9. Nurse management skills required at an emergency care unit

    OpenAIRE

    Montezeli, Juliana Helena; Peres, Aida Maris; Bernardino, Elizabeth

    2013-01-01

    Objective: To identify the management skills needed for this professional at an emergency care unit. Method: An exploratory descriptive qualitative study conducted with eight nurses in which semi-structured interviews with nonparticipating systematic observation were conducted; the data was processed by content analysis. Results: The categories which emerged from the content analysis served as a list of management skills necessary to their work at the emergency care unit: leadership, decision...

  10. Ophthalmic Skills Assessment of Primary Health Care Workers at ...

    African Journals Online (AJOL)

    Proficiency in the basic ophthalmic skills is a cri cal factor in the effec ve delivery of eye care services at the primary level of care. The aim of the study was to assess the ability of ... out visual acuity test and correctly iden fy cataract and conjunc vi s using pictures of eye condi ons and ..... Medical Laboratory Technician.

  11. Implementing digital skills training in care homes: a literature review.

    Science.gov (United States)

    Wild, Deidre; Kydd, Angela; Szczepura, Ala

    2016-05-01

    This article is the first of a two-part series that informs and describes digital skills training using a dedicated console computer provided for staff and residents in a care home setting. This was part of a programme of culture change in a large care home with nursing in Glasgow, Scotland. The literature review shows that over the past decade there has been a gradual increase in the use of digital technology by staff and older people in community settings including care homes. Policy from the European Commission presents a persuasive argument for the advancement of technology-enabled care to counter the future impact of an increased number of people of advanced age on finite health and social care resources. The psychosocial and environmental issues that inhibit or enhance the acquisition of digital skills in care homes are considered and include the identification of exemplar schemes and the support involved.

  12. Disparities in Private Health Insurance Coverage of Skilled Care

    Directory of Open Access Journals (Sweden)

    Stacey A. Tovino

    2017-10-01

    Full Text Available This article compares and contrasts public and private health insurance coverage of skilled medical rehabilitation, including cognitive rehabilitation, physical therapy, occupational therapy, speech-language pathology, and skilled nursing services (collectively, skilled care. As background, prior scholars writing in this area have focused on Medicare coverage of skilled care and have challenged coverage determinations limiting Medicare coverage to beneficiaries who are able to demonstrate improvement in their conditions within a specific period of time (the Improvement Standard. By and large, these scholars have applauded the settlement agreement approved on 24 January 2013, by the U.S. District Court for the District of Vermont in Jimmo v. Sebelius (Jimmo, as well as related motions, rulings, orders, government fact sheets, and Medicare program manual statements clarifying that Medicare covers skilled care that is necessary to prevent or slow a beneficiary’s deterioration or to maintain a beneficiary at his or her maximum practicable level of function even though no further improvement in the beneficiary’s condition is expected. Scholars who have focused on beneficiaries who have suffered severe brain injuries, in particular, have framed public insurance coverage of skilled brain rehabilitation as an important civil, disability, and educational right. Given that approximately two-thirds of Americans with health insurance are covered by private health insurance and that many private health plans continue to require their insureds to demonstrate improvement within a short period of time to obtain coverage of skilled care, scholarship assessing private health insurance coverage of skilled care is important but noticeably absent from the literature. This article responds to this gap by highlighting state benchmark plans’ and other private health plans’ continued use of the Improvement Standard in skilled care coverage decisions and

  13. From Communication Skills to Skillful Communication: A Longitudinal Integrated Curriculum for Critical Care Medicine Fellows.

    Science.gov (United States)

    Roze des Ordons, Amanda L; Doig, Christopher J; Couillard, Philippe; Lord, Jason

    2017-04-01

    Communication with patients and families in critical care medicine (CCM) can be complex and challenging. A longitudinal curricular model integrating multiple techniques within classroom and clinical milieus may facilitate skillful communication across diverse settings. In 2014-2015, the authors developed and implemented a curriculum for CCM fellows at the Cumming School of Medicine, University of Calgary, to promote the longitudinal development of skillful communication. A departmental needs assessment informed curriculum development. Five 4-hour classroom sessions were developed: basic communication principles, family meetings about goals and transitions of care, discussing patient safety incidents, addressing conflict, and offering organ donation. Teaching methods-including instructor-led presentations incorporating a consistent framework for approaching challenging conversations, simulation and clinical practice, and feedback from peers, trained facilitators, family members, and clinicians-supported integration of skills into the clinical setting and longitudinal development of skillful communication. Seven fellows participated during the first year of the curriculum. CCM fellows engaged enthusiastically in the program, commented that the framework provided was helpful, and highly valued the opportunity to practice challenging communication scenarios, learn from observing their peers, and receive immediate feedback. More detailed accounts of fellows', patients', and family members' experiences will be obtained to guide curricular development. The curriculum will be expanded to involve other members of the multidisciplinary intensive care unit team, and faculty education initiatives will be offered to enhance the quality of the feedback provided. The impact of the curriculum on initial skill development, retention, and progression will be assessed.

  14. Communication skills training curriculum for pulmonary and critical care fellows.

    Science.gov (United States)

    McCallister, Jennifer W; Gustin, Jillian L; Wells-Di Gregorio, Sharla; Way, David P; Mastronarde, John G

    2015-04-01

    The Accreditation Council for Graduate Medical Education requires physicians training in pulmonary and critical care medicine to demonstrate competency in interpersonal communication. Studies have shown that residency training is often insufficient to prepare physicians to provide end-of-life care and facilitate patient and family decision-making. Poor communication in the intensive care unit (ICU) can adversely affect outcomes for critically ill patients and their family members. Despite this, communication training curricula in pulmonary and critical care medicine are largely absent in the published literature. We evaluated the effectiveness of a communication skills curriculum during the first year of a pulmonary and critical care medicine fellowship using a family meeting checklist to provide formative feedback to fellows during ICU rotations. We hypothesized that fellows would demonstrate increased competence and confidence in the behavioral skills necessary for facilitating family meetings. We evaluated a 12-month communication skills curriculum using a pre-post, quasiexperimental design. Subjects for this study included 11 first-year fellows who participated in the new curriculum (intervention group) and a historical control group of five fellows who had completed no formal communication curriculum. Performance of communication skills and self-confidence in family meetings were assessed for the intervention group before and after the curriculum. The control group was assessed once at the beginning of their second year of fellowship. Fellows in the intervention group demonstrated significantly improved communication skills as evaluated by two psychologists using the Family Meeting Behavioral Skills Checklist, with an increase in total observed skills from 51 to 65% (P ≤ 0.01; Cohen's D effect size [es], 1.13). Their performance was also rated significantly higher when compared with the historical control group, who demonstrated only 49% of observed skills

  15. Perianesthesia nursing-beyond the critical care skills.

    Science.gov (United States)

    Ead, Heather

    2014-02-01

    Provision of patient care within the perianesthesia specialty is demanding in nature. Although a nurse may be well equipped with the assessment, planning, and critical thinking skills required for these fast-paced areas, there are other competencies to be developed. These include skills in mentorship, communication, crisis management, and competency as an ambassador of patient safety. Barriers to developing these skills may include a high patient acuity and turnover, a sense of isolation from other departments, and strong hierarchical structures. However, there are resources and strategies that nurses can leverage to facilitate development of these less-technical, "softer" skills. In this article, the author reviews some of the unique demands commonly seen within the perianesthesia specialty. Methods to address these challenges are shared to facilitate an enjoyable career in this dynamic environment. Copyright © 2014 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  16. Knowledge Attitude and Practice Towards Skilled Care Attendance ...

    African Journals Online (AJOL)

    response rate was 851 (91.8%) of the sample size. ... Conclusion: The study revealed that skilled care attendance at birth is still very low as compared to other ... Introduction. Maternal Mortality in Eritrea is one of the highest in the world.

  17. Calculation of the 5th AER dynamic benchmark with APROS

    International Nuclear Information System (INIS)

    Puska, E.K.; Kontio, H.

    1998-01-01

    The model used for calculation of the 5th AER dynamic benchmark with APROS code is presented. In the calculation of the 5th AER dynamic benchmark the three-dimensional neutronics model of APROS was used. The core was divided axially into 20 nodes according to the specifications of the benchmark and each six identical fuel assemblies were placed into one one-dimensional thermal hydraulic channel. The five-equation thermal hydraulic model was used in the benchmark. The plant process and automation was described with a generic VVER-440 plant model created by IVO PE. (author)

  18. Enhancing health care non-technical skills: the TINSELS programme.

    Science.gov (United States)

    Gordon, Morris; Box, Helen; Halliwell, Jo-Anne; Farrell, Michael; Parker, Linda; Stewart, Alison

    2015-12-01

    Training in 'non-technical skills', i.e. social (communication and teamwork) and cognitive (analytical and personal behaviour) skills, in health care have been of great interest over the last decade. Whereas the majority of publications focus on 'whether' such education can be successful, they overlook 'how' they enhance skills. We designed and piloted a theoretically robust teaching package that addresses non-technical skills in the context of medicine safety through simulation-based interprofessional learning: the Training In Non-technical Skills to Enhance Levels of Medicines Safety (TINSELS) programme. A modified Delphi process was completed to identify learning outcomes, and multi-professional teams were recruited through local publicity. The faculty staff developed a three-session simulation-based intervention: firstly, a simulated ward encounter with multiple medicine-related activities; secondly, an extended debriefing and facilitated discussion; and finally, a 'chamber of horrors', where interprofessional teams identified potential sources of error. Each session was completed in the simulation suite with between six and nine participants, lasted approximately 90 minutes and took place over 2 weeks. Full details of the course will be presented to facilitate dissemination. Training in 'non-technical skills' in health care have been of great interest over the last decade Feedback was collected on a Likert scale after the course (1, strongly disagree; 5, strongly agree). Mean scores were all greater than 4, with qualitative feedback noting the fidelity of the authentic interprofessional groups. A previously validated safety attitudes questionnaire found changes in attitudes towards handover of care and perceptions of safety in the workplace. An original, simulation-based, multi-professional training programme has been developed with learning and assessment materials available for widespread replication. © 2015 John Wiley & Sons Ltd.

  19. 5th Conference on Aerospace Materials, Processes, and Environmental Technology

    Science.gov (United States)

    Cook, M. B. (Editor); Stanley, D. Cross (Editor)

    2003-01-01

    Records are presented from the 5th Conference on Aerospace Materials, Processes, and Environmental Technology. Topics included pollution prevention, inspection methods, advanced materials, aerospace materials and technical standards,materials testing and evaluation, advanced manufacturing,development in metallic processes, synthesis of nanomaterials, composite cryotank processing, environmentally friendly cleaning, and poster sessions.

  20. Proceedings of the 5th Symposium on Laser Spectroscopy

    International Nuclear Information System (INIS)

    1997-11-01

    This proceedings contains articles of the 5th Symposium on Laser Spectroscopy. It was held on Nov 7-8, 1997 in Taejeon, Korea. The main topics are as follows: Laser Isotope, Laser Spectroscopy, Laser Fusion, Laser Applications and so on. (Yi, J. H.)

  1. 5th Annual Pan-European Science and Big Physics Symposium on March 5th, 2012, Zurich, Switzerland

    CERN Multimedia

    Balle, Ch

    2012-01-01

    The 5th Annual Pan-European Science and Big Physics Symposium on March 5th is a technical workshop that covers topics in the areas of control, measurement and diagnostics for accelerators, cyclotrons, tokamaks and telescopes. The symposium brings together over 60 scientists and engineers from major research labs around the world such as CERN, PSI, INFN, NPL, ESRF and other research institutions. Attend this event to share ideas and results and to learn from the presentations of your peers from different labs and experiments worldwide.

  2. Teaching home care electronic documentation skills to undergraduate nursing students.

    Science.gov (United States)

    Nokes, Kathleen M; Aponte, Judith; Nickitas, Donna M; Mahon, Pamela Y; Rodgers, Betsy; Reyes, Nancy; Chaya, Joan; Dornbaum, Martin

    2012-01-01

    Although there is general consensus that nursing students need knowledge and significant skill to document clinical findings electronically, nursing faculty face many barriers in ensuring that undergraduate students can practice on electronic health record systems (EHRS). External funding supported the development of an educational innovation through a partnership between a home care agency staff and nursing faculty. Modules were developed to teach EHRS skills using a case study of a homebound person requiring wound care and the Medicare-required OASIS documentation system. This article describes the development and implementation of the module for an upper-level baccalaureate nursing program located in New York City. Nursing faculty are being challenged to develop creative and economical solutions to expose nursing students to EHRSs in nonclinical settings.

  3. Rhetorical skills as a component of midwifery care.

    Science.gov (United States)

    Domajnko, Barbara; Drglin, Zalka; Pahor, Majda

    2011-04-01

    this article argues that rhetorical skills are an important quality factor of midwifery care. In particular, it aims to identify and discuss the relevance of three classical means of persuasion: ethos, pathos and logos. secondary analysis, rhetorical analysis of semi-structured interviews. Slovenia. Interviews were carried out predominantly in 2006. Data refer to childbirths in 2005 and 2006. four women with recent experience of childbirth. analysis identified the presence of all three means of persuasion in the interaction between midwives and women. Focusing on midwives, the quality of their awareness and command of rhetorical skills remains questionable. In particular, women experienced lack of a rational account of the situation and decisions made by health-care professionals involved in maternity care. acknowledging professional ethics, awareness and good command of all three means of persuasion [but above all, argumentative persuasion (logos)] is an integral component of midwifery care. It can contribute to collaborative relations between midwives and women, and thus promote women-centred midwifery care. knowledge of the three classical rhetorical means of persuasion should be integrated into professional midwifery curricula. Copyright © 2009 Elsevier Ltd. All rights reserved.

  4. Teaching menstrual care skills to intellectually disabled female students.

    Science.gov (United States)

    Altundağ, Sebahat; Çalbayram, Nazan Çakırer

    2016-07-01

    The aim of this study was to teach pad replacement skills to intellectually disabled adolescent female students during their menstruation periods by demonstrating on a dummy. It may be difficult to make intellectually disabled adolescents achieve self-care during menstruation. In addition, there are difficulties experienced in explaining menstruation, such as physical changes and the practice of cleaning during this period. The study used a 'One group pretest and post-test model'. The study was performed in a special educational institution. The population consisted of 77 female students in the high school section. Calculation of a sample size was not attempted, and 54 students with no attendance issues agreed to take part in the study and were included. In this work, we found that pad replacement training significantly changed the scores of mentally disabled adolescents before and after training. Our training yielded positive results, and the population improved their skills at all stages of skill building. Training adolescents with mental disabilities helped them gain hygiene habits. Performance of these trainings occurs at the beginning of menstrual hygiene education. To achieve improved success in life, it is important that adolescents assume the responsibility of self-care and manage sustained care activity on their own. © 2016 John Wiley & Sons Ltd.

  5. 5th Regional Study on Cadastre and Spatial Data Infrastructure

    Directory of Open Access Journals (Sweden)

    Ivica Skender

    2012-12-01

    Full Text Available In the aftermath of the 5th Regional Conference on Cadastre and Spatial Data Infrastructure (Banja Luka and Laktaši, Bosnia and Herzegovina, June 6–8, 2012, the Republic Authority for Geodetic and Property Affairs of the Republic of Srpska and the Federal Administration for Geodetic and Real Property Affairs published the 5th Regional Study on Cadastre and Spatial Data Infrastructure. The study was produced in the frame of the Project INSPIRATION – Spatial Data Infrastructure in the Western Balkans, which is being realized for the benefit and with cooperation of representatives of eight geodetic administrations in the region (Albania, Bosnia and Herzegovina, Montenegro, Croatia, Kosovo, Macedonia, Serbia by consortium led by German company GFA of Hamburg, in cooperation with GDi GISDATA of Zagreb, experts from the Austrian Environmental Agency and German company con terra GmbH and financed from the European Union IPA funding programme for 2010.

  6. Proceedings of the 5th nuclear science and technology conference

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-11-01

    The 5th conference on nuclear science and technology was held on 21-23 November, 1992 in Bangkok. This conference contain papers on non-power applications of nuclear technology in medicine, agriculture and industry. These application including irradiation of food for desinfestation; tram technologies used in diagnosis and therapy and radiation chemistry important to industrial processes. Some technologies which evolved from the development of the nuclear power industry are also discussed.

  7. Proceeding of the 5th international workshop on reflectometry

    International Nuclear Information System (INIS)

    Kawahata, Kazuo

    2001-05-01

    This is the proceedings of the 5th International Workshop on Reflectometry, which was held on 5-7 March, 2001, at the National Institute for Fusion Science. In this workshop, the latest experimental results in reflectometry (profile and fluctuations studies), new technological developments and a broad scope of the theory and simulation codes were presented. The 19 of the presented papers are indexed individually. (author)

  8. Proceedings of the 5th underground coal conversion symposium

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-05-01

    The 5th underground coal conversion symposium was held at Alexandria, Virginia, June 18--21, 1979. Thirty-three papers have been entered individually into EDB and ERA. Seven papers were also abstracted for Energy Abstracts for Policy Analysis. Seven papers had been entered previously from other sources. The symposium was sponsored by the US Department of Energy, Division of Fossil Fuel Extraction. (LTN)

  9. 5th environmental report submitted by the Hessian Government

    International Nuclear Information System (INIS)

    1992-01-01

    The 5th environmental report submitted by the Hessian Government informs about the success of environmental policies in the period under review and discuss the future tasks and targets with emphasis on I) environmental quality in Hesse (A. Nature and ladscape, B. water, C. air, D. noise, E. chemicals, industrial monitoring, F. wastes, G. pollutants in the food chain, H. radioactivity and radiation protection), II) selected instruments and points of main effort, III) work and environment; Appendix. (BBR) [de

  10. Proceedings of the 5th nuclear science and technology conference

    International Nuclear Information System (INIS)

    1994-11-01

    The 5th conference on nuclear science and technology was held on 21-23 November, 1992 in Bangkok. This conference contain papers on non-power applications of nuclear technology in medicine, agriculture and industry. These application including irradiation of food for desinfestation; tram technologies used in diagnosis and therapy and radiation chemistry important to industrial processes. Some technologies which evolved from the development of the nuclear power industry are also discussed

  11. The 5th National Logistics and Supply Chain Conference

    OpenAIRE

    PEKER, İskender

    2016-01-01

    Abstract. The 5thNational Logistics and Supply Chain Conference (ULTZK) held in Mersin Divan Hotel on the 26-28 May 2016. A number of academics, logistics service receiver company representatives (manufacturers, wholesalers, retailers, etc.), logistics service provider company representatives (transport, logistics, storage, etc.), non-governmental organization representatives, and the relevant public institution and organization representatives participated to the conducted panels and session...

  12. Expectations and outcome skills of a generalist health care administrator.

    Science.gov (United States)

    Jones, V B; Taylor, L C

    1990-01-01

    The question of the degree of technical versus managerial competence to be found in future graduates from health administration programs is not easily resolved. In the HIMSS 1988 survey of CIOs the attributes needed for success are listed in descending rank order as follows: leadership ability, vision/imagination, knowledge of hospital systems, business acumen, decisiveness, and technical competence. CIOs ranked technical competence as less important than other attributes associated with general management success. The expectations for attitudes, knowledge, and skills presented in this article support the greater importance of management abilities relative to pure technical competence. However, it is vital that an appropriate level of technical knowledge and skill be maintained to enable future alumni of health administration programs to function effectively as administrators. Depending on their role in a health care organization, greater or lesser technical knowledge may be needed. Those pursuing a career path toward CIO must, of necessity, have greater technical knowledge and skill. We have discussed necessary and expected attitudes, knowledge, and skills that will be needed by the generalist health administration graduate in the future. It will be important to develop and maintain an attitude that MIS is a strategic tool, that health care technology is a corporate asset, and that information is power. Graduates must recognize the necessity of maintaining and enhancing their knowledge and skills through continuing education. The knowledge base of MIS education should focus on determining information needs to support strategic goals, understanding of general systems theory, principles of systems analysis, design, implementation and maintenance, awareness and exposure to standard application software, and an awareness of external sources of data.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. 5th International Conference on Electronics, Communications and Networks

    CERN Document Server

    2016-01-01

    This book comprises peer-reviewed contributions presented at the 5th International Conference on Electronics, Communications and Networks (CECNet 2015), held in Shanghai, China, 12-15 December, 2015. It includes new multi-disciplinary topics spanning a unique depth and breadth of cutting-edge research areas in Electronic Engineering, Communications and Networks, and Computer Technology. More generally, it is of interest to academics, students and professionals involved in Consumer Electronics Technology, Communication Engineering and Technology, Wireless Communication Systems and Technology, and Computer Engineering and Technology.

  14. 5th Computer Science On-line Conference

    CERN Document Server

    Senkerik, Roman; Oplatkova, Zuzana; Silhavy, Petr; Prokopova, Zdenka

    2016-01-01

    This volume is based on the research papers presented in the 5th Computer Science On-line Conference. The volume Artificial Intelligence Perspectives in Intelligent Systems presents modern trends and methods to real-world problems, and in particular, exploratory research that describes novel approaches in the field of artificial intelligence. New algorithms in a variety of fields are also presented. The Computer Science On-line Conference (CSOC 2016) is intended to provide an international forum for discussions on the latest research results in all areas related to Computer Science. The addressed topics are the theoretical aspects and applications of Computer Science, Artificial Intelligences, Cybernetics, Automation Control Theory and Software Engineering.

  15. Conference Report: 5th Annual Georgia Conference on Information Literacy

    Directory of Open Access Journals (Sweden)

    Rebecca Ziegler

    2009-11-01

    Full Text Available The 5th annual Georgia Conference on Information Literacy took place in Savannah, Georgia on October 3-4, 2008. Since its inception, this conference has drawn participants from across the United States and even a few from abroad. Jointly sponsored by the Zach S. Henderson Library, the Department of Writing and Linguistics, the College of Education, and the Center for Continuing Education at Georgia Southern University, the conference offers both theoretical and practical discussions of the complex issues involved in teaching students how to find, interpret and use information in emerging electronic technologies against the backdrop of one of America’s loveliest cities.

  16. Fathers' Involvement in Child Care and Perceptions of Parenting Skill over the Transition to Parenthood

    Science.gov (United States)

    Barry, Amy A.; Smith, JuliAnna Z.; Deutsch, Francine M.; Perry-Jenkins, Maureen

    2011-01-01

    This study explored first-time fathers' perceived child care skill over the transition to parenthood, based on face-to-face interviews of 152 working-class, dual-earner couples. Analyses examined the associations among fathers' perceived skill and prenatal perception of skill, child care involvement, mothers' breastfeeding, maternal gatekeeping,…

  17. Mental health nurses' diabetes care skills - a training needs analysis.

    Science.gov (United States)

    Nash, Michael

    2009-05-28

    This article explores mental health nurses' diabetes training needs. A survey of inpatient and community mental health nurses was undertaken using a 16-item self-reporting questionnaire. Two hundred and twenty questionnaires were sent out and 138 returned, providing a response rate of 63%. Analysis shows that mental health nurses are currently involved in a range of diabetes care activities, however, their knowledge and skills may not be up to date. Mental health nurses also report the growing impact of diabetes care on their workload. Areas of identified training needs include taking blood glucose readings, giving dietary advice, liaison with diabetes nurse specialists and weight management. Mental health services and education providers need to consider developing specific training courses for mental health nurses.

  18. Factors affecting utilization of skilled maternal care in Northwest Ethiopia: a multilevel analysis.

    Science.gov (United States)

    Worku, Abebaw Gebeyehu; Yalew, Alemayehu Worku; Afework, Mesganaw Fantahun

    2013-04-15

    The evaluation of all potential sources of low skilled maternal care utilization is crucial for Ethiopia. Previous studies have largely disregarded the contribution of different levels. This study was planned to assess the effect of individual, communal, and health facility characteristics in the utilization of antenatal, delivery, and postnatal care by a skilled provider. A linked facility and population-based survey was conducted over three months (January - March 2012) in twelve "kebeles" of North Gondar Zone, Amhara Region. A total of 1668 women who had births in the year preceding the survey were selected for analysis. Using a multilevel modelling, we examined the effect of cluster variation and a number of individual, communal (kebele), and facility-related variables for skilled maternal care utilization. About 32.3%, 13.8% and 6.3% of the women had the chance to get skilled providers for their antenatal, delivery and postnatal care, respectively. A significant heterogeneity was observed among clusters for each indicator of skilled maternal care utilization. At the individual level, variables related to awareness and perceptions were found to be much more relevant for skilled maternal service utilization. Preference for skilled providers and previous experience of antenatal care were consistently strong predictors of all indicators of skilled maternal health care utilizations. Birth order, maternal education, and awareness about health facilities to get skilled professionals were consistently strong predictors of skilled antenatal and delivery care use. Communal factors were relevant for both delivery and postnatal care, whereas the characteristics of a health facility were more relevant for use of skilled delivery care than other maternity services. Factors operating at individual and "kebele" levels play a significant role in determining utilization of skilled maternal health services. Interventions to create better community awareness and perception about

  19. Pattern recognition in bioinformatics : 5th IAPR international conference, PRIB 2010, Nijmegen, The Netherlands, September 22-24, 2010 : proceedings

    NARCIS (Netherlands)

    Dijkstra, T.M.H.; Tsivtsivadze, E.; Marchiori, E.; Heskes, T.

    2010-01-01

    This book constitutes the refereed proceedings of the 5th International Conference on Pattern Recognition in Bioinformatics, PRIB 2010, held in Nijmegen, The Netherlands, in September 2010. The 38 revised full papers presented were carefully reviewed and selected from 46 submissions. The field of

  20. Predictors of women's utilization of primary health care for skilled pregnancy care in rural Nigeria.

    Science.gov (United States)

    Okonofua, Friday; Ntoimo, Lorretta; Ogungbangbe, Julius; Anjorin, Seun; Imongan, Wilson; Yaya, Sanni

    2018-04-18

    Although Primary Health Care (PHC) was designed to provide universal access to skilled pregnancy care for the prevention of maternal deaths, very little is known of the factors that predict the use of PHC for skilled maternity care in rural parts of Nigeria - where its use is likely to have a greater positive impact on maternal health care. The objective of this study was to identify the factors that lead pregnant women to use or not use existing primary health care facilities for antenatal and delivery care. The study was a cross-sectional community-based study conducted in Esan South East and Etsako East LGAs of Edo State, Nigeria. A total of 1408 randomly selected women of reproductive age were interviewed in their households using a pre-tested structured questionnaire. The data were analyzed with descriptive and multivariate statistical methods. The results showed antenatal care attendance rate by currently pregnant women of 62.1%, and a skilled delivery of 46.6% by recently delivered women at PHCs, while 25% of women delivered at home or with traditional birth attendants. Reasons for use and non-use of PHCs for antenatal and delivery care given by women were related to perceptions about long distances to PHCs, high costs of services and poor quality of PHC service delivery. Chi-square test of association revealed that level of education and marital status were significantly related to use of PHCs for antenatal care. The results of logistic regression for delivery care showed that women with primary (OR 3.10, CI 1.16-8.28) and secondary (OR 2.37, CI 1.19-4.71) levels education were more likely to receive delivery care in PHCs than the highly educated. Being a Muslim (OR 1.56, CI 1.00-2.42), having a partner who is employed in Estako East (OR 2.78, CI 1.04-7.44) and having more than five children in Esan South East (OR 2.00, CI 1.19-3.35) significantly increased the odds of delivery in PHCs. The likelihood of using a PHC facility was less for women who had more

  1. 5th International Conference on Research into Design

    CERN Document Server

    2015-01-01

    This book showcases cutting-edge research papers from the 5th International Conference on Research into Design – the largest in India in this area – written by eminent researchers from across the world on design process, technologies, methods and tools, and their impact on innovation, for supporting design across boundaries. The special features of the book are the variety of insights into the product and system innovation process, and the host of methods and tools from all major areas of design research for the enhancement of the innovation process. The main benefit of the book for researchers in various areas of design and innovation are access to the latest quality research in this area, with the largest collection of research from India. For practitioners and educators, it is exposure to an empirically validated suite of theories, models, methods and tools that can be taught and practiced for design-led innovation.

  2. 5th European Conference on Mechanisms Science (EUCOMES)

    CERN Document Server

    Viadero, Fernando; New Trends in Mechanism and Machine Science : from Fundamentals to Industrial Applications

    2015-01-01

    This work presents the most recent research in the mechanism and machine science field and its applications. The topics covered include: theoretical kinematics, computational kinematics, mechanism design, experimental mechanics, mechanics of robots, dynamics of machinery, dynamics of multi-body systems, control issues of mechanical systems, mechanisms for biomechanics, novel designs, mechanical transmissions, linkages and manipulators, micro-mechanisms, teaching methods, history of mechanism science and industrial and non-industrial applications. This volume consists of the Proceedings of the 5th European Conference on Mechanisms Science (EUCOMES), that was held in Guimarães, Portugal, from September 16 – 20, 2014. The EUCOMES is the main forum for the European community working in Mechanisms and Machine Science.

  3. 5th International Conference on Computational Collective Intelligence

    CERN Document Server

    Trawinski, Bogdan; Nguyen, Ngoc

    2014-01-01

    The book consists of 19 extended and revised chapters based on original works presented during a poster session organized within the 5th International Conference on Computational Collective Intelligence that was held between 11 and 13 of September 2013 in Craiova, Romania. The book is divided into three parts. The first part is titled “Agents and Multi-Agent Systems” and consists of 8 chapters that concentrate on many problems related to agent and multi-agent systems, including: formal models, agent autonomy, emergent properties, agent programming, agent-based simulation and planning. The second part of the book is titled “Intelligent Computational Methods” and consists of 6 chapters. The authors present applications of various intelligent computational methods like neural networks, mathematical optimization and multistage decision processes in areas like cooperation, character recognition, wireless networks, transport, and metal structures. The third part of the book is titled “Language and Knowled...

  4. Report from the 5th Workshop on Extremely Large Databases

    Directory of Open Access Journals (Sweden)

    Jacek Becla

    2012-03-01

    Full Text Available The 5th XLDB workshop brought together scientific and industrial users, developers, and researchers of extremely large data and focused on emerging challenges in the healthcare and genomics communities, spreadsheet-based large scale analysis, and challenges in applying statistics to large scale analysis, including machine learning. Major problems discussed were the lack of scalable applications, the lack of expertise in developing solutions, the lack of respect for or attention to big data problems, data volume growth exceeding Moore's Law, poorly scaling algorithms, and poor data quality and integration. More communication between users, developers, and researchers is sorely needed. A variety of future work to help all three groups was discussed, ranging from collecting challenge problems to connecting with particular industrial or academic sectors.

  5. 5th International Conference on Advanced Manufacturing Engineering and Technologies

    CERN Document Server

    Jakovljevic, Zivana; NEWTECH2017

    2017-01-01

    This book presents the proceedings from the 5th NEWTECH conference (Belgrade, Serbia, 5–9 June 2017), the latest in a series of high-level conferences that bring together experts from academia and industry in order to exchange knowledge, ideas, experiences, research results, and information in the field of manufacturing. The range of topics addressed is wide, including, for example, machine tool research and in-machine measurements, progress in CAD/CAM technologies, rapid prototyping and reverse engineering, nanomanufacturing, advanced material processing, functional and protective surfaces, and cyber-physical and reconfigurable manufacturing systems. The book will benefit readers by providing updates on key issues and recent progress in manufacturing engineering and technologies and will aid the transfer of valuable knowledge to the next generation of academics and practitioners. It will appeal to all who work or conduct research in this rapidly evolving field.

  6. 5th International Conference on Jets, Wakes and Separated Flows

    CERN Document Server

    2016-01-01

    This volume collects various contributions from the 5th International Conference on Jets, Wakes and Separated Flows (ICJWSF2015) that took place in Stockholm during June 2015. Researchers from all around the world presented their latest results concerning fundamental and applied aspects of fluid dynamics. With its general character, the conference embraced many aspects of fluid dynamics, such as shear flows, multiphase flows and vortex flows, for instance. The structure of the present book reflects the variety of topics treated within the conference i.e. Jets, Wakes, Separated flows, Vehicle aerodynamics, Wall-bounded and confined flows, Noise, Turbomachinery flows, Multiphase and reacting flows, Vortex dynamics, Energy-related flows and a section dedicated to Numerical analyses.

  7. 5th International Conference on Dynamics in Logistics

    CERN Document Server

    Kotzab, Herbert; Pannek, Jürgen

    2017-01-01

    These proceedings contain research papers presented at the 5th International Conference on Dynamics in Logistics, held in Bremen, Germany, February 2016. The conference is concerned with dynamic aspects of logistic processes and networks. The spectrum of topics reaches from modeling, planning and control of processes over supply chain management and maritime logistics to innovative technologies and robotic applications for cyber-physical production and logistic systems. The growing dynamic confronts the area of logistics with completely new challenges: it must become possible to describe, identify and analyze the process changes. Moreover, logistic processes and networks must be redevised to be rapidly and flexibly adaptable to continuously changing conditions. The book primarily addresses researchers and practitioners from the field of industrial engineering and logistics, but it may also be beneficial for graduate students.

  8. 5th International Conference on Electrical Engineering and Automatic Control

    CERN Document Server

    Yao, Yufeng

    2016-01-01

    On the basis of instrument electrical and automatic control system, the 5th International Conference on Electrical Engineering and Automatic Control (CEEAC) was established at the crossroads of information technology and control technology, and seeks to effectively apply information technology to a sweeping trend that views control as the core of intelligent manufacturing and life. This book takes a look forward into advanced manufacturing development, an area shaped by intelligent manufacturing. It highlights the application and promotion of process control represented by traditional industries, such as the steel industry and petrochemical industry; the technical equipment and system cooperative control represented by robot technology and multi-axis CNC; and the control and support of emerging process technologies represented by laser melting and stacking, as well as the emerging industry represented by sustainable and intelligent life. The book places particular emphasis on the micro-segments field, such as...

  9. 5th iTi Conference in Turbulence 2012

    CERN Document Server

    Oberlack, Martin; Peinke, Joachim

    2014-01-01

      This volume collects the edited and reviewed contributions presented in the 5th iTi Conference in Bertinoro. covering fundamental aspects in turbulent flows. In the spirit of the iTi initiative, the volume is produced after the conference so that the authors had the possibility to incorporate comments and discussions raised during the meeting. Turbulence presents a large number of aspects and problems, which are still unsolved and which challenge research communities in engineering and physical sciences both in basic and applied research. The book presents recent advances in theory related to new statistical approaches, effect of non-linearities and presence of symmetries. This edition presents new contributions related to the physics and control of laminar-turbulent transition in wall-bounded flows, which may have a significant impact on drag reduction applications. Turbulent boundary layers, at increasing Reynolds number, are the main subject of both computational and experimental long research programs ...

  10. 5th Conference on Information Technologies in Biomedicine

    CERN Document Server

    Badura, Pawel; Kawa, Jacek; Wieclawek, Wojciech

    2016-01-01

    ITiB’2016 is the 5th Conference on Information Technologies in Biomedicine organized by the Department of Informatics & Medical Equipment of Silesian University of Technology every other year. The Conference is under the auspices of the Committee on Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences. The meeting has become a recognized event that helps to bridge the gap between methodological achievements in engineering and clinical requirements in medical diagnosis, therapy, and rehabilitation. Mathematical information analysis, computer applications together with medical equipment and instruments have become standard tools underpinning the current rapid progress with developing Computational Intelligence. Members of academic societies of technical and medical background present their research results and clinical implementations. This proceedings (divided in 2 volumes) include the following sections: Ø Image Processing Ø Signal Processing Ø Medical Information System & ...

  11. 5th International Conference on Optics Within Life Sciences

    CERN Document Server

    Papazoglou, Theodore; Kalpouzos, Costas

    2000-01-01

    Following to previous OWLS conferences devoted to widespread applications of optics in life sciences, this 5th OWLS Conference focuses on recent achievements in applying lasers and optics in biomedicine and the preservation of our cultural heritage. Particular attention is paid to laser diagnostics in medicine, interaction of laser radiation with biological tissue, aspects of the preservation of cultural heritage, and the development of new systems for these studies. The contributors to this volume cover international research activities in the following areas: Laser-tissue interactions and tissue optics - photon migration in tissue; Medical sensors - fiber optics; Clinical use of lasers (dermatology, ENT, cardiology, etc.); Laser-based techniques in art conservation (cleaning, diagnostics, analytical applications); Imaging techniques and lasers in archaeology; Laser technologies in contemporary art (holography, marking, etc.); and New laser and opto-electronic systems for biomedical and art-related studies.

  12. 5th International Conference on Sustainable Automotive Technologies

    CERN Document Server

    Subic, Aleksandar; Trufin, Ramona

    2014-01-01

    This book captures selected peer reviewed papers presented at the 5th International Conference on Sustainable Automotive Technologies, ICSAT 2013, held in Ingolstadt, Germany. ICSAT is the state-of-the-art conference in the field of new technologies for transportation. The book brings together the work of international researchers and practitioners under the following interrelated headings: fuel transportation and storage, material recycling, manufacturing and management costs, engines and emission reduction. The book provides a very good overview of research and development activities focused on new technologies and approaches capable of meeting the challenges to sustainable mobility. About the Editors: Prof. Dr. Jörg Wellnitz is the Dean of the Faculty of Mechanical Engineering, Technische Hochschule Ingolstadt, Germany. Prof. Dr. Aleksandar Subic is the Head of the School of Aerospace, Mechanical and Manufacturing Engineering, RMIT University, Australia. Ramona Trufin, M.A. is the coordinator of the Facul...

  13. Providing oral care in haematological oncology patients: nurses' knowledge and skills

    NARCIS (Netherlands)

    Potting, Carin M. J.; Mank, Arno; Blijlevens, Nicole M. A.; Donnelly, J. Peter; van Achterberg, Theo

    2008-01-01

    In the international literature, the most commonly recommended intervention for managing oral mucositis is good oral care, assuming that nurses have sufficient knowledge and skills to perform oral care correctly. The aim of the present study was to investigate if knowledge and skills about oral care

  14. Providing oral care in haematological oncology patients: nurses' knowledge and skills.

    NARCIS (Netherlands)

    Potting, C.M.J.; Mank, A.; Blijlevens, N.M.A.; Donnelly, J.P.; Achterberg, T. van

    2008-01-01

    In the international literature, the most commonly recommended intervention for managing oral mucositis is good oral care, assuming that nurses have sufficient knowledge and skills to perform oral care correctly. The aim of the present study was to investigate if knowledge and skills about oral care

  15. Effect of ambulatory medicine tutorial on clinical performance of 5th year medical students.

    Science.gov (United States)

    Phisalprapa, Pochamana; Pandejpong, Denla

    2013-02-01

    The present study provided a group learning activity called "Ambulatory Medicine Tutorial-AMT" for 5th year medical students in order to facilitate learning experience at ambulatory setting and to improve medical students' clinical performance. This research aimed specifically to study the effect of AMT. Two groups of twenty 5th-year medical students were enrolled during their ambulatory medicine blocks. Each medical student was assigned to have 8 ambulatory sessions. AMT was assigned to one group while the other group only used conventional learning activity. At the end of the present study, total internal medicine scores, patient satisfaction surveys, and data on average time spent on each clinical encounter were collected and compared. The AMT group received a higher total internal medicine score as compared to the conventional group (76.2 +/- 3.6 vs. 72.9 +/- 2.8, p = 0.003). The AMT group could reduce average time spent on each clinical encounter within their first-6 ambulatory sessions while the conventional group could acquire the same skill later in their last 2 ambulatory sessions. There was no significant difference found on comparing patient satisfaction scores between the 2 groups. AMT helped improving medical students' outcomes as shown from higher total internal medicine score as well as quicker improvement during real-life clinical encounters, AMT could be a good alternative learning activity for medical students at ambulatory setting.

  16. Teaching systems thinking to 4th and 5th graders using Environmental Dashboard display technology.

    Science.gov (United States)

    Clark, Shane; Petersen, John E; Frantz, Cindy M; Roose, Deborah; Ginn, Joel; Rosenberg Daneri, Daniel

    2017-01-01

    Tackling complex environmental challenges requires the capacity to understand how relationships and interactions between parts result in dynamic behavior of whole systems. There has been convincing research that these "systems thinking" skills can be learned. However, there is little research on methods for teaching these skills to children or assessing their impact. The Environmental Dashboard is a technology that uses "sociotechnical" feedback-information feedback designed to affect thought and behavior. Environmental Dashboard (ED) combines real-time information on community resource use with images and words that reflect pro-environmental actions of community members. Prior research indicates that ED supports the development of systems thinking in adults. To assess its impact on children, the technology was installed in a primary school and children were passively exposed to ED displays. This resulted in no measurable impact on systems thinking skills. The next stage of this research examined the impact of actively integrating ED into lessons on electricity in 4th and 5th grade. This active integration enhanced both content-related systems thinking skills and content retention.

  17. Abstratcs of the 5th American Rabbit Congress

    Directory of Open Access Journals (Sweden)

    5th American Rabbit Congress Toluca, Estado de México, Mexico, September 8-11, 2014

    2015-03-01

    Full Text Available The 5th American Rabbit Congress was held in Toluca, Mexico State, Mexico from September 8th to the 11th, 2014. Research works representing 14 countries were accepted to take part at the congress, including papers from Algeria, Argentina, Brazil, China, Costa Rica, Cuba, Egypt, France, Hungary, Italy, México, Uruguay, the USA and Venezuela. These research works highlight the enormous interest, effort and commitment of the scientific community that bonds the trinomium of Research+Innovation+Technology Transfer, in favour of the integral development of rabbit rearing as an important primary activity that generates permanent employment, as well as healthy and nutritive meals for their respective countries for the XXI Century World. One major impact at this 5th American Rabbit Congress was the participation of Argentina, Brazil and China. The latter country’s report was presented by Laping Wu and Dong Wang (2014, showing that from 2005 to 2010, meat production of swine, beef and poultry underwent average growth of 2.6%, whereas rabbit meat production reported an annual average growth of 6.29%, reaching an annual volume of 761 000 tons, positioning China as the world’s main rabbit meat producer. This data highlights the great potential of rabbit production, both as an economic activity and a key strategy in the fight against hunger and poverty in many countries all over the world. During the congress, scientific works were presented related with the fields of Ethology, Housing & Welfare; Genetics; Reproduction; Digestive Physiology and Basic Nutrition; Feed Evaluation and Feeding; Pathology & Hygiene, Meat Quality, Safety & Dining; Management, Social & Economy. Furthermore, the meeting of the AB-WRSA chaired by the AB-WRSA founder, Dr. Steven Lukefahr, also took place at this congress, in which the new board of the American Branch was elected and the proposal put forward for the next American Rabbit Congress to be held in Costa

  18. 75 FR 63478 - 5th Annual PHEMCE Stakeholders Workshop and BARDA Industry Day

    Science.gov (United States)

    2010-10-15

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary 5th Annual PHEMCE Stakeholders... upcoming 5th Annual Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) Stakeholders... stakeholders including: Federal Officials, International Governments, Industry, Healthcare Providers, First...

  19. Vocabulary and syntactic knowledge factors in 5th grade students’ reading comprehension

    Directory of Open Access Journals (Sweden)

    Kouider Mokhtari

    2013-03-01

    Full Text Available In this study, we examined 5th grade students’ levels of vocabulary knowledge and syntactic awareness relative to their reading comprehension performance. The aim was to explore the contributions of vocabulary and syntactic awareness as potential sources of reading comprehension difficulty for these readers. Overall, we found that both vocabulary knowledge and syntactic awareness contributed in significant yet unique ways to students’ reading comprehension performance. Students who showed weaknesses in vocabulary and syntax also performed poorly on measures of reading comprehension. Additionally, we found that syntactic awareness explained a small amount of additional variance in reading comprehension beyond what was explained by vocabulary. The implications of these findings are discussed in light of research and practice addressing the relationships among syntax, vocabulary, and reading comprehension for more and less skilled readers.

  20. Spousal violence and receipt of skilled maternity care during and after pregnancy in Nepal.

    Science.gov (United States)

    Furuta, Marie; Bick, Debra; Matsufuji, Hiromi; Coxon, Kirstie

    2016-12-01

    a substantial number of Nepali women experience spousal violence, which affects their health in many ways, including during and after pregnancy. This study aimed to examine associations between women's experiences of spousal violence and their receipt of skilled maternity care, using two indicators: (1) receiving skilled maternity care across a continuum from pregnancy to the early postnatal period and (2) receiving any skilled maternity care in pregnancy, childbirth, or postpartum. data were analysed for married women aged 15-49 from the 2011 Nepal Demographic and Health Survey. Data were included on women who completed an interview on spousal violence as part of the survey and had given birth within the five years preceding the survey (weighted n=1375). Logistic regression models were developed for analyses. the proportion of women who received skilled maternity care across the pregnancy continuum and those who received any skilled maternity care was 24.1% and 53.7%, respectively. Logistic regression analyses showed that spousal violence was statistically significantly associated with receiving low levels of skilled maternity care, after adjusting for accessibility of health care. However, after controlling for women's sociodemographic backgrounds (age, number of children born, educational level, husband's education level, husband's occupation, region of residence, urban/rural residence, wealth index), these significant associations disappeared. Better-educated women, women whose husbands were professionals or skilled workers and women from well-off households were more likely to receive skilled maternity care either across the pregnancy continuum or at recommended points during or after pregnancy. spousal violence and low uptake of skilled maternity care are deeply embedded in a society in which gender inequality prevails. Factors affecting the receipt of skilled maternity care are multidimensional; simply expanding geographical access to maternity services may

  1. The 5th ATLAS Physics Workshop in Rome: Social Aspects

    CERN Multimedia

    Ferrari, P.

    Rome, the political and cultural capital of Italy, hosted the 5th ATLAS Physics Workshop. The attendance of this workshop was larger than any expectation: 450 people participated, making it a great success in terms of informing the broadest possible audience about the achievements of the physics groups in the last two years. The workshop took place at AULA MAGNA of the Literature & Philosophy faculty of the University of Roma Tre. The conference room was bright and large and could easily accommodate the wide audience, and the discomfort of hours of sitting was nicely offset by the frequent coffee breaks with excellent sweets and a large variety of drinks, which always seemed to offer the chance to stand up just in time! Participants listening to a talk in Aula Magna. The workshop started on Monday 6th June 2005 around 12:00 with the registration procedures, followed by a light lunch that was served (as was practically every lunch during the week) just outside the conference room. This arrangement ...

  2. 5th Seminar on Stochastic Processes, Random Fields and Applications

    CERN Document Server

    Russo, Francesco; Dozzi, Marco

    2008-01-01

    This volume contains twenty-eight refereed research or review papers presented at the 5th Seminar on Stochastic Processes, Random Fields and Applications, which took place at the Centro Stefano Franscini (Monte Verità) in Ascona, Switzerland, from May 30 to June 3, 2005. The seminar focused mainly on stochastic partial differential equations, random dynamical systems, infinite-dimensional analysis, approximation problems, and financial engineering. The book will be a valuable resource for researchers in stochastic analysis and professionals interested in stochastic methods in finance. Contributors: Y. Asai, J.-P. Aubin, C. Becker, M. Benaïm, H. Bessaih, S. Biagini, S. Bonaccorsi, N. Bouleau, N. Champagnat, G. Da Prato, R. Ferrière, F. Flandoli, P. Guasoni, V.B. Hallulli, D. Khoshnevisan, T. Komorowski, R. Léandre, P. Lescot, H. Lisei, J.A. López-Mimbela, V. Mandrekar, S. Méléard, A. Millet, H. Nagai, A.D. Neate, V. Orlovius, M. Pratelli, N. Privault, O. Raimond, M. Röckner, B. Rüdiger, W.J. Runggaldi...

  3. 5th National Conference on Processing and Characterization of Materials

    International Nuclear Information System (INIS)

    2016-01-01

    This volume contains selected full length technical papers from the oral presentations made during the 5 th National Conference on Processing and Characterization of Materials (NCPCM) 2015 organized by Department of Metallurgical and Materials Engineering, NIT Rourkela, India on 12 th - 13 th December, 2015. The first conference of the NCPCM series was held in December 2011. NCPCM 2015 has successfully carried the tradition of previous conferences. About 100 participants from various organizations across India have participated in the conference. The conference has attracted researchers, scientists and engineers from various R and D organizations, academic institutions and industries at a single forum. The interdisciplinary approach of the conference allowed the participants to look beyond their areas of activities. Besides oral presentations the conference also had poster and metallography sessions. The conference had four technical sessions. The themes of the sessions were: Materials Processing, Characterization, Materials Deformation and Materials Modelling and Simulation. In all, during the two day conference about fifty contributory talks along with four keynote lectures were presented. Out of these, forty peer-reviewed papers have been selected for publication in this volume of IOP Conference Series: Materials Science and Engineering. We would like to thank all the contributors, members of the organizing committee, session chairs as well as colleagues and students who helped us with the preparation of the conference and particularly, with the preparation of this volume. We would also like to convey our heartiest gratitude to all the sponsors of NCPCM 2015. (paper)

  4. Seeing beyond monitors-Critical care nurses' multiple skills in patient observation: Descriptive qualitative study.

    Science.gov (United States)

    Alastalo, Mika; Salminen, Leena; Lakanmaa, Riitta-Liisa; Leino-Kilpi, Helena

    2017-10-01

    The aim of this study was to provide a comprehensive description of multiple skills in patient observation in critical care nursing. Data from semi-structured interviews were analysed using thematic analysis. Experienced critical care nurses (n=20) from three intensive care units in two university hospitals in Finland. Patient observation skills consist of: information gaining skills, information processing skills, decision-making skills and co-operation skills. The first three skills are integrated in the patient observation process, in which gaining information is a prerequisite for processing information that precedes making decisions. Co-operation has a special role as it occurs throughout the process. This study provided a comprehensive description of patient observation skills related to the three-phased patient observation process. The findings contribute to clarifying this part of the competence. The description of patient observation skills may be applied in both clinical practice and education as it may serve as a framework for orientation, ensuring clinical skills and designing learning environments. Based on this study, patient observation skills can be recommended to be included in critical care nursing education, orientation and as a part of critical care nurses' competence evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. The legal nature of the duty of care and skill: Contract or delict ...

    African Journals Online (AJOL)

    This article evaluates the legal nature of the duty of care and skill of directors. In terms of the Companies Act 71 of 2008 this duty is essentially delictual in nature. This article evaluates whether the duty is in fact delictual in nature. Case law, which considered the duty of care and skill and where it had been sought to establish ...

  6. Impact of communication skills training on parents perceptions of care: intervention study

    DEFF Research Database (Denmark)

    Ammentorp, Jette; Kofoed, Poul-Erik; Laulund, Lone W

    2011-01-01

    This paper is a report of a study of the effects of communication-skills training for healthcare professionals on parents' perceptions of information, care and continuity.......This paper is a report of a study of the effects of communication-skills training for healthcare professionals on parents' perceptions of information, care and continuity....

  7. A study of communication skills in health care management students and its association with demographic characteristics

    OpenAIRE

    Shiva Karimzadeh; Rita Rezaee; Peivand Bastani

    2017-01-01

    Introduction: Communication skills are one of the most important skills for health care managers and play an important role in their personal life and future occupation. The present study aimed to evaluate the students’ communication skills as well as its relationship with the students’ demographic characteristics. Method: This descriptive-analytical study was performed on 153 university students majoring in healthcare management in 2014. A self-administered communication skills questionna...

  8. Non-technical skills in the intensive care unit

    NARCIS (Netherlands)

    Reader, T.; Flin, R.; Lauche, K.; Cuthbertson, B.H.

    2006-01-01

    In high-risk industries such as aviation, the skills not related directly to technical expertise, but crucial for maintaining safety (e.g. teamwork), have been categorized as non-technical skills. Recently, research in anaesthesia has identified and developed a taxonomy of the non-technical skills

  9. Teaching 5th grade science for aesthetic understanding

    Science.gov (United States)

    Girod, Mark A.

    Many scientists speak with great zeal about the role of aesthetics and beauty in their science and inquiry. Few systematic efforts have been made to teach science in ways that appeal directly to aesthetics and this research is designed to do just that. Drawing from the aesthetic theory of Dewey, I describe an analytic lens called learning for aesthetic understanding that finds power in the degree to which our perceptions of the world are transformed, our interests and enthusiasm piqued, and our actions changed as we seek further experiences in the world. This learning theory is contrasted against two other current and popular theories of science learning, that of learning for conceptual understanding via conceptual change theory and learning for a language-oriented or discourse-based understanding. After a lengthy articulation of the pedagogical strategies used to teach for aesthetic understanding the research is described in which comparisons are drawn between students in two 5th grade classrooms---one taught for the goal of conceptual understanding and the other taught for the goal of aesthetic understanding. Results of this comparison show that more students in the treatment classroom had aesthetic experiences with science ideas and came to an aesthetic understanding when studying weather, erosion, and structure of matter than students in the control group. Also statistically significant effects are shown on measures of interest, affect, and efficacy for students in the treatment class. On measures of conceptual understanding it appears that treatment class students learned more and forgot less over time than control class students. The effect of the treatment does not generally depend on gender, ethnicity, or prior achievement except in students' identity beliefs about themselves as science learners. In this case, a significant interaction for treatment class females on science identity beliefs did occur. A discussion of these results as well as elaboration and

  10. Special Issue. 5th Meeting on Technology and Safety

    International Nuclear Information System (INIS)

    Kusakabe, Masashi; Kumagaya, Tadafusa; Minohara, Shinichi

    2010-01-01

    The documents in this Special Issue are the representative reports of achievements presented in the National Institute of Radiological Sciences (NIRS) 5th Meeting on Technology and Safety held on March 17, 2010. Personnel and investigators of NIRS and related companies gave their achievements by 19 oral and 31 poster presentations in fields of [IAR] irradiation (2 topics), accelerator/radiometry (9 topics), [EA] experimental animals (25 topics), [SM] safety management of facilities (5 topics), computer network system (4 topics), experimental instrument (1 topic), molecular imaging (2 topics) and others (2 topics). The Issue contains, as well as introductory and ending remarks, following 12 topics: [IAR] Working report of patient positioning system for radiotherapy with use of X-ray flat panel detector; Status of maintenance and management of facilities and equipments in Research center for Radiation Emergency Medicine; [EA] Past, present and future of mouse breeding in NIRS; Breeding of marmoset in NIRS/How can we have a bouncing marmoset baby?; Establishment of a genotyping method of transformed genes in transgenic mouse/genome walking method; Genetic monitoring system of mice by micro-satellite marker and its application in NIRS; Verification of sorting precision of FACSAria (Becton Dickinson and Co.), a highly sensitive, rapid sorting apparatus of cells/for precise sorting; Proposal of a task-solution workflow to determine the animal features for molecular imaging studies; [SM] Toward the introduction of Occupational Safety and Health Management System in NIRS; Use of unsealed radioisotopes less than the lower limit outside the legal control area; Arrangement of managing and supporting system for clinical studies; and Rearrangement of working system of personnel affairs. (T.T.)

  11. Care and caring in the intensive care unit: Family members' distress and perceptions about staff skills, communication, and emotional support.

    Science.gov (United States)

    Carlson, Eve B; Spain, David A; Muhtadie, Luma; McDade-Montez, Liz; Macia, Kathryn S

    2015-06-01

    Family members of intensive care unit (ICU) patients are sometimes highly distressed and report lower satisfaction with communication and emotional support from staff. Within a study of emotional responses to traumatic stress, associations between family distress and satisfaction with aspects of ICU care were investigated. In 29 family members of trauma patients who stayed in an ICU, we assessed symptoms of depression and posttraumatic stress disorder (PTSD) during ICU care. Later, family members rated staff communication, support, and skills and their overall satisfaction with ICU care. Ratings of staff competence and skills were significantly higher than ratings of frequency of communication, information needs being met, and support. Frequency of communication and information needs being met were strongly related to ratings of support (rs = .75-.77) and staff skills (rs = .77-.85), and aspects of satisfaction and communication showed negative relationships with symptoms of depression (rs = -.31 to -.55) and PTSD (rs = -.17 to -.43). Although satisfaction was fairly high, family member distress was negatively associated with several satisfaction variables. Increased understanding of the effects of traumatic stress on family members may help staff improve communication and increase satisfaction of highly distressed family members. Published by Elsevier Inc.

  12. PREFACE: 5th Workshop of Young Researchers in Astronomy & Astrophysics

    Science.gov (United States)

    Forgács-Dajka, Emese; Plachy, Emese; Molnár, László

    2010-04-01

    The 5th Workshop of Young Researchers in Astronomy and Astrophysics was held on 2-4 September 2009 at the Eötvös University in Budapest, Hungary. This meeting fits into a conference series which can already be considered a tradition where the younger generation has the opportunity to present their work. The event was also a great opportunity for senior astronomers and physicists to form new connections with the next generation of researchers. The selection of invited speakers concentrated on the researchers currently most active in the field, mostly on a post-doctoral/tenure/fresh faculty position level. A number of senior experts and PhD students were also invited. As the conference focused on people rather than a specific field, various topics from theoretical physics to planetology were covered in three days. The programme was divided into six sections: Physics of the Sun and the Solar System Gravity and high-energy physics Galactic and extragalactic astronomy, cosmology Celestial mechanics and exoplanets Infrared astronomy and young stars Variable stars We had the pleasure of welcoming 10 invited review talks from senior researchers and 42 contributed talks and a poster from the younger generation. Participants also enjoyed the hospitality of the pub Pál at the Pálvölgyi-cave after giving, hearing and disputing countless talks. Brave souls even descended to the unbuilt, adventurous Mátyásvölgyi-cave. Memories of the conference were shadowed though. Péter Csizmadia, one of our participants and three other climbers attempted a first ever ascent to the Ren Zhong Feng peak in Sichuan, China, but they never returned from the mountains. Péter departed to China shortly after the conference, with best wishes from participants and friends. We dedicate this volume to his memory. The organisers thankthe Physics Doctoral School of Eötvös University for its hospitality. The workshop was supported by the Mecenatúra and Polányi Mihály Programmes of the National

  13. A study of communication skills in health care management students and its association with demographic characteristics

    Directory of Open Access Journals (Sweden)

    Shiva Karimzadeh

    2017-04-01

    Full Text Available Introduction: Communication skills are one of the most important skills for health care managers and play an important role in their personal life and future occupation. The present study aimed to evaluate the students’ communication skills as well as its relationship with the students’ demographic characteristics. Method: This descriptive-analytical study was performed on 153 university students majoring in healthcare management in 2014. A self-administered communication skills questionnaire and demographic information form were used to collect the data. Then, the data were analyzed by using SPSS software and appropriate statistical tests including T-Test and ANOVA. Results: The results showed that the students on average got 77.60 out of possible 100 in communication skills. The relationship between communication skills and demographic characteristics, except age, was not statistically significant (p<0.001. The total Cronbach’s alpha was estimated 0.7. There was a statistically significant difference between the communication skills scores of participants in terms of different age groups (p<0.05. Conclusion: The present findings showed a moderate score in communicative skills in students of health care management. Although the communication skill levels in these students were not low, due to the importance of these skills in their future occupation, serious attention is needed to improve their communication skills.

  14. Communication Skills Training Increases Self-Efficacy of Health Care Professionals

    Science.gov (United States)

    Norgaard, Birgitte; Ammentorp, Jette; Kyvik, Kirsten Ohm; Kofoed, Poul-Erik

    2012-01-01

    Introduction: Despite the knowledge of good communication as a precondition for optimal care and treatment in health care, serious communication problems are still experienced by patients as well as by health care professionals. An orthopedic surgery department initiated a 3-day communication skills training course for all staff members expecting…

  15. The utility of a 5(th) nap in multiple sleep latency test.

    Science.gov (United States)

    Muza, Rexford; Lykouras, Dimosthenis; Rees, Kate

    2016-02-01

    This is the first study that aimed to look specifically at the utility of the 5(th) nap in the multiple sleep latency test (MSLT), a test used to assist in the diagnosis of narcolepsy. Data was retrospectively collected from the Sleep Disorders Centre of a Tertiary Hospital on patients that had a 5(th) nap during their MSLT from the 08(th) November 2011 to 12(th) November 2014. Fifty-three patients had a 5(th) nap performed out of 378 MSLT studies. In 16% of cases a diagnosis of narcolepsy was given directly due to the inclusion of the 5(th) nap on the MSLT. Here a 5(th) nap allowed diagnostic criteria of mean sleep latency 2 SOREMPS to be met. In 53% of cases the mean sleep latency increased due to 5(th) nap inclusion; the mean sleep latency of the first four naps was 5.6 vs. 6.7 after inclusion of the 5(th) nap. The 5(th) nap is not often performed within the MSLT studies. Our study shows that only a few patients may benefit from a 5(th) nap opportunity which also led to increase of the mean sleep latency at the expense of extra time, cost, labour and increased patient anxiety.

  16. Chronology of 3rd–5th Century Female Graves from Tarasovo Burial Ground

    Directory of Open Access Journals (Sweden)

    Goldina Rimma D.

    2017-07-01

    Full Text Available The article represents the concluding part a series of works by the authors on the dating of burials from the unique 1st–5th century Tarasovo burial ground in the Middle Kama region. The first article was dedicated to the chronology of graves dating back to the early Nyrgynda stage (1st–2nd centuries of this monument. The second and third publications feature an analysis of the chronology of 3rd–5th century male burials. The present work describes 160 female burials of 3rd–5th centuries analyzed from the perspective of chronology. Similarly to previous research, the three main methods employed by the authors of this research include those of formal typology, cultural stratigraphy and the nearest neighbour method. A total of 12 chronological groups were singled out as a result: 1st half of 3rd century A.D. (group 1; 2nd half of 3rd century (2; 3rd century (3; 4th century (group 4; 2nd half of 3rd–4th centuries (5а; 3rd–4th centuries (5б; 1st half of 5th century (6; 2nd half of 5th century (7; 5th century (group 8; 2nd half of 4th–5th centuries (9; 4th–5th centuries (10; 2nd half of 3rd–5th centuries

  17. Gaps in the knowledge and skills of Portuguese mothers associated with newborn health care

    Directory of Open Access Journals (Sweden)

    Alexandrina Maria Ramos Cardoso

    2018-05-01

    Full Text Available ABSTRACT Objectives: assess mothers’ parenting knowledge and skills associated with the parental competence health promotion and monitoring for newborns and infants aged up to six months and determine the key characteristics of mothers who are better prepared for parenting. Method: cross-sectional study conducted in three health centers belonging to a Local Health Unit in the Northern Region of Portugal. Data was collected using clinical interviews conducted with pregnant women or mothers with a child aged up to six months. The tool used contained 21 child health promotion and monitoring indicators associated with different assessment moments: pregnancy, 1st/2nd week, 1st/2nd month, 3rd/4th month, and 5th/6th month. Results: we assessed the knowledge and skills of 629 women. Learning needs were identified for each of the indicators. The mothers who were better prepared for parenting tended to have a higher level of schooling, resided with the child’s father, had other children, had planned pregnancy, and intended to breastfeed. Conclusions: the results showed that knowledge and skills were lacking for each of the periods assessed by this study. First-time single mothers whose pregnancy was unplanned and who did not prepare themselves for parenthood may be considered a vulnerable group.

  18. Skilled care at birth among rural women in Nepal: practice and challenges.

    Science.gov (United States)

    Dhakal, Sulochana; van Teijlingen, Edwin; Raja, Edwin Amalraj; Dhakal, Keshar Bahadur

    2011-08-01

    In Nepal, most births take place at home, and many, particularly in rural areas, are not attended by a skilled birth attendant. The main objectives of the study were to assess the use of skilled delivery care and barriers to access such care in a rural community and to assess health problems during delivery and seeking care. This cross-sectional study was carried out in two Village Development Committees in Nepal in 2006. In total, 150 women who had a live birth in the 24 months preceding the survey were interviewed using a structured questionnaire. The sample population included married women aged 15-49 years. Forty-six (31%) women delivered their babies at hospital, and 104 (69%) delivered at home. The cost of delivery at hospital was significantly (p home. Results of univariate analysis showed that women from Brahmin-Chhetri ethnicity, women with higher education or who were more skilled, whose husbands had higher education and more skilled jobs, had first or second childbirth, and having adverse previous obstetric history were associated with institutional delivery while women with higher education and having an adverse history of pregnancy outcome predicted the uptake of skilled delivery care in Nepal. The main perceived problems to access skilled delivery care were: distance to hospital, lack of transportation, lack of awareness on delivery care, and cost. The main reasons for seeking intrapartum care were long labour, retained placenta, and excessive bleeding. Only a quarter of women sought care immediately after problems occurred. The main reasons seeking care late were: the woman or her family not perceiving that there was a serious problem, distance to health facility, and lack of transport. The use of skilled birth attendants at delivery among rural women in Nepal is very poor. Home delivery by unskilled birth attendants is still a common practice among them. Many associated factors relating to the use of skilled delivery care that were identified

  19. Improving communication skills in the Southeast Asian health care context

    OpenAIRE

    Claramita, Mora; Susilo, Astrid Pratidina

    2014-01-01

    The aim of these two PhD thesis are to develop a guideline on doctor-patient communication skills based on cultural characteristics of Southeast Asian context and to develop communication skills training for nurses to enhance their contribution to the informed consent and shared decision making process, in the same context. These studies started with qualitative methods; including grounded theory methodology, by exploring doctors’, patients’, medical students’ and nurses’ perceptions on the c...

  20. Factors affecting utilization of skilled maternal care in Northwest Ethiopia: a multilevel analysis

    OpenAIRE

    Worku, Abebaw Gebeyehu; Yalew, Alemayehu Worku; Afework, Mesganaw Fantahun

    2013-01-01

    Background The evaluation of all potential sources of low skilled maternal care utilization is crucial for Ethiopia. Previous studies have largely disregarded the contribution of different levels. This study was planned to assess the effect of individual, communal, and health facility characteristics in the utilization of antenatal, delivery, and postnatal care by a skilled provider. Methods A linked facility and population-based survey was conducted over three months (January - March 2012) i...

  1. Communication skills training in dementia care: a systematic review of effectiveness, training content, and didactic methods in different care settings.

    Science.gov (United States)

    Eggenberger, Eva; Heimerl, Katharina; Bennett, Michael I

    2013-03-01

    Caring for and caring about people with dementia require specific communication skills. Healthcare professionals and family caregivers usually receive little training to enable them to meet the communicative needs of people with dementia. This review identifies existent interventions to enhance communication in dementia care in various care settings. We searched MEDLINE, AMED, EMBASE, PsychINFO, CINAHL, The Cochrane Library, Gerolit, and Web of Science for scientific articles reporting interventions in both English and German. An intervention was defined as communication skills training by means of face-to-face interaction with the aim of improving basic communicative skills. Both professional and family caregivers were included. The effectiveness of such training was analyzed. Different types of training were defined. Didactic methods, training content, and additional organizational features were qualitatively examined. This review included 12 trials totaling 831 persons with dementia, 519 professional caregivers, and 162 family caregivers. Most studies were carried out in the USA, the UK, and Germany. Eight studies took place in nursing homes; four studies were located in a home-care setting. No studies could be found in an acute-care setting. We provide a list of basic communicative principles for good communication in dementia care. Didactic methods included lectures, hands-on training, group discussions, and role-play. This review shows that communication skills training in dementia care significantly improves the quality of life and wellbeing of people with dementia and increases positive interactions in various care settings. Communication skills training shows significant impact on professional and family caregivers' communication skills, competencies, and knowledge. Additional organizational features improve the sustainability of communication interventions.

  2. Using communication skills for difficult conversations in palliative care

    African Journals Online (AJOL)

    2011-07-02

    Jul 2, 2011 ... research interests in primary palliative care and medical education. LINDa gaNca ... professional nurse administers medication and gives nursing care, the social worker .... future communication in the therapeutic relationship.

  3. Determination of the Colour Preferences of 5th Grade Students in Relation to Gender

    Science.gov (United States)

    Uysal, Hüseyin

    2016-01-01

    The purpose of this research is to determine the colour preferences of 5th grade students in relation to the concept of gender. The study was conducted with the 19 5th grade students studying at Central District of Bartin Province in 2015 to 2016 academic year. Throughout the research, quantitative research method had been used while survey had…

  4. Communication skills training for health care professionals improves the adult orthopaedic patient's experience of quality of care

    DEFF Research Database (Denmark)

    Nørgaard, Birgitte; Kofoed, Poul-Erik; Ohm Kyvik, Kirsten

    2012-01-01

    Scand J Caring Sci; 2012; Communication skills training for health care professionals improves the adult orthopaedic patient's experience of quality of care Rationale:  Despite the fact that communication has become a core topic in health care, patients still experience the information provided...... as insufficient or incorrect and a lack of involvement. Objective:  To investigate whether adult orthopaedic patients' evaluation of the quality of care had improved after a communication skills training course for healthcare professionals. Design and methods:  The study was designed as an intervention study...... offering professionals training in communicating with patients and colleagues. The outcome was measured by assessing patients' experience of quality of care. Data were collected by means of a questionnaire and analysed using a linear regression model. Approval was obtained from the Danish Data Protection...

  5. 5th International Workshop on Complex Networks and their Applications

    CERN Document Server

    Gaito, Sabrina; Quattrociocchi, Walter; Sala, Alessandra

    2017-01-01

    This book highlights cutting-edge research in the field of network science, offering scientists, researchers and graduate students a unique opportunity to catch up on the latest advances in theory and a multitude of applications. It presents the peer-reviewed proceedings of the fifth International Workshop on Complex Networks & their Applications (COMPLEX NETWORKS 2016), which took place in Milan during the last week of November 2016. The carefully selected papers are divided into 11 sections reflecting the diversity and richness of research areas in the field. More specifically, the following topics are covered: Network models; Network measures; Community structure; Network dynamics; Diffusion, epidemics and spreading processes; Resilience and control; Network visualization; Social and political networks; Networks in finance and economics; Biological and ecological networks; and Network analysis.

  6. Importance and performance of managerial skills in the Australian aged care sector - a middle managers' perspective.

    Science.gov (United States)

    Meissner, Ellen; Radford, Katrina

    2015-09-01

    This study examined the importance and performance of middle managers' skills to provide a starting point for a sector-wide leadership and management framework. There is an increasing consensus that the quality of management, leadership and performance of any organisation is directly linked to the capabilities of its middle managers and the preparation and on-going training they receive. A total of 199 middle managers from three aged care organisations in Australia participated in a questionnaire conducted during 2010-2011. This study found that middle managers perceived the need to develop their communication skills, self-awareness, change management, conflict resolution and leadership skills. Middle managers perceive a discrepancy between performance and importance of various managerial skills. This study demonstrated that provision of training needs to go beyond clinical skills development and further investigation into managers' needs is necessary, particularly considering the diversity of this critical group in organisations. Future training opportunities provided to middle managers need to address the 'softer' skills (e.g. communication) rather than 'technical' skills (e.g. clinical skills). The provision of training in these skills may improve their performance, which may also lead to increased job satisfaction, continuity in leadership and management and ultimately improvements in the quality of care provided. © 2014 John Wiley & Sons Ltd.

  7. Skilled delivery care service utilization in Ethiopia: analysis of rural ...

    African Journals Online (AJOL)

    Only 4.5% women in rural areas received assistance from skilled birth attendants (SBAs) compared to 64.1 % of their urban counter parts. Through Bayesian logistic regression analysis, place of residence, ANC utilization, women's education, age and birth order were identified as key predictors of service utilization.

  8. Knowledge, perceived skills and activities of nursing staff to support oral home care among older domiciliary care clients.

    Science.gov (United States)

    Salmi, Riikka; Tolvanen, Mimmi; Suhonen, Riitta; Lahti, Satu; Närhi, Timo

    2018-04-25

    Increasing number of older adults lives in their own homes, but needs help in many daily routines. Domiciliary care nursing staff (DCNS) is often needed to support oral home care. However, information of nursing staff's knowledge, skills and activity in this task is sparse. The study aimed to assess DCNS knowledge, perceived skills and activities to support oral home care of older domiciliary care clients. The study was conducted among DCNS in one of the largest cities in Finland. All DCNS members (n = 465) received a questionnaire with 14 multiple choice and open questions regarding the perceived skills, knowledge and activities of oral health guidance of older domiciliary care clients. In total, 115 (25%) DCNS members returned the questionnaires. Frequencies, percentages, means and standard deviations were used to describe the samples and study variables. DCNS was categorised according to age and working years for group comparisons, which were assessed with chi-squared test. Knowledge concerning oral health was mostly on a high level. Around 50% of DCNS considered their knowledge regarding dental prosthesis hygiene as sufficient. Of the DCNS, 67% informed that they had received education on oral health care. However, over 50% of the DCNS had a need for further education in issues related to oral home care. DCNS were active in supporting most oral and prosthesis hygiene means, yet less in guidance concerning toothbrushing. Activity to support cleaning the interdental spaces was the weakest, in which only 12% of the respondents considered having average or excellent skills. Younger DCNS had better knowledge on oral home care due to recent education, but older staff members were more skilful in performing oral hygiene measures. There is a need for structured instructions and training on oral home care for DCNS. Oral home care should be taken into account more often and regularly. © 2018 Nordic College of Caring Science.

  9. Using a measure of person-perception skills to identify outstanding home care workers.

    Science.gov (United States)

    Grosch, Kerry; Medvene, Louis; Walker, Diane

    2011-01-01

    This study involved university-community collaboration with an international home care company for the purpose of developing a tool to identify talented caregivers. Tested was the hypothesis that workers' ability to provide care in person-centered ways would be positively associated with their ability to describe others in complex ways--that is, their person-perception skills. Company coordinators functioning as supervisors used an innovative 10-item instrument to screen 554 home health aides for their person centeredness. The most and least person-centered workers were evaluated for their person-perception skills. Person centeredness was positively associated with the complexity of home care workers' descriptions of others.

  10. Review of The Behavioral Health Specialist in Primary Care: Skills for Integrated Practice.

    Science.gov (United States)

    Harsh, Jennifer

    2016-03-01

    Reviews the book, The Behavioral Health Specialist in Primary Care: Skills for Integrated Practice edited by Mary Ann Burg and Oliver Oyama (see record 2015-46891-000). The editors and the chapter authors of this useful book provide insight into the skills and knowledge needed to do integrated behavioral health in primary care. The most beneficial part of the book is the layout of the chapters, and the authors do a great job of articulating the clinical components of care. Behavioral health and medical providers in practice or in training could greatly benefit from reading this book. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  11. Kindergarten Child Care Experiences and Child Achievement and Socioemotional Skills

    Science.gov (United States)

    Claessens, Amy

    2012-01-01

    Young children's experiences outside of both home and school are important for their development. As women have entered the labor force, child care has become an increasingly important context for child development. Child care experiences prior to school entry have been well-documented as important influences on children's academic and…

  12. Assessing the skills of home care workers in helping older people take their prescribed medications.

    Science.gov (United States)

    Smyth, Elizabeth E J

    2015-08-01

    The Southern Health and Social Care Trust in Northern Ireland applied a modified version of the Objective Structured Clinical Examination (OSCE) to assess the skills of home care workers in assisting older people taking prescribed medications. In Northern Ireland, home care workers are care workers employed by health and social care trusts or private agencies. The application of the model has developed the skills of this staff group, improved the relationship between the commissioner and provider, significantly reduced the time spent by community nurses in individual training and assessment, and enhanced the patient experience for those taking medication. Overall, the application of this model has provided assurances to the Trust board, the executive director of nursing, and operational directors that home care workers are competent in assisting older people in this high-risk activity.

  13. The Place and Importance of Values Education in 4.th and 5th. Grade Primary School Social Studies Textbooks

    Directory of Open Access Journals (Sweden)

    Mehmet Fatih Yiğit

    2013-11-01

    Full Text Available The term ‘value’ has been used in many different meanings until today in different areas and it has been the reason for confusion in values education. In this sense, Weber (1990 has stated that different approaches to the term ‘value’ have played a negative role for the production of values. Kohlberg (1981 has defined ‘value’ as giving moral decisions and acting accordingly while Hill (1991 interpreted values as the beliefs that people care and direct the life of individuals. On the other hand, Veugelers (2000 defined values as the beliefs that help individuals to decide what is good or evil. International organizations also saw the need to define values in accordance with their missions. In the Declaration of Human Rights by the United Nations, it is indicated that education should strengthen human rights and freedom while supporting tolerance among different religious groups, ethnicities and nations (Universal Declaration of Human Rights, 1948. UNESCO is another organization that defined the role of values in education. According to the report by UNESCO, education becomes valuable if one learns (a how to know (b how to do, (c how to live together and (d how to be. In this sense, UNESCO has also claimed that in order to develop intercultural and interfaith dialogue, common values accepted by everyone should be given in schools. It has been observed that critical thinking and problem solving skills were given in values education programs in western societies while those skills have started to be taught in Turkey recently. In this study, the main values education movements and the processes and principles of teaching values education in real life are analyzed. We looked at the place of values education in 4th and 5th grade Social Studies textbooks in Turkey. After analyzing the basic processes and principles of values education, we looked at the values to be given to the students in the textbooks. Values education approaches have

  14. Curing and caring competences in the skills training of physiotherapy students.

    Science.gov (United States)

    Dahl-Michelsen, Tone

    2015-01-01

    This article explores the significance of curing and caring competences in physiotherapy education, as well as how curing and caring competences intersect within the professional training of physiotherapy students. The empirical data include participant observations and interviews with students attending skills training in the first year of a bachelor's degree program in Norway. Curing and caring are conceptualized as gender-coded competences. That is, curing and caring are viewed as historical and cultural constructions of masculinities and femininities within the physiotherapy profession, as well as performative actions. The findings illuminate the complexity of curing and caring competences in the skills training of physiotherapy students. Curing and caring are both binary and intertwined competences; however, whereas binary competences are mostly concerned with contextual frames, intertwined competences are mostly concerned with performative aspects. The findings also point to how female and male students attend to curing and caring competences in similar ways; thus, the possibilities of transcending traditional gender norms turn out to be significant in this context. The findings suggest that, although curing somehow remains hegemonic to caring, the future generation of physiotherapists seemingly will be able to use their skills for both caring and curing.

  15. Effectiveness of interventions to provide culturally appropriate maternity care in increasing uptake of skilled maternity care: a systematic review.

    Science.gov (United States)

    Coast, Ernestina; Jones, Eleri; Lattof, Samantha R; Portela, Anayda

    2016-12-01

    Addressing cultural factors that affect uptake of skilled maternity care is recognized as an important step in improving maternal and newborn health. This article describes a systematic review to examine the evidence available on the effects of interventions to provide culturally appropriate maternity care on the use of skilled maternity care during pregnancy, for birth or in the postpartum period. Items published in English, French and/or Spanish between 1 January 1990 and 31 March 2014 were considered. Fifteen studies describing a range of interventions met the inclusion criteria. Data were extracted on population and intervention characteristics; study design; definitions and data for relevant outcomes; and the contexts and conditions in which interventions occurred. Because most of the included studies focus on antenatal care outcomes, evidence of impact is particularly limited for care seeking for birth and after birth. Evidence in this review is clustered within a small number of countries, and evidence from low- and middle-income countries is notably lacking. Interventions largely had positive effects on uptake of skilled maternity care. Cultural factors are often not the sole factor affecting populations' use of maternity care services. Broader social, economic, geographical and political factors interacted with cultural factors to affect targeted populations' access to services in included studies. Programmes and policies should seek to establish an enabling environment and support respectful dialogue with communities to improve use of skilled maternity care. Whilst issues of culture are being recognized by programmes and researchers as being important, interventions that explicitly incorporate issues of culture are rarely evaluated. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  16. Shared decision making in ante- & postnatal care – focus on communication skills training

    DEFF Research Database (Denmark)

    Nielsen, Annegrethe; Yding, Annika; Skovsted, Katrine Brander

    In recent years political focus has increasingly been on patient involvement in decisions in healthcare. One challenge in implementing the principles of shared decision making is to develop suitable communication practice in the clinical encounters between patients and healthcare providers....... A project where a group of midwives and nurses worked together in a serial of workshops training communication skills suitable for involving women in decisions in ante- and postnatal care was conducted in 2015. Communication skills training involved group analysis of videos of real consultations...... and a variety of roleplays and rehearsals of communication situations. Besides training communication skills the project aimed at documenting institutional practices obstructive to the purpose of sharing decisions....

  17. The impact of intermediate care services on job satisfaction, skills and career development opportunities.

    Science.gov (United States)

    Nancarrow, Susan

    2007-07-01

    The purpose of this study was to examine, in depth, the impact of intermediate care services on staff job satisfaction, skills development and career development opportunities. Recruitment and retention difficulties present a major barrier to the effective delivery of intermediate care services in the UK. The limited existing literature is contradictory, but points to the possibility of staff deskilling and suggests that intermediate care is poorly understood and may be seen by other practitioners as being of lower status than hospital work. These factors have the potential to reduce staff morale and limit the possibilities of recruiting staff. The research is based on interviews with 26 staff from case studies of two intermediate care services in South Yorkshire. Participants reported high levels of job satisfaction, which was because of the enabling philosophy of care, increased autonomy, the setting of care and the actual teams within which the workers were employed. For most disciplines, intermediate care facilitated the application of existing skills in a different way; enhancing some skills, while restricting the use of others. Barriers to career development opportunities were attributed to the relative recency of intermediate care services, small size of the services and lack of clear career structures. Career development opportunities in intermediate care could be improved through staff rotations through acute, community and intermediate care to increase their awareness of the roles of intermediate care staff. The non-hierarchical management structures limits management career development opportunities, instead, there is a need to enhance professional growth opportunities through the use of consultant posts and specialization within intermediate care. This study provides insight into the impact of an increasingly popular model of care on the roles and job satisfaction of workers and highlights the importance of this learning for recruitment and retention of

  18. Proceedings of the 5th International Workshop on Constraints and Language Processing (CSLP 2008)

    DEFF Research Database (Denmark)

    This research report constitutes the proceedings of the 5th International Workshop on Constraints and Language Processing (CSLP 2008) which is part of the European Summer School in Logic, Language, and Information (ESSLLI 2008), Hamburg, Germany, August 2008.......This research report constitutes the proceedings of the 5th International Workshop on Constraints and Language Processing (CSLP 2008) which is part of the European Summer School in Logic, Language, and Information (ESSLLI 2008), Hamburg, Germany, August 2008....

  19. Virtual Reality Skills Training for Health Care Professionals in Alcohol Screening and Brief Intervention

    Science.gov (United States)

    Fleming, Michael; Olsen, Dale; Stathes, Hilary; Boteler, Laura; Grossberg, Paul; Pfeifer, Judie; Schiro, Stephanie; Banning, Jane; Skochelak, Susan

    2009-01-01

    Background Educating physicians and other health care professionals to identify and treat patients who drink above recommended limits is an ongoing challenge. Methods An educational Randomized Control Trial (RCT) was conducted to test the ability of a stand alone training simulation to improve the clinical skills of health care professionals in alcohol screening and intervention. The “virtual reality simulation” combines video, voice recognition and non branching logic to create an interactive environment that allows trainees to encounter complex social cues and realistic interpersonal exchanges. The simulation includes 707 questions and statements and 1207 simulated patient responses. Results A sample of 102 health care professionals (10 physicians; 30 physician assistants [PAs] or nurse practitioners [NPs]; 36 medical students; 26 pharmacy, PA or NP students) were randomly assigned to no training (n=51) or a computer based virtual reality intervention (n=51). Subjects in both groups had similar pre-test standardized patient alcohol screening skill scores – 53.2 (experimental) vs. 54.4 (controls), 52.2 vs. 53.7 alcohol brief intervention skills, and 42.9 vs. 43.5 alcohol referral skills. Following repeated practice with the simulation there were significant increases in the scores of the experimental group at 6 months post-randomization compared to the control group for the screening (67.7 vs. 58.1, pvirtual reality simulation to demonstrate an increase in the alcohol screening and brief intervention skills of health care professionals. PMID:19587253

  20. Virtual reality skills training for health care professionals in alcohol screening and brief intervention.

    Science.gov (United States)

    Fleming, Michael; Olsen, Dale; Stathes, Hilary; Boteler, Laura; Grossberg, Paul; Pfeifer, Judie; Schiro, Stephanie; Banning, Jane; Skochelak, Susan

    2009-01-01

    Educating physicians and other health care professionals about the identification and treatment of patients who drink more than recommended limits is an ongoing challenge. An educational randomized controlled trial was conducted to test the ability of a stand-alone training simulation to improve the clinical skills of health care professionals in alcohol screening and intervention. The "virtual reality simulation" combined video, voice recognition, and nonbranching logic to create an interactive environment that allowed trainees to encounter complex social cues and realistic interpersonal exchanges. The simulation included 707 questions and statements and 1207 simulated patient responses. A sample of 102 health care professionals (10 physicians; 30 physician assistants or nurse practitioners; 36 medical students; 26 pharmacy, physican assistant, or nurse practitioner students) were randomly assigned to a no training group (n = 51) or a computer-based virtual reality intervention (n = 51). Professionals in both groups had similar pretest standardized patient alcohol screening skill scores: 53.2 (experimental) vs 54.4 (controls), 52.2 vs 53.7 alcohol brief intervention skills, and 42.9 vs 43.5 alcohol referral skills. After repeated practice with the simulation there were significant increases in the scores of the experimental group at 6 months after randomization compared with the control group for the screening (67.7 vs 58.1; P virtual reality simulation to demonstrate an increase in the alcohol screening and brief intervention skills of health care professionals.

  1. Through the Eyes of Nurse Managers in Long-Term Care: Identifying Perceived Competencies and Skills.

    Science.gov (United States)

    Dever, Kathleen H

    2018-05-01

    Nurse managers (NMs) in long-term care supervise health care services for individuals with high acuity levels and numerous comorbidities. There is minimal research identifying NMs' skills and competencies as unit leaders within the long-term care environment. The current mixed-methods study identified NMs' leadership skills and competencies. Nineteen NMs with ≥5 years' long-term care management experience completed the Nurse Manager Inventory Tool and were individually interviewed. They rated their clinical skills at the competent level and their financial/strategic management skills at the novice level. All other skill categories, including leadership reflective practice, diversity, human resource leadership/management, relationship management, performance improvement, and problem solving, were rated at a competent level. Emergent interview qualitative themes included their visibility on the unit, trial and error learning, a sense of "aloneness" due to the absence of other RNs, NM position being a tough job, need for peer support, role modeling, and importance of supporting the resident through their "final journey." [Journal of Gerontological Nursing, 44(5), 32-38.]. Copyright 2018, SLACK Incorporated.

  2. Identifying Primary Care Skills and Competencies in Opioid Risk Management

    Science.gov (United States)

    Chiauzzi, Emil; Trudeau, Kimberlee J.; Zacharoff, Kevin; Bond, Kathleen

    2011-01-01

    Introduction: Primary care physicians (PCPs) treat a high proportion of chronic pain patients but often lack training about how to assess and address issues associated with prescribing opioids when they are an appropriate component of therapy. The result may be that they may avoid treating these patients, which can lead to an undertreatment of…

  3. Better Care Teams: A Stepwise Skill Reinforcement Model.

    Science.gov (United States)

    Christopher, Beth-Anne; Grantner, Mary; Coke, Lola A; Wideman, Marilyn; Kwakwa, Francis

    2016-06-01

    The Building Healthy Urban Communities initiative presents a path for organizations partnering to improve patient outcomes with continuing education (CE) as a key component. Components of the CE initiative included traditional CE delivery formats with an essential element of adaptability and new methods, with rigorous evaluation over time that included evaluation prior to the course, immediately following the CE session, 6 to 8 weeks after the CE session, and then subsequent monthly "testlets." Outcome measures were designed to allow for ongoing adaptation of content, reinforcement of key learning objectives, and use of innovative concordant testing and retrieval practice techniques. The results after 1 year of programming suggest the stepwise skill reinforcement model is effective for learning and is an efficient use of financial and human resources. More important, its design is one that could be adopted at low cost by organizations willing to work in close partnership. J Contin Educ Nurs. 2016;47(6):283-288. Copyright 2016, SLACK Incorporated.

  4. The effect of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills rate of nurses in hospitals of tabriz, iran.

    Science.gov (United States)

    Khodadadi, Esmail; Ebrahimi, Hossein; Moghaddasian, Sima; Babapour, Jalil

    2013-03-01

    Having an effective relationship with the patient in the process of treatment is essential. Nurses must have communication skills in order to establish effective relationships with the patients. This study evaluated the impact of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills of nurses. This is an experimental study with a control group that has been done in 2012. The study sample consisted of 73 nurses who work in hospitals of Tabriz; they were selected by proportional randomizing method. The intervention was only conducted on the experimental group. In order to measure the quality of care 160 patients, who had received care by nurses, participated in this study. The Data were analyzed by SPSS (ver.13). Comparing the mean scores of communication skills showed a statistically significant difference between control and experimental groups after intervention. The paired t-test showed a statistically significant difference in the experimental group before and after the intervention. Independent t-test showed a statistically significant difference between the rate of quality of care in patients of control and experimental groups after the intervention. The results showed that the training of communication skills can increase the nurse's rate of communication skills and cause elevation in quality of nursing care. Therefore, in order to improve the quality of nursing care it is recommended that communication skills be established and taught as a separate course in nursing education.

  5. Maternal complications and women's behavior in seeking care from skilled providers in North Gondar, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Abebaw Gebeyehu Worku

    Full Text Available BACKGROUND: Maternal complications are morbidities suffered during pregnancy through the postpartum period of 42 days. In Ethiopia, little is known about women's experience of complications and their care-seeking behavior. This study attempted to assess experiences related to obstetric complication and seeking assistance from a skilled provider among women who gave birth in the last 12 months preceding the study. METHODS: This study was a cross-sectional survey of women who gave birth within one year preceding the study regardless of their delivery place. The study was carried out in six selected districts in North Gondar Zone, Amhara Region. Data was collected house-to-house in 12 selected clusters (kebeles using a pretested Amharic questionnaire. During the survey, 1,668 women were interviewed. Data entry was done using Epi Info version 3.5.3 and was exported to SPSS for analysis. Logistic regression was applied to control confounders. RESULTS: Out of the total sample, 476 women (28.5%, 95% CI: 26.4%, 30.7% reported some kind of complication. The most common complications reported were; excessive bleeding and prolonged labor that occurred mostly at the time of delivery and postpartum period. Out of the total women who faced complications, 248 (52.1%, 95% CI: 47.6%, 56.6% sought assistance from a skilled provider. Inability to judge the severity of morbidities, distance/transport problems, lack of money/cost considerations and use of traditional options at home were the major reasons for not seeking care from skilled providers. Belonging to a wealthier quintile, getting antenatal care from a skilled provider and agreement of a woman in planning for possible complications were significantly associated with seeking assistance from a skilled provider. CONCLUSION: Nearly half of the women who faced complications did not use skilled providers at the time of obstetric complications. Cognitive, geographic, economic and cultural barriers were involved

  6. Fathers and Asthma Care: Paternal Involvement, Beliefs, and Management Skills.

    Science.gov (United States)

    Friedman, Deborah; Masek, Bruce; Barreto, Esteban; Baer, Lee; Lapey, Allen; Budge, Eduardo; McQuaid, Elizabeth L

    2015-09-01

    To compare asthma care roles of maternal and paternal caregivers, and examine associations between caregiver involvement and the outcomes of adherence, morbidity, and parental quality of life (QoL). Mothers and fathers in 63 families of children, ages 5-9 years, with persistent asthma completed semistructured interviews and questionnaires. Adherence was measured via electronic monitoring. Paired t tests compared parental asthma care roles, and analysis of covariance, controlling for socioeconomic status, evaluated associations of asthma outcomes with caregiver involvement scores. Mothers had higher scores on measures of involvement, beliefs in medication necessity, and on four subscales of the Family Asthma Management System Scale interview (Asthma Knowledge, Relationship with Provider, Symptom Assessment, and Response to Symptoms). Maternal QoL was lowest when both maternal and paternal involvement was high. Paternal involvement was associated with increased morbidity. There is room for enhancement of fathers' asthma care roles. Higher levels of paternal involvement may be driven by family need. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Three principles to improve clinician communication for advance care planning: overcoming emotional, cognitive, and skill barriers.

    Science.gov (United States)

    Weiner, Joseph S; Cole, Steven A

    2004-12-01

    Medical care of patients with life limiting illness remains fraught with serious deficiencies, including inadequate advance care planning, delayed hospice referral, and continued delivery of aggressive treatment that is overtly counter to patients' preferences. This paper describes clinicians' emotional, cognitive, and skill barriers to shared decision-making with seriously ill patients and their loved ones. Thematic literature review. Based on a literature review, as well as clinical and educational experience, we articulate three principles to address these barriers and guide future professional communication training for advance care planning. We argue that these barriers must be overcome before deficiencies in end-of-life care can be fully ameliorated.

  8. Mandatory communication skills training for cancer and palliative care staff: does one size fit all?

    Science.gov (United States)

    Turner, Mary; Payne, Sheila; O'Brien, Terri

    2011-12-01

    There is increasing recognition of the importance of good communication between healthcare professionals and patients facing cancer or end of life. In England, a new national 3-day training programme called 'Connected' has been developed and is now mandatory for all cancer and palliative care professionals. This study aimed to explore the attitudes of staff in one region to undertaking this training. A survey questionnaire was developed through a series of discussions with experts and semi-structured interviews with five healthcare professionals. The questionnaire was distributed to 200 cancer and palliative care staff; 109 were completed and returned. There were significant differences between doctors' and nurses' attitudes to communication skills training, with doctors demonstrating more negative attitudes. More nurses than doctors felt that communication skills training should be mandatory for cancer and palliative care professionals (p ≤ 0.001), whilst more doctors felt that these staff should already be skilled communicators and not require further training (p ≤ 0.001). Nurses also self-rated their communication skills more highly than doctors. The current 'one size fits all' approach being taken nationally to advanced communication skills training does not meet the training preferences of all healthcare professionals, and it is recommended that tailoring courses to individuals' needs should be considered. Copyright © 2010 Elsevier Ltd. All rights reserved.

  9. Sales skills for health-care professionals: the emotional side of sales.

    Science.gov (United States)

    Nigon, D L

    2001-01-01

    Health-care sales continues to be an area of opportunity for many laboratory professionals. For those who possess the necessary skills and the desire to enthusiastically embrace the unique challenges of a sales career, a new CLMA publication by CLMR contributor Donna L. Nigon, MT(ASCP), titled Sales Skills for Health-Care Professionals, will provide the knowledge of sales structure and techniques needed to succeed. This Sales Skills excerpt, "The Emotional Side of Sales," describes many of the emotional aspects of sales and selling, including how to handle the transition from a technical or medical role to that of sales representative, relationship building, maintaining personal and professional support systems, dealing with rejection, avoiding burnout, time management, and customer concerns. For more information about this book, please see the order form that accompanies this excerpt, or visit www.clma.org.

  10. Perceptions of Field Instructors: What Skills are Critically Important inManaged Care and Privatized Environments?

    Directory of Open Access Journals (Sweden)

    Michael N. Kane

    2000-12-01

    Full Text Available There is an increasing demand for social work practitioners to work in managed care and privatized environments. In an attempt to build social work curriculum and identify important competencies needed in contemporary service environments, researchers investigated South Florida field instructors’ (N=79 perceptions of necessary knowledge and skill to work in environments affected by privatization and managed care. This study’s findings indicate that field instructors (98% identified documentation as the most critically important skill for any social work position. Additionally, respondents identified intervention evaluation (95%, time focused and needs-based assessments strategies (94%, and evaluation of progress through outcome measures (94% as other critically important skills for current and future practitioners.

  11. Teaching Social Skills to Enhance Work Performance in a Child Care Setting

    Science.gov (United States)

    Gear, Sabra; Bobzien, Jonna; Judge, Sharon; Raver, Sharon A.

    2011-01-01

    Adults with intellectual disabilities face difficulty seeking employment in the community workforce. Using a single-subject design, this study examined the utility of role playing and self-management strategies to enhance work performance by promoting the social skills of a young woman with Down syndrome working in a community child care setting.…

  12. Identifying Child-Staff Ratios That Promote Peer Skills in Child Care

    Science.gov (United States)

    Iluz, Reli; Adi-Japha, Esther; Klein, Pnina S.

    2016-01-01

    Research Findings: Early child care policy and practice are grounded in a growing understanding of the importance of the first years of life. In earlier studies, associations between child-staff ratios and peer skills yielded inconsistent findings. The current study used data from the National Institute of Child Health and Human Development Study…

  13. Spatial abilities and technical skills performance in health care: a systematic review.

    Science.gov (United States)

    Langlois, Jean; Bellemare, Christian; Toulouse, Josée; Wells, George A

    2015-11-01

    The aim of this study was to conduct a systematic review and meta-analysis of the relationship between spatial abilities and technical skills performance in health care in beginners and to compare this relationship with those in intermediate and autonomous learners. Search criteria included 'spatial abilities' and 'technical skills'. Keywords related to these criteria were defined. A literature search was conducted to 20 December, 2013 in Scopus (including MEDLINE) and in several databases on EBSCOhost platforms (CINAHL Plus with Full Text, ERIC, Education Source and PsycINFO). Citations were obtained and reviewed by two independent reviewers. Articles related to retained citations were reviewed and a final list of eligible articles was determined. Articles were assessed for quality using the Scottish Intercollegiate Guidelines Network-50 assessment instrument. Data were extracted from articles in a systematic way. Correlations between spatial abilities test scores and technical skills performance were identified. A series of 8289 citations was obtained. Eighty articles were retained and fully reviewed, yielding 36 eligible articles. The systematic review found a tendency for spatial abilities to be negatively correlated with the duration of technical skills and positively correlated with the quality of technical skills performance in beginners and intermediate learners. Pooled correlations of studies were -0.46 (p = 0.03) and -0.38 (95% confidence interval [CI] -0.53 to -0.21) for duration and 0.33 (95% CI 0.20-0.44) and 0.41 (95% CI 0.26-0.54) for quality of technical skills performance in beginners and intermediate learners, respectively. However, correlations between spatial abilities test scores and technical skills performance were not statistically significant in autonomous learners. Spatial abilities are an important factor to consider in selecting and training individuals in technical skills in health care. © 2015 John Wiley & Sons Ltd.

  14. Critical Care nurses' understanding of the NHS knowledge and skills framework. An interpretative phenomenological analysis.

    Science.gov (United States)

    Stewart, Laura F M; Rae, Agnes M

    2013-01-01

    This small-scale research study aimed to explore Critical Care nurses' understanding of the National Health Service (NHS) Knowledge and Skills Framework (KSF) in relationship to its challenges and their nursing role. The NHS KSF is central to the professional development of nurses in Critical Care and supports the effective delivery of health care in the UK. KSF was implemented in 2004 yet engagement seems lacking with challenges often identified. This qualitative study adopted an Interpretative Phenomenological Analysis framework. Data were collected from five Critical Care nurses using semi-structured interviews that were transcribed for analysis. Two super-ordinate themes of 'engagement' and 'theory-practice gap' were identified. Six subthemes of 'fluency', 'transparency', 'self-assessment', 'achieving for whom', 'reflection' and 'the nursing role' further explained the super-ordinate themes. Critical Care nurses demonstrated layers of understanding about KSF. Challenges identified were primarily concerned with complex language, an unclear process and the use of reflective and self-assessment skills. Two theory-practice gaps were found. Critical Care nurses understood the principles of KSF but they either did not apply or did not realize they applied these principles. They struggled to relate KSF to Critical Care practice and felt it did not capture the 'essence' of their nursing role in Critical Care. Recommendations were made for embedding KSF into Critical Care practice, using education and taking a flexible approach to KSF to support the development and care delivery of Critical Care nurses. © 2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.

  15. Blood Pressure Directed Booster Trainings Improve Intensive Care Unit Provider Retention of Excellent Cardiopulmonary Resuscitation Skills.

    Science.gov (United States)

    Wolfe, Heather; Maltese, Matthew R; Niles, Dana E; Fischman, Elizabeth; Legkobitova, Veronika; Leffelman, Jessica; Berg, Robert A; Nadkarni, Vinay M; Sutton, Robert M

    2015-11-01

    Brief, intermittent cardiopulmonary resuscitation (CPR) training sessions, "Booster Trainings," improve CPR skill acquisition and short-term retention. The objective of this study was to incorporate arterial blood pressure (ABP) tracings into Booster Trainings to improve CPR skill retention. We hypothesized that ABP-directed CPR "Booster Trainings" would improve intensive care unit (ICU) provider 3-month retention of excellent CPR skills without need for interval retraining. A CPR manikin creating a realistic relationship between chest compression depth and ABP was used for training/testing. Thirty-six ICU providers were randomized to brief, bedside ABP-directed CPR manikin skill retrainings: (1) Booster Plus (ABP visible during training and testing) versus (2) Booster Alone (ABP visible only during training, not testing) versus (3) control (testing, no intervention). Subjects completed skill tests pretraining (baseline), immediately after training (acquisition), and then retention was assessed at 12 hours, 3 and 6 months. The primary outcome was retention of excellent CPR skills at 3 months. Excellent CPR was defined as systolic blood pressure of 100 mm Hg or higher and compression rate 100 to 120 per minute. Overall, 14 of 24 (58%) participants acquired excellent CPR skills after their initial training (Booster Plus 75% vs 50% Booster Alone, P = 0.21). Adjusted for age, ABP-trained providers were 5.2× more likely to perform excellent CPR after the initial training (95% confidence interval [95% CI], 1.3-21.2; P = 0.02), and to retain these skills at 12 hours (adjusted odds ratio, 4.4; 95% CI, 1.3-14.9; P = 0.018) and 3 months (adjusted odds ratio, 4.1; 95% CI, 1.2-13.9; P = 0.023) when compared to baseline performance. The ABP-directed CPR booster trainings improved ICU provider 3-month retention of excellent CPR skills without the need for interval retraining.

  16. Bypassing Primary Care Facilities for Childbirth: Findings from a Multilevel Analysis of Skilled Birth Attendance Determinants in Afghanistan.

    Science.gov (United States)

    Tappis, Hannah; Koblinsky, Marge; Doocy, Shannon; Warren, Nicole; Peters, David H

    2016-01-01

    The objective of this study was to assess the association between health facility characteristics and other individual/household factors with a woman's likelihood of skilled birth attendance in north-central Afghanistan. Data from a 2010 household survey of 6879 households in 9 provinces of Afghanistan were linked to routine facility data. Hierarchical logistic regression models were used to assess determinants of skilled birth attendance. Women who reported having at least one antenatal visit with a skilled provider were 5.6 times more likely to give birth with a skilled attendant than those who did not. The odds of skilled birth attendance were 84% higher for literate women than those without literacy skills and 79% higher among women in the upper 2 wealth quintiles than women in the poorest quintile. This study did not show any direct linkages between facility characteristics and skilled birth attendance but provided insights into why studies assuming that women seek care at the nearest primary care facility may lead to misinterpretation of care-seeking patterns. Findings reveal a 36 percentage point gap between women who receive skilled antenatal care and those who received skilled birth care. Nearly 60% of women with a skilled attendant at their most recent birth bypassed the nearest primary care facility to give birth at a more distant primary care facility, hospital, or private clinic. Distance and transport barriers were reported as the most common reasons for home birth. Assumptions that women who give birth with a skilled attendant do so at the closest health facility may mask the importance of supply-side determinants of skilled birth attendance. More research based on actual utilization patterns, not assumed catchment areas, is needed to truly understand the factors influencing care-seeking decisions in both emergency and nonemergency situations and to adapt strategies to reduce preventable mortality and morbidity in Afghanistan. © 2016 by the American

  17. The relationship between staff skill mix, costs and outcomes in intermediate care services

    Directory of Open Access Journals (Sweden)

    Martin Graham P

    2010-07-01

    Full Text Available Abstract Background The purpose of this study was to assess the relationship between skill mix, patient outcomes, length of stay and service costs in older peoples' intermediate care services in England. Methods We undertook multivariate analysis of data collected as part of the National Evaluation of Intermediate Care Services. Data were analysed on between 337 and 403 older people admitted to 14 different intermediate care teams. Independent variables were the numbers of different types of staff within a team and the ratio of support staff to professionally qualified staff within teams. Outcome measures include the Barthel index, EQ-5D, length of service provision and costs of care. Results Increased skill mix (raising the number of different types of staff by one is associated with a 17% reduction in service costs (p = 0.011. There is weak evidence (p = 0.090 that a higher ratio of support staff to qualified staff leads to greater improvements in EQ-5D scores of patients. Conclusions This study provides limited evidence on the relationship between multidisciplinary skill mix and outcomes in intermediate care services.

  18. Communication skills training increases self-efficacy of health care professionals

    DEFF Research Database (Denmark)

    Nørgaard, Birgitte; Ammentorp, Jette; Ohm Kyvik, Kirsten

    2012-01-01

    Despite the knowledge of good communication as a precondition for optimal care and treatment in health care, serious communication problems are still experienced by patients as well as by health care professionals. An orthopedic surgery department initiated a 3-day communication skills training...... course for all staff members expecting an increase in patient-centeredness in communication and more respectful intercollegial communication. The aim of this study was to investigate the impact of this training course on participants' self-efficacy with a focus on communication with both colleagues...

  19. Nucleic acids levels in X-irradiated 5th instar nymphs of Dysdercus koenigii F

    International Nuclear Information System (INIS)

    Harwalkar, M.R.; Ramakrishnan, V.

    1993-01-01

    Irradiation of early 5th instar nymphs of Dysdercus koenigii F. with X-ray doses ranging from 10 to 70 Gy affected their metamorphosis in a dose dependent manner. At 70 Gy dose, metamorphosis of nymphs was completely inhibited although these nymphs survived for more than 10 days. In unirradiated 5th instar nymphs, DNA content doubled between 2nd and 3rd day and it remained at this level till these nymphs completed metamorphosis. However, DNA content of nymphs exposed to metamorphosis inhibition dose of 70 Gy X-rays showed only slight increase from 4th day and its profile remained at lower level throughout 5th instar nymphal period. Though the increase in RNA content in both the groups was found to be gradual upto 3rd day, the increase was more pronounced in case of unexposed insects. (author). 9 refs., 2 tabs

  20. Motivational Interviewing Skills in Health Care Encounters (MISHCE): Development and psychometric testing of an assessment tool.

    Science.gov (United States)

    Petrova, Tatjana; Kavookjian, Jan; Madson, Michael B; Dagley, John; Shannon, David; McDonough, Sharon K

    2015-01-01

    Motivational interviewing (MI) has demonstrated a significant impact as an intervention strategy for addiction management, change in lifestyle behaviors, and adherence to prescribed medication and other treatments. Key elements to studying MI include training in MI of professionals who will use it, assessment of skills acquisition in trainees, and the use of a validated skills assessment tool. The purpose of this research project was to develop a psychometrically valid and reliable tool that has been designed to assess MI skills competence in health care provider trainees. The goal was to develop an assessment tool that would evaluate the acquisition and use of specific MI skills and principles, as well as the quality of the patient-provider therapeutic alliance in brief health care encounters. To address this purpose, specific steps were followed, beginning with a literature review. This review contributed to the development of relevant conceptual and operational definitions, selecting a scaling technique and response format, and methods for analyzing validity and reliability. Internal consistency reliability was established on 88 video recorded interactions. The inter-rater and test-retest reliability were established using randomly selected 18 from the 88 interactions. The assessment tool Motivational Interviewing Skills for Health Care Encounters (MISHCE) and a manual for use of the tool were developed. Validity and reliability of MISHCE were examined. Face and content validity were supported with well-defined conceptual and operational definitions and feedback from an expert panel. Reliability was established through internal consistency, inter-rater reliability, and test-retest reliability. The overall internal consistency reliability (Cronbach's alpha) for all fifteen items was 0.75. MISHCE demonstrated good inter-rater reliability and good to excellent test-retest reliability. MISHCE assesses the health provider's level of knowledge and skills in brief

  1. Important wheelchair skills for new manual wheelchair users: health care professional and wheelchair user perspectives.

    Science.gov (United States)

    Morgan, Kerri A; Engsberg, Jack R; Gray, David B

    2017-01-01

    The purpose of this project was to identify wheelchair skills currently being taught to new manual wheelchair users, identify areas of importance for manual wheelchair skills' training during initial rehabilitation, identify similarities and differences between the perspectives of health care professionals and manual wheelchair users and use the ICF to organize themes related to rehabilitation and learning how to use a manual wheelchair. Focus groups were conducted with health care professionals and experienced manual wheelchair users. ICF codes were used to identify focus group themes. The Activities and Participation codes were more frequently used than Structure, Function and Environment codes. Wheelchair skills identified as important for new manual wheelchair users included propulsion techniques, transfers in an out of the wheelchair, providing maintenance to the wheelchair and navigating barriers such as curbs, ramps and rough terrain. Health care professionals and manual wheelchair users identified the need to incorporate the environment (home and community) into the wheelchair training program. Identifying essential components for training the proper propulsion mechanics and wheelchair skills in new manual wheelchair users is an important step in preventing future health and participation restrictions. Implications for Rehabilitation Wheelchair skills are being addressed frequently during rehabilitation at the activity-dependent level. Propulsion techniques, transfers in an out of the wheelchair, providing maintenance to the wheelchair and navigating barriers such as curbs, ramps and rough terrain are important skills to address during wheelchair training. Environment factors (in the home and community) are important to incorporate into wheelchair training to maximize safe and multiple-environmental-setting uses of manual wheelchairs. The ICF has application to understanding manual wheelchair rehabilitation for wheelchair users and therapists for improving

  2. Communication skills training for dialysis decision-making and end-of-life care in nephrology.

    Science.gov (United States)

    Schell, Jane O; Green, Jamie A; Tulsky, James A; Arnold, Robert M

    2013-04-01

    Nephrology fellows often face difficult conversations about dialysis initiation or withdrawal but are frequently unprepared for these discussions. Despite evidence that communication skills are teachable, few fellowship programs include such training. A communication skills workshop for nephrology fellows (NephroTalk) focused on delivering bad news and helping patients define care goals, including end-of-life preferences. This 4-hour workshop, held in October and November 2011, included didactics and practice sessions with standardized patients. Participants were nephrology fellows at Duke University and the University of Pittsburgh (n=22). Pre- and post-workshop surveys evaluated efficacy of the curriculum and measured changes in perceived preparedness on the basis on workshop training. Overall, 14% of fellows were white and 50% were male. Less than one-third (6 of 22) reported prior palliative care training. Survey response rate varied between 86% and 100%. Only 36% (8 of 22) and 38% (8 of 21) of respondents had received structured training in discussions for dialysis initiation or withdrawal. Respondents (19 of 19) felt that communication skills were important to being a "great nephrologist." Mean level of preparedness as measured with a five-point Likert scale significantly increased for all skills (range, 0.5-1.14; Pdecision-making and end-of-life care.

  3. Understanding the impact of simulated patients on health care learners' communication skills: a systematic review.

    Science.gov (United States)

    Kaplonyi, Jessica; Bowles, Kelly-Ann; Nestel, Debra; Kiegaldie, Debra; Maloney, Stephen; Haines, Terry; Williams, Cylie

    2017-12-01

    Effective communication skills are at the core of good health care. Simulated patients (SPs) are increasingly engaged as an interactive means of teaching, applying and practising communication skills with immediate feedback. There is a large body of research into the use of manikin-based simulation but a gap exists in the body of research on the effectiveness of SP-based education to teach communication skills that impact patient outcomes. The aim of this systematic review was to critically analyse the existing research, investigating whether SP-based communication skills training improves learner-patient communication, how communication skill improvement is measured, and who measures these improvements. The databases Medline, ProQuest (Health & Medical Complete, Nursing and Allied Health Source) and CINAHL (EBSCOhost) Education Resources Information Centre (ERIC) were searched for articles that investigated the effects of SP-based education on the communication skills of medical, nursing and allied health learners. There were 60 studies included in the review. Only two studies reported direct patient outcomes, one reporting some negative impact, and no studies included an economic analysis. Many studies reported statistically significant third-party ratings of improved communication effectiveness following SP-based education; however, studies were unable to be pooled for meta-analysis because of the outcome collection methods. There were a small number of studies comparing SP with no training at all and there were no differences between communication skills, contradicting the results from studies reporting benefits. Of the 60 studies included for analysis, 54 (90%) met the minimum quality score of 7/11, with four articles (7%) scoring 11/11. SP-based education is widely accepted as a valuable and effective means of teaching communication skills but there is limited evidence of how this translates to patient outcomes and no indication of economic benefit for this

  4. E-care as craftsmanship: virtuous work, skilled engagement, and information technology in health care

    NARCIS (Netherlands)

    Coeckelbergh, Mark

    2013-01-01

    Contemporary health care relies on electronic devices. These technologies are not ethically neutral but change the practice of care. In light of Sennett’s work and that of other thinkers (Dewey, Dreyfus, Borgmann) one worry is that “e-care”—care by means of new information and communication

  5. Mednarodna znanstvena konferenca ECEI 2010 = 5th European Conference on Innovation and Enterpreunership

    Directory of Open Access Journals (Sweden)

    Elizabeta Zirnstein

    2010-12-01

    Full Text Available The 5th European Conference on Innovation and Enterpreunership –ecei 2010 was hosted by the National and Kapodistrian University ofAthens from 15th to 17th September 2010. More than 150 authors andco-authors from 38 countries shared their research results, viewpointsand ideas on a wide range of topics that fall into this important area ofresearch

  6. A Longitudinal Study of a 5th Grade Science Curriculum Based on the 5E Model

    Science.gov (United States)

    Scott, Timothy P.; Schroeder, Carolyn; Tolson, Homer; Huang, Tse-Yang; Williams, Omah M.

    2014-01-01

    The Center for Mathematics and Science Education at Texas A&M University contracted with Region 4 Education Service Center (ESC) and a large, diverse school district to conduct a longitudinal study from 2005-2009. The state achievement test scores of 5th graders who were taught using a Grade 5 science textbook designed by Region 4 ESC were…

  7. The Performance of the European Market for Corporate Control : Evidence from the 5th Takeover Wave

    NARCIS (Netherlands)

    Martynova, M.; Renneboog, L.D.R.

    2006-01-01

    For the 5th takeover wave, European M&As were expected to create significant takeover value: the announcement reactions were strongly positive for target shareholders (more than 35%) and the bidding shareholders also expected to gain a small though significant increase in market value of 0.5%.While,

  8. The Performance of the European Market for Corporate Control : Evidence from the 5th Takeover Wave

    NARCIS (Netherlands)

    Martynova, M.; Renneboog, L.D.R.

    2006-01-01

    Abstract: For the 5th takeover wave, European M&As were expected to create significant takeover value: the announcement reactions were strongly positive for target shareholders (more than 8%) and the bidding shareholders also expected to gain a small though significant increase in market value of

  9. 5th World Congress on ADHD: From Child to Adult Disorder

    Directory of Open Access Journals (Sweden)

    Goryacheva T.G.

    2016-02-01

    Full Text Available The article concerns the 5th World ADHD Congress, organized by the World Federation of ADHD in May 2015. It informs about the lectures, symposia and discussions of diagnostics and differential diagnostics of ADHD, as well as issues, concerning intervention programs.

  10. 5th International scientific-research conference Radioactive waste management. Collection of abstracts

    International Nuclear Information System (INIS)

    2005-01-01

    Materials of the 5-th International scientific-research conference Radioactive waste management are represented. Reports illustrate such problems as experience of nuclear power plant exploitation connected with radioactive waste management, technologies and actions on decrease of radioactive waste volumes, decontamination of equipment and nuclear power plant units, management with radioactive wastes during nuclear power plant decommission [ru

  11. Analytical determination of 5th-order transfer matrices of magnetic quadrupole fringing fields

    International Nuclear Information System (INIS)

    Hartmann, B.; Irnich, H.; Wollnik, H.

    1993-01-01

    The fringing-field effects on particle trajectories in magnetic quadrupoles are described to 5th order by fringing-field integrals. It is shown that this method improves the description of fringing-field effects noticeably over the so far known use of third-order fringing-field integrals. (Author)

  12. A study to design the emergency reaction plan for LPG tanks in 5 th ...

    African Journals Online (AJOL)

    PROMOTING ACCESS TO AFRICAN RESEARCH ... On the other hand, today, with increased density and proximity of industrial units, the adverse consequences ... This study aims to identify the risks in LPG storage unit, 5th South Pars Gas Refinery and possible events ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  13. Vocabulary and Syntactic Knowledge Factors in 5th Grade Students' Reading Comprehension

    Science.gov (United States)

    Mokhtari, Kouider; Niederhauser, Dale S.

    2013-01-01

    In this study, we examined 5th grade students' levels of vocabulary knowledge and syntactic awareness relative to their reading comprehension performance. The aim was to explore the contributions of vocabulary and syntactic awareness as potential sources of reading comprehension difficulty for these readers. Overall, we found that both vocabulary…

  14. Silicon Photonics Integrated Circuits for 5th Generation mm-Wave Wireless Communications

    DEFF Research Database (Denmark)

    Rommel, Simon; Vegas Olmos, Juan José; Tafur Monroy, Idelfonso

    Hybrid photonic-wireless transmission schemes in the mm-wave frequency are promising candidates to enable the multi-gigabit per second data communications required from wireless and mobile networks of the 5th and future generations. Photonic integration may pave the way to practical applicability...

  15. 78 FR 48869 - Filing Dates for the Massachusetts Special Elections in the 5th Congressional District

    Science.gov (United States)

    2013-08-12

    ... in the 5th Congressional District AGENCY: Federal Election Commission. ACTION: Notice of filing dates... Special Primary and the Special General Election on December 10, 2013, shall file a 12-day Pre-Primary... Elections shall file a 12-day Pre-Primary Report on October 3, 2013; a 12-day Pre- General Report on...

  16. 78 FR 53454 - Filing Dates for the Louisiana Special Elections in the 5th Congressional District

    Science.gov (United States)

    2013-08-29

    ... the 5th Congressional District AGENCY: Federal Election Commission. ACTION: Notice of filing dates for special election. SUMMARY: Louisiana has scheduled a Special General Election on October 19, 2013, to fill... Special General and Special Runoff Elections shall file a 12-day Pre-General Report on October 7, 2013; a...

  17. [Social skills in emergency and critical care professionals of a regional public hospital].

    Science.gov (United States)

    Leal Costa, C; Luján Cebrián, I; Gascón García, J; Ferrer Villalonga, L; Van-der Hofstadt Román, C J

    2010-01-01

    To assess the social skills of health care professionals in the emergency and critical care units of the regional hospital Vega Baja and analyze the association between a series of sociodemographic and professionals variables and social skills. A cross-sectional, descriptive study. Two evaluation tools were used. These included a sociodemographic and professional variables questionnaire, and the Elena Gismero's Social Skills Scale (SSS). A response rate of 82.6% was obtained. Considering the standards made by the author in SSS validation, it can be seen that the sample has obtained a medium-high score in each one of the aspects. Significant differences have been found when considering the sociodemographic variable gender as an independent variable with the complete score of SSS (F=6.555; p=0.013), and with the scale dimensions, self-expression in social situations (F=4.468; p=0.039) and making a demand (F=7.982; p=0.007). In each one of the SSS dimensions, the sample has obtained a slightly higher score than the standard sample and it within the 50-69 percentile. This indicates the existence of a medium-high level of Social Skill. The doctors score higher than the nurses, although these differences are not statistically significant. Copyright © 2010 Elsevier España, S.L. y SEEIUC. All rights reserved.

  18. Modeling of Teaching 5th-7th-Grade Boys Physical Exercises

    Directory of Open Access Journals (Sweden)

    Т. Г. Абдулхалікова

    2017-09-01

    Full Text Available The research objective is to determine the effectiveness of orthogonal variants of teaching 5th-7th graders physical exercises. Materials and methods. The participants in the research were boys of the 5th grade (n = 32, 6th grade (n = 40, 7th grade (n = 52. To achieve the tasks set, the research used the following methods: analysis of scientific and methodological literature; pedagogical testing, pedagogical observation, timing of educational tasks; pedagogical experiment, medical and biological research methods; methods of mathematical statistics, methods of mathematical experiment planning. In order to achieve the objective set, the research has studied the effect of different variants of the educational process structure, namely: the number of repetitions (х1 and rest intervals (х2 when learning the technique of performing physical exercises. The research has conducted a complete factor experiment of type 22. According to the experiment plan, the 5th-7th graders were divided into training groups. In total, there were 12 experimental groups organized. Research results. The analysis of the regression equations shows that the teaching of physical exercises to the 5th-7th-grade boys is mostly influenced by rest intervals between repetitions (х2. The number of repetitions (х1 has somewhat less influence. The interaction of these factors is insignificant when teaching physical exercises and becomes much more influential only when teaching a switch leg pull-over exercise (х1х2. Conclusions. To increase the effectiveness of teaching 5th-7th graders physical exercises, it is necessary to shorten rest intervals between repetition to 60 s and to reduce the number of repetitions to six. When teaching boys the switch leg pull-over exercise, rest intervals should be increased to 120 s and the number of repetitions — to twelve.

  19. Empowering Children with Adaptive Technology Skills: Careful Engagement in the Digital Information Age

    Directory of Open Access Journals (Sweden)

    Miftachul HUDA

    2017-03-01

    Full Text Available The technological advancement occurring in the world today has a potency to create positive and negative side effects especially on children. The positive side may entail increased empathy and acceptance of diversity through modelling the prosocial behaviours, while the negative can be manifest in aggressive behaviour, risky sexual behaviour, and substance abuse. These challenges pose a need to draw a particular attention to children’s rights of protection and care in relation to the use of technology. This paper sought to critically explore the way in which children adapt technology skills and the way they respond towards media influences. The findings revealed that the adaptive technology skills are needed in providing a considerable guidance for child protection and careful engagement towards digital information as part of their rights to natural growth and development.

  20. Empowering children with adaptive technology skills: Careful engagement in the digital ınformation age

    Directory of Open Access Journals (Sweden)

    Miftachul Huda

    2017-03-01

    Full Text Available The technological advancement occurring in the world today has a potency to create positive and negative side effects especially on children. The positive side may entail increased empathy and acceptance of diversity through modelling the prosocial behaviours, while the negative can be manifest in aggressive behaviour, risky sexual behaviour, and substance abuse. These challenges pose a need to draw a particular attention to children’s rights of protection and care in relation to the use of technology. This paper sought to critically explore the way in which children adapt technology skills and the way they respond towards media influences. The findings revealed that the adaptive technology skills are needed in providing a considerable guidance for child protection and careful engagement towards digital information as part of their rights to natural growth and development.

  1. Geriatric Core Competencies for Family Medicine Curriculum and Enhanced Skills: Care of Elderly

    OpenAIRE

    Charles, Lesley; Triscott, Jean A.C.; Dobbs, Bonnie M.; McKay, Rhianne

    2014-01-01

    Background There is a growing mandate for Family Medicine residency programs to directly assess residents’ clinical competence in Care of the Elderly (COE). The objectives of this paper are to describe the development and implementation of incremental core competencies for Postgraduate Year (PGY)-I Integrated Geriatrics Family Medicine, PGY-II Geriatrics Rotation Family Medicine, and PGY-III Enhanced Skills COE for COE Diploma residents at a Canadian University. Methods Iterative expert panel...

  2. Pronounced impairment of everyday skills and self-care in posterior cortical atrophy.

    Science.gov (United States)

    Shakespeare, Timothy J; Yong, Keir X X; Foxe, David; Hodges, John; Crutch, Sebastian J

    2015-01-01

    Posterior cortical atrophy (PCA) is a neurodegenerative syndrome characterized by progressive visual dysfunction and parietal, occipital, and occipitotemporal atrophy. The aim of this study was to compare the impact of PCA and typical Alzheimer's disease (tAD) on everyday functional abilities and neuropsychiatric status. The Cambridge Behavioural Inventory-Revised was given to carers of 32 PCA and 71 tAD patients. PCA patients showed significantly greater impairment in everyday skills and self-care while the tAD group showed greater impairment in aspects of memory and orientation, and motivation. We suggest that PCA poses specific challenges for those caring for people affected by the condition.

  3. Knowledge, Skills and Experience Managing Tracheostomy Emergencies: A Survey of Critical Care Medicine trainees

    LENUS (Irish Health Repository)

    Nizam, AA

    2016-10-01

    Since the development of percutaneous tracheostomy, the number of tracheostomy patients on hospital wards has increased. Problems associated with adequate tracheostomy care on the wards are well documented, particularly the management of tracheostomy-related emergencies. A survey was conducted among non-consultant hospital doctors (NCHDs) starting their Critical Care Medicine training rotation in a university affiliated teaching hospital to determine their basic knowledge and skills in dealing with tracheostomy emergencies. Trainees who had received specific tracheostomy training or who had previous experience of dealing with tracheostomy emergencies were more confident in dealing with such emergencies compared to trainees without such training or experience. Only a minority of trainees were aware of local hospital guidelines regarding tracheostomy care. Our results highlight the importance of increased awareness of tracheostomy emergencies and the importance of specific training for Anaesthesia and Critical Care Medicine trainees.

  4. Physicians' professionalism at primary care facilities from patients' perspective: The importance of doctors' communication skills.

    Science.gov (United States)

    Sari, Merry Indah; Prabandari, Yayi Suryo; Claramita, Mora

    2016-01-01

    Professionalism is the core duty of a doctor to be responsible to the society. Doctors' professionalism depicts an internalization of values and mastery of professionals' standards as an important part in shaping the trust between doctors and patients. Professionalism consists of various attributes in which current literature focused more on the perspective of the health professionals. Doctors' professionalism may influence patients' satisfaction, and therefore, it is important to know from the patients' perspectives what was expected of medical doctors' professionalism. This study was conducted to determine the attributes of physician professionalism from the patient's perspective. This was a qualitative research using a phenomenology study design. In-depth interviews were conducted with 18 patients with hypertension and diabetes who had been treated for at least 1 year in primary care facilities in the city of Yogyakarta, Indonesia. The results of the interview were transcribed, encoded, and then classified into categories. Communication skills were considered as the top priority of medical doctors' attributes of professionalism in the perspectives of the patients. This study revealed that communication skill is the most important aspects of professionalism which greatly affected in the process of health care provided by the primary care doctors. Doctor-patient communication skills should be intensively trained during both basic and postgraduate medical education.

  5. Physicians′ professionalism at primary care facilities from patients′ perspective: The importance of doctors′ communication skills

    Directory of Open Access Journals (Sweden)

    Merry Indah Sari

    2016-01-01

    Full Text Available Background: Professionalism is the core duty of a doctor to be responsible to the society. Doctors′ professionalism depicts an internalization of values and mastery of professionals′ standards as an important part in shaping the trust between doctors and patients. Professionalism consists of various attributes in which current literature focused more on the perspective of the health professionals. Doctors′ professionalism may influence patients′ satisfaction, and therefore, it is important to know from the patients′ perspectives what was expected of medical doctors′ professionalism. Objective: This study was conducted to determine the attributes of physician professionalism from the patient′s perspective. Materials and Methods: This was a qualitative research using a phenomenology study design. In-depth interviews were conducted with 18 patients with hypertension and diabetes who had been treated for at least 1 year in primary care facilities in the city of Yogyakarta, Indonesia. The results of the interview were transcribed, encoded, and then classified into categories. Results: Communication skills were considered as the top priority of medical doctors′ attributes of professionalism in the perspectives of the patients. Conclusion: This study revealed that communication skill is the most important aspects of professionalism which greatly affected in the process of health care provided by the primary care doctors. Doctor-patient communication skills should be intensively trained during both basic and postgraduate medical education.

  6. Family Physicians May Benefit From Cognitive Behavioral Therapy Skills in Primary Care Setting.

    Directory of Open Access Journals (Sweden)

    Omer Serkan Turan

    2017-08-01

    Full Text Available Dr Francis Peabody commented that the swing of the pendulum toward specialization had reached its apex, and that modern medicine had fragmented the health care delivery system too greatly. Thus the system was in need of a generalist physician to provide comprehensive personalized care. Family physician is the perfect candidate to fill the gap which Dr Peabody once speaks of and grants biopsychosocial model as its main philosophy. Biopsychosocial model proposes physician to consider multiple aspects of patient's life in order to manage disease. Behavioral pathogens such as poor diet, lack of physical activity, stress, substance abuse, unsafe sexual activity, inadequate emotional support, nonadherence to medical advice contribute to disease progress. Family physician can guide patient like a coach to obtain higher levels in Maslow’s hierarchy of needs as biopsychosocial model suggests and obtain the change in behavior towards a healthier life with using cognitive behavioral therapy skills. So family physician, biopsychosocial model and cognitive behavioral skills are three pillars of comprehensive personalized care and family physicians having these skill sets can be very helpful in making positive changes in the life of the patient. [JCBPR 2017; 6(2.000: 98-100

  7. Factors that determine the use of skilled care during delivery in India: implications for achievement of MDG-5 targets.

    Science.gov (United States)

    Hazarika, Indrajit

    2011-11-01

    The objective of this study is to identify individual level factors that determine the use of skilled birth attendants in India. Data from the cross-sectional, population-based NFHS 3 Survey 2005-06 was used. A sample of 31,797 women, aged 15-49 years, who gave births in the 3 months preceding the survey and for whom information was available on most variables, were included in the analysis. Both bivariate and multivariate techniques were used to determine factors associated with the use of skilled attendants at birth. In the study we found that wealth is one of the strongest determinants of skilled birth attendant use, with the poor being at a disadvantage. There are significant differences in the use of skilled delivery care among the urban and rural populations in India. Women in urban areas are more likely to use skilled attendants. Muslim women and women with lower levels of education are also less likely to avail skilled delivery services. The use of skilled care depended significantly on the place of delivery. Women who gave history of antenatal visits were more likely to have skilled attendants at birth. Our analysis demonstrates that there are several financial, social, regional and cultural barriers to skilled birth attendant use in India. Effective strategies need to be planned to generate demand for skilled birth attendants and reduce barriers to care seeking, especially among rural poor.

  8. Identifying Challenges Associated With the Care Transition Workflow From Hospital to Skilled Home Health Care: Perspectives of Home Health Care Agency Providers.

    Science.gov (United States)

    Nasarwanji, Mahiyar; Werner, Nicole E; Carl, Kimberly; Hohl, Dawn; Leff, Bruce; Gurses, Ayse P; Arbaje, Alicia I

    2015-01-01

    Older adults discharged from the hospital to skilled home health care (SHHC) are at high risk for experiencing suboptimal transitions. Using the human factors approach of shadowing and contextual inquiry, we studied the workflow for transitioning older adults from the hospital to SHHC. We created a representative diagram of the hospital to SHHC transition workflow, we examined potential workflow variations, we categorized workflow challenges, and we identified artifacts developed to manage variations and challenges. We identified three overarching challenges to optimal care transitions-information access, coordination, and communication/teamwork. Future investigations could test whether redesigning the transition from hospital to SHHC, based on our findings, improves workflow and care quality.

  9. The relationship between intraoperative teamwork and management skills in patient care.

    Science.gov (United States)

    Phitayakorn, Roy; Minehart, Rebecca D; Hemingway, Maureen W; Pian-Smith, May C M; Petrusa, Emil

    2015-11-01

    Optimal team performance in the operating room (OR) requires a combination of interactions among OR professionals and adherence to clinical guidelines. Theoretically, it is possible that OR teams could communicate very well but fail to follow acceptable standards of patient care and vice versa. OR simulations offer an ideal research environment to study this relationship. The goal of this study was to determine the relationship between ratings of OR teamwork and communication with adherence to patient care guidelines in a simulated scenarios of malignant hyperthermia (MH). An interprofessional research team (2 anesthesiologists, 1 surgeon, an OR nurse, and a social scientist) reviewed videos of 5 intraoperative teams managing a simulated patient who manifested MH while undergoing general anesthesia for an epigastric herniorraphy in a high-fidelity, in situ OR. Participant teams consisted of 2 residents from anesthesiology, 1 from surgery, 1 OR nurse, and 1 certified surgical technician. Teamwork and communication were assessed with 4 published tools: Anesthesiologists' Non-Technical Skills (ANTS), Scrub Practitioners List of Intra-operative Non-Technical Skills (SPLINTS), Non-Technical Skills for Surgeons (NOTSS), and Objective Teamwork Assessment System (OTAS). We developed an evidence-based MH checklist to assess overall patient care. Interrater agreement for teamwork tools was moderate. Average rater agreement was 0.51 For ANTS, 0.67 for SPLINTS, 0.51 for NOTSS, and 0.70 for OTAS. Observer agreement for the MH checklist was high (0.88). Correlations between teamwork and MH checklist were not significant. Teams were different in percent of the MH actions taken (range, 50-91%; P = .006). In this pilot study, intraoperative teamwork and communication were not related to overall patient care management. Separating nontechnical and technical skills when teaching OR teamwork is artificial and may even be damaging, because such an approach could produce teams with

  10. Evaluation of Medication-related Self-care Skills in Patients With Cystic Fibrosis.

    Science.gov (United States)

    Lewis, Kelsey Lackey; John, Barnabas; Condren, Michelle; Carter, Sandra M

    2016-01-01

    BACKGROUND: As the life expectancy of patients with cystic fibrosis (CF) increases, the focus on ensuring success with medication therapies is increasingly important. The ability of patients to autonomously manage medications and related therapies is poorly described in the literature. OBJECTIVE: The goal of this project was to assess the level of medication-related knowledge and self-care skills in patients with CF. METHODS: This project took place in a Cystic Fibrosis Foundation accredited affiliate center. Eighty-nine patients between the ages of 6 and 60 were eligible to participate based on inclusion and exclusion criteria. Pharmacists administered a 16-item questionnaire and detailed medication history during clinic visits from January through May 2014. RESULTS: Forty-five patients 6 to 41 years old participated in the study. The skills most often performed independently were preparing nebulizer treatments (85%) and telling someone if they feel their medicines are causing a problem (89%). Skills least often performed were carrying a medication list (82%) and bringing a medication list to appointments (76%). In respondents 21 years of age and older, less than 75% of respondents were involved with obtaining financial resources, maintaining equipment, carrying a medication list, or rinsing their mouth after using inhaled medicines. Participants were able to provide drug name, dose, and frequency of use for pancreatic enzymes and azithromycin 37% and 24% of the time, respectively. CONCLUSIONS: In the population surveyed, many medication-related skills had not been acquired by early adulthood. Assessing and providing education for medication-related self-care skills at all ages are needed.

  11. Critical appraisal skills training for health care professionals: a randomized controlled trial [ISRCTN46272378

    Directory of Open Access Journals (Sweden)

    Ewings Paul E

    2004-12-01

    Full Text Available Abstract Introduction Critical appraisal skills are believed to play a central role in an evidence-based approach to health practice. The aim of this study was to evaluate the effectiveness and costs of a critical appraisal skills educational intervention aimed at health care professionals. Methods This prospective controlled trial randomized 145 self-selected general practitioners, hospital physicians, professions allied to medicine, and healthcare managers/administrators from the South West of England to a half-day critical appraisal skills training workshop (based on the model of problem-based small group learning or waiting list control. The following outcomes were assessed at 6-months follow up: knowledge of the principles necessary for appraising evidence; attitudes towards the use of evidence about healthcare; evidence seeking behaviour; perceived confidence in appraising evidence; and ability to critically appraise a systematic review article. Results At follow up overall knowledge score [mean difference: 2.6 (95% CI: 0.6 to 4.6] and ability to appraise the results of a systematic review [mean difference: 1.2 (95% CI: 0.01 to 2.4] were higher in the critical skills training group compared to control. No statistical significant differences in overall attitude towards evidence, evidence seeking behaviour, perceived confidence, and other areas of critical appraisal skills ability (methodology or generalizability were observed between groups. Taking into account the workshop provision costs and costs of participants time and expenses of participants, the average cost of providing the critical appraisal workshops was approximately £250 per person. Conclusions The findings of this study challenge the policy of funding 'one-off' educational interventions aimed at enhancing the evidence-based practice of health care professionals. Future evaluations of evidence-based practice interventions need to take in account this trial's negative findings

  12. A model linking clinical workforce skill mix planning to health and health care dynamics

    Directory of Open Access Journals (Sweden)

    McDonnell Geoff

    2010-04-01

    Full Text Available Abstract Background In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Methods Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. Results We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. Conclusion We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.

  13. A model linking clinical workforce skill mix planning to health and health care dynamics.

    Science.gov (United States)

    Masnick, Keith; McDonnell, Geoff

    2010-04-30

    In an attempt to devise a simpler computable tool to assist workforce planners in determining what might be an appropriate mix of health service skills, our discussion led us to consider the implications of skill mixing and workforce composition beyond the 'stock and flow' approach of much workforce planning activity. Taking a dynamic systems approach, we were able to address the interactions, delays and feedbacks that influence the balance between the major components of health and health care. We linked clinical workforce requirements to clinical workforce workload, taking into account the requisite facilities, technologies, other material resources and their funding to support clinical care microsystems; gave recognition to productivity and quality issues; took cognisance of policies, governance and power concerns in the establishment and operation of the health care system; and, going back to the individual, gave due attention to personal behaviour and biology within the socio-political family environment. We have produced the broad endogenous systems model of health and health care which will enable human resource planners to operate within real world variables. We are now considering the development of simple, computable national versions of this model.

  14. Safe delivery care practices in western Nepal: Does women’s autonomy influence the utilization of skilled care at birth?

    Science.gov (United States)

    Kutty, V. Raman; Sarma, P. Sankara; Dangal, Ganesh

    2017-01-01

    Despite various efforts to increase the utilization of skilled birth attendants (SBA), nearly two-thirds of deliveries take place at home without the assistance of SBAs in Nepal. We hypothesized that the ability of women to take decisions about their own lives—women’s autonomy—plays an important part in birth choices. To know this, we conducted a community-based cross-sectional study for assessing women’s autonomy and utilization of safe delivery care service in Kapilvastu district of Nepal from June to October 2014. We used multivariate modeling to associate socioeconomic factors and women’s autonomy with the utilization of safe delivery care services. Just over one-third of women sought institutional delivery care during the birth of their last child. Out of the total deliveries at health facilities, nearly 58% women visited health facility for self-reported emergency obstructive care. Only 6.2% home deliveries were handled by health workers and 14.7% women used the safe delivery kit for home delivery care. Higher levels of women’s education had a strong positive association (odds ratio = 24.11, CI = 9.43–61.64) with institutional delivery care. Stratified analysis showed that when the husband is educated, women’s education seems to work partly through their autonomy in decision making. Educational status of women emerged as one of the key predictors of the utilization of delivery care services in Kapilvastu district. Economic status of household and husband’s education are other dominant predictors of the utilization of safe delivery care services. Improving the economic and educational status may be the way out for improving the proportion of institutional deliveries. Women’s autonomy may be an important mediating factor in this pathway. PMID:28771579

  15. Safe delivery care practices in western Nepal: Does women's autonomy influence the utilization of skilled care at birth?

    Science.gov (United States)

    Bhandari, Tulsi Ram; Kutty, V Raman; Sarma, P Sankara; Dangal, Ganesh

    2017-01-01

    Despite various efforts to increase the utilization of skilled birth attendants (SBA), nearly two-thirds of deliveries take place at home without the assistance of SBAs in Nepal. We hypothesized that the ability of women to take decisions about their own lives-women's autonomy-plays an important part in birth choices. To know this, we conducted a community-based cross-sectional study for assessing women's autonomy and utilization of safe delivery care service in Kapilvastu district of Nepal from June to October 2014. We used multivariate modeling to associate socioeconomic factors and women's autonomy with the utilization of safe delivery care services. Just over one-third of women sought institutional delivery care during the birth of their last child. Out of the total deliveries at health facilities, nearly 58% women visited health facility for self-reported emergency obstructive care. Only 6.2% home deliveries were handled by health workers and 14.7% women used the safe delivery kit for home delivery care. Higher levels of women's education had a strong positive association (odds ratio = 24.11, CI = 9.43-61.64) with institutional delivery care. Stratified analysis showed that when the husband is educated, women's education seems to work partly through their autonomy in decision making. Educational status of women emerged as one of the key predictors of the utilization of delivery care services in Kapilvastu district. Economic status of household and husband's education are other dominant predictors of the utilization of safe delivery care services. Improving the economic and educational status may be the way out for improving the proportion of institutional deliveries. Women's autonomy may be an important mediating factor in this pathway.

  16. Axial geometrical aberration correction up to 5th order with N-SYLC.

    Science.gov (United States)

    Hoque, Shahedul; Ito, Hiroyuki; Takaoka, Akio; Nishi, Ryuji

    2017-11-01

    We present N-SYLC (N-fold symmetric line currents) models to correct 5th order axial geometrical aberrations in electron microscopes. In our previous paper, we showed that 3rd order spherical aberration can be corrected by 3-SYLC doublet. After that, mainly the 5th order aberrations remain to limit the resolution. In this paper, we extend the doublet to quadruplet models also including octupole and dodecapole fields for correcting these higher order aberrations, without introducing any new unwanted ones. We prove the validity of our models by analytical calculations. Also by computer simulations, we show that for beam energy of 5keV and initial angle 10mrad at the corrector object plane, beam size of less than 0.5nm is achieved at the corrector image plane. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5): Background and rationale.

    Science.gov (United States)

    Davis, Gavin A; Purcell, Laura; Schneider, Kathryn J; Yeates, Keith Owen; Gioia, Gerard A; Anderson, Vicki; Ellenbogen, Richard G; Echemendia, Ruben J; Makdissi, Michael; Sills, Allen; Iverson, Grant L; Dvořák, Jiří; McCrory, Paul; Meeuwisse, Willem; Patricios, Jon; Giza, Christopher C; Kutcher, Jeffrey S

    2017-06-01

    This article presents the Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5). The Sport Concussion Assessment Tool was introduced in 2004, following the 2nd International Conference on Concussion in Sport in Prague, Czech Republic. Following the 4th International Consensus Conference, held in Zurich, Switzerland, in 2012, the SCAT 3rd edition (Child SCAT3) was developed for children aged between 5 and12 years. Research to date was reviewed and synthesised for the 5th International Consensus Conference on Concussion in Sport in Berlin, Germany, leading to the current revision of the test, the Child SCAT5. This article describes the development of the Child SCAT5. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. The Sport Concussion Assessment Tool 5th Edition (SCAT5): Background and rationale.

    Science.gov (United States)

    Echemendia, Ruben J; Meeuwisse, Willem; McCrory, Paul; Davis, Gavin A; Putukian, Margot; Leddy, John; Makdissi, Michael; Sullivan, S John; Broglio, Steven P; Raftery, Martin; Schneider, Kathryn; Kissick, James; McCrea, Michael; Dvořák, Jiří; Sills, Allen K; Aubry, Mark; Engebretsen, Lars; Loosemore, Mike; Fuller, Gordon; Kutcher, Jeffrey; Ellenbogen, Richard; Guskiewicz, Kevin; Patricios, Jon; Herring, Stanley

    2017-06-01

    This paper presents the Sport Concussion Assessment Tool 5th Edition (SCAT5), which is the most recent revision of a sport concussion evaluation tool for use by healthcare professionals in the acute evaluation of suspected concussion. The revision of the SCAT3 (first published in 2013) culminated in the SCAT5. The revision was based on a systematic review and synthesis of current research, public input and expert panel review as part of the 5th International Consensus Conference on Concussion in Sport held in Berlin in 2016. The SCAT5 is intended for use in those who are 13 years of age or older. The Child SCAT5 is a tool for those aged 5-12 years, which is discussed elsewhere. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. The influence of maltreatment history and out-of-home-care on children's language and social skills.

    Science.gov (United States)

    Lum, Jarrad A G; Powell, Martine; Snow, Pamela C

    2018-02-01

    This study examined the extent to which maltreatment history and the characteristics of out-of-home care correlated with the language and social skills of maltreated children. Participants in this study were 82 maltreated children aged between 5 and 12 years of age. All children were residing with state-designated carers in out-of-home-care. The children were presented with standardised tests assessing language and social skills. Results showed that the sample performed significantly below the normative mean on both tests. Correlation analyses showed social skills, but not language skills were correlated with aspects of maltreatment history. The education level of the state-designated carer/s was correlated with the children's language skills; higher education level was associated with higher language skills. The study provides evidence that at the group level, language and social skills are poor in maltreated children. However, gains in language skills might be made via the out-of-home-care environment. Improvements in the social skills of maltreated children may require additional support. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  20. PREFACE: 5th International Conference on Materials and Applications for Sensors and Transducers (IC-MAST2015)

    Science.gov (United States)

    Hristoforou, E.; Vlachos, D. S.; Giouroudi, I.; Kar-Narayan, S.; Potirakis, S.

    2016-03-01

    The 5th International Conference on Materials and Applications for Sensors and Transducers, Mykonos island, Greece, hosted about 110 oral and poster papers and more than 90 participants. IC-MAS, as an international annual conference which tries to meet the needs for various types of sensors, particularly those which may be manufactured by low cost methods (i.e. hybrid sensors, smart specialization devices, particular applications not necessarily requiring integrated micro-nano technologies), covering all types of materials and physical effects, appears to be a necessity. IC-MAST has been established as a high quality international conference by: I. Gathering together multinational researchers from all over the world, working in different materials for sensors and transducers and technical applications of sensors, but also in some cases in the management of the data coming from sensors and transducers. The careful selection of the conference place (like Aegean Sea, Budapest, Prague, Bilbao, Mykonos etc) allows for enjoying the local hospitality and sightseeing. II. Emphasizing in hybrid sensors and smart specialization devices produced by inexpensive methods, without excluding of course micro-nano technology, from all kinds of solid state, liquid and gaseous materials, as well as in particular transducer applications (design and development, as well as use of sensing data) III. Innovatively implementing the Virtual Paper Concept, allowing for large impact of research works presented in the conference by authors who either have no time or no funding support for visiting a conference; this year more than 12 virtual papers are presented in the 5th IC MAST, following a standardized procedure via the our robust and reliable Conference Site (www.icmast.net!) > IV. Allowing for lengthy technical and managerial discussions in terms of sensor, material and instrumentation development; furthermore, the different research groups gathered together are offered the particular

  1. Preface to Special Topic: Selected Papers from the 5th International Conference on Optofluidics

    OpenAIRE

    Fan, Shih-Kang; Yang, Zhenchuan

    2016-01-01

    The 5th International Conference on Optofluidics (Optofluidics 2015) was held in Taipei, Taiwan, July 26–29, 2015. The aim of this conference was to provide a forum to promote scientific exchange and to foster closer networks and collaborative ties between leading international researchers in optics and micro/nanofluidics across various disciplines. The scope of Optofluidics 2015 was deliberately broad and interdisciplinary, encompassing the latest advances and the most innovat...

  2. Mathematics Anxiety Among 4th And 5th Grade Turkish Elementary School Students

    OpenAIRE

    Fulya Yüksel-Şahin

    2008-01-01

    Using a sample of 4th and 5th graders, this study investigated whether students’ mathematics anxiety differed significantly according to a group of variables. A total of 249 students participated in the study. “The Mathematics Anxiety Scale for Elementary School Students” and “The Personal Information Form” were used for data collection. Independent samples t-tests, Oneway Anova and Schefee test were used to analyze the data. Results showed that students’ mathematics anxiety differed signific...

  3. Investigation of radioactivities on the wood samples taken from a fishing boat, the 5th Sumiyoshimaru

    International Nuclear Information System (INIS)

    Shizuma, Kiyoshi; Iwatani, Kazuo; Hasai, Hiromi

    1991-01-01

    Radioactivity survey has been performed on samples taken from a fishing boat, the 5th Sumiyoshimaru. This boat has been presumed to be exposed to the fallout of Bikini hydrogen bomb test. Gamma-ray measurements have been carried out for six wood samples and two soil samples. Since the 137 Cs concentration estimated for all samples were comparable to the fallout of the nuclear test, it was hard to judge whether the boat was definitely exposed to the Bikini fallout. (author)

  4. An Investigation of Science and Technology Teachers’ Views on the 5th Grade Science Course

    OpenAIRE

    İkramettin Daşdemir

    2014-01-01

    This study was conducted to explore the science and technology teachers’ views on the implementation of 5th grade science course. Open-ended questions were used as a data collection tool. The study sample consisted of 28 science and technology teachers working in Erzurum in 2012-2013 education year. The data gathered were analysed via content analysis method. According to the results obtained from the open-ended questions, a great majority of science and technology teache...

  5. 5th European Conference of the International Federation for Medical and Biological Engineering

    CERN Document Server

    European IFMBE MBEC : Cooperation for Effective Healthcare

    2012-01-01

    This volume presents the 5th European Conference of the International Federation for Medical and Biological Engineering (EMBEC),  held in Budapest, 14-18 September, 2011. The scientific discussion on the conference and in this conference proceedings include the following issues: - Signal & Image Processing - ICT - Clinical Engineering and Applications - Biomechanics and Fluid Biomechanics - Biomaterials and Tissue Repair - Innovations and Nanotechnology - Modeling and Simulation - Education and Professional

  6. Investigation of radioactivities on the wood samples taken from a fishing boat, the 5th Sumiyoshimaru

    Energy Technology Data Exchange (ETDEWEB)

    Shizuma, Kiyoshi; Iwatani, Kazuo; Hasai, Hiromi (Hiroshima Univ., Higashi-Hiroshima (Japan). Faculty of Engineering)

    1991-03-01

    Radioactivity survey has been performed on samples taken from a fishing boat, the 5th Sumiyoshimaru. This boat has been presumed to be exposed to the fallout of Bikini hydrogen bomb test. Gamma-ray measurements have been carried out for six wood samples and two soil samples. Since the {sup 137}Cs concentration estimated for all samples were comparable to the fallout of the nuclear test, it was hard to judge whether the boat was definitely exposed to the Bikini fallout. (author).

  7. Intensive care nursing students' perceptions of simulation for learning confirming communication skills: A descriptive qualitative study.

    Science.gov (United States)

    Karlsen, Marte-Marie Wallander; Gabrielsen, Anita Kristin; Falch, Anne Lise; Stubberud, Dag-Gunnar

    2017-10-01

    The aim of this study was to explore intensive care nursing students experiences with confirming communication skills training in a simulation-based environment. The study has a qualitative, exploratory and descriptive design. The participants were students in a post-graduate program in intensive care nursing, that had attended a one day confirming communication course. Three focus group interviews lasting between 60 and 80min were conducted with 14 participants. The interviews were transcribed verbatim. Thematic analysis was performed, using Braun & Clark's seven steps. The analysis resulted in three main themes: "awareness", "ice-breaker" and "challenging learning environment". The participants felt that it was a challenge to see themselves on the video-recordings afterwards, however receiving feedback resulted in better self-confidence in mastering complex communication. The main finding of the study is that the students reported improved communication skills after the confirming communication course. However; it is uncertain how these skills can be transferred to clinical practice improving patient outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Geriatric core competencies for family medicine curriculum and enhanced skills: care of elderly.

    Science.gov (United States)

    Charles, Lesley; Triscott, Jean A C; Dobbs, Bonnie M; McKay, Rhianne

    2014-06-01

    There is a growing mandate for Family Medicine residency programs to directly assess residents' clinical competence in Care of the Elderly (COE). The objectives of this paper are to describe the development and implementation of incremental core competencies for Postgraduate Year (PGY)-I Integrated Geriatrics Family Medicine, PGY-II Geriatrics Rotation Family Medicine, and PGY-III Enhanced Skills COE for COE Diploma residents at a Canadian University. Iterative expert panel process for the development of the core competencies, with a pre-defined process for implementation of the core competencies. Eighty-five core competencies were selected overall by the Working Group, with 57 core competencies selected for the PGY-I/II Family Medicine residents and an additional 28 selected for the PGY-III COE residents. The core competencies follow the CanMEDS Family Medicine roles. Both sets of core competencies are based on consensus. Due to demographic changes, it is essential that Family Physicians have the required skills and knowledge to care for the frail elderly. The core competencies described were developed for PGY-I/II Family Medicine residents and PGY-III Enhanced Skills COE, with a focus on the development of geriatric expertise for those patients that would most benefit.

  9. Nephrologists and Integrated Kidney Disease Care: Roles and Skills Essential for Nephrologists for Future Success.

    Science.gov (United States)

    Nissenson, Allen R; Maddux, Franklin W

    2017-07-01

    As the costs of caring for patients with end-stage renal disease have grown, so has the pressure to provide high-quality care at a lower cost. Prompted in large part by regulatory and legislative changes, reimbursement is shifting from a fee-for-service environment to one of value-based payment models. Nephrologists in this new environment are increasingly responsible not only for direct patient care, but also for population management and the associated clinical outcomes for this vulnerable population. This Perspective article aims to recognize the key role and skills needed in order to successfully practice within these new value-based care models. The new paradigm of delivering and financing care also presents opportunities for nephrologists to shape how care is delivered, define meaningful quality metrics, and share in the financial outcomes of these approaches. Though it will take time, the training and mind-set of nephrologists must evolve to accommodate these expanded practice expectations required by a system that demands measurement, reporting, accountability, and improvement, not only for individuals but also for populations of patients. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  10. The Factor Structure of Coordination Abilities Development in 5th-7th Grade Boys

    Directory of Open Access Journals (Sweden)

    В. В. Приходько

    2017-12-01

    Full Text Available The objective is to determine the structure of coordination abilities development in 5th-7th grade boys. Materials and methods. The participants in the study were boys of the 5th grade (n=21, 6th grade (n=20, and 7th grade (n=19. The paper used analysis and generalization of the scientific and methodological literature data, general scientific methods of theoretical level, namely: analogy, analysis, synthesis, abstracting, induction, as well as general scientific methods of empirical level: observation, testing, experiment. To evaluate of the motor preparedness, the results of motor tests, height and body weight were recorded. The materials of the study were processed in the statistical analysis program IBM SPSS 20. Factor analysis was carried out using a model of the principal components with the rotation method: Variamax with Kaiser normalization. Results. Analysis of the similarities shows that the most informative in the structure of the 5th grade boys’ motor preparedness are Test 9 “Static Equilibrium Evaluation by E. Ya. Bondarevsky’s Method” (,999, Test 2 “Standing Long Jump (cm” (,998, Test 10 “Dynamic Equilibrium Evaluation by Bess Method” (,916; for the 6th grade boys such are Test 9 “Static Equilibrium Evaluation by E. Ya. Bondarevsky’s Method” (1.0, Test 2 “Standing Long Jump (cm” (,999, Test 5 “Sit-Up for 30 sec.” (,968, Test 10 “Dynamic Equilibrium Evaluation by Bess Method” (,918; for the 7th grade boys such are Test 2 “Standing Long Jump (cm” (,994, Test 9 “Static Equilibrium Evaluation by E. Ya. Bondarevsky’s Method” (,987, Test 10 “Dynamic Equilibrium Evaluation by Bess Method” (,945. Conclusions. The most informative in the structure of 5th-7th grade boys’ coordination abilities is vestibular tolerance. For pedagogical control of 5th-7th grade boys’ motor preparedness the following can be recommended: Test 2 “Standing Long Jump (cm”, Test 9 “Static Equilibrium

  11. Challenges for Nurses Caring for Individuals with Peripherally Inserted Central Catheters in Skilled Nursing Facilities.

    Science.gov (United States)

    Harrod, Molly; Montoya, Ana; Mody, Lona; McGuirk, Helen; Winter, Suzanne; Chopra, Vineet

    2016-10-01

    To understand the perceived preparedness of frontline nurses (registered nurses (RNs), licensed practical nurses (LPNs)), unit nurse managers, and skilled nursing facility (SNF) administrators in providing care for residents with peripherally inserted central catheters (PICCs) in SNFs. Exploratory, qualitative pilot study. Two community based SNFs. Residents with PICCs, frontline nurses (RNs, LPNs), unit nurse managers, and SNF administrators. Over 36 weeks, 56 residents with PICCs and their nurses were observed and informally interviewed, focusing on PICC care practices and documentation. In addition, baseline PICC data were collected on placement indication (e.g., antimicrobial administration), placement setting (hospital vs SNF), and dwell time. Focus groups were then conducted with frontline nurses and unit nurse managers, and semistructured interviews were conducted with SNF administrators to evaluate perceived preparedness for PICC care. Data were analyzed using a descriptive analysis approach. Variations in documentation were observed during weekly informal interviews and observations. Differences were noted between resident self-reported PICC concerns (quality of life) and those described by frontline nurses. Deficiencies in communication between hospitals and SNFs with respect to device care, date of last dressing change, and PICC removal time were also noted. During focus group sessions, perceived inadequacy of information at the time of care transitions, limited availability of resources to care for PICCs, and gaps in training and education were highlighted as barriers to improving practice and safety. Practices for PICC care in SNFs can be improved. Multimodal strategies that enhance staff education, improve information exchange during care transitions, and increase resource availability in SNFs appear necessary to enhance PICC care and safety. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  12. Development of skills-based competencies for forensic nurse examiners providing elder abuse care

    Science.gov (United States)

    Du Mont, Janice; Kosa, Daisy; Macdonald, Sheila; Elliot, Shannon; Yaffe, Mark

    2016-01-01

    Objective As a critical step in advancing a comprehensive response to elder abuse built on existing forensic nursing-led hospital-based programmes, we developed a list of skills-based competencies for use in an Elder Abuse Nurse Examiner curriculum. Participants and setting Programme leaders of 30 hospital-based forensic nursing-led sexual assault and domestic violence treatment centres. Primary and secondary outcome measures 149 verbatim recommendations for components of an elder abuse response were identified from a systematic scoping review. In 2 online Delphi consensus survey rounds, these components of care were evaluated by an expert panel for their overall importance to the elder abuse intervention under development and for their appropriateness to the scope of practice of an elder abuse nurse examiner. The components retained after evaluation were translated into skills-based competencies using Bloom's Taxonomy of Learning and, using the Nominal Group Technique, were subsequently reviewed and revised by a subset of members of the expert panel in a consensus meeting. Results Of the 148 recommendations evaluated, 119 were rated as important and achieved consensus or high level of agreement. Of these, 101 were determined to be within the scope of practice of an Elder Abuse Nurse Examiner and were translated into skills-based competencies. Following review and revision by meeting experts, 47 final competencies were organised by content into 5 metacompetencies: documentation, legal and legislative issues; interview with older adult, caregiver and other relevant contacts; assessment; medical and forensic examination; and case summary, discharge plan and follow-up care. Conclusions We determined the skills-based competencies of importance to training forensic nurse examiners to respond to elder abuse in the context of a hospital-based intervention. These findings may have implications for violence and abuse treatment programmes with a forensic nursing component

  13. Appraisal Skills, Health Literacy and the Patient-Provider Relationship: Considerations as the Health Care Consumer Turns to the Internet to Inform their Care.

    Science.gov (United States)

    O'Dell, Rosann

    2012-01-01

    Health care consumers increasingly obtain health information from the Internet to inform their health care; the health care consumer, who also has the role of patient, maintains the right to access information from sources of their choosing for this purpose. However, noteworthy considerations exist including information appraisal skills, health literacy and the patient-provider relationship. Awareness and education are warranted to assist the health care consumer in achieving proficiency as they turn to the Internet for health information.

  14. Assessing and developing critical-thinking skills in the intensive care unit.

    Science.gov (United States)

    Swinny, Betsy

    2010-01-01

    A lot of resources are spent on the development of new staff in the intensive care unit (ICU). These resources are necessary because the environment in the ICU is complex and the patients are critically ill. Nurses need an advanced knowledge base, the ability to accurately define and change priorities rapidly, good communication and teamwork skills, and the ability to work in a stressful environment in order to succeed and give their patients quality care. Critical thinking helps the nurse to navigate the complex and stressful environment of the ICU. Critical thinking includes more than just nursing knowledge. It includes the ability to think through complex, multifaceted problems to anticipate needs, recognize potential and actual complications, and to expertly communicate with the team. A nurse who is able to think critically will give better patient care. Various strategies can be used to develop critical thinking in ICU nurses. Nurse leaders are encouraged to support the development of critical-thinking skills in less experienced staff with the goal of improving the nurse's ability to work in the ICU and improving patient outcomes.

  15. [Migration. Opportunities for recruitment of skilled employees in the care sector].

    Science.gov (United States)

    Braeseke, G; Merda, M; Bauer, T K; Otten, S; Stroka, M A; Talmann, A E

    2013-08-01

    A central objective of this study was to estimate the potential workforce for the elderly care sector in Germany and to compare it with the predicted demand for nurses in 2030. The authors describe the opportunities and obstacles in recruiting skilled professionals from EU member states and from countries outside the EU. Different scenarios of how to raise labor input are discussed so as to determine the domestic potential until 2030 in Germany. The results show that only by assuming unrealistic conditions, e. g., expectations of a high full-time working quota or far more working women, can the domestic potential meet the predicted future demands. Therefore, Germany's chances of attracting skilled foreign workers were assessed by analyzing wage differentials, unemployment probabilities, demographic developments, and professional and cultural aspects between the countries. A major finding study is that the German labor market cannot provide enough nursing care professionals for the elderly care sector by 2030. Secondly, most of the other EU member states are facing similar challenges, at least in the long run. Therefore, it is recommendable to intensify collaboration with populous Asian countries in the future.

  16. Self-perceived competence among medical residents in skills needed to care for patients with advanced dementia versus metastatic cancer.

    Science.gov (United States)

    Manu, Erika; Marks, Adam; Berkman, Cathy S; Mullan, Patricia; Montagnini, Marcos; Vitale, Caroline A

    2012-06-01

    To examine medical residents' perceived competence in caring for patients with dementia we conducted an online survey of all 120 second, third and fourth-year residents in Internal Medicine, Medicine/Pediatrics, and Family Medicine at University of Michigan. A structured survey elicited residents' training, experience, confidence, and perceived career needs for skills in estimating prognosis, symptom management, and communication in caring for patients with dementia, compared to patients with metastatic cancer. Among the 61 (51 %) respondents, a majority report lower confidence in assessing prognosis and eliciting treatment wishes in patients with dementia (vs. metastatic cancer), and in performing skills integral to the care of patients with dementia, including the ability to assess caregiver needs, decisional capacity, advise on place of care, and manage agitation, despite viewing these skills as important to their future careers. These findings support the need for enhanced education on optimal care of patients with advanced dementia.

  17. Medical students can learn the basic application, analytic, evaluative, and psychomotor skills of critical care medicine.

    Science.gov (United States)

    Rogers, P L; Jacob, H; Thomas, E A; Harwell, M; Willenkin, R L; Pinsky, M R

    2000-02-01

    To determine whether fourth-year medical students can learn the basic analytic, evaluative, and psychomotor skills needed to initially manage a critically ill patient. Student learning was evaluated using a performance examination, the objective structured clinical examination (OSCE). Students were randomly assigned to one of two clinical scenarios before the elective. After the elective, students completed the other scenario, using a crossover design. Five surgical intensive care units in a tertiary care university teaching hospital. Forty fourth-year medical students enrolled in the critical care medicine (CCM) elective. All students evaluated a live "simulated critically ill" patient, requested physiologic data from a nurse, ordered laboratory tests, received data in real time, and intervened as they deemed appropriate. Student performance of specific behavioral objectives was evaluated at five stations. They were expected to a) assess airway, breathing, and circulation in appropriate sequence; b) prepare a manikin for intubation, obtain an acceptable airway on the manikin, demonstrate bag-mouth ventilation, and perform acceptable laryngoscopy and intubation; c) provide appropriate mechanical ventilator settings; d) manage hypotension; and e) request and interpret pulmonary artery data and initiate appropriate therapy. OSCEs were videotaped and reviewed by two faculty members masked to time of examination. A checklist of key behaviors was used to evaluate performance. The primary outcome measure was the difference in examination score before and after the rotation. Secondary outcomes included the difference in scores at each rotation. The mean preelective score was 57.0%+/-8.3% compared with 85.9%+/-7.4% (ppsychomotor skills necessary to initially manage critically ill patients. After an appropriate 1-month CCM elective, students' thinking and application skills required to initially manage critically ill patients improved markedly, as demonstrated by an OSCE

  18. Self-assessment of managerial knowledge and skills of medical doctors in primary health care

    Directory of Open Access Journals (Sweden)

    Aida Pilav

    2016-03-01

    Full Text Available Introduction: The aim of this paper was to evaluate the managerial knowledge and skills of mid-level managers – medical doctors in Medical center of the Canton Sarajevo.Methods: A cross-sectional study of the mid-level managers in the Medical center of the Canton Sarajevo was conducted using an originally developed questionnaire for self-assessment of managerial knowledge and skills. The respondents answered each of the questions using a 5-point Likert scale. Apart from the quantitative section, the respondents could present their observations concerning the educational needs in the health care system.Results: Almost 40% of the respondents said that the process of assessing health care needs is not conducted. No statistical significance was observed in the responses according to the length of service in a managerial position. In total, 41% of the respondents were not sure whether a plan exists, even though the development of these plans should be a principal managerial responsibility in the quality management. Managers who were longer in the position reported no plans for corrective actions. This result was in contrast with the answers obtained from the managers who were in the position for a shorter period. In addition, 91% of the respondents said that they regularly discuss problems with their employees.Conclusions: Self- assessment and assessment of managerial competencies should be regular activities in a health care organization, in order to monitor the knowledge and skills, as well as to make the development plans. The results of this study could serve as the basis for planning and developing the health management education in the Canton Sarajevo.

  19. Effects of the 5th and 7th Grade Enhanced Versions of the "keepin' it REAL" Substance Use Prevention Curriculum

    Science.gov (United States)

    Elek, Elvira; Wagstaff, David A.; Hecht, Michael L.

    2010-01-01

    This study assessed the outcomes of adapting the culturally-grounded, middle school, substance-use prevention intervention, "keepin' it REAL" ("kiR"), to target elementary school students and to address acculturation. At the beginning of 5th grade, 29 schools were randomly assigned to conditions obtained by crossing grade of implementation (5th,…

  20. Follow-up evaluation of a course to develop effective communication and relationship skills for palliative care.

    Science.gov (United States)

    Andrew, Jane; Taylor, Cara

    2012-09-01

    This paper reports on a longitudinal follow-up evaluation of an interprofessional experiential course to support the development of effective communication and interpersonal relationship skills in palliative care: 'It's good to listen: advanced communication skills in end of life care'. The course was developed from evidence-based guidance produced by the West of Scotland Cancer Network and NHS Education for Scotland in 2009. The aim of the study was to explore the factors that support or hinder the sustainable integration of skills and learning from the course into clinical practice. Three focus groups were held across the NHS Board area. Following analysis of the transcripts the emergent themes were grouped under four headings; impact on practice, facilitating factors, hindering factors, and organisational issues. The findings suggest that organisations should consider the value they place on supporting interpersonal skills in end-of-life care and how they can enhance sustainability and behavioural change.

  1. Comparison of postarthroplasty functional outcomes in skilled nursing facilities among Medicare and Managed Care beneficiaries

    Directory of Open Access Journals (Sweden)

    Brandon A. Haghverdian, BSc

    2017-12-01

    Full Text Available Background: After home health care, the skilled nursing facility (SNF is the most commonly used postacute care modality, among Medicare beneficiaries, after total joint arthroplasty. Prior studies demonstrated that a loss in postsurgical ambulatory gains is incurred in the interval between hospital discharge and arrival at the SNF. The aim of this present study is to determine the consequences of that loss in function, as well as compare SNF-related outcomes in patients with Medicare vs Managed Care (MC insurance. Methods: We conducted a retrospective analysis of 80 patients (54 Medicare and 26 MC who attended an SNF after hospitalization for total joint arthroplasty. Outcomes from physical therapy records were abstracted from each patient's SNF file. Results: There was an approximately 40% drop-off in gait achievements between hospital discharge and SNF admission. This decline in ambulation was significantly greater in Medicare patients (Medicare: 94.6 ± 123.2 ft, MC: 40.0 ± 48.9 ft, P = .034. Larger reductions in gait achievements between hospital discharge and SNF admission were significantly correlated with longer SNF lengths of stay and poorer gait achievements by SNF discharge. Patients with MC insurance made significant improvements in gait training at the SNF beyond that which was acquired at the hospital, whereas Medicare patients did not (PMedicare = .28, PMC = .003. Conclusions: Large losses in motor function between hospital discharge and SNF admission were associated with poor functional outcomes and longer stays at the SNF. These effects were more pronounced in Medicare patients than those with MC insurance. Keywords: Total joint arthroplasty, Skilled nursing facility, Medicare, Managed Care, Physical therapy

  2. Preface to Special Topic: Selected Papers from the 5th International Conference on Optofluidics.

    Science.gov (United States)

    Fan, Shih-Kang; Yang, Zhenchuan

    2016-01-01

    The 5th International Conference on Optofluidics (Optofluidics 2015) was held in Taipei, Taiwan, July 26-29, 2015. The aim of this conference was to provide a forum to promote scientific exchange and to foster closer networks and collaborative ties between leading international researchers in optics and micro/nanofluidics across various disciplines. The scope of Optofluidics 2015 was deliberately broad and interdisciplinary, encompassing the latest advances and the most innovative developments in micro/nanoscale science and technology. Topics ranged from fundamental research to its applications in chemistry, physics, biology, materials, and medicine.

  3. ROCAM: The 5-th International Edition of Romanian Conference on Advanced Materials. Abstracts

    International Nuclear Information System (INIS)

    Stanculescu, Florin

    2006-01-01

    The proceedings of the 5-th International Edition of Romanian Conference on Advanced Materials and Crystal Growth with special topics on nano and multifunctional materials held on September 11-14, 2006 in Bucharest- Magurele, Romania, contains contributions presented as plenary lectures, invited papers and regular contributions in eight sections, namely: 1. Growth and characterization of inorganic crystals; 2. Growth and characterization of organic and biological crystals; 3. Nano and microstructured materials and thin films; 4. Polymers/fuel cells and hydrogen storage; 5. Plasma deposition and applications; 6. Advanced processing and characterization / noncrystalline solids; 7. Advanced nuclear materials; 8. Advanced materials: general aspects

  4. Sexual distinction between 5th instar nymphs of six species of Triatominae (Hemiptera, Reduviidae

    Directory of Open Access Journals (Sweden)

    João Aristeu da Rosa

    1992-06-01

    Full Text Available The aim of this paper is to present the analysis of sexual morphological differences observed in 5th instar nymphs of the following species: Panstrongylus megistus; Rhodnius neglectus; Triatoma brasiliensis; T. infestans; T. matogrosensis and T. tibiamaculata. Male and female nymphs were examined and photographed with a Scanning Electron Microscope. The 9th segment dimensions of dorsal and ventral faces were determined through a Profile Projector. Results and statistical analysis showed significant differences: the 9th sternite is significantly broader in male than female nymphs, while in five species; tergites in female nymphs are broad and in male are narrow.

  5. Proceedings of the 5th symposium on accelerator science and technology

    International Nuclear Information System (INIS)

    1985-01-01

    This proceedings are included 157 papers to submitting 5th Symposium on Accelerator Science and Technology. The papers are presented under the following main topics: a) invited talk (3 papers), b) status of accelerator construction and operation (12 papers), c) ion source and DC accelerator(7 papers), d) linac (16 papers), e) RF acceleration system (15 papers), f) beam monitor and beam handling (20 papers), g) magnet and power supply (13 papers), h) vacuum (12 papers), i) beam dynamics (20 papers), j) accelerator operation and control (22 papers), k) radiation and safety (8 papers), 1) future project (8 papers) and so on. (J.P.N.)

  6. Proceedings of the 5th meeting on ultra high vacuum techniques for accelerators and storage rings

    International Nuclear Information System (INIS)

    Horikoshi, Gen-ichi

    1984-08-01

    This is the proceedings of the 5th meeting on UHV Techniques for Accelerators and Storage Rings held at KEK, March 26-27, 1984. More than 110 vacuum scientists attended the meeting, and 23 reports were presented. Main subjects were, of course, concerning with the vacuum systems for large accelerators and plasma devices under planning or construction in Japan. At the same time, many reports on the general problems of vacumm science were also presented. The subjects of these reports were outgassing phenomenon, surface problems, new type UHV pumps and others. (author)

  7. Home birth without skilled attendants despite millennium villages project intervention in Ghana: insight from a survey of women's perceptions of skilled obstetric care.

    Science.gov (United States)

    Nakua, Emmanuel Kweku; Sevugu, Justice Thomas; Dzomeku, Veronica Millicent; Otupiri, Easmon; Lipkovich, Heather R; Owusu-Dabo, Ellis

    2015-10-07

    Skilled birth attendance from a trained health professional during labour and delivery can prevent up to 75% of maternal deaths. However, in low- and middle-income rural communities, lack of basic medical infrastructure and limited number of skilled birth attendants are significant barriers to timely obstetric care. Through analysis of self-reported data, this study aimed to assess the effect of an intervention addressing barriers in access to skilled obstetric care and identified factors associated with the use of unskilled birth attendants during delivery in a rural district of Ghana. A cross-sectional survey was conducted from June to August 2012 in the Amansie West District of Ghana among women of reproductive age. Multi-stage, random, and population proportional techniques were used to sample 50 communities and 400 women for data collection. Weighted multivariate logistic regression analysis was used to identify factors associated with place of delivery. A total of 391 mothers had attended an antenatal care clinic at least once for their most recent birth; 42.3% of them had unskilled deliveries. Reasons reported for the use of unskilled birth attendants during delivery were: insults from health workers (23.5%), unavailability of transport (21.9%), and confidence in traditional birth attendants (17.9%); only 7.4% reported to have had sudden labour. Other factors associated with the use of unskilled birth attendants during delivery included: lack of partner involvement aOR = 0.03 (95% CI; 0.01, 0.06), lack of birth preparedness aOR = 0.05 (95% CI; 0.02, 0.13) and lack of knowledge of the benefits of skilled delivery aOR = 0.37 (95% CI; 0.11, 1.20). This study demonstrated the importance of provider-client relationship and cultural sensitivity in the efforts to improve skilled obstetric care uptake among rural women in Ghana.

  8. Changes in job stress and coping skills among caregivers after dementia care practitioner training.

    Science.gov (United States)

    Takizawa, Takeya; Takahashi, Megumi; Takai, Michiko; Ikeda, Taichiro; Miyaoka, Hitoshi

    2017-01-01

    Dementia care practitioner training is essential for professional caregivers to acquire medical knowledge and care skills for dementia patients. We investigated the significance of training in stress management by evaluating caregivers' job stress and coping style before and after they have completed training. The subjects included 134 professional caregivers (41 men, 93 women) recruited from participants in training programmes held in Kanagawa Prefecture from August 2008 to March 2010. A survey using a brief job stress questionnaire and a coping scale was carried out before and after they completed their training. A t-test and multiple regression analysis were performed to evaluate the effects of the training. After the training, the scores of modifiers on the job stress scale and of the coping scale increased, whereas the scores of stress reactions on the job stress scale decreased. However, there were no changes in participants' subjective cognition concerning their workplace environment. Furthermore, the change in stress reaction score tended to correlate with the change in consultation score in all participants and with the change in problem-solving and consultation in male participants. Among female participants, the change in stress reaction score tended to correlate with change in support from superiors and colleagues as modifiers. The factors that correlated to the change in stress reaction score differed between genders. The findings suggest that training caregivers improves their stress reaction and coping skills. © 2016 The Authors. Psychogeriatrics © 2016 Japanese Psychogeriatric Society.

  9. Definition of Specific Functions and Procedural Skills Required by Cuban Specialists in Intensive Care and Emergency Medicine.

    Science.gov (United States)

    Véliz, Pedro L; Berra, Esperanza M; Jorna, Ana R

    2015-07-01

    INTRODUCTION Medical specialties' core curricula should take into account functions to be carried out, positions to be filled and populations to be served. The functions in the professional profile for specialty training of Cuban intensive care and emergency medicine specialists do not include all the activities that they actually perform in professional practice. OBJECTIVE Define the specific functions and procedural skills required of Cuban specialists in intensive care and emergency medicine. METHODS The study was conducted from April 2011 to September 2013. A three-stage methodological strategy was designed using qualitative techniques. By purposive maximum variation sampling, 82 professionals were selected. Documentary analysis and key informant criteria were used in the first stage. Two expert groups were formed in the second stage: one used various group techniques (focus group, oral and written brainstorming) and the second used a three-round Delphi method. In the final stage, a third group of experts was questioned in semistructured in-depth interviews, and a two-round Delphi method was employed to assess priorities. RESULTS Ultimately, 78 specific functions were defined: 47 (60.3%) patient care, 16 (20.5%) managerial, 6 (7.7%) teaching, and 9 (11.5%) research. Thirty-one procedural skills were identified. The specific functions and procedural skills defined relate to the profession's requirements in clinical care of the critically ill, management of patient services, teaching and research at the specialist's different occupational levels. CONCLUSIONS The specific functions and procedural skills required of intensive care and emergency medicine specialists were precisely identified by a scientific method. This product is key to improving the quality of teaching, research, administration and patient care in this specialty in Cuba. The specific functions and procedural skills identified are theoretical, practical, methodological and social contributions to

  10. Stepped Skills: A team approach towards communication about sexuality and intimacy in cancer and palliative care

    Directory of Open Access Journals (Sweden)

    Hilde de Vocht

    2011-11-01

    Full Text Available BackgroundCancer often has a profound and enduring impact on sexuality, affecting both patients and their partners. Most healthcare professionals in cancer and palliative care are struggling to address intimate issues with the patients in their care.MethodsStudy 1: An Australian study using semi-structured interviews and documentary data analysis.Study 2: Building on this Australian study, using a hermeneutic phenomenological approach, data were collected in the Netherlands through interviewing 15 cancer patients, 13 partners and 20 healthcare professionals working in cancer and palliative care. The hermeneutic analysis was supported by ATLAS.ti and enhanced by peer debriefing and expert consultation.ResultsFor patients and partners a person-oriented approach is a prerequisite for discussing the whole of their experience regarding the impact of cancer treatment on their sexuality and intimacy. Not all healthcare professionals are willing or capable of adopting such a person-oriented approach.ConclusionA complementary team approach, with clearly defined roles for different team members and clear referral pathways, is required to enhance communication about sexuality and intimacy in cancer and palliative care. This approach, that includes the acknowledgement of the importance of patients’ and partners’ sexuality and intimacy by all team members, is captured in the Stepped Skills model that was developed as an outcome of the Dutch study.

  11. Efficient rehabilitation care for joint replacement patients: skilled nursing facility or inpatient rehabilitation facility?

    Science.gov (United States)

    Tian, Wenqiang; DeJong, Gerben; Horn, Susan D; Putman, Koen; Hsieh, Ching-Hui; DaVanzo, Joan E

    2012-01-01

    There has been lengthy debate as to which setting, skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF), is more efficient in treating joint replacement patients. This study aims to determine the efficiency of rehabilitation care provided by SNF and IRF to joint replacement patients with respect to both payment and length of stay (LOS). This study used a prospective multisite observational cohort design. Tobit models were used to examine the association between setting of care and efficiency. The study enrolled 948 knee replacement patients and 618 hip replacement patients from 11 IRFs and 7 SNFs between February 2006 and February 2007. Output was measured by motor functional independence measure (FIM) score at discharge. Efficiency was measured in 3 ways: payment efficiency, LOS efficiency, and stochastic frontier analysis efficiency. IRF patients incurred higher expenditures per case but also achieved larger motor FIM gains in shorter LOS than did SNF patients. Setting of care was not a strong predictor of overall efficiency of rehabilitation care. Great variation in characteristics existed within IRFs or SNFs and severity groups. Medium-volume facilities among both SNFs and IRFs were most efficient. Early rehabilitation was consistently predictive of efficient treatment. The advantage of either setting is not clear-cut. Definition of efficiency depends in part on preference between cost and time. SNFs are more payment efficient; IRFs are more LOS efficient. Variation within SNFs and IRFs blurred setting differences; a simple comparison between SNF and IRF may not be appropriate.

  12. Stepping It Up: Walking Behaviors in Children Transitioning from 5th to 7th Grade

    Directory of Open Access Journals (Sweden)

    Sharon E. Taverno Ross

    2018-02-01

    Full Text Available The purpose of this study was to (1 describe children’s walking behaviors in 5th to 7th grade and change over time and (2 examine associations between walking behaviors and Walk Score®. Participants consisted of n = 586 students from the Transitions and Activity Changes in Kids (TRACK Study. Children reported any walking behavior (e.g., exercise and transportation over the past five days. Walk Score was calculated based on children’s home address. Descriptive statistics summarized walking behaviors by gender and time, and repeated measure mixed models examined the relationship between walking behaviors and Walk Score. Approximately 46.8% and 19.2% of 5th grade children reported walking for exercise and transportation, respectively, and these percentages declined through 7th grade. Girls reported higher levels of total walking behavior and walking for exercise than boys (p < 0.001. Girls with a higher Walk Score had 63% higher odds of reporting walking for transportation than girls with a lower Walk Score (OR = 1.63, 95% CI = 1.02, 2.62. Walking behaviors among children were infrequent with significant declines over time, and of the nine associations examined with Walk Score, only one was significant. Efforts should prioritize frequent walking behavior and community design to increase children’s physical activity.

  13. The 5th surveillance testing for Kori unit 1 reactor vessel materials

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Kee Ok; Kim, Byoung Chul; Lee, Sam Lai; Choi, Kwun Jae; Gong, Un Sik; Chang, Jong Hwa; Joo, Yong Sun; Ahn, Sang Bok; Hong, Joon Hwa [Korea Atomic Energy Research Institute, Taejeon (Korea)

    2000-08-01

    Surveillance testing for reactor vessel materials is performed in order to evaluate the irradiation embrittlement due to neutrons during operation and set the condition of safe operation of nuclear reactor. The 5th surveillance testing was performed primarily by Korea Atomic Energy Research Institute and Westinhouse corporation partially involved in testing and calculation data evaluation in order to obtain reliable test result. Fast neutron fluences for capsule V, T, S, R and P were 5.087E+18, 1.115E+19, 1.228E+19, 2.988E+19, and 3.938E+19n/cm2, respectively. The bias factor, the ratio of calculation/measurement, was 0.940 for the 1st through 5th testing and the calculational uncertainty, 7% satisfied the requirement of USNRC Reg.Guide DG-1053, 20%. The best estimated neutron fluence for reactor vessel inside surface was 1.9846E+19n/cm{sup 2} based on the end of 17th fuel cycle and it was predicted that the fluences of vessel inside surface at 24, 32, 40 and 48EFPY would reach 3.0593E+19, 4.0695E+19, 5.0797E+19 and 6.0900E+19n/cm{sup 2} based on the current calculation. PTS analysis for Kori unit 1 showed that 27.93EFPY was the threshold value for 300 deg F requirement. 71 refs., 33 figs., 52 tabs. (Author)

  14. 5th Bionanotox and Applications International Research Conference, Peabody, Little Rock, Arkansas, USA

    Science.gov (United States)

    Sabb, Taneicie; Chowdhury, Parimal

    2011-06-01

    "BioNanoTox and Toxicity: using Technology to Advance Discovery" was this year's theme at the 5th BioNanoTox and Applications International Research Conference held at the Peabody Hotel, Little Rock, Arkansas on November 4-5th, 2010. This year, the international participation in this conference increased to 25 countries spanning the globe. The conference began with opening remarks by Paul Howard, Associate Director of the National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, United States. Two keynote speakers, Dr. Ananth V. Annapragada and Dr. Merle G. Paule presented lectures on "Toxicity of Novel Nanoparticles for CT imaging" and "The Biology of Neurotoxicity: using Technology to Advance Discovery", respectively. Teachers, students, faculty, and scientists presented oral and poster presentations on fundamental and translational research related to BioNanoTox and related fields of science. Six presentation sessions were held over the two-day conference. There were 31 presentations and 39 posters from disciplines ranging from biology to chemistry, toxicology, nanotechnology, computational sciences, mathematics, engineering, plant science, and biotechnology. Poster presentation awards were presented to three high school students, three high school teachers, and three college students. In addition to poster awards a memorial, travel, and BioNanoTox award were presented. This year's meeting paved the way for a more outstanding meeting for the future.

  15. Fostering critical thinking skills: a strategy for enhancing evidence based wellness care

    Directory of Open Access Journals (Sweden)

    Jamison Jennifer R

    2005-09-01

    Full Text Available Abstract Chiropractic has traditionally regarded itself a wellness profession. As wellness care is postulated to play a central role in the future growth of chiropractic, the development of a wellness ethos acceptable within conventional health care is desirable. This paper describes a unit which prepares chiropractic students for the role of "wellness coaches". Emphasis is placed on providing students with exercises in critical thinking in an effort to prepare them for the challenge of interfacing with an increasingly evidence based health care system. Methods This case study describes how health may be promoted and disease prevented through development of personalized wellness programs. As critical thinking is essential to the provision of evidence based wellness care, diverse learning opportunities for developing and refining critical thinking skills have been created. Three of the learning opportunities are an intrinsic component of the subject and, taken together, contributed over 50% of the final grade of the unit. They include a literature review, developing a client wellness contract and peer evaluation. In addition to these 3 compulsory exercises, students were also given an opportunity to develop their critical appraisal skills by undertaking voluntary self- and unit evaluation. Several opportunities for informal self-appraisal were offered in a structured self-study guide, while unit appraisal was undertaken by means of a questionnaire and group discussion at which the Head of School was present. Results Formal assessment showed all students capable of preparing a wellness program consistent with current thinking in contemporary health care. The small group of students who appraised the unit seemed to value the diversity of learning experiences provided. Opportunities for voluntary unit and self-appraisal were used to varying degrees. Unit evaluation provided useful feedback that led to substantial changes in unit structure

  16. Effect of the essentials of critical care orientation (ECCO) program on the development of nurses' critical thinking skills.

    Science.gov (United States)

    Kaddoura, Mahmoud A

    2010-09-01

    It is essential for nurses to develop critical thinking skills to ensure their ability to provide safe and effective care to patients with complex and variable needs in ever-changing clinical environments. To date, very few studies have been conducted to examine how nursing orientation programs develop the critical thinking skills of novice critical care nurses. Strikingly, no research studies could be found about the American Association of Critical Care Nurses Essentials of Critical Care Orientation (ECCO) program and specifically its effect on the development of nurses' critical thinking skills. This study explored the perceptions of new graduate nurses regarding factors that helped to develop their critical thinking skills throughout their 6-month orientation program in the intensive care unit. A convenient non-probability sample of eight new graduates was selected from a hospital that used the ECCO program. Data were collected with demographic questionnaires and semi-structured interviews. An exploratory qualitative research method with content analysis was used to analyze the data. The study findings showed that new graduate nurses perceived that they developed critical thinking skills that improved throughout the orientation period, although there were some challenges in the ECCO program. This study provides data that could influence the development and implementation of future nursing orientation programs. Copyright 2010, SLACK Incorporated.

  17. Comparative Analysis of Indicators of Coordination Abilities Development in 5th-7th Graders

    Directory of Open Access Journals (Sweden)

    В. В. Приходько

    2017-09-01

    Full Text Available The objective of the research is to determine the regularities of coordination abilities development in 5th-7th-grade boys.  Materials and methods. The participants in the research were boys of the 5th grade (n = 21, 6th grade (n = 20, 7th grade (n = 19. To achieve the tasks outlined, the research used the following methods: analysis of scientific and methodological literature; pedagogical testing, pedagogical observation, methods of mathematical statistics. Research results. The 5th-6th-grade boys show a statistically significant difference between their results in the following tests: “Standing long jump (cm” (p < 0.002; “Six standing accuracy ball handlings to a partner from a 7 m distance using one of the techniques learned” (p < 0.049; “Rhythmic hand tapping” (p < 0.044; “Rhythmic movements of upper and lower limbs” (p < 0.042 (p < 0.05; “Height (cm”; “Body weight (kg”. The 6th-7th-grade boys — “30 m running (s”; “Standing long jump (cm”; “Sit-ups in 30 seconds”; “Evaluation of static equilibrium by E. Ya. Bondarevsky’s method”; “Evaluation of dynamic equilibrium by the BESS method”; “Rhythmic hand tapping”; “Rhythmic movements of upper and lower limbs”; “Shuttle run (4 × 9 m”; “Tossing rings over a peg”. The 5th-7th-grade boys — “Standing long jump (cm”; “Pull-ups (number of times”; “Evaluation of the ability to differentiate movement speed (accuracy in reproduction of running speed, 90% of maximum”; “Evaluation of static equilibrium by E. Ya. Bondarevsky’s method”; “Evaluation of dynamic equilibrium by the BESS method”; “Rhythmic hand tapping”; “Shuttle run (4 × 9 m”; “Height (cm”; “Body weight (kg”. Conclusions. The research has observed a positive dynamics of the results in the following group of tests: “Standing long jump” by 8.4%, “Rhythmic hand tapping and rhythmic movements of upper and lower

  18. Movement Coordination: Factor Structure of Development in 5th-7th Grade Girls

    Directory of Open Access Journals (Sweden)

    O. Ivashchenko

    2018-03-01

    Full Text Available The study objective is to determine the structure of coordination abilities development in 5th-7th grade girls. Materials and methods. The participants in the study were 5th grade girls (n = 20, 6th grade girls (n = 23, 7th grade girls (n = 19. The study used the following methods: analysis and collation of scientific and methodological literature, general scientific methods of theoretical level, such as analogy, analysis, synthesis, abstraction, induction, as well as general scientific methods of empirical level: observation, testing, experiment. To evaluate motor preparedness, the study recorded the results of motor tests, body height and weight. The IBM SPSS 20 statistical analysis software was used to process the study materials. A factor analysis was performed, for which the study used principal component analysis with the rotation method: Variamax with Kaiser Normalization. Results. The analysis of similarities shows that the most informative tests in the structure of motor preparedness of the 5th grade girls are the following: test 11 “Evaluation of the ability for vestibular (statokinetic stability. Running with turns” (.884, test 9 “Static equilibrium evaluation by E. Ya. Bondarevsky’s method” (.826, test 6 “Evaluation of the sense of movement speed in sprinting” (.824; of the 6th grade girls — test 11 “Evaluation of the ability for vestibular (statokinetic stability. Running with turns” (0.884, test 9 “Static equilibrium evaluation by E. Ya. Bondarevsky’s method” (.826, test 6 “Evaluation of the sense of movement speed in sprinting” (.824; of the 7th grade girls — test 8 “Evaluation of the ability to differentiate movement speed (reproduction accuracy of running speed at 90% intensity of maximum” (.902, test 11 “Evaluation of the ability for vestibular (statokinetic stability. Running with turns” (.900, test 1 “30 m running (s” (.869. Conclusions. In the structure of

  19. Development of skills-based competencies for forensic nurse examiners providing elder abuse care.

    Science.gov (United States)

    Du Mont, Janice; Kosa, Daisy; Macdonald, Sheila; Elliot, Shannon; Yaffe, Mark

    2016-02-10

    As a critical step in advancing a comprehensive response to elder abuse built on existing forensic nursing-led hospital-based programmes, we developed a list of skills-based competencies for use in an Elder Abuse Nurse Examiner curriculum. Programme leaders of 30 hospital-based forensic nursing-led sexual assault and domestic violence treatment centres. 149 verbatim recommendations for components of an elder abuse response were identified from a systematic scoping review. In 2 online Delphi consensus survey rounds, these components of care were evaluated by an expert panel for their overall importance to the elder abuse intervention under development and for their appropriateness to the scope of practice of an elder abuse nurse examiner. The components retained after evaluation were translated into skills-based competencies using Bloom's Taxonomy of Learning and, using the Nominal Group Technique, were subsequently reviewed and revised by a subset of members of the expert panel in a consensus meeting. Of the 148 recommendations evaluated, 119 were rated as important and achieved consensus or high level of agreement. Of these, 101 were determined to be within the scope of practice of an Elder Abuse Nurse Examiner and were translated into skills-based competencies. Following review and revision by meeting experts, 47 final competencies were organised by content into 5 metacompetencies: documentation, legal and legislative issues; interview with older adult, caregiver and other relevant contacts; assessment; medical and forensic examination; and case summary, discharge plan and follow-up care. We determined the skills-based competencies of importance to training forensic nurse examiners to respond to elder abuse in the context of a hospital-based intervention. These findings may have implications for violence and abuse treatment programmes with a forensic nursing component that are considering the provision of a dedicated response to the abuse of older women and men

  20. EDITORIAL: 'Best article' prize for the 5th anniversary of Environmental Research Letters 'Best article' prize for the 5th anniversary of Environmental Research Letters

    Science.gov (United States)

    Kammen, Dan; Wright, Guillaume

    2011-12-01

    To celebrate the 5th anniversary of Environmental Research Letters (ERL) the publishers of the journal, IOP Publishing, have awarded a prize for the five best articles published in ERL since the journal began in 2006. The procedure for deciding the winning articles was as thorough as possible to ensure that the most outstanding articles would win the prize. A shortlist of 25 nominated research articles, five for each year since ERL was launched, which were chosen based on a range of criteria including novelty, scientific impact, readership, broad appeal and wider media coverage, was selected. The ERL Editorial Board then assessed and rated these 25 articles in order to choose a winning article for each year. We would like to announce that the following articles have been awarded ERL's 5th anniversary best article prize: 2006/7 The Bodélé depression: a single spot in the Sahara that provides most of the mineral dust to the Amazon forest Ilan Koren, Yoram J Kaufman, Richard Washington, Martin C Todd, Yinon Rudich, J Vanderlei Martins and Daniel Rosenfeld 2006 Environ. Res. Lett. 1 014005 2008 Causes and impacts of the 2005 Amazon drought Ning Zeng, Jin-Ho Yoon, Jose A Marengo, Ajit Subramaniam, Carlos A Nobre, Annarita Mariotti and J David Neelin 2008 Environ. Res. Lett. 3 014002 2009 How difficult is it to recover from dangerous levels of global warming? J A Lowe, C Huntingford, S C B Raper, C D Jones, S K Liddicoat and L K Gohar 2009 Environ. Res. Lett. 4 014012 2010 Is physical water scarcity a new phenomenon? Global assessment of water shortage over the last two millennia Matti Kummu, Philip J Ward, Hans de Moel and Olli Varis 2010 Environ. Res. Lett. 5 034006 2011 Implications of urban structure on carbon consumption in metropolitan areas Jukka Heinonen and Seppo Junnila 2011 Environ. Res. Lett. 6 014018 Our congratulations go to these authors. In recognition of their outstanding work, we are delighted to offer all of the authors of the winning articles free

  1. Innovative health care delivery teams: learning to be a team player is as important as learning other specialised skills.

    Science.gov (United States)

    Fitzgerald, Anneke; Davison, Graydon

    2008-01-01

    The purpose of the paper is to show that free flowing teamwork depends on at least three aspects of team life: functional diversity, social cohesion and superordinate identity. The paper takes the approach of a discussion, arguing for a strong need to understand multidisciplinary and cross-functional barriers for achieving team goals in the context of health care. These barriers include a strong medically dominated business model, historically anchored delineations between professional identities and a complex organisational environment where individuals may have conflicting goals. The paper finds that the complexity is exacerbated by the differences between and within health care teams. It illustrates the differences by presenting the case of an operating theatre team. Whilst the paper recommends some ideas for acquiring these skills, further research is needed to assess effectiveness and influence of team skills training on optimising multidisciplinary interdependence in the health care environment. The paper shows that becoming a team member requires team membership skills.

  2. The Bridge Project: improving heart failure care in skilled nursing facilities.

    Science.gov (United States)

    Boxer, Rebecca S; Dolansky, Mary A; Frantz, Megan A; Prosser, Regina; Hitch, Jeanne A; Piña, Ileana L

    2012-01-01

    Rehospitalization rates and transitions of care for patients with heart failure (HF) continue to be of prominent importance for hospital systems around the United States. Skilled nursing facilities (SNF) are pivotal sites for transition especially for older adults. The purpose of this study was to evaluate in SNF both the (1) current state of HF management (HF admissions, protocols, and staff knowledge) and (2) the acceptability and effect of a HF staff educational program. Four SNF participated in the project, 2 the first year and 2 the second year. SNF were surveyed by discipline as to HF disease management techniques. Staff were evaluated on HF knowledge and confidence in pre- and post-HF disease management training. All-cause rehospitalization rates ranged from 18% to 43% in the 2 SNF evaluated. Overall, there was a lack of identification and tracking of HF patients in all the SNF. There were no HF-specific disease management protocols at any SNF and staff had limited knowledge of HF care. Staff pre and post test scores indicated an improvement in both staff knowledge and confidence in HF management after receiving training. The lack of identification and tracking of patients with HF limits SNF ability to care for patients with HF. HF education for staff is likely important to effective HF management in the SNF. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  3. Nurses' knowledge and skills in providing mental health care to people living with HIV/AIDS in Malawi.

    Science.gov (United States)

    Chorwe-Sungani, G

    2013-09-01

    Nurses are the majority of health-care professionals who frequently come in contact with people living with HIV/AIDS (PLWHA). However, most health workers such as nurses lack competence and confidence in dealing with the mental health problems (MHPs) of their clients in Malawi. The study aimed at exploring nurses' levels of knowledge and skills in providing mental health care to PLWHA. The study used a descriptive quantitative survey design. Ethical approval and permission were granted by relevant authorities to conduct the study. A convenient sample of 109 nurses was used. They gave written consent and completed self-administered questionnaires. Descriptive statistics namely: means, frequencies and percentages were used to analyse data. The findings suggest that nurses who care for PLWHA lack knowledge and skills to deal with MHPs of these people. Many participants (53.2%, n = 58) lacked knowledge and skills to care for PLWHA who have MHPs. Nurses are potentially essential human resource for dealing with MHPs of PLWHA in Malawi. Unfortunately, some nurses lack the necessary knowledge and skills to deal with MHPs. Nurses must be equipped with adequate knowledge and skills so that they are able to deal with MHPs of PLWHA. © 2013 John Wiley & Sons Ltd.

  4. Magnitude and trends of inequalities in antenatal care and delivery under skilled care among different socio-demographic groups in Ghana from 1988 - 2008.

    Science.gov (United States)

    Asamoah, Benedict O; Agardh, Anette; Pettersson, Karen Odberg; Östergren, Per-Olof

    2014-08-29

    Improving maternal and reproductive health still remains a major challenge in most low-income countries especially in sub-Saharan Africa. The growing inequality in access to maternal health interventions is an issue of great concern. In Ghana, inadequate attention has been given to the inequality gap that exists amongst women when accessing antenatal care during pregnancy and skilled attendance at birth. This study therefore aimed at investigating the magnitude and trends in income-, education-, residence-, and parity-related inequalities in access to antenatal care and skilled attendance at birth. A database was constructed using data from the Ghana Demographic and Health Surveys (DHS) 1988, 1993, 1998, 2003, and 2008. The surveys employed standard DHS questionnaires and techniques for data collection. We applied regression-based Total Attributable Fraction (TAF) as an index for measuring socioeconomic inequalities in antenatal care and skilled birth attendance utilization. The rural-urban gap and education-related inequalities in the utilization of antenatal care and skilled birth attendants seem to be closing over time, while income- and parity-related inequalities in the use of antenatal care are on a sharp rise. Income inequality regarding the utilization of skilled birth attendance was rather low and stable from 1988 to 1998, increased sharply to a peak between 1998 and 2003, and then leveled-off after 2003. The increased income-related inequalities seen in the use of antenatal care and skilled birth attendance should be addressed through appropriate strategies. Intensifying community-based health education through media and door-to-door campaigns could further reduce the mentioned education- and parity-related inequalities. Women should be highly motivated and incentivized to attend school up to secondary level or higher. Education on the use of maternal health services should be integrated into basic schools so that women at the lowest level would be

  5. 5th International Workshop on Real-World Wireless Sensor Networks

    CERN Document Server

    Hu, Wen; Ferrari, Federico; Zimmerling, Marco; Mottola, Luca

    2014-01-01

    This edited book presents the results of the 5th Workshop on Real-world Wireless Sensor Networks (REALWSN). The purpose of this workshop  was to bring together researchers and practitioners working in the area of sensor networks, with focus on real-world experiments or deployments of wireless sensor networks. Included were, nonetheless, emerging forms of sensing such as those that leverage smart phones, Internet of Things, RFIDs, and robots. Indeed, when working with real-world experiments or deployments, many new or unforeseen issues may arise: the network environment may be composed of a variety of different technologies, leading to very heterogeneous network structures; software development for large scale networks poses new types of problems; the performance of prototype networks may differ significantly from the deployed system; whereas actual sensor network deployments may need a complex combination of autonomous and manual configuration. Furthermore, results obtained through simulation are typically n...

  6. Dental health in antique population of Vinkovci - Cibalae in Croatia (3rd-5th century).

    Science.gov (United States)

    Peko, Dunja; Vodanović, Marin

    2016-08-01

    Roman city Cibalae (Vinkovci) - the birthplace of Roman emperors Valentinian I and Valens was a very well developed urban ares in the late antique what was evidenced by numerous archaeological findings. The aim of this paper is to get insight in dental health of antique population of Cibalae. One hundred individuals with 2041 teeth dated to 3rd - 5th century AD have been analyzed for caries, antemortem tooth loss, periapical diseases and tooth wear. Prevalence of antemortem tooth loss was 4.3% in males, 5.2% in females. Prevalence of caries per tooth was 8.4% in males, 7.0% in females. Compared to other Croatian antique sites, ancient inhabitants of Roman Cibalae had rather good dental health with low caries prevalence and no gender differences. Statistically significant difference was found between males in females in the prevalence of periapical lesions and degree of tooth wear. Periapical lesions were found only in males.

  7. 5th International Conference on Engineering Surveying Brijuni, September 22-24, 2011

    Directory of Open Access Journals (Sweden)

    Rinaldo Paar

    2011-12-01

    Full Text Available 5th International Conference on Engineering Surveying was held on the Brijuni Islands from 22 to 24 September 2011. The conference organizers were the Department of Surveying Faculty of Civil Engineering at the Slovak University of Technology in Bratislava and the Institute for Applied Geodesy at the Faculty of Geodesy, University of Zagreb, with the FIG Commission 6. The conference was held under the patronage of the Ministry of Environmental Protection, Physical Planning and Construction of the Republic of Croatia. The conference took place in the Castrum Congress Hall of Hotel Neptun-Istra. The official language of the conference was English. The conference was attended by 70 representatives from Croatia, Slovenia, Serbia, Kosovo, Austria, Germany, Hungary, Greece, Czech Republic and Slovakia, and a total of 40 papers were presented.

  8. Female Headdress from Dubrovskiy Burial Ground of 4th–5th Centuries

    Directory of Open Access Journals (Sweden)

    Krasnopeоrov Alexander A.

    2017-03-01

    Full Text Available The article examines the remains of a female headdress from Dubrovskiy burial ground of Mazunino type in the Kama region of Udmurtia. The burial is defined by the Migration Period, and the leader of the excavations generally attributed it to the 4th – 5th centuries AD. As widely known, female dress was a status symbol, a sign of belonging to a tribe. The headdress studied here belonged to a young woman, whose status was demonstrated through the context of this collective burial and the grave goods. The type of the headdress is reconstructed by its constructive details, peculiar location of metallic decorations and preserved organics. According to the authors, the headdress had the front part (frontal piece on a solid base with decorative elements, and a soft back part (a shawl with metallic details. The authors refer to archaeological analogies and ethnographic parallels, which allow reconstructing the cultural context of the find.

  9. The 5th questionnaire report of safety control on instrument in nuclear medicine laboratory

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-08-01

    The questionnaire was done every three years from 1986 for the ultimate purpose of safe medical examinations and this 5th one was performed in May, 1998 for the period of April, 1995-March, 1998. Subjects were 1,258 nuclear medicine facilities and answers were obtained in 81.6%. Questionnaire concerned the personnel involved in nuclear medical examinations, instruments, accidents occurred, matters possibly leading to accident, improvement in safety control, serious trouble and breakage of the instrument, request for the instrument manufacturers and so on. Summaries were: numbers of medical radiology technicians were increased, in vitro tests were decreased, SPECT instruments came into wide use, in accident and improvement cases, examination beds were arousing much interest, concerns to examine were further required, communication with the manufacturers was insufficient, and problems for Y2K were pointed out to be resolved. (K.H.)

  10. Proceedings of the 5th International workshop on hydrogen and fuel cells WICaC 2010

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    The 5th International Workshop on Hydrogen and Fuel Cells - WICaC 2010 aims to bring the most recent advances on fuel cell and hydrogen technologies. The conference will address the trends on hydrogen production, distribution, delivery, storage and infrastructure as well as fuel cell research, development, demonstration and commercialization. Some of the issues addressed at WICaC 2010 are: the official Brazilian hydrogen and fuel cell programs and its participation in the international programs and partnerships such as the IPHE (The International Partnership for Hydrogen and Fuel Cells in the Economy); the integration of renewable energy sources with hydrogen and fuel cell systems; the challenges to deploy the commercialization and use of fuel cells and hydrogen; distributed generation of energy; fuel cell uses in portable devices and in vehicles; life-cycle assessment of fuel cells and hydrogen technologies; environmental aspects; energy efficiency.

  11. 5th International and 41st National Conference on FMFP 2014

    CERN Document Server

    Das, Debopam; Srivastava, Rajesh; Panigrahi, P; Muralidhar, K

    2017-01-01

    This volume comprises the proceedings of the 42nd National and 5th International Conference on Fluid Mechanics and Fluid Power held at IIT Kanpur in December, 2014.The conference proceedings encapsulate the best deliberations held during the conference. The diversity of participation in the conference, from academia, industry and research laboratories reflects in the articles appearing in the volume. This contributed volume has articles from authors who have participated in the conference on thematic areas such as Fundamental Issues and Perspectives in Fluid Mechanics; Measurement Techniques and Instrumentation; Computational Fluid Dynamics; Instability, Transition and Turbulence; Turbomachinery; Multiphase Flows; Fluid‐Structure Interaction and Flow‐Induced Noise; Microfluidics; Bio‐inspired Fluid Mechanics; Internal Combustion Engines and Gas Turbines; and Specialized Topics. The contents of this volume will prove useful to researchers from industry and academia alike. .

  12. 5th CIRP international conference on industrial product-service systems

    CERN Document Server

    2013-01-01

    “An Industrial Product-Service System is characterized by the integrated and mutually  determined planning, development, provision and use of product and service shares including its immanent software components in Business-to-Business applications and represents a knowledge-intensive socio-technical system.” – Meier, Roy, Seliger (2010) Since the first conference in 2009, the CIRP International Conference on Industrial Product-Service Systems has become a well-established international forum for the review and discussion of advances, research results and industrial improvements. Researchers from all over the world have met at previous IPS² conferences in Cranfield (2009), Linköping (2010), Braunschweig (2011) and Tokyo (2012). In 2013, the 5th CIRP International Conference on Industrial Product-Service Systems is held in Bochum. Important topics of IPS² research presented at the conference are: planning and development, sustainability, business models, operation, service engineering, knowledge mana...

  13. 5th International Conference on Changeable, Agile, Reconfigurable and Virtual Production

    CERN Document Server

    2014-01-01

    The changing manufacturing environment requires more responsive and adaptable manufacturing systems. The theme of the 5th International Conference on Changeable, Agile, Reconfigurable and Virtual production (CARV2013) is "Enabling Manufacturing Competitiveness and Economic Sustainability. Leading edge research and best implementation practices and experiences, which address these important issues and challenges, are presented. The proceedings include advances in manufacturing systems design, planning, evaluation, control and evolving paradigms such as mass customization, personalization, changeability, re-configurability and flexibility. New and important concepts such as the dynamic product families and platforms, co-evolution of products and systems, and methods for enhancing manufacturing systems' economic sustainability and prolonging their life to produce more than one product generation are treated. Enablers of change in manufacturing systems, production volume and capability, scalability and managing t...

  14. Recurrent Idiopathic Catatonia: Implications beyond the Diagnostic and Statistical Manual of Mental Disorders 5th Edition.

    Science.gov (United States)

    Caroff, Stanley N; Hurford, Irene; Bleier, Henry R; Gorton, Gregg E; Campbell, E Cabrina

    2015-08-31

    We describe a case of recurrent, life-threatening, catatonic stupor, without evidence of any associated medical, toxic or mental disorder. This case provides support for the inclusion of a separate category of "unspecified catatonia" in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) to be used to classify idiopathic cases, which appears to be consistent with Kahlbaum's concept of catatonia as a distinct disease state. But beyond the limited, cross-sectional, syndromal approach adopted in DSM-5, this case more importantly illustrates the prognostic and therapeutic significance of the longitudinal course of illness in differentiating cases of catatonia, which is better defined in the Wernicke-Kleist-Leonhard classification system. The importance of differentiating cases of catatonia is further supported by the efficacy of antipsychotics in treatment of this case, contrary to conventional guidelines.

  15. 5th International Conference on Simulation and Modeling Methodologies, Technologies and Applications

    CERN Document Server

    Kacprzyk, Janusz; Ören, Tuncer; Filipe, Joaquim

    2016-01-01

    The present book includes a set of selected extended papers from the 5th International Conference on Simulation and Modeling Methodologies, Technologies and Applications (SIMULTECH 2015), held in Colmar, France, from 21 to 23 July 2015. The conference brought together researchers, engineers and practitioners interested in methodologies and applications of modeling and simulation. New and innovative solutions are reported in this book. SIMULTECH 2015 received 102 submissions, from 36 countries, in all continents. After a double blind paper review performed by the Program Committee, 19% were accepted as full papers and thus selected for oral presentation. Additional papers were accepted as short papers and posters. A further selection was made after the Conference, based also on the assessment of presentation quality and audience interest, so that this book includes the extended and revised versions of the very best papers of SIMULTECH 2015. Commitment to high quality standards is a major concern of SIMULTECH t...

  16. Proceedings of the 5th US/German Workshop on Salt Repository Research Design and Operation

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, Francis D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Leigh, Christi [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Stein, Walter [Karlsruhe Inst. of Technology (KIT) (Germany); Bollingerfehr, Wilhelm [DBE Technology, Peine (Germany); Von Berlepsche, Thilo [DBE Technology, Peine (Germany)

    2015-01-01

    The 5th US/German Workshop on Salt Repository Research, Design, and Operation was held in Santa Fe New Mexico September 8-10, 2014. The forty seven registered participants were equally divided between the United States (US) and Germany, with one participant from The Netherlands. The agenda for the 2014 workshop was under development immediately upon finishing the 4th Workshop. Ongoing, fundamental topics such as thermomechanical behavior of salt, plugging and sealing, the safety case, and performance assessment continue to advance the basis for disposal of heat-generating nuclear waste in salt formations. The utility of a salt underground research laboratory (URL) remains an intriguing concept engendering discussion of testing protocol. By far the most interest in this years’ workshop pertained to operational safety. Given events at the Waste Isolation Pilot Plant (WIPP), this discussion took on a new sense of relevance and urgency.

  17. Results of the 5th regular inspection of Unit 1 in the Hamaoka Nuclear Power Station

    International Nuclear Information System (INIS)

    1983-01-01

    The 5th regular inspection of Unit 1 in the Hamaoka Nuclear Power Station was carried out from March 27 to July 27, 1982. Inspection was made on the reactor proper, reactor cooling system, instrumentation/control system, radiation control facility, etc. By the examinations of external appearance, leakage, performance, etc., no abnormality was observed. In the regular inspection, personnel exposure dose was all below the permissible level. The works done during the inspection were the following: the replacement of control rod drives, the replacement of core support-plate plugs, the repair of steam piping, steam extraction pipes and feed water heaters, the repair of a waste-liquid concentrator, the installation of barriers and leak detectors, the installation of drain sump monitors in a containment vessel, the replacement of concentrated liquid waste pumps, the employment of type B fuel. (Mori, K.)

  18. The Internet of Skills: The use of 5th Generation Telecommunications, Haptics, and Artificial Intelligence in Robotic Surgery.

    Science.gov (United States)

    Kim, Sandra Sy; Dohler, Mischa; Dasgupta, Prokar

    2018-05-11

    Minimally invasive surgery (MIS) is well established in many surgical applications, with an estimated surgical robot device markets anticipated to reach $20 billion by 2021 (1). It yields many known advantages over traditional open surgery, examples being smaller incision sites resulting in decreased blood loss and risk of infection, decreased length of hospital stay and time to return to work, and improved cosmesis (2).The field as a whole suffers from shortcomings today, and thus does not live up to its full potential. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. The effect of breast anthropometry on the Hybrid III 5th female chest response.

    Science.gov (United States)

    Tylko, Suzanne; Charlebois, Dominique; Bussières, Alain; Dalmotas, Dainius

    2006-11-01

    Two manufacturers, Denton ATD and FTSS, currently produce the Hybrid III 5th percentile female dummy. In response to concerns raised by industry that differences in the anthropometry of the molded breasts between the two manufacturers may influence chest responses, Transport Canada conducted a comparative testing program. Thorax biofidelity tests were conducted to compare force-deflection characteristics; full frontal rigid-barrier tests were conducted at 40, 48 and 56 km/h to compare chest responses, and out-of-position chest on module static airbag deployment tests were conducted to compare peak chest deflections of the Denton and FTSS dummy jackets and of a prototype jacket without breasts. Differences in force-deflection characteristics were observed during biofidelity pendulum impacts of the two dummies, with much of the differences attributed to the different chest jackets. Differences of up to 11 mm in the peak sternum deflection and of the order of 15 g for the 3-ms chest acceleration clips were noted in rigid-barrier vehicle tests. In the out-of-position airbag-deployment tests, differences in the magnitude of peak chest deflections were observed. The prototype chest jacket without breasts was found to improve repeatability in the belted crash tests and in out-of-position airbag testing. Though neither the Denton nor the FTSS chest jackets fully meet the original design intent of the Hybrid III 5th percentile dummy, the Denton dummy more closely met the drawing specifications and had less manufacturing variability. The results demonstrate the importance of detailed chest flesh assembly specifications, provide evidence that a fully molded jacket design would eliminate manufacturing variability and suggest that removal of the breasts may further improve test repeatability.

  20. The 5th surveillance testing for Kori unit 2 reactor vessel materials

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Kee Ok; Kim, Byoung Chul; Lee, Sam Lai; Choi, Kwon Jae; Gong, Un Sik; Chang, Jong Hwa; Joo, Yong Sun; Ahn, Sang Bok; Hong, Joon Hwa [Korea Atomic Energy Research Institute, Taejeon (Korea)

    2001-03-01

    Surveillance testing for reactor vessel materials is performed in order to evaluate the irradiation embrittlement due to neutrons during operation and set the condition of safe operation of nuclear reactor. The 5th surveillance testing was performed completely by Korea Atomic Energy Research Institute at Taejeon after the capsule was transported from Kori site including its removal from reactor. Fast neutron fluences for capsules were calculated and various testing including mechanical and chemistry analysis were performed in order to evaluate the integrity of Kori unit 2 reactor vessel during the operation until life time. The evaluation results are as follows; Fast neutron fluences for capsules V, R, P, T and N are 2.837E+18, 1.105E+19, 2.110E+19, 3.705E+19 and 4.831E+19n/cm{sup 2}, respectively. The bias factor, the ratio of measurement/calculation, was 0.918 for the 1st through 5th testing and the calculational uncertainty, 11.6% satisfied the requirement of USNRC Reg.Guide DG-1053, 20%. The best estimated neutron fluence for reactor vessel inside surface was 1.898E+19n/cm{sup 2} based on the end of 15th fuel cycle and it was predicted that the fluences of vessel inside surface at 32, 40, 48 and 56EFPY would reach 4.203E+19, 5.232E+19, 6.262E+19 and 7.291E+19n/cm{sup 2} based on the current calculation. The result through this analysis for Kori unit 2 showed that there would be no problem for the pressurized thermal shock(PTS) during the operation until design life. 49 refs., 35 figs., 48 tabs. (Author)

  1. The primacy of vital signs--acute care nurses' and midwives' use of physical assessment skills: a cross sectional study.

    Science.gov (United States)

    Osborne, Sonya; Douglas, Clint; Reid, Carol; Jones, Lee; Gardner, Glenn

    2015-05-01

    Registered nurses and midwives play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status. Yet, evidence suggests that clinical deterioration frequently goes unnoticed in hospitalised patients. While much attention has been paid to early warning and rapid response systems, little research has examined factors related to physical assessment skills. To determine a minimum data set of core skills used during nursing assessment of hospitalised patients and identify nurse and workplace predictors of the use of physical assessment to detect patient deterioration. The study used a single-centre, cross-sectional survey design. The study included 434 registered nurses and midwives (Grades 5-7) involved in clinical care of patients on acute care wards, including medicine, surgery, oncology, mental health and maternity service areas, at a 929-bed tertiary referral teaching hospital in Southeast Queensland, Australia. We conducted a hospital-wide survey of registered nurses and midwives using the 133-item Physical Assessment Skills Inventory and the 58-item Barriers to Registered Nurses' Use of Physical Assessment Scale. Median frequency for each physical assessment skill was calculated to determine core skills. To explore predictors of core skill utilisation, backward stepwise general linear modelling was conducted. Means and regression coefficients are reported with 95% confidence intervals. A p value skills used by most nurses every time they worked included assessment of temperature, oxygen saturation, blood pressure, breathing effort, skin, wound and mental status. Reliance on others and technology (F=35.77, pskill use. The increasing acuity of the acute care patient plausibly warrants more than vital signs assessment; however, our study confirms nurses' physical assessment core skill set is mainly comprised of vital signs. The focus on these endpoints of deterioration as dictated by

  2. Weight status and gender-related differences in motor skills and in child care - based physical activity in young children.

    Science.gov (United States)

    Bonvin, Antoine; Barral, Jérôme; Kakebeeke, Tanja H; Kriemler, Susi; Longchamp, Anouk; Marques-Vidal, Pedro; Puder, Jardena J

    2012-03-09

    Over the last decades, a decline in motor skills and in physical activity and an increase in obesity has been observed in children. However, there is a lack of data in young children. We tested if differences in motor skills and in physical activity according to weight or gender were already present in 2- to 4-year-old children. Fifty-eight child care centers in the French part of Switzerland were randomly selected for the Youp'là bouge study. Motor skills were assessed by an obstacle course including 5 motor skills, derived from the Zurich Neuromotor Assessment test. Physical activity was measured with accelerometers (GT1M, Actigraph, Florida, USA) using age-adapted cut-offs. Weight status was assessed using the International Obesity Task Force criteria (healthy weight vs overweight) for body mass index (BMI). Of the 529 children (49% girls, 3.4 ± 0.6 years, BMI 16.2 ± 1.2 kg/m2), 13% were overweight. There were no significant weight status-related differences in the single skills of the obstacle course, but there was a trend (p = 0.059) for a lower performance of overweight children in the overall motor skills score. No significant weight status-related differences in child care-based physical activity were observed. No gender-related differences were found in the overall motor skills score, but boys performed better than girls in 2 of the 5 motor skills (p ≤ 0.04). Total physical activity as well as time spent in moderate-vigorous and in vigorous activity during child care were 12-25% higher and sedentary activity 5% lower in boys compared to girls (all p physical activity was higher in boys compared to girls. These results are important to consider when establishing physical activity recommendations or targeting health promotion interventions in young children.

  3. Teaching differential diagnosis in primary care using an inverted classroom approach: student satisfaction and gain in skills and knowledge.

    Science.gov (United States)

    Bösner, Stefan; Pickert, Julia; Stibane, Tina

    2015-04-01

    Differential diagnosis is a crucial skill for primary care physicians. General practice plays an increasing important role in undergraduate medical education. Via general practice, students may be presented with an overview of the whole spectrum of differential diagnosis in regard to common symptoms encountered in primary care. This project evaluated the impact of a blended learning program (using the inverted classroom approach) on student satisfaction and development of skills and knowledge. An elective seminar in differential diagnosis in primary care, which utilized an inverted classroom design, was offered to students. Evaluation followed a mixed methods design: participants completed a pre- and post-test, a questionnaire, and a focus group discussion. Interviews were transcribed verbatim and answers were grouped according to different themes. Test results were analysed using the Wilcoxon matched-pairs signed-ranks test. Participants (n = 17) rated the course concept very positively. Especially the inverted classroom approach was appreciated by all students, as it allowed for more time during the seminar to concentrate on interactive and practice based learning. Students (n = 16) showed a post-test significant overall gain in skills and knowledge of 33%. This study showed a positive effect of the inverted classroom approach on students' satisfaction and skills and knowledge. Further research is necessary in order to explore the potentials of this approach, especially the impact on development of clinical skills.

  4. The Role of Grit in College Student Health Care Management Skills and Health-Related Quality of Life.

    Science.gov (United States)

    Sharkey, Christina M; Bakula, Dana M; Gamwell, Kaitlyn L; Mullins, Alexandria J; Chaney, John M; Mullins, Larry L

    2017-10-01

    To examine the relationship of grit, an intrapersonal characteristic defined by perseverance and passion for long-term goals, to health care management skills and adolescent and young adult (AYA) health-related quality of life (HRQoL). Higher levels of grit were expected to relate to greater health care management skills and HRQoL, and skills were predicted to mediate the relationship between grit and HRQoL. Four hundred seventy undergraduates (Mdnage=19, interquartile range = 2) completed online questionnaires, including the short Grit Scale, Transition Readiness Assessment Questionnaire, and 36-Item Short Form Survey (SF-36) (HRQoL). Higher grit related to greater health care management skills (R2=0.15 p.05). This preliminary investigation illustrates the role of grit in AYA health, suggesting that it may be a target for interventions aimed at improving skills and HRQoL outcomes. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  5. Minimal improvement of nurses' motivational interviewing skills in routine diabetes care one year after training: a cluster randomized trial.

    Science.gov (United States)

    Jansink, Renate; Braspenning, Jozé; Laurant, Miranda; Keizer, Ellen; Elwyn, Glyn; Weijden, Trudy van der; Grol, Richard

    2013-03-28

    The effectiveness of nurse-led motivational interviewing (MI) in routine diabetes care in general practice is inconclusive. Knowledge about the extent to which nurses apply MI skills and the factors that affect the usage can help to understand the black box of this intervention. The current study compared MI skills of trained versus non-trained general practice nurses in diabetes consultations. The nurses participated in a cluster randomized trial in which a comprehensive program (including MI training) was tested on improving clinical parameters, lifestyle, patients' readiness to change lifestyle, and quality of life. Fifty-eight general practices were randomly assigned to usual care (35 nurses) or the intervention (30 nurses). The ratings of applying 24 MI skills (primary outcome) were based on five consultation recordings per nurse at baseline and 14 months later. Two judges evaluated independently the MI skills and the consultation characteristics time, amount of nurse communication, amount of lifestyle discussion and patients' readiness to change. The effect of the training on the MI skills was analysed with a multilevel linear regression by comparing baseline and the one-year follow-up between the interventions with usual care group. The overall effect of the consultation characteristics on the MI skills was studied in a multilevel regression analyses. At one year follow up, it was demonstrated that the nurses improved on 2 of the 24 MI skills, namely, "inviting the patient to talk about behaviour change" (mean difference=0.39, p=0.009), and "assessing patient's confidence in changing their lifestyle" (mean difference=0.28, p=0.037). Consultation time and the amount of lifestyle discussion as well as the patients' readiness to change health behaviour was associated positively with applying MI skills. The maintenance of the MI skills one year after the training program was minimal. The question is whether the success of MI to change unhealthy behaviour must be

  6. Minimal improvement of nurses’ motivational interviewing skills in routine diabetes care one year after training: a cluster randomized trial

    Science.gov (United States)

    2013-01-01

    Background The effectiveness of nurse-led motivational interviewing (MI) in routine diabetes care in general practice is inconclusive. Knowledge about the extent to which nurses apply MI skills and the factors that affect the usage can help to understand the black box of this intervention. The current study compared MI skills of trained versus non-trained general practice nurses in diabetes consultations. The nurses participated in a cluster randomized trial in which a comprehensive program (including MI training) was tested on improving clinical parameters, lifestyle, patients’ readiness to change lifestyle, and quality of life. Methods Fifty-eight general practices were randomly assigned to usual care (35 nurses) or the intervention (30 nurses). The ratings of applying 24 MI skills (primary outcome) were based on five consultation recordings per nurse at baseline and 14 months later. Two judges evaluated independently the MI skills and the consultation characteristics time, amount of nurse communication, amount of lifestyle discussion and patients’ readiness to change. The effect of the training on the MI skills was analysed with a multilevel linear regression by comparing baseline and the one-year follow-up between the interventions with usual care group. The overall effect of the consultation characteristics on the MI skills was studied in a multilevel regression analyses. Results At one year follow up, it was demonstrated that the nurses improved on 2 of the 24 MI skills, namely, “inviting the patient to talk about behaviour change” (mean difference=0.39, p=0.009), and “assessing patient’s confidence in changing their lifestyle” (mean difference=0.28, p=0.037). Consultation time and the amount of lifestyle discussion as well as the patients’ readiness to change health behaviour was associated positively with applying MI skills. Conclusions The maintenance of the MI skills one year after the training program was minimal. The question is whether

  7. Discussing Death, Dying, and End-of-Life Goals of Care: A Communication Skills Training Module for Oncology Nurses.

    Science.gov (United States)

    Coyle, Nessa; Manna, Ruth; Shen, Megan; Banerjee, Smita C; Penn, Stacey; Pehrson, Cassandra; Krueger, Carol A; Maloney, Erin K; Zaider, Talia; Bylund, Carma L

    2015-12-01

    Effective communication, particularly at the end of life, is an essential skill for oncology nurses, but few receive formal training in this area. The aim of this article is to adapt an end-of-life care communication skills training (CST) module, originally developed for oncologists, for oncology nurses and to evaluate participants' confidence in using the communication skills learned and their satisfaction with the module. The adapted end-of-life care module consisted of a 45-minute didactic, exemplary video and 90 minutes of small group interaction and experiential role play with a simulated patient. Using a five-point Likert-type scale, 247 inpatient oncology nurses completed pre-/post-workshop surveys rating their confidence in discussing death, dying, and end-of-life goals of care with patients, as well as overall satisfaction with the module. Nurses' confidence in discussing death, dying, and end-of-life goals of care increased significantly after attending the workshop. Nurse participants indicated satisfaction with the module by agreeing or strongly agreeing to all six items assessing satisfaction 90%-98% of the time. Nurses' CST in discussing death, dying, and end-of-life care showed feasibility, acceptability, and potential benefit at improving confidence in having end-of-life care discussions.

  8. Enrolment of children and adolescents in psychosocial care: more likely with low family social support and poor parenting skills.

    Science.gov (United States)

    Nanninga, Marieke; Jansen, Danielle E M C; Knorth, Erik J; Reijneveld, Sijmen A

    2015-04-01

    Knowledge about determinants of child and adolescent enrolment in psychosocial care concerns only single types of care and usually only socio-demographic factors. The social environment is also a likely key determinant but evidence is lacking. The aim of this study was to examine the associations between family social support, parenting skills and child and adolescent enrolment in psychosocial care. We obtained data on 1,331 children (response rate 56.6%), 4-18 years old, enrolled in preventive child health care, and child and adolescent social care and mental health care because of psychosocial problems, and on 463 children (response rate 70.3%) not enrolled in psychosocial care. Results showed that enrolment in psychosocial care was associated with low family social support (odds ratio; 95%-confidence interval: 3.2; 2.4-4.4), and with poor parenting skills, i.e. poor supervision (1.5; 1.1-2.1) and inconsistent disciplining (1.5; 1.1-2.1). Children's psychosocial problems partially mediated the associations with family social support and completely with parenting skills. Children's problems did not moderate the associations. Positive parenting was not associated with care enrolment. We conclude that low family social support and poor parenting are important factors associated with enrolment, in particular because they are associated with more frequent occurrence of children's psychosocial problems. This implies that professionals and policymakers need to be aware that factors in children's social environment are related with enrolment in psychosocial care, in addition to children's psychosocial problems.

  9. Utilization of Skills in the Care of Patients with Deviations in Psychosocial Adaptation (NS 207): Competency-Based Course Syllabus.

    Science.gov (United States)

    Wells, Tanya G.

    "Utilization of Skills in the Care of Patients with Deviations in Psychosocial Adaptation" (NS 207) is an associate degree nursing course offered at Chattanooga State Technical Community College. The course stresses the individual as a system in his/her psychosocial adaptation to internal and external stressors, and highlights the…

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

    Science.gov (United States)

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

    2012-01-01

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

  11. Infant Motor Skills After a Cardiac Operation: The Need for Developmental Monitoring and Care.

    Science.gov (United States)

    Uzark, Karen; Smith, Cynthia; Donohue, Janet; Yu, Sunkyung; Romano, Jennifer C

    2017-08-01

    Neurodevelopmental dysfunction is increasingly recognized as a common outcome of congenital heart defects and their treatment in infancy. The effects of the intensive care unit (ICU) experience and environment on these infants are unknown and potentially modifiable, but no validated metric is available for objective evaluation of early motor impairments in the ICU/hospital setting. The purpose of this study was to characterize the motor status of hospitalized infants after cardiac operations, including the development and field-testing of the Congenital Heart Assessment of Sensory and Motor Status (CHASMS) metric. CHASMS item generation was based on review of the literature, focused interviews with parents, and expert consensus. A nurse administered CHASMS to 100 infants aged younger than 10 months old undergoing cardiac operations. Preoperative and postoperative CHASMS scores were compared, and associations between CHASMS scores and patient characteristics were examined. Physical therapists assessed neuromotor skills by using the Test of Infant Motor Performance or the Alberta Infant Motor Scales for correlation with CHASMS scores. CHASMS gross motor scores declined postoperatively in 64% (25 of 39). Lower CHASMS scores, after adjusting for age, were associated with longer duration of mechanical ventilation (p motor CHASMS scores were significantly correlated with Test of Infant Motor Performance (r = 0.70, p Motor Scales scores (r = 0.88, p Motor impairments in infants after cardiac operations are common and may be exacerbated by longer intubation and prolonged exposure to the ICU environment. The feasibility, reliability, and validity of CHASMS were supported for the evaluation of motor skills in this at-risk population. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Skill sharing and delegation practice in two Queensland regional allied health cancer care services: a comparison of tasks.

    Science.gov (United States)

    Passfield, Juanine; Nielsen, Ilsa; Brebner, Neil; Johnstone, Cara

    2017-07-24

    Objective Delegation and skill sharing are emerging service strategies for allied health (AH) professionals working in Queensland regional cancer care services. The aim of the present study was to describe the consistency between two services for the types and frequency of tasks provided and the agreement between teams in the decision to delegate or skill share clinical tasks, thereby determining the potential applicability to other services. Methods Datasets provided by two similar services were collated. Descriptive statistical analyses were used to assess the extent of agreement. Results In all, 214 tasks were identified as being undertaken by the services (92% agreement). Across the services, 70 tasks were identified as high frequency (equal to or more frequently than weekly) and 29 as not high frequency (46% agreement). Of the 68 tasks that were risk assessed, agreement was 66% for delegation and 60% for skill sharing, with high-frequency and intervention tasks more likely to be delegated. Conclusions Strong consistency was apparent for the clinical tasks undertaken by the two cancer care AH teams, with moderate agreement for the frequency of tasks performed. The proportion of tasks considered appropriate for skill sharing and/or delegation was similar, although variation at the task level was apparent. Further research is warranted to examine the range of factors that affect the decision to skill share or delegate. What is known about the topic? There is limited research evidence regarding the use of skill sharing and delegation service models for AH in cancer care services. In particular, the extent to which decisions about task safety and appropriateness for delegation or skill sharing can be generalised across services has not been investigated. What does this paper add? This study investigated the level of clinical task consistency between two similar AH cancer care teams in regional centres. It also examined the level of agreement with regard to

  13. Weight status and gender-related differences in motor skills and in child care - based physical activity in young children

    Science.gov (United States)

    2012-01-01

    Background Over the last decades, a decline in motor skills and in physical activity and an increase in obesity has been observed in children. However, there is a lack of data in young children. We tested if differences in motor skills and in physical activity according to weight or gender were already present in 2- to 4-year-old children. Methods Fifty-eight child care centers in the French part of Switzerland were randomly selected for the Youp'là bouge study. Motor skills were assessed by an obstacle course including 5 motor skills, derived from the Zurich Neuromotor Assessment test. Physical activity was measured with accelerometers (GT1M, Actigraph, Florida, USA) using age-adapted cut-offs. Weight status was assessed using the International Obesity Task Force criteria (healthy weight vs overweight) for body mass index (BMI). Results Of the 529 children (49% girls, 3.4 ± 0.6 years, BMI 16.2 ± 1.2 kg/m2), 13% were overweight. There were no significant weight status-related differences in the single skills of the obstacle course, but there was a trend (p = 0.059) for a lower performance of overweight children in the overall motor skills score. No significant weight status-related differences in child care-based physical activity were observed. No gender-related differences were found in the overall motor skills score, but boys performed better than girls in 2 of the 5 motor skills (p ≤ 0.04). Total physical activity as well as time spent in moderate-vigorous and in vigorous activity during child care were 12-25% higher and sedentary activity 5% lower in boys compared to girls (all p motor skills. However, in accordance to data in older children, child care-based physical activity was higher in boys compared to girls. These results are important to consider when establishing physical activity recommendations or targeting health promotion interventions in young children. PMID:22405468

  14. Weight status and gender-related differences in motor skills and in child care - based physical activity in young children

    Directory of Open Access Journals (Sweden)

    Bonvin Antoine

    2012-03-01

    Full Text Available Abstract Background Over the last decades, a decline in motor skills and in physical activity and an increase in obesity has been observed in children. However, there is a lack of data in young children. We tested if differences in motor skills and in physical activity according to weight or gender were already present in 2- to 4-year-old children. Methods Fifty-eight child care centers in the French part of Switzerland were randomly selected for the Youp'là bouge study. Motor skills were assessed by an obstacle course including 5 motor skills, derived from the Zurich Neuromotor Assessment test. Physical activity was measured with accelerometers (GT1M, Actigraph, Florida, USA using age-adapted cut-offs. Weight status was assessed using the International Obesity Task Force criteria (healthy weight vs overweight for body mass index (BMI. Results Of the 529 children (49% girls, 3.4 ± 0.6 years, BMI 16.2 ± 1.2 kg/m2, 13% were overweight. There were no significant weight status-related differences in the single skills of the obstacle course, but there was a trend (p = 0.059 for a lower performance of overweight children in the overall motor skills score. No significant weight status-related differences in child care-based physical activity were observed. No gender-related differences were found in the overall motor skills score, but boys performed better than girls in 2 of the 5 motor skills (p ≤ 0.04. Total physical activity as well as time spent in moderate-vigorous and in vigorous activity during child care were 12-25% higher and sedentary activity 5% lower in boys compared to girls (all p Conclusions At this early age, there were no significant weight status- or gender-related differences in global motor skills. However, in accordance to data in older children, child care-based physical activity was higher in boys compared to girls. These results are important to consider when establishing physical activity recommendations or targeting

  15. Information, motivation, and behavioral skills for early pre-ART engagement in HIV care among patients entering clinical care in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Smith, Laramie R; Amico, K Rivet; Shuper, Paul A; Christie, Sarah; Fisher, William A; Cornman, Deborah H; Doshi, Monika; MacDonald, Susan; Pillay, Sandy; Fisher, Jeffrey D

    2013-01-01

    Little is known regarding factors implicated in early engagement and retention in HIV care among individuals not yet eligible for antiretroviral therapy (pre-ART) in sub-Saharan Africa. Identifying such factors is critical for supporting retention in pre-ART clinical care to ensure timely ART initiation and optimize long-term health outcomes. We assessed patients' pre-ART HIV care-related information, motivation, and behavioral skills among newly diagnosed ART-ineligible patients, initiating care in KwaZulu-Natal, South Africa. The survey was interviewer-administered to eligible patients, who were aged 18 years or older, newly entering care (diagnosed within the last six-months), and ineligible for ART (CD4 count > 200 cells/mm(3)) in one of four primary care clinical sites. Self-reported information, motivation, and behavioral skills specific to retention in pre-ART HIV-care were characterized by categorizing responses into those reflecting potential strengths and those reflective of potential deficits. Information, motivation, and behavioral skills deficits sufficiently prevalent in the overall sample (i.e.,≥30% prevalent) were identified as areas in need of specific attention through intervention efforts adapted to the clinic level. Gender-based differences were also evaluated. A total of 288 patients (75% female) completed structured interviews. Across the sample, eight information, eight motivation, and eight behavioral skills deficit areas were identified as sufficiently prevalent to warrant specific targeted attention. Gender differences did not emerge. The deficits in pre-ART HIV care-related information, motivation, and behavioral skills that were identified suggest that efforts to improve accurate information on immune function and HIV disease are needed, as is accurate information regarding HIV treatment and transmission risk prior to ART initiation. Additional efforts to facilitate the development of social support, including positive interactions

  16. The UK fuel poverty strategy: 5th annual progress report 2007

    International Nuclear Information System (INIS)

    2007-12-01

    This fifth annual progress report details government progress in 2007 in tackling fuel poverty and movement towards targets. The United Kingdom were the first country in the world to recognise the issue of fuel poverty and to put in place measures to tackle the issue, including spending 20 billion pounds sterling on benefits and programmes since the year 2000. The report covers progress to date, schemes and initiatives to tackle fuel poverty, the energy market and looks ahead to the future. Progress and development of the schemes across the devolved nations are also considered. This report is the first to publish the Government's proposals for the Carbon Emissions Reduction Target (CERT) priority group, which were laid before Parliament on 5th December 2007. This report is the first to present the fuel poverty figures for 2005, and shows the effects of rising energy prices. The Government continues to take action to ensure that the energy market is working properly, and to encourage reform in the EU on energy market liberalisation - this should reduce pressure on prices. Those in fuel poverty have much to gain by switching supplier and this report outlines the action taken by Ofgem and Energywatch to encourage this

  17. Primary Retroperitoneal Mucinous Cystadenocarcinoma: 5th Male Case in the Literature

    Directory of Open Access Journals (Sweden)

    F. Tugba Kos

    2015-11-01

    Full Text Available Retroperitoneal primary mucinous tumor is an extremely rare malignancy. To date, only 52 cases of primary retroperitoneal mucinous cystadenocarcinoma (PRMC have been reported in the literature, with the majority being women. Our patient is the 5th known male case. A 57-year-old male patient presented with a two year history of an undefined abdominal pain.Computed tomography demonstrated a 12 x 9.5 cm cystic mass lesion extending superiorly from right iliac fossa, while localizing below the abdominal wall and close to the psoas muscle. According to the laparotomy, iliopsoas muscle was infiltrated by the mass in the retroperitoneal region. Pathological diagnosis was mucinous cystadenocarcinoma . The asymptomatic patient was followed up without applying an adjuvant chemotherapy, since the clinical course of the tumor is known to be slow and postoperative therapy is not recognized as a standardized treatment. The clinical course of PRMC is generally indolent, however, it may manifest an aggressive course, as well. It has no definitive and clear pathogenesis. The treatment is contentious, as well. Diagnosis and treatment require surgical excision but data on adjuvant chemotherapy is limited.

  18. 5th International Conference on Mathematical Modeling in Physical Sciences (IC-MSquare 2016)

    International Nuclear Information System (INIS)

    Vagenas, Elias C.; Vlachos, Dimitrios S.

    2016-01-01

    The 5th International Conference on Mathematical Modeling in Physical Sciences (IC- MSQUARE) took place at Athens, Greece, from Monday, 23"t"h of May, to Thursday, 26"t"h of May 2016. The Conference was attended by more than 130 participants and hosted about 170 oral, poster, and virtual presentations while counted more than 500 pre-registered authors. The 5"t"h IC-MSQUARE consisted of different and diverging workshops and thus covered various research fields where Mathematical Modeling is used, such as Theoretical/Mathematical Physics, Neutrino Physics, Non-Integrable Systems, Dynamical Systems, Computational Nanoscience, Biological Physics, Computational Biomechanics, Complex Networks, Stochastic Modeling, Fractional Statistics, DNA Dynamics, Macroeconomics etc. The scientific program was rather heavy since after the Keynote and Invited Talks in the morning, three parallel oral and one poster session were running every day. However, according to all attendees, the program was excellent with high level talks and the scientific environment was fruitful, thus all attendees had a creative time. We would like to thank the Keynote Speaker and the Invited Speakers for their significant contribution to IC-MSQUARE. We also would like to thank the Members of the International Advisory and Scientific Committees as well as the Members of the Organizing Committee. (paper)

  19. Tectonic Implication of the 5th March 2005, Doublet Earthquake in Ilan, Taiwan

    Directory of Open Access Journals (Sweden)

    En-Chao Yeh

    2016-01-01

    Full Text Available The 5th March 2005 earthquake doublet focal mechanism was determined as strike-slip faulting from Harvard and BATS moment tensor inversion. However, based on first motion polarities, the first shock has a normal focal mechanism (Wu et al. 2008a. This discrepancy has caused a debate over the focal mechanism solution because different focal mechanisms have different tectonic implications. Based on the dislocation determination from Global Position System (GPS measurements, we find this event includes both tensile and strike-slip components. This finding illustrates the reason for the differences in the determined focal mechanisms using two different types of seismic data and analyzing methods. Field mapping and microstructure examination results indicate that the ductile deformation around the study area was characterized by the evolution from transpression to transtension with a predominant strike-slip component, but present-day active structures may be dominated by normal faulting. Thus, the active tensile slip result determined from dislocation modeling strongly suggests that the back arc extension of the Okinawa trough influences the stress state in this region, and changes the major transtension from strike-slip faulting to normal faulting.

  20. The 5th ATLAS Physics Workshop in Rome: Report from the Physics Sessions

    CERN Multimedia

    Cobal, M

    The 5th ATLAS physics workshop took place between the 6th and the 11th of June in Rome (after Trest '95, Grenoble '98, Lund '01, and Athens '03). This event turned out to be a great occasion to review the status of the physics and detector performance studies, under the beautiful sun of Rome. It is quite difficult to summarize the 100 talks (for a total of about 35 hours of presentations and discussions): I will just try to give here the general flavour of the workshop structure and conclusions. Four groups represented the Combined Detector Performances: Flavour tagging, E/gamma, Muon Combined and Jet/missing-transverse-energy/Tau. The main focus has been on the results of trigger studies: one introductory and one final talk provided the frame for more detailed presentations embedded in the relevant sessions. Progress was shown also from the Combined Testbeam analyses, where the data from the full ATLAS slice, collected in 2004, are being validated on real data reconstruction algorithms. During the physics ...

  1. After-school setting, physical activity, and sedentary behavior in 5th grade boys and girls.

    Science.gov (United States)

    Taverno Ross, S E; Dowda, M; Colabianchi, N; Saunders, R; Pate, R R

    2012-09-01

    After-school hours are considered critical for children's physical activity (PA) and sedentary behaviors (SB); however, whether the after-school setting influences children's activity patterns is unknown. This study examined the influence of after-school setting (i.e., parent report of the child's usual after-school setting) on 5th grade children's PA and SB, and differences by race/ethnicity. Boys whose parents reported they usually attended an after-school program had higher PA than boys who usually went home after school. A significant interaction between race/ethnicity and after-school setting showed that minority girls whose parents reported they usually attended an after-school program had higher PA and engaged in less SB compared with those who usually went home, whereas the activity patterns of white girls did not differ by after-school setting. Children's usual after-school setting affects their activity patterns; after-school programs may potentially increase PA in boys and minority girls. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Soft Computing Applications : Proceedings of the 5th International Workshop Soft Computing Applications

    CERN Document Server

    Fodor, János; Várkonyi-Kóczy, Annamária; Dombi, Joszef; Jain, Lakhmi

    2013-01-01

                    This volume contains the Proceedings of the 5thInternational Workshop on Soft Computing Applications (SOFA 2012).                                The book covers a broad spectrum of soft computing techniques, theoretical and practical applications employing knowledge and intelligence to find solutions for world industrial, economic and medical problems. The combination of such intelligent systems tools and a large number of applications introduce a need for a synergy of scientific and technological disciplines in order to show the great potential of Soft Computing in all domains.                   The conference papers included in these proceedings, published post conference, were grouped into the following area of research: ·         Soft Computing and Fusion Algorithms in Biometrics, ·         Fuzzy Theory, Control andApplications, ·         Modelling and Control Applications, ·         Steps towa...

  3. Bridging Divides for Water? Dialogue and Access at the 5th World Water Forum

    Directory of Open Access Journals (Sweden)

    Nícola Ulibarrí

    2011-10-01

    Full Text Available The 5th World Water Forum was officially presented as a deliberative democracy where diverse stakeholders could gather to talk about water. However, the conference was marred by significant conflict, ranging from audience complaints to protests, and to alternative political declarations. This paper explores why a Forum designed to 'Bridge Divides for Water' (the official theme was so contentious that participants were unable to reach any sort of consensus. I explore four hypothesised mechanisms by which the Forum itself counteracted the possibility of Bridging Divides and creating constructive dialogue. First, I argue that, because of cost, security and size, the Forum made many participants feel unable to fully access the Forum and share their opinions. Second, I suggest that the programmatic structure of the Forum promoted simplified ways of talking about water that made translation between perspectives difficult. Third, I contend that the physical space where Forum deliberations occurred institutionalised unequal social arrangements, making certain viewpoints more audible than others. Fourth, I demonstrate that the Turkish host government actively masked contestation to present a 'civilised' Forum to the world.

  4. The 5th Symposium on Post-Transcriptional Regulation of Plant Gene Expression (PTRoPGE)

    Energy Technology Data Exchange (ETDEWEB)

    Karen S. Browning; Marie Petrocek; Bonnie Bartel

    2006-06-01

    The 5th Symposium on Post-Transcriptional Regulation of Plant Gene Expression (PTRoPGE) will be held June 8-12, 2005 at the University of Texas at Austin. Exciting new and ongoing discoveries show significant regulation of gene expression occurs after transcription. These post-transcriptional control events in plants range from subtle regulation of transcribed genes and phosphorylation, to the processes of gene regulation through small RNAs. This meeting will focus on the regulatory role of RNA, from transcription, through translation and finally degradation. The cross-disciplinary design of this meeting is necessary to encourage interactions between researchers that have a common interest in post-transcriptional gene expression in plants. By bringing together a diverse group of plant molecular biologist and biochemists at all careers stages from across the world, this meeting will bring about more rapid progress in understanding how plant genomes work and how genes are finely regulated by post-transcriptional processes to ultimately regulate cells.

  5. Prolonged grief: where to after Diagnostic and Statistical Manual of Mental Disorders, 5th Edition?

    Science.gov (United States)

    Bryant, Richard A

    2014-01-01

    Although there is much evidence for the construct of prolonged grief, there was much controversy over the proposal to introduce a prolonged grief diagnosis into Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), and it was finally rejected as a diagnosis in DSM-5. This review outlines the evidence for and against the diagnosis, and highlights the implications of the DSM-5 decision. Convergent evidence indicates that prolonged grief characterized by persistently severe yearning for the deceased is a distinct construct from bereavement-related depression and anxiety, is associated with marked functional impairment, is responsive to targeted treatments for prolonged grief, and has been validated across different cultures, age groups, and types of bereavement. Although DSM-5 has rejected the construct as a formal diagnosis, evidence continues to emerge on related mechanisms, including maladaptive appraisals, memory and attentional processes, immunological and arousal responses, and neural circuitry. It is most likely that the International Classification of Diseases (ICD-11) will introduce a diagnosis to recognize prolonged grief, even though DSM-5 has decided against this option. It is probable that the DSM-5 decision may result in more prolonged grief patients being incorrectly diagnosed with depression after bereavement and possibly incorrectly treated. The DSM-5 decision is unlikely to impact on future research agendas.

  6. The acquired preparedness risk model applied to smoking in 5th grade children.

    Science.gov (United States)

    Combs, Jessica L; Spillane, Nichea S; Caudill, Leann; Stark, Brittany; Smith, Gregory T

    2012-03-01

    The very early onset of smoking predicts numerous health problems. The authors conducted the first test of one risk model for elementary school age smoking, known as the acquired preparedness (AP) model of risk, in a cross-sectional sample of 309 5th grade children. The model posits that (a) impulsivity-related personality traits contribute to risk for a variety of risky, maladaptive behaviors; (b) smoking expectancies confer risk only for smoking; and (c) the personality traits contribute to the formation of high risk expectancies for reinforcement from smoking, which in turn increases the likelihood of early onset smoking. The model was supported: the high-risk personality traits distinguished children engaging in any risky, maladaptive behavior from other children, and the smoking expectancies differentiated smokers from all other children. The relationship between personality tendencies to act rashly when experiencing intense positive or negative emotions and smoker status was partially mediated by expectancies for reinforcement from smoking. This model should be investigated longitudinally. Copyright © 2011. Published by Elsevier Ltd.

  7. Proceedings of the 5th annual meeting of Japanese Society of Radiation Safety Management 2006 Nagoya

    International Nuclear Information System (INIS)

    2006-01-01

    This is the program and the proceedings of the 5th annual meeting of Japanese Society of Radiation Safety Management held from November 29th through December 1st of 2006. The sessions held are: (1) Radiation Measurement 1, (2) Education Method, (3) Radiation Control, (4) Waste Handling, Contamination Inspection, and Renewal, (5) Exposure Reduction, Radiation Evaluation, and Radioactivity Control (6) Radiation Measurement 2, (7) Operation Environment, (8) Medical Exposure, (9) Radiation Measurement 3, (10) Software, IT Technology, and Data Processing, (11) Emission and Drainage Handling, and (12) Radiation Effect and Contamination Countermeasure. The poster sessions held are: (1) Radiation Measurement, (2) Environmental Radiation, (3) Scattering Rate, Penetration Rate, and Contamination Inspection, (4) Education Method, (5) Medical Exposure, (6) Access Control and Software, and (7) Radiation Control Method and Monitoring. The symposia held are: (1) 'Toward Establishment of Guideline for Safe X-ray Handling Education' and 'International Situation of Radiation Safety'. 2 keynote lectures were also held. (S.K.)

  8. Longitudinal testing of the Information-Motivation-Behavioral Skills model of self-care among adults with type 2 diabetes.

    Science.gov (United States)

    Meunier, Sophie; Coulombe, Simon; Beaulieu, Marie-Dominique; Côté, José; Lespérance, François; Chiasson, Jean-Louis; Bherer, Louis; Lambert, Jean; Houle, Janie

    2016-11-01

    The study's aim was to test prospective associations between information, motivation, and behavioral skills (IMB model) and self-care behaviors (diet, exercise, and blood glucose testing) among patients with type 2 diabetes. 295 participants were surveyed one (T1), six (T2), and 12 (T3) months after a diabetes course. Cross-lagged panel analyses were performed to test unidirectional and bidirectional relationships between IMB model variables and self-care behaviors. Blood-glucose testing at T1 was positively related to information at T2, which in turn was positively related to blood-glucose testing at T3. Controlled motivation at T1 was positively related to exercise at T2. Autonomous motivation at T2 was positively associated with exercise at T3. There was a positive bidirectional relationship across time between behavioral skills and general diet. Patterns of prospective associations between IMB model variables and diabetes self-care depend on the self-care behavior considered. This model offers an interesting framework for examining how diabetes self-care behaviors evolve. Diabetes education programs should provide information about current health status and promote experiential learning to help patients realize the impact of their behaviors on glycemic control; should foster autonomous motivation for long-term change; and should build on patients' strengths and skills. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Trainer-to-student ratios for teaching psychomotor skills in health care fields, as applied to osteopathic manipulative medicine.

    Science.gov (United States)

    Snider, Karen T; Seffinger, Michael A; Ferrill, Heather P; Gish, Eric E

    2012-04-01

    The hallmark of osteopathic medical education is the inclusion of hands-on instruction in osteopathic manipulative medicine (OMM), which includes palpatory diagnosis and osteopathic manipulative treatment (OMT). This OMM training typically involves a primary instructor presenting theory and techniques with step-by-step demonstrations to a large group of first- and second-year osteopathic medical students. Additional instructors, referred to as table trainers, assist the primary instructor by supervising the students as they practice the presented techniques. To the authors' knowledge, there is no currently accepted standard for a table trainer-to-student ratio in OMM skills laboratories within osteopathic medical schools in the United States. However, through a Google Web search and PubMed literature review, the authors identified published trainer-to-student ratios used in other health care skills training curricula. Psychomotor skills training courses in health care fields typically have a table trainer-to-student ratio of 1 trainer to 8 or fewer students. On the basis of these findings and psychomotor skills learning theory, the authors conclude that this ratio is likely sufficient for OMM skills training.

  10. Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study

    Directory of Open Access Journals (Sweden)

    Sharad Onta

    2014-08-01

    Full Text Available Background: Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. Design: We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Results: Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs, distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Conclusions: Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps.

  11. Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study.

    Science.gov (United States)

    Onta, Sharad; Choulagai, Bishnu; Shrestha, Binjwala; Subedi, Narayan; Bhandari, Gajananda P; Krettek, Alexandra

    2014-01-01

    Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs), distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps.

  12. The impact of the SAGE & THYME foundation level workshop on factors influencing communication skills in health care professionals.

    Science.gov (United States)

    Connolly, Michael; Thomas, Joanne M; Orford, Julie A; Schofield, Nicola; Whiteside, Sigrid; Morris, Julie; Heaven, Cathy

    2014-01-01

    The "SAGE & THYME Foundation Level Workshop" delivers evidence-based communication skills training to 30 health care workers in 3 hours. It teaches a structured approach (the SAGE & THYME model) to discuss patient/carer concerns. The aim of this study was to determine whether the workshop had a positive outcome on factors that influence communication skills. The study had a pragmatic, mixed methods design. Workshops were run in an acute hospital. One hundred seventy health care workers completed questionnaires pre- and post-workshop; 141 were sent follow-up questionnaires at 2 weeks and 2 months; and 9 were filmed talking to a simulated patient pre- and post-workshop. From pre- to post-workshop, there was a significant increase in knowledge (p communication skills knowledge, self-efficacy, and outcome expectancy of hospital health care workers who are predominantly white, female, nursing, or nonclinical staff. This suggests that the workshop may have a positive impact on some factors influencing communication skills in this group. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  13. Enhancing Student Empathetic Engagement, History-Taking, and Communication Skills During Electronic Medical Record Use in Patient Care.

    Science.gov (United States)

    LoSasso, Alisa Alfonsi; Lamberton, Courtney E; Sammon, Mary; Berg, Katherine T; Caruso, John W; Cass, Jonathan; Hojat, Mohammadreza

    2017-07-01

    To examine whether an intervention on proper use of electronic medical records (EMRs) in patient care could help improve medical students' empathic engagement, and to test the hypothesis that the training would reduce communication hurdles in clinical encounters. Seventy third-year medical students from the Sidney Kimmel Medical College at Thomas Jefferson University were randomly divided into intervention and control groups during their six-week pediatric clerkship in 2012-2013. The intervention group received a one-hour training session on EMR-specific communication skills, including discussion of EMR use, the SALTED mnemonic and technique (Set-up, Ask, Listen, Type, Exceptions, Documentation), and role-plays. Both groups completed the Jefferson Scale of Empathy (JSE) at the clerkship's start and end. At clerkship's end, faculty and standardized patients (SPs) rated students' empathic engagement in SP encounters, using the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and their history-taking and communication skills. Faculty mean ratings on the JSPPPE, history-taking skills, and communication skills were significantly higher for the intervention group than the control group. SP mean ratings on history-taking skills were significantly higher for the intervention group than the control group. Both groups' JSE mean scores increased pretest to posttest, but the changes were not significant. The intervention group's posttest JSE mean score was higher than the control group's, but the difference was not significant. The findings suggest that a simple intervention providing specialized training in EMR-specific communication can improve medical students' empathic engagement in patient care, history-taking skills, and communication skills.

  14. A Systematic Review of End-of-Life Care Communication Skills Training for Generalist Palliative Care Providers: Research Quality and Reporting Guidance.

    Science.gov (United States)

    Brighton, Lisa Jane; Koffman, Jonathan; Hawkins, Amy; McDonald, Christine; O'Brien, Suzanne; Robinson, Vicky; Khan, Shaheen A; George, Rob; Higginson, Irene J; Selman, Lucy Ellen

    2017-09-01

    End-of-life care (EoLC) communication skills training for generalist palliative care providers is recommended in policy guidance globally. Although many training programs now exist, there has been no comprehensive evidence synthesis to inform future training delivery and evaluation. To identify and appraise how EoLC communication skills training interventions for generalist palliative care providers are developed, delivered, evaluated, and reported. Systematic review. Ten electronic databases (inception to December 2015) and five relevant journals (January 2004 to December 2015) were searched. Studies testing the effectiveness of EoLC communication skills training for generalists were included. Two independent authors assessed study quality. Descriptive statistics and narrative synthesis are used to summarize the findings. From 11,441 unique records, 170 reports were identified (157 published, 13 unpublished), representing 160 evaluation studies of 153 training interventions. Of published papers, eight were of low quality, 108 medium, and 41 high. Few interventions were developed with service user involvement (n = 7), and most were taught using a mixture of didactics (n = 123), reflection and discussion (n = 105), and role play (n = 86). Evaluation designs were weak: communication skills training interventions in the literature, evidence is limited by poor reporting and weak methodology. Based on our findings, we present a CONSORT statement supplement to improve future reporting and encourage more rigorous testing. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  15. Suitability of a structured Fundamental Movement Skills program for long day care centres: a process evaluation.

    Science.gov (United States)

    Petrunoff, Nick; Lloyd, Beverley; Watson, Natalie; Morrisey, David

    2009-04-01

    Early childhood presents an opportunity to encourage development of Fundamental Movement Skills (FMS). Implementation of a structured program in the Long Day Care (LDC) setting presents challenges. Implementation of a structured FMS program FunMoves was assessed in LDC in metropolitan New South Wales. LDC staff attended a training session conducted by trained Health Promotion Officers (HPOs) and completed an evaluation. During implementation HPOs completed lesson observations. De-identified attendance data was collected and director and staff feedback on the program including barriers to implementation was obtained via questionnaire. Qualitative information relevant to process evaluation was obtained via open questions on questionnaires, and a de-brief diary recording feedback from directors and staff. Knowledge of FMS and FunMoves and staff confidence to deliver the program were high after training. On average, staff stated they ran lessons more than the suggested twice weekly and the majority of children attended 1-3 lessons per week. However, lesson delivery was not as designed, and staff found FunMoves disruptive and time consuming. Six directors and the majority of staff thought that FunMoves could be improved. Structured program delivery was hampered by contextual issues including significant staff turnover and program length and structure being at odds with the setting. Implementation could be enhanced by guidelines for more flexible delivery options including less structured approaches, shorter and simpler lessons, ongoing conversations with the early childhood sector, in-centre engagement of staff and post-training support.

  16. Women's education level, antenatal visits and the quality of skilled antenatal care: a study of three African countries.

    Science.gov (United States)

    Babalola, Stella

    2014-02-01

    Many pregnant women in Africa who access professional antenatal care do not receive all the WHO-recommended components of care. Using Demographic and Health Survey (DHS) data from Kenya, Malawi and Nigeria, this study assesses the relationship of education level with the quality of antenatal care received and highlights how the number of antenatal visits mediates this relationship. The results show that a large proportion of the effect of education level on quality of care is direct, while only a small portion is mediated through the number of antenatal visits. Efforts to improve pregnancy outcomes for under-privileged women should focus on removing structural barriers to access, strengthening the technical and interpersonal skills of providers, and addressing providers' biases and discriminatory practices towards these women. Such efforts should also seek to empower underprivileged women to insist on quality antenatal care by explaining what to expect during an antenatal visit.

  17. Manifestations of the 2.5-th order phase transition in electronic properties of ω-uranium and cadmium

    International Nuclear Information System (INIS)

    Makarov, V.I.; Kle ner, V.Z.; Ignat'eva, T.A.

    1979-01-01

    It is shown that nonlinear temperature dependence of α-uranium superconducting transformation on the pressure P is a result of two-phase transformations of 2.5-th order. By means of parameters characterizing these transformations calculated is the coefficient of temperature expansion being in agreement with the experimental data. Explained is the influence of molybdenum addition on the electronic specific heat and Tsub(k)(p) dependence. Basing on the representation of the 2.5-th order phase transformation analyzed is a nonlinear change of cadmium Tsub(k) in case of uniaxial deformation

  18. 5th International Fair Konfindustria Albania & Kosovo: Report di un viaggio

    Directory of Open Access Journals (Sweden)

    Renzo Carlucci

    2012-06-01

    Full Text Available Quando la redazione di GeoMedia ha ricevuto l’invito da parte della rete di Impresa GIS Italiana GeoNetCom di partecipare come “osservatore” ad un interessante mercato estero (l’Albania e di verificare come 5 aziende italiane (GisItalia srl Milano-Trento, I&S Informatica e Servizi Trento, Geoslab srl Avellino, Sistemi Territoriali srl Pisa e Tecnopiani srl Roma-Chieti e due new entry della rete (MARSec spa Benevento e ISE-Net Torino stanno lavorando insieme per l’internazionalizzazione, l’offerta era troppo ghiotta per rinunciarci, anche perchè per il sottoscritto era l’occasione di rientrare in contatto con Tirana dopo ben 16 anni. 5th International Fair Konfindustria Albania & Kosovo GeoMedia  has  received  an  invitation  from  GeoNetCom, an Italian  network  of  Enterprise  GIS,  to  participate  as  "observ-ers" to a foreign market attractive (Albania and to see how five Italian Companies (GisItalia srl Milano-Trento, I & S Infor-mation Technology and Services Trento, Geoslab srl Avellino, Regional Systems srl Rome-Pisa and Infopiani Chieti with two new entries in the network (MARSEC ISE-net spa Benevento and Turin, are working together to bring their activity at the international level in a Country quickly growing as Albania.

  19. Increasing knowledge, skills, and empathy among direct care workers in elder care: a preliminary study of an active-learning model.

    Science.gov (United States)

    Braun, Kathryn L; Cheang, Michael; Shigeta, Dennis

    2005-02-01

    We describe the development of a 24-hr curriculum for nonclinical direct care workers in elder care that features active-learning strategies and consumer-directed approaches. Our curricular design was based on adult education theory and a survey of 70% of the community's service providers. Training was completed by 88 participants, 90% of whom had no prior formal training in elder care. Questionnaires measured participant knowledge, attitudes, and perceived improvements in understanding, empathy, and skills. A subgroup of participants and employers provided additional feedback through focus groups. Participants significantly improved their scores on knowledge and attitude measures. In addition, direct care workers and employers gave the training high marks and identified ways in which the course helped increase workers' competence, empathy toward elders, and self-esteem. Lack of time and funds for training were two major barriers to broader participation. This active-learning curriculum represents a frugal yet effective way to train current and future direct care workers.

  20. Validation of an information-motivation-behavioral skills model of self-care among Chinese adults with type 2 diabetes.

    Science.gov (United States)

    Gao, Junling; Wang, Jingli; Zhu, Yaocheng; Yu, Jinming

    2013-02-04

    Self-care is a crucial component of diabetes management. But comprehensive behavior change frameworks are needed to provide guidance for the design, implementation, and evaluation of diabetes self-care programs in diverse populations. We tested the Information-Motivation-Behavioral Skills (IMB) model in a sample of Chinese adults with Type 2 diabetes. A cross-sectional study of 222 Chinese adults with type 2 diabetes was conducted in a primary care center. We collected information on demographics, provider-patient communication (knowledge), social support (motivation), self-efficacy (behavioral skills), and diabetes self-care (behavior). The values of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were also obtained. Measured variable path analyses were used to the IMB framework. Provider-patient communication (β = 0.12, p = .037), and social support (β = 0.19, p = .007) and self-efficacy (β = 0.41, p motivation and behavioral skills to effect behavior change.

  1. Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: a systematic review.

    Science.gov (United States)

    Vieira, Claudia; Portela, Anayda; Miller, Tina; Coast, Ernestina; Leone, Tiziana; Marston, Cicely

    2012-01-01

    Improved access to skilled health personnel for childbirth is a priority strategy to improve maternal health. This study investigates interventions to achieve this where traditional birth attendants were providers of childbirth care and asks what has been done and what has worked? We systematically reviewed published and unpublished literature, searching 26 databases and contacting experts to find relevant studies. We included references from all time periods and locations. 132 items from 41 countries met our inclusion criteria and are included in an inventory; six were intervention evaluations of high or moderate quality which we further analysed. Four studies report on interventions to deploy midwives closer to communities: two studies in Indonesia reported an increase in use of skilled health personnel; another Indonesian study showed increased uptake of caesarean sections as midwives per population increased; one study in Bangladesh reported decreased risk of maternal death. Two studies report on interventions to address financial barriers: one in Bangladesh reported an increase in use of skilled health personnel where financial barriers for users were addressed and incentives were given to skilled care providers; another in Peru reported that use of emergency obstetric care increased by subsidies for preventive and maternity care, but not by improved quality of care. The interventions had positive outcomes for relevant maternal health indicators. However, three of the studies evaluate the village midwife programme in Indonesia, which limits the generalizability of conclusions. Most studies report on a main intervention, despite other activities, such as community mobilization or partnerships with traditional birth attendants. Many authors note that multiple factors including distance, transport, family preferences/support also need to be addressed. Case studies of interventions in the inventory illustrate how different countries attempted to address these

  2. The effectiveness of birth plans in increasing use of skilled care at delivery and postnatal care in rural Tanzania: a cluster randomised trial.

    Science.gov (United States)

    Magoma, Moke; Requejo, Jennifer; Campbell, Oona; Cousens, Simon; Merialdi, Mario; Filippi, Veronique

    2013-04-01

    To determine the effectiveness of birth plans in increasing use of skilled care at delivery and in the postnatal period among antenatal care (ANC) attendees in a rural district with low occupancy of health units for delivery but high antenatal care uptake in northern Tanzania. Cluster randomised trial in Ngorongoro district, Arusha region, involving 16 health units (8 per arm). Nine hundred and five pregnant women at 24 weeks of gestation and above (404 in the intervention arm) were recruited and followed up to at least 1 month postpartum. Skilled delivery care uptake was 16.8% higher in the intervention units than in the control [95% CI 2.6-31.0; P = 0.02]. Postnatal care utilisation in the first month of delivery was higher (difference in proportions: 30.0% [95% CI 1.3-47.7; P < 0.01]) and also initiated earlier (mean duration 6.6 ± 1.7 days vs. 20.9 ± 4.4 days, P < 0.01) in the intervention than in the control arm. Women's and providers' reports of care satisfaction (received or provided) did not differ greatly between the two arms of the study (difference in proportion: 12.1% [95% CI -6.3-30.5] P = 0.17 and 6.9% [95% CI -3.2-17.1] P = 0.15, respectively). Implementation of birth plans during ANC can increase the uptake of skilled delivery and post delivery care in the study district without negatively affecting women's and providers' satisfaction with available ANC services. Birth plans should be considered along with the range of other recommended interventions as a strategy to improve the uptake of maternal health services. © 2013 Blackwell Publishing Ltd.

  3. Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study

    OpenAIRE

    Sharad Onta; Bishnu Choulagai; Binjwala Shrestha; Narayan Subedi; Gajananda P. Bhandari; Alexandra Krettek

    2014-01-01

    Background: Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care.Design: We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the...

  4. Development and psychometric properties of ECPICID-AVC to measure informal caregivers' skills when caring for older stroke survivors at home.

    Science.gov (United States)

    Araújo, Odete; Lage, Isabel; Cabrita, José; Teixeira, Laetitia

    2016-12-01

    Informal caregivers provide a significant part of the total care needed by dependent older people poststroke. Although informal care is often the preferred option of those who provide and those who receive informal care, informal caregivers often report lack of preparation to take care of older dependent people. This article outlines the development and psychometric testing of informal caregivers' skills when providing care to older people after a stroke - ECPICID-AVC. Prospective psychometric instrument validation study. Eleven experts participated in a focus group in order to delineate, develop and validate the instrument. Data were gathered among adult informal caregivers (n = 186) living in the community in Northern Portugal from August 2013 to January 2014. The 32-item scale describes several aspects of informal caregiver's skills. The scale has eight factors: skill to feed/hydrate by nasogastric feeding, skill to assist the person in personal hygiene, skill to assist the person for transferring, skill to assist the person for positioning, skill to provide technical aids, skill to assist the person to use the toilet, skill to feed/hydrate and skill to provide technical aids for dressing/undressing. Analysis demonstrated adequate internal consistency (Cronbach's alpha = 0.83) and good temporal stability 0.988 (0.984-0.991). The psychometric properties of the measurement tool showed acceptable results allowing its implementation in clinical practice by the nursing community staff for evaluating practical skills in informal caregivers when providing care to older stroke survivors living at home. © 2016 Nordic College of Caring Science.

  5. Hands-On Defibrillation Skills of Pediatric Acute Care Providers During a Simulated Ventricular Fibrillation Cardiac Arrest Scenario.

    Science.gov (United States)

    Bhalala, Utpal S; Balakumar, Niveditha; Zamora, Maria; Appachi, Elumalai

    2018-01-01

    Introduction: Timely defibrillation in ventricular fibrillation cardiac arrest (VFCA) is associated with good outcome. While defibrillation skills of pediatric providers have been reported to be poor, the factors related to poor hands-on defibrillation skills of pediatric providers are largely unknown. The aim of our study was to evaluate delay in individual steps of the defibrillation and human and non-human factors associated with poor hands-on defibrillation skills among pediatric acute care providers during a simulated VFCA scenario. Methods: We conducted a prospective observational study of video evaluation of hands-on defibrillation skills of pediatric providers in a simulated VFCA in our children's hospital. Each provider was asked to use pads followed by paddles to provide 2 J/kg shock to an infant mannequin in VFCA. The hands-on skills were evaluated for struggle with any step of defibrillation, defined a priori as >10 s delay with particular step. The data was analyzed using chi-square test with significant p -value 10 s delay) with each of connecting the pads/paddles to the device, using pads/paddles on the mannequin and using buttons on the machine was 34 (50%), 26 (38%), and 31 (46%), respectively. Conclusions: The defibrillation skills of providers in a tertiary care children's hospital are poor. Both human and machine-related factors are associated with delay in defibrillation. Prior use of the study defibrillator is associated with a significantly shorter time-to-first shock as compared to prior use of any other defibrillator or no prior use of any defibrillator.

  6. Building Resilience for Palliative Care Clinicians: An Approach to Burnout Prevention Based on Individual Skills and Workplace Factors.

    Science.gov (United States)

    Back, Anthony L; Steinhauser, Karen E; Kamal, Arif H; Jackson, Vicki A

    2016-08-01

    For palliative care (PC) clinicians, the work of caring for patients with serious illness can put their own well-being at risk. What they often do not learn in training, because of the relative paucity of evidence-based programs, are practical ways to mitigate this risk. Because a new study indicates that burnout in PC clinicians is increasing, we sought to design an acceptable, scalable, and testable intervention tailored to the needs of PC clinicians. In this article, we describe our paradigm for approaching clinician resilience, our conceptual model, and curriculum for a workplace resilience intervention for hospital-based PC teams. Our paradigm for approaching resilience is based on upstream, early intervention. Our conceptual model posits that clinician well-being is influenced by personal resources and work demands. Our curriculum for increasing clinician resilience is based on training in eight resilience skills that are useful for common challenges faced by clinicians. To address workplace issues, our intervention also includes material for the team leader and a clinician perception survey of work demands and workplace engagement factors. The intervention will focus on individual skill building and will be evaluated with measures of resilience, coping, and affect. For PC clinicians, resilience skills are likely as important as communication skills and symptom management as foundations of expertise. Future work to strengthen clinician resilience will likely need to address system issues more directly. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Predictors of Antenatal Care, Skilled Birth Attendance, and Postnatal Care Utilization among the Remote and Poorest Rural Communities of Zambia: A Multilevel Analysis.

    Science.gov (United States)

    Jacobs, Choolwe; Moshabela, Mosa; Maswenyeho, Sitali; Lambo, Nildah; Michelo, Charles

    2017-01-01

    Optimal utilization of maternal health-care services is associated with reduction of mortality and morbidity for both mothers and their neonates. However, deficiencies and disparity in the use of key maternal health services within most developing countries still persist. We examined patterns and predictors associated with the utilization of specific indicators for maternal health services among mothers living in the poorest and remote district populations of Zambia. A cross-sectional baseline household survey was conducted in May 2012. A total of 551 mothers with children between the ages 0 and 5 months were sampled from 29 catchment areas in four rural and remote districts of Zambia using the lot quality assurance sampling method. Using multilevel modeling, we accounted for individual- and community-level factors associated with utilization of maternal health-care services, with a focus on antenatal care (ANC), skilled birth attendance (SBA), and postnatal care (PNC). Utilization rates of focused ANC, SBA, and PNC within 48 h were 30, 37, and 28%, respectively. The mother's ability to take an HIV test and receiving test results and uptake of intermittent preventive treatment for malaria were positive predictors of focused ANC. Receiving ANC at least once from skilled personnel was a significant predictor of SBA and PNC within 48 h after delivery. Women who live in centralized rural areas were more likely to use SBA than those living in remote rural areas. Utilization of maternal health services by mothers living among the remote and poor marginalized populations of Zambia is much lower than the national averages. Finding that women that receive ANC once from a skilled attendant among the remote and poorest populations are more likely to have a SBA and PNC, suggests the importance of contact with a skilled health worker even if it is just once, in influencing use of services. Therefore, it appears that in order for women in these marginalized communities to

  8. Increasing the health literacy of learning disability and mental health nurses in physical care skills: a pre and post-test evaluation of a workshop on diabetes care.

    Science.gov (United States)

    Hemingway, Steve; Stephenson, John; Trotter, Fiona; Clifton, Andrew; Holdich, Phillip

    2015-01-01

    This paper presents the pre- and post-test results of the outcomes of a workshop designed to increase learning disability and mental health nurses' knowledge and skill to undertake interventions for service users at risk of, or with a diagnosis of, type 2 diabetes. Health literacy is also discussed as a way of explaining why such nurses may lack expertise in physical health care. Findings from the workshop show that learning disability and mental health nurses have the motivation to increase their health literacy (skills and knowledge) in diabetes care. The potential of such workshops, and how organisations looking forward to the future can build health literacy, is discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Advances in Grid and Pervasive Computing: 5th International Conference, GPC 2010, Hualien, Taiwan, May 10-13, 2010: Proceedings

    NARCIS (Netherlands)

    Bellavista, P.; Chang, R.-S.; Chao, H.-C.; Lin, S.-F.; Sloot, P.M.A.

    2010-01-01

    This book constitutes the proceedings of the 5th international conference, CPC 2010, held in Hualien, Taiwan in May 2010. The 67 full papers are selected from 184 submissions and focus on topics such as cloud and Grid computing, peer-to-peer and pervasive computing, sensor and mobile networks,

  10. Proceedings of the International Conference on Educational Data Mining (EDM) (5th, Chania, Greece, June 19-21, 2012)

    Science.gov (United States)

    International Educational Data Mining Society, 2012

    2012-01-01

    The 5th International Conference on Educational Data Mining (EDM 2012) is held in picturesque Chania on the beautiful Crete island in Greece, under the auspices of the International Educational Data Mining Society (IEDMS). The EDM 2012 conference is a leading international forum for high quality research that mines large data sets of educational…

  11. Coming 5th Edition of the API Standard 618: major changes compared to the API 618, 4th edition

    NARCIS (Netherlands)

    Pyle, A.; Eijk, A.; Elferink, H.

    2003-01-01

    This paper will present the highlights of changes that will be found in the 5th Edition of API 618, which is expected to be published in late 2003 or early 2004. Approximately every 5 years the API Standards are revised in such a way that the latest field experiences and proven designs are included

  12. Communicating Science to Impact Learning? A Phenomenological Inquiry into 4th and 5th Graders' Perceptions of Science Information Sources

    Science.gov (United States)

    Gelmez Burakgazi, Sevinc; Yildirim, Ali; Weeth Feinstein, Noah

    2016-01-01

    Rooted in science education and science communication studies, this study examines 4th and 5th grade students' perceptions of science information sources (SIS) and their use in communicating science to students. It combines situated learning theory with uses and gratifications theory in a qualitative phenomenological analysis. Data were gathered…

  13. FOREWORD: 5th International Workshop on New Computational Methods for Inverse Problems

    Science.gov (United States)

    Vourc'h, Eric; Rodet, Thomas

    2015-11-01

    This volume of Journal of Physics: Conference Series is dedicated to the scientific research presented during the 5th International Workshop on New Computational Methods for Inverse Problems, NCMIP 2015 (http://complement.farman.ens-cachan.fr/NCMIP_2015.html). This workshop took place at Ecole Normale Supérieure de Cachan, on May 29, 2015. The prior editions of NCMIP also took place in Cachan, France, firstly within the scope of ValueTools Conference, in May 2011, and secondly at the initiative of Institut Farman, in May 2012, May 2013 and May 2014. The New Computational Methods for Inverse Problems (NCMIP) workshop focused on recent advances in the resolution of inverse problems. Indeed, inverse problems appear in numerous scientific areas such as geophysics, biological and medical imaging, material and structure characterization, electrical, mechanical and civil engineering, and finances. The resolution of inverse problems consists of estimating the parameters of the observed system or structure from data collected by an instrumental sensing or imaging device. Its success firstly requires the collection of relevant observation data. It also requires accurate models describing the physical interactions between the instrumental device and the observed system, as well as the intrinsic properties of the solution itself. Finally, it requires the design of robust, accurate and efficient inversion algorithms. Advanced sensor arrays and imaging devices provide high rate and high volume data; in this context, the efficient resolution of the inverse problem requires the joint development of new models and inversion methods, taking computational and implementation aspects into account. During this one-day workshop, researchers had the opportunity to bring to light and share new techniques and results in the field of inverse problems. The topics of the workshop were: algorithms and computational aspects of inversion, Bayesian estimation, Kernel methods, learning methods

  14. Interpersonal Skills

    Directory of Open Access Journals (Sweden)

    Barakat NG

    2007-01-01

    Full Text Available INTRODUCTIONInterpersonal skills are becoming more and more a necessity in the medical profession. The expectation from health care professionals is beyond just knowledge of the medical facts. To practice medicine effectively, doctors need to develop interpersonal skills in communication, leadership, management, teaching and time management. All of these are vital tools and are becoming increasingly essential subjects in teaching both undergraduate students and postgraduate doctors. However, a degree of self-motivation and personal initiative is needed to develop these skills. In this article, I will give an overview on interpersonal skills and will be follow this by a series of articles, in future issues, dealing with these skills.

  15. Simulation-based end-of-life care training during surgical clerkship: assessment of skills and perceptions.

    Science.gov (United States)

    Parikh, Priti P; Brown, Ronald; White, Mary; Markert, Ronald J; Eustace, Rosemary; Tchorz, Kathryn

    2015-06-15

    Assessment of interpersonal and psychosocial competencies during end-of-life care training is essential. This study reports the relationship between simulation-based end-of-life care Objective Structured Clinical Examination ratings and communication skills, trust, and self-assessed empathy along with the perceptions of students regarding their training experiences. Medical students underwent simulation-based end-of-life care OSCE training that involved standardized patients who evaluated students' communication skills and physician trust with the Kalamazoo Essential Elements Communication Checklist and the Wake Forest Physician Trust Scale. Students also completed the Jefferson Scale of Physician Empathy. Pearson correlation was used to examine the relationship between OSCE performance grades and communication, trust, and empathy scores. Student comments were analyzed using the constant comparative method of analysis to identify dominant themes. The 389 students (mean age 26.6 ± 2.8 y; 54.5% female) had OSCE grades that were positively correlated with physician trust scores (r = 0.325, P training to be a valuable learning experience and appreciated its placement early in clinical training. We found that simulation-based OSCE training in palliative and end-of-life care can be effectively conducted during a surgery clerkship. Moreover, the standardized patient encounters combined with the formal assessment of communication skills, physician trust, and empathy provide feedback to students at an early phase of their professional life. The positive and appreciative comments of students regarding the opportunity to practice difficult patient conversations suggest that attention to these professional characteristics and skills is a valued element of clinical training and conceivably a step toward better patient outcomes and satisfaction. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Let’s Talk Critical. Development and Evaluation of a Communication Skills Training Program for Critical Care Fellows

    Science.gov (United States)

    Hsieh, S. Jean; Howes, Jennifer M.; Keene, Adam B.; Fausto, James A.; Pinto, Priya A.; Gong, Michelle Ng

    2015-01-01

    Rationale: Although expert communication between intensive care unit clinicians with patients or surrogates improves patient- and family-centered outcomes, fellows in critical care medicine do not feel adequately trained to conduct family meetings. Objectives: We aimed to develop, implement, and evaluate a communication skills program that could be easily integrated into a U.S. critical care fellowship. Methods: We developed four simulation cases that provided communication challenges that critical care fellows commonly face. For each case, we developed a list of directly observable tasks that could be used by faculty to evaluate fellows during each simulation. We developed a didactic curriculum of lectures/case discussions on topics related to palliative care, end-of-life care, communication skills, and bioethics; this month-long curriculum began and ended with the fellows leading family meetings in up to two simulated cases with direct observation by faculty who were not blinded to the timing of the simulation. Our primary measures of effectiveness were the fellows’ self-reported change in comfort with leading family meetings after the program was completed and the quality of the communication as measured by the faculty evaluators during the family meeting simulations at the end of the month. Measurements and Main Results: Over 3 years, 31 critical care fellows participated in the program, 28 of whom participated in 101 family meeting simulations with direct feedback by faculty facilitators. Our trainees showed high rates of information disclosure during the simulated family meetings. During the simulations done at the end of the month compared with those done at the beginning, our fellows showed significantly improved rates in: (1) verbalizing an agenda for the meeting (64 vs. 41%; Chi-square, 5.27; P = 0.02), (2) summarizing what will be done for the patient (64 vs. 39%; Chi-square, 6.21; P = 0.01), and (3) providing a follow-up plan (60 vs. 37%; Chi

  17. Non-technical skills and health care provision in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Scott, John; Revera Morales, Dianali; McRitchie, Andrew; Riviello, Robert; Smink, Douglas; Yule, Steven

    2016-04-01

    Health care workers must possess high levels of medical knowledge, technical skills and also non-technical skills (NTS) in order to provide safe, effective and patient-centred care. Although there has been a recent proliferation of NTS assessment and training tools developed in high-income countries, little is known about NTS in low- and middle-income countries (LMICs), which face a variety of provider-level and system-level challenges. The aim of this study was to identify the NTS used by providers in LMICs that have been studied, describe how they are assessed and taught, and explain the contextual factors in LMICs that affect their use. We conducted a systematic literature review in accordance with preferred reporting items for systematic reviews and meta-analyses guidelines for primary research publications from January 1994 to December 2013 on evaluation or teaching of NTS used by health care workers in LMICs using MEDLINE, Embase, CIHHAL and Web of Science. Bibliographies of relevant manuscripts were also hand-searched to identify all potentially eligible manuscripts. We identified 21 manuscripts from 17 LMICs involving eight types of health care providers and trainees. These studies covered five NTS categories: decision making, communication, teamwork, leadership and stress management. The most commonly used methods were questionnaires, interviews and observations, and 43% (n = 9) scored > 10 points using the Medical Education Research Study Quality Instrument. Although many studies highlighted the ways in which overburdened health care systems, lack of provider empowerment and deficiencies in provider training had an impact on providers' use of these NTS, no context-specific assessment or educational tools were identified. There is growing worldwide interest in understanding and teaching critical non-technical skills to health care providers. This review highlights several studies describing a variety of important non-technical skills. However, these

  18. Improvements in primary care skills and knowledge with a vocational training program – a pre–post survey

    Directory of Open Access Journals (Sweden)

    Djalali S

    2017-07-01

    Full Text Available Sima Djalali, Ryan Tandjung, Thomas Rosemann, Stefan Markun Institute of Primary Care, University of Zurich, University Hospital Zurich, Zurich, Switzerland Background: Facing the upcoming shortage of primary care physicians (PCPs, medical and governmental organizations have recently made major investments to foster vocational training programs in Switzerland, designed to provide context-specific training for trainees in primary care practices. Less is known about the impact of these programs on the skills and specific knowledge of trainees. We aimed to evaluate the Cantonal program for vocational primary care training in the Canton of Zurich, Switzerland’s largest Canton.Methods: We undertook a pretest–posttest study and surveyed physicians before and after participating in the Cantonal program for vocational primary care training in the Swiss Canton of Zurich. All trainees who participated in the program from 2013 until the end of 2015 were eligible. Primary outcome was the proportion of trainees being confident about their professional, organizational, examination and management skills before and after completing vocational training. Secondary outcomes were the proportion of trainees stating knowledge gain in entrepreneurship and the proportion of trainees being motivated to pursue a career as PCP.Results: Data of 47 trainees participating in the vocational training between 2013 and 2015 were eligible. In total, 35 (74.5% participated in the T1 survey and 34 (72.3% in the T2 survey. At T2, significantly more trainees (T1: 11%−89%, T2: 79%−100% stated to be at least “slightly confident” about their skills (p<0.05 for each individual skill. Knowledge gain in entrepreneurship was highly expected and experienced by the trainees (55%−77% of respondents in case of medicine-specific contents, but hardly expected in case of general business contents (≤47% of respondents. Concerning trainees’ motivation to pursue a career as PCP

  19. Ensuring relational competency in critical care: Importance of nursing students' communication skills.

    Science.gov (United States)

    Sánchez Expósito, Judit; Leal Costa, César; Díaz Agea, José Luis; Carrillo Izquierdo, María Dolores; Jiménez Rodríguez, Diana

    2018-02-01

    The aim of this study was to analyse the communication skills of students in interactions with simulated critically-ill patients using a new assessment tool to study the relationships between communication skills, teamwork and clinical skills and to analyse the psychometric properties of the tool. A cross-sectional study was conducted to assess the communications skills of 52 students with critically-ill patients through the use of a new measurement tool to score video recordings of simulated clinical scenarios. The 52 students obtained low scores on their skills in communicating with patients. The reliability of the measuring instrument showed good inter-observer agreement (ICC between 0.71 and 0.90) and the validity yielded a positive correlation (pskills when communicating with critically ill patients in simulated scenarios. The measuring instrument used is therefore deemed valid and reliable for assessing nursing students through a clinical simulation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Health in the 5th 5-years Development Plan of Iran: Main Challenges, General Policies and Strategies.

    Science.gov (United States)

    Vosoogh Moghaddam, A; Damari, B; Alikhani, S; Salarianzedeh, Mh; Rostamigooran, N; Delavari, A; Larijani, B

    2013-01-01

    Access to the right to the highest attainable level of health is a constitutional right that obliges governments and other players to take step to increase all individuals' chances of obtaining good health. At the least, health and education are two crucial requirements for this as well. Iran's vision 2025 is going to lead the country to a developed state with the highest rank of economic, scientific and technological status in the region. Enjoying health, welfare, food security, social security, equal opportunities, etc, are also considered as part of characteristics of Iranian society in 2025. Although health system of Iran has many achievements in providing health services specially for the poor following the Islamic Revolution of 1979, but the evidences gathered to develop the 5(th) 5-years economical, social and cultural plan (5(th)5YDP:2011-2015), listed a variety of main challenges in stewardship, financing, resources generation and service provision functions of the existing health system. Thus, to overcome the main challenges, about 11% of general policies of 5(th)5YDP are directly address health related issues with emphasizing on healthy human and comprehensive health approach with considering: Integration of policy making, planning, evaluation, supervision and public financing; Developing both quantity and quality of health insurance system and reducing out-of-pocket expenditures for health services to 30% by the end of the 5th plan. The strategies of 5(th)5YDP adopted by the parliament as an Act will change the health system fundamentally through tuning the main drivers; so, its implementation needs brave leaders, capable managers, motivated technical staff and social mobilization.

  1. PREFACE: 5th International Workshop on Top Quark Physics (TOP2012)

    Science.gov (United States)

    Salamanna, G.; Boisvert, V.; Cerrito, L.; Khan, A.; Moretti, S.; Owen, M.; Schwanenberger, C.

    2013-07-01

    The 5th International Workshop on Top Quark Physics (TOP 2012) took place in Winchester, UK, from the 16-21 September. It gathered students as well as people active in the top quark sector and provided a framework to highlight the newest results and matters related to top quark physics. Discovered in 1995, the top quark is the sixth and heaviest of all quarks, and it is the only one with a lifetime short enough to be observed 'naked'. This makes it an important testing ground in the search for new physics. In fact, the fact of its mass being so much larger than the other quarks, hints at its special role in the Higgs mechanism. For the same reason, in many models of New Physics, new heavy resonances are expected to couple mostly with top quarks. Even if no new particles are observed, the direct correlation between its angular momentum and that of its detectable decay products allows us to probe indirectly New Physics in action when top quarks are created. In this edition of the TOP conference series, for the first time, the agenda was equally balanced between 'traditional' measurements and the now vast number of searches for physics BSM in the top quark sector, thanks mostly to the amount of data collected at the LHC in its Run I. New results were presented by both the Tevatron and the LHC collaborations: improved ttbar and single top cross-section measurements, refined techniques to measure the top quark mass and a large number of results on properties such as spin correlation and W boson polarization in top quark decays were shown. More technical discussions on the experimental issues, both from the detector and the simulation side also took place, drawing together experimentalists and theorists. Reviews of the latest results on ttbar asymmetry both from CDF and D0 and from ATLAS and CMS were shown, and theorists active in the field made some interesting points on this hot topic. Additionally, results on the search for fourth generation fermions and new

  2. The 5th Conference on Asian Trends in Prostate Cancer Hormone Therapy.

    Science.gov (United States)

    Akaza, Hideyuki; Moore, Malcolm A; Chang, Shu-Jen; Cheng, Christopher; Choi, Han Yong; Esuvaranathan, Kesavan; Hinotsu, Shiro; Hong, Sung-Joon; Kim, Choung-Soo; Kim, Wun-Jae; Murai, Masaru; Naito, Seiji; Soebadi, Doddy; Song, Jae-Mann; Umbas, Rainy; Usami, Michiyuki; Xia, Shujie; Yang, Chi-Rei

    2007-01-01

    The Conference on Asian Trends in Prostate Cancer Hormone Therapy is an annual forum for Asian urologists now in its 5th year. The 2006 conference, held in Bali, Indonesia, was attended by 27 leading urologic oncologists from China, Indonesia, Japan, Korea, Singapore, and Taiwan and featured a packed program of presentations and discussions on a wide range of topics such as relationships among clinicians and the newly opened Asia Regional Office for Cancer Control of the International Union Against Cancer (UICC), detection rates of prostate cancer by biopsy in each of the 6 Asian countries, and favored treatment modalities for hormone-refractory prostate cancer (HRPC) in each country. The first session of the conference kicked off with a keynote lecture entitled "Activities of the UICC ARO". UICC's new office will be the nerve center for its activities in the Asia region. Along with the Asian Pacific Organization for Cancer Prevention (APOCP), UICC aims to shift the focus of attention to cancer control. As such APOCP's long-running publication the APJCP is to be re-launched as the Asian Pacific Journal of Cancer Control. Although UICC is primarily concerned with cancer, several risk factors for cancer are common also to other non-communicable diseases such as diabetes and heart disease, and an important strategy is to implement measures to control these various pathologic conditions as a whole. Apart from contributing to an Asian prostate cancer registry the UICC-ARO will provide training courses, working groups, and assistance in collecting and processing data. The keynote lecture was followed by a roundtable discussion on possible ways in which clinicians from each Asian country can work with UICC. A number of suggestions were put forth including better registration, epidemiology research, possible implementation of UICC prostate cancer guidelines, early detection and screening, and roles of diet and phytotherapy. The underlying reasons for the large but

  3. PREFACE: 5th DAE-BRNS Workshop on Hadron Physics (Hadron 2011)

    Science.gov (United States)

    Jyoti Roy, Bidyut; Chatterjee, A.; Kailas, S.

    2012-07-01

    The 5th DAE-BRNS Workshop on Hadron Physics was held at the Bhabha Atomic Research Centre (BARC), Mumbai from 31 October to 4 November 2011. This workshop series, supported by the Board of Research in Nuclear Sciences, Department of Atomic Energy (BRNS, DAE), Govt. of India, began ten years ago with the first one being held at BARC, Mumbai in October 2002. The second one was held at Puri in 2005, organized jointly by Institute of Physics, Bhubneswar and Saha Institute of Nuclear Physics, Kolkata. The 3rd and 4th ones took place, respectively, at Shantineketan in 2006, organized by Visva Bharati University, and at Aligarh in 2008, organized by Aligarh Muslim University, Aligarh. The aim of the present workshop was to bring together the experts and young researchers in the field of hadron physics (both experiment and theory) and to have in-depth discussions on the current research activities in this field. The format of the workshop was: a series of review lectures by various experts from India and abroad, the presentation of advanced research results by researchers in the field, and a review of major experimental programs being planned and pursued in major laboratories in the field of hadron physics, with the aim of providing a platform for the young participants for interaction with their peers. The upcoming international FAIR facility at GSI is a unique future facility for studies of hadron physics in the charm sector and hyper nuclear physics. The Indian hadron physics community is involved in this mega science project and is working with the PANDA collaboration on the development of detectors, simulation and software tools for the hadron physics programme with antiprotons at FAIR. A one-day discussion session was held at this workshop to discuss India-PANDA activities, the current collaboration status and the work plan. This volume presents the workshop proceedings consisting of lectures and seminars which were delivered during the workshop. We are thankful to

  4. Individual, household and contextual factors associated with skilled delivery care in Ethiopia: Evidence from Ethiopian demographic and health surveys.

    Science.gov (United States)

    Mezmur, Markos; Navaneetham, Kannan; Letamo, Gobopamang; Bariagaber, Hadgu

    2017-01-01

    Despite evidence that social contexts are key determinants of health, research into factors associated with maternal health service utilization in Ethiopia has often focused on individual and household factors. The downside is that this underestimates the importance of taking contextual factors into account when planning appropriate interventions in promoting safe motherhood in the country. The purpose of this study is to fill this knowledge gap drawing attention to the largely unexplored contextual factors affecting the uptake of skilled attendance at delivery in a nationally representative sample. Data for the study comes from two rounds of the Ethiopian Demographic and Health Surveys (EDHS) conducted in the year 2005 and 2011. Analysis was done using a two-level multivariable multilevel logistic regression model with data from 14, 242 women who had a live birth in the five years preceding the surveys clustered within 540 (in the year 2005) and 624 (in the year 2011) communities. The results of the study point to multiple levels of measured and unmeasured factors affecting the uptake of skilled delivery care in the country. At community level, place of residence, community level of female education and fertility significantly predict the uptake of skilled delivery care. At individual and household level, maternal age, birth order, maternal education, household wealth and access to media predict the uptake of such service. Thus, there is a need to consider community contexts in the design of maternal health programs and employ multi-sectorial approach to addressing barriers at different levels. For example, improving access and availability of skilled delivery care should eventually enhance the uptake of such services at community level in Ethiopia. At individual level, efforts to promote the uptake of such services should constitute targeted interventions paying special attention to the needs of the youth, the multiparous, the less educated and women in the

  5. Individual, household and contextual factors associated with skilled delivery care in Ethiopia: Evidence from Ethiopian demographic and health surveys.

    Directory of Open Access Journals (Sweden)

    Markos Mezmur

    Full Text Available Despite evidence that social contexts are key determinants of health, research into factors associated with maternal health service utilization in Ethiopia has often focused on individual and household factors. The downside is that this underestimates the importance of taking contextual factors into account when planning appropriate interventions in promoting safe motherhood in the country. The purpose of this study is to fill this knowledge gap drawing attention to the largely unexplored contextual factors affecting the uptake of skilled attendance at delivery in a nationally representative sample. Data for the study comes from two rounds of the Ethiopian Demographic and Health Surveys (EDHS conducted in the year 2005 and 2011. Analysis was done using a two-level multivariable multilevel logistic regression model with data from 14, 242 women who had a live birth in the five years preceding the surveys clustered within 540 (in the year 2005 and 624 (in the year 2011 communities. The results of the study point to multiple levels of measured and unmeasured factors affecting the uptake of skilled delivery care in the country. At community level, place of residence, community level of female education and fertility significantly predict the uptake of skilled delivery care. At individual and household level, maternal age, birth order, maternal education, household wealth and access to media predict the uptake of such service. Thus, there is a need to consider community contexts in the design of maternal health programs and employ multi-sectorial approach to addressing barriers at different levels. For example, improving access and availability of skilled delivery care should eventually enhance the uptake of such services at community level in Ethiopia. At individual level, efforts to promote the uptake of such services should constitute targeted interventions paying special attention to the needs of the youth, the multiparous, the less educated and

  6. [Training of communication skills in stationary long care homes--the evaluation of a model project to develop communication skills and transfer it into practice].

    Science.gov (United States)

    Heinemann-Knoch, M; Korte, E; Heusinger, J; Klünder, M; Knoch, T

    2005-02-01

    The training of communication skills of professional caregivers in six homes for elderly people has been developed and evaluated in a model project. The purpose of the project was to strengthen the staff's orientation towards the residents, their needs, handicaps and abilities. Therefore, a series of 8 in-house training courses as well as procedures to establish the contents of the program into daily care-giving (transfer) have been developed and implemented with six teams during one year. The evaluation included interviews, questionnaires and observations and was realized with participants and non-participants of the program once before the implementation of the training program and once afterwards. We found evidence for positive effects of the training: although the staff's positive self perception of the climate of communication remained stable and mainly not affected by the training, this was contradictory to the observations. The way of giving information to the residents was improved by the training program as well as the quality of relations between staff and residents. Again, sending messages about oneself which are not care-oriented had not been affected by the training-as to the observations of care giving situations. Although the staff's self perception about the change of sending these messages was highly positive.Thus, the further development of the training program has to consider these effects.To establish the transfer of the training program into daily care giving, it proved to be helpful to specify exercises after each session which had to be carried out and discussed by the participants until the next training session.

  7. Training teachers to teach mental health skills to staff in primary care settings in a vast, under-populated area.

    Science.gov (United States)

    Goldberg, D P; Gask, L; Zakroyeva, A; Proselkova, E; Ryzhkova, N; Williams, P

    2012-12-01

    Background The Arkhangelsk Oblast is an area the size of France with a sparsely distributed population. The existing primary care staff have had very little training in the management of mental health disorders, despite the frequency of these disorders in the population. They requested special teaching on depression, suicide, somatisation and alcohol problems. Methods An educational intervention was developed in partnership with mental health and primary care staff in Russia, to develop mental health skills using established, evidence-based methods. After a preliminary demonstration of teaching methods to be employed, a 5-day full-time teaching course was offered to trainers of general practitioners and feldshers. Results The findings are presented by providing details of improvements that occurred over a 3-month period in four areas, namely depression in primary care, somatic presentations of distress, dealing with suicidal patients, and alcohol problems. We present preliminary data on how the training has generalised since our visits to Archangelsk. Conclusions Teachers who are used to teaching by didactic lectures can be taught the value of short introductory talks that invite discussion, and mental health skills can be taught using role play. The content of such training should be driven by perceived local needs, and developed in conjunction with local leaders and teachers within primary care services. Further research will be needed to establish the impact on clinical outcomes.

  8. Intercultural doctor-patient communication in daily outpatient care: relevant communication skills

    NARCIS (Netherlands)

    Paternotte, E.; Scheele, F.; Seeleman, C.M.; Bank, L.; Scherpbier, A.J.; Dulmen, S. van

    2016-01-01

    INTRODUCTION: Intercultural communication (ICC) between doctors and patients is often associated with misunderstandings and dissatisfaction. To develop ICC-specific medical education, it is important to find out which ICC skills medical specialists currently apply in daily clinical consultations.

  9. Is the Scale for Measuring Motivational Interviewing Skills a valid and reliable instrument for measuring the primary care professionals motivational skills?: EVEM study protocol.

    Science.gov (United States)

    Pérula, Luis Á; Campiñez, Manuel; Bosch, Josep M; Barragán Brun, Nieves; Arboniés, Juan C; Bóveda Fontán, Julia; Martín Alvarez, Remedios; Prados, Jose A; Martín-Rioboó, Enrique; Massons, Josep; Criado, Margarita; Fernández, José Á; Parras, Juan M; Ruiz-Moral, Roger; Novo, Jesús M

    2012-11-22

    Lifestyle is one of the main determinants of people's health. It is essential to find the most effective prevention strategies to be used to encourage behavioral changes in their patients. Many theories are available that explain change or adherence to specific health behaviors in subjects. In this sense the named Motivational Interviewing has increasingly gained relevance. Few well-validated instruments are available for measuring doctors' communication skills, and more specifically the Motivational Interviewing. The hypothesis of this study is that the Scale for Measuring Motivational Interviewing Skills (EVEM questionnaire) is a valid and reliable instrument for measuring the primary care professionals skills to get behavior change in patients. To test the hypothesis we have designed a prospective, observational, multi-center study to validate a measuring instrument. - Thirty-two primary care centers in Spain. -Sampling and Size: a) face and consensual validity: A group composed of 15 experts in Motivational Interviewing. b) Assessment of the psychometric properties of the scale; 50 physician- patient encounters will be videoed; a total of 162 interviews will be conducted with six standardized patients, and another 200 interviews will be conducted with 50 real patients (n=362). Four physicians will be specially trained to assess 30 interviews randomly selected to test the scale reproducibility. -Measurements for to test the hypothesis: a) Face validity: development of a draft questionnaire based on a theoretical model, by using Delphi-type methodology with experts. b) Scale psychometric properties: intraobservers will evaluate video recorded interviews: content-scalability validity (Exploratory Factor Analysis), internal consistency (Cronbach alpha), intra-/inter-observer reliability (Kappa index, intraclass correlation coefficient, Bland & Altman methodology), generalizability, construct validity and sensitivity to change (Pearson product-moment correlation

  10. Is the Scale for Measuring Motivational Interviewing Skills a valid and reliable instrument for measuring the primary care professionals motivational skills?: EVEM study protocol

    Directory of Open Access Journals (Sweden)

    Pérula Luis Á

    2012-11-01

    Full Text Available Abstract Background Lifestyle is one of the main determinants of people’s health. It is essential to find the most effective prevention strategies to be used to encourage behavioral changes in their patients. Many theories are available that explain change or adherence to specific health behaviors in subjects. In this sense the named Motivational Interviewing has increasingly gained relevance. Few well-validated instruments are available for measuring doctors’ communication skills, and more specifically the Motivational Interviewing. Methods/Design The hypothesis of this study is that the Scale for Measuring Motivational Interviewing Skills (EVEM questionnaire is a valid and reliable instrument for measuring the primary care professionals skills to get behavior change in patients. To test the hypothesis we have designed a prospective, observational, multi-center study to validate a measuring instrument. –Scope: Thirty-two primary care centers in Spain. -Sampling and Size: a face and consensual validity: A group composed of 15 experts in Motivational Interviewing. b Assessment of the psychometric properties of the scale; 50 physician- patient encounters will be videoed; a total of 162 interviews will be conducted with six standardized patients, and another 200 interviews will be conducted with 50 real patients (n=362. Four physicians will be specially trained to assess 30 interviews randomly selected to test the scale reproducibility. -Measurements for to test the hypothesis: a Face validity: development of a draft questionnaire based on a theoretical model, by using Delphi-type methodology with experts. b Scale psychometric properties: intraobservers will evaluate video recorded interviews: content-scalability validity (Exploratory Factor Analysis, internal consistency (Cronbach alpha, intra-/inter-observer reliability (Kappa index, intraclass correlation coefficient, Bland & Altman methodology, generalizability, construct validity and

  11. Teaching a Model of Social Skills Training to Child Care Workers at a Group Home for Adolescents, for Improvement of Treatment Planning.

    Science.gov (United States)

    Gramling, Lyle T.

    This practicum study implemented a training program in the teaching of social skills for 4 child care workers at a group home for 12 adolescents having moderate to severe emotional and behavioral problems. The inservice training program involved teaching concepts, techniques, and social skills terminology during the first four sessions, with…

  12. Intercultural doctor-patient communication in daily outpatient care: relevant communication skills.

    Science.gov (United States)

    Paternotte, Emma; Scheele, Fedde; Seeleman, Conny M; Bank, Lindsay; Scherpbier, Albert J J A; van Dulmen, Sandra

    2016-10-01

    Intercultural communication (ICC) between doctors and patients is often associated with misunderstandings and dissatisfaction. To develop ICC-specific medical education, it is important to find out which ICC skills medical specialists currently apply in daily clinical consultations. Doctor-patient consultations of Dutch doctors with non-Dutch patients were videotaped in a multi-ethnic hospital in the Netherlands. The consultations were analyzed using the validated MAAS-Global assessment list in combination with factors influencing ICC, as described in the literature. In total, 39 videotaped consultations were analyzed. The doctors proved to be capable of practising many communication skills, such as listening and empathic communication behaviour. Other skills were not practised, such as being culturally aware and checking the patient's language ability. We showed that doctors did practice some but not all the relevant ICC skills and that the ICC style of the doctors was mainly biomedically centred. Furthermore, we discussed the possible overlap between intercultural and patient-centred communication. Implications for practice could be to implement the relevant ICC skills in the existing communication training or develop a communication training with a patient-centred approach including ICC skills.

  13. Targeted neurosurgical outreach: 5-year follow-up of operative skill transfer and sustainable care in Lima, Peru.

    Science.gov (United States)

    Duenas, Vincent J; Hahn, Edward J; Aryan, Henry E; Levy, Michael V; Jandial, Rahul

    2012-08-01

    This study evaluates the efficacy of operative skill transfer in the context of targeted pediatric outreach missions. In addition, the ability to implement surgical care improvements that are sustainable is investigated. Three 1-week targeted neurosurgical missions were performed (2004-2006) to teach neuroendoscopy, which included donation of the necessary equipment so newly acquired surgical skills could be performed by local neurosurgeons in between and after the departure of the mission team. After the targeted missions were completed, 5 years of neuroendoscopy case follow-up data were obtained. After performing pediatric neurosurgery missions in 2004-2006, with a focus on teaching neuroendoscopy, the host team demonstrated the sustainability of our didactic efforts in the subsequent 5 years by performing cases independently for their citizens. To date, a total of 196 operations have been performed in the past 5 years independent of any visiting team. Effective operative skill transfer to host neurosurgeons can be accomplished with limited international team visits utilizing a targeted approach that minimizes expenditures on personnel and capital. With the priority being teaching of an operative technique, as opposed to perennially performing operations by the mission team, sustainable surgical care was achieved after missions officially concluded.

  14. Coronal MR imaging of the normal 3rd, 4th, and 5th lumbar and 1st sacral nerve roots

    International Nuclear Information System (INIS)

    Hald, J.K.; Nakstad, P.H.; Hauglum, B.E.

    1991-01-01

    Seven healthy volunteers underwent coronal MR imaging at 1.5 tesla of the normal 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots. Coronal slices, 3-mm-thick with a 0.3-mm gap between the slices were obtained (TR/TE 600/22) through the lumbar spinal canal. All the nerve roots were visible on at least one image. One can routinely expect to demonstrate the 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots on T1-weighted, 3-mm-thick coronal MR scans. We found no correlation between the degree of lumbar lordosis and the lengths of the visible nerve roots. Five patients with one of the following spinal problems: anomaly, tumor, disk herniation, and failed back surgery syndrome were examined according to our protocol. In all these cases coronal MR imaging gave the correct diagnosis. (orig.)

  15. Coronal MR imaging of the normal 3rd, 4th, and 5th lumbar and 1st sacral nerve roots

    Energy Technology Data Exchange (ETDEWEB)

    Hald, J K; Nakstad, P H; Hauglum, B E [National Hospital, Oslo (Norway). Dept. of Radiology

    1991-05-01

    Seven healthy volunteers underwent coronal MR imaging at 1.5 tesla of the normal 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots. Coronal slices, 3-mm-thick with a 0.3-mm gap between the slices were obtained (TR/TE 600/22) through the lumbar spinal canal. All the nerve roots were visible on at least one image. One can routinely expect to demonstrate the 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots on T1-weighted, 3-mm-thick coronal MR scans. We found no correlation between the degree of lumbar lordosis and the lengths of the visible nerve roots. Five patients with one of the following spinal problems: anomaly, tumor, disk herniation, and failed back surgery syndrome were examined according to our protocol. In all these cases coronal MR imaging gave the correct diagnosis. (orig.).

  16. Draft of the 3. update of the energy programme of the Federal Government from 5th October 1981

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    On 4th November 1981 the Federal Government is expected to pass the third update of the energy programme of the Federal Government. The last drafts are being made within the Federal Ministries. 'Technologie-Nachrichten' has herewith published the most important passages from this 3rd update according to the draft of the Federal Government from 5th October 1981 which has been presented to the Nuclear Cabinet. The following texts are taken from this version. (orig./UA) [de

  17. Fast Food Consumption and Food Prices: Evidence from Panel Data on 5th and 8th Grade Children

    OpenAIRE

    Khan, Tamkeen; Powell, Lisa M.; Wada, Roy

    2012-01-01

    Fast food consumption is a dietary factor associated with higher prevalence of childhood obesity in the United States. The association between food prices and consumption of fast food among 5th and 8th graders was examined using individual-level random effects models utilizing consumption data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K), price data from American Chamber of Commerce Researchers Association (ACCRA), and contextual outlet density data from...

  18. PREFACE: The 5th International Symposium on Quantum Theory and Symmetries (QTS5)

    Science.gov (United States)

    Gadella, M.; Izquierdo, J. M.; Kuru, S.; Negro, J.; del Olmo, M. A.

    2008-08-01

    This special issue of Journal of Physics A: Mathematical and Theoretical appears on the occasion of the 5th International Symposium on Quantum Theory and Symmetries (QTS5), held in Valladolid, Spain, from 22-28 July 2007. This is the fith in a series of conferences previously held in Goslar (Germany) 1999, QTS1; Cracow (Poland) 2001, QTS2; Cincinnati (USA) 2003, QTS3; and Varna (Bulgaria) 2005, QTS4. The QTS5 symposium gathered 181 participants from 39 countries working in different fields of theoretical physics. The spirit of the QTS conference series is to join researchers in a wide variety of topics in theoretical physics, as a way of making accessible recent results and the new lines of different fields. This is based on the feeling that it is good for a physicist to have a general overview as well as expertise in his/her own field. There are many other conferences devoted to specific topics, which are of interest to gain deeper insight in many technical aspects and that are quite suitable for discussions due to their small size. However, we believe that general conferences like this are interesting and worth keeping. We like the talks, in both plenary and parallel sessions, which are devoted to specific topics, to be prepared so as to be accessible to any researcher in any branch of theoretical physics. We think that this objective is compatible with rigour and high standards. As is well known, similar methods and techniques can be useful for many problems in different fields. We hope that this has been appreciated during the sessions of the QTS5 conference. The QTS5 conference offered the following list of topics: 1. Symmetries in string theory, quantum gravity and related topics 2. Symmetries in quantum field theories, conformal and related field theories, lattice and noncommutative theories, gauge theories 3.Quantum computing, information and control 4. Foundations of quantum theory 5. Quantum optics, coherent states, Wigner functions 6. Dynamical and

  19. PREFACE: The 5th International Symposium in Quantum Theory and Symmetries (QTS5)

    Science.gov (United States)

    Arratia, O.; Calzada, J. A.; Gómez-Cubillo, F.; Negro, J.; del Olmo, M. A.

    2008-02-01

    This volume of Journal of Physics: Conference Series contains the Proceedings of the 5th International Symposium in Quantum Theory and Symmetries (QTS5), held in Valladolid, Spain, 22-28 July 2007. This is the fifth of a series of conferences previously held in Goslar (Germany) 1999, QTS1; Cracow (Poland) 2001, QTS2; Cincinnati (USA) 2003, QTS3, and Varna (Bulgaria) 2005, QTS4. The QTS5 symposium gathered 181 participants from 39 countries working in different fields on Theoretical Physics. The spirit of the QTS conference series is to join researchers in a wide variety of topics in Theoretical Physics, as a way to make accessible recent results and the new lines of different fields. The QTS5 conference offered the following list of topics: Symmetries in String Theory, Quantum Gravity and related Symmetries in Quantum Field Theories, Conformal and Related Field Theories, Lattice and Noncommutative Theories, Gauge Theories Quantum Computing, Information and Control Foundations of Quantum Theory Quantum Optics, Coherent States, Wigner Functions Dynamical and Integrable Systems Symmetries in Condensed Matter and Statistical Physics Symmetries in Particle Physics, Nuclear, Atomic and Molecular Nonlinear Quantum Mechanics Time Asymmetric Quantum Mechanics SUSY Quantum Mechanics, PT symmetries and pseudo-Hamiltonians Mathematical Methods for Symmetries and Quantum Theories Symmetries in Chemistry Biology and other Sciences Papers accepted for publication in the present issue are based on the contributions from the participants in the QTS5 conference after a peer review process. In addition, a special issue of Journal Physics A: Mathematical and Theoretical contains contributions from plenary speakers, some participants as well as contributions from other authors whose works fit into the topics of the conference. The organization of the conference had the following pattern. In the morning there were five plenary or general sessions for all the participants, which aimed to

  20. Collaborative and Bidirectional Feedback Between Students and Clinical Preceptors: Promoting Effective Communication Skills on Health Care Teams.

    Science.gov (United States)

    Myers, Kara; Chou, Calvin L

    2016-11-01

    Current literature on feedback suggests that clinical preceptors lead feedback conversations that are primarily unidirectional, from preceptor to student. While this approach may promote clinical competency, it does not actively develop students' competency in facilitating feedback discussions and providing feedback across power differentials (ie, from student to preceptor). This latter competency warrants particular attention given its fundamental role in effective health care team communication and its related influence on patient safety. Reframing the feedback process as collaborative and bidirectional, where both preceptors and students provide and receive feedback, maximizes opportunities for role modeling and skills practice in the context of a supportive relationship, thereby enhancing team preparedness. We describe an initiative to introduce these fundamental skills of collaborative, bidirectional feedback in the nurse-midwifery education program at the University of California, San Francisco. © 2016 by the American College of Nurse-Midwives.

  1. An interprofessional workshop for students to improve communication and collaboration skills in end-of-life care.

    Science.gov (United States)

    Erickson, Jeanne M; Blackhall, Leslie; Brashers, Valentina; Varhegyi, Nikole

    2015-12-01

    Interprofessional care is critical for patients at the end of life (EOL), but programs to teach communication skills to medical and nursing students are rare. The aims of this study were to determine whether an interprofessional workshop improves (1) student attitudes toward teamwork and (2) self-efficacy for communicating in difficult situations. Nursing and medical students attended a workshop with collaborative role play of an EOL conversation. Before the workshop, students showed different attitudes toward teamwork and collaboration and varying levels of confidence about communication skills. After the workshop, both groups reported more positive attitudes toward teamwork but a mixed picture of confidence in communication. Experiential interprofessional education workshops enhance perceptions about the benefits of teamwork, but further teaching and evaluation methods are needed to maximize the effectiveness. © The Author(s) 2014.

  2. Publication Manual of the American Psychological Association--5th edition: a review of additions and changes in style requirements.

    Science.gov (United States)

    Russell, Cynthia L; Aud, Myra A

    2002-01-01

    The purpose of this article is to highlight the substantive changes and enhancements between the 4th edition and new 5th edition of the so that modifications and enhancements are more easily incorporated into the reader's writing and editing practice. The 4th and new 5th editions of the were compared and substantive changes are presented. The following text style requirements are addressed: (a) use of parentheses to enclose statistical values, (b) use of italics, and (c) presentation of statistical data. Reference citation style changes include: (a) use of italics instead of underlining, (b) use of et al., and (c) use of the hanging indent. With the explosion of electronic media use, guidelines for documenting these sources are reviewed. Appropriate use of adverbs and research subject descriptors, submission of manuscripts on disks or files, responsibilities of corresponding authors, and converting the dissertation into a journal article are addressed. This information should assist the reader to quickly and accurately focus upon the enhancements and changes in the recently released 5th edition. Hopefully these changes will easily be incorporated into the readers' editing responsibilities, manuscripts, and subsequent publications.

  3. Atomistic simulations of nanocrystalline U0.5Th0.5O2 solid solution under uniaxial tension

    Directory of Open Access Journals (Sweden)

    Hongxing Xiao

    2017-12-01

    Full Text Available Molecular dynamics simulations were performed to investigate the uniaxial tensile properties of nanocrystalline U0.5Th0.5O2 solid solution with the Born–Mayer–Huggins potential. The results indicated that the elastic modulus increased linearly with the density relative to a single crystal, but decreased with increasing temperature. The simulated nanocrystalline U0.5Th0.5O2 exhibited a breakdown in the Hall–Petch relation with mean grain size varying from 3.0 nm to 18.0 nm. Moreover, the elastic modulus of U1-yThyO2 solid solutions with different content of thorium at 300 K was also studied and the results accorded well with the experimental data available in the literature. In addition, the fracture mode of nanocrystalline U0.5Th0.5O2 was inclined to be ductile because the fracture behavior was preceded by some moderate amount of plastic deformation, which is different from what has been seen earlier in simulations of pure UO2.

  4. 5th Grade Primary School Students’ Perceptions on the Notion of Republic, Reign, and Leadership in the Social

    Directory of Open Access Journals (Sweden)

    Mehmet Suat Bal

    2011-12-01

    Full Text Available The objective of this study is to examine the perceptions of 5th grade students concerning the notion of republic, reign, and leadership, and to identify the reasons of these perceptions. In this research, phenomenography method has been used as the data collection and analysis method. A semi-structured interview form has been used as the data collection method. Randomly selected fifteen 5th grade students, who are attending state schools during the spring semester of 2010-2011 education and instruction year in a Southern province of Turkey, constitute the working group of the current study. The findings reveal that 5th grade students do not perceive the notions by themselves. Students perceive the notion of republic as Ataturk, nation, administration, war, rights, freedom, revolution, symbol, and Turkey. Similarly, the notion of reign is perceived as sultanate, sultan, Ataturk and music, and the notion of leadership is perceived as managership, superiority, manuduction, and victory. In conclusion, many students are not able to associate republic with its true meaning, namely administration, but they are able to associate it with other notions to a large extent. It should be noted that various dimensions of the notions should be emphasized to fully teach them. Also, the basic meaning of the notion should be taken as the focal point

  5. Assessment of global motor performance and gross and fine motor skills of infants attending day care centers.

    Science.gov (United States)

    Souza, Carolina T; Santos, Denise C C; Tolocka, Rute E; Baltieri, Letícia; Gibim, Nathália C; Habechian, Fernanda A P

    2010-01-01

    To analyze the global motor performance and the gross and fine motor skills of infants attending two public child care centers full-time. This was a longitudinal study that included 30 infants assessed at 12 and 17 months of age with the Motor Scale of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). This scale allows the analysis of global motor performance, fine and gross motor performance, and the discrepancy between them. The Wilcoxon test and Spearman's correlation coefficient were used. Most of the participants showed global motor performance within the normal range, but below the reference mean at 12 and 17 months, with 30% classified as having "suspected delays" in at least one of the assessments. Gross motor development was poorer than fine motor development at 12 and at 17 months of age, with great discrepancy between these two subtests in the second assessment. A clear individual variability was observed in fine motor skills, with weak linear correlation between the first and the second assessment of this subtest. A lower individual variability was found in the gross motor skills and global motor performance with positive moderate correlation between assessments. Considering both performance measurements obtained at 12 and 17 months of age, four infants were identified as having a "possible delay in motor development". The study showed the need for closer attention to the motor development of children who attend day care centers during the first 17 months of life, with special attention to gross motor skills (which are considered an integral part of the child's overall development) and to children with suspected delays in two consecutive assessments.

  6. Routine programs of health care systems as an opportunity toward communication skills training for family physicians: A randomized field trial.

    Science.gov (United States)

    Zamani, Ahmad Reza; Motamedi, Narges; Farajzadegan, Ziba

    2015-01-01

    To have high-quality primary health care services, an adequate doctor-patient communication is necessary. Because of time restrictions and limited budget in health system, an effective, feasible, and continuous training approach is important. The aim of this study is to assess the appropriateness of a communication skills training program simultaneously with routine programs of health care system. It was a randomized field trial in two health network settings during 2013. Twenty-eight family physicians through simple random sampling and 140 patients through convenience sampling participated as intervention and control group. The physicians in the intervention group (n = 14) attended six educational sessions, simultaneous organization meeting, with case discussion and peer education method. In both the groups, physicians completed communication skills knowledge and attitude questionnaires, and patients completed patient satisfaction of medical interview questionnaire at baseline, immediately after intervention, and four months postintervention. Physicians and health network administrators (stakeholders), completed a set of program evaluation forms. Descriptive statistics and Chi-square test, t-test, and repeated measure analysis of variance were used to analyze the data. Use of routine program as a strategy of training was rated by stakeholders highly on "feasibility" (80.5%), "acceptability" (93.5%), "educational content and method appropriateness" (80.75%), and "ability to integrating in the health system programs" (approximate 60%). Significant improvements were found in physicians' knowledge (P Communication skills training program, simultaneous organization meeting was successfully implemented and well received by stakeholders, without considering extra time and manpower. Therefore it can be a valuable opportunity toward communication skills training.

  7. Training oncology and palliative care clinical nurse specialists in psychological skills: evaluation of a pilot study.

    Science.gov (United States)

    Clark, Jane E; Aitken, Susan; Watson, Nina; McVey, Joanne; Helbert, Jan; Wraith, Anita; Taylor, Vanessa; Catesby, Sarah

    2015-06-01

    National guidelines in the United Kingdom recommend training Clinical Nurse Specialists in psychological skills to improve the assessment and intervention with psychological problems experienced by people with a cancer diagnosis (National Institute for Health and Clinical Excellence, 2004). This pilot study evaluated a three-day training program combined with supervision sessions from Clinical Psychologists that focused on developing skills in psychological assessment and intervention for common problems experienced by people with cancer. Questionnaires were developed to measure participants' levels of confidence in 15 competencies of psychological skills. Participants completed these prior to the program and on completion of the program. Summative evaluation was undertaken and results were compared. In addition, a focus group interview provided qualitative data of participants' experiences of the structure, process, and outcomes of the program. Following the program, participants rated their confidence in psychological assessment and skills associated with providing psychological support as having increased in all areas. This included improved knowledge of psychological theories, skills in assessment and intervention and accessing and using supervision appropriately. The largest increase was in providing psycho-education to support the coping strategies of patients and carers. Thematic analysis of interview data identified two main themes including learning experiences and program enhancements. The significance of the clinical supervision sessions as key learning opportunities, achieved through the development of a community of practice, emerged. Although this pilot study has limitations, the results suggest that a combined teaching and supervision program is effective in improving Clinical Nurse Specialists' confidence level in specific psychological skills. Participants' experiences highlighted suggestions for refinement and development of the program

  8. Collecting Validity Evidence for Simulation-Based Assessment of Point-of-Care Ultrasound Skills

    DEFF Research Database (Denmark)

    Jensen, Jesper Kørup; Dyre, Liv; Jørgensen, Mattis Enggaard

    2017-01-01

    OBJECTIVES: The aim of this study was to examine the validity of a simulator test designed to evaluate focused assessment with sonography for trauma (FAST) skills. METHODS: Participants included a group of ultrasound novices (n = 25) and ultrasound experts (n = 10). All participants had their FAST...... skills assessed using a virtual reality ultrasound simulator. Procedural performance on the 4 FAST windows was assessed by automated simulator metrics, which received a passing or failing score. The validity evidence for these simulator metrics was examined by a stepwise approach according...

  9. Effects of community participation on improving uptake of skilled care for maternal and newborn health: a systematic review.

    Directory of Open Access Journals (Sweden)

    Cicely Marston

    Full Text Available Despite a broad consensus that communities should be actively involved in improving their own health, evidence for the effect of community participation on specific health outcomes is limited. We examine the effectiveness of community participation interventions in maternal and newborn health, asking: did participation improve outcomes? We also look at how the impact of community participation has been assessed, particularly through randomised controlled trials, and make recommendations for future research. We highlight the importance of qualitative investigation, suggesting key areas for qualitative data reporting alongside quantitative work.Systematic review of published and 'grey' literature from 1990. We searched 11 databases, and followed up secondary references. Main outcome measures were the use of skilled care before/during/after birth and maternal/newborn mortality/morbidity. We included qualitative and quantitative studies from any country, and used a community participation theoretical framework to analyse the data. We found 10 interventions. Community participation had largely positive impacts on maternal/newborn health as part of a package of interventions, although not necessarily on uptake of skilled care. Interventions improving mortality or use of skilled care raised awareness, encouraged dialogue and involved communities in designing solutions-but so did those showing no effect.There are few high-quality, quantitative studies. We also lack information about why participation interventions do/do not succeed - an area of obvious interest for programme designers. Qualitative investigation can help fill this information gap and should be at the heart of future quantitative research examining participation interventions - in maternal/newborn health, and more widely. This review illustrates the need for qualitative investigation alongside RCTs and other quantitative studies to understand complex interventions in context, describe

  10. Annual Trauma Anesthesia and Critical Care Symposium (5th) Held in Amsterdam, The Netherlands on 11-12 June 1992

    Science.gov (United States)

    1992-10-01

    MB, ChB, FFARCS .\\lichael .1. Parr, .MBBS, M\\ RCP FC.Anaes 0:30 A.M. Panel Session: Questions and Answers Adolph H. Cieseekc, N.D. and Facildt 9):40...of the missions. The most frequent causes of request were neonatal emergencies or complications (31%), infections (19%) [sepsis, epiglotitis

  11. Integrating chronic care with primary care activities: enriching healthcare staff knowledge and skills and improving glycemic control of a cohort of people with diabetes through the First Line Diabetes Care Project in the Philippines

    Directory of Open Access Journals (Sweden)

    Grace Marie V. Ku

    2014-10-01

    Full Text Available Background: This study investigated the effects of integrating primary chronic care with current healthcare activities in two local government health units (LGHU of the Philippines on knowledge and skills of the LGHU staff and clinical outcomes for people with diabetes. Design: Integration was accomplished through health service reorganization, (redistribution of chronic care tasks, and training of LGHU staff. Levels of the staff's pre- and post-training diabetes knowledge and of their self-assessment of diabetes care-related skills were measured. Primary diabetes care with emphasis on self-care development was provided to a cohort of people with diabetes. Glycosylated hemoglobin (HbA1c and obesity measures were collected prior to and one year after full project implementation. Results: The training workshop improved diabetes knowledge (p<0.001 and self-assessed skills (p<0.001 of the LGHU staff. Significant reductions in HbA1c (p<0.001, waist–hip ratio (p<0.001 and waist circumference (p=0.011 of the cohort were noted. Although the reduction in HbA1c was somewhat greater among those whose community-based care providers showed improvement in knowledge and self-assessed skills, the difference was not statistically significant. Conclusions: Primary care for chronic conditions such as diabetes may be integrated with other healthcare activities in health services of low-to-middle-income countries such as the Philippines, utilizing pre-existing human resources for health, and may improve clinical endpoints.

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

    Science.gov (United States)

    Sinatra-Wilhelm, Tina

    2012-01-01

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

  13. Communication skills of tutors and family medicine physician residents in Primary Care clinics

    Directory of Open Access Journals (Sweden)

    Francisco Javier Valverde Bolívar

    2016-12-01

    Conclusion: Physicians excel in terms of creating a friendly environment, possessing good listening skills, and providing the patient with information. However the ability to empathise, exploring the psychosocial sphere, carrying out shared decision-making, and asking open questions must be improved. Being a tutor, devoting more time to consultations, and being younger, results in a significant improvement in communication with the patient.

  14. Intercultural doctor-patient communication in daily outpatient care: relevant communication skills.

    NARCIS (Netherlands)

    Paternotte, E.; Scheele, F.; Seeleman, C.M.; Bank, L.; Scherpbier, A.J.J.A.; Dulmen, A.M. van

    2016-01-01

    Introduction Intercultural communication (ICC) between doctors and patients is often associated with misunderstandings and dissatisfaction. To develop ICC-specific medical education, it is important to find out which ICC skills medical specialists currently apply in daily clinical

  15. Decentralizing Maternity Services to Increase Skilled Attendance at Birth and Antenatal Care Utilization in Rural Rwanda: A Prospective Cohort Study

    Science.gov (United States)

    Nathan, Lisa M.; Shi, Quihu; Plewniak, Kari; Zhang, Charles; Nsabimana, Damien; Sklar, Marc; Mutimura, Eugene; Merkatz, Irwin R.; Einstein, Mark H.; Anastos, Kathryn

    2015-01-01

    To evaluate the effectiveness of decentralizing ambulatory reproductive and intrapartum services to increase rates of antenatal care (ANC) utilization and skilled attendance at birth (SAB) in Rwanda. A prospective cohort study was implemented with one control and two intervention sites: decentralized ambulatory reproductive healthcare and decentralized intrapartum care. Multivariate logistic regression analysis was performed with primary outcome of lack of SAB and secondary outcome of ≥3 ANC visits. 536 women were entered in the study. Distance lived from delivery site significantly predicted SAB (p = 0.007), however distance lived to ANC site did not predict ≥3 ANC visits (p = 0.81). Neither decentralization of ambulatory reproductive healthcare (p = 0.10) nor intrapartum care (p = 0.40) was significantly associated with SAB. The control site had the greatest percentage of women receive ≥3 ANC visits (p < 0.001). Receiving <3 ANC visits was associated with a 3.98 times greater odds of not having SAB (p = 0.001). No increase in adverse outcomes was found with decentralization of ambulatory reproductive health care or intrapartum care. The factors that predict utilization of physically accessible services in rural Africa are complex. Decentralization of services may be one strategy to increase rates of SAB and ANC utilization, but selection biases may have precluded accurate analysis. Efforts to increase ANC utilization may be a worthwhile investment to increase SAB. PMID:25652061

  16. Indonesia. Adolescent reproductive health forms part of 5th country programme cycle.

    Science.gov (United States)

    1995-01-01

    Indonesia is now entering the Fifth Country Program Cycle of Population. The reproductive health and family well-being of the youth forms part of the country program. In order to translate this component into concrete action program, a project document in its first draft was developed for UNFPA (UN Population Fund) funding by the government and with the assistance of UNFPA CST, Bangkok and UNFPA Field Office in Jakarta. The project aims to raise the level of commitment and degree of participation of families, particularly parents, for developing among their pre-adolescent and adolescent children a better understanding of the concepts/process of adolescent reproductive health and desirable attitudes and values dealing with family well-being. This is to be achieved through family-centered learning approaches that will contribute to the adoption of the small, happy, and prosperous family norm. To achieve this goal, the project will develop national capacity by creating management teams, developing sets of training and counseling materials, delivering key messages through the media, upgrading skills in adolescent counseling and developing better understanding of adolescent reproductive health and family well-being issues among the facilitators. The strategy to be used is to set up small groups of 20-30 families which will regularly meet to discuss adolescent problems and issues with the help of cadres. They will be supported by provincial reproductive health and family well-being counseling centers which will also be set up to handle serious cases difficult for parents to handle. These centers, to be run by NGOs, will provide counseling services to parents and youth, evolve innovative and culturally acceptable counseling techniques, and at the same time serve as material and information collection, development and dissemination centers. The project will be launched in collaboration with seven NGOs in seven selected provinces. It is currently under review by UNFPA and

  17. The Moderating Role of Popular Peers’ Achievement Goals in 5th- and 6th- graders Achievement-related Friendships : A Social Network Analysis

    NARCIS (Netherlands)

    Wijnen, A.M.; Ryan, Allison; Harakeh, Z.; Shin, Huiyoung; Vollebergh, W.A.M.

    This research investigated whether classroom-based peer norms for achievement goals moderate friendship selection, maintenance and influence processes related to academic achievement in 46 5th and 6th grade classrooms (N = 901, 58.7% 5th grade students, 48.5% boys). A distinction was made between

  18. Exploring the Requisite Skills and Competencies of Pharmacists Needed for Success in an Evolving Health Care Environment.

    Science.gov (United States)

    McLaughlin, Jacqueline E; Bush, Antonio A; Rodgers, Philip T; Scott, Mollie Ashe; Zomorodi, Meg; Pinelli, Nicole R; Roth, Mary T

    2017-08-01

    Objective. To identify and describe the core competencies and skills considered essential for success of pharmacists in today's rapidly evolving health care environment. Methods. Six breakout groups of 15-20 preceptors, pharmacists, and partners engaged in a facilitated discussion about the qualities and characteristics relevant to the success of a pharmacy graduate. Data were analyzed using qualitative methods. Peer-debriefing, multiple coders, and member-checking were used to promote trustworthiness of findings. Results. Eight overarching themes were identified: critical thinking and problem solving; collaboration across networks and leading by influence; agility and adaptability; initiative and entrepreneurialism; effective oral and written communication; accessing and analyzing information; curiosity and imagination; and self-awareness. Conclusion. This study is an important step toward understanding how to best prepare pharmacy students for the emerging health care needs of society.

  19. The Quality of Toddler Child Care and Cognitive Skills at 24 Months: Propensity Score Analysis Results from the ECLS-B

    Science.gov (United States)

    Ruzek, Erik; Burchinal, Margaret; Farkas, George; Duncan, Greg J.

    2013-01-01

    Over half of the toddlers in the U.S. experience routine nonparental care, but much less is known about early care than about preschool care. This study analyzed 2-year-old child care and child outcome data from the nationally representative ECLS-B sample of children born in 2001. At two-years of age, 51% of children experienced exclusive parental care, 18% relative care, 15% family child care, and 16% center care. More children in nonparental care were in medium quality care (61%) than in high quality (26%) or low quality (13%) care. Low-income children were more likely than non-low income children to be cared for by their parents and, when in care, were more often in lower quality care. The impact of toddler care quality on cognitive skills was estimated using propensity score adjustments to account for potential selection confounds due to family and child characteristics. Children’s cognitive scores were higher in high or medium quality care than in low quality care, but no evidence emerged suggesting that poverty moderated the quality effects. Nevertheless, this suggests that increasing the proportion of low-income children in high quality care could reduce the achievement gap because low-income children are very unlikely to experience high quality care. PMID:24347815

  20. Effects of Universal Child Care Participation on Pre-teen Skills and Risky Behaviors

    DEFF Research Database (Denmark)

    Gupta, Nabanita Datta; Simonsen, Marianne

    This paper uses a Danish panel data child survey merged with administrative records along with a pseudo-experiment that generates variation in the take-up of preschool across municipalities to investigate pre-teenage effects of child care participation at age three (either parental care, preschoo...

  1. Marketing skills for hospital-based laboratory managers in a managed care environment.

    Science.gov (United States)

    Marchwinski, J; Coggins, F

    1997-01-01

    Managers of hospital-based laboratories have begun to realize the importance of a successful outreach program in protecting against declining inpatient activity. Succeeding in the highly competitive field of outpatient testing requires some new skills and techniques that may not have been apparent when addressing normal inpatient requirements. This article provides an overview of some very basic marketing concepts and attempts to show how they can assist the hospital-based laboratory manager in developing a successful outreach program.

  2. The impact of fatigue on the non-technical skills performance of critical care air ambulance clinicians.

    Science.gov (United States)

    Myers, J A; Powell, D M C; Aldington, S; Sim, D; Psirides, A; Hathaway, K; Haney, M F

    2017-11-01

    The relationship between fatigue-related risk and impaired clinical performance is not entirely clear. Non-technical factors represent an important component of clinical performance and may be sensitive to the effects of fatigue. The hypothesis was that the sum score of overall non-technical performance is degraded by fatigue. Nineteen physicians undertook two different simulated air ambulance missions, once when rested, and once when fatigued (randomised crossover design). Trained assessors blinded to participants' fatigue status performed detailed structured assessments based on expected behaviours in four non-technical skills domains: teamwork, situational awareness, task management, and decision making. Participants also provided self-ratings of their performance. The primary endpoint was the sum score of overall non-technical performance. The main finding, the overall non-technical skills performance rating of the clinicians, was better in rested than fatigued states (mean difference with 95% CI, 2.8 [2.2-3.4]). The findings remained consistent across individual non-technical skills domains; also when controlling for an order effect and examining the impact of a number of possible covariates. There was no difference in self-ratings of clinical performance between rested and fatigued states. Non-technical performance of critical care air transfer clinicians is degraded when they are fatigued. Fatigued clinicians may fail to recognise the degree to which their performance is compromised. These findings represent risk to clinical care quality and patient safety in the dynamic and isolated environment of air ambulance transfer. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  3. Introduction of an alternative standardized radiographic measurement method to evaluate volar angulation in subcapital fractures of the 5th metacarpal

    Energy Technology Data Exchange (ETDEWEB)

    Hoffelner, Thomas; Resch, Herbert; Moroder, Philipp; Korn, Gundobert; Steinhauer, Felix [University of Salzburg, Department of Traumatology and Sports Injuries, Salzburg (Austria); Atzwanger, Joerg [University of Salzburg, Department of Radiology, Salzburg (Austria); Minnich, Bernd [University of Salzburg, Department of Organismic Biology, Salzburg (Austria); Tauber, Mark [Shoulder and Elbow Surgery ATOS Clinic Munich, Munich (Germany)

    2012-10-15

    The purpose of the present study was to compare the intra- and interobserver reliability of two different measurement methods for volar angulation of the 5th metacarpal (MC) in an attempt to establish a new standard measurement method to reduce interobserver discrepancies for therapeutic decisions. Twenty patients with subcapital fractures of the 5th MC were radiologically investigated. Imaging consisted of a radiographs in antero-posterior and precise lateral view in addition to a CT scan of the 5th MC. Measurement of volar angulation was accomplished using the conventional and the shaft articular surface (SAS) method. The measurements of five investigators were exported to a spreadsheet for statistical analysis to evaluate the intra-and interobserver reliability. The conventional technique showed large differences among the investigators and poor interobserver reliability (W = 0.328 and 0.307) both at injury (p = 0.001) and at follow-up (p = 0.189). The intraobserver concordance of all investigators showed better results with the SAS than with the conventional technique. With the SAS technique, no statistically significant difference among the investigators could be detected at either the time of injury (p = 0.418) or at follow-up (p = 0.526) with excellent interobserver reliability (W = 0.051 and W = 0.041). Evaluation of volar angulation at follow-up using CT scans did not show any statistically significant difference between the techniques with better correlation among the observers with the SAS technique (p = 0.838). The interobserver correlation of volar angulation with lateral radiographs using the conventional technique was insufficient. Therefore, we recommend the use of the novel SAS technique as standardized measurement method which showed higher accuracy and interobserver reliability in order to facilitate the choice of adequate treatment option. (orig.)

  4. Introduction of an alternative standardized radiographic measurement method to evaluate volar angulation in subcapital fractures of the 5th metacarpal

    International Nuclear Information System (INIS)

    Hoffelner, Thomas; Resch, Herbert; Moroder, Philipp; Korn, Gundobert; Steinhauer, Felix; Atzwanger, Joerg; Minnich, Bernd; Tauber, Mark

    2012-01-01

    The purpose of the present study was to compare the intra- and interobserver reliability of two different measurement methods for volar angulation of the 5th metacarpal (MC) in an attempt to establish a new standard measurement method to reduce interobserver discrepancies for therapeutic decisions. Twenty patients with subcapital fractures of the 5th MC were radiologically investigated. Imaging consisted of a radiographs in antero-posterior and precise lateral view in addition to a CT scan of the 5th MC. Measurement of volar angulation was accomplished using the conventional and the shaft articular surface (SAS) method. The measurements of five investigators were exported to a spreadsheet for statistical analysis to evaluate the intra-and interobserver reliability. The conventional technique showed large differences among the investigators and poor interobserver reliability (W = 0.328 and 0.307) both at injury (p = 0.001) and at follow-up (p = 0.189). The intraobserver concordance of all investigators showed better results with the SAS than with the conventional technique. With the SAS technique, no statistically significant difference among the investigators could be detected at either the time of injury (p = 0.418) or at follow-up (p = 0.526) with excellent interobserver reliability (W = 0.051 and W = 0.041). Evaluation of volar angulation at follow-up using CT scans did not show any statistically significant difference between the techniques with better correlation among the observers with the SAS technique (p = 0.838). The interobserver correlation of volar angulation with lateral radiographs using the conventional technique was insufficient. Therefore, we recommend the use of the novel SAS technique as standardized measurement method which showed higher accuracy and interobserver reliability in order to facilitate the choice of adequate treatment option. (orig.)

  5. Cambridge Healthtech Institute's 5th Annual Conference: impact of genomics on medicine.

    Science.gov (United States)

    Zanders, E D

    2001-08-01

    The recent publications in Nature and Science by the Human Genome Consortium and Celera Genomics, respectively, while being landmark achievements in themselves, have also given pause for thought. A definitive catalogue of human genes is still not available but the broad picture of how humans compare with lower organisms at the genomic level is becoming clearer. The full impact of these findings on the practice of medicine is hard to predict, but research being conducted now, in the early years of the 21st century, will form the basis of future advances in the diagnosis and treatment of disease. Exactly what this will entail is the subject of intense debate, but there are some common starting points that were discussed at this meeting in Munich. The main theme to emerge was the need to move beyond the human genome sequence towards an understanding of proteins and their interactions in complex biological pathways, thereby increasing opportunities for drug discovery through the identification of new targets. The majority of the talks were therefore devoted to the description of technological advances in the analysis of gene and protein expression (and interaction) and in the use of various methods of gene deletion in order to validate individual proteins as drug targets. Perhaps it will still be a few years before it will be possible to report on the application of genomic analyses to routine medical practice at the first point of care for patients but when that happens, the research efforts described here will have been worthwhile.

  6. “Patenting Bioprinting Technologies in the US and Europe– The 5th element in the 3rd dimension"

    DEFF Research Database (Denmark)

    Minssen, Timo; Mimler, Marc

    2017-01-01

    of bioprinting- inventions are being patented or would be- protectable under European and US patent laws. Rather than focusing on the highly relevant questions that 3D printing poses for patent infringement doctrines and research exemptions , this paper concentrates on the question of patentable subject matter......, “Patenting Bioprinting Technologies in the US and Europe– The 5th element in the 3rd dimension", Working Paper, forthcoming in: RM Ballardini, M Norrgård & J Partanen (red), 3D printing, Intellectual Property and Innovation – Insights from Law and Technology. Wolters Klu. Available at https...

  7. The 14th international workshop on wave hindcasting and forecasting and the 5th coastal hazards symposium

    Science.gov (United States)

    Breivik, Øyvind; Alves, Jose Henrique; Greenslade, Diana; Horsburgh, Kevin; Swail, Val

    2017-04-01

    Following the 14th International Workshop on Wave Hindcasting and Forecasting and 5th Coastal Hazards Symposium in November 2014 in Key West, Florida, a topical collection has appeared in recent issues of Ocean Dynamics. Here, we give a brief overview of the 16 papers published in this topical collection as well as an overview of the widening scope of the conference in recent years. A general trend in the field has been towards closer integration between the wave and ocean modelling communities. This is also seen in this topical collection, with several papers exploring the interaction between surface waves and mixed layer dynamics and sea ice.

  8. 5th HUPO BPP Bioinformatics Meeting at the European Bioinformatics Institute in Hinxton, UK--Setting the analysis frame.

    Science.gov (United States)

    Stephan, Christian; Hamacher, Michael; Blüggel, Martin; Körting, Gerhard; Chamrad, Daniel; Scheer, Christian; Marcus, Katrin; Reidegeld, Kai A; Lohaus, Christiane; Schäfer, Heike; Martens, Lennart; Jones, Philip; Müller, Michael; Auyeung, Kevin; Taylor, Chris; Binz, Pierre-Alain; Thiele, Herbert; Parkinson, David; Meyer, Helmut E; Apweiler, Rolf

    2005-09-01

    The Bioinformatics Committee of the HUPO Brain Proteome Project (HUPO BPP) meets regularly to execute the post-lab analyses of the data produced in the HUPO BPP pilot studies. On July 7, 2005 the members came together for the 5th time at the European Bioinformatics Institute (EBI) in Hinxton, UK, hosted by Rolf Apweiler. As a main result, the parameter set of the semi-automated data re-analysis of MS/MS spectra has been elaborated and the subsequent work steps have been defined.

  9. IBA investigations of loose garnets from Pietroasa, Apahida and Cluj-Someşeni treasures (5th century AD)

    International Nuclear Information System (INIS)

    Bugoi, R.; Oanţă-Marghitu, R.; Calligaro, T.

    2016-01-01

    This paper reports the archaeometric investigations of 418 loose garnets from Pietroasa and Cluj-Someşeni treasures and Apahida II and III princely grave inventories (5th century AD). The chemical composition of the gems was determined by external beam micro-PIXE technique at the AGLAE accelerator of C2RMF, Paris, France. Complementary observations made by Optical Microscopy revealed details on the gemstones cutting and polishing and permitted to identify certain mineral inclusions. The compositional results evidenced several types of garnets from the pyralspite series, suggesting distinct provenances for these Early Medieval gems.

  10. IBA investigations of loose garnets from Pietroasa, Apahida and Cluj-Someşeni treasures (5th century AD)

    Science.gov (United States)

    Bugoi, R.; Oanţă-Marghitu, R.; Calligaro, T.

    2016-03-01

    This paper reports the archaeometric investigations of 418 loose garnets from Pietroasa and Cluj-Someşeni treasures and Apahida II and III princely grave inventories (5th century AD). The chemical composition of the gems was determined by external beam micro-PIXE technique at the AGLAE accelerator of C2RMF, Paris, France. Complementary observations made by Optical Microscopy revealed details on the gemstones cutting and polishing and permitted to identify certain mineral inclusions. The compositional results evidenced several types of garnets from the pyralspite series, suggesting distinct provenances for these Early Medieval gems.

  11. IBA investigations of loose garnets from Pietroasa, Apahida and Cluj-Someşeni treasures (5th century AD)

    Energy Technology Data Exchange (ETDEWEB)

    Bugoi, R., E-mail: bugoi@nipne.ro [Horia Hulubei National Institute for Nuclear Physics and Engineering, Măgurele 077125 (Romania); Oanţă-Marghitu, R., E-mail: rodicamarghitu@yahoo.com [Muzeul Naţional de Istorie a României, Bucureşti 030026 (Romania); Calligaro, T., E-mail: thomas.calligaro@culture.gouv.fr [Centre de Recherche et de Restauration des Musées de France, C2RMF, Palais du Louvre – Porte des Lions, 75001 Paris (France); PSL Research University, Chimie ParisTech – CNRS, Institut de Recherche Chimie Paris, UMR8247, 75005 Paris (France)

    2016-03-15

    This paper reports the archaeometric investigations of 418 loose garnets from Pietroasa and Cluj-Someşeni treasures and Apahida II and III princely grave inventories (5th century AD). The chemical composition of the gems was determined by external beam micro-PIXE technique at the AGLAE accelerator of C2RMF, Paris, France. Complementary observations made by Optical Microscopy revealed details on the gemstones cutting and polishing and permitted to identify certain mineral inclusions. The compositional results evidenced several types of garnets from the pyralspite series, suggesting distinct provenances for these Early Medieval gems.

  12. Industrial energy from water-mills in the European economy, 5th to 18th Centuries: the limitations of power,

    OpenAIRE

    Munro, John H.

    2002-01-01

    The water-mill, though known in the Roman Empire from the second century BCE, did not come to enjoy any widespread use until the 4th or 5th centuries CE, and then chiefly in the West, which was then experiencing not only a rapid decline in the supply of slaves, but also widespread depopulation, and thus a severe scarcity of labour. For the West -- those regions that came to form Europe -- the water-mill then became by far the predominant ‘prime mover’: i.e., an apparatus that converts natural...

  13. Validation of an Information-Motivation-Behavioral Skills model of diabetes self-care (IMB-DSC).

    Science.gov (United States)

    Osborn, Chandra Y; Egede, Leonard E

    2010-04-01

    Comprehensive behavior change frameworks are needed to provide guidance for the design, implementation, and evaluation of diabetes self-care programs in diverse populations. We applied the Information-Motivation-Behavioral Skills (IMB) model, a well-validated, comprehensive health behavior change framework, to diabetes self-care. Patients with diabetes were recruited from an outpatient clinic. Information gathered pertained to demographics, diabetes knowledge (information); diabetes fatalism (personal motivation); social support (social motivation); and diabetes self-care (behavior). Hemoglobin A1C values were extracted from the patient medical record. Structural equation models tested the IMB framework. More diabetes knowledge (r=0.22 pbehavior; and through behavior, were related to glycemic control (r=-0.20, pmotivation (less fatalistic attitudes), and social motivation (more social support) was associated with behavior; and behavior was the sole predictor of glycemic control. The IMB model is an appropriate, comprehensive health behavior change framework for diabetes self-care. The findings indicate that in addition to knowledge, diabetes education programs should target personal and social motivation to effect behavior change. 2009 Elsevier Ireland Ltd. All rights reserved.

  14. Creating a network of high-quality skilled nursing facilities: preliminary data on the postacute care quality improvement experiences of an accountable care organization.

    Science.gov (United States)

    Lage, Daniel E; Rusinak, Donna; Carr, Darcy; Grabowski, David C; Ackerly, D Clay

    2015-04-01

    Postacute care (PAC) is an important source of cost growth and variation in the Medicare program and is critical to accountable care organization (ACO) and bundled payment efforts to improve quality and value in the Medicare program, but ACOs must often look outside their walls to identify high-value external PAC partners, including skilled nursing facilities (SNFs). As a solution to this problem, the integrated health system, Partners HealthCare System (PHS) and its Pioneer ACO launched the PHS SNF Collaborative Network in October 2013 to identify and partner with high-quality SNFs. This study details the method by which PHS selected SNFs using minimum criteria based on public scores and secondary criteria based on self-reported measures, describes the characteristics of selected and nonselected SNFs, and reports SNF satisfaction with the collaborative. The selected SNFs (n = 47) had significantly higher CMS Five-Star scores than the nonselected SNFs (n = 93) (4.6 vs 3.2, P improving care in SNFs remain daunting, this approach can serve as a first step toward greater clinical collaboration between acute and postacute settings that will lead to better outcomes for frail older adults. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  15. Use of Medical Orders for Scope of Treatment for Heart Failure Patients During Postacute Care in Skilled Nursing Facilities.

    Science.gov (United States)

    Lum, Hillary; Obafemi, Oluyomi; Dukes, Joanna; Nowels, Molly; Samon, Kristina; Boxer, Rebecca S

    2017-10-01

    Individuals with heart failure (HF) who are hospitalized and admitted to skilled nursing facilities (SNFs) are at high risk for rehospitalization and death. The care preferences of this high-risk population have not been studied. To describe care preferences of patients with HF admitted to SNFs for rehabilitation based on Medical Orders for Scope of Treatment (MOST) documentation, and evaluate goal-concordant care based on MOST documentation, emergency department (ED) visits, and hospitalization. Retrospective study of patients with HF in 35 SNFs enrolled in a randomized controlled trial of HF-disease management versus usual care between July 2014 and May 2016. Validity of MOST forms, care preference documentation, and ED visits/hospitalizations within 60 days of SNF admission. Of 370 patients (mean age 78.6 years, 58% women, 25% systolic HF), 278 (75%) had a MOST form in the SNF chart, of which 96 forms (35%) were invalid. The most common reason for an invalid MOST form was missing date accompanying patient or provider signature. Of 182 valid MOST forms, 47% of patients chose no cardiopulmonary resuscitation ("No CPR"), 58% selected "Full Treatment," 17% chose "Selective Treatment," and 23% chose "Comfort-Focused Treatment." Patients who were older [odds ratio (OR) = 1.50, 95% confidence interval (CI) = 1.25, 1.81] and female (OR = 2.33, 95% CI = 1.18, 4.59) had higher odds of choosing "No CPR." Sixty-six of 182 patients (36%) with valid MOST forms had an ED/hospital visit within 60 days of SNF admission; only 3 patients received medical care that was potentially discordant: all 3 chose "Comfort-Focused Treatment" and were hospitalized for more than symptom management. Seventy-five percent of patients with HF admitted to SNFs had care preferences documented using the MOST form, and 95% received goal-concordant care based on care preferences documented during the SNF admission. Clinicaltrials.gov # NCT01822912. Copyright © 2017 AMDA – The Society for

  16. The Influence of Skill Development Training Program for Spiritual Care of Elderly Individual on Elderly Care Technician Students' Perception of Spiritual Support.

    Science.gov (United States)

    Bulduk, Serap; Usta, Esra; Dinçer, Yeliz

    2017-06-01

    Spiritual care means helping an individual protect, maintain and gain all the dimensions of his/her existence. Elderly care technicians face numerous cases or crisis situations in which elderly individuals from different backgrounds question the meaning and value of life. Elderly care technicians must acknowledge that the spirituality is an important element in the way an elderly individual receives healthcare and they must be equipped for this matter. This study was conducted in order to examine the influence of "Skill Development Training Program for Spiritual Care of Elderly Individual," which was carried out with students from elderly care program, on the perception of spirituality support in a pretest-posttest quasi-experimental study design with control group. As the data collection form, "Spiritual Support Perception" (SSP) scale was used. The mean scores of the intervention group after the training and after one month are 50.39 ± 5.34 and 51.13 ± 4.98, respectively, and those of the control group are 43.16 ± 4.83 and 42.72 ± 4.48. A statistically significant difference was found between the mean scores of the intervention group from the pretest and the posttests immediately after the training and one month after the training (f = 94.247, p = 0.001). In the control group, however, there was no significant change in the SSP mean scores (f = 0.269, p = 0.77). As a result, this study pointed out the necessity of such training programs for healthcare professionals to make a distinction between their professional duties and their own personalities in order to offer spiritual care to the elderly individual.

  17. A Novel Use of Peer Coaching to Teach Primary Palliative Care Skills: Coaching Consultation.

    Science.gov (United States)

    Jacobsen, Juliet; Alexander Cole, Corinne; Daubman, Bethany-Rose; Banerji, Debjani; Greer, Joseph A; O'Brien, Karen; Doyle, Kathleen; Jackson, Vicki A

    2017-10-01

    We aim to address palliative care workforce shortages by teaching clinicians how to provide primary palliative care through peer coaching. We offered peer coaching to internal medicine residents and hospitalists (attendings, nurse practioners, and physician assistants). An audit of peer coaching encounters and coachee feedback to better understand the applicability of peer coaching in the inpatient setting to teach primary palliative care. Residents and hospitalist attendings participated in peer coaching for a broad range of palliative care-related questions about pain and symptom management (44%), communication (34%), and hospice (22%). Clinicians billed for 68% of encounters using a time-based billing model. Content analysis of coachee feedback identified that the most useful elements of coaching are easy access to expertise, tailored teaching, and being in partnership. Peer coaching can be provided in the inpatient setting to teach primary palliative care and potentially extend the palliative care work force. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  18. Non-technical skills evaluation in the critical care air ambulance environment: introduction of an adapted rating instrument--an observational study.

    Science.gov (United States)

    Myers, Julia A; Powell, David M C; Psirides, Alex; Hathaway, Karyn; Aldington, Sarah; Haney, Michael F

    2016-03-08

    In the isolated and dynamic health-care setting of critical care air ambulance transport, the quality of clinical care is strongly influenced by non-technical skills such as anticipating, recognising and understanding, decision making, and teamwork. However there are no published reports identifying or applying a non-technical skills framework specific to an intensive care air ambulance setting. The objective of this study was to adapt and evaluate a non-technical skills rating framework for the air ambulance clinical environment. In the first phase of the project the anaesthetists' non-technical skills (ANTS) framework was adapted to the air ambulance setting, using data collected directly from clinician groups, published literature, and field observation. In the second phase experienced and inexperienced inter-hospital transport clinicians completed a simulated critical care air transport scenario, and their non-technical skills performance was independently rated by two blinded assessors. Observed and self-rated general clinical performance ratings were also collected. Rank-based statistical tests were used to examine differences in the performance of experienced and inexperienced clinicians, and relationships between different assessment approaches and assessors. The framework developed during phase one was referred to as an aeromedical non-technical skills framework, or AeroNOTS. During phase two 16 physicians from speciality training programmes in intensive care, emergency medicine and anaesthesia took part in the clinical simulation study. Clinicians with inter-hospital transport experience performed more highly than those without experience, according to both AeroNOTS non-technical skills ratings (p = 0.001) and general performance ratings (p = 0.003). Self-ratings did not distinguish experienced from inexperienced transport clinicians (p = 0.32) and were not strongly associated with either observed general performance (r(s) = 0.4, p = 0

  19. Concept mapping in a critical care orientation program: a pilot study to develop critical thinking and decision-making skills in novice nurses.

    Science.gov (United States)

    Wahl, Stacy E; Thompson, Anita M

    2013-10-01

    Newly graduated registered nurses who were hired into a critical care intensive care unit showed a lack of critical thinking skills to inform their clinical decision-making abilities. This study evaluated the effectiveness of concept mapping as a teaching tool to improve critical thinking and clinical decision-making skills in novice nurses. A self-evaluation tool was administered before and after the learning intervention. The 25-item tool measured five key indicators of the development of critical thinking skills: problem recognition, clinical decision-making, prioritization, clinical implementation, and reflection. Statistically significant improvements were seen in 10 items encompassing all five indicators. Concept maps are an effective tool for educators to use in assisting novice nurses to develop their critical thinking and clinical decision-making skills. Copyright 2013, SLACK Incorporated.

  20. Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background As the diversity of the European population evolves, measuring providers’ skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. Methods A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians’ and nurses’ mean composite scores and proportion of “3-good/4-very good” responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit “sensitized” to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Results Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = −0.34, p cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians. PMID:24479405

  1. Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study.

    Science.gov (United States)

    Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick

    2014-01-30

    As the diversity of the European population evolves, measuring providers' skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians' and nurses' mean composite scores and proportion of "3-good/4-very good" responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit "sensitized" to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = -0.34, p cultural competency improvement among providers. These results support the need for cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians.

  2. The use of tyranny in response to the Visigothic domination in the Tarraconensis (5th-6th centuries

    Directory of Open Access Journals (Sweden)

    Juan Antonio Jiménez Sánchez

    2012-08-01

    Full Text Available At the end of the 5th century, the Hispano-Roman population watched in dismay as the Visigothic presence in Tarraconensis lands grew. Between the end of the 5th century and the beginning of the 6th century, two individuals —Burdunelus and Peter— illegally came into power and led revolts against the Visigothic domination. The source that reports on these events, the Pseudo Chronica Caesaraugustana, is an extremely problematic text which for many years was interpreted as the remains of the historiola written by bishop Maximus of Saragossa (c. 599-614/620, when, in fact, they are mere annotations made on the margins of previous chronicles. Moreover, the vicissitudes of the transmission of the manuscript led to the displacement of some of these annotations from their original position, which resulted in erroneous dates. In this paper we study the entries regarding the rebellions of Burdunelus and Peter, we propose a new chronology, we analyse the social origins of these leaders, and we examine the implications of these uprisings in the context of an imminent confrontation between Visigoths and Franks.

  3. Labor and birth care by nurse with midwifery skills in Brazil.

    Science.gov (United States)

    Gama, Silvana Granado Nogueira da; Viellas, Elaine Fernandes; Torres, Jacqueline Alves; Bastos, Maria Helena; Brüggemann, Odaléa Maria; Theme Filha, Mariza Miranda; Schilithz, Arthur Orlando Correa; Leal, Maria do Carmo

    2016-10-17

    The participation of nurses and midwives in vaginal birth care is limited in Brazil, and there are no national data regarding their involvement. The goal was to describe the participation of nurses and nurse-midwives in childbirth care in Brazil in the years 2011 and 2012, and to analyze the association between hospitals with nurses and nurse-midwives in labor and birth care and the use of good practices, and their influence in the reduction of unnecessary interventions, including cesarean sections. Birth in Brazil is a national, population-based study consisting of 23,894 postpartum women, carried out in the period between February 2011 and October 2012, in 266 healthcare settings. The study included all vaginal births involving physicians or nurses/nurse-midwives. A logistic regression model was used to examine the association between the implementation of good practices and suitable interventions during labor and birth, and whether care was a physician or a nurse/nurse-midwife led care. We developed another model to assess the association between the use of obstetric interventions during labor and birth to the personnel responsible for the care of the patient, comparing hospitals with decisions revolving exclusively around a physician to those that also included nurses/nurse-midwives as responsible for vaginal births. 16.2 % of vaginal births were assisted by a nurse/nurse-midwife. Good practices were significantly more frequent in those births assisted by nurses/nurse-midwives (ad lib. diet, mobility during labor, non-pharmacological means of pain relief, and use of a partograph), while some interventions were less frequently used (anesthesia, lithotomy position, uterine fundal pressure and episiotomy). In maternity wards that included a nurse/nurse-midwife in labour and birth care, the incidence of cesarean section was lower. The results of this study illustrate the potential benefit of collaborative work between physicians and nurses/nurse-midwives in labor

  4. Preliminary Report of a Pilot Tele-Health Palliative Care and Bioethics Program for Residents in Skilled Nursing Facilities

    Directory of Open Access Journals (Sweden)

    Sean O’Mahony

    2009-12-01

    Full Text Available Currently about 25% of Americans die in nursing homes, many with poorly controlled pain and other symptoms, with minimal provisions for psychosocial support. New models are necessary to lessen structural and process barriers to give effective end-of-life care in nursing homes. Objectives: 1 To extend hospital-based Bioethics Consultation Services (BCS and Palliative Care Services (PCS at Montefiore Medical Center (MMC in the Bronx to two local Skilled Nursing Facilities (SNFs, Morningside House Aging in America (MSH using direct face-to-face consultations and Beth Abraham Health Systems (BAHS via video consultations (VC; 2 Achieve improvements in quality of life and comfort for elderly residents and their families; 2a Improve the level of practice and increase staff satisfaction with palliative care content-related knowledge and bioethical analysis. Methods: We report preliminary findings of this two group quasi experimental project with results of pre- and post- tests rating content-related knowledge in aspects of end-of-life care for staff. Select pre-test and post-test questions were given to physicians and other staff, but were re-configured for, registered and licensed practice nurses, social workers, and certified nursing assistants from the End-of-Life Physician Education Resource Center (EPERC. Patient, family, and staff ratings of the quality of palliative care were measured with a Palliative Outcomes Scale (POS one week prior to and post consultation. Results: 72 staff attended in-services; 53 completed pre-tests and 49 post-tests. Overall knowledge scores increased for 9 of the 16 items that were analyzed. There were improvements in knowledge scores in 12 of 16 items tested for staff content related knowledge which were statistically significant in regard to management of cancer pain from 63.8% to 81.5% (p = 0.03 and a trend to significance for assessment and management of delirium from 31.6% to 61.9% (p = 0.073. Seventy five POS

  5. Development of Finnish Elementary Pupils’ Problem-Solving Skills in Mathematics

    Directory of Open Access Journals (Sweden)

    Anu Laine

    2014-09-01

    Full Text Available The purpose of this study is to determine how Finnish pupils’ problemsolving skills develop from the 3rd to 5th grade. As research data, we use one non-standard problem from pre- and post-test material from a three-year follow-up study, in the area of Helsinki, Finland. The problems in both tests consisted of four questions related to each other. The purpose of the formulation of the problem was to help the pupils to find how many solutions for a certain answer exist. The participants in the study were 348 third-graders and 356 fifth-graders. Pupils’ fluency, i.e. ability to develop different solutions, was found to correlate with their ability to solve the problem. However, the proportions of the pupils (17% of the 3rd graders and 21% of the 5th graders who answered that there were an infinite number of solutions are of the same magnitude. Thus, the pupils’ ability to solve this kind of problem does not seem to have developed from the 3rd to the 5th grade. The lack and insufficiency of pupils’ justifications reveal the importance of the teacher carefully listening to the pupils’ ideas in order to be able to promote pupils’ understanding of the concept of infinity, as well as the basic calculations.

  6. Transgenerational effects of maternal care interact with fetal growth and influence attention skills at 18 months of age.

    Science.gov (United States)

    Neuwald, Marla F; Agranonik, Marilyn; Portella, André K; Fleming, Alison; Wazana, Ashley; Steiner, Meir; Levitan, Robert D; Meaney, Michael J; Silveira, Patrícia P

    2014-05-01

    Evidence suggests that there is an association between being born small for gestational age (SGA) and an increased risk of internalizing and externalizing problems, such as ADHD. Additionally, individuals who report having received a lower quality of maternal care show an increased prevalence of depression and anxiety, and they are generally worse caregivers of their offspring. Therefore, an interaction between the birth weight status and the quality of maternal care perceived by the mother could affect behavioral outcomes of the children. Evaluate the influence of being born SGA and parental bonding, as perceived by the mother during her infancy, on the children's behavior at 18 months of age. Nested cross-sectional study within a Canadian prenatal cohort (MAVAN, Maternal Adversity, Vulnerability and Neurodevelopment) recruited from 2003 to 2010. Data from 305 children who were evaluated at 18 months of age. Early Childhood Behavior Questionnaire--ECBQ and Infant-Toddler Social and Emotional Assessment--ITSEA) were included. Children born SGA whose mothers reported low maternal care during her infancy (using the Parental Bonding Instrument--PBI) showed lower scores in the attentional set shifting trait (ECBQ, p=0.002) and attention construct (ITSEA, p=0.05) at 18 months of age. We also found that SGA increases decreases cuddliness (p=0.011) and poor perceived maternal care decreases low intensity pleasure (p=0.016) on the ECBQ. These findings suggest a complex transgenerational transmission whereby mother's own care interacts with the fetal growth of her offspring to predict its attentional skills at 18 months of age. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. IntelliCare: An Eclectic, Skills-Based App Suite for the Treatment of Depression and Anxiety.

    Science.gov (United States)

    Mohr, David C; Tomasino, Kathryn Noth; Lattie, Emily G; Palac, Hannah L; Kwasny, Mary J; Weingardt, Kenneth; Karr, Chris J; Kaiser, Susan M; Rossom, Rebecca C; Bardsley, Leland R; Caccamo, Lauren; Stiles-Shields, Colleen; Schueller, Stephen M

    2017-01-05

    Digital mental health tools have tended to use psychoeducational strategies based on treatment orientations developed and validated outside of digital health. These features do not map well to the brief but frequent ways that people use mobile phones and mobile phone apps today. To address these challenges, we developed a suite of apps for depression and anxiety called IntelliCare, each developed with a focused goal and interactional style. IntelliCare apps prioritize interactive skills training over education and are designed for frequent but short interactions. The overall objective of this study was to pilot a coach-assisted version of IntelliCare and evaluate its use and efficacy at reducing symptoms of depression and anxiety. Participants, recruited through a health care system, Web-based and community advertising, and clinical research registries, were included in this single-arm trial if they had elevated symptoms of depression or anxiety. Participants had access to the 14 IntelliCare apps from Google Play and received 8 weeks of coaching on the use of IntelliCare. Coaching included an initial phone call plus 2 or more texts per week over the 8 weeks, with some participants receiving an additional brief phone call. Primary outcomes included the Patient Health Questionnaire-9 (PHQ-9) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. Participants were compensated up to US $90 for completing all assessments; compensation was not for app use or treatment engagement. Of the 99 participants who initiated treatment, 90.1% (90/99) completed 8 weeks. Participants showed substantial reductions in the PHQ-9 and GAD-7 (P<.001). Participants used the apps an average of 195.4 (SD 141) times over the 8 weeks. The average length of use was 1.1 (SD 2.1) minutes, and 95% of participants downloaded 5 or more of the IntelliCare apps. This study supports the IntelliCare framework of providing a suite of skills-focused apps that can be used frequently and

  8. Mentoring and Social Skills Training: Ensuring Better Outcomes for Youth in Foster Care

    Science.gov (United States)

    Williams, Charles A.

    2011-01-01

    Youth in foster care face significant life challenges that make it more likely that they will face negative outcomes (i.e., school failure, homelessness, and incarceration). While the reason(s) for out-of-home placement (i.e., family violence, abuse, neglect and/or abandonment) provide some context for negative outcomes, such negative outcomes…

  9. Physician-Pharmacist Collaborative Care for Dyslipidemia Patients: Knowledge and Skills of Community Pharmacists

    Science.gov (United States)

    Villeneuve, Julie; Lamarre, Diane; Lussier, Marie-Therese; Vanier, Marie-Claude; Genest, Jacques; Blais, Lucie; Hudon, Eveline; Perreault, Sylvie; Berbiche, Djamal; Lalonde, Lyne

    2009-01-01

    Introduction: In a physician-pharmacist collaborative-care (PPCC) intervention, community pharmacists were responsible for initiating lipid-lowering pharmacotherapy and adjusting the medication dosage. They attended a 1-day interactive workshop supported by a treatment protocol and clinical and communication tools. Afterwards, changes in…

  10. Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis

    Science.gov (United States)

    Munabi-Babigumira, Susan; Glenton, Claire; Lewin, Simon; Fretheim, Atle; Nabudere, Harriet

    2017-01-01

    Background In many low- and middle-income countries women are encouraged to give birth in clinics and hospitals so that they can receive care from skilled birth attendants. A skilled birth attendant (SBA) is a health worker such as a midwife, doctor, or nurse who is trained to manage normal pregnancy and childbirth. (S)he is also trained to identify, manage, and refer any health problems that arise for mother and baby. The skills, attitudes and behaviour of SBAs, and the extent to which they work in an enabling working environment, impact on the quality of care provided. If any of these factors are missing, mothers and babies are likely to receive suboptimal care. Objectives To explore the views, experiences, and behaviours of skilled birth attendants and those who support them; to identify factors that influence the delivery of intrapartum and postnatal care in low- and middle-income countries; and to explore the extent to which these factors were reflected in intervention studies. Search methods Our search strategies specified key and free text terms related to the perinatal period, and the health provider, and included methodological filters for qualitative evidence syntheses and for low- and middle-income countries. We searched MEDLINE, OvidSP (searched 21 November 2016), Embase, OvidSP (searched 28 November 2016), PsycINFO, OvidSP (searched 30 November 2016), POPLINE, K4Health (searched 30 November 2016), CINAHL, EBSCOhost (searched 30 November 2016), ProQuest Dissertations and Theses (searched 15 August 2013), Web of Science (searched 1 December 2016), World Health Organization Reproductive Health Library (searched 16 August 2013), and World Health Organization Global Health Library for WHO databases (searched 1 December 2016). Selection criteria We included qualitative studies that focused on the views, experiences, and behaviours of SBAs and those who work with them as part of the team. We included studies from all levels of health care in low- and middle

  11. Contribution of Visualized Phrases on Word Using Skill

    Science.gov (United States)

    Batur, Zekerya

    2013-01-01

    In this study it was researched whether visualized proverbs, idioms and epigrams have effect of primary school 3rd, 5th and 7th grade students' speaking skills. The study was executed in spring semester of the academic year of 2010-2011, with 30 students studying at primary school in 3rd, 5th and 7th grade. The students who participated in the…

  12. Epiphanies, velcro balls and McDonaldization: highlights from the 5th Meeting of the International Society for Behavioral Nutrition and Physical Activity

    Directory of Open Access Journals (Sweden)

    Ball Kylie

    2006-09-01

    Full Text Available Abstract This commentary provides an overview and selected highlights from the scientific program of the 5th Annual Meeting of the International Society for Behavioral Nutrition and Physical Activity.

  13. Ready, set, stop: mismatch between self-care beliefs, transition readiness skills, and transition planning among adolescents, young adults, and parents.

    Science.gov (United States)

    Sawicki, Gregory S; Kelemen, Skyler; Weitzman, Elissa R

    2014-10-01

    Health care transition (HCT) from pediatric to adult-focused systems is a key milestone for youth. Developing self-care skills and HCT planning are key elements. In a survey at 4 pediatric specialty clinics to 79 youth aged 16 to 25 years and 52 parents, skill-based HCT readiness was assessed using the Transition Readiness Assessment Questionnaire (TRAQ). Multivariable logistic regression evaluated the association between TRAQ scores and self-care beliefs. In all, 70% of youth and 67% of parents believed that they/their child could manage their care. Only 38% of youth and 53% of parents reported thinking about HCT; only 18% of youth and 27% of parents reported having a HCT plan. Youth with higher TRAQ scores were more likely to believe they could manage their care, controlling for age and gender (adjusted odds ratio = 4.0, 95% confidence interval = 1.7-9.5). Transition readiness skills are associated with self-care beliefs. However, a mismatch exists between high reported self-care beliefs and low levels of transition planning. © The Author(s) 2014.

  14. 5th International Symposium on Experimental Mechanics (5-ISEM) and 9th Symposium on Optics in Industry

    CERN Document Server

    Furlong, Cosme; Barrientos, Bernardino; Pryputniewicz, Ryszard

    2017-01-01

    This book contains papers of the 5th International Symposium on Experimental Mechanics (5-ISEM) and the 9th Symposium on Optics in Industry (9-SOI), whose general theme is Emerging Challenges for Experimental Mechanics in Energy and Environmental Applications. These symposia are organized by Centro de Investigaciones en Optica (CIO) and Mexican Academy for Optics (AMO), under the sponsorship of the Society of Experimental Mechanics (SEM) and other national and international Organizations; Symposia are interdisciplinary forums for engineers, technicians, researchers and managers involved in all fields of Optics, Opto-mechatronics, Mechanics and Mechanical Engineering. · Addresses a broad readership including graduate and postgraduate students, researchers, and engineers working in experimental mechanics and in the application of optical methods · Covers a broad spectrum of topics highlighting the use of optical methods in experimental mechanics, energy, and in the environment.

  15. Macracanthorhynchus hirudinaceus Eggs in Canine Coprolite from the Sasanian Era in Iran (4(th/5(th Century CE.

    Directory of Open Access Journals (Sweden)

    Gholamreza Mowlavi

    2015-06-01

    Full Text Available Present paper is the second publication introducing the paleoparasitological findings from animal coprolites obtained from archeological site of Chehrabad salt mine in northwestern Iran. The current archeological site is located in northwest of Iran, dated to the Sassanian Era (4(th/5(th century CE. In the summer 2012 the carnivore coprolite was obtained within the layers in the mine and were thoroughly analyzed for parasites using TSP rehydration technique. Eggs of 0 were successfully retrieved from the examined coprolite and were confidently identified based on reliable references. Identifying of M. hirudinaceus eggs in paleofeces with clear appearance as demonstrated herein, is much due to appropriate preservation condition has been existed in the salt mine .The present finding could be regarded as the oldest acanthocephalan infection in Iran.

  16. Results of the independent verification of radiological remedial action at 98 East 5th South Street, Monticello, Utah (MS00076)

    International Nuclear Information System (INIS)

    Crutcher, J.W.; Smuin, M.W.

    1989-10-01

    In 1980 the site of a vanadium and uranium mill at Monticello, Utah, was accepted into the US Department of Energy's (DOE's) Surplus Facilities Management program with the objectives of restoring the government-owned mill site to safe levels of radioactivity, disposing of or containing the tailings in an environmentally safe manner, and performing remedial actions on off-site (vicinity) properties that had been contaminated by radioactive material resulting from mill operations. During 1984, UNC Geotech, the remedial action contractor designated by DOE, performed remedial action on the vicinity property at 98 East 5th South Street, Monticello, Utah. The Pollutant Assessments Group (PAG) of Oak Ridge National Laboratory was assigned the responsibility of verifying the data supporting the adequacy of remedial action and confirming the site's compliance with DOE guidelines. The PAG found that the site successfully meets the DOE remedial action objectives. Procedures used by PAG are described. 3 refs., 2 tabs

  17. The Berlin 2016 process: a summary of methodology for the 5th International Consensus Conference on Concussion in Sport.

    Science.gov (United States)

    Meeuwisse, Willem H; Schneider, Kathryn J; Dvořák, Jiří; Omu, Onutobor Tobi; Finch, Caroline F; Hayden, K Alix; McCrory, Paul

    2017-06-01

    The purpose of this paper is to summarise the methodology for the 5th International Consensus Conference on Concussion in Sport. The 18 months of preparation included engagement of a scientific committee, an expert panel of 33 individuals in the field of concussion and a modified Delphi technique to determine the primary questions to be answered. The methodology also involved the writing of 12 systematic reviews to inform the consensus conference and submission and review of scientific abstracts. The meeting itself followed a 2-day open format, a 1-day closed expert panel meeting and two additional half day meetings to develop the Concussion Recognition Tool 5 (Pocket CRT5), Sport Concussion Assessment Tool 5 (SCAT5) and Child SCAT5. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Results of the independent verification of radiological remedial action at 87 East 5th South Street, Monticello, Utah (MS00074)

    International Nuclear Information System (INIS)

    Crutcher, J.W.; Smuin, M.W.

    1989-10-01

    In 1980 the site of a vanadium and uranium mill at Monticello, Utah, was accepted into the US Department of Energy's (DOE's) Surplus Facilities Management Program, with the objectives of restoring the government-owned mill site to safe levels of radioactivity, disposing of or containing the tailings in an environmentally safe manner, and performing remedial actions on off-site (vicinity) properties that had been contaminated by radioactive material resulting from mill operations. During 1984, UNC Geotech, the remedial action contractor designated by DOE, performed remedial action on the vicinity property at 87 East 5th South Street, Monticello, Utah. The Pollutant Assessments Group (PAG) of Oak Ridge National Laboratory was assigned the responsibility of verifying the data supporting the adequacy of remedial action and confirming the site's compliance with DOE guidelines. The PAG found that the site successfully meets the DOE remedial action objectives. Procedures used by PAG are described

  19. 5th Optimization Day

    CERN Document Server

    Mees, Alistair; Fisher, Mike; Jennings, Les

    2000-01-01

    'Optimization Day' (OD) has been a series of annual mini-conferences in Australia since 1994. The purpose of this series of events is to gather researchers in optimization and its related areas from Australia and their collaborators, in order to exchange new developments of optimization theories, methods and their applications. The first four OD mini-conferences were held in The Uni­ versity of Ballarat (1994), The University of New South Wales (1995), The University of Melbourne (1996) and Royal Melbourne Institute of Technology (1997), respectively. They were all on the eastern coast of Australia. The fifth mini-conference Optimization Days was held at the Centre for Ap­ plied Dynamics and Optimization (CADO), Department of Mathematics and Statistics, The University of Western Australia, Perth, from 29 to 30 June 1998. This is the first time the OD mini-conference has been held at the west­ ern coast of Australia. This fifth OD preceded the International Conference on Optimization: Techniques and Applica...

  20. Primary School 5th and 8th Graders' Understanding and Mental Models about the Shape of the World and Gravity

    Science.gov (United States)

    Öztürk, Ayse; Doganay, Ahmet

    2013-01-01

    This study investigated primary school 5th and 8th graders' understanding and mental models related to the shape of the world and gravity, and how these models reflected the fact and what kind of a change there is from 5th to 8th graders. This research is based on a cross-sectional design. The study was conducted in a low socioeconomic level…

  1. Skilled delivery care service utilization in Ethiopia: analysis of rural-urban differentials based on national demographic and health survey (DHS) data.

    Science.gov (United States)

    Fekadu, Melaku; Regassa, Nigatu

    2014-12-01

    Despite the slight progress made on Antenatal Care (ANC) utilization, skilled delivery care service utilization in Ethiopia is still far-below any acceptable standards. Only 10% of women receive assistance from skilled birth attendants either at home or at health institutions, and as a result the country is recording a high maternal mortality ratio (MMR) of 676 per 100,000 live births (EDHS, 2011). Hence, this study aimed at identifying the rural-urban differentials in the predictors of skilled delivery care service utilization in Ethiopia. The study used the recent Ethiopian Demographic and Health Survey (EDHS 2011) data. Women who had at least one birth in the five years preceding the survey were included in this study. The data were analyzed using univariate (percentage), bivariate (chi-square) and multivariate (Bayesian logistic regression). The results showed that of the total 6,641 women, only 15.6% received skilled delivery care services either at home or at health institution. Rural women were at greater disadvantage to receive the service. Only 4.5% women in rural areas received assistance from skilled birth attendants (SBAs) compared to 64.1 % of their urban counter parts. Through Bayesian logistic regression analysis, place of residence, ANC utilization, women's education, age and birth order were identified as key predictors of service utilization. The findings highlight the need for coordinated effort from government and stakeholders to improve women's education, as well as strengthen community participation. Furthermore, the study recommended the need to scale up the quality of ANC and family planning services backed by improved and equitable access, availability and quality of skilled delivery care services.

  2. Engaging 5th/6th Graders in Representations of Change Over Time in the Context of Adaptations to Climate Change in the Gulf of Maine

    Science.gov (United States)

    Peake, L.; Young Morse, R.

    2017-12-01

    Since 2005, the Gulf of Maine Research Institute has brought 70% of Maine's 5th/6th grade cohort annually to our marine research lab for a 2.5-hour exploration of ecosystem complexity. Using a digital platform, tools of science, and live marine species, students consider the interconnections among key Gulf of Maine species while experiencing the process of authentic marine research. With funding from NASA, we are renovating the program's learning content, underlying technology, and physical interfaces to leverage NASA data sets. The new experience will emphasize development of students' data skills as they investigate the impacts of climate change in the Gulf of Maine. To do this, students will explore representations of rising ocean temperatures and connect that to representations of changes in the populations of key species like lobster and black sea bass. Past experience suggests the abstraction and synthesis required to make meaning from data visualizations is extremely challenging for this age student. We will report on an early round of informal testing with 250+ students to understand their ability to extract meaning from geospatial and graphical representations of change over time. We will also report on experiments that will be conducted in Fall 2017 to understand the kinds of informal learning experiences, and the sequences of data representations, that best support growth in students' ability to interpret a range of representations. Finally, we will discuss the project's work to extend the learning experiences 1) back into the classroom, including through citizen science; and 2) out to regional science centers for adaptation to investigations of local climate impacts.

  3. Effect of the Japanese preventive-care version of the Minimum Data Set--Home Care on the health-related behaviors of community-dwelling, frail older adults and skills of preventive-care managers: a quasi-experimental study conducted in Japan

    DEFF Research Database (Denmark)

    Igarashi, Ayumi; Ikegami, Naoki; Yamada, Yukari

    2009-01-01

    . The skills of the preventive-care managers were assessed by considering the number of and variations in the needs of the clients, as reflected in the care plans formulated by the managers. RESULTS: The clients' self-care levels were higher in the intervention group than in the control group (P ...AIM: To determine whether the Japanese preventive-care version of the Minimum Data Set-Home Care improves the health-related behaviors of older adults and the skills of preventive-care managers. METHODS: Municipal preventive-care managers were instructed on the use of the Japanese preventive...... Data Set--Home Care may improve the skills of preventive-care managers, and consequently, the health-related behaviors of frail older clients....

  4. Elementary School Students Perception Levels of Problem Solving Skills

    Science.gov (United States)

    Yavuz, Günes; Yasemin, Deringöl; Arslan, Çigdem

    2017-01-01

    The purpose of this study is to reveal the perception levels of problem solving skills of elementary school students. The sample of the study is formed by totally 264 elementary students attending to 5th, 6th, 7th and 8th grade in a big city in Turkey. Data were collected by means of "Perception Scale for Problem Solving Skills" which…

  5. Improvements in primary care skills and knowledge with a vocational training program: a medical student's perspective

    Directory of Open Access Journals (Sweden)

    Ghosh A

    2017-09-01

    Full Text Available Anita Ghosh, Diya Kapila, Trisha Ghosh  Faculty of Medicine, Imperial College London, Kensington, London, UK We read with great interest, the article by Djalali et al evaluating the impact of a training program during residency, targeted toward primary care.1 This resonated with us from a medical student’s perspective as we are fortunate enough to have a similar program at medical school. Although the article states that future career choices are more likely to be determined during residency, we believe that this can be nurtured earlier through knowledge and early exposure.  View the original paper by Djalali and colleagues. 

  6. Measurement properties and implementation of a checklist to assess leadership skills during interdisciplinary rounds in the intensive care unit.

    Science.gov (United States)

    Ten Have, Elsbeth C M; Nap, Raoul E; Tulleken, Jaap E

    2015-01-01

    The implementation of interdisciplinary teams in the intensive care unit (ICU) has focused attention on leadership behavior. A daily recurrent situation in ICUs in which both leadership behavior and interdisciplinary teamwork are integrated concerns the interdisciplinary rounds (IDRs). Although IDRs are recommended to provide optimal interdisciplinary and patient-centered care, there are no checklists available for leading physicians. We tested the measurement properties and implementation of a checklist to assess the quality of leadership skills in interdisciplinary rounds. The measurement properties of the checklist, which included 10 essential quality indicators, were tested for interrater reliability and internal consistency and by factor analysis. The interrater reliability among 3 raters was good (κ, 0.85) and the internal consistency was acceptable (α, 0.74). Factor analysis showed all factor loadings on 1 domain (>0.65). The checklist was further implemented during videotaped IDRs which were led by senior physicians and in which 99 patients were discussed. Implementation of the checklist showed a wide range of "no" and "yes" scores among the senior physicians. These results may underline the need for such a checklist to ensure tasks are synchronized within the team.

  7. Impact of Skill-Based Approaches in Reducing Stigma in Primary Care Physicians: Results from a Double-Blind, Parallel-Cluster, Randomized Controlled Trial.

    Science.gov (United States)

    Beaulieu, Tara; Patten, Scott; Knaak, Stephanie; Weinerman, Rivian; Campbell, Helen; Lauria-Horner, Bianca

    2017-05-01

    Most interventions to reduce stigma in health professionals emphasize education and social contact-based strategies. We sought to evaluate a novel skill-based approach: the British Columbia Adult Mental Health Practice Support Program. We sought to determine the program's impact on primary care providers' stigma and their perceived confidence and comfort in providing care for mentally ill patients. We hypothesized that enhanced skills and increased comfort and confidence on the part of practitioners would lead to diminished social distance and stigmatization. Subsequently, we explored the program's impact on clinical outcomes and health care costs. These outcomes are reported separately, with reference to this article. In a double-blind, cluster randomized controlled trial, 111 primary care physicians were assigned to intervention or control groups. A validated stigma assessment tool, the Opening Minds Scale for Health Care Providers (OMS-HC), was administered to both groups before and after training. Confidence and comfort were assessed using scales constructed from ad hoc items. In the primary analysis, no significant differences in stigma were found. However, a subscale assessing social distance showed significant improvement in the intervention group after adjustment for a variable (practice size) that was unequally distributed in the randomization. Significant increases in confidence and comfort in managing mental illness were observed among intervention group physicians. A positive correlation was found between increased levels of confidence/comfort and improvements in overall stigma, especially in men. This study provides some preliminary evidence of a positive impact on health care professionals' stigma through a skill-building approach to management of mild to moderate depression and anxiety in primary care. The intervention can be used as a primary vehicle for enhancing comfort and skills in health care providers and, ultimately, reducing an important

  8. Questioning: a critical skill in postmodern health-care service delivery.

    Science.gov (United States)

    Brown, Cary A; Bannigan, Katrina; Gill, Joanna R

    2009-06-01

    Occupational therapists can no longer rely exclusively on biomedical frameworks to guide their practice and facilitate clinical problem-solving. A postmodernist perspective of health and well-being underlines that the illness experience is not a linear, cause-and-effect equation. Rather, life experiences are constructed through a myriad of social, cultural, physical and economic contexts that are highly unique to each individual. In other words, the assumption that 'one-size-fits-all' is as flawed in health care as it is in clothing design. This paper contributes to the growing discussion of health care within the postmodern context of the twenty-first century through first presenting a brief discussion of emerging postmodern thinking and application within the profession, followed by a rationale for the need to scrutinise prevalent modernist assumptions that guide decision-making. Finally, the paper introduces the method of Socratic questioning as a critical tool in successfully carrying out this scrutiny in an empowering and respectful manner for all stakeholders.

  9. Acceptability and Impact of a Required Palliative Care Rotation with Prerotation and Postrotation Observed Simulated Clinical Experience during Internal Medicine Residency Training on Primary Palliative Communication Skills.

    Science.gov (United States)

    Vergo, Maxwell T; Sachs, Sharona; MacMartin, Meredith A; Kirkland, Kathryn B; Cullinan, Amelia M; Stephens, Lisa A

    2017-05-01

    Improving communication training for primary palliative care using a required palliative care rotation for internal medicine (IM) residents has not been assessed. To assess skills acquisition and acceptability for IM residents not selecting an elective. A consecutive, single-arm cohort underwent preobjective structured clinical examination (OSCE) with learner-centric feedback, two weeks of clinical experience, and finally a post-OSCE to crystallize learner-centric take home points. IM second year residents from Dartmouth-Hitchcock were exposed to a required experiential palliative care rotation. Pre- and post-OSCE using a standardized score card for behavioral skills, including patient-centered interviewing, discussing goals of care/code status, and responding to emotion, as well as a confidential mixed qualitative and quantitative evaluation of the experience. Twelve residents were included in the educational program (two were excluded because of shortened experiences) and showed statistically significant improvements in overall communication and more specifically in discussing code status and responding to emotions. General patient-centered interviewing skills were not significantly improved, but prerotation scores reflected pre-existing competency in this domain. Residents viewed the observed simulated clinical experience (OSCE) and required rotation as positive experiences, but wished for more opportunities to practice communication skills in real clinical encounters. A required palliative care experiential rotation flanked by OSCEs at our institution improved the acquisition of primary palliative care communication skills similarly to other nonclinical educational platforms, but may better meet the needs of the resident and faculty as well as address all required ACGME milestones.

  10. First-dollar cost-sharing for skilled nursing facility care in medicare advantage plans.

    Science.gov (United States)

    Keohane, Laura M; Grebla, Regina C; Rahman, Momotazur; Mukamel, Dana B; Lee, Yoojin; Mor, Vincent; Trivedi, Amal

    2017-08-29

    The initial days of a Medicare-covered skilled nursing facility (SNF) stay may have no cost-sharing or daily copayments depending on beneficiaries' enrollment in traditional Medicare or Medicare Advantage. Some policymakers have advocated imposing first-dollar cost-sharing to reduce post-acute expenditures. We examined the relationship between first-dollar cost-sharing for a SNF stay and use of inpatient and SNF services. We identified seven Medicare Advantage plans that introduced daily SNF copayments of $25-$150 in 2009 or 2010. Copays began on the first day of a SNF admission. We matched these plans to seven matched control plans that did not introduce first-dollar cost-sharing. In a difference-in-differences analysis, we compared changes in SNF and inpatient utilization for the 172,958 members of intervention and control plans. In intervention plans the mean annual number of SNF days per 100 continuously enrolled inpatients decreased from 768.3 to 750.6 days when cost-sharing changes took effect. Control plans experienced a concurrent increase: 721.7 to 808.1 SNF days per 100 inpatients (adjusted difference-in-differences: -87.0 days [95% CI (-112.1,-61.9)]). In intervention plans, we observed no significant changes in the probability of any SNF service use or the number of inpatient days per hospitalized member relative to concurrent trends among control plans. Among several strategies Medicare Advantage plans can employ to moderate SNF use, first-dollar SNF cost-sharing may be one influential factor. Not applicable.

  11. Computer Games : 5th Workshop on Computer Games, CGW 2016, and 5th Workshop on General Intelligence in Game-Playing Agents, GIGA 2016, held in conjunction with the 25th International Conference on Artificial Intelligence, IJCAI 2016, New York, USA, July 9-10, 2016, Revised selected papers

    NARCIS (Netherlands)

    Cazenave, Tristan; Winands, Mark H. M; Edelkamp, Stefan; Schiffel, Stephan; Thielscher, Michael; Togelius, Julian

    2017-01-01

    This book constitutes the refereed proceedings of the 5th Computer Games Workshop, CGW 2016, and the 5th Workshop on General Intelligence in Game-Playing Agents, GIGA 2016, held in conjunction with the 25th International Conference on Artificial Intelligence, IJCAI 2016, in New York, USA, in July

  12. Simulation for the training of human performance and technical skills: the intersection of how we will train health care professionals in the future.

    Science.gov (United States)

    Hamman, William R; Beaubien, Jeffrey M; Beaudin-Seiler, Beth M

    2009-12-01

    The aims of this research are to begin to understand health care teams in their operational environment, establish metrics of performance for these teams, and validate a series of scenarios in simulation that elicit team and technical skills. The focus is on defining the team model that will function in the operational environment in which health care professionals work. Simulations were performed across the United States in 70- to 1000-bed hospitals. Multidisciplinary health care teams analyzed more than 300 hours of videos of health care professionals performing simulations of team-based medical care in several different disciplines. Raters were trained to enhance inter-rater reliability. The study validated event sets that trigger team dynamics and established metrics for team-based care. Team skills were identified and modified using simulation scenarios that employed the event-set-design process. Specific skills (technical and team) were identified by criticality measurement and task analysis methodology. In situ simulation, which includes a purposeful and Socratic Method of debriefing, is a powerful intervention that can overcome inertia found in clinician behavior and latent environmental systems that present a challenge to quality and patient safety. In situ simulation can increase awareness of risks, personalize the risks, and encourage the reflection, effort, and attention needed to make changes to both behaviors and to systems.

  13. Effect of mHealth in improving antenatal care utilization and skilled birth attendance in low- and middle-income countries: a systematic review protocol.

    Science.gov (United States)

    Abraha, Yosef G; Gebrie, Serebe A; Garoma, Desalegn A; Deribe, Fasil M; Tefera, Mamuye H; Morankar, Sudhakar

    2017-07-01

    The objective of this review is to identify and synthesize the best available evidence on the effect of mobile health (mHealth) interventions in antenatal care utilization and skilled birth attendance in low- and middle-income countries.More specifically, the review questions are as follows.

  14. Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana.

    Directory of Open Access Journals (Sweden)

    Fiifi Amoako Johnson

    Full Text Available The Community-based Health Planning and Services (CHPS initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas.Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km.Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.

  15. Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana.

    Science.gov (United States)

    Johnson, Fiifi Amoako; Frempong-Ainguah, Faustina; Matthews, Zoe; Harfoot, Andrew J P; Nyarko, Philomena; Baschieri, Angela; Gething, Peter W; Falkingham, Jane; Atkinson, Peter M

    2015-01-01

    The Community-based Health Planning and Services (CHPS) initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas. Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km. Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.

  16. Effects of nursing process-based simulation for maternal child emergency nursing care on knowledge, attitude, and skills in clinical nurses.

    Science.gov (United States)

    Kim, Sunghee; Shin, Gisoo

    2016-02-01

    Since previous studies on simulation-based education have been focused on fundamental nursing skills for nursing students in South Korea, there is little research available that focuses on clinical nurses in simulation-based training. Further, there is a paucity of research literature related to the integration of the nursing process into simulation training particularly in the emergency nursing care of high-risk maternal and neonatal patients. The purpose of this study was to identify the effects of nursing process-based simulation on knowledge, attitudes, and skills for maternal and child emergency nursing care in clinical nurses in South Korea. Data were collected from 49 nurses, 25 in the experimental group and 24 in the control group, from August 13 to 14, 2013. This study was an equivalent control group pre- and post-test experimental design to compare the differences in knowledge, attitudes, and skills for maternal and child emergency nursing care between the experimental group and the control group. The experimental group was trained by the nursing process-based simulation training program, while the control group received traditional methods of training for maternal and child emergency nursing care. The experimental group was more likely to improve knowledge, attitudes, and skills required for clinical judgment about maternal and child emergency nursing care than the control group. Among five stages of nursing process in simulation, the experimental group was more likely to improve clinical skills required for nursing diagnosis and nursing evaluation than the control group. These results will provide valuable information on developing nursing process-based simulation training to improve clinical competency in nurses. Further research should be conducted to verify the effectiveness of nursing process-based simulation with more diverse nurse groups on more diverse subjects in the future. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Changes in Breast Density Reporting Patterns of Radiologists After Publication of the 5th Edition BI-RADS Guidelines: A Single Institution Experience.

    Science.gov (United States)

    Irshad, Abid; Leddy, Rebecca; Lewis, Madelene; Cluver, Abbie; Ackerman, Susan; Pavic, Dag; Collins, Heather

    2017-10-01

    The objective of our study was to determine the impact of 5th edition BI-RADS breast density assessment guidelines on density reporting patterns in our clinical practice. PenRad reporting system was used to collect mammographic breast density data reported by five radiologists: 16,907 density assignments using 5th edition BI-RADS guidelines were compared with 19,066 density assessments using 4th edition guidelines. Changes in the density assessment pattern were noted between the 4th and 5th edition guidelines, and agreement in density distribution was compared using the intraclass correlation coefficient. A chi-square analysis was conducted for each reader to examine the change in the proportion of dense versus nondense assignments and on each category type to examine specific changes in proportion of density assignments from the 4th to the 5th edition. All reported p values are two-sided, and statistical significance was considered at the p densities (p < 0.001), 2.6% increase in heterogeneously dense (p < 0.001), and 0.4% decrease in extremely dense assessments (p = 0.15). Comparing the dense with nondense categories, there was a 2.3% overall increase in the dense assessments (p < 0.001) using 5th edition guidelines, mainly in the heterogeneously dense category. Two radiologists showed increased dense assessments (p < 0.001) using the 5th edition, and three radiologists showed no change (p = 0.39, 0.67, and 0.76). There was an overall increase in the dense assessments using the 5th edition, but individual radiologists in our clinical practice showed a variable adaptation to new guidelines.

  18. Does the Janani Suraksha Yojana cash transfer programme to promote facility births in India ensure skilled birth attendance? A qualitative study of intrapartum care in Madhya Pradesh

    Directory of Open Access Journals (Sweden)

    Sarika Chaturvedi

    2015-07-01

    Full Text Available Background: Access to facility delivery in India has significantly increased with the Janani Suraksha Yojana (JSY cash transfer programme to promote facility births. However, a decline in maternal mortality has only followed secular trends as seen from the beginning of the decade well before the programme began. We, therefore, examined the quality of intrapartum care provided in facilities under the JSY programme to study whether it ensures skilled attendance at birth. Design: 1 Non-participant observations (n=18 of intrapartum care during vaginal deliveries at a representative sample of 11 facilities in Madhya Pradesh to document what happens during intrapartum care. 2 Interviews (n=10 with providers to explore reasons for this care. Thematic framework analysis was used. Results: Three themes emerged from the data: 1 delivery environment is chaotic: delivery rooms were not conducive to safe, women-friendly care provision, and coordination between providers was poor. 2 Staff do not provide skilled care routinely: this emerged from observations that monitoring was limited to assessment of cervical dilatation, lack of readiness to provide key elements of care, and the execution of harmful/unnecessary practices coupled with poor techniques. 3 Dominant staff, passive recipients: staff sometimes threatened, abused, or ignored women during delivery; women were passive and accepted dominance and disrespect. Attendants served as ‘go-betweens’ patients and providers. The interviews with providers revealed their awareness of the compromised quality of care, but they were constrained by structural problems. Positive practices were also observed, including companionship during childbirth and women mobilising in the early stages of labour. Conclusions: Our observational study did not suggest an adequate level of skilled birth attendance (SBA. The findings reveal insufficiencies in the health system and organisational structures to provide an

  19. Does the Janani Suraksha Yojana cash transfer programme to promote facility births in India ensure skilled birth attendance? A qualitative study of intrapartum care in Madhya Pradesh.

    Science.gov (United States)

    Chaturvedi, Sarika; De Costa, Ayesha; Raven, Joanna

    2015-01-01

    Access to facility delivery in India has significantly increased with the Janani Suraksha Yojana (JSY) cash transfer programme to promote facility births. However, a decline in maternal mortality has only followed secular trends as seen from the beginning of the decade well before the programme began. We, therefore, examined the quality of intrapartum care provided in facilities under the JSY programme to study whether it ensures skilled attendance at birth. 1) Non-participant observations (n=18) of intrapartum care during vaginal deliveries at a representative sample of 11 facilities in Madhya Pradesh to document what happens during intrapartum care. 2) Interviews (n=10) with providers to explore reasons for this care. Thematic framework analysis was used. Three themes emerged from the data: 1) delivery environment is chaotic: delivery rooms were not conducive to safe, women-friendly care provision, and coordination between providers was poor. 2) Staff do not provide skilled care routinely: this emerged from observations that monitoring was limited to assessment of cervical dilatation, lack of readiness to provide key elements of care, and the execution of harmful/unnecessary practices coupled with poor techniques. 3) Dominant staff, passive recipients: staff sometimes threatened, abused, or ignored women during delivery; women were passive and accepted dominance and disrespect. Attendants served as 'go-betweens' patients and providers. The interviews with providers revealed their awareness of the compromised quality of care, but they were constrained by structural problems. Positive practices were also observed, including companionship during childbirth and women mobilising in the early stages of labour. Our observational study did not suggest an adequate level of skilled birth attendance (SBA). The findings reveal insufficiencies in the health system and organisational structures to provide an 'enabling environment' for SBA. We highlight the need to ensure

  20. 5th Nanosafe International Conference on Health and Safety issues related to nanomaterials for a socially responsible approach (NANOSAFE 2016)

    International Nuclear Information System (INIS)

    2017-01-01

    This volume contains a collection of contributions presented at the 5 th Nanosafe International Conference on Health and Safety issues related to nanomaterials for a socially responsible approach (NANOSAFE 2016) held in Grenoble, France, from 7 th to 10 th November 2016.Nano objects represent a powerful “enabling technology” leading to revolutionary breakthroughs in many different areas vital for humanity including medicine, energy, environment, etc. and also preserving the rare mineral resources by rendering mater more efficient.For one of the first time in the science history, risks have been taken into account since the very beginning of the manufactured nanomaterials and Nanosafety is now considered as a specific new scientific area, gaining in importance and maturity each days thanks to our dynamic community spread all over the world.Following the successful outcome of the four past international conferences on Safe Production and Use of Nanomaterials: Nanosafe 2008, 2010, 2012 and 2014, the Platform Nano Safety “PNS” welcomed the attendees to Minatec, Grenoble, for this fifth edition with some of the most famous specialists in the field.In 2016, the subtitle of the conference had been slightly changed to “Health and Safety Issues Related to Nanomaterials” in order to welcome inboard two new topics: Urban Nanoparticles and some aspect of Nanomedicine, in addition to the usual issues addressed in previous Nanosafe conferences such as Detection and Characterization, Expology, Release from Nano-enabled Products, Safer by Design Nanomaterials and Process, Risk Management, Nanoproducts to waste, Toxicology, Environmental Interactions, Regulation and Standardization and Nano Responsible Development.Furthermore, three 3 round tables had been organized in order to promote friendly discussions between attendees: Nano-Responsible Development, Urban Particles Mitigation: What is Reasonably Possible, Nanomedecine: Benefice/Risk.In this 5 th edition, there were

  1. Knowledge and Skills of Healthcare Providers in Sub-Saharan Africa and Asia before and after Competency-Based Training in Emergency Obstetric and Early Newborn Care.

    Science.gov (United States)

    Ameh, Charles A; Kerr, Robert; Madaj, Barbara; Mdegela, Mselenge; Kana, Terry; Jones, Susan; Lambert, Jaki; Dickinson, Fiona; White, Sarah; van den Broek, Nynke

    2016-01-01

    Healthcare provider training in Emergency Obstetric and Newborn Care (EmOC&NC) is a component of 65% of intervention programs aimed at reducing maternal and newborn mortality and morbidity. It is important to evaluate the effectiveness of this. We evaluated knowledge and skills among 5,939 healthcare providers before and after 3-5 days 'skills and drills' training in emergency obstetric and newborn care (EmOC&NC) conducted in 7 sub-Saharan Africa countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Zimbabwe) and 2 Asian countries (Bangladesh, Pakistan). Standardised assessments using multiple choice questions and objective structured clinical examination (OSCE) were used to measure change in knowledge and skills and the Improvement Ratio (IR) by cadre and by country. Linear regression was performed to identify variables associated with pre-training score and IR. 99.7% of healthcare providers improved their overall score with a median (IQR) increase of 10.0% (5.0% - 15.0%) for knowledge and 28.8% (23.1% - 35.1%) for skill. There were significant improvements in knowledge and skills for each cadre of healthcare provider and for each country (phealthcare providers working in maternity wards in both sub-Saharan Africa and Asia. Additional support and training is needed for use of the partograph as a tool to monitor progress in labour. Further research is needed to assess if this is translated into improved service delivery.

  2. The Cognitive Predictors of Computational Skill with Whole versus Rational Numbers: An Exploratory Study

    Science.gov (United States)

    Seethaler, Pamela M.; Fuchs, Lynn S.; Star, Jon R.; Bryant, Joan

    2011-01-01

    The purpose of the present study was to explore the 3rd-grade cognitive predictors of 5th-grade computational skill with rational numbers and how those are similar to and different from the cognitive predictors of whole-number computational skill. Students (n=688) were assessed on incoming whole-number calculation skill, language, nonverbal…

  3. Communicating Science to Impact Learning? A Phenomenological Inquiry into 4th and 5th Graders' Perceptions of Science Information Sources

    Science.gov (United States)

    Gelmez Burakgazi, Sevinc; Yildirim, Ali; Weeth Feinstein, Noah

    2016-04-01

    Rooted in science education and science communication studies, this study examines 4th and 5th grade students' perceptions of science information sources (SIS) and their use in communicating science to students. It combines situated learning theory with uses and gratifications theory in a qualitative phenomenological analysis. Data were gathered through classroom observations and interviews in four Turkish elementary schools. Focus group interviews with 47 students and individual interviews with 17 teachers and 10 parents were conducted. Participants identified a wide range of SIS, including TV, magazines, newspapers, internet, peers, teachers, families, science centers/museums, science exhibitions, textbooks, science books, and science camps. Students reported using various SIS in school-based and non-school contexts to satisfy their cognitive, affective, personal, and social integrative needs. SIS were used for science courses, homework/project assignments, examination/test preparations, and individual science-related research. Students assessed SIS in terms of the perceived accessibility of the sources, the quality of the content, and the content presentation. In particular, some sources such as teachers, families, TV, science magazines, textbooks, and science centers/museums ("directive sources") predictably led students to other sources such as teachers, families, internet, and science books ("directed sources"). A small number of sources crossed context boundaries, being useful in both school and out. Results shed light on the connection between science education and science communication in terms of promoting science learning.

  4. [Progress and prospects on evaluation of ecological restoration: a review of the 5th World Conference on Ecological Restoration].

    Science.gov (United States)

    Ding, Jing-Yi; Zhao, Wen-Wu

    2014-09-01

    The 5th World Conference on Ecological Restoration was held in Madison, Wisconsin, USA on October 6-11, 2013. About 1200 delegates from more than 50 countries attended the conference, and discussed the latest developments in different thematic areas of ecological restoration. Discussions on evaluation of ecological restoration were mainly from three aspects: The construction for evaluation indicator system of ecological restoration; the evaluation methods of ecological restoration; monitoring and dynamic evaluation of ecological restoration. The meeting stressed the importance of evaluation in the process of ecological restoration and concerned the challenges in evaluation of ecological restoration. The conference had the following enlightenments for China' s research on evaluation of ecological restoration: 1) Strengthening the construction of comprehensive evaluation indicators system and focusing on the multi-participation in the evaluation process. 2) Paying more attentions on scale effect and scale transformation in the evaluation process of ecological restoration. 3) Expanding the application of 3S technology in assessing the success of ecological restoration and promoting the dynamic monitoring of ecological restoration. 4) Carrying out international exchanges and cooperation actively, and promoting China's international influence in ecological restoration research.

  5. The 5th July 1930 earthquake at Montilla (S Spain). Use of regionally recorded smoked paper seismograms

    Science.gov (United States)

    Batlló, J.; Stich, D.; Macià, R.; Morales, J.

    2009-04-01

    On the night of 5th July 1930 a damaging earthquake struck the town of Montilla (near Córdoba, S-Spain) and its surroundings. Magnitude estimation for this earthquake is M=5, and its epicentral intensity has been evaluated as VIII (MSK). Even it is an earthquake of moderate size, it is the largest one in-strumentally recorded in this region. This makes this event of interest for a better definition of the regional seismicity. For this reason we decided to study a new its source from the analysis of the available contemporary seismograms and related documents. A total of 25 seismograms from 11 seismic stations have been collected and digitized. Processing of some of the records has been difficult because they were obtained from microfilm or contemporary reproductions on journals. Most of them are on smoked paper and recorded at regional distances. This poses a good opportunity to test the limits of the use of such low frequency - low dynamics recorded seismograms for the study of regional events. Results are promising: Using such regional seismograms the event has been relocated, its magnitude recalculated (Mw 5.1) and inversion of waveforms to elucidate its focal mechanism has been performed. We present the results of this research and its consequences for the regional seismicity and we compare them with present smaller earthquakes occurred in the same place and with the results obtained for earthquakes of similar size occurred more to the East on 1951.

  6. Fast Food Consumption and Food Prices: Evidence from Panel Data on 5th and 8th Grade Children

    Directory of Open Access Journals (Sweden)

    Tamkeen Khan

    2012-01-01

    Full Text Available Fast food consumption is a dietary factor associated with higher prevalence of childhood obesity in the United States. The association between food prices and consumption of fast food among 5th and 8th graders was examined using individual-level random effects models utilizing consumption data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K, price data from American Chamber of Commerce Researchers Association (ACCRA, and contextual outlet density data from Dun and Bradstreet (D&B. The results found that contextual factors including the price of fast food, median household income, and fast food restaurant outlet densities were significantly associated with fast food consumption patterns among this age group. Overall, a 10% increase in the price of fast food was associated with 5.7% lower frequency of weekly fast food consumption. These results suggest that public health policy pricing instruments such as taxes may be effective in reducing consumption of energy-dense foods and possibly reducing the prevalence of overweight and obesity among US children and young adolescents.

  7. Using peer-assisted learning and role-playing to teach generic skills to dental students: the health care simulation model.

    Science.gov (United States)

    El Tantawi, Maha M A; Abdelaziz, Hytham; AbdelRaheem, Amira S; Mahrous, Ahmed A

    2014-01-01

    Increasing importance is attached to teaching generic skills to undergraduate students in various disciplines. This article describes an extracurricular, student-led activity for teaching generic skills using the Model United Nations over three months. The activity used the Health Care Simulation Model (HCSM) with peer learning and role-playing to accomplish its objectives. An interview was used to select from undergraduate and postgraduate dental students at Alexandria University, Alexandria, Egypt, to develop a group of staff to act as peer teachers after receiving training (n=77). These peer teachers provided training for 123 undergraduate dental students to serve as delegates who acted as trainees or peer learners. At the end of the training sessions, a conference was held in which the students played the roles of delegates representing officials responsible for health care systems in ten countries. The students reported improvement in generic skills, enjoyed several aspects of the experience, and disliked other aspects of the model to a lesser extent. In multivariate analysis, perceived usefulness of the HCSM was significantly greater for staff than delegates and increased as self-reported improvement in knowledge of health care systems increased. This study suggests that innovative, student-centered educational methods can be effective for teaching generic skills and factual information.

  8. Pain and Satisfaction With Pain Management Among Older Patients During the Transition From Acute to Skilled Nursing Care.

    Science.gov (United States)

    Simmons, Sandra F; Schnelle, John F; Saraf, Avantika A; Simon Coelho, Chris; Jacobsen, J Mary Lou; Kripalani, Sunil; Bell, Susan; Mixon, Amanda; Vasilevskis, Eduard E

    2016-12-01

    Approximately 20% of hospitalized Medicare beneficiaries are discharged from the hospital to skilled nursing facilities (SNFs); and up to 23% of SNF patients return to the hospital within 30 days of hospital discharge, with pain as one of the most common symptoms precipitating hospital readmission. We sought to examine the prevalence of moderate to severe pain at hospital discharge to SNF, the incidence of new moderate to severe pain (relative to prehospitalization), and satisfaction with pain management among older acute care patients discharged to SNF. Structured patient interviews were conducted with 188 Medicare beneficiaries discharged to 23 area SNFs from an academic medical center. Pain level (0-10) and satisfaction with pain management were assessed upon hospital admission, discharge, and within 1 week after transition to SNF. There was a high prevalence of moderate to severe pain at each time point including prehospital (51%), hospital discharge (38%), and following SNF admission (53%). Twenty-eight percent of participants reported new moderate to severe pain at hospital discharge, whereas 44% reported new moderate to severe pain following SNF admission. Most participants reported being "satisfied" with their pain treatment, even in the context of moderate to severe pain. Moderate to severe pain is a common problem among hospitalized older adults discharged to SNF and continues during their SNF stay. Pain assessment and management should involve a specific, planned process between hospital and SNF clinicians at the point of care transition, even if patients express "satisfaction" with current pain management. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis.

    Science.gov (United States)

    Munabi-Babigumira, Susan; Glenton, Claire; Lewin, Simon; Fretheim, Atle; Nabudere, Harriet

    2017-11-17

    In many low- and middle-income countries women are encouraged to give birth in clinics and hospitals so that they can receive care from skilled birth attendants. A skilled birth attendant (SBA) is a health worker such as a midwife, doctor, or nurse who is trained to manage normal pregnancy and childbirth. (S)he is also trained to identify, manage, and refer any health problems that arise for mother and baby. The skills, attitudes and behaviour of SBAs, and the extent to which they work in an enabling working environment, impact on the quality of care provided. If any of these factors are missing, mothers and babies are likely to receive suboptimal care. To explore the views, experiences, and behaviours of skilled birth attendants and those who support them; to identify factors that influence the delivery of intrapartum and postnatal care in low- and middle-income countries; and to explore the extent to which these factors were reflected in intervention studies. Our search strategies specified key and free text terms related to the perinatal period, and the health provider, and included methodological filters for qualitative evidence syntheses and for low- and middle-income countries. We searched MEDLINE, OvidSP (searched 21 November 2016), Embase, OvidSP (searched 28 November 2016), PsycINFO, OvidSP (searched 30 November 2016), POPLINE, K4Health (searched 30 November 2016), CINAHL, EBSCOhost (searched 30 November 2016), ProQuest Dissertations and Theses (searched 15 August 2013), Web of Science (searched 1 December 2016), World Health Organization Reproductive Health Library (searched 16 August 2013), and World Health Organization Global Health Library for WHO databases (searched 1 December 2016). We included qualitative studies that focused on the views, experiences, and behaviours of SBAs and those who work with them as part of the team. We included studies from all levels of health care in low- and middle-income countries. One review author extracted data and

  10. The correlation between mothers' participation in infant care in the NICU and their anxiety and problem-solving skill levels in caregiving.

    Science.gov (United States)

    Çakmak, Emine; Karaçam, Zekiye

    2018-01-01

    To examine the correlation between mothers' participation in infant care in the Neonatal Intensive Care Unit (NICU) and their anxiety and problem-solving skill levels in caregiving. The cross-sectional study was conducted with 340 mothers whose babies were in the NICU. Data were collected with a questionnaire, a Participation in Caregiving Observation Form, the State and Trait Anxiety Inventory and the Problem-solving Skills Evaluation Form. Descriptive statistics and correlation analysis were used in the evaluation of the data. The mothers were with their babies an average of 6.28 ± 2.43 (range: 1-20) times a day, participating in many basic procedures of care. A negative correlation was found between the mothers' scores on the Participation in Caregiving Observation Form and their State and Trait Anxiety Inventory scores (respectively, r = -0.48, p Problem-solving Process (r = 0.41, p problem-solving skills with respect to baby care and related problems.

  11. Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care

    Science.gov (United States)

    Aiken, Linda H; Rafferty, Anne Marie; Bruyneel, Luk; McHugh, Matthew; Maier, Claudia B; Moreno-Casbas, Teresa; Ball, Jane E; Ausserhofer, Dietmar; Sermeus, Walter

    2017-01-01

    Objectives To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. Design Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. Setting Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. Participants Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. Main outcome measures Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. Results Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80nurses is associated with an 11% increase in the odds of death. In our hospital sample, there were an average of six caregivers for every 25 patients, four of whom were professional nurses. Substituting one nurse assistant for a professional nurse for every 25 patients is associated with a 21% increase in the odds of dying. Conclusions A bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. Reducing nursing skill mix by adding nursing associates and other categories of assistive nursing personnel without professional nurse qualifications may contribute to preventable deaths, erode quality and safety of hospital care and contribute to hospital nurse shortages. PMID:28626086

  12. Implementing SPRINTT [Student Polar Research with IPY National(and International)Teacher Training] in 5th Grade Science

    Science.gov (United States)

    Glass, D. S.

    2009-12-01

    I implemented the new NSF-funded SPRINTT (Student Polar Research with IPY National (and International) Teacher Training) curriculum with a 5th grade science class. SPRINTT, developed at U.S. Satellite Laboratory, Inc., is a 5-8 week science program teaching 5th through 10th graders to investigate climate change using polar data. The program includes perspectives of both Western scientists and the indigenous Northern population. The course contains three phases: Phase 1 includes content, data interpretation, and hands-on experiments to study Frozen Water, Frozen Land, and Food; Phase 2 (optional) includes further content on specific polar topics; and Phase 3 is a scaffolded research investigation. Before the course, teachers were trained via live webinars. This curriculum capitalizes on children’s innate fascination with our planet’s final frontier and combines it with the politically and scientifically relevant topic of climate change. In 2009, I used SPRINTT with 23 heterogeneous fifth grade students at National Presbyterian School in Washington DC for an environmental science unit. Overall, it was a success. The students met most of the learning objectives and showed enthusiasm for the material. I share my experiences to help other educators and curriculum developers. The Phase 1 course includes earth science (glaciers, sea ice, weather and climate, greenhouse gases, seasons, and human impacts on environments), life science (needs of living things, food and energy transfer, adaptations, and ecosystems and biomes) and physical science (phases of matter). Tailoring the program, I focused on Phase 1, the most accessible material and content, while deemphasizing the more cumbersome Phase 3 online research project. Pre-assessments documented the students’ misconceptions and informed instruction. The investigations were appropriately educational and interesting. For example, students enjoyed looking at environmental factors and their impact on the people in the

  13. 5th international exhaust gas and particulate emissions forum. Proceedings; 5. Internationales Forum Abgas- und Partikelemissionen. Beitraege

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-12-11

    The Proceedings of the 5th International Exhaust Gas and Particulate Emissions Forum contains 22 printed contributions as well as a CD-ROM. The titles of them are: (1) Diesel Emissions Control in the United States - 2010 and Beyond; (2) The MBE90 commercial vehicle engine for EPA '07 emissions regulations; (3) Concepts for engines and exhaust-gas cleaning systems for heavy duty trucks of the future; (4) HD Engine Technology for Near-Zero Emissions and Lowest Cost of Ownership; (5) (Partially-) Homogeneous Diesel Combustion; (6) Exhaust gas sensors for NOx storage catalysts and ammonia-SCR systems; (7) Sensors for modern exhaust gas after-treatment systems; (8) New reducing agents for low NOx-SCR Techno-logy; (9) Exhaust gas Aftertreatment on Lean Burn Gasoline Direct Injection Engines: The System of TWC and NOx-Storage Catalyst; (10) New Platinum/Palladium based catalyzed filter technologies for future passenger car applications; (11) Development of a Roadway Hydrocarbon Sorption Model and Characterization of a Novel PM Generator; (12) Requirements for current and future particulate measurement instrumentation from the point of view of the Physikalisch-Technische Bundesanstalt; (13) Standardized dilution conditions for gravimetric PM sampling - measures to assure results that correlate; (14) Particle Counting according PMP; (15) Future high-confidence measurement of diesel particulate emissions for approval and development; (16) New developments in optical instrumentation for exhaust gas; (17) Simultaneous Detection of Gaseous and Particulate Exhaust Components by Photoacoustic Spectroscopy; (18) Boundaries of modern exhaust gas instrumentation; (19) Raising quality and reducing application effort through efficient data input to the particulate filter load model for a EURO5 diesel car; (20) Stop-start operation of diesel engines - modified require-ment for exhaust gas after-treatment?; (21) Particulates emission with Biodiesel B30 impact on CSF management; (22

  14. Breastfeeding, introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendations

    Science.gov (United States)

    Hörnell, Agneta; Lagström, Hanna; Lande, Britt; Thorsdottir, Inga

    2013-01-01

    The present systematic literature review is part of the 5th revision of the Nordic Nutrition Recommendations. The overall aim was to review recent scientific data valid in a Nordic setting on the short- and long-term health effects of breastfeeding (duration of both any and exclusive breastfeeding) and introduction of foods other than breast milk. The initial literature search resulted in 2,011 abstracts; 416 identified as potentially relevant. Full paper review resulted in 60 quality assessed papers (6A, 48B, and 6C). A complementary search found some additional papers. The grade of evidence was classified as convincing, probable, limited-suggestive, and limited-no conclusion. The evidence was convincing of a protective dose/duration effect of breastfeeding against overweight and obesity in childhood and adolescence, overall infections, acute otitis media, and gastrointestinal and respiratory tract infections. The evidence was probable that exclusive breastfeeding for longer than 4 months is associated with slower weight gain during the second half of the first year which could be part of the reason behind the reduced risk of later overweight or obesity. There was also probable evidence that breastfeeding is a protective factor against inflammatory bowel disease, celiac disease, and diabetes (type 1 and 2), provides beneficial effects on IQ and developmental scores of children as well as a small reductive effect on blood pressure and blood cholesterol levels in adulthood. Other associations explored were limited-suggestive or inconclusive. In conclusion, convincing and probable evidence was found for benefits of breastfeeding on several outcomes. The recommendation in NNR2004 about exclusive breastfeeding for 6 months and continued partial breastfeeding thereafter can stand unchanged. The relatively low proportion of infants in the Nordic countries following this recommendation indicates that strategies that protect, support and promote breastfeeding should be

  15. Breastfeeding, introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendations

    Directory of Open Access Journals (Sweden)

    Agneta Hörnell

    2013-04-01

    Full Text Available The present systematic literature review is part of the 5th revision of the Nordic Nutrition Recommendations. The overall aim was to review recent scientific data valid in a Nordic setting on the short- and long-term health effects of breastfeeding (duration of both any and exclusive breastfeeding and introduction of foods other than breast milk. The initial literature search resulted in 2,011 abstracts; 416 identified as potentially relevant. Full paper review resulted in 60 quality assessed papers (6A, 48B, and 6C. A complementary search found some additional papers. The grade of evidence was classified as convincing, probable, limited-suggestive, and limited-no conclusion. The evidence was convincing of a protective dose/duration effect of breastfeeding against overweight and obesity in childhood and adolescence, overall infections, acute otitis media, and gastrointestinal and respiratory tract infections. The evidence was probable that exclusive breastfeeding for longer than 4 months is associated with slower weight gain during the second half of the first year which could be part of the reason behind the reduced risk of later overweight or obesity. There was also probable evidence that breastfeeding is a protective factor against inflammatory bowel disease, celiac disease, and diabetes (type 1 and 2, provides beneficial effects on IQ and developmental scores of children as well as a small reductive effect on blood pressure and blood cholesterol levels in adulthood. Other associations explored were limited-suggestive or inconclusive. In conclusion, convincing and probable evidence was found for benefits of breastfeeding on several outcomes. The recommendation in NNR2004 about exclusive breastfeeding for 6 months and continued partial breastfeeding thereafter can stand unchanged. The relatively low proportion of infants in the Nordic countries following this recommendation indicates that strategies that protect, support and promote

  16. Validating the proposed diagnostic and statistical manual of mental disorders, 5th edition, severity indicator for personality disorder.

    Science.gov (United States)

    Morey, Leslie C; Bender, Donna S; Skodol, Andrew E

    2013-09-01

    The authors sought to determine whether a 5-point global rating of personality dysfunction on the Level of Personality Functioning Scale proposed as a severity index for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), would be related to DSM-IV personality disorder diagnosis as well as to other key clinical judgments. Data were collected from a national sample of 337 mental health clinicians who provided complete diagnostic information relevant to DSM-IV and proposed DSM-5 personality disorder diagnoses, as well as demographic information and other clinical judgments, on one of their patients. Of the 337 patients described, 248 met criteria for 1 of the 10 specific DSM-IV personality disorders. A "moderate" or greater rating of impairment in personality functioning on the Level Scale demonstrated 84.6% sensitivity and 72.7% specificity for identifying patients meeting criteria for a specific DSM-IV personality disorder. The Level of Personality Functioning Scale had significant and substantial validity correlations with other measures of personality pathology and with clinical judgments regarding functioning, risk, prognosis, and optimal treatment intensity. Furthermore, the single-item Level of Personality Functioning rating was viewed as being as clinically useful as the 10 DSM-IV categories for treatment planning and patient description and was a better predictor of clinician ratings of broad psychosocial functioning than were the 10 DSM-IV categories combined. These results confirm hypotheses that the single-item Level of Personality Functioning Scale rating provides an indication of severity of personality pathology that predicts both assignment of personality disorder diagnosis and clinician appraisals of functioning, risk, prognosis, and needed treatment intensity.

  17. Web-mediated database for internet-based dental radiology teaching files constructed by 5th-year undergraduate students

    International Nuclear Information System (INIS)

    Kito, Shinji; Wakasugi-Sato, Nao; Matsumoto-Takeda, Shinobu; Oda, Masafumi; Tanaka, Tatsurou; Fukai, Yasuhiro; Tokitsu, Takatoshi; Morimoto, Yasuhiro

    2009-01-01

    To provide oral healthcare for patients of all ages, dental welfare environments and technical aspects of dentistry have evolved and developed and dental education must also diversify. Student-centered voluntary education and establishment of a life-long self-learning environment are becoming increasingly important in the changing world of dental education. In this article, we introduce a new process for the construction of a web-mediated database containing internet-based teaching files on the normal radiological anatomy of panoramic radiographs and CT images of the oral and maxillofacial regions, as well as a system for the delivery of visual learning materials through an intra-faculty local network. This process was developed by our 5th-year undergraduate students. Animated CT scan images were produced using Macintosh Iphoto and Imovie animation software. Normal anatomical images of panoramic radiographs and CT scans were produced using Adobe Illustrator CS and Adobe Photoshop CS. The web database was constructed using Macromedia Dreamweaver MX and Microsoft Internet Explorer. This project was the basis of our participation in the Student Clinician Research Program (SCRP). At Kyushu Dental College, we developed a new series of teaching files on the web. Uploading these teaching files to the internet allowed many individuals to access the information. Viewers can easily select the area of study that they wish to examine. These processes suggest that our laboratory practice is a useful tool for promoting students' motivation and improving life-long self learning in dental radiology. We expect that many medical and dental students, practitioners and patients will be able to use our teaching files to learn about the normal radiological anatomy of the oral and maxillofacial regions.(author)

  18. 5th international exhaust gas and particulate emissions forum. Proceedings; 5. Internationales Forum Abgas- und Partikelemissionen. Beitraege

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-12-11

    The Proceedings of the 5th International Exhaust Gas and Particulate Emissions Forum contains 22 printed contributions as well as a CD-ROM. The titles of them are: (1) Diesel Emissions Control in the United States - 2010 and Beyond; (2) The MBE90 commercial vehicle engine for EPA '07 emissions regulations; (3) Concepts for engines and exhaust-gas cleaning systems for heavy duty trucks of the future; (4) HD Engine Technology for Near-Zero Emissions and Lowest Cost of Ownership; (5) (Partially-) Homogeneous Diesel Combustion; (6) Exhaust gas sensors for NOx storage catalysts and ammonia-SCR systems; (7) Sensors for modern exhaust gas after-treatment systems; (8) New reducing agents for low NOx-SCR Techno-logy; (9) Exhaust gas Aftertreatment on Lean Burn Gasoline Direct Injection Engines: The System of TWC and NOx-Storage Catalyst; (10) New Platinum/Palladium based catalyzed filter technologies for future passenger car applications; (11) Development of a Roadway Hydrocarbon Sorption Model and Characterization of a Novel PM Generator; (12) Requirements for current and future particulate measurement instrumentation from the point of view of the Physikalisch-Technische Bundesanstalt; (13) Standardized dilution conditions for gravimetric PM sampling - measures to assure results that correlate; (14) Particle Counting according PMP; (15) Future high-confidence measurement of diesel particulate emissions for approval and development; (16) New developments in optical instrumentation for exhaust gas; (17) Simultaneous Detection of Gaseous and Particulate Exhaust Components by Photoacoustic Spectroscopy; (18) Boundaries of modern exhaust gas instrumentation; (19) Raising quality and reducing application effort through efficient data input to the particulate filter load model for a EURO5 diesel car; (20) Stop-start operation of diesel engines - modified require-ment for exhaust gas after-treatment?; (21) Particulates emission with Biodiesel B30 impact on CSF management; (22

  19. The Effect and Value of a WebQuest Activity on Weather in a 5th Grade Classroom

    Science.gov (United States)

    Oliver, Deborah

    2010-01-01

    WebQuests are increasing in popularity across the country, yet it remains unclear whether WebQuests confer a significant benefit in student content learning. In addition, the perceptions of teachers regarding the classroom value and efficacy of WebQuests in teaching higher level thinking skills are still unclear. The goals of the study were (a) to…

  20. Experential Learning Group Investigation as Effort to Developt Environmental Literacy Ability at 5th Grade Students of Madrasah Ibtidaiyah

    Directory of Open Access Journals (Sweden)

    Yuswa Istikomayanti

    2016-03-01

    Full Text Available The development of learning tools for Environmental Education to develop students' environmental literacy skills are indispensable. Methods of research and development using 4-D Thiagarajan (Define, Design, Develop and Disseminate. The result of the development of the device include syllabi, lesson plans, modules, and assessment instruments tested in class IV A Lesson Study by performing well. The trial results actually (validation testing with pre-experiment (class IV B can improve the literacy skills of students include aspects of environmental knowledge, attitudes, and skills and habituation. The trial results actually (class IV B obtained N-Score Gain knowledge and attitude tests of 0.64 (medium, and N-Gain Score of the attitude scale questionnaire 0.67 (moderate. While aspects of the student's skills include practical activities seed, move into the growing medium, and the practice of making compost with N-Gain Score of 0.54 (medium and 0.69 (moderate. Activity habituation maintain plants and credible form of checks compost with N-Gain Score of 0.48 (moderate. The results of research and development is expected to be utilized by the school and can be distributed to other schools

  1. Standardized patient simulation versus didactic teaching alone for improving residents' communication skills when discussing goals of care and resuscitation: A randomized controlled trial.

    Science.gov (United States)

    Downar, James; McNaughton, Nancy; Abdelhalim, Tarek; Wong, Natalie; Lapointe-Shaw, Lauren; Seccareccia, Dori; Miller, Kim; Dev, Shelly; Ridley, Julia; Lee, Christie; Richardson, Lisa; McDonald-Blumer, Heather; Knickle, Kerry

    2017-02-01

    Communication skills are important when discussing goals of care and resuscitation. Few studies have evaluated the effectiveness of standardized patients for teaching medical trainees to communicate about goals of care. To determine whether standardized patient simulation offers benefit over didactic sessions alone for improving skill and comfort discussing goals of care. Single-blind, randomized, controlled trial of didactic teaching plus standardized patient simulation versus didactic teaching alone. First-year internal medicine residents. Changes in communication comfort and skill between baseline and 2 months post-training assessed using the Consultation and Relational Empathy measure. We enrolled 94 residents over a 2-year period. Both groups reported a significant improvement in comfort when discussing goals of care with patients. There was no difference in Consultation and Relational Empathy scores following the workshop ( p = 0.79). The intervention group showed a significant increase in Consultation and Relational Empathy scores post-workshop compared with pre-workshop (35.0 vs 31.7, respectively; p = 0.048), whereas there was no improvement in Consultation and Relational Empathy scores in the control group (35.6 vs 36.0; p = 0.4). However, when the results were adjusted for baseline differences in Consultation and Relational Empathy scores in a multivariable regression analysis, group assignment was not associated with an improvement in Consultation and Relational Empathy score. Improvement in comfort scores and perception of benefit were not associated with improvements in Consultation and Relational Empathy scores. Simulation training may improve communication skill and comfort more than didactic training alone, but there were important confounders in this study and further studies are needed to determine whether simulation is better than didactic training for this purpose.

  2. Self-care and mobility skills in children with cerebral palsy, related to their manual ability and gross motor function classifications.

    Science.gov (United States)

    Öhrvall, Ann-Marie; Eliasson, Ann-Christin; Löwing, Kristina; Ödman, Pia; Krumlinde-Sundholm, Lena

    2010-11-01

    The aim of this study was to investigate the acquisition of self-care and mobility skills in children with cerebral palsy (CP) in relation to their manual ability and gross motor function. Data from the Pediatric Evaluation of Disability Inventory (PEDI) self-care and mobility functional skill scales, the Manual Ability Classification System (MACS), and the Gross Motor Function Classification System (GMFCS) were collected from 195 children with CP (73 females, 122 males; mean age 8 y 1 mo; SD 3 y 11 mo; range 3-15 y); 51% had spastic bilateral CP, 36% spastic unilateral CP, 8% dyskinetic CP, and 3% ataxic CP. The percentage of children classified as MACS levels I to V was 28%, 34%, 17%, 7%, and 14% respectively, and classified as GMFCS levels I to V was 46%, 16%, 15%, 11%, and 12% respectively. Children classified as MACS and GMFCS levels I or II scored higher than children in MACS and GMFCS levels III to V on both the self-care and mobility domains of the PEDI, with significant differences between all classification levels (pskills (66%) and that GMFCS was the strongest predictor of mobility skills (76%). A strong correlation between age and self-care ability was found among children classified as MACS level I or II and between age and mobility among children classified as GMFCS level I. Many of these children achieved independence, but at a later age than typically developing children. Children at other MACS and GMFCS levels demonstrated minimal progress with age. Knowledge of a child's MACS and GMFCS level can be useful when discussing expectations of, and goals for, the development of functional skills. © The Authors. Journal compilation © Mac Keith Press 2010.

  3. Marketing your skills outside the hospital walls.

    Science.gov (United States)

    Waxman, K T

    1998-08-01

    As patient care shifts from acute care to outpatient and community home health care, nurses need to repackage their skills. A personal skill assessment on an ongoing basis helps nurses plan for the future.

  4. EDITORIAL: Proceedings of the 5th Edoardo Amaldi Conference on Gravitational Waves, Tirrenia, Italy, 6-11 July 2003

    Science.gov (United States)

    Berger, Beverly; Isenberg, James

    2004-02-01

    It is hard to find an area of mathematical relativity that has not been profoundly influenced and advanced by the work of Vincent Moncrief. He has done groundbreaking work on everything from his studies of gravitational radiation production by astrophysical systems to his model proofs of strong cosmic censorship. His work on the manifold structure of the space of solutions of the Einstein constraint equations, and on methods for systematically constructing such solutions, has done much to define and shape that field of inquiry, while his work on long time existence for the Yang-Mills and Einstein equations has significantly advanced the study of nonlinear hyperbolic PDE theory. The underlying theme to this very diverse portfolio of work is this: throughout his career, Vince has consistently chosen to attack those problems in general relativity which are both central to understanding the physical content of the gravitational physics of the theory, and are amenable to rigorous mathematical analysis. Combining an uncanny physical insight with a deep mathematical skill, and adding a legendary degree of carefulness, Vince has remade a great many of the areas of mathematical general relativity. The best known early example of Vince's unique style is the tour de force represented by his analyses of perturbations of black holes. He combined remarkable insight and calculational ability to develop techniques based on gauge invariant variables that both simplified the calculations and clarified their physical significance. These methods have proven invaluable for subsequent analytic and numerical studies (by Vince and by many others) of black hole stability and gravitational radiation from perturbed black holes. While a significant portion of Vince's earliest work concentrated on black hole systems, from around 1980 on, Vince's focus has been on cosmological spacetimes. He has shown that large families of them have Cauchy horizons (and therefore violate causality), and has

  5. Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on Educational Technologies (5th, Sydney, Australia, December 11-13, 2017)

    Science.gov (United States)

    Kommers, Piet, Ed.; Issa, Tomayess, Ed.; Isaias, Pedro, Ed.; Hol, Ana, Ed.

    2017-01-01

    These proceedings contain the papers and posters of the 5th International Conference on Educational Technologies 2017 (ICEduTech 2017), which has been organised by the International Association for Development of the Information Society and co-organised by the Western Sydney University, held in Sydney, Australia, 11-13 December 2017. ICEduTech is…

  6. Indoor air quality, ventilation and energy conservation. Trip report 5th J Cartier Conference, Montreal 1992, FAGO report 92.37.K

    NARCIS (Netherlands)

    Hensen, J.L.M.

    1992-01-01

    This trip report serves as a brief description of my visit to the 5th International Jacques Carrier Conference, in Montreal 1992. First some general infonnation about the conference is presented. Then there is a list of contributions. This is followed by a brief indication of my own contribution,

  7. Determination of Motivation of 5th Grade Students Living in Rural and Urban Environments towards Science Learning and Their Attitudes towards Science-Technology Course

    Science.gov (United States)

    Kenar, Ismail; Köse, Mücahit; Demir, Halil Ibrahim

    2016-01-01

    In this research, determination of motivation of 5th grade students living in rural and urban environments towards science learning and their attitudes towards science-technology course is aimed. This research is conducted based on descriptive survey model. Samples are selected through teleological model in accordance with the aim of this…

  8. Measures of self-efficacy and norms for low-fat milk consumption are reliable and related to beverage consumption among 5th graders at school lunch

    Science.gov (United States)

    The objective was to determine the reliability and validity of scales measuring low-fat milk consumption self-efficacy and norms during school lunch among a cohort of 5th graders. Two hundred seventy-five students completed lunch food records and a psychosocial questionnaire measuring self-efficacy ...

  9. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors.

    Science.gov (United States)

    Pandit, J J; Andrade, J; Bogod, D G; Hitchman, J M; Jonker, W R; Lucas, N; Mackay, J H; Nimmo, A F; O'Connor, K; O'Sullivan, E P; Paul, R G; Palmer, J H M G; Plaat, F; Radcliffe, J J; Sury, M R J; Torevell, H E; Wang, M; Hainsworth, J; Cook, T M

    2014-10-01

    We present the main findings of the 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia (AAGA). Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19,600 anaesthetics (95% confidence interval 1:16,700-23,450). However, there was considerable variation across subtypes of techniques or subspecialities. The incidence with neuromuscular block (NMB) was ~1:8200 (1:7030-9700), and without, it was ~1:135,900 (1:78,600-299,000). The cases of AAGA reported to NAP5 were overwhelmingly cases of unintended awareness during NMB. The incidence of accidental awareness during Caesarean section was ~1:670 (1:380-1300). Two-thirds (82, 66%) of cases of accidental awareness experiences arose in the dynamic phases of anaesthesia, namely induction of and emergence from anaesthesia. During induction of anaesthesia, contributory factors included: use of thiopental, rapid sequence induction, obesity, difficult airway management, NMB, and interruptions of anaesthetic delivery during movement from anaesthetic room to theatre. During emergence from anaesthesia, residual paralysis was perceived by patients as accidental awareness, and commonly related to a failure to ensure full return of motor capacity. One-third (43, 33%) of accidental awareness events arose during the maintenance phase of anaesthesia, mostly due to problems at induction or towards the end of anaesthesia. Factors increasing the risk of accidental awareness included: female sex, age (younger adults, but not children), obesity, anaesthetist seniority (junior trainees), previous awareness, out-of-hours operating, emergencies, type of surgery (obstetric, cardiac, thoracic), and use of NMB. The following factors were not risk factors for accidental awareness: ASA physical status, race, and use or omission

  10. Technological Characterization of Wall Paintings from the A Mithraic Tomb Dated to 4th-5th Century AD, Gargaresc, Libya

    Science.gov (United States)

    Abd El Salam, S.; Maniatis, Y.

    2009-04-01

    The excavations of Gargaresc started in 1965 and were one of the most important archaeological sites in Tripoli because it includes a period of about 500 years starting from the 1stc. AD was and continuing until the 5th century AD. The Mithraic tomb is one of the most important outlying monuments of Oea, 200 yards south of the western end of Gargaresc oasis, on the left of the Tripoli-Zuara road between kilometers 5 & 6. The tomb is cut in an outcrop of soft sandstone. The wall paintings found were symbolic to the religion of that period; which contained a mixture of older religions and Christian, and presented the interaction between the artistic and religious elements of that time. Several optical, chemical and mineralogical methods were applied to identify the materials, composition and technology of the plasters and mortars, as well as, the pigments used in the tomb. These are: -OP: Optical microscopy was used as the initial examination of polished cross-sections to identify the structure and microstratigraphy of the plasters and mortars as well as the painted layers. -MCT: Micro-chemical tests were used to identify the type of the plasters and mortars- calcium aluminium silicate and water-soluble salt to identify sulphates, chlorides, carbonates, nitrites and nitrates. -SM: Standard methods for chemical analysis to identify the quantitative and qualitative nature of the plasters and mortars and their mixture. -SEM & EDS: Analytical Scanning electron microscope with energy dispersive x-ray analysis system to examine the micrmorphology and determine the chemical composition of the plasters, pigments and the inclusions. -XRD: X-ray powder diffraction to identify the mineralogical composition of the plasters, mortars and pigments. On the bases of all the data obtained, it was possible to establish the nature of the plasters, mortars and their binder. The examination and analysis gave a full picture about the materials and the approximate ratio of amount of

  11. A look back on how far to walk: Systematic review and meta-analysis of physical access to skilled care for childbirth in Sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Kerry L M Wong

    Full Text Available To (i summarize the methods undertaken to measure physical accessibility as the spatial separation between women and health services, and (ii establish the extent to which distance to skilled care for childbirth affects utilization in Sub-Saharan Africa.We defined spatial separation as the distance/travel time between women and skilled care services. The use of skilled care at birth referred to either the location or attendant of childbirth. The main criterion for inclusion was any quantification of the relationship between spatial separation and use of skilled care at birth. The approaches undertaken to measure distance/travel time were summarized in a narrative format. We obtained pooled adjusted odds ratios (aOR from studies that controlled for financial means, education and (perceived need of care in a meta-analysis.57 articles were included (40 studied distance and 25 travel time, in which distance/travel time were found predominately self-reported or estimated in a geographic information system based on geographic coordinates. Approaches of distance/travel time measurement were generally poorly detailed, especially for self-reported data. Crucial features such as start point of origin and the mode of transportation for travel time were most often unspecified. Meta-analysis showed that increased distance to maternity care had an inverse association with utilization (n = 10, pooled aOR = 0.90/1km, 95%CI = 0.85-0.94. Distance from a hospital for rural women showed an even more pronounced effect on utilization (n = 2, pooled aOR = 0.58/1km increase, 95%CI = 0.31,1.09. The effect of spatial separation appears to level off beyond critical point when utilization was generally low.Although the reporting and measurements of spatial separation in low-resource settings needs further development, we found evidence that a lack of geographic access impedes use. Utilization is conditioned on access, researchers and policy makers should therefore

  12. A look back on how far to walk: Systematic review and meta-analysis of physical access to skilled care for childbirth in Sub-Saharan Africa.

    Science.gov (United States)

    Wong, Kerry L M; Benova, Lenka; Campbell, Oona M R

    2017-01-01

    To (i) summarize the methods undertaken to measure physical accessibility as the spatial separation between women and health services, and (ii) establish the extent to which distance to skilled care for childbirth affects utilization in Sub-Saharan Africa. We defined spatial separation as the distance/travel time between women and skilled care services. The use of skilled care at birth referred to either the location or attendant of childbirth. The main criterion for inclusion was any quantification of the relationship between spatial separation and use of skilled care at birth. The approaches undertaken to measure distance/travel time were summarized in a narrative format. We obtained pooled adjusted odds ratios (aOR) from studies that controlled for financial means, education and (perceived) need of care in a meta-analysis. 57 articles were included (40 studied distance and 25 travel time), in which distance/travel time were found predominately self-reported or estimated in a geographic information system based on geographic coordinates. Approaches of distance/travel time measurement were generally poorly detailed, especially for self-reported data. Crucial features such as start point of origin and the mode of transportation for travel time were most often unspecified. Meta-analysis showed that increased distance to maternity care had an inverse association with utilization (n = 10, pooled aOR = 0.90/1km, 95%CI = 0.85-0.94). Distance from a hospital for rural women showed an even more pronounced effect on utilization (n = 2, pooled aOR = 0.58/1km increase, 95%CI = 0.31,1.09). The effect of spatial separation appears to level off beyond critical point when utilization was generally low. Although the reporting and measurements of spatial separation in low-resource settings needs further development, we found evidence that a lack of geographic access impedes use. Utilization is conditioned on access, researchers and policy makers should therefore prioritize quality

  13. What can we learn from simulation-based training to improve skills for end-of-life care? Insights from a national project in Israel.

    Science.gov (United States)

    Brezis, Mayer; Lahat, Yael; Frankel, Meir; Rubinov, Alan; Bohm, Davina; Cohen, Matan J; Koslowsky, Meni; Shalomson, Orit; Sprung, Charles L; Perry-Mezare, Henia; Yahalom, Rina; Ziv, Amitai

    2017-11-06

    Simulation-based training improves residents' skills for end-of-life (EOL) care. In the field, staff providers play a significant role in handling those situations and in shaping practice by role modeling. We initiated an educational intervention to train healthcare providers for improved communication skills at EOL using simulation of sensitive encounters with patients and families. Hospital physicians and nurses (n = 1324) attended simulation-based workshops (n = 100) in a national project to improve EOL care. We analyzed perceptions emerging from group discussions following simulations, from questionnaires before and after each workshop, and from video-recorded simulations using a validated coding system. We used the simulation setting as a novel tool for action research. We used a participatory inquiry paradigm, with repetitive cycles of exploring barriers and challenges with participants in an iterative pattern of observation, discussion and reflection - including a description of our own responses and evolution of thought as well as system effects. The themes transpiring included lack of training, knowledge and time, technology overuse, uncertainty in decision-making, poor skills for communication and teamwork. Specific scenarios demonstrated lack of experience at eliciting preferences for EOL care and at handling conflicts or dilemmas. Content analysis of simulations showed predominance of cognitive utterances - by an order of magnitude more prevalent than emotional expressions. Providers talked more than actors did and episodes of silence were rare. Workshop participants acknowledged needs to improve listening skills, attention to affect and teamwork. They felt that the simulation-based workshop is likely to ameliorate future handling of EOL situations. We observed unanticipated consequences from our project manifested as a field study of preparedness to EOL in nursing homes, followed by a national survey on quality of care, leading to expansion of

  14. The self-perceived knowledge, skills and attitudes of Australian practice nurses in providing nutrition care to patients with chronic disease.

    Science.gov (United States)

    Martin, Louise; Leveritt, Michael D; Desbrow, Ben; Ball, Lauren E

    2014-04-01

    Nutrition is important for the management of chronic diseases. While practice nurses have numerous roles in primary care, the expectations on practice nurses to provide nutrition care for chronic disease management are increasing. The self-perceived knowledge, skills and attitudes of practice nurses in providing nutrition care has not been widely investigated. The aim of the present study was to investigate the perceptions of Australian practice nurses on the provision of nutrition care for chronic disease management, including specific nutrition-related activities. A cross-sectional online survey was completed by 181 Australian practice nurses in 2013. Descriptive analyses were conducted on each survey item. The survey sample was tested for representation of the Australian practice nurse workforce, and associations between respondents' demographic characteristics and responses to survey items were explored. Almost all practice nurses (89%) felt it was important to address diet whenever they cared for a patient. Over half of practice nurses (61%) were unsure if their practices were effective in increasing patients' compliance with nutritional recommendations. Nearly all practice nurses (98%) perceived further education on nutrition would assist them in their role. Practice nurses perceive they have an important role and favourable attitudes towards providing nutrition care; however, further training and education to enhance their self-perceived effectiveness is warranted. Future research should clarify whether an increase in nutrition-focused training results in improved effectiveness of nutrition care provided by practice nurses in terms of patient health outcomes.

  15. How primary health care staff working in rural and remote areas access skill development and expertise to support health promotion practice.

    Science.gov (United States)

    McFarlane, Kathryn A; Judd, Jenni; Wapau, Hylda; Nichols, Nina; Watt, Kerrianne; Devine, Sue

    2018-05-01

    Health promotion is a key component of comprehensive primary health care. Health promotion approaches complement healthcare management by enabling individuals to increase control over their health. Many primary healthcare staff have a role to play in health promotion practice, but their ability to integrate health promotion into practice is influenced by their previous training and experience. For primary healthcare staff working in rural and remote locations, access to professional development can be limited by what is locally available and prohibitive in terms of cost for travel and accommodation. This study provides insight into how staff at a large north Queensland Aboriginal community controlled health service access skill development and health promotion expertise to support their work. A qualitative exploratory study was conducted. Small group and individual semi-structured interviews were conducted with staff at Apunipima Cape York Health Council (n=9). A purposive sampling method was used to recruit participants from a number of primary healthcare teams that were more likely to be involved in health promotion work. Both on-the-ground staff and managers were interviewed. All participants were asked how they access skill development and expertise in health promotion practice and what approaches they prefer for ongoing health promotion support. The interviews were transcribed verbatim and analysed thematically. All participants valued access to skill development, advice and support that would assist their health promotion practice. Skill development and expertise in health promotion was accessed from a variety of sources: conferences, workshops, mentoring or shared learning from internal and external colleagues, and access to online information and resources. With limited funds and limited access to professional development locally, participants fostered external and internal organisational relationships to seek in-kind advice and support. Irrespective of

  16. It takes a community to define a discipline: the 5th anniversary of Environmental Research Letters It takes a community to define a discipline: the 5th anniversary of Environmental Research Letters

    Science.gov (United States)

    Kammen, Dan

    2012-03-01

    commentary environment, a unique service in itself, and also a specific forum for research published in ERL. Individual topics often come up that warrant not only single articles, but collections of assessments, and ERL has published focus issues in key areas of environmental science including: tropical deforestation, wind energy, the Deepwater Horizon oil spill and climate engineering. ERL is currently publishing seven high-quality focus issues in cutting-edge areas such as arctic vegetation dynamics and cryospheric changes. Research letters appearing in ERL have received regular and significant coverage in the wider media, with several major news outlets and agencies choosing to cover ERL research, such as Nature, BBC News, New Scientist, The Guardian, Scientific American, Le Monde and many others. 4.The future community of ERL The process of community support will take many forms at ERL. The journal is growing—we have published the highest number of articles ever in a single volume in 2011 and are looking to continue this growth through into 2012. ERL had an over 50% increase in submissions from 2010 to 2011. One initiative to mark the journal's 5th anniversary was the 'Best articles' collection [1] a nominated compilation of articles showcasing the quality of published work in ERL as well as the subject area breadth. Co-authors of the five winning articles have been awarded free publication in ERL until the end of 2012. We can also see the open access model working, in that our articles are highly downloaded outside of the traditionally strong geographical areas of academia (North America and Western Europe), showing that the journal's readership is geographically diverse with high interest from Asia, South America and Africa. The journal is committed to progress and innovation; coming soon will be a set of new communication tools and online innovations, including: Video abstracts from the start of 2012 (for example, the video commentary published alongside this

  17. Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care.

    Science.gov (United States)

    Aiken, Linda H; Sloane, Douglas; Griffiths, Peter; Rafferty, Anne Marie; Bruyneel, Luk; McHugh, Matthew; Maier, Claudia B; Moreno-Casbas, Teresa; Ball, Jane E; Ausserhofer, Dietmar; Sermeus, Walter

    2017-07-01

    To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80nurses is associated with an 11% increase in the odds of death. In our hospital sample, there were an average of six caregivers for every 25 patients, four of whom were professional nurses. Substituting one nurse assistant for a professional nurse for every 25 patients is associated with a 21% increase in the odds of dying. A bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. Reducing nursing skill mix by adding nursing associates and other categories of assistive nursing personnel without professional nurse qualifications may contribute to preventable deaths, erode quality and safety of hospital care and contribute to hospital nurse shortages. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

  18. A qualitative evaluation of the choice of traditional birth attendants for maternity care in 2008 Sierra Leone: implications for universal skilled attendance at delivery.

    Science.gov (United States)

    Oyerinde, Koyejo; Harding, Yvonne; Amara, Philip; Garbrah-Aidoo, Nana; Kanu, Rugiatu; Oulare, Macoura; Shoo, Rumishael; Daoh, Kizito

    2013-07-01

    Maternal and newborn death is common in Sierra Leone; significant reductions in both maternal and newborn mortality require universal access to a skilled attendant during labor and delivery. When too few women use health facilities MDGs 4 and 5 targets will not be met. Our objectives were to identify why women use services provided by TBAs as compared to health facilities; and to suggest strategies to improve utilization of health facilities for maternity and newborn care services. Qualitative data from focus group discussions in communities adjacent to health facilities collected during the 2008 Emergency Obstetric and Newborn Care Needs Assessment were analyzed for themes relating to decision-making on the utilization of TBAs or health facilities. The prohibitive cost of services, and the geographic inaccessibility of health facilities discouraged women from using them while trust in the vast experience of TBAs as well as their compassionate care drew patients to them. Poor facility infrastructure, often absent staff, and the perception that facilities were poorly stocked and could not provide continuum of care services were barriers to facility utilization for maternity and newborn care. Improvements in infrastructure and the 24-hour provision of free, quality, comprehensive, and respectful care will minimize TBA preference in Sierra Leone.

  19. [Team Care for Patient Safety, TeamSTEPPS to Improve Nontechnical Skills and Teamwork--Actions to Become an HRO].

    Science.gov (United States)

    Kaito, Ken

    2015-07-01

    It is important to develop safer medical systems and follow manuals of medical procedures for patient safety. However, these approaches do not always result in satisfactory results because of many human factors. It is known that defects of nontechnical skills are more important than those of technical skills regarding medical accidents and incidents. So, it is necessary to improve personal nontechnical skills and compensate for each other's defects based on a team approach. For such purposes, we have implemented TeamSTEPPS to enhance performance and patient safety in our hospital. TeamSTEPPS (team strategies and tools to enhance performance and patient safety) is a useful method to improve the nontechnical skills of each member and the team. In TeamSTEPPS, leadership to share mental models among the team, continuous monitoring and awareness for team activities, mutual support for workload and knowledge, and approaches to complete communication are summarized to enhance teamwork and patient safety. Other than improving nontechnical skills and teamwork, TeamSTEPPS is also very important as a High Reliability Organization (HRO). TeamSTEPPS is worth implementing in every hospital to decrease medical errors and improve patient outcomes and satisfaction.

  20. Skilled nursing or rehabilitation facilities

    Science.gov (United States)

    ... ency/patientinstructions/000435.htm Skilled nursing or rehabilitation facilities To use the sharing features on this page, ... to go to a Skilled Nursing or Rehabilitation Facility? Your health care provider may determine that you ...

  1. TEWS'98. Final report [5th annual International Science Camp: The Earth We Share 1998, Golden, CO

    Energy Technology Data Exchange (ETDEWEB)

    Mae C. Jemison

    1999-04-06

    The fifth annual International Science Camp The Earth We Share 1998 (TEWS'98) was held at the Colorado School of Mines located in Goldez Colorado. TEWS98 was a four week residential program which focused on providing a meaningful science education experience while developing critical thinking skills. Thirty three students, three teachers, four college interns and the camp administrator lived and worked together while developing solutions to several worldwide problems. These problems are called the Discovery Topics and they are: (1) design the worlds perfect house; (2) how many people can the world hold; and (3) predict the hot stocks for the year 2030. The participants, both students and staff came from different countries all over the world The following countries were represented: The United Kingdom, Sierra Leone (West Africa), Ireland, USA Nigeria, West Indies and Barbados.

  2. The effectiveness of communication-skills training interventions in end-of-life noncancer care in acute hospital-based services: A systematic review.

    Science.gov (United States)

    Lord, Laura; Clark-Carter, David; Grove, Amy

    2016-08-01

    A systematic review was conducted in order to explore the effectiveness of communication-skills training interventions in end-of-life care with noncancer acute-based healthcare staff. Articles were included if they (1) focused on communication-skills training in end-of-life/palliative care for noncancer acute-based staff and (2) reported an outcome related to behavior change with regard to communication. Sixteen online databases were searched, which resulted in 4,038 potential articles. Screening of titles left 393 articles that met the inclusion criteria. Abstracts (n = 346) and full-text articles (n = 47) were reviewed, leaving 10 papers that met the criteria for our review. All articles explored the effect of communication-skills training on aspects of staff behavior; one study measured the effect on self-efficacy, another explored the impact on knowledge and competence, and another measured comfort levels in discussing the end of life with patients/families. Seven studies measured a number of outcomes, including confidence, attitude, preparedness, stress, and communication skills. Few studies have focused on end-of-life communication-skills training in noncancer acute-based services. Those that do have report positive effects on staff behavior with regard to communication about the end of life with patients and families. The studies varied in terms of the population studied and the health services involved, and they scored only moderately or weakly on quality. It is a challenge to draw a definite conclusion about the effectiveness of training interventions in end-of-life communication because of this. However, the findings from our review demonstrate the potential effectiveness of a range of training interventions with healthcare professionals on confidence, attitude, self-efficacy, and communication skills. Further research is needed to fully explore the effectiveness of existing training interventions in this population, and evidence using objective measures

  3. Specific technological communication skills and functional health literacy have no influence on self-reported benefits from enrollment in the TeleCare North trial.

    Science.gov (United States)

    Lilholt, Pernille Heyckendorff; Hæsum, Lisa Korsbakke Emtekær; Ehlers, Lars Holger; Hejlesen, Ole K

    2016-07-01

    The Danish TeleCare North trial has developed a telehealth system, Telekit, which is used for self-management by patients diagnosed with chronic obstructive pulmonary disease (COPD). Self-management is the engagement in one's own illness and health by monitoring and managing one's symptoms and signs of illness. The study examines the association between COPD patients' use of Telekit and their functional health literacy and the association between their use of Telekit and their specific technological communication skills. A consecutive sample of participants (n=60) from the TeleCare North trial were recruited. Face-to-face interviews were conducted with each participant to collect demographic data. Functional health literacy was measured with the Danish TOFHLA test. Participants completed a non-standardised questionnaire about their health status, their use of the Telekit system, and their specific technological communication skills. Binary logistic regressions were performed to examine how functional health literacy and specific technological communication skills influenced the use of Telekit by giving users an enhanced sense of freedom, security, control, and a greater awareness of COPD symptoms. Participants (27 women, 33 men) had a mean age of 70 (SD: 8.37) years. Functional health literacy levels were classified as inadequate in 14 (23%) participants, as marginal in 12 (20%), and as adequate in 34 (57%). Participants self-reported a feeling of increased security (72%), greater freedom (27%), more control (62%), and greater awareness of symptoms (50%) when using Telekit. The use of Telekit was not significantly associated with levels of functional health literacy or with the number of specific technological communication skills (p>0.05) based on the binary logistic regressions. The enhanced sense of security, freedom, control, and the greater awareness of COPD symptoms achieved by using Telekit were unassociated both with the patients' score of functional health

  4. FOREWORD: The 5th International Colloquium on Atomic Spectra and Oscillator Strengths for Astrophysical and Laboratory Plasmas

    Science.gov (United States)

    Tchang-Brillet, Wad Lydia; Wyart, Jean-François; Zeippen, Claude

    1996-01-01

    The 5th International Colloquium on Atomic Spectra and Oscillator Strengths for Astrophysical and Laboratory Plasmas was held in Meudon, France, from August 28 to 31 1995. It was the fifth in a series started by the Atomic Spectroscopic Group at the University of Lund, Sweden, in 1983. Then followed the meetings in Toledo, USA, Amsterdam, The Nether- lands and Gaithersburg, USA, with a three year period. The original title of the series ended with "... for Astrophysics and Fusion Research" and became more general with the 4th colloquium in Gaithersburg. The purpose of the present meeting was, in line with tradition, to bring together "producers" and "users" of atomic data so as to ensure optimal coordination. Atomic physicists who study the structure of atoms and their radiative and collisional properties were invited to explain the development of their work, emphasizing the possibilities of producing precise transition wavelengths and relative line intensities. Astrophysicists and laboratory plasma physicists were invited to review their present research interests and the context in which atomic data are needed. The number of participants was about 70 for the first three meetings, then exploded to 170 at Gaithersburg. About 140 participants, coming from 13 countries, attended the colloquium in Meudon. This large gathering was partly due to a number of participants from Eastern Europe larger than in the past, and it certainly showed a steady interest for interdisciplinary exchanges between different communities of scientists. This volume includes all the invited papers given at the conference and, in the appendix, practical information on access to some databases. All invited speakers presented their talks aiming at good communication between scientists from different backgrounds. A separate bound volume containing extended abstracts of the poster papers has been published by the Publications de l'Observatoire de Paris, (Meudon 1996), under the responsibility of

  5. Let your communication skills equal your clinical skills.

    Science.gov (United States)

    Demarais, Ann; Baum, Neil

    2012-01-01

    Relating effectively with patients is among the most valued skills of clinical care. Honing your communication skills is an art that every physician needs to learn and understand. In this era of increased volume of patients there is a tendency to lose sight of the importance of having good communication skills. This article will review 11 suggestions for letting your communication skills equal your clinical skills.

  6. Comparison of Visual Assessment of Breast Density in BI-RADS 4th and 5th Editions With Automated Volumetric Measurement.

    Science.gov (United States)

    Youk, Ji Hyun; Kim, So Jung; Son, Eun Ju; Gweon, Hye Mi; Kim, Jeong-Ah

    2017-09-01

    The purpose of this study was to compare visual assessments of mammographic breast density by radiologists using BI-RADS 4th and 5th editions in correlation with automated volumetric breast density measurements. A total of 337 consecutive full-field digital mammographic examinations with standard views were retrospectively assessed by two radiologists for mammographic breast density according to BI-RADS 4th and 5th editions. Fully automated measurement of the volume of fibroglandular tissue and total breast and percentage breast density was performed with a commercially available software program. Interobserver and intraobserver agreement was assessed with kappa statistics. The distributions of breast density categories for both editions of BI-RADS were compared and correlated with volumetric data. Interobserver agreement on breast density category was moderate to substantial (κ = 0.58-0.63) with use of BI-RADS 4th edition and substantial (κ = 0.63-0.66) with use of the 5th edition but without significant difference between the two editions. For intraobserver agreement between the two editions, the distributions of density category were significantly different (p density data, including percentage breast density, were significantly different among density categories (p density assessment had good correlation with visual assessment for both editions of BI-RADS.

  7. Do HCAHPS Doctor Communication Scores Reflect the Communication Skills of the Attending on Record? A Cautionary Tale from a Tertiary-Care Medical Service.

    Science.gov (United States)

    Velez, Vicente J; Kaw, Roop; Hu, Bo; Frankel, Richard M; Windover, Amy K; Bokar, Dan; Rish, Julie M; Rothberg, Michael B

    2017-06-01

    Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores measure patient satisfaction with hospital care. It is not known if these reflect the communication skills of the attending physician on record. The Four Habits Coding Scheme (4HCS) is a validated instrument that measures bedside physician communication skills according to 4 habits, namely: investing in the beginning, eliciting the patient's perspective, demonstrating empathy, and investing in the end. To investigate whether the 4HCS correlates with provider HCAHPS scores. Using a cross-sectional design, consenting hospitalist physicians (n = 28), were observed on inpatient rounds during 3 separate encounters. We compared hospitalists' 4HCS scores with their doctor communication HCAHPS scores to assess the degree to which these correlated with inpatient physician communication skills. We performed sensitivity analysis excluding scores returned by patients cared for by more than 1 hospitalist. A total of 1003 HCAHPS survey responses were available. Pearson correlation between 4HCS and doctor communication scores was not significant, at 0.098 (-0.285, 0.455; P = 0.619). Also, no significant correlations were found between each habit and HCAHPS. When including only scores attributable to 1 hospitalist, Pearson correlation between the empathy habit and the HCAHPS respect score was 0.515 (0.176, 0.745; P = 0.005). Between empathy and overall doctor communication, it was 0.442 (0.082, 0.7; P = 0.019). Attending-of-record HCAHPS scores do not correlate with 4HCS. After excluding patients cared for by more than 1 hospitalist, demonstrating empathy did correlate with the doctor communication and respect HCAHPS scores. Journal of Hospital Medicine 2017;12:421-427. © 2017 Society of Hospital Medicine

  8. [Involuntary hospitalization under the Act of July 5th 2011: A study of patients' experience and understanding of their hearing with the judge ruling on civil detention cases].

    Science.gov (United States)

    Rossini, K; Verdoux, H

    2015-09-01

    To assess involuntary admitted patients' experience and understanding of their hearing with the judge ruling on civil detention cases according to the Act of July 5th 2011. The evaluation was conducted through face-to-face interviews, from a semi-structured questionnaire, with 48 involuntary admitted patients under psychiatric care admission on a third party request (ASPDT) or on state representative decision (ASPDRE) (participation rate=96%). Few participants knew the name of the hearing place (13%) and the judge's exact title (21%). About 58% of them had benefited from lawyer services. During the hearing, half of the patients contested the need for hospitalization. The judge was perceived as clear (79%), listening (69%) and benevolent (58%), but only 46% of patients believed that he/she was impartial and 35% that he/she was independent from medical decisions. More than half of the patients disagreed with the judge's decision (56%). However, only 19% of them planned to appeal. Three out of four were in favour of a judicial review of involuntary hospitalization. A feeling of protection was more common in people with a higher educational level (65% versus 35%, Chi(2) (1) = 3.9, P = 0.05) and who suffered from mood disorders (75% versus 46%, Chi(2) (1) = 3.8, P = 0.05). A feeling of being accused was more frequent in persons with hospitalization under psychiatric care admission on state representative decision (ASPDRE) than on a third party request (ASPDT) (37% vs 10%, Chi(2) (1) = 4.9, P = 0.03). Persons under guardianship were also more likely to report such feelings (32% versus 10%, Chi(2) (1) = 3.4, P=0.06). The feeling that "everything was preordained" was more common in younger patients (m = 36.4 years [SD = 13.9] vs m = 46.2 years [SD = 17.8], t-test [46] = 2.01, P = 0.04), as well as among those who used the advice of a lawyer, with an association at a trend level (73% versus 46%, Chi(2) (1) = 3.5, P = 0.06). Systematic judicial review of involuntary

  9. A Comparison of Japanese and Turkish Mothers' Views about Self Care Skill Acquisition Age and Their Expectations from Preschools

    Science.gov (United States)

    Ramazan, M. Oya; Sakai, Aya

    2017-01-01

    Spanning the vital temporal interval between birth and the elementary school education, the preschool period is one of the most critical times of human life due to its importance in the formation and nourishment of personality. Specifically the preschool education enables children to acquire and develop basic knowledge, skills and habits, thus…

  10. The Cognitive Predictors of Computational Skill with Whole versus Rational Numbers: An Exploratory Study.

    Science.gov (United States)

    Seethaler, Pamela M; Fuchs, Lynn S; Star, Jon R; Bryant, Joan

    2011-10-01

    The purpose of the present study was to explore the 3(rd)-grade cognitive predictors of 5th-grade computational skill with rational numbers and how those are similar to and different from the cognitive predictors of whole-number computational skill. Students (n = 688) were assessed on incoming whole-number calculation skill, language, nonverbal reasoning, concept formation, processing speed, and working memory in the fall of 3(rd) grade. Students were followed longitudinally and assessed on calculation skill with whole numbers and with rational numbers in the spring of 5(th) grade. The unique predictors of skill with whole-number computation were incoming whole-number calculation skill, nonverbal reasoning, concept formation, and working memory (numerical executive control). In addition to these cognitive abilities, language emerged as a unique predictor of rational-number computational skill.

  11. 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.

  12. The Effect of Communication Skills Training for Generalist Palliative Care Providers on Patient-Reported Outcomes and Clinician Behaviors: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Selman, Lucy Ellen; Brighton, Lisa J; Hawkins, Amy; McDonald, Christine; O'Brien, Suzanne; Robinson, Vicky; Khan, Shaheen A; George, Rob; Ramsenthaler, Christine; Higginson, Irene J; Koffman, Jonathan

    2017-09-01

    As most end-of-life care is provided by health care providers who are generalists rather than specialists in palliative care, effective communication skills training for generalists is essential. To determine the effect of communication training interventions for generalist palliative care providers on patient-reported outcomes and trainee behaviors. Systematic review from searches of 10 databases to December 2015 (MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, CENTRAL, Web of Science, ICTRP, CORDIS, and OpenGrey) plus hand searching. Randomized controlled trials of training interventions intended to enhance generalists' communication skills in end-of-life care were included. Two authors independently assessed eligibility after screening, extracted data, and graded quality. Data were pooled for meta-analysis using a random-effects model. PRISMA guidelines were followed. Nineteen of 11,441 articles were eligible, representing 14 trials. Eleven were included in meta-analyses (patients n = 3144, trainees n = 791). Meta-analysis showed no effect on patient outcomes (standardized mean difference [SMD] = 0.10, 95% CI -0.05 to 0.24) and high levels of heterogeneity (chi-square = 21.32, degrees of freedom [df] = 7, P = 0.003; I 2  = 67%). The effect on trainee behaviors in simulated interactions (SMD = 0.50, 95% CI 0.19-0.81) was greater than in real patient interactions (SMD = 0.21, 95% CI -0.01 to 0.43) with moderate heterogeneity (chi-square = 8.90, df = 5, P = 0.11; I 2  = 44%; chi-square = 5.96, df = 3, P = 0.11; I 2  = 50%, respectively). Two interventions with medium effects on showing empathy in real patient interactions included personalized feedback on recorded interactions. The effect of communication skills training for generalists on patient-reported outcomes remains unclear. Training can improve clinicians' ability to show empathy and discuss emotions, at least in simulated consultations. Personalized feedback on recorded patient

  13. Enhancing the quality of life for palliative care cancer patients in Indonesia through family caregivers: a pilot study of basic skills training.

    Science.gov (United States)

    Kristanti, Martina Sinta; Setiyarini, Sri; Effendy, Christantie

    2017-01-17

    Palliative care in Indonesia is problematic because of cultural and socio-economic factors. Family in Indonesia is an integral part of caregiving process in inpatient and outpatient settings. However, most families are not adequately prepared to deliver basic care for their sick family member. This research is a pilot project aiming to evaluate how basic skills training (BST) given to family caregivers could enhance the quality of life (QoL) of palliative care cancer patients in Indonesia. The study is a prospective quantitative with pre and post-test design. Thirty family caregivers of cancer patients were trained in basic skills including showering, washing hair, assisting for fecal and urinary elimination and oral care, as well as feeding at bedside. Patients' QoL were measured at baseline and 4 weeks after training using EORTC QLQ C30. Hypothesis testing was done using related samples Wilcoxon Signed Rank. A paired t-test and one-way ANOVA were used to check in which subgroups was the intervention more significant. The intervention showed a significant change in patients' global health status/QoL, emotional and social functioning, pain, fatigue, dyspnea, insomnia, appetite loss, constipation and financial hardship of the patients. Male patient's had a significant effect on global health status (qol) (p = 0.030); female patients had a significant effect on dyspnea (p = 0.050) and constipation (p = 0.038). Younger patients had a significant effect in global health status/QoL (p = 0.002). Patients between 45 and 54 years old had significant effect on financial issue (p = 0.039). Caregivers between 45 and 54 years old had significant effect on patients' dyspnea (p = 0.031). Basic skills training for family caregivers provided some changes in some aspects of QoL of palliative cancer patients. The intervention showed promises in maintaining the QoL of cancer patients considering socio-economic and cultural challenges in the provision of

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, sample pouch) Ostomy self-care checklist Evaluation (Complete the Ostomy Patient Survey . We ...

  15. Enrolment of children and adolescents in psychosocial care : more likely with low family social support and poor parenting skills

    NARCIS (Netherlands)

    Nanninga, Marieke; Jansen, Danielle E M C; Knorth, Erik J; Reijneveld, Sijmen A

    2015-01-01

    Knowledge about determinants of child and adolescent enrolment in psychosocial care concerns only single types of care and usually only socio-demographic factors. The social environment is also a likely key determinant but evidence is lacking. The aim of this study was to examine the associations

  16. Care of patients with Alzheimer and their skills in caring, in the city of Cartagena Los cuidadores de pacientes con Alzheimer y su habilidad de cuidado, en la ciudad de Cartagena

    Directory of Open Access Journals (Sweden)

    MONTALVO PRIETO AMPARO ASTRID

    2007-12-01

    Full Text Available The study established the characteristics and the skills in caring for an Alzheimer's patient, by the main family care provider in Cartagena. We carried out a descriptive quantitative study of 84 care providers for Alzheimer patients, in Cartagena and neighboring towns, of different gender and social level, who came to the hospital institution, i.e. the "Fundación Instituto de Rehabilitación del Epiléptico (FIRE". The instruments used was care ability index or, "Inventario de la habilidad de cuidado (CAI" by Ngozi Nkongho, whose reliability was validated in its Spanish version, which enable us to measure the degree of knowledge, the value and patience in skilled care of family care providers, and the characterizing them as per the survey characteristics of care providers, i.e. "Caracterización de los cuidadores". The finding confirmed the thesis of the literature regarding the similarities present among care providers in as far as gender, age, family ties and low skill level of those family providers in terms of knowledge, the worth and the patience when caring for patients with Alzheimer diseases. The results suggest the need to strengthen family care providers in terms of skilled care in three dimensions, thru the conformation of support groups.El estudio estableció las características y la habilidad de cuidado del cuidador familiar principal del paciente con Alzheimer en la ciudad de Cartagena. Se realizó un estudio descriptivo de abordaje cuantitativo a 84 cuidadores de pacientes con Alzheimer, en la ciudad de Cartagena y pueblos aledaños, de diferente género y estrato social, que acuden como usuarios a la institución hospitalaria Fundación Instituto de Rehabilitación del Epiléptico (FIRE. Los instrumentos utilizados, "Inventario de la habilidad de cuidado (CAI" de Ngozi Nkongho, cuya confiabilidad se validó en su versión al español, permitió hacer la medición de la dimensiones conocimiento, valor y paciencia de la

  17. Improving knowledge, technical skills, and confidence among pediatric health care providers in the management of chronic tracheostomy using a simulation model.

    Science.gov (United States)

    Agarwal, Amit; Marks, Nancy; Wessel, Valerie; Willis, Denise; Bai, Shasha; Tang, Xinyu; Ward, Wendy L; Schellhase, Dennis E; Carroll, John L

    2016-07-01

    The results from a recent national survey about catastrophic complications following tracheostomy revealed that the majority of events involved a loss of airway. Most of the events due to airway loss involved potentially correctable deficits in caregiver education. Training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the knowledge and confidence level of pediatric health care providers at a large tertiary care children's hospital in routine and emergency tracheostomy care and evaluated the efficacy of a comprehensive simulation-based tracheostomy educational program. The prospective observational study was comprised of 33 subjects including pediatric residents, internal medicine-pediatric residents, pediatric hospitalist faculty physicians, and advanced practice registered nurses who are involved in the care of patients with tracheostomies within a tertiary-care children's hospital. The subjects completed self-assessment questionnaires and objective multiple-choice tests before and after attending a comprehensive educational course that employed patient simulation. The outcome measurements included pre- and post-course questionnaires, pre- and post-course test scores, and observational data from the simulation sessions. Before the education and simulation, the subjects' comfort and confidence levels on a five-point Likert scale in performing routine tracheostomy tube care, routine tracheostomy tube change, and an emergency tracheostomy tube change were as follows (median (Q1, Q3)): 1 (1, 2), 1 (1, 2), and 1 (1, 2), respectively (n = 28). The levels of comfort and confidence after completing the course improved significantly to 4 (4, 5), 4 (4, 5), 4 (4, 5), respectively (P tracheostomy tubes (e.g., cuffed versus uncuffed), physiological significance of the cuff, mechanism of action and physiological significance of the speaking valve, and the importance of the obturator in changing the tracheostomy tube

  18. Improving communication with palliative care cancer patients at home - A pilot study of SAGE & THYME communication skills model.

    Science.gov (United States)

    Griffiths, Jane; Wilson, Charlotte; Ewing, Gail; Connolly, Michael; Grande, Gunn

    2015-10-01

    To pilot an evidence-based communication skills model (SAGE & THYME) with UK District Nurses (DNs) who visit patients with advanced cancer early in the dying trajectory. Evidence suggests that DNs lack confidence in communication skills and in assessing cancer patients' psycho-social needs; also that they lack time. SAGE & THYME is a highly structured model for teaching patient centred interactions. It addresses concerns about confidence and time. Mixed methods. 33 DNs were trained in SAGE & THYME in a three hour workshop and interviewed in focus groups on three occasions: pre-training, immediately post-training and two months post-training. Questionnaires measuring perceived outcomes of communication, confidence in communication and motivation to use SAGE & THYME were administered at the focus groups. SAGE & THYME provided a structure for conversations and facilitated opening and closing of interactions. The main principle of patient centeredness was reportedly used by all. Knowledge about communication behaviours helpful to patients improved and was sustained two months after training. Increased confidence in communication skills was also sustained. Motivation to use SAGE & THYME was high and remained so at two months, and some said the model saved them time. Challenges with using the model included controlling the home environment and a change in style of communication which was so marked some DNs preferred to use it with new patients. Training DNs in SAGE & THYME in a three hour workshop appears to be a promising model for improving communication skills when working with cancer patients. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  19. Can the feedback of patient assessments, brief training, or their combination, improve the interpersonal skills of primary care physicians? A systematic review.

    Science.gov (United States)

    Cheraghi-Sohi, Sudeh; Bower, Peter

    2008-08-21

    Improving quality of primary care is a key focus of international health policy. Current quality improvement efforts place a large focus on technical, clinical aspects of quality, but a comprehensive approach to quality improvement should also include interpersonal care. Two methods of improving the quality of interpersonal care in primary care have been proposed. One involves the feedback of patient assessments of interpersonal care to physicians, and the other involves brief training and education programmes. This study therefore reviewed the efficacy of (i) feedback of real patient assessments of interpersonal care skills, (ii) brief training focused on the improvement of interpersonal care (iii) interventions combining both (i) and (ii) Systematic review of randomised controlled trials. Three electronic databases were searched (CENTRAL, Medline and Embase) and augmented by searches of the bibliographies of retrieved articles. The quality of studies was appraised and results summarised in narrative form. Nine studies were included (two patient based feedback studies and seven brief training studies). Of the two feedback studies, one reported a significant positive effect. Only one training study reported a significant positive effect. There is limited evidence concerning the effects of patient based feedback. There is reasonable evidence that brief training as currently delivered is not effective, although the evidence is not definitive, due to the small number of trials and the variation in the training methods and goals. The lack of effectiveness of these methods may reflect a number of issues, such as differences in the effectiveness of the interventions in experienced practitioners and those in training, the lack of theory linking feedback to behaviour change, failure to provide sufficient training or to use a comprehensive range of behaviour change techniques. Further research into both feedback and brief training interventions is required before these

  20. Can the feedback of patient assessments, brief training, or their combination, improve the interpersonal skills of primary care physicians? A systematic review

    Directory of Open Access Journals (Sweden)

    Bower Peter

    2008-08-01

    Full Text Available Abstract Background Improving quality of primary care is a key focus of international health policy. Current quality improvement efforts place a large focus on technical, clinical aspects of quality, but a comprehensive approach to quality improvement should also include interpersonal care. Two methods of improving the quality of interpersonal care in primary care have been proposed. One involves the feedback of patient assessments of interpersonal care to physicians, and the other involves brief training and education programmes. This study therefore reviewed the efficacy of (i feedback of real patient assessments of interpersonal care skills, (ii brief training focused on the improvement of interpersonal care (iii interventions combining both (i and (ii Methods Systematic review of randomised controlled trials. Three electronic databases were searched (CENTRAL, Medline and Embase and augmented by searches of the bibliographies of retrieved articles. The quality of studies was appraised and results summarised in narrative form. Results Nine studies were included (two patient based feedback studies and seven brief training studies. Of the two feedback studies, one reported a significant positive effect. Only one training study reported a significant positive effect. Conclusion There is limited evidence concerning the effects of patient based feedback. There is reasonable evidence that brief training as currently delivered is not effective, although the evidence is not definitive, due to the small number of trials and the variation in the training methods and goals. The lack of effectiveness of these methods may reflect a number of issues, such as differences in the effectiveness of the interventions in experienced practitioners and those in training, the lack of theory linking feedback to behaviour change, failure to provide sufficient training or to use a comprehensive range of behaviour change techniques. Further research into both feedback

  1. Measurement properties and implementation of a checklist to assess leadership skills during interdisciplinary rounds in the intensive care unit

    NARCIS (Netherlands)

    Ten Have, Elsbeth C M; Nap, Raoul E; Tulleken, Jaap E

    2015-01-01

    The implementation of interdisciplinary teams in the intensive care unit (ICU) has focused attention on leadership behavior. A daily recurrent situation in ICUs in which both leadership behavior and interdisciplinary teamwork are integrated concerns the interdisciplinary rounds (IDRs). Although IDRs

  2. Irradiation experiments of 3rd, 4th and 5th fuel assemblies by an in-pile gas loop, OGL-1

    International Nuclear Information System (INIS)

    Fukuda, Kousaku; Kobayashi, Fumiaki; Hayashi, Kimio; Minato, Kazuo; Kikuchi, Teruo; Adachi, Mamoru; Iwamoto, Kazumi; Ikawa, Katsuichi; Itami, Hiroharu.

    1986-07-01

    Three irradiation experiments for 3rd, 4th and 5th fuel assemblies which had been composed of VHTR reference coated particle fuels and graphite components were carried out by an in-pile gas loop, OGL-1 during 1979 and 1982. The main purposes of these experiments were to study on bowing of the fuel rod by irradiation for the 3rd fuel assembly, to study on fuel behavior under relatively low burnup irradiation for the 4th fuel assembly, and to study on fuel behavior up to full burnup of VHTR design for the 5th fuel assembly. For understanding in-pile fuel behavior, fractional releases of fission gases from each fuel assembly were estimated by measuring the fission gas concentrations in the primary loop of OGL-1. The post-irradiation examination (PIE) was carried out extensively on the fuel block, the fuel rods and the fuel compacts in Tokai Hot Laboratory. Also, made were the measurements of metallic fission product distributions in the fuel assemblies and the fuel rods. The results in these experiments were given as follows ; bowing of the fuel rod in the 3rd fuel assembly was 0.7 mm, but integrity of the rod was kept under irradiation. Fractional release of the fission gas from the 4th fuel assembly remained in the order of 10 -7 during irradiation, suggesting that the fuel performance was excellent. The fractional release from the 5th fuel assembly, on the other hand, was in the order of 10 -5 which was the same level in the VHTR design. (author)

  3. Emergency nurses' knowledge and self-rated practice skills when caring for older patients in the Emergency Department.

    Science.gov (United States)

    Rawson, Helen; Bennett, Paul N; Ockerby, Cherene; Hutchinson, Alison M; Considine, Julie

    2017-11-01

    Older adults are high users of emergency department services and their care requirements can present challenges for emergency nurses. Although clinical outcomes for older patients improve when they are cared for by nurses with specialist training, emergency nurses' knowledge and self-assessment of care for older patients is poorly understood. To assess emergency nurses' knowledge and self-rating of practice when caring for older patients. A cross-sectional self-report survey of emergency nurses (n=101) in Melbourne, Australia. Mean scores were 12.7 (SD 2.66) for the 25-item knowledge of older persons questionnaire, and 9.04 (SD 1.80) for the 15-item gerontic health related questions. Scores were unaffected by years of experience as a registered nurse or emergency nurse. More than 80% of nurses rated themselves as 'very good' or 'good' in assessing pain (94.9%), identifying delirium (87.8%), and identifying dementia (82.8%). Areas with a 'poor' ratings were identifying depression (46.5%), assessing polypharmacy (46.5%) and assessing nutrition (37.8%). There was variation in knowledge and self-rating of practice related to care of older patients. The relationship between knowledge and self-ratings of practice in relation to actual emergency nursing care of older people and patient outcomes warrants further exploration. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  4. On the possibility of highest energy cosmic rays bursts and their correlation with gamma rays bursts e.g. March 5th, 1979 event

    International Nuclear Information System (INIS)

    Drukier, K.

    1982-01-01

    The avalanche production of magnetic monopoles is possible in neutron stars. Big part of the magnetic field energy can be used to accelerate a pulse of 10 30 monopoles to the energy E > approximately 10 17 eV. Thus the neutron stars may be ''point'' sources of bursts of highest energy Cosmic Rays. The emission of brehmsstrahlung photons by these highly relativistic monopoles would be seen as X and gamma bursts. This ''exotic'' model for March 5th, 1979 event, predicts that it has been followed by burst of highest energy Cosmic Rays coming from the direction of LMC supernovae remanent N49

  5. 5th National meeting of the SA Institution of Chemical Engineers: chemical engineering in support of industry and society. V. 1-3

    International Nuclear Information System (INIS)

    1988-01-01

    The 5th national meeting of the SA Institution of Chemical Engineering was held from 15-16 August 1988 at Pretoria. The subject scope covered on the meeting include the broad spectrum of work done by the chemical engineer. The main categories include the processing of agricultural products, biotechnology, coal and hydrocarbons, the chemical engineering practice, fluid dynamics, gas treatment, heat and mass transfer, materials of construction, minerals processing, source materials and products, training and education, vapour-liquid equilibrium, and water and effluents. One seminar specifically covers process engineering in the context of nuclear reactors and two other papers cover supported liquid membrane extraction of uranium

  6. (SPartners for Heart Health: a school-based program for enhancing physical activity and nutrition to promote cardiovascular health in 5th grade students

    Directory of Open Access Journals (Sweden)

    Sehnert Scott T

    2008-12-01

    Full Text Available Abstract Background The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA. In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU faculty, clinicians, and health profession students was formed to "(Spartner" with elementary school physical education (PE teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (Spartnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1 improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2 increase the number of students achieving national recommendations for PA and nutrition; and 3 increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. Methods/Design This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students

  7. (S)Partners for Heart Health: a school-based program for enhancing physical activity and nutrition to promote cardiovascular health in 5th grade students.

    Science.gov (United States)

    Carlson, Joseph J; Eisenmann, Joey C; Pfeiffer, Karin A; Jager, Kathleen B; Sehnert, Scott T; Yee, Kimbo E; Klavinski, Rita A; Feltz, Deborah L

    2008-12-22

    The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD) through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA). In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU) faculty, clinicians, and health profession students was formed to "(S)partner" with elementary school physical education (PE) teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (S)partnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1) improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2) increase the number of students achieving national recommendations for PA and nutrition; and 3) increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly) designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students (Spartners). The final 10 minutes of each lesson

  8. Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 4. Results: specific problem solving skills.

    Science.gov (United States)

    Hummers-Pradier, Eva; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; van Royen, Paul

    2010-09-01

    The 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. The previous articles presented background, objectives, and methodology, as well results on 'primary care management' and 'community orientation' and the person-related core competencies of GP/FM. This article reflects on the general practitioner's 'specific problem solving skills'. These include decision making on diagnosis and therapy of specific diseases, accounting for the properties of primary care, but also research questions related to quality management and resource use, shared decision making, or professional education and development. Clinical research covers most specific diseases, but often lacks pragmatism and primary care relevance. Quality management is a stronghold of GP/FM research. Educational interventions can be effective when well designed for a specific setting and situation. However, their message that 'usual care' by general practitioners is insufficient may be problematic. GP and their patients need more research into diagnostic reasoning with a step-wise approach to increase predictive values in a setting characterized by uncertainty and low prevalence of specific diseases. Pragmatic comparative effectiveness studies of new and established drugs or non-pharmaceutical therapy are needed. Multi-morbidity and complexity should be addressed. Studies on therapy, communication strategies and educational interventions should consider impact on health and sustainability of effects.

  9. Seventeen Years of Geodynamic Monitoring of a Seismic Gap that was Partially Filled by the Nicoya, Costa Rica, Mw=7.6 Earthquake of September 5th, 2012

    Science.gov (United States)

    Protti, M.; Gonzalez, V. M.; Schwartz, S. Y.; Dixon, T. H.; Newman, A. V.; Lundgren, P.; Kaneda, Y.; Kato, T.

    2013-05-01

    Nicoya is a segment of the subduction zone at the Middle American Trench, where the Cocos plate subducts under the Caribbean plate. Nicoya had large earthquakes (Mw>7) in 1853, 1900, 1950 and in 2012. The September 5th, 2012, Mw=7.6, Nicoya earthquake ruptured mainly the deeper portion of the seismogenic zone. Pre, co and post earthquake deformation data suggests that the shallow portion of the plate interface might still be locked. Since 1995 a geodynamic control network has been built up over a around what was defined as the Nicoya seismic gap. The aim of this network was to map and understand the seismogenic zone, as well as to record deformation changes at different stages within the earthquake cycle. The Nicoya peninsula sits on top of the seismogenic zone allowing monitoring crustal deformation in the near field at a much lower cost than on most subduction zones in the world. With the goals of finding the upper and lower limits of the seismogenic zone and for documenting the evolution of loading and stress release along this seismic gap, an international effort involving several institutions from Costa Rica, the United States and Japan has been carried out in the region. This effort involved the installation of temporary and permanent seismic and geodetic networks. We will be presenting the history and results of these networks, including co-seismic records from the September 5th, 2012 Nicoya earthquake and will emphasize on the importance of continuous monitoring for the understanding of subduction zone processes.

  10. Overview of the IAEA Joint Convention and Implementation Status of the Obligation as the Contracting Party of the 5th Joint Convention

    International Nuclear Information System (INIS)

    Lee, Jeong Ken; Lee, Youn Keun; Ahn, Sang Myeon

    2016-01-01

    The Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management (Joint Convention) was adopted on 5 September 1997 by a Diplomatic Conference convened by the International Atomic Energy Agency (IAEA). The Joint Convention was opened for signature at Vienna in September 1997 and will remain open for signature until its entry into force. Korean government signed the Joint Convention in 1997 and this Convention was effective in 2002 as the Convention No. 1612. This paper will show overview of the Joint Convention and implementation status of the obligation as a Contracting Party of the 5th Joint Convention. The Joint Convention is the inter-national convention organized by the IAEA. All contracting parties shall comply with rules of the Joint Convention and conduct the obligation of this convention. Korean government successfully conducted all obligation (attending Organization Meeting and Review Meeting, submitting paper including National Report, question paper and answer paper) of the 5th Joint Convention from May 2014 to May 2015, and will prepare the obligation of the 6th Joint Convention

  11. Comparison of effectiveness of class lecture versus workshop-based teaching of basic life support on acquiring practice skills among the health care providers.

    Science.gov (United States)

    Karim, Habib Md Reazaul; Yunus, Md; Bhattacharyya, Prithwis; Ahmed, Ghazal

    2016-01-01

    Basic life support (BLS) is an integral part of emergency medical care. Studies have shown poor knowledge of it among health care providers who are usually taught BLS by lecture-based teachings in classes. This study is designed to assess the effectiveness of class lecture versus workshop-based teaching of BLS on acquiring the practice skills on mannequin. After ethical approval and informed consent from the participants, the present study was conducted among the health care providers. Participants were grouped in lecture-based class teaching and workshop-based teaching. They were then asked to practice BLS on mannequin (Resusci Anne with QCPR) and evaluated as per performance parameters based on American Heart Association BLS. Statistical analyses are done by Fisher's exact t-test using GraphPad INSTAT software and P 0.05). Though more than 83% of lecture-based teaching group has started chest compression as compared 96% of workshop group; only 49% of the participants of lecture-based group performed quality chest compression as compared to 82% of other group (P = 0.0005). The workshop group also performed better bag mask ventilation and defibrillation (P < 0.0001). Workshop-based BLS teaching is more effective and lecture-based class teaching better is replaced in medical education curriculum.

  12. Comparison of effectiveness of class lecture versus workshop-based teaching of basic life support on acquiring practice skills among the health care providers

    Science.gov (United States)

    Karim, Habib Md. Reazaul; Yunus, Md.; Bhattacharyya, Prithwis; Ahmed, Ghazal

    2016-01-01

    Background: Basic life support (BLS) is an integral part of emergency medical care. Studies have shown poor knowledge of it among health care providers who are usually taught BLS by lecture-based teachings in classes. Objectives: This study is designed to assess the effectiveness of class lecture versus workshop-based teaching of BLS on acquiring the practice skills on mannequin. Methods: After ethical approval and informed consent from the participants, the present study was conducted among the health care providers. Participants were grouped in lecture-based class teaching and workshop-based teaching. They were then asked to practice BLS on mannequin (Resusci Anne with QCPR) and evaluated as per performance parameters based on American Heart Association BLS. Statistical analyses are done by Fisher's exact t-test using GraphPad INSTAT software and P 0.05). Though more than 83% of lecture-based teaching group has started chest compression as compared 96% of workshop group; only 49% of the participants of lecture-based group performed quality chest compression as compared to 82% of other group (P = 0.0005). The workshop group also performed better bag mask ventilation and defibrillation (P < 0.0001). Conclusion: Workshop-based BLS teaching is more effective and lecture-based class teaching better is replaced in medical education curriculum. PMID:27308252

  13. Dialysis Dependence Predicts Complications, Intensive Care Unit Care, Length of Stay, and Skilled Nursing Needs in Elective Primary Total Knee and Hip Arthroplasty.

    Science.gov (United States)

    Patterson, Joseph T; Tillinghast, Kyle; Ward, Derek

    2018-07-01

    Limited data describe risks and perioperative resource needs of total joint arthroplasty (TJA) in dialysis-dependent patients. Retrospective multiple cohort analysis of dialysis-dependent American College of Surgeons National Surgical Quality Improvement Program patients undergoing primary elective total hip and knee arthroplasty compared to non-dialysis-dependent controls from 2005 to 2015. Relative risks (RRs) of 30-day adverse events were determined by multivariate regression adjusting for baseline differences. Six hundred forty-five (0.2%) dialysis-dependent patients of 342,730 TJA patients were dialysis-dependent and more likely to be dependent, under weight, anemic, hypoalbuminemic, and have cardiopulmonary disease. In total hip arthroplasty patients, dialysis was associated with greater risk of any adverse event (RR = 1.1, P care unit (ICU) care (RR = 9.8, P total knee arthroplasty patients, dialysis conferred greater risk of any adverse event (RR = 1.1, P care (RR = 6.0, P care, longer admission, and rehabilitation needs in TJA patients. Thirty days is not sufficient to detect infectious complications among these patients. These findings inform shared decision-making, perioperative resource planning, and risk adjustment under alternative reimbursement models. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Development and validation of a self-efficacy questionnaire (SE-12) measuring the clinical communication skills of health care professionals

    DEFF Research Database (Denmark)

    Axboe, Mette K; Christensen, Kaj S; Kofoed, Poul-Erik

    2016-01-01

    of the theoretical approach applied in the communication course, statements from former course participants, teachers, and experts in the field. The questionnaire was initially validated through face-to-face interviews with 9 staff members following a test-retest including 195 participants. Results After minor......Background The outcome of communication training is widely measured by self-efficacy ratings, and different questionnaires have been used. Nevertheless, none of these questionnaires have been formally validated through systematic measurement of assessment properties. Consequently, we decided....... We consider the questionnaire useful for self-evaluation of clinical communication skills; the SE-12 is user-friendly and can be administered as an electronic questionnaire. However, future research should explore potential needs for adjustments to reduce the identified ceiling effect. Keyword...

  15. GP Surgeons’ Experiences of Training in British Columbia and Alberta: A Case Study of Enhanced Skills for Rural Primary Care Providers

    Directory of Open Access Journals (Sweden)

    Jude Kornelsen

    2012-04-01

    Full Text Available Background: There has been a steady erosion of family physicians with enhanced surgical skills providing care for rural residents. This has been largely due to the lack of formal training avenues and continuing medical education (CME opportunities afforded to those interested and attrition of those currently practicing.. Methods: A qualitative study was undertaken using an exploratory policy framework to guide the collection of in-depth interview data on GP surgeons’ training experiences. A purposive sample of GP surgeons currently practicing in rural BC and Alberta communities yielded interviews with 62 participants in person and an additional 8 by telephone. Interviews were audio recorded and transcribed then subjected to a process analysis. Results: Participants thematically identified motivations for acquiring advanced skills training, resources required (primarily in the area of solid mentorship, the most efficacious context for a training program (structured and differences in mentorship between obstetricians and general surgeons. Conclusions: Mentors and role models were the most salient influencing factor in the trajectory of training for the participants in this study. Mentorship between specialists and generalists was constrained at times by inter-professional tensions and was accomplished more successfully within a cirriculum-based, structured environment as opposed to a learner-responsive training environment.

  16. Improving Nursing Communication Skills in an Intensive Care Unit Using Simulation and Nursing Crew Resource Management Strategies: An Implementation Project.

    Science.gov (United States)

    Turkelson, Carman; Aebersold, Michelle; Redman, Richard; Tschannen, Dana

    Effective interprofessional communication is critical to patient safety. This pre-/postimplementation project used a multifaceted educational strategy with high-fidelity simulation to introduce evidence-based communication tools, adapted from Nursing Crew Resource Management, to intensive care unit nurses. Results indicated that participants were satisfied with the education, and their perceptions of interprofessional communication and knowledge improved. Teams (n = 16) that used the communication tools during simulation were more likely to identify the problem, initiate key interventions, and have positive outcomes.

  17. Leadership Skills.

    Science.gov (United States)

    Hutchison, Cathleen; And Others

    1988-01-01

    Lists skills identified by the Leadership Development Task Force as being critical skills for a leader. Discussion focuses on information managing skills, including problem solving, decision making, setting goals and objectives; project management; and people managing skills, including interpersonal communications, conflict management, motivation,…

  18. Skilled Nursing Facility Partnerships May Decrease 90-Day Costs in a Total Joint Arthroplasty Episode Under the Bundled Payments for Care Improvement Initiative.

    Science.gov (United States)

    Behery, Omar A; Kouk, Shalen; Chen, Kevin K; Mullaly, Kathleen A; Bosco, Joseph A; Slover, James D; Iorio, Richard; Schwarzkopf, Ran

    2018-03-01

    The Bundled Payments for Care Improvement initiative was developed to reduce costs associated with total joint arthroplasty through a single payment for all patient care from index admission through a 90-day post-discharge period, including care at skilled nursing facilities (SNFs). The aim of this study is to investigate whether forming partnerships between hospitals and SNFs could lower the post-discharge costs. We hypothesize that institutionally aligned SNFs have lower post-discharge costs than non-aligned SNFs. A cohort of 615 elective, primary total hip and knee arthroplasty subjects discharged to an SNF under the Bundled Payments for Care Improvement from 2014 to 2016 were included in our analysis. Patients were grouped into one of the 3 categories of SNF alignment: group 1: non-partners; group 2: agreement-based partners; group 3: institution-owned partners. Demographics, comorbidities, length of stay (LOS) at SNF, and associated costs during the 90-day post-operative period were compared between the 3 groups. Mean index hospital LOS was statistically shortest in group 3 (mean 2.7 days vs 3.5 for groups 1 and 2, P = .001). SNF LOS was also shortest in group 3 (mean 11 days vs 19 and 21 days in groups 2 and 1 respectively, P Total SNF costs and total 90-day costs were both significantly lower in group 3 compared with groups 1 and 2 (P total 90-day costs, without increased risk of readmissions, compared with other SNFs. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Using a didactic model to improve patient observation skills in neonatal intensive care nurse trainees - a pilot study.

    Science.gov (United States)

    Solberg, Marianne Trygg; Tandberg, Bente Silnes; Lerdal, Anners

    2012-08-01

    To implement a didactic model for students specialising in intensive care nursing (n=12) and nurses working in neonatal intensive care units (NICU) (n=17). To evaluate nurse self-assessments following observation of children with congenital heart disease (CHD), before and after participation in the programme, as well as the usefulness of the programme. A pilot study with a pre- and post-test design, using self-administered questionnaires. The didactic model increased the number of clinical observations and assessments of physiological factors made by both students and NICU nurses during evaluation of children with suspected CHD. The majority of nurses reported that both participation in the programme and the didactic model were useful and they demonstrated high-level knowledge, according to Bloom's taxonomy for cognitive learning. In particular, subjects found that the literature provided and structured bedside guidance in the clinical setting assisted learning. Intensive care students and NICU nurses performed clinical observations and physical factor assessments more frequently after completing the programme, compared with baseline. We speculate that this didactic model may also be useful in other clinical settings. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Community and provider perceptions of traditional and skilled birth attendants providing maternal health care for pastoralist communities in Kenya: a qualitative study.

    Science.gov (United States)

    Byrne, Abbey; Caulfield, Tanya; Onyo, Pamela; Nyagero, Josephat; Morgan, Alison; Nduba, John; Kermode, Michelle

    2016-03-01

    Kenya has a high burden of maternal and newborn mortality. Consequently, the Government of Kenya introduced health system reforms to promote the availability of skilled birth attendants (SBAs) and proscribed deliveries by traditional birth attendants (TBAs). Despite these changes, only 10% of women from pastoralist communities are delivered by an SBA in a health facility, and the majority are delivered by TBAs at home. The aim of this study is to better understand the practices and perceptions of TBAs and SBAs serving the remotely located, semi-nomadic, pastoralist communities of Laikipia and Samburu counties in Kenya, to inform the development of an SBA/TBA collaborative care model. This descriptive qualitative study was undertaken in 2013-14. We conducted four focus group discussions (FGDs) with TBAs, three with community health workers, ten with community women, and three with community men. In-depth interviews were conducted with seven SBAs and eight key informants. Topic areas covered were: practices and perceptions of SBAs and TBAs; rewards and challenges; managing obstetric complications; and options for SBA/TBA collaboration. All data were translated, transcribed and thematically analysed. TBAs are valued and accessible members of their communities who adhere to traditional practices and provide practical and emotional support to women during pregnancy, delivery and post-partum. Some TBA practices are potentially harmful to women e.g., restricting food intake during pregnancy, and participants recognised that TBAs are unable to manage obstetric complications. SBAs are acknowledged as having valuable technical skills and resources that contribute to safe and clean deliveries, especially in the event of complications, but there is also a perception that SBAs mistreat women. Both TBAs and SBAs identified a range of challenges related to their work, and instances of mutual respect and informal collaborations between SBAs and TBAs were described. These findings

  1. The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors.

    Science.gov (United States)

    Pandit, J J; Andrade, J; Bogod, D G; Hitchman, J M; Jonker, W R; Lucas, N; Mackay, J H; Nimmo, A F; O'Connor, K; O'Sullivan, E P; Paul, R G; Palmer, J H MacG; Plaat, F; Radcliffe, J J; Sury, M R J; Torevell, H E; Wang, M; Hainsworth, J; Cook, T M

    2014-10-01

    We present the main findings of the 5th National Audit Project on accidental awareness during general anaesthesia. Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19 600 anaesthetics (95% CI 1:16 700-23 450). However, there was considerable variation across subtypes of techniques or subspecialties. The incidence with neuromuscular blockade was ~1:8200 (1:7030-9700), and without it was ~1:135 900 (1:78 600-299 000). The cases of accidental awareness during general anaesthesia reported to 5th National Audit Project were overwhelmingly cases of unintended awareness during neuromuscular blockade. The incidence of accidental awareness during caesarean section was ~1:670 (1:380-1300). Two thirds (82, 66%) of cases of accidental awareness experiences arose in the dynamic phases of anaesthesia, namely induction of and emergence from anaesthesia. During induction of anaesthesia, contributory factors included: use of thiopental; rapid sequence induction; obesity; difficult airway management; neuromuscular blockade; and interruptions of anaesthetic delivery during movement from anaesthetic room to theatre. During emergence from anaesthesia, residual paralysis was perceived by patients as accidental awareness, and commonly related to a failure to ensure full return of motor capacity. One third (43, 33%) of accidental awareness events arose during the maintenance phase of anaesthesia, most due to problems at induction or towards the end of anaesthesia. Factors increasing the risk of accidental awareness included: female sex; age (younger adults, but not children); obesity; anaesthetist seniority (junior trainees); previous awareness; out-of-hours operating; emergencies; type of surgery (obstetric, cardiac, thoracic); and use of neuromuscular blockade. The following factors were

  2. Need for integrative thinking to fight against emerging infectious diseases. Proceedings of the 5th seminar on emerging infectious diseases, March 22, 2016 - current trends and proposals.

    Science.gov (United States)

    Burdet, C; Guégan, J-F; Duval, X; Le Tyrant, M; Bergeron, H; Manuguerra, J-C; Raude, J; Leport, C; Zylberman, P

    2018-02-01

    We present here the proceedings of the 5th seminar on emerging infectious diseases, held in Paris on March 22nd, 2016, with seven priority proposals that can be outlined as follows: encourage research on the prediction, screening and early detection of new risks of infection; develop research and surveillance concerning transmission of pathogens between animals and humans, with their reinforcement in particular in intertropical areas ("hot-spots") via public support; pursue aid development and support in these areas of prevention and training for local health personnel, and foster risk awareness in the population; ensure adapted patient care in order to promote adherence to treatment and to epidemic propagation reduction measures; develop greater awareness and better education among politicians and healthcare providers, in order to ensure more adapted response to new types of crises; modify the logic of governance, drawing from all available modes of communication and incorporating new information-sharing tools; develop economic research on the fight against emerging infectious diseases, taking into account specific driving factors in order to create a balance between preventive and curative approaches. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Interprofessional Simulations Promote Knowledge Retention and Enhance Perceptions of Teamwork Skills in a Surgical-Trauma-Burn Intensive Care Unit Setting.

    Science.gov (United States)

    George, Katie L; Quatrara, Beth

    The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources. The Institute of Medicine recommendations from 2015 include "strengthening the evidence base for interprofessional education (IPE)" and "linking IPE with changes in collaborative behavior." In one surgical-trauma-burn intensive care unit (STBICU), no IPE existed. The highly acute and diverse nature of the patients served by the unit highlights the importance of appropriate training. This is heightened during critical event situations where patients deteriorate rapidly and the team intervenes swiftly. The aims of this study were to (1) evaluate knowledge retention and analyze changes in perceptions of teamwork among nurses and resident physicians in a STBICU setting after completion of an interprofessional critical event simulation and (2) provide insight for future interprofessional simulations (IPSs), including the ideal frequency of such training, associated cost, and potential effect on nursing turnover. A comparison-cohort pilot study was developed to evaluate knowledge retention and analyze changes in perceptions of teamwork. A 1-hour critical event IPS was held for nurses and resident physicians in a STBICU setting. A traumatic brain injury patient with elevated intracranial pressure, rapid deterioration, and cardiac arrest was utilized for the simulation scenario. The simulation required the team to use interventions to reduce elevated intracranial pressure and then perform cardiac resuscitation according to Advanced Cardiac Life Support guidelines. A

  4. The evolution of parental self-efficacy in knowledge and skill in the home care of preterm infants

    Directory of Open Access Journals (Sweden)

    Nicolette Anne Ribeiro

    2017-01-01

    Full Text Available Background: The American Academy of Pediatrics recommends the consideration of the ability and confidence of a caregiver to take care of a preterm infant before discharge (D/C.Objective: To identify how parental self-efficacy as measured by the Infant Care Survey (ICS evolves during their preterm child’s Neonatal Intensive Care Unit (NICU admission, and to identify conditions associated with caregiver confidence.Methods: Prospective cohort study involving parents of infants ≤ 32 weeks gestation who were enrolled between 10-20 days of their infant’s life. Parent/infant demographic, pregnancy, NICU, and D/C data was collected. Parents responded to the ICS at enrollment and D/C. Enrollment and D/C ICS scores were compared to one another using a Paired Samples t-test to assess the change in scores over time. Further, conditions which are thought to affect self-efficacy were compared to enrollment, D/C, and the change in total ICS scores to assess for correlations.Results: Total ICS scores showed significant improvement from enrollment to D/C: (188.3 ± 60.5 vs. 235.9 ± 20.9. When comparing caregivers who did not have other children in the home to parents who did, caregivers without previous children had significantly lower ICS scores at enrollment (149.8 ± 64.0 vs. 221.7 ± 31.2; however, D/C ICS scores were similar (228.7 ± 23.1 vs. 242.1 ± 17.2. This was the result of a more profound improvement in self-efficacy amongst first time parents during their child’s NICU admission (79.0 ± 68.1 vs. 20.3 ± 35.2.Conclusion: Despite the stress and anxiety of having a child in the NICU, parental self-efficacy is likely to significantly improve during their child’s hospitalization. This was most evident amongst first time parents. We suspect that parental participation in their infant’s care and formal educational opportunities contribute to improvement in confidence over time.

  5. Industry in the 5th Environmental Outlook. Background information and final conclusions on the future development of environmental pressure (emissions) due to industrial production in the Netherlands

    International Nuclear Information System (INIS)

    Wesselink, L.G.; Elzenga, H.E.; Booij, H.; Peek, K.; Thomas, R.; Duvoort, G.L.; Van Schijndel, M.W.

    2001-01-01

    The present and future development of environmental pressure (here emissions) due to industrial production in the Netherlands are discussed. Results were - strongly aggregated - also presented in the 5th Environmental Outlook. We studied developments in production levels, energy use and emissions of Dutch industry and the effect of environmental policy measures, in the period 1980-2020. We used monitoring data for the period 1980-1998 en two scenarios (Global Competition and European Coordination) for the subsequent 1998-2020 period. It is concluded, that future CO2 emissions due to industrial production will continue to increase, that emissions of fluorinated (Kyoto) gasses will strongly decrease and that emissions of NOx, SO2, VOS en fine particles will continue to decrease. Yet, current environmental policy is insufficient to meet national Dutch emission targets of NOx, SO2, VOS in 2010

  6. An Exploratory Study of 4th, 5th, and 6th Grade Summer Camp Participants’ Attitudes and Intentions Towards Physical Activity

    Directory of Open Access Journals (Sweden)

    Melissa Cater

    2015-10-01

    Full Text Available Physical inactivity is a growing problem among children, particularly school-aged youth. Research suggests children are especially prone to inactivity in the summer months when access to structured school-time and extra-curricular activities is reduced. Community programs like residential summer camps offer an excellent environment for engaging children in enjoyable physical activities while also helping them learn to be more physically active when they return home. Pre-existing attitudes often influence how much change a program inspires in an individual. The purpose of this study was to explore 4th, 5th, and 6th grade summer camp participants’ attitudes towards physical activity. Results of this study indicate that youth have a fairly neutral, though positive, attitude towards physical activity and that parental support of physical activity is still extremely important, even at this age. Campers also indicated relatively high intentions to remain physically active in the two weeks after the camp ended

  7. [The Revision and 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): Consequences for the Diagnostic Work with Children and Adolescents].

    Science.gov (United States)

    Zulauf Logoz, Marina

    2014-01-01

    The Revision and 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): Consequences for the Diagnostic Work with Children and Adolescents.The present paper describes and discusses the major revisions in DSM-5 for children and adolescents. A major modification is that the sep